In this episode, I am speaking with Miriam Rahav, MD- who is a triple board-certified physician in the fields of internal medicine, hospice and palliative medicine, and functional medicine. Dr. Rahav is currently working in the front-lines, successfully treating patients with COVID-19. We will discuss the functional medicine approach to treating COVID-19 and what you can do to improve your immune system from home.
Table of Contents
In this podcast, Dr. Rahav will Cover:
- Her experience in treating patients with Coronavirus and how it differs from the common flu
- The unspoken pressure on health professionals during this crisis
- The essential role media plays in the communication about this pandemic and why you should question their motives and potential biases
- Does hydroxychloroquine work in treating COVID-19?
- Will a change in legislation make a difference in the overall public health?
- The best tips for boosting the immune system and preventing severe viral infections
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Transcript
Ari: Hey everyone, welcome back to The Energy Blueprint podcast. I’m your host Ari Whitten and today I have with me Dr. Miriam Rahav, who is a Triple Board certified physician in the fields of internal medicine, hospice and palliative medicine and functional medicine. That sounds like 15 years of training [laughs] or something really remarkable. Dr. Rahav is also certified in acupuncture through the Tri-State school of acupuncture. As if all of her past training is not enough, she’s currently training in a diagnostic and treatment modality called Autonomic Response Testing through the Klinghardt Academy.
Yesterday actually, on Facebook, she made a post and tagged me and a group of 20 or so other people in the health space and doctors and other people with a platform who are health experts. She shared some really fascinating stuff. She is a doctor on the frontlines treating people with coronavirus and she’s doing it with some really novel therapies beyond just kind of what’s going on in standard conventional hospitals.
She’s really experimenting with some stuff based on logical speculation on some of the mechanisms of action of how some of these things might work, and they’re getting great results. The goal of this podcast and of this conversation is really just for her to share what she’s been doing and hopefully advance the state of care, maybe have people do some research on some of these things and advance the state of care as far as what these patients are receiving. Hopefully we can help find more effective treatment protocols.
Welcome to the show Dr. Rahav, such a pleasure to have you.
Dr. Rahav: Thank you so much Ari. Thank you so much for being there and being a voice spreading information, like empowerment and information. It’s really exciting to be asked and I’m very honoured to be asked to share my experience with you and your listenership today.
Ari: Awesome. Well, it’s my pleasure and the honor is mine. In that vein, I want to say, I mentioned this to you before we started recording just how courageous it is, I think, for all of these practitioners to be on the frontlines treating this, knowingly exposing yourself to patients who have this virus and doing it in a way where you’re being exposed to very high viral loads. You’re being exposed to a lot of the virus potentially, which makes it actually much more deadly.
I just want to applaud you and thank you for that work. I think it’s amazingly important and heroic. Thank you for the work you’re doing. Before we even get into any of the questions, I just want to express that.
Dr. Rahav: Thank you so much. I thank you for that. I also want to give a shoutout to all my brothers and sisters in arms, in healthcare providers across the continuum of healthcare providers, all those people who trained with me and supported me, all the nursing and all the transporters and all the phlebotomists and everyone who made my life brighter and better. They’re all in hospital.
I think differently from what I’m about to share with you are not necessarily kind of armed with the same tools that we hold within the integrative and functional medicine space. I want to share that we in the functional Integrative Medicine space, I’m standing on the shoulders of so many giants in medicine who have created these treatment protocols, who have experimented with ozone and with IV vitamin C and with IV hydrogen peroxide and all these tools that we know and have tested previously to be strong antiviral tools.
I feel like I’ve honed my clinical skill around viral illness for many years and so that when this clearly became a clinical entity that we would be grappling with, me and my team felt like we were prepared. I think there are nuances to this particular clinical entity which we can go into, but overall, we feel like, not with hubris, but to a certain extent like, we’ve been here to some extent and therefore, we can do this. We needed to prove it to ourselves, of course, and then we are proving it to ourselves. I feel like our sense that it would be possible to address this effectively and then actually address it effectively so far and I can talk about caveats and nuances within that.
I think that’s different from what’s happening in hospital medicine, where my colleagues are actually affected, where they’re actually infected, where they’re actually dying right alongside the humans that they’re treating. I think that’s part of why I felt so compelled to raise my voice, because all of us healthcare providers have signed up to alleviate human suffering and to live a life in service.
Part of what training is, is to run towards that thing that your lizard brain would have you run away from. Right? That’s true when someone codes or when someone is vomiting blood or if someone is having a seizure. The lizard part of us wants to run away and then the medial training part of us, reconditions ourselves to run precisely into the problem the way firefighters will run into a fire.
It’s a conditioning training that’s part of what our medical training across the continuum health professions if for. I just want to give a huge shoutout to all those people who are actually materially in harm’s way and have been harmed.
What treatment for coronavirus looks like
Ari: Beautifully said. What is your experience like right now treating patients with coronavirus? What’s going on in your clinic? What are you seeing and how does this differ from maybe the flu or other viruses that you’ve dealt with in the clinic previously?
Dr. Rahav: I think the bottom line for all infectious illness is that on a cellular level, it’s anaerobic. We know that tools that increase oxygen tension in the body are going to be antiviral tools. It’s not common practice to use ozone in the United States, but ozone has been proven an effective antimicrobial, because it’s broad spectrum. Also therefore, and this is kind of another offshoot, we’ve been using these tools, for example in our practice, as a complementary treatment for cancer, because we know that our proponents of understanding cancer as a metabolic disease are also figuring out ways to heal the mitochondria. Part of that is increasing the oxygen tension. There’s interesting work around that.
All of those things I just think are kind of circling our understanding of how we would then deal with a viral illness. Specifically, the excellent question that you asked about how coronavirus might be different from influenza viruses, is the fact that it’s novel in terms of our immune system exposure and our immune system’s ability to rally a response A, and B, it seem to be working specifically at the level of the heme molecule, so that corona is binding to the heme molecule and dissociating the iron, which is part of how the heme molecule at the level of the alveolus, which is the functional unit of the lung where we’re actually getting oxygen and carrying it up through our circulatory system to our tissues, it’s leading to a dissociation on that level, so that we’re actually dealing with two things. One, lower oxygen saturation, which frankly makes you a better host, because remember all viruses are anaerobic and so the lower the oxygen tension, the easier it is for any infection to thrive. Two, also, the offshoot is these kind of rogue iron molecules which are leading to a lot of inflammation oxidative stress in lung tissue.
What we’re seeing in terms of what that means when people are coming in, is that it’s almost like an altitude sickness, if anyone has experienced that in terms of that feeling of air hunger. I think depending on someone’s fitness or we can think about this a different way, let’s say fitness or a conditioning or an a cellular level, I’m thinking about the mitochondria and someone’s ability to make ATP, which is the fuel oxygen drives that, and so people are describing the lack of that. If you’ve ever exercised maximally until you feel like burning and aching, people are describing muscle aches and bone pain. I think that’s different. I think if the flu, you’ll experience what we call myalgias or an achiness in muscles, but people are hurting down to their bones and they’re weak. They’re incredibly weak. I think the body’s trying to overcome the oxidative stress of that rogue iron molecule or the many rogue iron molecules.
At the level of the lung, there’s a special lining of the alveolus, again, the functional unit of the lung, it’s called surfactant, that helps it open and close, so that doesn’t stick, because it’s like a little mini balloon and that is usually as surfactant is rich in vitamin C to manage the usual oxidative stress associated with breathing and oxygen exchange at that level, but that the body’s antioxidant defense is overwhelmed.
I think that’s one mechanism we’re finding where IV vitamin C or vitamin C orally, first of all, orally, first of all is helpful in both preventing and then maybe managing some of the more mild syndromes. The people who are showing up in our office are sicker, they frequently have tried to manage this at home, they’re trying to shelter in place. We are all dealing with the overwhelming amounts of fear-inducing information, terrifying information that’s on the media. Coming here as somewhere, some of them have actually been rejected by hospitals because they haven’t de-saturated well enough to qualify for admission in the hospitals, so they’re hovering their oxygen saturation around the 90s, some of them 88 to 93. Officially, I think we’re qualifying for hospital admission when we dip below the 90.
They’re coming in here quite de-conditioned. That’s different, I think and maybe we’ll want to tease out what I’m recommending for people at home versus what I’m seeing clinically in office, but the bottom line is that, when we’re using the higher doses of vitamin C, we’re actually, hopefully I’m sure that the body is recruiting some of that for antioxidant defense, but when we’re getting to those higher doses that we’re getting to, at like the 20 gram level, which just to translate that, if we’re taking pills, we’re trying to hit maybe 2,000 milligrams a day and what we’re doing IV is closer to the 20,000 milligrams. We’re modifying that so we can talk about that like some nuances, but we’re actually leading to a pro-oxidative state where we’re actually that’s going to translate the bottom line in the body’s increasing oxygen tension. That’s where we’re getting some of that antiviral activity that’s related on increased oxygen tension in the body. I think that’s a little bit confusing for everyone.
How vitamin C affects the body
Ari: Let’s clarify that just, I think there’s a lot packed in there. Normally, vitamin C is an antioxidant at lower doses, at these higher doses that you’re talking about, it actually becomes more of a pro-oxidant, but the goal is for it to be a selective pro-oxidant where it’s specifically delivering free radicals to the virus. Is that accurate?
Dr. Rahav: Let me see if that’s accurate. The way I understand it, is that vitamin C at higher concentrations winds up pulling a little bit, it’s more than the body can process and will pull around the cells and be converted into hydrogen peroxide and actually then be converted into oxygen deliver. I think I understand it as more of an extended release oxygen delivery system. Yes in the sense that and this is something I’m also trying I think that most of the time I’m at the point of care and I’ve been trying to beef up my own mechanistic understanding of oxidation and reduction.
On a mechanistic level, my understanding of neutrophils and the way they work is when they engulf a bacterial or viral particle, the way they’re working is by stealing electrons and electrically destabilizing a pathogen and that in order to do that we need free electrons and that vitamin C is also an electron donor. I think that’s also what antioxidant means, an electron donor. I think that’s one mechanism.
The potential role of heme and hemoglobin in COVID-19
Ari: Got it. I want to address your thoughts on policy, but before we get in there, you mentioned the heme and the hemoglobin aspect of this situation. This is a newly emerging model, the situation, there still isn’t a ton of research on it. I did a podcast in last week’s episode, talking about this in depth, talking about also the potential of methylene blue, especially methylene blue combined with photobiomodulation from red light therapy may be an effective tool for inactivation of viruses.
Just yesterday, or the day before, there was an article published by a young guy who’s a new MD PhD, who put out this article basically saying– debunking the hemoglobin iron hypothesis of COVID-19. I read the article and more than anything, it was just saying like, hey, we don’t have enough evidence to say– The real argument was, we don’t have enough evidence to say that this is going on in COVID-19, but he framed it as, we have so much strong evidence against this hypothesis that we can completely debunk this and discard it. I think that framing of it was totally inaccurate. I think it’s totally accurate to say, hey, this is still early evidence, it’s somewhat speculative, but things seem to line up with the clinical picture.
Dr. Rahav: I think that’s the best way of saying it, that things are lining up with the clinical picture. You’re seeing a disseminated bilateral pulmonary process and what I’m describing is a broad clinical picture of a low level hypoxia. Why are people’s muscles aching? Have you never worked out? Have you never climbed a few flights of stairs and hit your maximum level of fitness and feeling the burn? What is that? That’s burning through your ability for aerobic metabolism and then you start kicking into anaerobic metabolism and lactic acid production people. This is common sense. I’m literally sitting here at the point of care and listening to what people are saying.
Ari: Just to clarify for people listening, you’re saying that anaerobic metabolism, that muscle burning effect is the result of the muscle cells shifting into anaerobic metabolism, where they’re producing more lactic acid as a result of oxygen deprivation.
Dr. Rahav: And they’re more achy.
Ari: Right, but instead of happening as a result of high intensity exercise, it’s happening at rest, which you’re saying it lines up with explanation of low oxygen level.
Dr. Rahav: Exactly. Common sense, this is not new physiology. In some ways, this is novel, but this is common sense, basic physiology. Also, I think what’s happening here is that a lot of people are reporting nausea, that this is really burdening the liver and I think that furthermore, is when people are nauseous they’re not eating and I think it leads to this whole cycle of de-compensation.
Ari: One quick thing, that the argument put forth by this guy was basically saying, it’s probably not attacking the hemoglobin on red blood cells, it’s probably just damaging the lungs and that’s causing the low oxygen state. Do you have any thoughts on that and why you think–?
Dr. Rahav: If that were the case, then why would people repeatedly have deregulation of ferritin? No, let me qualify that because ferritin acts as an acute phase reactant, but I don’t think we’ve seen it go into the thousands the way we see it right now. I think the jury’s still out, expecting us to have a complete laboratory understanding what’s going on while people are actively dying in hospitals is a little bit farfetched for me. This is a time to take care of people who are in distress, don’t ask me to be responsible for a randomized double control trial with all the laboratory essays and so on and so forth. I am a clinician at the point of care who is daring to stand up and say, let me try, let me try and help you because that is my professional mandate, that is my ethos and so far, let me tell you so good and that is really awesome.
It’s really awesome, it’s joyful, it’s hopeful, it’s empowering and that is a message that we need to share because this fear stuff, I can tell you based on experience, past experience, I can tell you, I came into medicine through the Thai AIDS crisis, I happened to be in a place in time and the first response of the Thai Ministry of Public Health was well-intentioned, but they sent out in a huge media campaign, pictures of end-stage AIDS and it led to isolation and stigmatization of the humans precisely in the moment they needed help the most. It’s a similar thing for me, this is like déjà vu. It’s like people who are sick; we’re going to run away from them? No, I’m going to step forward because that is what I signed up for and I’m going to do everything possibly within my power, especially when we look at the harm benefit ratio, how much can I possibly hurt people by giving them an IV bag with nutrients?
Ari: I love it and thank you for expressing that. I think it’s such an important and powerful message.
Dr. Rahav: That’s the other, it’s working.
How current policies and media coverage may affect response to and treatment of COVID-19
Ari: Yes. I want to get into some of those specifics of what exactly you’re doing. First, you alluded there to what the government, what the media is doing. I’m curious what your thoughts are on, if you were making decisions at a policy level, what would you be doing differently, if anything, than what the government and the media, I guess, are currently doing?
Dr. Rahav: I think that right now what’s happening in my practice is that a on a policy level, if we pooled our collective wisdom in the spirit of true scientific inquiry. The first thing that we do when we think that something might be working is we reproduce it.
I’m a single operator and I have an amazing team, but we’re just a small boutique clinic in New York City. What would happen if we took exactly what I was doing and reproduced it at the hospital level? That would be something that would be worth pursuing where there would be a lot greater ability to monitor and actually collect both clinical and laboratory evidence and scale what single operators like me are doing. What could be the harm in that?
Also, feet, boots on the ground, if we look at what’s happening in hospitals are we seeing acceptable clinical outcomes there? Who are the medical authorities guiding policymakers? Who are they? Are we looking at them and any conflicts of interest they might have in promoting one therapy or another?
I can’t help but ask those questions because in my medical training coming from a background where I was really interested and cut my teeth in terms of becoming an integrative practitioner in the time of the AIDS crisis, where there was a lack of pharma available and people banded together in the areas most severely affected by HIV AIDS in the upper north of [unintelligible] and said what are our own resources and found plant resources and found spiritual resources.
I’ve been in a situation where we didn’t necessarily have the answers, but we cast around to look for them and banded together and amplified our voices. I think that this is such a time where we can’t have all the answers, that can’t be the expectation but that we can pool our resources and we can– in terms of what’s working. Why can’t doctors like me be involved in ensuring my voice to policymakers and saying, maybe this is cheap people, this is cheap medicine? We’re ordering more ventilators? I don’t need a ventilator, why don’t we just buy some vitamin C? This is like the cost is infinitesimal compared to what we’re spending, or we’re saying, let’s get some convalescent blood and spin out immunoglobulin. Those are so resource-intensive. Why wouldn’t the motivation be to spend less and find better clinical outcomes? Why isn’t that the dominant paradigm? What’s going on here?
Ari: One quick question before we get into that. The media, this is kind of an unprecedented thing at least in my life– I think in anyone’s lifetime, as far as any sort of infectious disease epidemic that has taken place during the era of such widespread travel, such widespread news circulation and news watching and the ease of availability of news, and especially the internet where we’re all you know touching the internet via our computers, via our phone multiple times a day if not hundreds of times a day. We’re constantly getting updates, it is all over the news nonstop, coronavirus pandemic this many deaths, hospitals being overwhelmed, people are dying.
Dr. Rahav: challenge the media to pick up my story. I challenge the media to promulgate messages of can-do hopefulness and in fact, are doing and are doing successfully. If we talk about human interest stories or feel-good stories, this is a feel-good story. Humans who come here asking for help leave feeling better and we call them the next day and they feel great and they’re so happy and they’re sending in neighbors and cousins and brothers and sisters. Why is the story not blowing up?
Ari: It should and hopefully people listen to this podcast, and maybe some media outlets will.
Dr. Rahav: I hope so.
Ari: We’ll do a story on it I hope so too.
Dr. Rahav: It would be better for humankind. I think the role of the media is that I don’t think ever before the media has been acknowledged as playing such a huge role in public health, and that, of course, can be like anything else. With great power comes great responsibility, and always journalism has been focused on not being biased. I think that this invites all of us to become critically literate and just look for the possible, I’m not saying yes, but, is there a possible bias here? If so, how can we address that? And how can we as journalists the way I also try to be unbiased as a physician and not be adherent to one form of therapy or another?
One of my teachers– one of my favorite sayings that he has taught me is the truth is what works. I think sometimes we fall into traps, for example, me as an integrative medicine practitioner. Well if it’s pharma, then maybe I won’t like it as much because it’s pharma. No. If it’s pharma and it’s appropriate and it’s judicious and it works then pharma it is, and if it’s a natural supplement or if it’s a neutraceutical or if it’s a food-based strategy or it’s a dietary or lifestyle intervention if that’s what works then that’s it. The truth is what works. Try to examine the tools in our toolkit; I think the point of integrative medicine is an expansion of the toolkit. Truthfully and frankly in my four years of medical school, I had a two-hour lecture that wasn’t elective and that I wasn’t graded on nutrition in four years of medical training.
Ari: Well, I think a lot of schools don’t even a lot of get the two hours.
Dr. Rahav: Exactly, and that was like a good scenario.
Ari: Let me ask you this. There are a lot of people right now who are feeling like we have these lockdowns. There are a lot of people who feel like I’m just going to stay home isolate myself, hope I don’t get this thing and wait as long as it takes for them to develop a vaccine and that’s the answer to this thing. Hopefully, it’ll come out in a year maybe 18 months at the most. I literally know some people that are saying that their intention is to stay home and isolate themselves until a vaccine is available. It seems like certain people like Bill Gates, for example, are wanting to push for that sort of interpretation of what’s going on right now.
How affordable treatments may be efficient against COVID-19
Dr. Rahav: Which is why I think we need to be critically literate and ask ourselves, who stands to profit from all the media, which is literally focused on infection and death toll and the lack of equipment. It’s like this Doomsday news reporting. I’m saying something completely different. I’m saying with a couple of readily available and cheap tools, I am able to bring people who have been very symptomatic, very sick and even it might not have made it, and certainly, were headed towards the hospital and they’re literally turning around in a day. I’m not saying cured in a day, because sometimes we have to do a little more. In a few cases, we’ve actually repeated an IV therapy, so two days, three days. But they’re back to themselves, they’re eating, they’re at home, they’re happy. They’re calling us up saying, “Thank you for being our guardian angels,” and it makes us cry from joy.
Ari: Let’s say they are skeptics listening to this, who are conventional medical doctors, you’re a conventionally trained MD, but let’s say there’s conventional MDs who are– don’t have any of your background in functional medicine in nutrition, in lifestyle therapies, in integrative medicine and so on, and all these things that you’ve spent so much time training in, and they’re listening to this and saying, “Well if she’s experiencing such great results, maybe it just it’s because she’s not seeing severe patients with really severe sickness like we’re seeing, and she wouldn’t have such good outcomes if she was treating the same severity of patients.” What would you say to somebody who’s a skeptic that’s thinking that?
Dr. Rahav: I think there is some crossover in terms of medicine and things that work. If we’re talking about potentially the pathophysiology of the dissociation from iron from the heme molecule, in that case, what’s been studied to be effective is that hydroxide chloroquine, which seems to work on that same level. I think the mechanism of action is not completely understood, but it’s not completely understood newly. It’s an old not completely understood mechanism, and I don’t think the onus is on it for me to prove something that has not been completely understood, and yet has been commonly used by medicine.
I think that’s also like a take away from this is sometimes in clinical practice, we use things that work because that’s what we do, and coquinol or hydroxide chloroquine is one such example that’s still within the pharmacological canon. What I found for example over this weekend, I was challenged with a couple that found me through a word of mouth and got in touch with me, and I wasn’t physically in my practice, I was you know celebrating holiday with my family trying to take a day of downtime. I was out on Long Island and they were in Newark New Jersey, and they didn’t sound good. I said, “You know what? Let’s put this to the test.” I called some pharmacies around them, I found a pharmacy that had hydroxychloroquine available. They had each been struggling with symptoms and displayed every sign and symptom that I had already clinically experienced, a loss of sense of taste and smell, bone pain, myalgias, cough, shortness of breath and a generalized malaise and weakness, a loss of appetite, that kind of constellation which screams COVID.
I prescribed to them COVID positive, because I had every clinical reason to prescribe and label them as COVID positive. They were able to get the medication around 1:00 PM on Saturday. They physically came into my office for in-person assessment today, and the myalgias and the pain had largely already resolved.
Ari: How many days is that, just for people who don’t know [crosstalk]?
Dr. Rahav: They were five doses in. The first day we do a loading dose of hydroxychloroquine, one tablet is 200 milligrams for people who are well and young enough, for older people I’ll go a little bit lower, that’s 400 milligrams, two tabs twice a day. Day one, that’s a loading dose. They each had four tabs the first day that was Saturday; they got four tabs into their system. Sunday they had a tab morning and a tab evening and then Monday when they came in, they were after one tab. That’s a total of one, two, three, four, five, six, seven tablets.
Ari: Just for people listening, we’re recording this on a Monday.
Dr. Rahav: Also with zinc, I insisted that they take zinc with it. There seems to be a story here with zinc and COVID’s interrelationship with blocking the zinc ionophores, that ability for zinc to get into the cell, opening that up with hydroxychloroquine. On the wings and a prayer of clinicians who are smarter than me, I put those things together and again, clinically see a response.
What I would say to my colleagues, if this whole nutraceutical, I don’t think zinc is so far-fetched for my colleagues, I don’t think vitamin C is far-fetched, I don’t think vitamin D is far-fetched these are things that we know and speak to in the allopathic canon plus a little hydroxychloroquine. So far, azithromycin on its own doesn’t seem to be doing the trick, the study as far as azithromycin with it, but in this case this is just a clinical scenario where I use the combination of hydroxychloroquine with zinc without azithromycin with clinical improvement based on my understanding, which again is nascent of the pathophysiology of coronavirus.
Ari: I love the emphasis on nascent there. You’ve mentioned zinc, vitamin C, vitamin D, hydroxychloroquine. Is that the crux of what you’re doing with these patients? Is there any other thing that you want to mention as far as the strategies that you’re using, that you’re seeing good results with?
Dr. Rahav: Again, and then higher doses of vitamin C IV, and we discussed that that could be mechanistically more than one thing at play.
What I’m seeing also is that people who are sick or let’s say they’re physically coming into the office; I have the luxury of physical exam. Some of the people who are sicker also have physical signs and symptoms of insulin resistance. I can see belly fat, I can see skin tags, which is a sign often of insulin resistance. Insulin-like growth factor leads to proliferation of little skin tags, the name for that in medicine is acanthosis nigricans. We always have like the best names for things that, say 10 times fast, and also a lot of amalgam in the teeth. We know this, that there is an inverse at least in the functional geek space, this inverse correlation between toxic burden and what we’d call allostatic load.
The sum total of our environmental exposure is a term that’s been coined in the functional medicine space, the exposum and an immune system ability to function optimally.
Ari: If you don’t mind me interjecting.
Dr. Rahav: Not at all.
Ari: Obviously, we have some stats from Italy and then there are some recent stats that emerged in the United States. The stats in the United States are that 86% of people who have died in the United States thus far, as of, we are on April 13th right now, are people I think over– it was either over the age of 50 or 60 and had at least one pre-existing condition. Cardiovascular disease, diabetes, hypertension are big ones, COPD is a big one as well. Then in Italy, the numbers are even bigger, it’s 99% of people that have died are above the age of 50 or 60 and have at least one pre-existing condition.
There is absolutely this very, very clear, amazingly strong link with allostatic load, with the extent to which somebody is already ill and usually that’s connected. Most of these things I mentioned are diseases of lifestyle, which relate to this concept of allostatic load. To the degree you’ve had for many years, lots of allostatic load for lifestyle nutrition habits, you’re then going to start to get some of these cardio-metabolic diseases. Which then dramatically increase your risk of developing severe symptoms and dying from the coronavirus. Is there anything you want to add to that, or do you disagree with any I’ve said there?
Dr. Rahav: I don’t disagree with it. I just want to put a little qualifier there, because I always worry about lifestyle diseases in terms of a judgment or blame or a fault kind of nuance. Because I feel that really we’ve been, as a world population, not advocated for adequately, not informed adequately about what is and isn’t good for us. I think there’s just so much information out there and I think some of it for example, we say, “Okay.” We’re like fish in deep water, fish are good for your health they’re full of omegas, but what we’re finding when I start screening for mercury, aluminum, arsenic and lead is that people are walking around and they have all these diagnoses. They have attention deficit disorder, or they have depression, or they have hypertension, or they have diabetes but underlying it, they’re poisoned.
That’s not their fault. It’s not that anyone’s lazy, it’s that these things might be happening and they’re not part of what we look for or examine or speak to or treat or therefore if we see it and it’s rampant, like start thinking about what’s actually happening to our planet and our food supply because these are hidden, these are hidden scourges of our time. The amount of suffering that I think is being unveiled by this COVID-19 story is just staggering and beyond painful and one of the possible silver linings, I’m saying possible because I’m not celebrating anything here at all, is if this creates an opportunity for us to look at these underlying co-morbidities and what is driving them and really think about overhauls of our medical, our healthcare system, with emphasis on health. As opposed to being reactionary, how can we be proactive? How we can protect our planet, our food sources. What would happen if that was the way we operated, just from an ethos, never-mind the tools just from an ethos? Let’s just start looking.
Will new legislation support better health?
Ari: Absolutely. What if at a policy level, at a government level, we made more efforts to not accept eating glow in the dark breakfast cereals and donuts and soda and potato chips and pizza and ice cream. What if we didn’t accept that as the norm of what an acceptable diet is, and allows that to be the standard?
Dr. Rahav: Yes, but what if what’s making you sick is your farm’s tilapia and your glyphosate tomatoes that are GMO and your piece of toast, you know what I’m saying? What you’re saying I think might be more readily accepted and understood, but what if your behavior actually nutritionally is impeccable given your resources, given what you’re able to afford and that you don’t necessarily have the resources to grow your own food or be part of the CSA. What if you’re language locked, the way I’m finding that a population that has found me. One chapter of my life was actually living in South America, and I’ve had this amazing and beautiful South American community living in New York find me. It’s like this full circle, but they have different media outlets and different resources available to them. Many of them are uninsured and many of the pharmacies they’re saying just to monitor themselves at home, they said there are no thermometers available.
There is no hydrogen peroxide. If I say, “Give a little gargle with saltwater and prevent a sore throat from then descending into your lungs,” and they were like, “We can’t find it anywhere.” How do we really advocate for people who aren’t eating glow in the dark breakfast cereals? Yes, there’s certainly a huge amount of teaching and supporting that we need to do, but there’s more and it’s more nuanced, it’s more complex.
Ari: Yes, I really wonder what– Knowing those numbers, those I just shared, 86% and 99%-
Dr. Rahav: They’re staggering. They’re staggering
Ari: Knowing those diseases that are contributing to people dying from this are directly linked to nutrition and lifestyle, I really wonder how many lives could be saved if we had at a policy level policies that were more in favor of penalizing some of these food industry companies that are producing products that we know are harmful to our health, and we did more to support you know the companies that are producing products that we know are good for our health, and we changed what the norm is of what the majority of the population eat, and made it more economically feasible as well, made it cheaper.
Dr. Rahav: Let me think about it this way. There used to be a lobby in Washington that was anti-GMO labeling, and that lobby dissolved. It dissolved on its own, we didn’t go after it. Because humans fundamentally, we are interested in being well, we are interested in being there for our children. Just like that community of wonderful humans confronting their own mortality in the 90s in Thailand taught me that they wanted to be as healthy as possible even though they were HIV positive to live to see their children grow, to try to be present. If our motivation is here to love and nurture the next generation as is I think the universal human condition, all of us inherently want to be well, I would say. We’re here– like the thirst and zest for life, it’s programmed into us. We’re designed to love our progeny and procreate and create these family units of love and support.
When people learn that GMO might not be good for them, or that eating organic is better, it’s the biggest growth market. All of these companies, who were lobbying against this, when they found out that it was no longer profitable to resist labeling, started voluntarily labeling because it was better for business. I think that’s the bottom line, that health is good for business. I know that illness has been good for business, but I think fundamentally we need to recognize and acknowledge that treating each other well and being healthy and being vibrant can also be really good for a business’s bottom line, country’s bottom line. That’s been something that I challenge myself. Because as a medical doctor, I promise you, I have no business training and it was completely insane for me to decide that I would open my little own medical practice. I asked myself a question, can I run an ethical business that’s based on treating everyone around me really really well? I am again only three years into having my own practice, so you have to understand from that perspective I’m a baby. But I asked the question.
Everyone here in this practice was just as worried about being exposed to the virus and got just as much of the fear message that’s been so pervasive, and had family members question the need for them to show up at the office. I said, “Look, this is what I want to do. First of all, I want to show up, it’s what I signed up for. If you didn’t sign up for this I understand because I’m a medical doctor and a weirdo and you might not be, but if you join me, in this all of your IV Treatment, your medical treatment it’s on me because I want to protect you. If you aren’t well we can’t do this for others.” It’s that classic metaphor for taking the oxygen mask and putting that on yourself that you’re always taught, and like when you get onto an airplane and they go for safety protocols. We have to have our oxygen masks on.
Everyone in my practice got IV Vitamin C. Everyone in my practice is snorting up nano-ionized silver into their nose and all over their faces, a barrier method. Everyone here to the best of our ability, I’m trying to make meals. We’re like feeding ourselves. I’m making one-pot meals and our insta pot, full of healthy like legumes and vegetables and onions high in quercetin and mushrooms which are pro immune and tons of curry and just like whatever is in my pantry, and we’re eating one-pot meals together as a practice. It’s been delightful, actually, and it’s part of like we have to walk the walk. Guess what? My team feels better. Some of them are feeling better and going through their own health improvements and losing weight as a result of this. Another silver lining and we’re bonding, because we’re being fortified by our ability to band together.
That’s also like– so my team is thriving in the midst of all this because that’s been our choice, our conscious choice. It just proves that a business where like every member of the team is ethically treated and lovingly treated, can hopefully, God willing thrive as a business. We can talk about this God willing in a few years from now and check in and make sure that my experiment continues to be successful, but again so far so good.
Ari: Let me jump back to the clinical experience and what you’re seeing. Right now in most mainstream hospitals what they have to my understanding is, they’ve got ventilators, there’s been some experimentation with some antiviral drugs, I haven’t heard about that any of them are particularly effective. Then there’s hydroxide chloroquine which some hospitals seem to be experimenting with, some seem to be rejecting. I’m under the impression that they’re really– other than that it’s maybe symptomatic treatment, some Tylenol to reduce fevers and I don’t know if they have anything else beyond that.
Dr. Rahav: I think there are different things that are being tried. I think that it seems that all ventilated patients the mortality rate is really high. I think doctors are trying to avoid ventilation as much as possible and do high-flow oxygen which actually is appropriate. By the way just as we’re speaking its 7:00 PM and every day outside of my window, I hear New Yorkers cheer for essential workers. It’s like a really beautiful ritual that’s evolved, and I don’t know if you’ll hear it right outside.
Ari: I heard a little bit in the background.
Dr. Rahav: Anyway, I think that again there’s an evolution there. I heard that empirically when someone comes in with a clinical picture that is consistent with COVID people are using lower dose IV Vitamin C infusions at 1500 milligrams.
Ari: Why bother with an IV at that dose? I mean you could easily reach that with [crosstalk].
Dr. Rahav: That’s a really good question and they’re doing that a few times. I think that more than anything it’s a lack of familiarity. I think it’s always scary on a human level to just make change or to accept change, and I think in some ways this is why a crisis invites us to evolve our understanding of what’s necessary, whereas otherwise, we might be conservative.
At the same time speaking of conservative, if we were able to just push the envelope on vitamin C a little bit. I want to emphasize that vitamin C at higher doses can also induce kind of increase the body’s ability suddenly it gets that oxygen, and it starts working and starts kicking out– it’s like this idea of detoxification, which is more of a functional integrative concept because my beloved– I want to say my dearly beloved allopathic trained and brilliant colleagues are like, “We’re always detoxing, that’s what the liver is for, that’s what the kidney is for.” I think there’s a fundamental power dynamic difference in our understanding of what toxicity in the functional integrative medicine space is.
I haven’t been able to bridge that divide truthfully, even though I have tried to do that a little bit by just a little more testing. I am able to look at glutathion levels, I’m able to look at vitamin C levels, and speak a little bit. I look at Co-q, I look at carnitine. This is my routine testing, plus I screen for arsenic, aluminum, mercury and lead, and I’m able to document one higher toxic load in heavy metals, and two, a reduced antioxidant defense.
These are things that I’m able to look at routinely that help me bridge that divide and speak to– and then when I treat it for example, where I’m reducing mercury, and I’m increasing antioxidant defense, a lot of clinical symptoms resolve. Things like blood pressure get better, liver enzymes normalize, brain fog goes away, attention and cognitive function starts returning. A period comes back, menstrual dysfunction and amenorrhea. Anyway, so I think that’s something that I’m working on doing on a daily basis and that this is just like a poignant urgent kind of dramatization of that ongoing paradigmatic chasm, and that this situation begs us to bridge that a little bit better.
Ari: In mainstream hospitals, they’ve got those tools that I mentioned. The ventilators have been a big focus up till now. Now that attention is shifting away from those as for people who are seeing very low survival rates-
Dr. Rahav: PPE right? That’s been another. Like you know, yes we have all the mask and we ask people that come in because it’s also like we have to play our part, but we’re also doing a little bit of the alternative barrier methods. It looks backward in my camera.
The difficult choices clinicians face with patients who has COVID-19
Ari: The silver gel for people who are watching the video. At your– is it correct to say hospital or your private practice at your clinic, I assume you don’t really have ventilators, or it’s not a–
Dr. Rahav: Not at all. We are a community-based clinic. We don’t have the resources because ventilators require expertise. We have respiratory therapists, we have ventilator settings. As trainees in medicine, we have to familiarize ourselves. All of us internists rotate through the medical intensive care unit and have to have a basic familiarity. It’s really intensivists who are monitoring. I mean respiratory therapists who are monitoring.
There’s anesthesia that’s required because being intubated is incredibly uncomfortable, so it requires sedation. All of these things require intensive 24-hour care and, as you know, just a few operators, we don’t have the staffing to be able to support 24-hour monitoring. This is not the appropriate setting. No, we do not have ventilators, nor should we.
Ari: That last point is what I wanted to get at. Do you think you need ventilators? If someone’s coming into your clinic, they’re sick, they’ve got COVID-19, they’ve got lower oxygen saturation levels, they’re let’s say in the low 90s, let’s say they’re in the 80s, maybe even high 70s. I don’t know what the numbers are you’re seeing but do you immediately say, “Hey, I got to refer you out to the hospital to get on a ventilator.”?
Or, do you say, “Hey, I’ve got these tools with IV vitamin C, with some of the other things that you’ve mentioned, and I’m confident that we can get your oxygen saturation levels back up and get you better without the need for a ventilator.” And this is an important point, in scenarios where the conventional hospitals might actually intubate people or put them on a ventilator.
Dr. Rahav: That’s a really good question and thank you for asking. The answer is, if someone is coming in and they look like respiratory decompensation and they’re saturating, you said, depending on what I’m seeing, low 90s, high 80s, has it gone down to the 70s, and am I saying, “We’ve got this. We can treat you here,” or what am I doing. I’m recommending them to a hospital setting. I guess the frame for this answer is that I, regardless of being an integrative medicine physician, I’m also a medical doctor who did the Hippocratic Oath. The Hippocratic Oath states first, do no harm, primum non nocere.
I am personally, of course, and ethically, and professionally mandated to look out for any human who I’m honored enough to be able to care for his best interest. That means that they have to be safe. Of course, if someone isn’t qualifying for hospital admission, meaning they’ve– We’ve had many scenarios where people actually show up and they’re like, “Please take me in.” And the hospital’s like, “Listen, you don’t qualify yet. Your saturation is still too good.” That’s a perfect person for me because they still feel very unwell and they don’t qualify for hospital admission. That’s when someone is safe to be in my court. Putting little ear mark. You won’t be able to see on the podcast, my little rabbit ears. It’s safe to be in my court.
That is generally how I operate. If someone comes in with intractable abdominal pain, if they’ve already been scoped and they’ve already had all the gastroenterological appropriate assessment and they can’t find any reason for their intractable abdominal pain that would be a good case for me to try to work on. However, if they have some mass that needs to be removed, or examined, or diagnosed, or if they have some bleeding blood vessel or a giant ulcer, that’s why I have my colleagues. That’s why it’s an appropriate hospital referral or appropriate referral to a colleague. Everything needs to be done in the best interest of a human coming in for care.
So, the answer is that the people that I’ve seen, if they are sating too low and they’re in danger, think of respiratory de-compensation, I have to refer them. That’s why acute care exists. That’s the whole point and why I’m so grateful to my brothers and sisters in arms in hospital medicine, for doing the incredible work that they do. My hat is off to them. I’m here in the community to pick up and carry the humans that don’t qualify for hospital admission, keep them well in the community and away from the hospital, away from burdening the hospital. The more successful I am in doing that, the more I’m supporting my brothers and sisters in hospital medicine.
Ari: Yes. I also think it may be worth adding. I’m curious if you’d agree, but that because the survival rates on ventilators are so low and really disheartening, that it seems like the only real way that we’re going to save a ton of lives is not by fixing the shortage of ventilators– Of course, that should be done, but really to save a lot of lives and make a huge difference, it seems like the key is going to be intervening upstream before people get to that level of severity of sickness where they require being put on a ventilator, which is exactly the kind of people that you’re seeing.
In that scenario, in less dire, really end stage, super severe cases of this where there’s no choice but to put them on a ventilator, in those scenarios, do you think that your approach and your methods that you’re using would save a lot more lives compared to what’s taking place in most hospital treatments right now?
Dr. Rahav: I think that’s still conjecture, but that seems to be what my experience is teaching me, is that people are doing well. Also, people are doing well after struggling at home trying to heal using whatever they have available at home, and not successfully doing so. They’re de-compensated to a level where it’s still safe for me to treat. We’ve had, I think, a few scenarios where we said, “This is the little border line and you may qualify for a hospital.” If someone clearly qualifies for hospital admission, I will not hesitate and say, “Listen, this is not right, this is not safe for me to treat you in the community. If you’re treated there and come back then that’s fine.”
The more that I am treating this, once people have been struggling on their own and not getting through it and then successfully get them through it in a relatively short amount of time, the more I think that we might be able to extrapolate that experience to say fairly that we can really save lives. That seems to be approximating– Again, I have to stay humble. It’s not like I have these thousands and thousands of humans that I could say this for.
I wish it could be scaled to a larger clinical setting where my colleagues could help me prove this point on a scale and say we didn’t wait for someone to be in a de-compensated respiratory state, but accept people and figure out a way to use hospital facilities and hospital rooms to reproduce something akin to what I’m doing here and see if we are able to keep people away from needing the ventilator, keep people away from needing high-flow oxygen. Also, another outcome marker that we can look at that’s factual and concrete is just days of hospitalization.
If someone comes in, they’re de-compensated, how long for them to recover. Never mind the clinical systems, but just how long for them to come in and then just walk out on their own two feet.
What Dr. Rahav would do today if she was in charge of treatments in the hospitals
Ari: Got it. Two final questions for you. One is, if you were in charge of what all of the hospitals in the US right now were doing as a standard protocol to treat patients with COVID-19, what would you have them do? That’s my first question. Then the second question is, to everybody listening who is at home who is maybe potentially already somewhat sick in an early stage or hasn’t gotten COVID-19 yet but might in the future, what would you say to them to help protect them and bolster their health and their immune function to help avoid getting severe symptoms and dying from this?
Dr. Rahav: Those are two really big questions.
Ari: Let’s piece them apart. Let’s just completely separate them.
Dr. Rahav: Okay. When we’re talking about at policy level, this is something I think about a lot. I think about how to effect change. For me, with a background as an educator, I always think about medical education and how we raise, but that’s a longer term. I wish that all the incredible science that I was able to learn through my functional medicine training could be incorporated into mainstream medical education. It’s a really deep scientific, biochemistry-based systems approach. I think that would also prime, I think, the brilliant minds that go into medicine–
Bringing more of the science back into medicine and less of these protocols which can be a little bit rigid and not, tailored enough to the true complexity that each individual challenges us to really understand and accommodate to. That’s one; the medical education piece is something I think about a lot.
Ari: More than two hours of nutrition training?
Dr. Rahav: More than two hours of nutrition training. I think when you just spoke a little bit about my bio at [unintelligible 01:00:26] many, many more years of studying that might be really overwhelming but at least kind of an introduction to that and what I say to people is that I’m a specialist and you wouldn’t doubt the qualification of someone who, let’s say, is an immunopathologist who is highly, highly specialized at looking at tissue samples and stains and really being able to identify.
They are so specialized and they’re so amazing at what they do. I am also incredibly specialized and I think have earned a certain level both of kind of a theoretical competence through my studies and also clinical competence through my daily practice. And would love for a specialist in functional medicine to be able to serve as a resource for our community because we’ve been trained to do so and in fact are able to act. I think on a policy level, acknowledging functional medicine as a sub-specialty and allowing insurance reimbursement for the services that I give would open up accessibility and allow more people who are interested to be able to access this as opposed to it being currently more of a private enterprise.
I think looking to projects such as the Cleveland Clinic where they’re incorporating functional medicine as part of the Cleveland Clinic and came out not long ago with an article in JAMA about following a group that’s randomized the Cleveland Clinic in functional medicine care versus non-functional medicine care and improved clinical outcomes is a really exciting and important stuff in the right direction. I think you are part of that, Ari, in giving the opportunity for professionals like me to tell our story. I think those are all so, medical education, reimbursement, coverage for these services, and acknowledgment, I think a larger public acknowledgment for our expertise.
Ari: In terms of specifics, like let’s say you could not affect the policy in a broad, long term way, in any way but let’s say, starting next week, in a few days from now, you have the opportunity to say, “Hey, all physicians on the frontline treating COVID patients, here’s the strategies that you should be experimenting with.” What would those strategies be?
Dr. Rahav: I think those strategies would be it seems to be safe to push the envelope a little bit on IV nutrition and it would probably be safe for everyone to get 7.5 grams, I’m including the pregnant women I’ve treated with COVID who have tolerated 7.5 grams of IV vitamin C with some calcium gluconate, some sodium bicarb, if you think about it, it’s basically a modified Myers’ Cocktail, put some magnesium sulphate in there. If we’re able to put a little taurine in there I think to support the liver, and universally, people would tolerate probably 3A ccs of glutathione as a push.
And just have that be the standard of care where someone doesn’t feel well and comes in and you have presumed COVID and you get that right off the bat even as you’re gathering. Like the same needle that goes in to give the IV, first, you can grab a few tubes of blood too and you can do the swabs. You can do those empirically and see what happens in terms of clinical progression to the need for high flow oxygen or [unintelligible] and see how that changes the clinical trajectory of people walking into the hospital.
Ari: Do you think there’s a place for Hydroxychloroquine?
Dr. Rahav: The other thing I was going to say is I think that the low doses because there’s definitely there’s QT prolongation, there’s visual [unintelligible], there’s a lot of clinical concerns associated with Plaquenil, or Hydroxychloroquine that are generally associated with long term use when I’m looking at the literature between two and five years. Plaquenil is accepted for example in women with auto-immune either rheumatoid arthritis or lupus in pregnancy.
If we’re allowing things in pregnancy it generally has a more benign safety profile and certainly if we’re looking at the seven to a 10-day course that we’re looking at here, I would say given the mortality rate and the resource insensitivity, the current clinical trajectory is COVID in hospital. That would be well worth if I was on a hospital admin-level saying, “Okay, let’s really check this out,” because we probably couldn’t do worse than the clinical outcomes we’ve already seen, honestly.
The best tips for preventing contracting a severe case of COVID-19
Ari: Got it. What would you say to people who are not sick right now, who are at home but may get this in the next several weeks or months? What can they do? What would be your top recommendations to optimize immune function?
Dr. Rahav: I think there are a few things in terms of the basic immunity. One of the things that’s kind of the bedrock of our clinical protocols here have to do with binding, so binding of toxins. We use widely here either some chlorella or some combination of zeolite, or modified citrus pectin because all of us are dealing with a good amount of environmental toxins and so reducing those. Glycine and taurine across the general population are amino acids that are essential for liver pathways and we know that glyphosate might interfere with glycine metabolism and so those at low levels and also incredibly cheap.
Those are safe things to put into your regimen to kind of prime your body for wellness. Then most of us could do with a multi-mineral and we can think about that from a nutritional perspective. We can think about celery, and carrots, and onions, and parsley and other green herbs that are more nutrient-rich or maybe like trace mineral drops or we can think about it as an actual supplement, also tends to run really cheap. I know that trace mineral capsules that we use run anywhere between kind of like $9 and $13 or something for a bottle.
If you take one multi-trace mineral supplement because we’re all minerally depleted and that’s also we can pass it out into iodine and zinc and magnesium and selenium https://selfhacked.com/. Those are actually key and those are ones that across the board when I usually establish care with people they’re low in selenium, they’re low in zinc, they’re low in iodine, they’re low in magnesium. If they are not overly low they’re sub-optimal and so those are all key pieces to immune function and would be safe probably empirically mostly across the board especially in combination with that basic liver support, let’s say taurine, glycine, and some kind of a bidding agent, be it activated charcoal, be it some zeolite, be it modified citrus pectin, be it chlorella.
Of course, I have brands and things that I trust more and kind of lean on but lots of good options out there. Then on top of that, so that’s special and kind of my functional medicine geek-out foundation. On top of that everything that we’re hearing hopefully, that’s my mainstream vitamin C, yes, yes, yes. Zinc, yes. Again, it’s that blockage of the zinc ionophore that seems to possibly again emerging understanding of viral pathophysiology of COVID.
Then in terms of the herbal arsenal, it’s really, really huge and so I remember a long time ago reading about lomatium which is a commonly used anti-influenza herb of the history of the Spanish Flu which killed so many millions of people, 50 million death toll around the world. Anywhere an estimation that we don’t have exact numbers. The media there served an opposite role, not wanting to discourage people as they were going through World War I and keeping kind of tabs on everything. I think there is like interesting for historians to go back and maybe compare and contrast the roles of the media in both of those pandemics, then and now.
Definitely reading about people who knew about and used lomatium being saved from the mortality that was so widespread through the Spanish Flu. Lomatium is in many of the antiviral formulas that we have here on top. We have different herbalist companies; we use BioPure, different boutique companies. There is Herb Pharm, there is a small boutique company around here called Live with Essence. A lot of those companies have gotten overwhelmed and so it’s been hard for people to source these things and so that’s why I think I’m going to more readily available mainstream that we have boswellia which is an incredible anti-inflammatory for the lung.
We have Cataspa, it’s an amazing and ancient immune support. We have of course turmeric that’s anti-inflammatory. We use sometimes these products in combinations so we have like boswellia, tumeric combination. There is a combination that I’ve found online that I’m sending recommendations to people who are at home using boswellia and andrographis, which is a bitter and anti-inflammatory that also seems to be specifically helpful, andrographis with COIVD-19. We’ve been recommending a lot of andrographis either as standalone, but mostly in a combo product that we have here called ImmunoMod, which also has good old vitamin A, which sometimes gets cast to the wayside but shouldn’t be.
Andrographis. [unintelligible] is another one that’s incredible. I think what’s amazing about the plant kingdom is that in each– I had mentioned a few times that I had started studying plant medicine in Thailand and there we’d use whatever was available locally, so there was a plant in ayurvedic medicine known as amla, in Thailand, it’s known as Makham pom that is naturally the highest food-based source of vitamin C. Or the bitter melon. Depending on where we are, there are different solutions that emerge. We know that medicinal mushrooms are really helpful.
We also know that the body’s ability to respond to stress or resilience to stress is part of immunity. Those things that are adaptogenic and people might be familiar with different ones, Siberian Ginseng, ashwagandha, Rhodiola, vitamin C is actually one of those things that has a crossover because it’s very nourishing to the adrenals and is naturally antihistaminic. A lot of people are might be more vulnerable because of pre-existing conditions like asthma or seasonal allergies, which make their mucous membranes more permeable. Again, Quercetin. We’re thinking about antivirals versus anti-inflammatories.
There are different position statements that I’ve heard from different organizations, including my beloved Institute of Functional Medicine, including my brilliant herbalist colleague. I have these kinds of lists. We think that in the flu stage, licorice is anti-viral and anti-inflammatory, that’s one that’s coming up a lot. Baikal skullcap is one that’s coming up a lot. Thyme is one that’s a really wonderful lung anti-inflammatory. There’s a list. Depending on people’s familiarity with things that list might be changed and modified.
Rosemary seems to be one that’s helpful for multiple reasons because it’s also anti-inflammatory. It has anti-microbial properties and also supports a key liver detoxification pathway called glucuronidation. Olive leaf is a natural antiviral. Astragalus, which some people argue should be part of prevention and in some cases, I’m finding it’s also helpful during treatment reishi, maitake.
I think the list is really diverse and I think that’s really nice because once I think it’s known it might become out of stock, but that by no means means that you can’t find lots of other tools. A lot of these tools, for example, are also available in bulk herbs. It’s our common practice in this, a small boutique practice to just buy a lot of bulk herbs. We have just elderberry and rosehips and thyme and oregano and sage and we just buy big bulk bags of it from Frontier.
Frontier spices that I buy [unintelligible] a big bag of all different things for anywhere between $10 and $20. We put it in jars and we throw it into a French press. I’ll show you here. I don’t [unintelligible] this is our herbal medicine mix. We can just throw tons of things into there. We can throw hot water on it and we model how to drink your medicine here in our office. Everyone gets a pot of tea. I think there are so many things that we can do.
Depending on what you have in your home, there’s also your food pantry. There’s your turmeric, or there’s your curry mix, or there’s mushrooms, or there’s ginger. Just chew on a clove of garlic, for crying out loud. There are so many things we can do. I think that’s ultimately why I love this field so much, is because we are not relegated to this narrow arsenal. We have incredible tools at our disposal. Many of them are so inexpensive. Then in terms of what I do, if someone is acutely infected, well I change the dosing, then it should be in supplement form. Then it should be therapeutic doses.
Then I’ll go to actual supplements and try to hit mega doses of things. If you take olive leaf, maybe you have, whatever, 400 milligrams in a capsule or whatever it is and however many of activated standardized 22% oleoprotein. Then I’m going to say, “Take eight of them three times a day if you’re actively infected and really try to knock the crap out of this virus.” I think dosing changes, but the tools are there. I also think this knowledge isn’t exclusive. I think this knowledge is we have to learn how I think we can look for resources.
Right now, a colleague just invited me, I actually posted it to my Facebook page, if you want to take a look for people who are successfully treating COVID-19 and what tools are we using and trying to create in pool a database of this. My homework for tonight is to get on there and start showing what I’ve been doing and then hopefully learn from colleagues and really again, band our voices together to empower our community.
Ari: Is that an open link to that source?
Dr. Rahav: Yes. I believe so. I didn’t have a chance to fully fill it out. That’s something you can also disseminate to.
Ari: I’ll grab that link and put it on the podcast page on the website.
Dr. Rahav: Oh my God, that’d be so amazing.
Ari: Just for people listening, we will put this podcast at theenergyblueprint.com/miriam-rahav, which is her name. So, miriam-rahav, theenergyblueprint.com/miriam-rahav. You can look up how to spell it or you can look at whatever you’re listening to, whether you’re on iTunes or Stitcher or YouTube. You can find it there. The links will be there as well if you’re on YouTube. Hopefully, I’ll have my team compile a list of all the different things that you mentioned there for people’s reference. I’m curious, I assume you would not recommend people to necessarily use all of the items on that list, but maybe a nice assortment of them.
Do you have any concern over people saying like, “I’m going to go all out with using big doses of these 30 different compounds?” [unintelligible] more harm than good.
Dr. Rahav: I think what I was trying to say earlier is that if you’re starting at home and you’re just like there’s so many things you can do to just protect your fundamental immunity. Let’s say you take a trace mineral product, you take a little bit of glycine. Usually, I see capsules that are 500 milligrams once to twice a day, sometimes asking for people to do things twice a day is a tall order. At least once a day. Taurine, 500 milligrams once a day. Some kind of a binder. There’s a product I really like by a botanical research called GI Detox. That’s a good one to take at night before bed or if you’ve ever taken chlorella or blue-green algaes, I love that one because it can be mixed into food.
It’s a one size fits many. If you have IBS or gut issues, then that might not be a great starter for you, but most people will tolerate a little bit of modified citrus pectin which comes encapsulated. I like to use a product called PectaSol just as a general habit in the evening. It just helps. The nighttime is when our body is detoxifying. Our liver is most active according to Chinese medicine from 1 AM to 3 AM. Getting sleep, powering down.
I think we’re just on our screens all the time. There’s a huge association, I didn’t even have a chance to talk about this with melatonin. An interesting use in quenching the inflammasome with melatonin. So we’re just supporting our normal circadian rhythm is a foundational immune-supportive tool, which is so deregulated in all of us. I haven’t even had a chance to begin to touch upon all the varying aspects of these in terms of nutrition and circadian rhythm and light and EMF. There are just so many aspects to this, which is why I think it can become a little overwhelming to speak to all of it.
I think the bottom line is do what you can. Even if you don’t have these tools at home, but you have the ability to power down your devices an hour early and pick up a book or a magazine or just talk to someone, pet your cat, just make yourself a cup of tea and play on your piano or sing a song, I don’t know, something that’s not a device. I challenge myself to this, sometimes successfully and sometimes not when I’m in a frenzy of communicating with colleagues about everything going on. These are things that we can do that over time if you are able to get out of your house and put your feet on the ground.
I haven’t even spoken about grounding but it’s a huge thing that I’m interested in and been telling people a lot about in my practice. Stand on the earth. Remember, I mentioned this very briefly that our immune system is first electric and then chemical. I’m using the words of Clint Ober, may God bless him. We need those electrons. We need those electrons so our immune system can work normally. Grounding is another way to reduce inflammation. Can you put your feet on the ground and stand on the grass?
I live in New York City. That is incredibly challenging to do. It might not be for my community here, but if you have that option available to you, go for it. I don’t know, there are so many things I can say, Ari. I’m going to ramble on forever.
Ari: [laughs] I’m with you. I’m a big fan of circadian rhythm and I think that’s critical as well, the melatonin link. Circadian rhythm more broadly, deep sleep, and enough–
Dr. Rahav: [unintelligible] grounding. You’re all about earthing. You’re all about light.
Ari: I’m all about light. I think sunlight is huge. The vitamin D aspect is huge. Those other pathways to light. Sunlight also ties into circadian rhythm and sleep and melatonin. Yes, I agree, we could ramble on forever. Dr. Rahaz, this has been amazing. Thank you. I just want to extend on a personal level, thank you again for the work you’re doing. Thank you again, for the courage that you have to treat these patients putting yourself in danger and your family and your friends in danger by virtue of you being exposed to such high viral loads.
I really just want to honor the work you’re doing and thank you for the work you’re doing. I appreciate it much and I can say if I personally fell ill from this, I would definitely want you to be treating me. Really, thank you so much for the work you’re doing, it’s so important. Thank you for helping to get the word out and give other practitioners ideas to experiment with, to hopefully advance the state of care and hopefully save some lives. I really appreciate you sharing your wisdom. Thank you so much for coming on the show.
Dr. Rahav: Thank you so much for creating this space, for all the work that you do both personally in your own, becoming the change you want to see and then amplifying the voices of other who are contributing together to this endeavor of making this world a better place for us and for our children.
Ari: Absolutely. Thank you. Thank you so much. Also I should mention, as a final note, if somebody is interested in either following your work or actually coming to see you to your clinic, obviously, you’re in New York, but do you want to just let people know where they could reach out to you?
Dr. Rahav: Yes, absolutely. There are different ways you can find me or also some of these suggestions that we’re really just trying to put out there to support our community, our New York community, our United States community, our world community. We’re really trying to show up for anyone who needs us in whatever way that we can. Obviously physical immediacy is helpful if you’re sick, but we’re really committed to just sharing whatever we have to share. We have a Facebook page where we’re sharing tips. We have an Instagram.
I think that’s as sophisticated as we’ve been so far in terms of disseminating information.
It would be great to do something like what you’re doing at some point if I ever figure it out. Then you can also call us and we have a phone number. It’s 646-503-5202, 646-503-5202 and we have an incredible team who is really, really educated and well-informed. They are really good about asking me or my amazing nurse practitioner who works here and we can share information either directly or indirectly through our team. If I happen to have a moment, I sometimes grab the phone myself and give advice wherever I can.
Ari: The name of your clinic is if it’s available up online.
Dr. Rahav: It’s the same as my last name. R-A-H-A-V Rahav Wellness. We’re at rahavwellness.com and then Rahav Wellness on Facebook and Rahav Wellness, I think 205 on Instagram and then you can also– I’m on Instagram and people that have messaged me, our nurse practitioner, Danelle Eliseo people are [unintelligible] are messaging her directly. That’s how some people are signing up for IVs, like getting in touch with us initially through Instagram and asking us what we’re up to and then calling our office.
You can find us personally, again, we’re small, and we’re just a small little team of individuals standing together. It’s usually not that hard to get in touch with any of us, just like you’ve got in touch with me directly on Facebook.
Ari: Beautiful. Thank you again for sharing your wisdom with my audience. I really appreciate you coming on the show this was amazing.
Dr. Rahav: I want to thank you, I want to tell you that your work and your book on Red Light Therapy has been sitting in our waiting room and has been a really popular item that people take down and in fact, I’ve been thinking about ways to incorporate more in my life. I’m a little bit even real estate in New York is so precious, I would love to just have people be more exposed to your work. There’s another kind of practice around us that has some red light therapy. I just would want to expose more people to it, but I’m really grateful in at least trying to raise the bar of awareness by keeping it right there in our coffee table. I think that you are amazing. I think the work you’re doing is amazing and-
Ari: Thank you. [unintelligible] I really appreciate it.
Dr. Rahav: –I will personally, love to also and feature your podcasts on our social media and help you raise the bar of awareness on kinesiology, on body movement, on light, on circadian rhythm and all of these foundations of health and wellness that you have taught me and continue to teach our community.
Ari: Beautiful. Thank you so much. I really appreciate the kind words. I also want to say and I didn’t want to interject and interrupt the flow of anything here, but just two days ago, I released a really fascinating podcasts around methylene blue and how that may be-
Dr. Rahav: Yes.
Ari: -with red light therapy with photobiomodulation and there’s some, it’s very early research, it’s all very speculative, but there is research showing that it leads to inactivation of coronaviruses that’s been shown. Then there’s a brand new study, it just came out a few days ago showing that it leads to inactivation of this new coronavirus strain. I’d be super curious to have you listen to that and maybe even start experimenting with it and I don’t know the legal aspects of what you can and can’t experiment with, but if you can, I would love to hear feedback on if it’s effective or not.
Dr. Rahav: I wonder also, like in terms of your work, the fact that we’ve repeatedly used and we’ve had amazing, just unbelievable, clinical scenarios outside of COVID with a combination of use of ozone with ultraviolet light and radiation, also known as photox therapy. If I start telling you the stories, they’re really staggering also in terms of autoimmune and reduction of flares also in terms of blood flow, which is also something that you might know in terms of grounding that like that, like neutralizing voltage will lead to blood flow, but when we use light therapy in combination with ozone with that.
We had a woman show up with mesenteric ischemia, which is a blockage, similar to a blockage of your coronary arteries where you then can get a heart attack and die. You have a blockage to an artery feeding your intestines and so your intestines are exercising when you eat. You get after you eat this excruciating pain, which means you can’t eat because and the doctors were recommending her to get a stent the way you do for a coronary stent. She happens to be a relative of someone who knows our practice and he called and he said, “What can you offer for this?” I said, “Well, I know that this combination of light and ozone normalizes blood flow, so why don’t we see after one therapy?” She felt better after three. She was completely asymptomatic and was able to avoid stenting of her mesenteric artery.
I think we’re seeing just in terms of validating the power of light again in combination the photox and again, I’m standing on the shoulders of giants who put this thing together. I think there are some medical legal aspects with me rolling out things newly. I think I could do it on myself, but in terms of experimental treatment, there would be a consent and I think I’m dealing with people who are fearful and in a state of emergency. If I didn’t have other things that I’d already practiced and they are already been proven and that were more widely used, it would be a big question mark in terms of justification, if there were already other things that were working.
I still think it deserves clearly attention and that’s what we use that we talked about the pathophysiology with oxygen and how we deal with carbon monoxide poisoning. That’s where methylene blue comes out of. It’s a board exam question like, what do you do?
Ari: Yes. It’s funny. I’ve heard that in a number of conversations that I’ve had with doctors. They’re like, “It’s a board exam question.” [laughs] Well, thank you again. This has seriously been awesome and really thank you for the work you’re doing. I appreciate.
Dr. Rahav: You’re awesome and I can’t wait for the next time we get to chit chat.
Ari: Me too. Thank you.
Show Notes
What treatment for coronavirus looks like (06:06)
How vitamin C affects the body (12:12)
The potential role of heme and hemoglobin in COVID-19 (13:56)
How current policies and media coverage may affect response to and treatment of COVID-19 (19:30)
How affordable treatments may be efficient against COVID-19 (25:43)
Will new legislation support better health? (38:00)
The difficult choices clinicians face with patients who has COVID-19 ) (50:54)
What Dr. Rahav would do today if she was in charge of treatments in the hospitals (58:07)
The best tips for preventing contracting a severe case of COVID-19 (1:05:27)
Links
Follow Dr. Rahav on Facebook here.
Sign up for the Naturopathy and Complementary medicine COVID-19 Support Registry here
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