A Functional Medicine Approach to Pandemics

Each of us has a chance to focus on strengthening our health and immunity to not only fight off COVID-19, but future pandemics and outbreaks.

There is now evidence that lifestyle and environmental factors can help to improve the immune response.

These factors can lend themselves to specific personalized intervention that is focused on the renewal of immune system function, as well as increased resilience.

Potentially modifiable social factors include things related to structure and behavior, including housing, transportation, communication, health care systems, politics, and economics.

What about our biology and biochemistry?

Here I would place modifiable factors like stress, environmental toxicity, diet and nutrition, physical activity, sleep, hydration, intestinal microbiome composition, and biological rhythms.

Specifically, while social and environmental factors are outside of an individuals control, biological factors are personal and therefore completely controlled by an individual.

We need to start quantifying our health, not based on symptoms or observation, but by improving the way we define “health” to include measurements of nutrient status, inflammation, glucose and insulin regulation and immune function.

This whole experience should really be a wake up call for anyone who knows they need to focus on their health and hasn't.

The truth is, if your body is strong enough to tolerate a virus, when you do get sick, the illness is mild and you won't contribute to an already burdened system.

There is strong evidence that personal factors such as diet quality, exercise, sleep, microbiome composition, and stress reduction can be significant in determining the course of HIV/AIDS in an individual who has become infected. [1, 2]

We now know that more than 20 million Americans routinely take medications that suppress the immune system and change the way the body responds to viral and bacterial infections.

In a study of lifestyle factors and the incidence of community-acquired pneumonia in men and women living in the US, it was found that smoking and weight-gain, along with reduced physical activity, were associated with increased incidence. [3]

Additionally, scientists have found that regular physical activity improves immune response to viral infections. [4]

In March 2020, a study published in the Journal of the American Medical Association titled “Association of Daily Step Count and Step Intensity with Mortality Among US Adults,” researchers found that a greater number of daily steps was significantly associated with lower all-cause mortality. [5]

It has also been reported that the Mediterranean Diet improves immune function and lowers the incidence of recurring viral respiratory infections.[6]

Vitamin and mineral content of the diet may play an important role in reducing the risk to hepatitis C viral infection. [7]

Plant foods that contain phytochemicals such as flavonoids have been found to improve immune resistance to viral infection.[8]

Finally, probiotics that help support a healthy intestinal microbiome have been reported to enhance the antiviral effects of vaccination in elderly patients, which demonstrates the important role the microbiome has in immune function. [9]

Lastly, vitamin D has also been identified to be a very important nutrient for the support of immune function. [10]

With cold and flu more prevalent during winter months, it has been suggested that this may be due to a lower level of sun exposure at that time of year, and therefore reduced vitamin D production. [11] 

Finally, a whole food multivitamin would be an important factor to consider. In 2004, the New England Journal of Medicine published a study titled, “A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality.

In this study, investigators compared supplementation consisting of multivitamins alone, vitamin A alone, or both with placebo in women in Tanzania, Africa who had HIV infection.

They found that women who were randomly assigned to receive multivitamin supplementation were less likely to have progression to advanced stages of HIV disease. These women were found to have better preservation of CD4+ T cell counts and lower viral loads. [12]

They also had lower HIV-associated illness and mortality. 

Interestingly, it was found that vitamin A appeared to reduce the effect of the other multivitamins, and vitamin A alone had some negative outcomes.