San Francisco Institute for Integrative and Regenerative Medicine

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It’s time to put Hydroxychloroquine to rest and move on to other promising therapies. Plasma (from patients that have recovered from COVID-19) infusions do have a sound rationale and supporting observational studies but need more research to make a more definitive claim.

Good News! Dexamethasone is a low cost, readily available anti inflammatory that helps reduce the over activity of the immune response that is responsible for the more life threatening consequences of COVID-19.

The San Francisco Institute for Integrative and Regenerative Medicine supports the activists bringing awareness to institutionalized racism and police brutality. We are committed to the ideals of Pluralism and Social Justice.

I’ve had a number of patients send me this clip on the Plandemic. I’m with Z Dogg on this one. Like a lot of the misinformation out there, this is grabbing bits and pieces from all over the place without any coherent logical argument. Hospitals are going broke over this because they have had to stop elective surgeries. They are not cashing in on Covid-19. It is extremely expensive for a hospital to maintain someone on a ventilator in the ICU and to insinuate that hospital...s are part of a conspiracy is outlandish and immoral, as hospitals are making the ultimate sacrifice right now for the population around the world. I have no interest in protecting Big Pharma and in many cases I promote non pharmaceutical interventions that are safe and effective alternatives when it is appropriate to do so. But it is just as important to be critical of the types of arguments that come from the extreme of the anti-Pharma side. As a physician, with my patients best interest in mind, I strive to use the best of both holistic and conventional medicine to pragmatically address the unique problems that patients present with and that is the essence of Integrative Medicine.

A home pulse oximeter is one of the most clinically useful tools a person can have to help monitor for either a silent COVID or to help monitor the progress of a diagnosed case. All patients who have tested positive for the coronavirus should have pulse oximetry monitoring for two weeks, the period during which Covid pneumonia typically develops. All persons with cough, fatigue and fevers should also have pulse oximeter monitoring even if they have not had virus testing, or even if their swab test was negative, because those tests are only about 70 percent accurate. A vast majority of Americans who have been exposed to the virus don’t know it.

Acute Respiratory Distress Syndrome is the primary reason why patients with Covid-19 need to be hospitalized and intubated. Vitamin D deficiency puts patients at higher risk of ARDS. If you aren’t on a Vitamin D supplement than you are likely deficient. I test all of my patients at their annual physical and this holds true in the majority of cases. I usually recommend patients take high potency vitamin D3 50,000 IU twice a week for 8 weeks (with a meal since it requires dige...stive enzymes to absorb the fat soluble vitamin D) to replete their levels to the optimal range of about 65 (deficient is less than 30). Most patients will likely have to do this twice a year to maintain this level. Fall and early spring are best as summer may provide enough sun exposure if you live in the right latitude, don’t use sunscreen, which is not ideal for other reasons, and don’t wash the oil vitamin D off your skin within 6 hours of sun exposure. Too much vitamin D can be toxic to the liver and it builds up over time with continued use of high doses. When patients are starting to come down with something I usually recommend 100,000 IU Vitamin D3 per day x 3 days. After that 5-10,000 IU/ day is safe for the next week or two.

This is why having a home O2 saturation monitor can help determine when you are in need of more urgent medical attention and when it is fine to wait it out at home. Shortness of breath on exertion and at rest help differentiate a mild case that can be managed at home from a severe case that needs to be evaluated in the ER. An O2 saturation monitor can help further refine the severity and can provide more meaningful data to a telehealth provider or phone call to your primary care docs office so they can help triage your case.

A video by my former teacher at Shanghai University of TCM, Heng Li, M.D., PhD, describing the potential benefits of Astragalus for helping to support your immune system.

Here is an update from a recent UCSF presentation on how we understand the COVID-19 disease manifestation and phases of treatment as well as some initial promising studies looking at treatment efficacy.

Dr. Perlmutter offers a well grounded integrative medicine perspective answering common questions regarding the coronavirus.

One of the most important biometrics that determines the necessity for a trip to the ER is a patient’s blood oxygen level. An O2 sat monitor can cost $10-20 and provide critical life saving information about whether a patient’s lung function is decompensating. It can also be an early indicator of a subacute process happening in the lungs when your O2 saturation is dropping into the mid to low 90s at rest and your baseline is 97 or higher as would be normal for most people wit...hout lung disease. If your O2 saturation is less than 88 then I’m worried about organs like the brain and heart not getting enough oxygen and impending respiratory failure. Having an O2 sat monitor at home can help provide critical information to a doctor triaging your condition over the phone to determine whether you should go to the ER or continue to take care of yourself at home. See more

If ever we needed a trend to go viral, this is it. Staying Home is the best way to reduce transmission. Ordering in, closing our businesses and taking out loans as necessary are all sacrifices we will need to make but in those cases where we need to be in public for the foreseeable future, consider making your own mask until we have a significant stockpile for everyone that needs them the most. After seeing a number of patients from Hong Kong and discussing the differences b...etween our approach in the US vs Asia, mask wearing is an obvious benefit for reducing transmission that we are not utilizing. The problem we have in the US is that we have a shortage of masks and medical practitioners who are not able to self isolate and are in close contact with a high number of the most sick and contagious patients do need them. Here is a study looking at self fashioning your own mask and the efficacy of some of the materials that would be readily available to anyone. It would be truly patriotic for people walking outside to wear a self fashioned mask that says not only do I care about reducing any likelihood that I will transmit disease to other people in my community, but also I care about the healthcare workers who are putting their lives on the line to save our community and potentially any one of us.