#64 - Immune Reboot with Dr. Robert Silverman, Part 1

Hi guys, welcome to another episode of The Factor Podcast. I'm your host, Jessica Riddle. If this is your first time tuning in, welcome and thank you for listening. Today we kick off a new 2-part training titled Immune Reboot, a guide to maximizing immunity and optimizing vitality, featuring guest speaker, Dr. Robert Silverman. While it may seem like the darkest days of the COVID-19 pandemic are behind us, even now, as we are nearing the end of 2023, you'll be hard-pressed to find one healthcare provider who hasn't encountered a patient with the myriad of strange symptoms associated with long COVID. From lingering fatigue and neurological symptoms to chronic pain and an increase of autoimmune disease diagnoses, we are just now beginning to realize the long-term impacts of the virus on global health and longevity. So what do you do when the patient is standing in front of you with these strange symptoms? How do you help them boost their immune systems And get back on track towards the health and vitality that they once enjoyed. If you've ever asked yourself these questions, you're in luck. This training will definitely provide some answers as we take a deep dive into the science behind the rise in autoimmunity and increased inflammatory status following recovery from COVID-19 infection. Dr. Silverman will also provide actionable steps you can take To help your patients boost their immunity so that they can be more resilient to the next big superbug. And who better to discuss this important topic than someone who has dedicated their career to educating the masses about the importance of proper nutrition and gut health? Dr. Robert Silverman is a chiropractor and clinical nutritionist, bestselling author, renowned presenter, and the founder and CEO of West Chester Integrative Health Center. He serves on the advisory board for the Functional Medicine University, is a chief clinical consultant for KBMO Diagnostics and Erconia Laser Ltd., and holds a science board position with NutraDyne. With over 23 years of clinical experience, Dr. Silverman is considered a thought leader in his field and has contributed to several studies in peer-reviewed journals and other mainstream publications. This is one episode you'll definitely want to listen to more than once. So go ahead and hit that download button. Let's cue the intro music and get started.

Thanks so much, Jessica. It's a pleasure to be here. Sending regards to your wonderful husband, Dr. Todd. Does a great job with Factor. Big shout out. Most people ask, where did I come up with this idea? Why write the book? And it's a great question. I live in New York. I'm right outside New York City. I'm 30 minutes. I did happen to grow up in New York City. And in March of 2020, when COVID hit, it was 6 particular blocks from where I lived. So my neighbors, my patients, my friends, some family members. contracted COVID. And I was looking for answers, searching to find the guy, the girl, the expert, the guru, if you will. And they were nowhere to be found. Unfortunately, there was nobody in our space or nobody in the space that said that they were the immune experts. We all touch upon it. We all integrate it. It certainly has grown in the last 3 years, if you will. But there was no place to go. So I started to document, research, really make a real clear stew, if you will, of what was needed. The purpose was to document what we could do as a playbook to move on because our immune systems are working for us 24/7, 365. Our immune system represents our protection from the hostile outside world of bacteria, viruses, toxic chemicals, intestinal microbiome, stress factors, and of course trauma. It generally doesn't complain or speak up unless it's neglected or it has been mistreated. It just does its job quietly behind the scenes. But when our immune system is challenged, it typically jumps into action to defend us and help orchestrate the repair of damaged parts. We each possess a unique immune system truly based on our genetic history and the exposures we have encountered, starting from our earliest experiences in the womb. The ability of our immune system to function at higher levels over decades of our life depends upon how we have treated it, how we take care of it. Like every cell of our body, the immune cells need to be properly fed, exercised, rested, and supported with a healthy lifestyle. What the immune system needs for optimum function is different truly from person to person. And this really speaks to the idea of individualizing and personalizing our care for our patient base. So you'll learn in this presentation how the immune system can be rebooted to improve its ability to serve your needs without complaining. When I use the term complain as it relates to immune system function, I'm talking about how it talks back with us with inflammation, allergies, chemical and food sensitivities, and reduced resilience. So why is that so important, people ask? Well, the function of the immune system has been determined over the past 2 decades And with an emphasis over the last 3 years to be a major factor that determines not only our overall health and disease risk to both infectious and non-infectious diseases, but also our life expectancy, i.e., longevity. Yes, the function of a person's immune system as they age has been found to predict how long they will live. When you apply it in your life, you'll be learning this in this presentation, which can make a big difference in both your immediate long-term health. One of my quotes I love to use constantly is, you can't control the virus, you can only control the host. I cannot control the virus for my patients. I can't filter the invisible out of the air. We do have filters, there's things that we can do, but what I can do and what we can share with all our patients, friends, and family is how to make them an inhospitable host for a viral, bacterial, and a fungal infection. Obesity, a portmanteau. 42% of people gained more weight than intended over the past year because of COVID Some of these studies showed a 29-pound gain on average. 10% of the population over COVID gained 50 pounds. 54% gained weight due to COVID restrictions, 54% exercised less, and 68% because of the stress. Snacking more. So COVID, if you had COVID, you had a higher incidence of obesity. If you had obesity, you had a higher positivity rate for COVID-19. Interesting, if you have COVID, you're gonna see a change in your overall onset of increased normal heart rates. So about 79 days you had an increased heart rate. That's a long period of time. 32 days it took to get back to the exercise level before, once you popped a negative test. And what I think, which may be the most detrimental or deleterious effect of COVID was it took 24 days to get back to normal sleep patterns. So COVID-19 is linked to sleep problems and fatigue. We just talked about that. But these sleep disorders, interesting enough, may be due to inflammatory responses or blood-brain barrier dysfunction. The sleep disturbance also may be seen in chronic fatigue syndrome, which will see a parallel increase in the positivity of COVID-19. So mobility issues, why did I put this in? Well, chiropractors deal with mobility. We do functional movement assessments. We do functional movement screens. People over 50 had double the chance of mobility issues post-COVID. And it was shown in their participation in physical activities or worsening ability to engage in household activities. Talked about this just a little before about the long-term effect, but I really put it in and I wanted to mention it again was sleep patterns. Studies have shown that one night of loss of good quality sleep has a detrimental effect on your brain. You sleep, your brain goes to 40% of its size. It squeezes like a sponge all this metabolic waste. So if you don't have the ample time to do that, you can't detox your brain. You're not gonna, if you will, think straight the next day. 24 days of aberrant sleep patterns after a positive test. So clearly, we want to do the best we can to avoid having a positive test. But once we do, we want to work within the genre of getting people back healthy and their immune system rebooted as quick as possible. Now, obviously, we're mostly, if not all, chiropractors. So the prevalence of lower back pain did not change at the first few months of COVID-19 pandemic. But lower back pain-induced impairment in daily activities and pain intensity was higher when compared to before the pandemic. I said earlier, you're only as young as your immune system. And the reason I'm really hammering this point home is we have some very famous docs doing a great job releasing longevity books this year. 2023 is the talk about longevity, the matching of life and healthspan. You don't want to live to 80 if you only have 40 years of a healthy lifespan. You want to live to 80, especially if you have a good Healthspan. You're only as young as your immune system. So we can talk about longevity all we want, but if we have a break, a barrier, a breach in our immune system, that's going to show a tremendous mark against decreasing in our healthspan and our longevity. COVID also had a biological aging effect on many patients. It was an accumulation of epigenetic aging from COVID-19. which contributed to post-COVID-19 syndrome among survivors. Telomere shortenings. They showed a consistent biological age increase in post-COVID-19 population. Telomeres are the fuse to the dynamite. So when you shorten your telomeres, you're basically shortening your life. Tremendous interaction between COVID-19 and sarcopenia. Muscle mass is your longevity organ. Tufts University, 1998. has stated that the loss of muscle mass is the first sign of aging. So long COVID, which we're gonna go through in detail, shows an increase in C-reactive protein, specific blood markers, TNF-alpha, and the interleukins and ferritin, which are all inflammatory, which can lead to fatigue and dyspnea. Also, long COVID leads to malnutrition. These are all biomarkers that feed, unfortunately, the loss of muscle mass, i.e., sarcopenia. So long COVID leads to sarcopenia. Sarcopenia leads to a higher incidence of long COVID. This is one of the best studies that I've seen. I really made a point of this in my book. I gave it a few pages because the influence of nutritional intakes in Japan and the US really spoke to where we as Americans are and where we lack in health. COVID-19 cases, they were 12 times higher in the US than Japan. Times. Death was 17.4 times higher in the US than the Japanese. The prevalence of obesity in American men was 7.4 times greater than Japanese men, and American women 10 times greater than their counterparts. Take a look at the diet when it was analyzed. We as Americans consume more saturated fat, considerably less omega-3s, and we eat much more beef to the tune of about 400% of grain-fed beef And sugar and sweeteners to the tune of 235%. The average American consumes 160 pounds of sugar per year, 146 pounds of wheat being gluten, and 142 pounds of artificial sweeteners. The Japanese, on contrast, eat 45% more fish, slightly more rice, not as much as you would think, 11.5%, And about 55% more tea, or i.e., green tea. EGCG, green tea, the active ingredient that's critical for green tea's medicinal effects, has been shown to block the dock of spike proteins on our ACE2 receptor sites better than any drug or nutritional supplement.

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So let's really get into a conversation now. Let's be conversationalists. Let's recognize the possible rise in autoimmunity and increased inflammatory status following Recovery from COVID-19 infection. Taking a look at this slide, the cross-reactive patterns between SARS-CoV-2 proteins and autoimmune target proteins may play a role in the systemic inflammatory response from COVID-19, leading to the development of autoimmune diseases post-infection in susceptible subgroups, or potentially playing a role in the severity of COVID-19 illness. So when you take a look at this, SARS-CoV-2 damaged the GI in a tight junction, So the takeaway here, and if there's one thing, I'm a gut guy, SARS-CoV-2 damages the integrity of the gut barrier. It also damages your skin, your nervous system, i.e., your brain, thyroid, joint, muscle, and cellular components. So SARS-CoV-2, when allowed in the body, really led us down a slippery slope towards autoimmunity. So what is the trigger for autoimmunity? Well, we have some basic ideas of nutrition, genetics, chemicals. and ultraviolet light exposure, but the 2 big things that are really hurting us now are the COVID infection, which damages our microbiota or our ecosystem inside our gut. So when you look at the virus such as SARS-CoV-2, you realize it can trigger a strong activation in the immune system. The appearance of typical clinical manifestations such as myalgia, myositis, chronic fatigue, sleep disturbances, and neurological manifestations cognitive impairment, memory loss, all of which have been reported in SARS-CoV-2 infections. So then you would see the appearance of autoantibodies, which are antibodies that attack our own structure, which may lead to the development of autoimmune diseases, especially in genetically predisposed subjects. Therefore, the current COVID-19 pandemic/endemic indeed fulfilled almost all the major and minor criteria for autoimmune inflammatory syndrome induced by all these adjuvants. So therefore, this took you through a flowchart of SARS-CoV-2 infection, ultimately leading you with autoimmunity. For chiropractors, what does that mean? Well, autoimmunity is rheumatoid arthritis. Autoimmunity, chiropractors, colleagues, also means osteoarthritis, myalgia, muscle pain. People may be coming in and making complaints or having complaints. of these conditions, and the root cause could simply be COVID-19, a post-positive test. So the immune system provides 3 levels of defense against disease-causing organisms. Number one, the barrier system. It prevents entry. It does so with skin, skin and mucous membranes. When you look at your skin, everybody knows what skin looks like. It's the longest, largest organ in the body. Everybody knows when they cut their skin, that they can simply put a Band-Aid on it to protect it. If they cut their skin too much, they can have stitches to close up the gape. That said, when you have a hole in your gut, we can't see it. Patients can't see it. They're not that quick to want to patch the hole in their gut epithelium. Mucous membranes like stomach acids, digestive enzymes, all a part of your first part of your immune system. Beneficial bacteria in your gut, like your microbiota, part of your beneficial bacteria. It has been postulated that the first time the outside world meets the inside world is when something gets absorbed through your small intestine. And when it does so, it stimulates something that we're given at day 1, which is our innate immune system, or it's our generella defense. Innate immune system is a 365, 24/7 Security guards of our immune system. They're immune sentinels. They are neutrophils and macrophages, which engulf and destroy foreign invaders and damaged cells. We want a balance between that and our adaptive and our acquired or specific defense or acquired immunity. Why is it acquired? Well, everybody knows Jessica has 4 children, and I'm sure she popped on right now. She would say it's flu season, it's ear infection. Each one gets it when they go to school. Because they're acquiring immunity and they acquire immunity through their B and T cells. Their T cells come from their thymus, their thymus gland. Now what's interesting about their thymus or all our thymuses, it is the first gland that goes through involution. Involution means the shrinking of. Therefore, during our teenage years, our T cells shrink. So obviously when we reach 40, 50, We're not as effective at T-cell expansion. And typically 65 or 70, the thymus provides us no defense. When we look at our B-cells, they come from our bone marrow. Those are our antibodies. They catalog all different incidences with foreign invaders like viruses, bacteria, parasites, and fungi. They are called IgE, which is an acute allergic reaction. IgA, which occurs at the secretory levels, IgM, which is initial, and IgG, which is the most profound, proficient antibody in the body. It can pass the fetus because it's small and get— it can pass through the placenta, excuse me, and get to the fetus. 75% of our antibodies are IgG. The innate immune system provides an immediate response for foreign targets. With responses typically within minutes to hours. It consists of a number of soluble factors and proteins, such as a diverse set of cells, including macrophages, dendritic cells, and natural killer cells. The second branch of the immune system is the adaptive or acquired immune system, which provides specific long-lasting immune responses. The adaptive and innate immune responses are linked. For example, dendrite cells are an important adaptive immune cell activator. Natural killer cells and T cells are specific in that they overlap both the innate and the adaptive immunity. Therefore, ultimately, cells from both arms of the immune system are in development as potential cellular immunotherapies. Cytokine storm versus cytokine drizzle. We all heard about the storm. That's when we have an overexpression of interleukins. One of the reasons that we get this proverbial storm is very simple, that we are pre-inflamed. We already have a release of excessive amounts of interleukins because we are pre-inflamed. My mantra as a chiropractor is to manage and modulate inflammation. And I think unfortunately it's very hard to do so with the environment and especially the food choices that our patients are exposed to. The idea of a cytokine drizzle, it's drizzling outside. You're building up the water. And then you get sick, like with COVID which is a new gnarly virus, first time seen in our history, if you will, at least SARS-CoV-2. And what happens? That drizzle turns into a storm. So a normal immune response, inflammation, which is normal, we're supposed to get an inflammation. It's even normal sometimes to raise a fever. Then you have your innate immunity.

Right.

You go to specific immunity, you get to resolution, and you have a memory of it. This is a perfect normal response to infection. Unfortunately, our typical immune response to COVID was aberrant in that SARS-CoV-2 had too much inflammation because it's— we as adults started too high and it didn't shut down fast enough. It spilled over to innate immunity where we had less cells because we have a dysfunctional immune system because we're not a healthy population. Then we had the specific immunity, the acquired and adaptive immunity, virulent factors did not launch. Ultimately, we had a slow resolution and poor to no memory. So let's take that one step further. Let's look at the idea of viral infection, COVID-19, and an immune response to the virus, which led to an overexpression of cytokines, which ultimately led to microbial metabolites, which led to mitochondrial dysfunction and a disease. I.e., everybody felt real poor, or as I used to like to say, everybody feels like crap. This immune imprinting, I pause every time I see it because I shake my head. It's called original antigen sin. Let me give you the definition, and then let me break it down what they're really trying to say. It's a phenomenon in which the body preferentially repeats its immune response to the first variant it encounters despite being alerted to a new variant. It has been stated that we are still taking a COVID-19 picture of 2020. So the first virus infection that we encountered, we took a picture. So now we all know viruses' purpose is to mutate. It has variants. We're not able to take a new picture with our immune system for that variant because we've already imprinted the original virus. And now this is why you're seeing people getting infected, whether they're vaccinated or not. Not going in that rabbit hole. Now you're seeing people get infected the second and third time because our immune system is not resilient. Our immune system is not adapted. Our immune system takes a picture and doesn't adapt. And that's because most Americans are not healthy. To piggyback on that thought, immune imprinting and long COVID. MIT and Harvard did a joint study, 112 patients, neurological long COVID symptoms, which meant Inflammation of the brain with cognitive deficits. What was found was an underwhelming amount of antibodies to COVID-19. In addition, an overwhelming amount of antibodies in response to other coronaviruses. So the coronavirus could look like the common cold. And what was happening was we kept thinking that COVID-19 was the common cold. And we were not sending antibodies or proper strength or proper antibodies to help ourselves out. Therefore, immune imprinting actually led us down a path of neurological long COVID. So again, buzzword, immune resilience. We want to do everything in our everyday life, in our chiropractic armamentarium, to allow for immune resilience. There is no single blood test that tells us that we have COVID or long COVID. However, There is a litany of tests that can lead us to that conclusion. They are interleukin-1 beta, interleukin-6, interleukin-8, and TNF-alpha. These overactivated monocytes and macrophages are typically the likely source of this cytokine overproduction. What's the definition of Long COVID? It's changed. Here's where we are now. The continuation or development of new symptomology 3 months after the initiation of SARS-CoV-2 infection, and these symptoms lasting for at least 2 months with no other explanation. Also, some subphenotypes for long COVID. Number 1, the subphenotype 1, they are unfortunately your sickest patients. They had cardiac and renal involvement. Subphenotype 2, patients with respiratory and mental sleep dysfunction and anxiety problems. Subphenotype 3, Patients with predominant neurological and musculoskeletal presentations. And the last one, subphenotype 4, patients with just digestive symptoms. Huge takeaway. Numbers. Number factoid. Estimates have long shown that Long COVID costs the U.S. economy $3.7 trillion and is growing every day. This compares with the Great Recession of 2007 and 2009, Unfortunately, long COVID is still growing to the tune of about 28% of the population. UCLA researchers found that 30% of people treated for COVID developed PASC, post-acute sequelae of COVID-19, i.e., long COVID. Long COVID. 90% of those with long COVID initially had very mild symptoms. So we always thought that long COVID meant that it was in a continuation of a real severe case of COVID-19. That's not the case because the study was robust in that it was 1.2 million people over 20 countries. Symptoms had an impact, a severe and long-term effects mimicking concussion and TBI. Women have a greater risk than men, and women have even a greater risk over children to develop Long COVID. BMI and female sex risk factors seem to be the—

Factors.

Given for long COVID symptomology. Taking the concept of long COVID, here was a study with 100,000 participants anywhere from 6 to 18 months after infection. 1 in 20 and 42%, essentially 50%, had not recovered. The symptoms in long COVID were breathlessness, palpitations, chest pain, and of course brain fog, reduced mental activity. So many, many patients, many docs ask me, How does Long COVID exhaust the body? There's 4 factors that increase the risk. Number 1, higher level of viral RNA during the infection. We're in a room, we're in a movie theater, there's 500 people, and out of those 500, 200 are sick. Larger RNA load. We're in the same movie theater with the same 500 people and only 2 are sick. Well, obviously less of a chance of us being right next to them, but also less of a load. Presence of autoantibodies. Talked about that before. Those autoantibodies are antibodies that attack ourself and not foreign particles. This will blow your mind. The reactivation of a lot of dormant viruses, one in particular called Epstein-Barr virus, which is mononucleosis. About 18 months ago, I started to run a lot of blood labs on a lot of my post-COVID patients. And everybody had an elevation of a myriad of viruses, especially Epstein-Barr. So Epstein-Barr is obviously mononucleosis. There's a lot of fatigue. It has been stated that we know that there's fatigue associated with COVID-19. There's fatigue associated with Epstein-Barr. It could be one or the other or the combination thereof. Type 2 diabetes. If you do any blood labs, Blood sugar, insulin resistance are all markers that probably are the most ruinous to people's overall health. Long COVID patients have disrupted immune systems. Viral and genetic material are embedded in intestines and lymph nodes. The reason it's embedded in the intestines is that viruses are shed through the gut, as I seed you for a conversation in the next 20 minutes. Circulatory system, we see an increase in cytokines, microscopic blood clots in the brain. Very typical in cognitive impairment. 12 months following acute COVID-19 infection, there was an increased risk of an array of neurological sequelae like stroke, cognitive memories, peripheral nerve disorders, migraines, musculoskeletal disorders, movement disorders, mental health. So the conclusion was very simple. There's an increased risk of long-term neurological disorders in people who had COVID-19.

That's it for today's episode. Be sure to tune in for the second segment of this 2-part series where Dr. Silverman will discuss the long-term impacts of COVID-19 infection on the lung-gut-brain axis and gut microbiome, and the role of systemic inflammation in long-hauler COVID. We will also talk more about strategies for reducing inflammation, including diet, supplements, and lifestyle improvements, as well as effective nutritional protocols for the Omicron variant and immune support. You won't wanna miss it. Episode 65 drops in 2 weeks. And be sure to visit our show notes for all of the freebies and special offers mentioned in today's episode, as well as the link to the replay of our webinar if you're more of a visual learner. We've just launched our new website at factorpodcast.com, so be sure to check out that link in our show notes so that you can visit the site and get caught up on any past episodes you may have missed. You can subscribe to The Factor Podcast on Apple, Spotify, iHeartRadio, or the podcast app that works best for you. Give us a 5-star rating to help us grow the show, and be sure to share your favorite episodes with a friend. We'll see you next time. Hey guys, if you like what you heard today, I encourage you to visit our website at factor-store.com. That's spelled F-A-K-T-R-store.com to find out more information about all that we have to offer. We have a variety of online offerings as well as our hands-on Factor Rehab System course scheduled in cities around the globe. Be sure to also check out our event calendar and book Bookmark any of these upcoming live webinar dates coming up in the near future so you can join us live. And of course, the biggest compliment we can receive is for you to help us spread the word to your friends, colleagues, and classmates. You'll find all the important links as well as info about our sponsors in the show notes, so be sure to check those out.