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Using Melatonin to Fight COVID-19

If you’ve been keeping up with my blogs this year, you may have learned that coronaviruses (i.e. what causes the common cold and the novel SARS-CoV-2 or “COVID-19” infection) are RNA viruses that infect both humans and animals with their main focus of damage on the respiratory, gastrointestinal, and central nervous systems (Cui et al., 2019). 

You may have also learned that we’ve faced adversity before during two separate, but related, coronavirus epidemics:  Severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Although they were not as infectious or lethal as COVID-19, these past public health events nevertheless caused thousands of deaths in their own right. 

The outbreak in Wuhan, China certainly rocked our world in 2020, and although antiviral therapy, corticosteroid therapy, and mechanical respiratory support have been applied to treat those infected, there is a lack of targeted treatments for COVID-19 (Huang et al., 2020) which actually works. Hence, there is a TON of interest in finding resources already available to us which can both prevent the infection and accelerate its recovery process. And one of those is the Anti-inflammatory Melatonin, the hormone released by the pineal gland inside of the brain which regulates our sleep–wake cycle.

Melatonin (scientific name N-acetyl-5-methoxytryptamine) is a bioactive molecule with a wide variety of health-promoting properties. There is unquestionable evidence today which indicates that melatonin is critical for both supporting optimal human physiology, for preventing and fighting infections, like COVID-19.

 

What’s the Rationale for Melatonin Use?

Based on genetic homology and pathologic features of the infected lung, most scientists agree that the cytokine storm likely rages on in patients infected with COVID-19Read more about that in a previous post

What I see all the time in practice is now being confirmed in the scientific literature. Recent studies highlight that in some COVID-19 patients (although being negative for the viral nucleic acid test), can still present with marked inflammation. This is why we see that clinical trials which use certolizumab pegol (a powerful tumor necrosis factor (TNF) cytokine blocker), along with other anti-virus therapies, have beneficial effects in COVID-19 patients. 

Thus, excessive inflammation, depressed immune system function, and an activated cytokine storm all substantially contribute to the pathogenesis of COVID-19 and serious consequences from infection.

In the beginning stages of coronavirus infections, dendritic cells and epithelial cells are altered of the encroaching infection and pump out a cluster of pro-inflammatory cytokines and chemokines including IL-1β, IL-2, IL-6, IL-8, both IFN-α/β, TNF, CeC motif chemokine 3 (CCL3), CCL5, CCL2, and IP-10, etc.

Once more, these are under complete control of the immune system, and overproduction of these cytokines and chemokines contributes to the development of disease (Cheung et al., 2005; Law et al., 2005; Chu et al., 2016). Our body is doing the damage with the molecules produced above.

Note, IL-10, produced by T-helper-2 (Th2), is actually a helpful cytokine we want because it is antiviral, but it appears that an infection of coronaviruses leads to a decrease in this cytokine (Chien et al., 2006; Fehr et al., 2016). Interestingly, COVID-19 patients can have a rise in the level of IL-10 floating around (Huang et al., 2020); whether this is a hallmark of COVID-19 infection or the result of medical treatment is to be determined.

In theory, the amplification of the inflammatory response would drive cellular apoptosis or necrosis of the affected cells, which would further intensify inflammation, followed by increasing permeability of blood vessels and the aberrant accumulation of inflammatory monocytes, macrophages, and neutrophils in the lung alveoli (Channappanavar et al., 2016). 

Bottom line:  The vicious cycle intensifies the situation as the regulation and balance of immune response is lost and the cytokine storm is further activated. This results in dire consequences.

The cytokine storm pathology associated with coronaviruses is well supported by experimental SARS-CoV models. In fact, one research team found that the severity of ALI was accompanied with an increased expression of inflammation-related genes rather than increased viral titers (Channappanavar et al., 2016).

This means that the virus was less damaging than the cytokines made by immune cells. Talk about some power we possess! And in another report, the elimination of IFN-α/β receptors or the depletion of inflammatory monocytes/macrophages lead to a significant rise in the survival rate of coronaviruses host without a change in viral load (Smits et al., 2010). 

Both of the aforementioned situations point to a potential amplifying mechanism involved in CoV-induced ALI/ARDS, regardless of the viral load. If a similar pathology also exists in COVID-19, which it likely does, then the attenuation of the cytokine storm by targeting several key steps in the process could bring about improved outcomes. This is where melatonin comes in.

Check back next week as I will dive further into melatonin’s anti-inflammatory, anti-oxidative, and immunomodulatory role in health and illness. And the following week I will talk about how to put all of this information into practice, as well as other supportive adjuvant agents. I promise it’s simpler than you think. Until then, rest up!



Dr. Bhandari and the Advanced Health Team Are Here to Support Your Health.

Our expert team of integrative holistic practitioners work with patients suffering from chronic health concerns.  We help our patients reverse disease by better understanding how the body optimally functions and providing personalized treatment plans. To learn more and book an appointment, contact Advanced Health or call 1-415-506-9393.



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Author
Payal Bhandari M.D. Dr. Payal Bhandari M.D. Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of San Francisco' top ranked medical center, SF Advanced Health. Her well-experienced holistic healthcare team collaborates together to deliver whole-person personalized care and combines the best in Western and Eastern medicine. By being an expert of cell function, Dr. Bhandari defines the root cause of illness and is able to subside any disease within weeks to months. She specializes in cancer prevention and reversal, digestive & autoimmune disorders. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to www.sfadvancedhealth.com.

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