Functional Approach of CoViD-19

by Regio L. Sales MD
Functional Medicine Model :
- “An evolving understanding that disease is an endpoint
and function is a process...The functional medicine model
for health care is concerned less with what we call the
dysfunction or disease, and more about the dynamic
processes that resulted in the person's dysfunction.”
- Jeffrey Bland, PhD
Note:
No integrative or natural medicine measures have been
validated in human trials as effective specifically for CoViD-
19. The strategies presented here are based largely on pre-
clinical evidence and are supplemental to current public
health measures and conventional treatments.

Given how little definitive information there is regarding

CoViD-19, it is important to evaluate any intervention from a
potential benefit and possible risk perspective.
The Virus: SARS-CoV-2 : Functional Perspective
• Factors for Viral Survival, Infectivity, Disease Severity:
1. Temperature: thrives at 5℃, no transmission: 30℃
- Rx: hot water therapy, gargle w/ warm saline,
salabat, hot sitz bath for men
2. Humidity: thrives at 20-30%
- Rx: humidifier (not if w/ a CoViD patient), steam
inhalation with iodized salt (“tu-ob”), minimize nebulization
3. Viral load:
- avoid crowding in enclosed spaces,
disinfectants, far-UVc light disinfection, use of mask, Zinc,
Iodine
 4. Positively Charged Viral Spike Proteins
Rx: Negative ion generators, Electroceutical fabric
5. Iron in the host :
Rx: a. Decrease Iron-rich foods: liver, beef, alcohol,
sardines
b. Iron removers: alugbati, cocoa, iba, fiber,
beans, legumes, purslane, Zinc
c. Drugs: deferiprone, deferasirox
d. Avoid iron supplements & Vitamin C (at low
dose)
 6. Host ACE2 receptor expression / binding
- Astragalus - decrease ACE receptor activity
- Quercetin - compete a/g ACE2 viral binding
- Vitamin D3 - reduce ACE2 activation
- Melatonin - indirectly regulate ACE2
expression
- Upregulate ACE2 receptors: ARBs (e.g.
Losartan is protective), ibuprofen (may increase lung injury)
- High Renin-Angiotensin-Aldos-Sys
(dehydration, low salt, high bld sugar) > more ACE2
 7. pH of the host cell - viral replication in acidic
endosome
Rx: alkalinizing foods
alkaline water
8. Sex of the host : ratio of deaths (testicular ACE2)
Male: Female is 2.1:1 (Denmark, Greece);
1.7:1 (China)
- Estrogen suppresses escalation phase of
immune response > less cytokine release; better gut
microbiome; higher antibody response; inhibit IL-6
- need for sex-disaggregated data
 9. Penetration of host cell nucleus
- Use of Ivermectin - inhibits Importin protein
which helps the viral RNA penetrate the host cell nucleus
CoViD-19 Basic Disease Concerns:
1. The Virus (Iron, Viral load, cold, low humidity, etc)
2. Cytokine Storm - overactive immune response
- assoc'd w/ high Ferritin (already high in DM2,
hyperthyroidism, rheumatoid arthritis, high Fe in diet
- addressed with HCQ, melatonin, colchicine,
monoclonal antibodies
3. Pneumonia (Bacterial, Viral)
- 15% severe, 5% critical (ARDS)
4. Thromboembolism
Chlamydia : Rx: Azithromycin
Prevention: Aspirin 100mg, Vitamin K2

5. Levels of Prevention
6. Prognosis: Where are we headed?
Levels of Prevention

I. Primary - infection avoidance

a. Suppression - reversing pandemic growth
- population wide social distancing
- continuous lockdown until there is a vaccine

b. Mitigation - slow down pandemic spread but not

extinguish it; closing schools, case detection, isolation,
home quarantine, social distancing among the elderly, good
personal hygiene
 c. Face Mask - dominant measure in Czech republic,
HK (during SARS masks resulted to 70% less risk)

d. Disinfection:
Internal - Colloidal Silver, Stabilized Chlorine
Dioxide (don't ingest)
External - alcohol, diluted bleach, Negative ions,
far UV-C light
 e. Stress Reduction
- spirituality, religion, help others, nature, massage,
exercise, meditation, healthy diet, adequate sleep, virtual
chats, virtual gathering spaces, laughter, avoid “bad news”
from media or TV, finding a hobby
- consult UP-Psychserv,
https://mywellnesscoach.arizona.edu/
 f. Quarantine - of PUI's, CoViD positive with mild
symptoms

g. Testing :
1. Self-Testing
- loss of taste and smell
- warning signs: troubled breathing, chest
pain, new confusion/hard to arouse, bluish lips
- journaling of contacts
- self testing sheets (ISKOnsult in
endcov.ph)
 2. Diagnostics :
- RT-PCR- gold standard;PRC1158hotline
- Rapid Antibody Test
- IgM - 5-4 days of Symptoms, acute
- IgG - 21 days (15-39 days), immune
- for fast population survey (after 14d)
- to ID asymp'c positive cases &
immune individuals
- for presymptomatic transmission:
6.7% (Japan: 1-3 days, median: 4 days)
 3. Tests for Monitoring :
CBC- low WBC, low Lymphocytes,
low Platelet (5x risk of severe CoViD)
Ferritin: high
Procalcitonin: normal
4. Artificial Intelligence or Lifetrack CoViD CT
scan
- remote triaging via Chest CT scan
- to isolate & prioritize testing for
presumptive CoViD-19 cases
- for checking false negative RT-PCR
 h. Vaccination:
- SARS-CoV-2 Vaccine: effective? safe?
ethical (immunity passport)? multinational dependence?
- BCG potential use
- Ask Vaccination History/ BCG
surveillance
- Mechanism: enhanced T-cell response,
Cytokine production, enhanced macrophage activity,
lymphocyte activation, innate immune memory, enhanced
antibody titer
2. Secondary Level of Prevention - prevent worsening of the
infected
a. Chloroquine / Hydroxychloroquine (HCQ);
- blocks inflammatory cytokines (melatonin,Zn)
- increases pH in endosomes (alk diet/water)
- blocks glycosylation of ACE2 (ALA, GSH)
- acts as ionophore for Zinc
b. Tocilizumab monoclonal antibody (w/ steroids)
c. Steroids: Methylprednisolone - given w/in 5-7 days
of Sxs (no for viral pneumonia); Dexamethasone 6mg/d for
patients requiring oxygen therapy
 d. Azithromycin
e. Colchicine - anti-inflammatory (IL-1b, IL-6)
f. Antivirals: Kaletra, Avigan, Remdesevir,
Zinc, Andrographis, Berberine
g. Nutraceuticals: VCO, D3, Melatonin, Probiotics
h. Traditional Chinese Medicine:
Yupingfeng, Sang Ju Yin, Lianhua qingwen,
Jinhua Qinggan, Qing fei pai du tang, Xue Bi Jing, Shuang
Huang Lian (X-sanchi, HemoHim, Huang lian su,
Honeysuckle, licorice)
i. Ivermectin + Zinc + Doxycycline
 j. Anti-CoViD-19 Nutrition
a. Iron removing foods: alugbati, beans,
legumes, purslane, fiber, cocoa
b. Iron removing supplements: Zinc, Selenium,
turmeric, lipoic acid, glutathione
c. Zinc rich foods: Oysters (74mg/3oz),
Sugarcane (19-49.2mg/kg), coconut meat (2.05mg/100g),
squash seeds, pumpkin seeds
d. Zinc ionophores / enhancers: garlic, onion,
green tea, quercetin, tugabang
 e. Antivirals : Andrographis (Mirabilos or
Serpentina or Sinta), Berberine, VCO, licorice
f. Alkalinizers: avocado, banana, lemon,carrots,
kulitis, papaya, broccoli, onion, melon, radish, pineapple,
raisin, sprouts, cabbage, celery, squash, alugbati, nuts,
garlic, spirulina, wheatgrass, malonggay
g. Avoid high iron: liver, sardines, beef
h. Hot water
i. ACE2 regulator: melatonin, Vit D3, Astragalus
j. Anti-inflammatory: curcumin (IL-1), quercetin
(NO, TNFα,IL-6), Andrographis (IL-1β,caspase1,NLRP3)
3. Tertiary Level of Prevention - preventing death
a. Ventilators / ECMO
b. Convalescent plasma / Hyperimmune globulin
(Hyper-Ig)
c. IV immunoglobulin (IV-Ig)
d. Proning matress or beds
e. Hemoperfusion
f. Therapeutic plasma exchange
g. HFNC (High Flow Nasal Cannula)
 “EXPERTS ARE NOT SURE”
DOH/PSMID: Standard of Care: Supportive Care

WHO Solidarity Trials: HCQ/Chloroquine,

Lopinavir+Ritonavir, Remdesevir, Kaletra+interferon beta1a

RECOVERY Trial (Univ of Oxford): Lopinavir-Ritonavir,

Low-dose Dexamethasone, Azithromycin, Tocilizumab,
Convalescent plasma

Favipiravir (Avigan) trials

5. Prognosis: Where are we headed?
a. Doing Nothing (aside from ECQ):
- Ferguson suppression strategy model:
with Ro 2.5 > 250K will get infected w/ 1-3%
severe; if ECQ is removed after 2-4 weeks another spike is
expected after 2-3 months
- FF should be in place before lifting: needed
hospital capacity, proper social distancing in transpo, don't
open school yet
- Dr. Wittkowski (Rockefeller Univ): 2% will die
 b. Herd Immunity;
- Requires 60-82% immune population
- May require vaccination (?evidence)
- Qualities of CoViD amenable to Herd Imm:
1. confers long term immunity (SC1-17y,
average: 3yrs)
2. Only minor mutation
3. 50% of positv are ASx'c (15-78% Asx'c)
4. 80% are mildly symptomatic
 c. Vaccination - 30 strains, 20 under devt
d. ?Reinfection: rpt Positive after 2-3 mos Neg
- Ab dependent enhancement
- re-emergence of dormant virus / testicular
- low antibody response
- remnants of the virus: if rpt Positive after 3-4wk
- false negative result of PCR (after 3 wks)
- virus still in lower respiratory tract (specimen
taken fr upper resp tract)
- didn't achieve Herd Immunity
Rx: Care & Monitoring of the Recovered
 e. Transitioning to the New Normalcy
Factors to consider before lifting (McKinsey):
1. Prevalence of the virus
2. Capacity of the healthcare system
3. Social urgency (risk of losing jobs, dying
of hunger)
4. Which sectors could we ease the
restrictions & in what sequence
Benchmarks for Normalcy (Scott Gottlieb,et.al. The
National Corona Virus Response: A Roadmap to
Recovering)
1. Adequate Medical Care (drugs, beds, ventilators, staff)
2. Sufficient Testing
- capacity to test all with symptoms
- get reliable timely results
- about 0.2% of the population per week
- at present DOH target: 8k per day (0.05% per wk)
- ideally: PH 218k/wk; Negros Occ 5k/wk; Bacolod
1.2K/wk
3. Adequate monitoring, surveillance and quarantine

4. Sustained reduction of cases for 14 days

 WHO framework for lifting strict quarantine measures
1. Is viral transmission under control ?
2. Is the health-care system equipped to detect, test,
isolate, treat cases and trace contacts ?
3. Are outbreaks minimized in vulnerable places like health
facilities?
4. Are there measures to prevent spread in schools and
workplaces?
5. Are risks of imported cases managed ?
6. Are local communities educated, engaged, empowered to
adjust to the “new norm?”
Transitioning to the New Normalcy: Models
I. Radical (Dr. Knut Wittkowski, Rockefeller Univ)
Focus: Achieving herd immunity & shortening the
duration of the pandemic while preventing a second peak
(Sweden)
Action Plan:
- Protect the vulnerable
- Enhance health facilities
- Use masks (not compulsory) and proper hygiene
- Open schools
II. Traditional (Scott Gottlieb, et.al.)
Key Points:
1. Improve healthcare
2. Good monitoring, surveillance, isolation
3. Sufficient testing
4. Sustained drop of cases for 2 weeks
5. Vaccination
6. Phases
 Phases toward normalcy:
I. Slow the spread: Quarantine & Social
distancing
II. State by state (or province by province)
reopening
III. Establish Immune protection & lift physical
distancing
IV. Rebuild readiness for next pandemic
III. Non-Traditional (Flexible reopening suggestion);
Phase 1:
a. Immune enhancement
- drug / supplement procurement or
preparation
b. Hospital enhancement / subsidy
c. Antibody testing (or PCR) followed by Quarantine
d. Free flow of cargo & supplies (supply chain mgt)
e. Zoning of hot spots
f. Open essential businesses(healthcare,BPO,food)
 g. Compulsory face mask
h. Augment transpo or easing of transpo w/ social
distancing

Phase 2 (after 1 or 2 week evaluation):

a. Dietary enhancement / supplementation,
supplement distribution
b. Enhanced TV/Cable/radio education campaign
c. loosening of check points
d. Social distancing in public transpo
 e. No mass gathering
f. Opening secondary business: construction,
retail, manufacturing, raw materials (farm needs, hardware,
clothing) - businesses with lower risk of spread
g. Compulsory mask wearing
h. Temporal lifting: ECQ only on Sat & Sun

Phase 3.
a. Open Business
b. No School
 c. Mask wearing
d. Social distancing

Phase 4:
a. Open school
b. Mask
c. Inter-island travel
d. Secure the vulnerable
e. International travel depending on country
In Conclusion
Successful mitigation of the impact of CoViD-19 in a
financially challenged locality may come about thru..
- An empowered citizenry properly educated in the
different levels of prevention against CoViD-19
- Enhancement of the immunity of the people thru
supplementation with: Zinc, Zinc-rich foods (oyster,
sugarcane), Virgin coconut oil, Vitamin D3, Andrographis,
Probiotics/Prebiotics, melatonin, turmeric, tugabang
- Maintaining physical distancing especially of the
vulnerable population
- Mask wearing & proper hygiene
Anti-CoViD Immune Support Made Simple
For Prevention:
VitaminD3 2000iu per day
Melatonin 6mg at 8PM(for 40 yrs and above)
Turmeric or Curcumin, Sinta or Serpentina
Zinc 5-50mg (Children: 2 or 5mg) / Oyster or Sugarcane
Virgin Coconut oil 1 tbsp 2 or 3x a day (Children: 1tsp)
and/or oil pulling
ACE inhibitors or ARBs like Losartan (for hypertensives)
HCQ 200mg every 3 weeks (Dr. Cahill)
Ivermectin
Prevention
TCM (traditional chinese medicine):
Yupingfeng (Astragalus, Atractylodes, Ledebouriella)
Lianhua Qingwen: (for those exposed to CoVid-19 positives
in isolation facilities): 2 capsules 3x a day for 5 days
For Children: Probiotics, Vit D3/Cod liver oil, BCG, VCO,
breast feeding/ good nutrition

For Mild to Moderate Symptoms:

Andrographis (Sinta/Serpentina) tea or 6gm/day
Turmeric, Melatonin (high dose), Vitamin D3
Zinc 220mg per day for 5 days + HCQ + Azith. (Dr. Zelenko)
Tugabang or Saluyot / Onion / Garlic (Quercetin)
Virgin Coconut oil 30-50ml 2 or 3x a day
TCM: Lianhua Qingwen (clear heat, detoxify) 4caps tidx8d
Ivermectin + Doxycycline + Zinc
THANK YOU
STAY SAFE