With the previous five articles in this series, we have discussed the maintenance of normal physiological functions in the body, including a strong immune system.
We all are aware of the admonitions about making claims of treating patients affected with any immune dysfunction. Those are the exclusive province of medicine. There’s no argument here, but we all can agree there is a difference between offering treatment for an infectious disorder and recognizing the comorbidities that may exist in patients that make them more vulnerable to pathogens. My purpose in writing these articles is to point out the early warning signs that may appear in patients who may not know they are prone to infection.
In my previous article, I talked about how viruses enter the body and the ability to detect early deviations from normal function that occur when they attempt to do so. I discussed how stomach acid provides limited immune protection against bacteria entering the body. I presented how the digestive system is stressed and produces symptoms of energy deficiencies caused by inadequate digestion of macronutrients, particularly the impact and frequently overlooked consequences of inadequate and blocked gastric digestion. How many of your patients take PPIs or H2 blockers?
Next, I presented the role of the protective mucosal lining of not only the digestive tract but also the respiratory, urinary tract, and uterus, which also have mucosal linings. Viruses must first penetrate those linings to enter the body. I refer you to my last article, if need be, before proceeding with this article.
“Scientists Suggest COVID-19 Should Be Treated as an Acute Inflammatory Disease” was the title of a study a team of scientists conducted at Virginia Commonwealth University and published on August 5,2020, in the Journal of Immunology. We all know the symptoms of any inflammatory response anywhere in the body include the appearance of heat or fever, redness, swelling, pain, and involuntary muscle contractions in those muscles that share a peripheral nerve innervation with the involved visceral tissue. So do you have patients with those symptoms in the gastrointestinal tract, urinary tract, or uterus? If so, they apparently are just as susceptible to any virus, like those with respiratory symptoms.
For this study, scientists performed a comprehensive analysis of worldwide COVID-19 data to identify key strategies for moving forward to develop effective therapeutics. They suggested that COVID-19 should be treated as an acute inflammatory disease and that the severity of infection is associated with the dysregulation of inflammatory immune responses and the subsequent inability to develop protective immunity from the virus.
In response to injury or infection, the immune system will normally react with an immediate inflammatory response to limit the infection and help develop a long-lasting, protective immunity against the virus within 7 to 10 days following infection. However, when inflammation is not modulated or resolved after serving it's purpose, it becomes chronic and results in the inhibition of adaptive immune responses, tissue damage, or organ failure, as evidenced in many cases of the novel coronavirus.
Please recall that my only point here is recognizing the possibility that otherwise so-called “healthy patients” have a viral infection when the protective mucosal lining in the gastrointestinal and urinary tracts, as well as respiratory tract and uterus, is inflamed.
I want to cite one more study for your perusal that may not have received the attention it deserves, in my opinion. This study found a strong link between abnormal liver tests and poor COVID-19 outcomes. It was performed at Yale University and published in the August 7, 2020, issue of the journal Hepatology. Researchers found that patients with COVID-19 presented with abnormal liver tests at much higher rates than suggested by earlier studies. They also discovered that higher levels of liver enzymes (proteins released when the liver is damaged) were associated with poorer outcomes for these patients, including ICU admission, mechanical ventilation, and death.
The researchers looked at 1,827 COVID-19 patients and found the incidence of abnormal liver tests was between 41.6% and 83.4% of patients, depending on the specific test. They examined five liver tests, looking at factors such as elevations in aspartate aminotransferase (AST) and alanine transaminase (ALT), which indicate liver cell inflammation; an increase in bilirubin, which indicates liver dysfunction; and increased levels of alkaline phosphatase (ALP), which may indicate inflammation of bile ducts.
So-called “liver enzymes” indicate inflammation or damage to other cells, not just the liver. Inflamed or injured cells leak higher-than-normal amounts of certain chemicals, including enzymes, into the bloodstream, which elevates the following enzymes on blood tests:
• Alanine transaminase (ALT)
• Aspartate transaminase (AST)
• Alkaline phosphatase (ALP)
• Gamma-glutamyl transpeptidase (GGT)
Also, recall that the body’s inflammatory response has two phases. The second phase occurs as the tissue damage is repaired and the enzyme levels slowly return to normal. Of course, the body requires protein to repair tissues, not carbohydrates or lipids. Therefore, the patient will need adequate protein ingestion, digestion, absorption, and liver function to restore normal physiologic function and health.
Because the Yale researchers had access to patients’ health records, they were also able to look at their liver tests before being diagnosed with COVID-19. Approximately one-quarter of patients in the study had abnormal liver tests before being admitted for the virus. In the U.S., close to one-third of people have fatty liver disease, and several million people have chronic hepatitis B or C. These scientists speculated that U.S. patients might have an increased rate of other risk factors, such as alcoholic or nonalcoholic fatty liver disease.
Regardless of whether patients went to the hospital with existing liver problems or developed them during their COVID-19-related hospitalization, a strong association was observed between abnormal liver tests and the severity of the COVID-19 cases. One wonders what the percentage would be in your practice.
In conclusion, I suggest that the problem with gut health goes beyond COVID-19. Once the pandemic passes, the world will still have to reckon with chronic diseases and other problems associated with poor gut health. I believe the chiropractic profession can offer early recognition of problems with digestive health that are not presently well known. It’s all about maintaining health and preventing disease.
As always, I invite your comments and questions. You can email me at [email protected].
Dr. Howard F. Loomis Jr. has an extensive background in food enzyme nutrition. He is the president of the Food Enzyme Institute. The Food Enzyme Institute offers inperson and online seminars to healthcare practitioners around the country. Dr. Loomis published Enzymes: The Key to Health in 1999, The Enzyme Advantage in 2015, and The Enzyme Advantage for Women in 2016. His latest book, What Is Your Nutritional Deficiency?: Find It, Fix It, and Feel Better! was published in 2019. Contact info: 478 Commerce Dr. Suite 201, Madison, Wl 53719, [email protected], 800-662-2630.
