What is Cytokine Storm?
There are many coronaviruses but only seven or so are known to infect people. The first one that raised serious international concern was the SARS (Sudden Acute Respiratory Syndrome) in 2002. This new, very close relative to SARS called SARS-CoV2 has caused a worldwide pandemic and is a far more aggressive pathogen than its original cousin. An analysis of the first 75,000 who were infected found that it has a mortality rate of 2.3%, making it 23 times more fatal than seasonal flu infections. There is rapid deterioration of the lungs in some COVID-19 patients, and no one is safe. Even young patients who don’t have other comorbidities can be affected. It is called the cytokine storm.
Cytokine Storm is what happens when your immune system overreacts and puts you in a very vulnerable position.
A coronavirus such as SARS-CoV-2 can be deadly because of its ability to stimulate a part of the innate immune response called the inflammasome, which can cause uncontrolled release of pro-inflammatory cytokines, leading to cytokine storm and severe, sometimes irreversible, damage to respiratory epithelium. Another name for cytokine storm is macrophage activation syndrome. A macrophage is a white blood cell. A cytokine storm typically occurs when someone’s immune system is weak, they have a genetic weakness toward this condition, or they have predisposing medical conditions like heart disease, diabetes, hypertension, autoimmune conditions, and obesity.
A cytokine is a communication messenger. It signals the cells to do certain things. When the virus invades a cell, the cell sends out these messages to let the immune system know there is a problem. This is why a huge inflammatory reaction can occur. If it happens in the lungs, there can be destruction in the lungs. The cytokines basically tell your “soldiers” to fight. A severe immune reaction, leading to the secretion of too many cytokines into the bloodstream, can be harmful because an excess of immune cells can attack healthy tissue as well.
This little understood phenomenon is thought to occur in several types of infections and autoimmune conditions, but it appears to be particularly relevant in outbreaks of new flu variants. Cytokine storm is now seen as a likely major cause of mortality in the 1918–20 Spanish flu, which killed more than 50 million people worldwide, as well as the H1N1 swine flu and H5N1 bird flu of recent years. In these epidemics, the patients most likely to die were relatively young adults with apparently strong immune reactions to the infection, whereas ordinary seasonal flu epidemics disproportionately affect the very young and the elderly.
Increased pro-inflammatory cytokine responses against human coronaviruses such as SARS-CoV-1 (the cause of SARS), SARS-CoV-2 (the cause of COVID-19), and MERS can result in acute lung injury and acute respiratory distress syndrome (ARDS). The cytokine storm occurring in COVID-19 seems to affect the patient about 7 to 9 days into the illness, with the patient struggling through the first week, starting to feel better, and then suddenly crashing. According to Dr. Bhatraju, an assistant professor at the University of Washington who works in the ICU at Harborview Medical Center in Seattle, “We’ve seen some patients rapidly worsen. They initially were just requiring a little bit of oxygen. In twenty four hours they’re on a ventilator.”
How Can Nutrition Help Support Your Immune System?
Nutrition can help the immune system stay balanced and strong and help stave off disease and potentially fatal cytokine storms. In order to do this, we must first understand the immune system. There are two parts of the immune system that fight infection. One part is called the “innate immune system” and the other is called the “acquired immune system.” The innate immune system fights new pathogens the body hasn’t seen before, like COVID-19. The acquired immune system includes cells and antibodies primed to fight infections that the immune system has learned to fight.
When fighting COVID-19, the innate immune system acts first. The innate immune system is composed of barriers like our skin and mucous membranes like those in the nose. It includes various types of immune cells like natural killer cells (NK), dendritic cells, macrophages, phagocytes, and mast cells. Some of the innate immune cells produce protein virus and bacteria germ killers.
These lifestyle pointers support our innate immune system:
- Get enough sleep, 7–9 hours per night; rest is a must for your immune “soldiers.”
- Keep hydrated with drinking water with adequate electrolytes to move that water inside the cells.
- Move your body often and sweat a little with exercise, a minimum of 30–40 minutes a day 3–4 times a week.
- Last but not least, keep your stress level down with breathing exercises, meditation, counseling, and yoga to help keep your immune system strong. Emotional, mental, and physical stressors can weaken and in some cases destroy the immune system, leaving us vulnerable to attacks from pathogens like COVID-19.
Supplements that can boost and support the innate immune system include:
Probiotics (preferably ones with a prebiotic) appear to prime most innate immune cells. Beware of gummies or yogurts for they generally contain a higher sugar content, which can adversely affect your microbiome and thus your immune system.
Vitamin A regulates the immune system and supports the mucous membranes that act as a barrier to pathogens.
Vitamin D3 modulates the immune system, prevents excess inflammation, helps macrophages kill germs, and increases antimicrobial proteins that kill germs. Evidence suggests that supplementation may prevent upper respiratory infections.
Glutathione appears to support immune cells, best taken in the liposomal form for best absorption. You can take NAC (N-acetyl-cysteine), which is a precursor to glutathione.
How Can Nutrition Help Prevent Cytokine Storm?
People die from COVID-19 due to Acute Respiratory Distress Syndrome (ARDS). In this condition, the infection triggers the immune system to release very high levels of inflammatory cytokines. These excessive levels damage the lung tissue, leading to death.
These supplements may help prevent cytokine storm:
Cytokine production is controlled by a cellular genetic messenger. The herbs quercetin and curcumin block this messenger, leading to lower cytokines. Antioxidants like liposomal glutathione lower cytokines acutely. It is also possible to turn on a cell messenger that increases the cell production of antioxidants. Curcumin and quercetin turn on this cell messenger. Another way to limit cytokine production is to block kinase enzymes. Quercetin is a strong kinase inhibitor.
Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and acquired immune systems. Supplementation appears to be able both to prevent and to treat respiratory and systemic infections.
Zinc blocks the enzyme that controls virus replication inside infected cells. Zinc is an ion and it can’t get through cellular membranes without a transporter. Hydroxychloroquine is an ionophore that helps carry zinc into cells. Taking zinc supplements without an ionophore is not very helpful. Another zinc ionophore that is shown to help in laboratory studies is the supplement quercetin. One study suggests quercetin is most effective in decreasing coronavirus infectivity if the cells are treated with quercetin before they are infected.
Keep in mind that not all supplements are created equal — buying cheap could cost you more in the long run. You need products that your body can absorb in order for you to reap the benefits. Choose quality over quantity. Choose pharmaceutical grade products that leave out dangerous binders, fillers, and added junk like gluten, soy, sugar, wheat, and dairy that may contribute to other health conditions. We are living in a world filled with toxins and harmful free radicals damaging our cells and tissues — we don’t need more damage to the only bodies we have.
Cytokine storms are not unique to COVID-19, and treating patients can be tricky. On the one hand you want the immune system to fight the virus. On the other hand, you don’t want the immune system to go into overdrive. There are many theories on why this phenomenon occurs. One is that the virus continues to replicate despite the immune response. Scientists don’t have all the answers yet, but we can at least support our bodies’ natural defenses to prepare for what is to come.
If you need guidance on choosing the right nutritional supplements and dosing based on your individual need, please call us at TLC Medical Centre Pharmacy and we’ll be glad to help. If you would like assistance in figuring out what you need based on your medical conditions and the medications and supplements you are already taking, please make an appointment with our integrative and functional pharmacist Zoom Heaton for a comprehensive assessment based on your medical history, labs, medications, and personal health goals.
