Updates in CV: Preparing for a New Phase—Part IV The Root Cause for CoV’s Mysterious Presentation

Great to be back with everybody once again. This is the last video in this series of just trying to put things back together in perspective, just reorient our minds what we're dealing with, the disease of COVID 19 and how you as an individual can prepare yourself for the upcoming summer and the upcoming fall. Just reorienting ourselves as well to this idea of the 80, 25, 80% of people who get exposed this have no symptoms or have minimal symptoms and don't need really an interaction with the healthcare system, 20% do. Of that, about 5% will need intensive care, which can include intubation. And so how can we boost our immune systems? How can we improve our bias systems to combat this? There's been a new understanding that's come out in the last week or two about this disease in relation to inflammation. And so one of the things that kind of spurred my interest in this was data from New York as far as hospitalizations in New York. So what I want to do is I want to look at those numbers real quick, real briefly, and then go through this new idea of what actually may be the underlying cause for the disparity or the weirdness or the uniqueness or all the different things we can't quite explain with the disease. What could be the underlying thing that might help us understand all of these things? This is summary from an article that was published, which will be attached below from patients hospitalized in New York City. Now, one of the things we weren't quite expecting with this disease initially, as you all may remember, we were expecting to hit people with lung problems, asthmatics, patients with copd, sleep apnea. We're expecting those people to be hard hit by this disease. But for admissions in New York, we only saw 9% of patients with asthma, 5% of patients with COPD, and 3% of people with with sleep apnea. Those numbers roughly correlate with the general population in New York. So what we saw, what we see from the New York data is you don't see a difference in the people being admitted to the hospital with these underlying issues. The big difference you see is with hypertension, heart disease, and especially with obesity. So people with hypertension, you know, 57% of the patients admitted to the hospital had hypertension versus 29% in the general population. Over 42% had a BMI over 30, 11% with coronary artery disease, 10% with CHF. So one of the things is, how can you explain weight being a major admission characteristic or hypertension being a major risk characteristic? Well, by now we most of us know about the ACE2 receptor. And for those who are practitioners, we use angiotensin converting enzyme medications for blood pressure control, for heart attack prevention, for stroke prevention, for saving people's kidneys. If you're a diabetic, we'll use ACE inhibitors to actually help protect your kidneys. So we've been using these medications for quite some time. In the functional integrative world, we will use certain arbs like sarin to treat inflammation in people with chronic mold illness related to the tissue like growth factor 1 beta, which is one of these cytokines. So the idea of this angiotensin system related with inflammation is not a new concept. But now we're understanding, wait a second, Maybe, just maybe this is related with patients being admitted with COVID 19. So oxidative stress is the underlying issue between all of these things. This is a little graph showing oxidative stress and how we can see that with things like stroke, Parkinson's, Alzheimer's, ards, rheumatoid arthritis, a whole host of different disease processes. Where oxidative stress lives is in the endothelium. These are the smallest vessels that line every artery in your body. It's also where the ACE2 receptor lives. And it's also where, if you remember these little micro clots for people with the decreased oxygen to the lungs, that's where that lives, or strokes, where those things lives. And so it appears that oxidative stress may be the underlying issue that explains the pleiotrophic or pleomorphic. That's just a fancy way of saying the multifaceted and multi shaped presentation of this COVID 19 disease. One of the things that's interesting with oxidative stress as well is that that system has a huge association with reactive oxygen species or inflammation and the angiotensin II receptor. So to simplify that inflammation, that's what it comes down to. Inflammation. Inflammation may be the underlying reason why this goes wild. Wait a second. Our tocolizumab, you know, the drugs use it to treat this. That's an anti inflammatory. Wait a second. Some of these things like IV vitamin C are anti inflammatories. Wait a second. Some of these anti parasitic medications are being used for their anti inflammatory effects. So it appears that some of the emerging data is maybe, just maybe oxidative stress at the level of the small vessels. And that would also explain why this, the lung presentation is different. You can have some people with an ARDS like fluid in the lungs. You can have some people who have low Compliance lungs, where their lungs are working well, but there's no oxygen in there. And other people are having micro clots, small little clots in the arteries around the lungs and getting decreased oxygenation. That one thing would kind of tie together. And then a few, some of you all are hearing about these strokes in young people. That's one thing that would tie all this together. Also would explain why sometimes you're about people going home and getting sick later on, because the inflammatory process is still going on, even though the virus in the blood has been mostly resolved. Now, this wheelhouse of inflammation is also where integrative and functional medicine live. In our world, we realize inflammation has an underlying cause for diabetes, Alzheimer's, cardiovascular disease, and a whole host of other diseases. And we've been working on inflammation treatment in this world for decades. And we have some of the top thought leaders, whether it's Dr. Houston at Vanderbilt or Dr. Bredenson at UCLA, or Dr. Mullen and Faciano at Hopkins and Harvard, those are teachers or educators and our world that have been in this oxidative stress and inflammation world for years, if not decades. Here's another graphic showing this in a little different way, showing how obesity and diabetes and cancer with oxidative stress can be related with things like inflammation, increased risk of cancer. It's really quite interesting because in the nutritional world, in the functional nutritional world, we use things like whole grains like fiber to help decrease inflammation. We'll use things like omega threes, nuts, seeds, vitamin C, things like carotenoids found in your orange and yellow foods. And these are all things that we've had data for that actually waste again, these healthy inflammation in this COVID 19. And some of the research articles for those are in our, our Survival Guide, which is available on our website. So we're see, we're now coming full circle to this whole idea, but maybe inflammation, simply said, more specifically put, endothelial dysfunction in this reactive oxygen species world might be the underlying culprit in the very different multifaceted expression of this disease that we are now learning about, called COVID 19. This graphic is more specific to the actual endothelium, which is the smallest small cells line the smallest arteries in our body, showing the connection with this renin angiotensin aldosterone system, again, the Ace 2. That's where the Ace 2 kind of sits and the association with kidney function, liver function and lung function. One of the interesting things, when you have patients admitted to the hospital, they're using clinical diagnoses such as elevated liver Enzymes such as low platelets, low white counts, elevated ldh, crp, CRP is actually made from the liver sed rate, sedrate is actually an inflammatory marker from the blood. These are things we're seeing that the underlying, the common thread with all these is endothelial dysfunction, that is inflammation. So this may just be the key that helps us go forward with therapies as well as treatments with this disease. This is a little more complicated graphic showing the same kind of idea looking at the connection with the lungs, the liver, the kidneys, with the small arteries. And you have to realize that when we start looking at all these, these dots and these lines, the thing that connects all these is actually the endothelium. So endothelial dysfunction, which is the underlying cause for cardiovascular disease, heart attacks and strokes, dementia, autoimmune issues, actually might be the underlying issue with COVID 19 disease as well. And this is where functional medicine lives. Functional medicine lives. Sorry, There we go. This is where functional medicine lives. Functional medicine lives. The combination, the intersection, the connection point for all these things, it's where the small roots in the tree where the endothelium can be, that can affect with lifestyle, diet, nutrition, stress, sleep. We've talked about sleep and its impact on your immune system for the last eight to 10 weeks. Genetic predisposition, antecedents, those things that set you up for this. Is there a way that someone can figure out just for them what might be the things setting them up for this disease? Looking at your organ systems, seeing how the heart and the lung interact with the kidneys, all these other things, and then looking at the signs and symptoms. It's been really interesting to see how I've learned how to diagnose people based on weird shortness of breath, weird loss of smell, some muscle aches, some weakness, and this really what would have been unassociated group of symptoms. And now that I have a bigger view of what this disease is, I'm actually clinically diagnosing people, doing antibody testing on them and having it come back positive. So this is all quite interesting and unique and just really I think showing the future forward with this, this disease entity. So hopefully this last part of this was helpful, having a little these things around a little bit here. Hope this was helpful. As we go forward. I'd like to continue to discuss these things through our different educational media, on our website, through social media. If this four part series has spurned any questions, I'd love to take those, maybe do a live Q and A later on just to address some of those things. The reality is we are learning so much and so quick. Therapies we thought were great for COVID 19 are now obsolete. Things we thought were not obsolete and become useful and gone out again. So this is a very quick changing environment. But ultimately, as a physician, the first and foremost thing we're supposed to do is no harm. So anything we do should not harm the patient, should help them, but at a minimum, not harm them. That's where using a holistic integrative approach for patients outside the hospital can be beneficial to help boost our immune systems and get us prepared. Not just for the summer, as this is trickling through the environment, but for the fall when we see our next peak. So if this has been helpful, please continue to follow us. Share this information with your friends. That's how this gets out there is by you sharing this with people, your loved ones, friends, people you think this information would be helpful for. Let's create some more debate about this. Let's have some more discussion about what's going on in our way forward, individually and as a culture. It's been great to be with you all again. Thanks a lot and you all have a great day.