Live With Dr. Leisha
The Wellness Lounge Presents
Live with Dr. Leisha
Dr. Leisha Fowler, DNP, APRN, FNP-BC, CCRN is the Medical Director of the Wellness Lounge. These notes are from our Instagram Live where we talked with her about inflammation, Covid, POTS and what you can do on a daily basis to fight these processes.
Question 1: What is Ozone Therapy?
Ozone is a type of Oxygen that is added to the system, typically through a patient’s blood. Its benefits are abounding. This treatment specifically fights inflammation caused by free radicals (the by-products of inflammation) and boosts the immune system. It can be very helpful in fighting chronic diseases.
Question 2: Tell us about Inflammatory Processes and why we’re seeing an increase in inflammatory disease and autoimmune conditions.
Inflammation is specifically designed in our bodies to jump start the immune system. In a perfect world, if you get a cut, and bacteria gets into it. The body will send out cells to either repair the damaged tissue and immune cells to the cut to help fight the bacteria that got into it. So that’s why you get that puffy, inflamed looking cut. The same is said for a virus and you feel kind of tired, and fatigued, because your body is sending out those immune cells to kill the virus. How inflammation gets out of control is with extra toxins in the environment we interact with. Mold, heavy metals, pesticides and herbicides, stress, alcohol, and being overweight - these all create additional inflammation in the body. Over time, your body can keep up in a state called compensation - however that only lasts so long. So this is where we see those chronic inflammatory diseases or symptoms like long Covid, constant sickness, and autoimmune diseases. All these are signs that inflammation is out of control.
Question 2A: Can Weight Gain be a sign that your body is overloaded with inflammation?
Absolutely. In fact when that initial weight gain is water because your body is doing whatever it can to flush whatever is causing the inflammation out.
Question 3: Let’s talk about how Covid has compounded inflammatory responses people already had before it emerged, and the long term effects that we’re now seeing from that.
A lot of individuals already had a lot of underlying inflammation. So when they caught Covid, one of the most inflammatory viruses to date that we have ever seen, they would experience what’s called a Cytokine Storm. A Cytokine Storm is basically uncontrolled inflammation in the body, causing patient’s lungs to flood, their kidneys would fail, their heart would fail, and that was toward the end of the viral stage and into the inflammatory stage of the virus. That’s when we saw a lot of patient’s hospitalized and placed on the ventilator, and why they were unfortunately unable to go off the ventilator. Now that we know more about the virus, we know it’s so important to stop it from replicating and exacerbating to that inflammatory stage by treating it in the first five days of the virus, which is the viral replication stage. By the time you get to the inflammatory stage, it’s up to your body to determine what the response to Covid will be. Those who had an initial lower inflammatory state in their body fared better than those who did have a high inflammatory state in their body, experiencing a flu-like disease compared to having to go into the hospital or maybe, unfortunately, passing away. What I would advise people now is to try and decrease your current level of inflammation in order to either avoid getting sick at all or recover quicker, and to treat your sickness early when you do get something.
Question 4: What’s the best way to treat Covid in the first five days to avoid getting to that inflammatory stage by day 6?
Everything we offer at the Wellness Lounge in terms of IV would be recommended. If you don’t feel comfortable coming in and getting a treatment, or want to treat it at home, I would recommend chelated Zinc. Any supplements or medications I recommend will be either a chelated or liposomal form, because the quality of the supplements that you get is crucial when it comes down to being absorbed and utilized by your body and not just a waste of money. 50-60 mg of chelated Zinc, I would totally recommend. There’s not one specific brand but I do have my favorites. Liposomal Vitamin C 3000-4000 mg divided a day. Everything I suggest is for adults, pediatrics would have to be a different discussion. Definitely get in some NAD, mostly this is IV or injection form. This is the best absorbed form. Glutathione is very important for your immune and liver health. Additionally, there has been quite a bit of research on nebulizing. It’s something I personally did and I’ve heard other people do. There is a formula you mix up, similar to an asthma or COPD nebulizer, where you wear a mask and it kills the virus in the upper respiratory system and into your lungs. This is particularly important in the first couple of days because any upper respiratory virus replicates in those particular areas, and slowing or stopping that replication can be very important in preventing pneumonia, bronchitis, or any lingering lung conditions.
Question 5: Can utilizing a sauna be beneficial for Covid, and honestly any inflammatory processes?
It is so important to sweat, especially on a daily basis. However you do that best is great. Sauna is definitely the easiest because you don’t have to workout. However, if you’re acutely, actually sick, I would recommend avoiding the sauna because the heat can cause the inflammation to get a little more out of control. Some patient’s have fainted in the sauna when they're sick. But in general, as often as you can I would totally recommend it or sweating in some way. The cold plunge additionally, there’s a lot of research that is showing that it can help with mitochondrial regeneration so your cells can fight those inflammatory cells, and it can be anti-aging. As your cells are aging and they realize they’re getting too old or damaged to replicate normally, then they will undergo what’s called apoptosis where the cell is eaten by macrophages and then the healthy cells are left. So cold plunge and sauna, especially in combination, can keep those healthy cells reproducing and eradicate the unhealthy cells.
Question 6: Can we talk about Long Covid and what you’re seeing accompany Long Covid, specifically starting with POTS
Not a lot of people are able to specifically pinpoint what POTS is. Postural Orthostatic Tachycardia Syndrome. So as you are changing positions from sitting to standing, standing to lying, any combination of those - within 10 minutes of those postural changes you can feel your heart racing, vertigo, palpitations, nausea, vomiting, brain fog or malaise. While you don’t have to have all these symptoms, those are what we look for when diagnosing POTS. Interestingly enough, there has been quite a bit of research associated with Covid particularly, or any significant viral illness, including vaccination for Covid that is linked to POTS. It seems to be that there is a similar pathology to Bell’s Palsy, which is also triggered by a virus or significant immune event. What happens is you get Covid or a Virus, and in the weeks to months following these symptoms emerge which is known as Long Covid. They may be in combination with other Long Covid issues, such as gut issues, IBS, joint pain. In those terms, it’s important to look at the whole picture to determine that an individual body is not responding well to all that inflammation.
Question 6A: And is this something that is often paired with Ehlers Danlos Syndrome?
I think that would be more coincidental than a correlation or a causation. A lot of individuals who have Ehlers Danlos syndrome mast cell activation syndrome and other autoimmune diseases, so it seems it’s more related to the inflammatory response being impaired and it just adds on another problem.
Question 7: What would you recommend to do if you’ve recently been diagnosed with POTS or think you have POTS?
Well first and foremost I would recommend ensuring your safety by informing someone you trust about these symptoms, because they can be serious if you stand up and pass out and then seriously hurt yourself. Make sure your Primary Care Provider is aware, and they may be able to prescribe some medications for symptom management while the underlying issue is being addressed. Secondly, for supplements or IV therapy, I would recommend a high-quality magnesium supplement. A lot of patients with POTS will have a pre-existing heart or blood pressure problem, even if it’s just a family history of these things. Adding in a quality magnesium supplement such as Magnesium Glycinate or Magnesium Stearate, those are the only two bioavailable magnesium forms. Those are incredibly helpful for treating blood pressure, especially considering the majority of Americans are deficient in magnesium, and this deficiency influences blood pressure even more than salt does. With the exception of those of African American heritage or certain Native American or Native Alaskans, where their blood pressure is going to be defined by genetics, magnesium is really going to benefit the majority of Americans to maintain or lower their blood pressure naturally. I would start with 500 mg of Magnesium Glycinate and go up from there as tolerated. In addition, I recommend Liposomal Vitamin C. Liposomal Vitamin C is a powerful antioxidant that is going to fight those free radicals, or the little “error atoms” that are sent off by inflammation. Similar to how in nuclear energy, the atoms go throughout an individual’s body looking for an extra electron, therefore causing chaos, these free radicals similarly go throughout an individual’s body and cause chaos. Free radicals cause chaos, they cause cancer, they cause genetic mutations and abnormalities in the replication of our cells. That’s why antioxidants are so important because they target the oxidation of our cells. NAD, Triniagin is one of the only brands that is absorbed by the body aside from the IV route. Liposomal Curcumin is really important in helping our body have a regulated inflammatory response. Glutathione and Alpha lipoic acid, a lot of the amino acids have the Omega 3 fatty acids, especially DHA is really important in decreasing inflammation, so I’ll have a lot of my patient’s start on a high-quality fish oil with the DHA content of it being as close to 1000 as you can get to get that anti-inflammatory benefit from it. Those are the supplements I would recommend, obviously we offer the IV form as well so your body doesn’t have to digest it and it has to go through the liver as well and you’re able to get the full benefits of them.
Question 8: Can we talk about the Gastrointestinal effects from COVID and our “gut garden” and some of the trends we’re seeing now?
Well the majority of our immune system is in the gut, as well as the majority of our neurotransmitters, so what regulates our emotions, what helps us fall asleep at night (aside from melatonin) are centralized in the gut. If our gut is messed up and we’re not absorbing nutrients or we’re absorbing things we shouldn’t be, there’s a really huge implication for the downstream effects we see as a result. So, briefly summarizing, we see depression, anxiety, difficulty sleeping, difficulty with resiliency, bloating, weight gain, difficulty with weight loss, acid reflux, heartburn, constipation, diarrhea, floaty stools, those are just the surface of issues I commonly see; issues that are exacerbated with covid, which we already addressed causes inflammation which damages the gut. To start on a microscopic level, inside our intestines we have what’s called Tight Junctions. The way I think about it is a perfectly lined cobblestone street with no imperfections, and you can just glide over it in your car. Over these tight junctions, it’s just one cell deep so it’s really thin, you have this layer of mucus that is like a Siv, so it only lets in water and the vitamins and minerals and nutrients that you need from your food. Ideally that’s how it should work. However, because it’s so thin it is easily damaged by processed food, especially things that have a lot of nitrates and preservatives, stress, alcohol, sugar, and simple carbohydrates, these all don’t feed the two bacteria in your gut that keep that layer of mucus intact, so then those Tight Junctions become loose and things start getting into your body that shouldn’t be there. So your body, in response, sends everything it can to attack these toxins and the parts of the food that’s not supposed to be getting through. That's why we see a lot of bloating and variations with stool inconsistency. And now experts are theorizing that’s what causes Crohn’s or colitis, is just that chronic over-inflammatory response, and they can actually see those changes inside your colon or small intestine depending on the condition. So, the biggest thing would be to repair your gut, repair those tight junctions and re-establish that microbiome that creates that thin mucosal layer that protects those tight junctions by decreasing intake of what destroys it. The Lounge does offer those probiotics that helps re-establish that mucosal layer and helps repair those tight junctions. And then, after repair, it’s maintenance. Continuing to eat and drink things that protect the gut And, as a result, we see a lot of those chronic issues resolve. The body starts producing more GABA, which helps you relax, which helps you sleep; more serotonin; more stomach acid which actually helps resolve acid reflux and heartburn. Contrary to popular understanding it’s less, not more, stomach acid that causes all those issues.
Question 8A: And how do those GI issues relate to Covid and the Long Covid we’re seeing?
A lot of the Long Covid symptoms are the inflammation getting out of control, so a lot of individuals will report symptoms where they’re not absorbing the nutrients from their food, so their not getting enough energy, they have chronic diarrhea, or alternating diarrhea and constipation (termed Irritable Bowel Syndrome) or persistent acid reflux. All these are just an imbalance in our body’s natural system, and they can be treated addressing the root cause which is inflammation. Occasionally there are other things going on that we do need to test for, and get an idea for someone’s symptoms to lay out a road map for what’s really going on. We generally test for mold, or parasites, or small intestinal bacterial overgrowth, all of these can play a large factor in inflammation that Covid exacerbates and that’s where we see this Long Covid emerge. What I do is I typically start a patient on an antibiotic that specifically targets the bad gut bacteria and isn’t absorbed anywhere else in the body, and helps reset the gut, so then we can reintroduce good bacteria and foods that help this good bacteria grow. That’s what I would recommend for anyone experiencing GI symptoms in general. Typically you will have had some GI symptoms before Covid that become worse after Covid.
Question 8B: How often do you have to test for GI issues or how would you recommend going about determining what your specific GI health issues might be?
It's a little bit different for everyone based on their history, based on what medications they’ve been on, the type of lifestyle they live. That’s where I start, and then based on that I like to go from where a patient is financially, because these tests can get quite expensive, so I’ll try to start at a basic level and do some lifestyle changes for a couple weeks, and if that doesn’t work that’s when I’ll encourage more of the investment into those tests just to determine what’s actually going on.
Question 9: So, moving from the GI system, let’s talk a little bit about fatty liver disease; what it is, why its increasing, etc.
So now what we’re seeing is 25% of Americans are diagnosed with Liver Disease, but based on other metabolic diseases like heart disease and diabetes, I’d say we’re actually a lot closer to 75% of Americans have undiagnosed liver. The liver is a lot like a siv, it filters through all of the blood in our body. Along with our kidneys, lungs, and bowels, it gets rid of toxins. It does so through four main pathways - the first being it gets rid of the big stuff such as medications, mold, heavy metals, etc. and it uses glutathione and NAD to target those toxins. As we get older, a lot of our detoxification pathways become less efficient. So, by the time you're 40, you're making less than half the Glutathione and NAD than you did when you were a teenager. That’s why it’s really important to eat foods or supplement with things that assist with your body creating NAD and Glutathione. So by the time you get down to the fourth pathway you’re getting to smaller toxins that get past the first. However, the issue is that the Liver does is it both stores sugar and breaks down sugar when you need it. So when you are exercising or haven’t eaten in a while, to maintain a normal blood sugar level of about 70-110 mg/dL, your liver will secrete a little sugar to ensure you don’t go hypoglycemic. So, the problem is, that many people eat too much sugar or things that your body think of as sugar, so even if you don’t eat a candy bar, but eat another simple carbohydrate like white rice, or white flour, or milk, or some cereal, your body still thinks its a candy bar, it doesn’t know the difference. Then the body will store a majority of that sugar in the liver if you don’t go automatically to the gym to work that off. One of the processes in storing that sugar will secrete uric acid, which a lot of people associate with Gout. And those goat crystals will get stuck in your liver, and those gout crystals are so tiny, but over time it can clog up the liver so that the normal functions are impaired. 50 years ago, if you went to the doctor and you got your labs run, the normal values would be half of what the normal values are for today, and the reason for that is because they’ve changed so drastically in the past decades. And the “normal” that we’re basing these lab levels at are going off an algorithm of averages, they’re not ideals, so as the population becomes more unhealthy those lab ranges will change with them. So, when someone comes to see me and their liver values are like 40, the values say their normal but the ideal level should actually be 20. The encouraging thing is that the damage can be reversed through dietary changes, and cleaning up those liver pathways through some of those supplements we talked about, because the liver is a regenerative organ. So as long as you’re eating things that don’t insult it, you can reverse that damage.
Question 9A: What are some of the reasons you believe we’re seeing this increase in fatty liver disease?
I would say the single biggest factor is diet. Our culture consumes a highly processed, high fat, high carbohydrate diet. Even in other cultures where alcohol is consumed very widely, which alcohol impacts the liver significantly, but they’re diet is better, they don’t have the same level of liver disease we do. It’s a compilation of everything we consume. While I’m not saying enjoy something here or there, I’m talking about what we’re consuming everyday. I would say it’s that 80/20 rule where 80% of what you have is clean and healthy and that remaining 20% is something your body can adjust to. As far as other things that can impact your liver, you know a lot of food that can have mold or pesticides or herbicides on them, our body can get rid of those things when it’s not excessive. The issue emerges when the liver is already compromised and then those pesticides or mold come in and wreak havoc on the body. There are certainly treatments that are available to help your liver to work more efficiently, and then it does its job; it gets rid of the mold, it gets rid of the heavy metals, it gets rid of those pesticides and herbicides. I would recommend avoiding pesticides and herbicides when you can wash them or buy organic. I would recommend not buying organic for everything because it gets expensive, but anything that doesn’t have a skin you can peel off I would recommend purchasing organic.
Question 10: What are things we can do to encourage natural detoxification in the body?
Biggest thing I would recommend is diet. I’m not talking about calories or quantity, I’m talking about quality, you want natural food. So I’d recommend googling a cookbook on an anti-inflammatory diet. And this needs to be a complete lifestyle change, I’m not talking about a fad diet, I would recommend something that you like that’s sustainable and feasible, something that you enjoy. It can be very individualized. There’s a lot of different vegetables, seeds, nuts, berries (which actually have a lot of antioxidants), and seafood like trout and salmon. The basic idea is to consume foods that you’ve prepared, not processed foods. And then I would recommend organic foods as often as you can - especially things that you can’t wash or take out of their peel. Additionally, those supplements that I talked about before - the Magnesium Glycinate, Glutathione, ALA, NAD, and Vitamin C are all super important for decreasing inflammation. I would recommend cutting out alcohol for a while initially while you’re making this change for the first 6-8 weeks. Getting 7-8 hours of sleep, and decreasing stress where you can by practicing resilience techniques for an hour or two at the end of the day. Lastly, definitely no gluten, it doesn’t matter if you have celiacs or not, because no one can process the amount of gluten that’s in the grain in the U.S., which is 10 times more than the gluten content in Europe. Gluten is actually the biggest factor in breaking apart those tight junctions and causing that bloating and gas.
Resources:
See all of Dr. Leisha’s suggested supplements here.
Lower gluten flour:
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Italian Pasta at Costco:
