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  Fundamental MedicineTeresa Gryder, ND

COVID-19 Antibodies: Introd to Immunology and Vaccines

3/26/2020

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Are you an immunologist? Yeah, probably not. There aren't a lot of immunologists in the world. I'm not one, though I've studied immunology under one of the best (Dr. Heather Zwickey) and I try to keep up. It's a fast moving field. Every time I hear Dr Zwickey speak she tells us about some new receptor or cytokine that they've discovered, and a bunch of new correlations between the things we already have a little info about. 

If you don't speak the language of immunology, a lot of the talk these days won't make a lot of sense. How does the body fight off a virus? How is a vaccine made? These questions have long, complicated answers. In this post I want to teach you the basic outline of the answers, even if we don't go into all the terminology and details.

One word you're going to hear a lot about is ANTIBODIES. Antibodies are, for the most part, a good thing. Antibodies are what you have if you have gotten sick and managed to fight off the infection.

But how do you get them? 
Picture

When you first get an infection, something has invaded your body. It could be a virus or a bacteria or a cancer cell that won't stop multiplying. The first step in fighting off such an invader is to recognize it. We have immune cells who are always on patrol for invaders. The take samples of antigens from the invader's surface and deliver them to headquarters (a lymph node). At headquarters there are cells that design and manufacture antibodies that match those antigens. Antibodies are Y-shaped proteins that stick to the antigens on the invader cells and mark them for destruction.

After the invader antigens are marked, a different set of immune cells charges out and kills them. This is when you start getting better from your illness. Unfortunately the process of noticing the invader, delivering the antigen sample to HQ, designing and making the antibodies, tagging the invader cells and killing them takes about a week. It's not fast.

When your body has never fought off a certain invader before, your immune system is said to be "naive" about it. Once you have been exposed and are making antibodies, you are said to have "immunity".

This is why vaccines are so useful. A vaccine is basically a sample of antigen injected into your system to jump-start the process of recognition, delivery, and antibody-making. If you've had the vaccine for a particular kind of invader, then your body already has the antibody designed and a few of them are already made. This cuts days off of your response time to that infection. The faster you can mark the invader with antibodies and send in the troops to destroy it, the less time it has to grow in your body and make you badly sick.

When it comes to COVID-19, we had doubts about humans making good antibodies to it, because we don't seem to develop antibodies to the other coronaviruses that cause the common cold. Without developing antibodies, we don't have immunity. We can get the common cold over and over again, and it can be just as bad as it was the last time.

But the GOOD NEWS is in, and that is that people who've had COVID-19 are making antibodies to it! That means that we will be able to make a vaccine, and that the vaccine will work. This study from China, posted today (3/26/2020), says they found 206 different antibodies to COVID-19 in the immune cells of patients that survived it. Not only are there 206 antibodies detected so far, but they stick really well to the virus. Good news indeed!

The next step after testing people for the virus is to test them for the antibodies. Some of us have already had it. Wouldn't it be great to know if you've had it yet? If you knew that your immune system had already beat this virus and was ready to beat it again, you could go work in a hospital with sick people and not worry about getting sick.

It's true, we don't know how long immunity will last after exposure and antibody response, but we will learn that in the next year or two. In the meanwhile I am encouraged that research is finding good antibodies that can be used for a vaccine. Hope is on the Horizon.
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COVID-19 Links 1

3/18/2020

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 This list was updated daily, 3/18, 3/19, 3/20.

In Colorado A Whole Town Will Get Tested

https://coloradosun.com/2020/03/20/telluride-san-miguel-county-coronavirus-covid19-testing/

​
Worse Than the Flu: More Contagious and More Lethal
https://nymag.com/intelligencer/2020/03/the-story-of-a-coronavirus-infection.html
​

Overview of Situation and Actions to Take
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

Johns Hopkins COVID-19 Dashboard (for tracking the numbers)
https://coronavirus.jhu.edu/map.html

Details on Lab Testing
https://www.wired.com/story/everything-you-need-to-know-about-coronavirus-testing/
​

CDC on What To Do if you are Sick
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

Dr Teresa Gryder on Self Care and Self Treatment Options
rb.gy/9gocvh

What Will Happen to Hospitals (Models by Propublica)
https://projects.propublica.org/graphics/covid-hospitals

Simulitis: Washington Post Graphic on How Social Distancing Works
https://www.washingtonpost.com/graphics/2020/world/corona-simulator/

Dr Heather Zwickey (audio) on Immune Support and Why C19 is so Bad
https://www.naturalmedicinejournal.com/sites/default/files/media/nmj_covid_update_zwickey.mp3

Seattle Intensivist's One Page Notes 3/15/2020
https://www.kevinmd.com/blog/wp-content/uploads/ICU_one_pager_COVID_v2.3.png

Mental Health Maintenance Tips
https://www.internationalsos.com/client-magazines/looking-after-yourself-during-the-coronavirus-outbreak

Don't take Ibuprofen, Aspirin or Naproxin (Tylenol OK)
https://www.sciencealert.com/who-recommends-to-avoid-taking-ibuprofen-for-covid-19-symptoms

CDC Clinical guidance for Clinicians treating Confirmed cases
https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html
​

Diarrhea = Presenting Symptom in <50%, Presents Later, Worse Prognosis
​(Chinese study, n=204)
https://journals.lww.com/ajg/Documents/COVID_Digestive_Symptoms_AJG_Preproof.pdf

Social Distancing May Last a Long Time
https://www.npr.org/sections/health-shots/2020/03/17/817214311/new-analysis-suggests-months-of-social-distancing-may-be-needed-to-stop-virus

No Free Pass for Young People
https://thehill.com/policy/healthcare/488325-cdc-data-show-coronavirus-poses-serious-risk-for-younger-people
​

Half of the patients in France's hospitals are under 65
https://theweek.com/speedreads/902571/about-half-frances-coronavirus-patients-intensive-care-are-under-65-health-official-says

Most Cases are Still Hidden 3/16/2020
https://www.nytimes.com/2020/03/16/health/coronavirus-statistics-undetected.html

American ICU's Will Be Over Max
http://www.centerforhealthsecurity.org/cbn/2020/cbnreport-03132020.html
​

Effect of Mitigation: No Way to Win 3/9/2020
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30567-5/fulltext

Genetics of COVID-19 Show It is NOT Manmade
https://www.modernhealthcare.com/safety-quality/covid-19-not-man-made-comparative-genomic-study-finds
​

Capitalism is the Vector 3/18/2020
https://theecologist.org/2020/mar/18/virus-haunting-europe-vector-capitalism

​
Single Payer Healthcare Systems Performing Better Than For Profit Systems
https://www.commondreams.org/news/2020/03/16/public-health-experts-single-payer-systems-coping-coronavirus-more-effectively
​

Rich and Famous Get Tested, Regular People Wait
https://apnews.com/b8dcd1b369001d5a70eccdb1f75ea4bd
​

Kushner aims to get rich on this too
1) https://www.msn.com/en-us/news/politics/guess-who-previously-owned-health-insurance-co-operating-coronavirus-testing-website/ar-BB11kwPT​
2) ​
https://www.washingtonpost.com/politics/kushner-coronavirus-team-sparks-confusion-plaudits-inside-white-house-response-efforts/2020/03/18/02038a16-6874-11ea-9923-57073adce27c_story.html

Why Paid Sick Leave Should be Mandatory
​
https://www.modernhealthcare.com/safety-quality/sick-staff-fueled-outbreak-seattle-area-care-centers

On the Idea that we should let everybody get it and save the economy
https://theweek.com/articles/902582/conservatives-who-sacrifice-elderly-save-economy
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A Fever is a Good Thing (Here's Why)

10/26/2019

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Picture
This is the author using a down jacket and cat to get warm.
​

  If you’ve ever had the flu, you know how miserable it can be. Chills and sweats, body aches, coughs and sniffles—there’s nothing about it that anyone would choose to embrace. Many people get the flu vaccine every year and while that’s not the subject of this article, I will say that most of us don’t need it. Even if you get the vaccine, you might get the flu. Even if you don’t get the flu, you could easily get a cold or some other bug. When the days get short and the air gets cold and dry, more people get sick. That’s just the way it is.

In my parents’ generation the main treatment for a cold or flu was lowering the fever. Aspirin was avoided for children because it could cause Reye’s syndrome, but Tylenol was given. These days ibuprofen or naproxen are popular options for lowering a fever. But what if lowering the fever makes you sicker in the long run? What if it impairs your body’s effort to kick the bug out?

That is exactly what is happening. If you start to feel sick and get chills, the last thing you really want to do is lower the fever. It does not help you get better any faster. Instead of popping pills intended to keep yourself from getting a fever, you want to facilitate the fever. This is because fever is part of your immune system’s way of dominating infections and kicking them out. Once you realize this, you will know what to do. You might even be able to prevent yourself from getting all the way sick.

Whenever you feel strangely cold, it could be because your body has decided to turn up its internal thermostat. Chills are a sign that your body wants to be hotter. The best thing you can do is help it get as hot as it wants. Drinking hot tea, wrapping up in a blanket, curling up next to a fire are a good start. A hot bath is great. It’s hard to keep a bathtub hot for very long so boil a kettle of water and keep it on the side to pour in (carefully!!) when your water starts to cool down. If you have access to a hot tub or sauna where you won’t infect others, those are even better. Put on a warm hat or hoodie. Make a hot water bottle and put it on your midsection or your feet. Curl up with the kittie. The only warming thing you don’t really want to do is to exercise because you probably feel really tired if you have a fever and it will only make you more tired. Get warm and rest.

If your body is getting sick, it is mounting an immune response to something. You want it to do that. You want it to get the fever because that will help it get rid of the infection. Heating treatments are used for cancer too, because heat activates the immune system. There is nothing wrong with letting your body get a degree or three warmer than it usually is!

Unfortunately as we get older our bodies don’t get fevers like they used to. Kids make great fevers, so high that they can have harmless seizures from being so hot. Adults can get good fevers, high enough to kick infections, but rarely hot enough to cause seizures. Old people sometimes don’t get fevers at all, and this is a problem, because it’s hard to tell when they have an infection, and because the infections can hang around a long time. Regular heating treatments for elders are not a bad idea even when they are not sure if they’re sick. Some elders have low body temperatures to start with so if their temperature measures as “normal” (98.6F) they actually are having a fever.

Obviously you must be careful when using boiling water, heating pads or anything hot that you do not burn someone. A body temperature of 99F or more generally counts as a fever and if it gets over 101F or so your fever is getting real. This means the body is fighting something it considers dangerous. Generally we get higher fevers from bacterial infections than from viral ones, but getting our body totally warm helps us beat viruses just like it helps us beat bacteria.

The moral of the story is that fevers are good! If you get a fever, that means you are healthy enough to have a functional immune system, and it is doing its job. If you get the chills, your body is serious about beating an infection, and the best thing you can do is to get yourself toasty warm, drink liquids, and rest. Don’t eat food, that distracts the immune system, much of which lives in the intestine. Just get yourself hot and wait it out.

When your body suddenly starts sweating and you feel way too hot, the fever has broken. It’s OK to take off your hat and get out from the covers when this happens. The fever might come back again, or it might not. If it comes back again, drink hot liquids and cover up and get warm again. Usually after a few cycles of this the illness will be over. Unlike the lingering sickness that would have happened if you lowered the fever with pills and stopped your immune system from working. So be thankful for the innate intelligence of your body and enjoy the fever! It’s what nature intended.
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SEVEN ALLERGY SEASON TIPS

5/25/2018

 
The long version on this topic went out in a newsletter, but for those of you who are not subscribed, here’s a quick checklist of ways that you can reduce your dependence on drugstore remedies during allergy season. Now that we know benadryl can contribute to dementia, the last thing we want to do is take that every day.

1. Tolerate some symptoms. A runny nose is rinsing allergens out of your head, and that is good. If you want to help your runny nose do its job instead of taking some drug that dries you up and makes the allergens stay in there, try using a neti pot.

2. Exercise daily. Cardio immediately changes the balance of your immune system and makes you better able to fight infections and less prone to hayfever.

3. Eat a clean diet rich in fruit, veggies and fresh fish, and limited in meat and cheese. Mangos, blueberries, cherries, raspberries, ginger and hot peppers have been shown to reduce allergies. Fast food, leftover fish, and aged meat and cheese definitely increase allergies. Kids who eat fast food have a much higher risk of developing allergic asthma.

4. Limit allergic exposures. This includes changing your sheets and dusting your house, cutting back on foods you are sensitive to, not using soaps that you sometimes react to, wiping down your pets, and generally trying to live in a minimal-allergen environment.

5. Increase Omega 3 fatty acids—You can take fish oil or you can change your diet to consume more fresh fish and certain nuts and seeds, specifically walnuts, chia, flax and hemp. Eggs are allowed because there are omega 3’s in the yolk.

6. Be nice to your intestines because leaky gut is another allergy trigger. Avoid stress, eat fermented foods, avoid NSAIDS, and keep going back to that clean diet with lots of veggies. Make sure you are eliminating every day. A happy intestine reduces your risk of allergies and autoimmune disease.
​

7. If you drink alcohol, go easy on beer and wine and try mixing drinks with clear liquors instead. Wine contains sulfites which worsen allergies. Gin contains juniper berries which are a fairly strong anti-allergy medicine. And there’s something about gin and tonics that’s perfect when the weather turns warm.

Simple but Feared Treatment for the FLU

1/9/2015

 
Americans are pretty much terrified to stop eating.  In this newsletter Dr Gryder discusses why fasting is a reasonable home treatment for the flu.  If you'd like to receive future email newsletters directly to your inbox, you can sign up here.

Sproing!

4/9/2014

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Do you feel it?  The sun has returned!  The warmth is soaking into the ground and flowers are coming up everywhere.  In our garden the peas and asparagus are coming up, and the daffodils and tulips are on full display. The enlivening of the earth gives ME energy.  Suddenly I can do things that seemed pointless just a month or two ago.  Come see me for a spring tuneup!  Now is the time to start your allergy-prevention protocol.  I'm learning to use some new herbal combinations that are really making me feel sproingy and I'm eager to share.
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    Author: Teresa Gryder

    Integrative Physician and Student of Life, Medicine, and the River.

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