COVID-19 Update: Understanding Data, Immunity, and Handling Illness

Welcome back everybody. For another update today I'm going to be going over two different topics. The first topic is reading and researching peer reviewed studies and their importance. I'm actually going to be using the study that was published on 31 March on hydroxychloroquine as an example of what I'm referring to. The reason I want to talk about this is people using the word research and published articles very loosely right now in the media. And so I'm going to walk through what the process actually looks like using this article. The article will be actually attached on social media below where this is posted so everybody can look at the actual article. But I want to just kind of go through this so people can understand what the actual words, the verbiage and what's actually being talked about. Crowd knowledge, crowd grouping, group information, metadata are not the same thing as peer reviewed research, even though we're using it. And even though I've written for my first patient hydroxychloroquine this past week with azithromycin and doing the protocol appropriately. It's because this is a very special time. But I also want people to understand what these words actually mean. The second is an update on boosting our immune system via boosting our basal body temperature. So I want to review a couple of interesting articles that came out and just take a historical perspective on actually boosting your basal body temperature and how that was actually even used during the spash smash influenza to improve outcomes. So first of all, so a lot of stuff is being published out there right now. So what's the typical process of publishing an article and the one that everybody's referring to that was actually put out there, that will be attached below, that came out on the threshold 30th 30th of March, 31st of March, that's my reference. And that actually is not a peer reviewed published article. It's actually an unrefereed preprint released prior to review. So I'll talk about that at the very end. So what's the process? First you have to perform the actual research and study. I have a clinical research company and we do this all the time. You have patients, you see patients, you have a study protocol, you collect data. This typically happens over the period of years. Once the data is compiled, then you'll tabulate the data. Usually the people who tabulate the data are separate from the individuals who actually collect the data. After the data is tabulated, someone will write a manuscript. Again, that's usually done by somebody Else I've been a part of writing just one manuscript for one study we published in Lancet. It took us about two years to get that whole thing done. And that's one of the reasons why I've only done it once, because it takes a long time and it's not always as rewarding as people like to think it is. But a manuscript has to be written for publication. So you collect the data, you process and tabulate the data and then you actually write a manuscript. Usually that's a different group of people doing this every time. Next is you submit it to publication to a journal. And usually within the journal, it's reviewed by a pre selection group that looks at it and reads it to determine whether or not they believe the data is correct and accurate. Once that passes that muster, it then goes to the editors of the journal like New England Journal of Medicine or jama, et cetera. And the editors will look at, review it. If they feel like it's met criteria, it's met mustered, it appears to be accurately collected data, then they will publish it. Once it's published, the entire scientific community now has access to it. So people like me, people like your personal doctor, patients now can look at the information, the data, review it and critically analyze it. Then there's a debate in the scientific community, is this information accurate? Is it not accurate? And the goal would be if you're going to use this data for clinical treatment or if you want to verify it, you have to reproduce the study. So a different group from a different place will redo it all over again. And once the data has been verified by second party research, it's considered to be fairly accurate or fairly reliable. Sometimes there are massive studies where you have 20, 30,000 patients where the data is so powerful it does not need a second group to do it or it'd be impossible to do that. Examples would be the National Nursing Health Studies is a great one where there's like 20 to 30,000. There's tens of thousands of nurses in Canada in HS1 and 2 that's never been reproduced. Framingham studies, another one in England, never been reproduced. Such huge, massive, powerful studies. So why do I go over that process? Well, there was a unrefereed preprint released prior to review. What does that mean? So unrefereed means that on stage three that I mentioned, there was no review before the editorial board of this information. It was not refereed and it was released prior to review, which means it has not been evaluated by the scientific community as of date. It was just thrown out to the population at large. And that's the thing I'm referring to. So why would this happen? Why would we bypass the natural order of research for publication? Editorial review already just be put out there? Well, a couple reasons. One, we're in a worldwide pandemic and so we want to get information out there so we can review it as quickly as possible and implement it as fast as possible if appropriate. The other thing is hydroxychloroquine has been used around the world for decades. It's used currently for patients with autoimmune issues, lupus. I have several patients taking it. It's used in anti malarial as well as anti Lyme protocols. So we have a lot of experience with the drug and we know its safety profile fairly well and we're dealing with something that's not treatable. Covid19 so it was put out there, released for us to look at. It's not the same as a randomized, double blind, placebo controlled peer reviewed trials. And that's the difference. There's different levels and quality of data. And so this is pushed out very quickly. One thing you have to realize as well, half of all published, and this is According to Dr. Ioannes, it was published several years ago in PLOS, if you want to look this up. But about half of all published studies who actually make it through this seven point process, almost half of clinical research studies are later, the results are later found to be false. So even when we go through this amount of rigor, half of the findings are later found to be false. That's the reason why it's important for you to work with a clinician, a physician, a practitioner who's well versed in the literature, but more importantly, who actually sees real patients in the real world, who's used real medications and has a grasp on how studies can be flawed. Now personally, I've used the hydroxychloroquine with patients. There's a physician in New York who I think as of this past week has treated over 800 patients with hydroxychloroquine, zinc, azithromycin, etc. So it's being used again. We're in a special time, it's a special situation. But we also have to realize that this is not the normal order of things and how research and stuff gets out there. So when you're looking at things, make sure, first of all, you look at the study, has it been peer reviewed? Where has it been published? Has it been reproduced? Now with the hydroxychloroquine data, it was originally the original data actually coming from South Korea and China. This one article was actually from China. Showed at the cell level proof of concept that actually hydroxychloroquine can improve cell survival with COVID 19. So there's a lot of other research that are out there that would justify the use of the hydroxychloroquine. But we just need to be aware of the level and the quality of data we're looking at. For this reason, we're not going to use it on the 80% of people who just have mild COVID 19 who aren't going to get sick. We don't want to use it with those people. We want to use it with people that are really sick who we don't have a whole lot of options. You don't want to use a risky medication that may potentially cause a heart arrhythmia if it's mixed with azithromycin. There's a thing called a prolonged QT interval that can cause torsade de point. And so before using it, I personally have been doing EKGs on the patients to make sure that I won't cause a cardiac arrhythmia. So again, working with the clinician, being aware of the literature, but this is exciting time. Things are coming out fast. You know, functional medicine. I'm a primary care doctor, family practitioner. I'm also a functional medicine practitioner. This is kind of what happens in functional medicine all the time, where you look at clinical research for egcg, which is a green tea extract, or quercetin, which is an apple onion extract which acts just like hydroxychloroquine. Okay, interesting. And you combine it with zinc and you get a similar effect. And that's what I'm doing for prevention with patients. On a side note, I will be putting out a COVID 19 survival guide which will have, which will have some of these protocols in there. So just, you know, pay attention to social media, sign up for our newsletter and you'll be in the loop with that as well. So the next topic I want to talk about is boosting our innate immune system by bumping up our basal body temperature. So with COVID 19, on day zero, when you get this, you have no symptoms. It takes about day five before you get some symptoms to day seven. By day 12, you're in the hospital. If you're going to get the cytokine storm that usually starts about day 10 to day 12 and day 17, the day 21 is usually when death ensues. So you know, if you're day zero, we know what to do. Okay, if you're day, you know, 12, you're in the hospital. What can you do from day five to 12 when you have some symptoms but you're probably not going to be in the hospital? Can you boost your immune system in a safe way? You know? And why would you want to do this? Well, if 80% of people who get COVID 19 who get better on their own, if we can bump this up to 85% then the 20% who have to interact with the hospital care system goes down to 15% and we've had a 25% reduction hospitalizations from basic self care measures. That's kind of where I'm trying to fill the gap and help keep people out of the hospital. So what's the proof of concept here? Well, there's a couple studies. Again these will be put below in social media so you all can look at the studies. There's an interesting study looking at white blood cell response to hyperthermia. Now hypothermia is heating up the body temperature by about a degree or two. We talked about fever before, so why would you not want to take anti fever medications? Well, if I can boost your immune system through heating it up and increase your white blood cell function, maybe I shouldn't try to artificially lower it. There's actually an interesting Swedish study as well looking at sauna sessions and how they boost white blood cell and natural killer cell count. And they were actually looking at athletes and non athletes how getting a sauna for short periods of time. So 15 minute sauna session, increasing the core body temperature by about 1.2 degrees centigrade for about 15 minutes actually had a significant increase in the person's white cell function. There's another interesting study looking at cooling cold. Now it's interesting in Finland, in Germany and Europe you have a lot of these sauna places where you go in, you get hot water for 20, 30 minutes, you get in the cold water. This is practiced pretty typically over in Europe. We don't do it a whole lot here. And there's a lot of cultures that have been doing this for millennia. This idea of hot, cold, hot cold. So it's not a new concept, but this was a study looking at that in a Finnish population. Another interesting study looked at regular sauna bathing and how regular sauna bathing can actually decrease the incidence of common cold. So, so why am I talking about this? What's the point? Well, interesting as I was Going through some things, I actually found a study, an old, old study from the Spanish influenza of 1918, 1919. And it was actually a sanitarium where they're using hydrotherapy in a hospital to treat patients. And so one group was treated strictly in the hospital. One group was out, was done outpatient hydrotherapy out of the hospital, and one was just an army camp. And they showed the mortality of the sanitarium group treated with hydrotherapy was 1.3%. The outpatient hydrotherapy was 3.8%. And with the Spanish influenza of 1918 and 1919, those treated in the army camp, these are young military guys, had a 6.4% mortality. You have to also realize this as well. This was before antibiotics. This was before a lot of things, therapies. This was before immune modulation was even known. So they were just doing all they could do, and they saw that, hey, doing hydrotherapy can actually boost your immune system. So what does that mean for us? That means we should do more research on it. And so all these, most of these articles I reviewed talked about the need for more research on hydrotherapy. So I think that's an interesting thing to think about, boosting your body's immune temperature to boost your immune system. But I think more practically, what that means for me right now is if you get a fever, let it ride. Let it go up to 101, let it go up to 102. You know, if you're even considering doing hydrotherapy or getting a hot water, you know, getting a tub at 97, 98 degrees, warming your body up, your core body temperature by a degree or so, if you've been considering that, why would you take advantage of a fever if you don't need it? Why would you suppress your fever if you even consider this? And just, you just have to realize there actually are cultures that do that. So. So I'm taking this information, not that I'm telling people to hop in silence and heat their bodies up, because right now, if you don't have one at home, it's not really an option. But maybe if you get a fever, don't take that Tylenol or Advil. You know, again, if your fever is less than 106, not 100.6, but 106, you'll be fine, you know, unless you're a little kid. Temperature going up fast. There are febrile seizures, but that's not as common. And again, little kiddos are typically okay with this infection. So. Interesting update. These articles will be published on social media as well. If this is helpful. If you feel like this is interesting information, please follow us on Facebook Instagram Please like us as well. I am going to be putting out a COVID 19 survival guide, which is a summary of some of my recommendations. People have been asking me to put everything in one place, so that's kind of what I'm doing. And that will be launched hopefully either this weekend or early next week. So just follow us. Sign up for our newsletter on richmondfunctionalmedicine.com and you'll be among the first to find out when I put that out there. So hope you all stay safe, stay well and enjoy the rest of your day. Take care.