COVID-19, Cytokine Storm and the Mold-Injured or Immunocompromised Patient
In previous articles, we have discussed the inflammatory cascade of events that occurs in patients made ill by mold. More recently we have presented an illustration of “cytokine storm” and what happens in the body when attacked by the coronavirus and why people can become so ill. Thus, a question has been raised about if these inflammatory responses are similar events and, if so, whether an individual who has mold-related injury has a higher chance of severe coronavirus infection. Unfortunately, due in part to the newness of the coronavirus and the lack of published studies on its precise disease pathway in humans, there is not an easy answer to this question. Adding to the difficulty in giving a clear answer is the fact that there are many factors, including genetics, and total body load that impact the severity of any illness–mold illness, coronavirus, or otherwise.
Cytokine Storm, Both Chronic and Acute
In review, cytokine storm is the response of the body’s immune system to a foreign invader. In the case of mold-related injury, the invaders are the mycotoxins, the chemicals produced by the mold spores that enter into the system by exposure. In COVID-19, it is the coronavirus that is the invader. Both mold and viral pathogens can stimulate that same inflammatory cascade that can cause extreme reaction in the respiratory pathways and the kidneys. It does seem, however, that the progression is lower and slower in mold injured patients, likely due to the fact that the exposure is slower and more chronic. In the case of COVID-19 the virus reproduces itself extremely rapidly in the body, and initial reactions may be much more intense and acute. This is when we refer to “cytokine storm” as the release of cytokines as protective soldiers. The body’s reaction is so immense that there is massive inflammation. The immediate targets of this inflammation are the lungs, kidneys, and blood vessels, and the result can be fibrosis, inability to regulate fluid in the body and in the cells, and bleeding through damaged vessels. Mold-injured patients tend to show a slower response, and we term this CIRS, or Chronic inflammatory Response Syndrome. While similar to the body’s response to a virus as an overzealous reaction, CIRS typically causes different and more gradual symptoms which can manifest in respiratory passages, brain tissue, and hormonal systems. It is like being slowly poisoned overtime, rather than being given one enormous life-ending dose.
Immunocompromised Patients and CIRS or Cytokine Storm
Of course either of these scenarios can be much more severe in patients who are immunocompromised, and by this I mean those who do not have the normal amount of protective immune cells in their body as a result of cancer chemotherapy, HIV infection, and other medications. It has been asked if patients with other autoimmune disorders, such as lupus or rheumatoid arthritis are more at risk. There is no hard evidence that I could find that this is the case, but it would stand to reason that if medications are being used to treat these autoimmune illnesses that suppress immune function to control symptoms, then potential risk would likely be increased. That said, some of the medications used for these autoimmune disorders are the very things that are being tried to suppress the immense cytokine storm of COVID-19, namely steroids and hydroxychloroquine. Therefore, could these medications be protective in some way if patients taking them do get infected with the virus or mold spores? There is no quick “yes” or “no” answer to this question.
I believe that the answer largely depends on how much immune suppression is taking place vs. how much immune protectivity remains. If autoimmune disorders are mild and are not being medicated, then it is even possible that this upregulation of the immune system could potentially even be protective, but again, no studies are yet available to show this in the COVID epidemic. If we look at mold-related illness for answers about upregulation of the immune system being protective, we actually see things quite in reverse. Patients with mold-related illness, or who have had mold-related illness are more likely to develop autoimmune disorders, rather than vice-versa. For example, it is common for mold sufferers to be diagnosed such autoimmune diseases as Crohn’s, Hashimotos, Lyme, etc., because the chronic and heightened inflammation from the mold causes the immune system to attack the body’s own organs and tissues. As a matter of fact, many patients whose immune-aggrevating issue is the mold finally find out that mold is causing their symptoms only after being diagnosed with a more accepted and readily diagnosed autoimmune disorder. It seems backwards, but those diseases are easier to pinpoint and test for.
Are There Any Answers?
It is my opinion that the answers protecting us from both environmentally-triggered symptoms and the spread of the potentially deadly coronavirus are remarkably similar. These are things that help us to stay protected and well, or to mitigate the beginnings of either illness.
1. CLEAN AIR
For viral protection, this means AVOIDANCE! Social distancing is necessary to stay out of the air zones where droplets of viral laden vapors from coughs and sneezes are present.
For mold, make sure your home, office, car are free of mold spores and water intrusion. Discarding of mold or spore laden materials in your home is a must. Exposure to moldy belongings can make you as sick as exposure to moldy air.
2. CLEAN WATER
For both mold and viruses, drink half of your body weight in ounces daily of purified or filtered water. No chlorine, it kills good bacteria too!
3. CLEAN FOOD
Nourish your body and immune system with good quality proteins and vitamin-rich vegetables Avoid sugars, processed foods and too many refined carbohydrates.
4. EXERCISE
With the inability to go to gyms, now is the perfect time to get that home routine going. The blessing in all of this is that this can become a habit that lasts long after the viral-induced isolation is past. Exercise is also wonderful for countering the effects of inflammation-related disease. Any movement is better than none.
5. A QUIETED MIND
Meditation, prayer, gratitude journaling Whatever helps with positivity and quelling of anxiety also helps with immune system strength.
6. SUPPELEMENTS FOR PREVENTION AND STABLIZATION
Please refer to last week’s article for a full descriptive list and how to order them, as well as a rationale for why they may be helpful. There are also more mold-specific supplements that help with an overactive immune response like Sinus Defense, and those that target and treat mold in the body specifically, like Candida Rid and CitriDrops Dietary Supplement. These are also over-the-counter and can be used safely for most people.
7. NEBULIZATION FOR PREVENTION AND PROTECTION
Nebulization is a safe and effective way of rapidly introducing medications across respiratory membranes. Not only does this treat infections topically, but medications are very rapidly absorbed into the bloodstream by this method and can be nearly as potent as IV administration. The process of nebulization is where a liquid is put into a machine which turns this liquid into vapor which is breathed in through either the nose or into the lungs or both. A very common treatment in asthma and COPD, it has also become a great way to treat mold and viral illnesses.
Medical-grade hydrogen peroxide is very safe and inexpensive and has been used extensively in treating both mold and viral illnesses. 4 ml of peroxide can be put in the nebulizer and breathed as instructed in the nebulizer kit for about 15 minutes. This can be done 2 to 3 times a day.
Glutathione, an extremely important antioxidant to support liver and brain function, may also be nebulized but must be obtained by prescription from compounding pharmacies.
Remember, we are all in this together and you are not alone. I think we are all doing an excellent job at learning what we can and at supporting our families and communities through this. We should all be proud of the progress we are making in treating both of these illnesses.
Questions? Comments? Write to us below or email us at newsletter@sinusitiswellness.com.
Dr. David Brownstein teaches to dilute about 3 drops of 3% H2O2 in 5 ml of normal saline and add drops of Lugol’s Iodine (we used 3 drops of 2% Lugol’s). Perhaps the article should be edited to avoid someone using 4 ml of H2O2 as the way it is stated is to use it full strength.
Dr. David Brownstein teaches to dilute about 3 drops of 3% H2O2 in 5 ml of normal saline and add drops of Lugol’s Iodine (we used 3 drops of 2% Lugol’s). Perhaps the article should be edited to avoid someone using 4 ml of H2O2 as the way it is stated is to use it full strength.
Dear Dr. Tanner,
First, thank you so much for writing this. I have been scouring the internet hoping a physician would speak to CIRS and Covid 19 and you were the one who did!
Could you talk a little bit about how you would advise CIRS patients who’ve been diagnosed but not yet treated to think about managing family in this time? For example would you call a person with CIRS in a higher risk? Would you advise them to allow family from out of town to come visit and be in the home together?
Should CIRS patients think of themselves as needing to be extra cautious in these days until we know more about how CIRS and Covid relate? Thank you for all you do.
Thank you for your question, and after much thought am not sure I can give you an absolute answer. If the overall immune system has taken a huge blow then the susceptibility to COVID and other infections could be greater. But then again, there is some belief that the inflammatory stimulation to the cytokine system as in CIRS actually may have some protective mechanism. I think this is all so very individual and may not be the same for all CIRS patients.
I think still exerting much caution with exposure to others is in order; especially, as you mention, until we know more about the interaction and if there are general increased susceptibilities.
What concentrate (3% ?) of medical-grade hydrogen peroxide?
We always tell patients to source the hydrogen peroxide from a pharmacy so that it is pure with no additives. The percentage doesn’t necessarily matter, but it should be mixed with distilled or purified water to 1% strength for the nebulizer.