by Kimberly Rivers

kimberly@vcreporter.com

Disease may not always be as fatal or widespread as a plague, but it is humanity’s ever-present companion. Our bodies are constantly bombarded by viruses and bacteria. Some are beneficial, and in fact vital, to healthy body processes like digestion, while others present a threat of infection. Our immune system has evolved over millions of years to recognize and respond to these invaders when they penetrate our initial defenses, and build natural immunity to infectious diseases we’ve been exposed to and survived. While modern medical knowledge has advanced wildly in the past century, bringing us life-saving vaccines, we are still vulnerable in the face of novel infections — a fact that the coronavirus has painfully brought home.

The VCReporter spoke with three local doctors about the challenges of fighting COVID-19 and the role immunity and overall health plays.  

Allergies and stress

Dr. Christina Porch-Curren, M.D.

“Think of white blood cells as the soldiers of our immune system,” explained Dr. Cristina Porch-Curren M.D., a Camarillo-based allergist board certified in allergy, clinical immunology and internal medicine. The soldiers “have different tools that they make to help fight infection.” Those tools are antibodies “that help fight infections, in particular bacterial infections, and then cytokines and interleukins which are made inside the white blood cells and are released when our bodies are ‘insulted’ by an infection.” 

When our bodies are stressed, Porch said that “those white blood cells just don’t work as well. They’re not prepared to run the marathon that they need to run. There’s just not that ability to fight the infection.” 

Porch is tracking a study showing that those who suffer from allergies, an immune-response illness, “tend to be a little protective against the coronavirus because they tend to have less of the receptors that coronavirus attacks.”

Promoting health v. fighting disease

Dr. Matthew Bloom, D.O. | M.D. vs. D.O. Doctor of Medicine and Doctor of Osteopathic Medicine are two pathways in medical training. DO programs prepare doctors to take a more “holistic” approach and  have 200 additional hours of hands-on education of the musculoskeletal system aimed at preparing these doctors to “diagnose, treat, and prevent illness or injury,” according to the American Medical Association.

“Something we’ve been missing along the way is promoting health rather than just fighting disease,” said Dr. Matthew Bloom, D.O., a physical medicine and rehabilitation specialist with a focus in the diagnosis and non-surgical treatment of musculoskeletal and neurologic disorders. He said it’s typical in medicine to be “very focused on identifying symptoms rather than the underlying cause and to focus on treating those symptoms. When someone is in pain it’s easy to give them pain meds to mask the pain, give an injection or have surgery, which may or may not help.” 

Bloom sees the same thing happening with COVID-19. “People are getting very sick and we are trying to manage symptoms on lockdown. But what have we done to really teach people how to live healthier lives to boost immunity and avoid getting sick?”

He feels the medical community could do a better job of promoting one simple approach: increasing Vitamin D levels — either through food or (modest) exposure to sunlight.  “Vitamin D is involved in regulating different proteins and immune modulators. It allows the immune system to function in a normal and healthy manner. Without [adequate] Vitamin D there are missing parts in the immune system and it can’t do its job . . . We could easily prompt the population to try to boost Vitamin D levels. Traditional medicine education includes very little information about diet or nutrition.”

Even in sunny climates, like California, he sees Vitamin D deficiencies due to lifestyle, use of sunblock or just not getting outside enough. It’s hard to get enough through diet, but just 20 minutes a day, between 10 a.m. and 3 p.m., is when the UVB rays provide the best opportunity for Vitamin D exposure on the upper torso and arms, without UVB blocking sunlight

Grass-fed red meat and fatty fish like salmon do offer some Vitamin D. Vitamin supplements can work, too, but Bloom says sunlight is the best. 

Porch agrees. “We know that Vitamin D is a natural anti-infective and it’s anti-inflammatory. We’ve been looking at Vitamin D levels for probably 10 years now . .  Many physicians that treat autoimmune disease or treat multiple sclerosis or asthma, we’ve definitely seen a correlation: If someone has a higher Vitamin D level, they tend to do better as opposed to those patients with really low vitamin D levels.”

COVID UNKOWNS – Antibody testing
“Some things are very clear and what is clear is the muddiness of the water,” said Dr. Stan Frochtzwajg, chief medical officer at Community Memorial Health System. “It’s really important for people to understand that much more is not known than is known about the coronavirus.”
As the county reopens, and positive cases spike with serious case numbers plateauing, focus is shifting to antibody testing. 
“Antibody testing is fraught with many unknowns,” said Frochtzwajg. “First, when somebody has positive antibodies, one, we don’t know if they are neutralizing. Number two, we do not know if they’re still shedding virus. Number three, we do not know how long they will be immune with those antibodies. And if one person is immune for a few months, does that mean an older person will be immune for a few weeks or longer?”
He said that patients are asking him about getting antibody testing. “I tell them it would be academically and curiosity satisfying to have that information, but it really doesn’t tell us or you whether you can infect your grandmother or not.”

Seven elements of a healthy immune system

“We have an in-and-out society, we like to get our needs met promptly, quickly and move along to the next topic and, unfortunately, all the ways of enhancing our immunity in a natural fashion have been given very short shrift,” said Dr. Stan Frochtzwajg M.D., a family medicine specialist and chief medical officer of Community Memorial Health System. “As a result, we are leaving on the table critical elements that would help us not get these diseases or, in this case specifically, decrease our risks to coronavirus.” 

Frochtzwajg acknowledges that genetics is something we don’t have control over and which does lay the foundation for our “response to immunity and various germs and in our case now to COVID.” 

But he does offer seven elements “to enhance” in our daily lives to build a healthy immune system to fight off disease and infection. 

Nutrition

“At the top of the list for me is nutrition.” Frochtzwajg said he’s really come to put stock in the “concept of the anti-inflammatory diet. It is not an exotic diet, it just means we need to eat real food and food that has not been adulterated with hormones, antibiotics and pesticides which alter our microbiome which we really need to nurture and treat properly.”
An anti-inflammatory diet is low in refined sugar, mindful of gluten’s impact on a person’s system and might exclude milk.

“Unfortunately I love this substance, milk,” said Frochtzwajg. “We are the only mammal that drinks milk past weaning. And we drink cow’s milk. which is anthrogenically inconsistent with our immune system and causes a whole array of both lactose intolerance as well as milk protein allergies that I see in newborn babies and infants routinely in the form of eczema and asthma.”

Some people, he added, “tolerate gluten just perfectly well, even though they would do better without it.” But he said he’s discovered in his practice that in some people, gluten “causes a chronic, low-grade inflammatory reaction in the intestines and gut that lead to inflammatory reactions and amplification of our inherent allergies.”

Hydration

“Water is the medium through which all our biochemical reactions are processed,” Frochtzwajg explained. “When people are dehydrated, it adversely affects our kidneys and every biochemical reaction in our body.” 

Sleep

“We need to sleep adequately and we need to have good sleep and we don’t pay enough attention to that.”

“People can get mad when I say it, but alcohol is bad for us. It is damaging to almost every system in our body,” Frochtzwajg continued. “Of course it is dose related, you can have a glass of wine once a day; most people tolerate that well. But I’ll tell you, there is no greater substance that will disrupt sleep cycles than alcohol.” It’s common for people to think a bit of alcohol will relax them and help them sleep, but “what they don’t appreciate is that most of the time that alcohol will disrupt their restorative sleep. We really need our REM sleep, our deep sleep, and that gets disrupted by alcohol.” 

Dr. Stan Frochtzwajg, M.D.

Exercise

“I’m a big believer in walking. You don’t need to do much more than walk. If you cycle or swim, those are other really good ones, but you don’t have to be [doing] a marathon or extreme sports. A simple 20- to 30-minute walk every day, and preferably outside. It’s been shown that when we get into nature and when we get sunlight and exposure to the outdoor world, there is an enhancing element to our health.”

Meditation

“Something in the rat race that we all avoid and that is meditation. And it doesn’t have to be transcendental meditation. It can be yoga, or any kind of creative opportunity like gardening or painting or playing an instrument or napping. Any of those things are meditative states that are critical.”

Social interaction

“Everything from having a conversation, physical hugging, sex . . . these are critical items in our lives that are wholly neglected by many many people and recently it’s made worse, of course, by the pandemic,” Frochtzwajg said, who noted that for now, virtual face-to-face connections work. “We know [physical touch and interactions] boost dopamine levels in our brain, which provides us with peace of mind, calm and a lower heart rate and lower blood pressure.” 

Spirituality

“It can be religion, philosophy or any aspect thereof. We need to have a sense of ourselves and how we belong in this universe, within our world, within our society, within our family, and it’s only through spirituality that you have an expansive or greater sense of that.”

Every week seems to offer some new twist or turn in the road to finding a treatment to save those who get seriously ill from COVID-19. Things that worked last week don’t work today — but then might work again tomorrow. 

“That’s why we call it the practice of medicine, and it’s an art,” said Porch, reflecting on how medical approaches to the pandemic seem to constantly change. “I think as a practicing clinician one of the hardest things for me, personally, is when my patients want this black-and-white answer from me about this virus. I’m happy to have discussion about their unique circumstance and what’s going on to determine the  best plan for them, but there is no black and white answer.”