Facing and Addressing Fragility

COVID-19 officially became a pandemic on March 11, 2020.

And absolutely nothing in our lives has been the same ever since.

The World Health Organization (WHO) had been monitoring the novel coronavirus since early January, when a cluster of pneumonia cases in Wuhan, Hubei Province, China was reported.

Past experiences with infectious respiratory viruses such as SARS and MERS informed decision-making in the weeks that preceded the declaration of a public health emergency, but nothing could have prepared the world for what was going to occur.

Two factors were of high concern: spread and severity.

These concerns proved justified but personally, I have never feared (whether for myself or my family) or developed anxiety over them.

Why? Because I’m not fragile and I understand my own and my families vulnerabilities. Most humans unfortunately, could not – and currently cannot say the same.

Quite the opposite – I feared the amount of fear and anxiety that this virus would cause globally, more than the harm and damage to individuals.

As of July 11, 2020, 12.5 Million cases of COVID-19 have been confirmed, with 560,000 deaths.

This means COVID19 currently has a 0.04% fatality rate suggesting you have a higher chance of dying from a car accident than this virus.

What has become clear however, is that there are significant differences among people in terms of both risk to infection and – if infected – the severity of the disease. So like all things in health – it depends.

This is because SARSCOV2/COVID-19 brings out the hidden vulnerabilities that humans are currently walking around with.

The Lancet, a highly respected professional journal, published the first international medical report about COVID-19 infection in Wuhan, China on February 15, 2020, and this article indicated that the infection was associated with acute respiratory symptoms and many other complex medical problems.[1]

A March 2020 follow-up study, also in Lancet, discussed the clinical course of the infection and risk factors associated with mortality.[2] Specifically, they looked at how preexisting health conditions might increase the risk for COVID-19 complications.

The researchers noted that older age, hypertension, obesity, and diabetes were all associated with increased disease severity.

As the virus spread, so too did support for this finding. From Seattle to New York, patients with COVID-19 did worse when comorbidities were present.[3],[4]

Why do some people fare so poorly while others have only mild symptoms? Because COVID19 is not a big, bad scary virus that kills everything it comes into contact with, but a virus that when tied to the functional status of a person’s immune system, reveals that individuals fragility.

Because COVID19 is not a big, bad scary virus that kills everything it comes into contact with, buta virus that, when tied to the functional status of a person’s immune system and health status, reveals that individuals fragility.

Chronic Health Conditions and Altered Immune Function

Certain chronic health conditions, including the pre-existing health conditions mentioned above, result in altered immune system function, which can include unhealthy forms of inflammation.

Not only does an infection of COVID19 cause increased levels of inflammation, but we also know this virus can impact the function of many critical organ systems.

Respiratory, cardiovascular, neurological, gastrointestinal, renal, and hepatic performance are all associated with alteration in immune system function.

Inflammation is a hallmark of immune system dysfunction and is also strongly associated with COVID-19 infection.

This is exactly what a cytokine storm is all about. A cytokine storm results when there is a breakdown in control of the immune system. An overwhelming inflammatory response takes place in the body, similar to a septic shock event.

This means that we have to be thinking about how our immune systems become dysfunction in the first place, what pre-existing health conditions we have knowingly or unknowingly and what are connections between this virus and its impact on our body.

How many humans had altered immune function prior to 2020?

How many humans had cardiovascular disease, metabolic syndrome, pre-diabetes or diabetes, allergies and immune intolerance prior to 2020?

What happens when the world’s most prevalent non-communicable health conditions (all mentioned above) and a highly infectious viral disease collide?

We find ourselves not only in a cytokine storm, but shit-storm of new realities and frustrations: a COVID-19 pandemic that is really nothing other than a reality check of how unhealthy most people are.

chronic health conditions and immune function

Basic Immune Function

While medicine is concerned with studying and fighting disease, Chiropractic and Functional Medicine are concerned with studying health and strengthening the body to suit its environment.

Chiropractic and Functional Medicine are concerned with studying health and strengthening the body to suit its environment.

This article is not intended to teach you everything you need to know about immune function and how to optimize it.

But I do want you to understand that our immune system has two primary pillars:

The Innate Immune System and Adaptive Immune System.

Innate Immunity is the first line defense system that all humans have in common. It consists of the first line barriers that prevent the outside world from harming the insides of our body.

The primary barriers include:

Blood Brain Barrier (brain health)Nasopharynx Barrier (sinuses, mucus membrane health)Pulmonary Barrier (lung and respiratory health)Intestinal Barrier (digestive health)

The innate immune system consists of our skin (which protects our insides), the digestive tract (which prevents bad stuff from passing through our mouth and into our body), the mucus membranes and enzymes in our nose, mouth, ears and any other orifice, the lungs (to protect you from things you breathe) and even our blood brain barrier.

If you have digestive issues – you could have problems with your intestinal barrier.If you have unresolved allergies, chronic sinus infections or post-nasal drop – you could have nasopharynx barrier problems.If you have asthma, respiratory distress or breathing issues – you could have pulmonary barrier problems.If you have cognitive problem, depression, anxiety or memory lapse – you could have blood brain barrier issues.

See how that works? Now it’s important to understand that the innate immune system has nothing to do with previous infections or vaccinations. This means a vaccine won’t protect you from unresolved barrier dysfunctions.

Previous infections, childhood traumas, emotional health or the health of your momma’s pregnancy all have an impact on our adaptive immune system.

So the adaptive immune system is not something we all share, but is highly individualized and personalized based on our individual life experiences.

The adaptive immune system has a memory of our life and works to respond based on previous experiences. Sometimes our past experience can prime our immune system to help us, but sometimes our past experience can also cause our immune system to become overactive and dysfunctional (autoimmunity, allergies, asthma, food sensitivities, etc.)

Either way, both of these systems are controlled by the Nervous System.

Immune Function and Chiropractic

A 2005 basic science review of chiropractic summarized the state of the science in several areas including the nervous system response to chiropractic spinal manipulation.

The review confirmed that between 1997 and 2005 the basic science body of evidence confirming a relationship between chiropractic spinal manipulation and the central nervous system.

They concluded, basic science studies support chiropractic theory that spinal subluxation and spinal manipulation impact neurologic function.

These studies suggest mechanisms by which spinal influences may mediate a clinically significant impact on immune function [6]

The nervous system and immune system cross-talk with each other.

“Considerable evidence has mounted to support active communication between the nervous system and the immune system. The nervous system, including the brain and the peripheral divisions can either stimulate or inhibit various activities of both the innate and adaptive immune systems.” [7]

Several excellent reviews have addressed the subjects of nervous and immune system “cross-talk” in great detail.

Very recently, however, several peptides, recognized initially for their neural or neuro-hormone signaling functions have been shown to exhibit potent antimicrobial activity.

This discovery signals the possibility that the nervous system, through utilization of these peptides, has the capacity to deliver anti-infective agents directly to innervated sites localized with great spatial specificity and delivered rapidly.

A 2018 article reporting on the study design of a clinical trial designed to provide knowledge regarding the underlying mechanisms of the effects of Chiropractic Adjustments provided the following analysis of the evidence:

Chiropractic care including spinal manipulative therapy (SMT) has been found to be a safe, effective and cost-effective non-invasive treatment for some types of spinal pain. SMT has both local and regional pain reducing effects as well as central nervous system effects such as a general reduction of pain sensitivity. SMT is thought to decrease pain by mechanically affecting muscular and joint function (i.e. normalizing muscle tone and improving joint mobility). However, recent experimental research has suggested that SMT may also be influencing the incoming/ascending pain signals (local nociceptive input affecting dorsal horn excitability or temporal summation) and/or the excitability of the central pain regulating mechanisms. A systematic review concluded that short-term sympathetic upregulation can be found with SMT, regardless of the spinal area being treated. This raises the question of whether the pain reducing effect of SMT is associated with a modulation of autonomic nervous system (ANS) activity.”[8]

What we are seeing is that Chiropractic Adjustments do so much more than just help with pain.

Chiropractic Adjustments may modulate the immune system by way of nervous system activation.

5 Studies on Chiropractic and Immune Function

Neuroimmunomodulation and a Possible Correlation with Musculoskeletal System Function. [9]

“There is an increasing body of evidence that the nervous system is capable of modulating the immune response. Receptors for neuromodulators and

neurohormones have been found on human T lymphocytes. Activation of these receptors can be stimulatory or inhibitory depending on the neuroactive substance. The immune system may be able to communicate with the nervous system using neuromodulators and neurohormones secreted by lymphocytes. Sympathetic innervation of lymphoid tissues is not restricted to blood vessels and smooth muscle, but directly supplies lymphocytes and blood precursor cells. It is theorized that spinal fixations may adversely affect the immune response through somatosympathetic reflexes. Spinal manipulation can correct the spinal fixations and may eliminate the adverse effects of somatosympathetic reflexes.”

A Literature Review sought to determine the effects of spinal manipulation on biochemical markers in humans and establish the level of evidence for changes in biochemical biomarkers. [10]

Spinal Manipulation (SM), defined as a high-velocity, lowamplitude thrust technique. Among the outcome measured sought were neuropeptides (neurotensin, oxytocin, SP) (2) inflammatory (TNF, IL) and (3) endocrine (cortisol, epinephrine, nor-epinephrine, leutinizing hormone) biomarkers from any body fluids

(blood/urine/saliva). After removal of duplications, 1217 citations were screened. That was culled down to 96 abstracts screened, 45 full-text articles were assessed for eligibility. And a total of 8 trials included in the review.The review found the studies varied in study design, quality, and outcomes. The conclusion after the review was that a moderate level of evidence existed in the eight studies which found that spinal manipulation influences various biomarkers typically identified as ones not only involved in pain perception/modulation but also play an important role in inflammation, tissue healing and immune response. Studies in the review found that Spinal Manipulation influences various biochemical markers. Spinal Manipulation can increase Substance P, neurotensin, oxytocin and interleukin levels and may influence cortisol levels post-intervention.

Low Back Pain and the Production of Chemokines. [11]

Researchers documented significant differences existing in the levels of the studied chemokines between low back pain patients and the asymptomatic controls.

Several of the chemokines studied were significantly augmented in acute low back pain patients when compared to the control patients. The production of one of the measured chemokines, CCL4, was significantly higher in the acute low back pain patients than the chronic low back pain patients at baseline, while the other measurements were not significantly different.

Spinal Manipulation effect on interleukin-2 production. [12]

The study measured the effect of spinal manipulation on selected parameters of the immune response. The study had three arms – the control group, a group that received spinal manipulation with cavitation (the audible release); and spinal manipulation without cavitation. The goal was to gather knowledge not only on the immune response, but also to determine if cavitation provides a measurable difference in outcomes. The outcomes of the study included a statistically significant increase in the production of IL-2 in both of the arms of the study in which patients received spinal manipulation relative to baseline and to the control group at 20 minutes post adjustment. An increase in IL-2 was also found 2 hours later. There were no differences between the two adjustments arms, meaning that cavitation did not appear to change the outcomes. In this study as with many others, the authors state, “the biological mechanisms associated with spinal manipulation are poorly understood.” The authors also stated that earlier studies have demonstrated increased activity of the innate immune response components following a single spinal manipulation. The authors concluded that a single high velocity, low amplitude thrust to the thoracic spine of asymptomatic subjects causes a significant enhancement in IL-2 secretion in vitro.

Spinal Manipulative Thrust Reduces Inflammatory Cytokines. [13]

In a study of 64 asymptomatic subjects, were separated into three arms of the study, one to receive a single adjustment of the thoracic spine. The second group was a sham manipulation and the third was a venipuncture control. The authors stated, “the present study supports the hypothesis that the spinovisceral reflex effect can encompass functional activity of the immune system. We believe this to be the first report to demonstrate that a single manipulative thrust to an aberrant vertebral motion segment in the upper thoracic spine of asymptomatic subjects results in downregulation of the capacity of human leukocytes for the production of proinflammatory cytokines induced by lipopolysaccharide (LPS)- induced inflammatory response in invitro, in control subjects submitted to multiple venipunctures, became augmented.” The authors concluded there is a time dependent attenuation of LPS-induced production of the inflammatory cytokines unrelated to systemic levels of Substance P after spinal manipulative thrust. The central mechanism of action was not known.

In Summary

Chiropractic is a health care discipline which emphasizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery.

The practice of chiropractic focuses on the relationship between structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health.

It is founded upon the principle that the body’s innate recuperative power is affected by and integrated through the nervous system.

The current global health crisis surrounding the COVID-19 Pandemic has resulted in changes in our everyday lives and has created increased levels of stress and anxiety, and fear.

Scientific evidence has validated that long-term exposure to stress negatively effects the immune system.

As an essential health care provider, Family Health Chiropractic is in a unique position to assist its patients during this time of heightened stress.

Although there are no clinical trials to substantiate a direct causal relationship between the chiropractic adjustment and increased protection from the COVID-19 virus, there is a growing body of evidence that there is a relationship between the nervous system and the immune system.

Get Adjusted.

The post COVID19, Immune Function and Chiropractic appeared first on Family Health Chiropractic.

By: Dr. Daniel Gonzalez
Title: COVID19, Immune Function and Chiropractic
Sourced From: familyhealthchiropractic.com/covid19-immune-function-and-chiropractic/
Published Date: Sat, 11 Jul 2020 21:34:56 +0000