Herbal Medicine and COVID-19: Creating Beneficial Outcomes

 

I hope all of you are well and safe.  This has been an extremely challenging and at times frightening few weeks for all of us.  Hummingbird Community Acupuncture has been informed that we will have to cease treating patients in the clinic.  We are waiting for final confirmation from DORA but we have closed the clinic in anticipation of this order.  When we are able, we will reopen to serve our community.

Although you cannot come in at this time, we do want to let you know that we can help from afar.  Joaquina recently sent out a newsletter offering online herbal consultations. The resulting herbal formulas are be available for delivery or pickup.

 

Today I would like to explain how herbal formulas can help you during this pandemic.

 

I have not been the most vocal person in the clinic regarding my knowledge of herbal/plant medicine.  Often when you arrive to the clinic, I may be sitting in the blue chair looking at my phone.  I admit sometimes I am vegging out, but most often I am researching different medicinals from eastern and western perspectives.  I like to pour over Chinese thought on herbs and I also like to read in vivo and in vitro laboratory studies of medicinal constituents.  I feel that it is very important to have a classical/ nonlinear as well as a very modern/linear understanding of herbal medicinals.

 

Chinese Herbalism and the Treatment of Pandemic Disease

 

I strongly believe that herbal medicine has been misperceived in this country as being gentle and mild in effect.  This is largely due to the approach many herbalists take in prescribing only gentle and supportive herbal formulas.  This approach has its place, however, there is also a time for formulations to be powerful and ferocious.

Chinese herbalism has utilized this stronger approach multiple times throughout history in times of pandemic diseases.  From the Han to the Qing dynasty (2000 years) there are historical records of around 320 epidemics and the herbal treatments that arose from these situations During this current outbreak, Chinese herbal medicine has been integral to patient recovery in the hospital setting in China.  There is a reason China is one of the most populous countries in the world.

 

Our Current COVID-19 Situation

 

From what I have observed, COVID-19 testing and hospitalization are being reserved for very severe cases in the US.  I know there are testing locations starting to open around the country.   However, I am also hearing from presumptive COVID-19 patients that, due to the scarcity of test kits, they are being denied testing unless symptoms are severe.  From what I gather, the government is working rapidly to change this situation however this is our current landscape.

Most presumptive cases are being told to self-isolate unless they are ill enough to require hospitalization.  This situation is where we can help. 

We are successfully treating our first presumptive case of COVID-19 and I suspect that we will be treating many more in the coming days.

When Should You Start Taking Herbal Medicine?

 

In my experience, it is best to use herbal medicine at the very first sign of symptoms in order to disarm the virus before it gains a strong foothold in the body.  We are offering telephone consults for these situations as well as for people who want to strengthen their immune system to avoid contracting this disease.  Herbs are available for pickup or delivery.

Obviously, we are not attempting to replace western medical treatment.  If your situation progresses to the point that hospitalization is necessary, that is the route to immediately seek.  Again though, I am seeing many people denied medical care unless they are extremely sick and as cases rise, I expect this situation to worsen.

 

Explanation of the Progression of COVID-19 & the Application of Herbal Medicine

 

Finally, I want to explain the progression of COVID-19 and some of the herbal applications that we use to combat this.  This is a very oversimplified explanation of the pathophysiology of this disease; however, I want to give everyone a rudimentary understanding of the viral progression and treatment.

 

COVID-19 can be broken down into 3 main stages of infection:

 

  1. Initial infection leading to viral replication
  2. The resulting immune response
  3. And finally resulting pulmonary damage and possible multiple system organ damage.

 

Initial infection: Stage 1

 

This initial stage of infection will feel fairly similar to the common flu with most people (some estimates say up to 80%) experiencing mild symptoms such as low-grade fever, coughing & sneezing, tiredness, runny nose, and sore throat.

The remaining 20% of infected individuals progress to more severe symptoms including: difficulty breathing, difficult to expectorate phlegm, and eventually pneumonia.  This can progress to a much worse situation as we are all hearing of in the media.  Most of the 20% of severe cases are individuals who are advanced in age or have underlying health conditions such as heart disease, high blood pressure, diabetes, immune system dysfunction, or obesity.

 

A deeper look at Stage 1

 

On a physiological level, COVID-19 first enters the lung and infects human cells with the ACE2 receptor site.  I’m not going to go into great detail on this (if you are interested let me know and I will post another article), however, ACE2 receptors are part of a complex system in the body that regulates water & salt balance as well as blood pressure.

The coronavirus itself is a spherical virus with “spikes” on its surface that resemble small antennae.  These spikes have proteins at their tips that bind to ACE2 receptors on human cell surfaces and allow the virus to enter the cells’ internal environment.  ACE2 receptors are very common in the lungs, heart, GI tract, vascular system, and the kidneys.

Unfortunately, in this case ACE2 receptors are also very common on the cilia of the lungs.  The cilia can be described as little hairs located on the cellular surfaces of the lungs and bronchial tree.  The cilia move in synchronized waves like tall grass blowing in the wind.  Their function is to remove particulate matter and mucus from the lungs.  The coronavirus infects and subsequently kills these cells.  This causes a buildup of fluid and mucus in the lungs in part leading to the second stage of this disease.

 

Application of Herbal Medicine in Stage 1

 

During this first stage we employ herbs that inhibit viral entry into lung cells and other herbs that inhibit viral replication.  The list of herbs we employ is quite large, however I will give a brief example of a few.

• To inhibit viral attachment, Huang Qin is a powerful herb. This medicinal binds to ACE2 receptors and competes with the coronavirus for attachment sites.

• To inhibit viral replication, Jin Yin Hua is very effective. This particular medicinal has been shown to inhibit replication of coronaviruses in the SARS family, of which COVID-19 is a member.

 

Immune Response: Stage 2

 

In the second stage of infection, the virus has gained a substantial foothold in the lungs.  As the virus hijacks the body’s cells and causes their death, these cells burst open spreading more copies of the virus.  This causes the body to mount a large immune response to the infection.  There are a variety of inflammatory chemical messengers the body produces to create an effective immune response to the infection.

For simplicity’s sake I will call this family of inflammatory messengers, “cytokines”.  These messengers create inflammation to slow the spread of the disease and to signal macrophages and T-cells to directly attack the virus.  Elderly people or immune compromised patients do not have a strong enough immune system to initiate a powerful enough response to stop the virus’s attack putting them at higher risk of complications.

In general, if the immune system fails to stop the virus, the inflammatory response becomes more severe causing the lung epithelium (surface tissue) to become more porous.  This causes interstitial fluid (fluid that our body’s cells are constantly bathed in) to leak into the lung.  This leakage is where the viral pneumonia starts.  Combine this with reduced cilia in the lung and the patient has great difficulty expectorating phlegm from the lungs.

Many patients describe this sensation as “feeling like drowning”.  The porousness of the epithelium allows the virus to penetrate deeper into subsurface lung tissues.  As the virus has access to these deeper tissues it inhibits the maturation of T cells (immune cells) by infecting the dendritic (parent) cells that produce T cells.  This results in an increased inflammatory response.  With immune cells compromised, the infection rapidly progresses at this point.  This is also where CT scans start to show fibrosis in lung tissue.

 

Application of Herbal Medicine in Stage 2

 

There are a variety of herbs that we use at this point, again, I will list only a few. 

 

  • To modulate cytokine production and reduce tissue inflammation  Dan Shen is particularly effective.
  • To clear phlegm from the lungs, one of our primary herbs is Gua Lou.
  • Finally, to limit oxygen deprivation to the lung tissues (caused by fluid buildup), we like to use adaptogens such as Rhodiola.

Again, the list of herbs we employ is very large and varies depending on the situation.  I want to be clear here.  If you are employing herbal treatment, whatever the source, this stage needs to be closely monitored.  As stage two progresses (if not stopped) there becomes a point that hospitalization is needed.  The patient we are treating for COVID-19 was in the beginning to middle of stage two.  Had the situation continued to progress we would have immediately counseled emergency care.  There is a fine line here and whomever is treating better have adequate training to know when to make this call.

 

Critical stage: Stage 3

 

This is the end stage of this disease.  At this point if inflammation is not controlled and the virus is not halted, the patient develops a condition called a “cytokine storm”.  This situation is caused by inappropriately high levels of inflammatory cytokines which cause cellular toxicity.  This occurs in the lungs and as the cytokines circulate through the bloodstream (the lung tissue is porous at this point), they also damage the spleen, liver, kidneys, blood vessels, and heart.

At this point the damage is so severe the body is beginning to shut down.  Patients are already on ventilators and organ systems are beginning to fail.  The virus has destroyed so many ACE2 receptors in the lungs that the body is failing to properly maintain water/ salt balance and blood pressure.  You may have heard reports in the media that many people are having heart attacks due to dangerously high blood pressure.  This is why that is happening.  Combined with a lack of oxygen from fluid filled lungs and extensive fibrosis, mortality becomes very high.  It is critical that treatment stops the progression of COVID-19 before this stage is reached.  At this point we are not treating anyone with herbs. The patient would have already been in the hospital for some time.

 

Final thoughts:

 

I have given a lot of information and I hope I have made it accessible to most people.  This disease is minor for most (80%) but for some (20%) it quickly becomes a life-threatening situation.  Hospitals are going to become overwhelmed as this progresses.

In light of this I suggest that you do everything you can to avoid getting to this point.  This includes:

  • Engaging in light exercise
  • Resting
  • Practicing stress reduction techniques (yoga, meditation, breathing exercises)
  • Eating healthy and nutritious meals
  • Taking immune boosting supplements and herbs
  • Social distancing
  • Frequent hand washing

I also highly recommend seeking herbal medicine from a qualified practitioner as soon as you feel any symptoms.  This is your best way to avoid ending up in a hospital.  This is not a guarantee that you won’t, but again, if you take appropriate measures you are greatly lowering your risk of hospitalization.

I have been observing other practitioners online discussing herbal formulas to combat this virus and I will be honest; I have not been impressed.  In light of this, I recommend that you seek care with a highly qualified practitioner whom you trust.  In addition, I do not recommend that you attempt to treat yourself based on what I have written.  Herbal formulas are very complex synergistic blends that are different for every individual.  Furthermore, additional considerations need to be safely made if one is taking any kind of medication.

I will continue to update everyone as we have more information and if you have any questions or would like to schedule a telephone consult please email us @

Bradley@communityacupuncture.org

Joaquina@communityacupuncture.org

or call 303-447-0443.

 

Thank you for taking the time to read this and if we’re all vigilant we will make it through these very trying times.

In good health,

Bradley & Joaquina

References:

  1. Bensky, Dan. Chineses Herbal Medicine Materia Medica, Eastland Press 3rd Ed 2004

 

  1. Buhner, Stephen Harrod. Herbal Antivirals, Storey Publishing, 2013

 

  1. Buhner, Stephen Harrod. https://www.stephenharrodbuhner.com/wp-content/uploads/2020/03/coronavirus.txt.pdf, Web, March 2020

 

  1. Deng, Aluko, Jin, Zhang, Yuan. Inhibitory activities of baicalin against renin and angiotensin-converting enzyme, https://www.ncbi.nlm.nih.gov/pubmed/22136493

 

  1. Jia, Look, Shi, Hickey, Pewe, Netland, Farzan, Wohlford-Leane, Perlman, McCray Jr. ACE2 Receptor Expression and Severe Acute Respiratory Syndrome Coronavirus Infection Depend on Differentiation of Human Airway Epitheliahttps://www.ncbi.nlm.nih.gov/pubmed/16282461,  Journal of Virology, 2005 Dec; 79(23) 14614-14621

 

  1. National Institutes of Health. https://www.nih.gov/health-information/coronavirus, March 2020

 

  1. Wang, Ma, Liu, Zhu, Guo, Tang, Li, Niu, Fu, Gao, Zhang. Salvia miltiorrhiza: A Potential Red Light to the Development of Cardiovascular Diseases, https://www.ncbi.nlm.nih.gov/pubmed/27748194, Current Pharmaceutical Design 2017 Feb; 23(7): 1077-1097
Joaquina Cante
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