Blackhawk Center For Digestive Health

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This week, I’d like to answer some questions people have asked me about the immune system, specifically the 2 approved messenger RNA vaccines put out by Pfizer ...BioNTech and Moderna and immune resiliency. If you need a refresher on how the details on these vaccines and how they work I refer you to the previous 2 blogs on the website regarding these vaccines at https://www.allfunctionalhealth.com//what-you-need-to-know Let me first start with the question about how long immune memory might last. The three primary aspects of immune memory are antibodies, killer T cells, and helper T cells. The following graphics and images are from the article in Cell Volume 181 issue 7, pages 1489-1501.E15, June 25, 2020: Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals. Circulating SARS-CoV-2-specific CD8+ and CD4+ T cells were seen in 70% and 100% of COVID-19 recovered patients, respectively. CD4+ T cell responses to spike, the main target of the current vaccines that are approved and were robust and correlated with the anti-SARS-CoV-2 IgG and IgA titers. The M, spike, and N proteins each accounted for 11%27% of the total CD4+ response, with additional responses commonly targeting nsp3, nsp4, ORF3a, and ORF8, among other sites. For CD8+ T cells, spike and M proteins were recognized, with at least eight SARS-CoV-2 ORFs targeted. Of note, it was also found that SARS-CoV-2-reactive CD4+ T cells in 40%60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating common cold coronaviruses and SARS-CoV-2. There is a recently released paper on November 1, 2020, entitled Immunological memory to SARS-CoV-2 assessed for greater than six months after infection. The authors included lead author Jennifer M. Dan and they analyzed multiple compartments of circulating immune memory to SARS-CoV-2 in 185 COVID-19 cases, including 41 cases at > 6 months postinfection. They found that the IgG antibody to the Spike protein was relatively stable over 6 months. Spike-specific memory B cells were more abundant at 6 months than at 1 month. The SARS-CoV-2-specific CD4+ T cells and CD8+ T cells declined with a half-life of 3-5 months. In their examination of antibody, memory B cell, CD4+ T cell, and CD8+ T cell memory to SARS-CoV-2 in an integrated manner, they observed that each component of the SARS-CoV-2 immune system memory exhibited continued activity at least to 6 months. There have been questions about mutations in the SARS COV-2 spike protein in the UK. News outlets implied that new strains were developing but most virologists believe these are variants to SARS COV2 at this time and it is hard to prove that they are more virulent or accounting for higher rates of infection in the UK. Reports of mutations were also brought up recently with the extermination of most of the mink population in Denmark. People infected minks which apparently have similar susceptibility to the SARS COV2 virus and then a mutation occurred where at least 12 humans apparently were infected back by the minks. There was concern that the spike or other proteins were changed enough that the current vaccines in development potentially would not be as effective or be effective. Most virologists believe that the spike protein remains stable enough for now so that there will be continued immune protection from the current 2 vaccines. Of course, coronaviruses like the flu can have significant season variations and are always mutating so we will have to see over time if this SARS COV2 will behave more like other coronaviruses. As you may know, we get new yearly flu vaccines based on the most prevalent new variation of the flu virus and our immunity starts to wane after a few months. We were initially worried that antibody counts initially dropped to undetectable after 3-4 months with the SARS COV2 but with the study above other components of the immune system like the memory T cells and helper T cells, and B cells may still be involved in immune memory for at least 6 months. How long does the RNA last? Typically the RNA is made from a DNA template and can last several hours to 1 day. After vaccination with the messenger RNA based vaccine, the lipid bilayer surrounding the messenger RNA gets incorporated into muscle cells or lymphoid tissue at the injection site and the cell will make read the RNA several times making SARS-CO2 spike protein for several hours up to 2 days as the messenger RNA was specifically engineered to last 1-2 days but then gets broken down like any normal messenger RNA. There have been questions about whether an enzyme call reverse transcriptase can convert the viral messenger RNA into DNA and then be incorporated into our human DNA. In theory, this might be possible but it has not been demonstrated in any study with the current engineered RNA that I know of and this messenger RNA is in the cytosol and not in the nucleus of the cell which houses our genetic library or DNA. Are there any additives to the current messenger RNA vaccines? From what I’ve heard from the companies there are no preservatives or other additives other than saline and perhaps buffering agents to adjust for pH and other characteristics to keep the lipids inadequate suspension. Should people who have already had COVID-19 get vaccinated? The current CDC and FDA recommendation is that even people who have had COVID-19 get vaccinated and the rationale may be that immune responses may vary as people that have less severe symptoms may not have as vigorous an immune memory and lasting protection as people with more severe symptoms. The paper we mentioned seems to indicate immune memory is present for at least 6 months but we don’t know if the body was rechallenged with another infection with the same virus or a variation if the body would mount an adequate protective immune response. We, unfortunately, do not know who long the vaccine protection would last as well so the strategy seems to follow the one we currently have the flu vaccine. In terms of immunity from natural infection versus immunity from the vaccine, there have not been enough studies to draw definitive conclusions. The vaccine immunity is based on a single component of the virus namely the spike protein and the premise that this protein would be conserved as the virus goes through its cycles of mutation. As I’ve shown you in the previous diagrams, people that had the actual COVID-19 infection after exposure to the SARS-COV-2 virus also develop immune memory to other 25 or so proteins found in the virus including the M and N proteins and other sites like nsp3, nsp4, ORF3a, and ORF8. In theory, this would be more a complete immune memory response to multiple potential targets for antibodies and killer T cells to target and may increase the chance of an effective immune response to re-exposure to the virus. Of course, even young people can have long-lasting negative health effects from an actual COVID -19 infection so the added immune memory may come at a significant cost. At the present time, those known to have had COVID-19 within the past 4-6 months will likely be asked to wait until non-infected people have been vaccinated. There are always questions about safety. So far, during the phase 3 trials of these vaccines over 40,000 people have been studied. In the Pfizer vaccine study, less than 0.5 percent had serious adverse events reported in both the vaccine and the placebo group. Four cases of Bell’s palsy were reported in participants who received the vaccine, while none has been reported in those who got the placebo. Study authors noted that those four cases are consistent with the rate of Bell’s palsy in the general population. They concluded that there was no clear evidence that Bell’s palsy was caused by the vaccine. The most common reaction to the vaccine was pain at the injection site. 63 percent reported fatigue while 55 and 38 percent of participants reported headache and muscle pain respectively. Fewer people reported chills, joint pain, and fever after the vaccination with more people having reactions after the second dose. There were reports of a severe anaphylactoid reaction requiring the use of an EpiPen in 2 healthcare workers in the UK on the first day of their vaccination rollout. These 2 healthcare workers were known to have multiple allergies and fortunately always carried an EpiPen around anyway. Because of these cases, vaccines were no longer given to people with allergies until more studies are done. At least 2 people vaccinated in Alaska with severe reactions with one having a septic shock response requiring significant medications to support blood pressure and a 1 day stay at the hospital for stabilization. These patients were not known to have previous allergies and there is not a definitive reason why these reactions occurred. Likewise, 4 workers in a suburb in Chicago had severe vaccination reactions serious enough to that halted their vaccination program for about a day while the facility reviewed their vaccination protocols. Again, definitive reasons have not been known or disclosed. So at this point, I’ve answered a lot of the more common questions but as you can see there are a lot more unanswered questions at this time. I didn’t mention this much before but we have no meaningful studies on our pediatric population. There is even controversy on the Pfizer BioNTech vaccine for people aged 16-18 as the phase 3 trial date released to the public were consenting adults over the age of 18 yet the FDA granted 16 and 17-year-olds emergency use authorization as well for the Pfizer and BioNtech vaccine. It is possible that they have more data than the rest of us. Also, we are just at the beginning of this vaccine rollout, and even though over 1 million people are expected to have had the vaccines before the end of the year many won’t have access. There are also surveys that show up to half the U.S population is hesitant about getting a vaccine and at least 20 percent would refuse a vaccine if offered. This leaves the majority of us with the only option of following CDC guidelines, optimizing our immune health, and building up immune resiliency. Vitamin D, D3&K2 drops, may play a key role and I’ve discussed this extensively in my articles and blogs. We have pharmaceutical grade Zinc Support, Allergy and Immune support, Immuno Max, Immune Defense, Virax, Liposomal Glutathione, and Liposomal Vitamin C available at our office for pick up, or they can be mailed directly to your home. All these natural supplements support the immune system and are discussed in my blogs. You can click on the links provided, go to the blogs on immune optimization or immune-boosting supplements, or contact us by emailing [email protected] or call (925) 736-9828. Have an intimate, meaningful, healthy holiday with your loved ones at your home. Take care, stay healthy. Jeffrey Mark, M.D. Your Quadruple Board Certified Physician

As we head into a fall and winter surge of the pandemic, we learn that vaccines for SARS COV2 may be coming very soon. Here is what you need to know about Pfiz...er and BioNTech’s headline-making SARS COV2 Vaccine. (https://www.allfunctionalhealth.com//what-you-need-to-know) If you have comments, questions, or want to learn how functional medicine can help with improving your gut, maintaining brain health, and optimizing immune function call our office at (925) 736-9828 or email [email protected]. For more information on B Supreme to optimize mental function and mood, cardiovascular health, and immune function, click on this link, call our office at (925) 736-9828, or email [email protected]. For more information on our Omegas Complete to optimize brain health and memory, support heart health, and modulate the inflammatory response, click on this link, call our office at (925) 736-9828, or email [email protected]. Take Care and Stay Healthy. Jeffrey Mark, M. #omega #vitaminb12 #healthylifestyle #healthyliving #cardiovascularhealth #bloodvessels #advancedglycationendproducts #moodoftheday #immunesystem #DNA #pandemic #vac

Should you be taking probiotics? Can you list at least three healthy benefits of probiotics? Many of you know probiotics help treat diarrhea, help with regular... bowel movements, and boost your immune system but did you know they help keep your heart healthy, improve your mood, and prevent traveler’s diarrhea? Learn eight health benefits of taking probiotics, the different beneficial strains, and ProBio 350 with 18 researched beneficial strains. Join me here (https://www.allfunctionalhealth.com//probiotics-8-healthy-) for a discussion. If you have comments, questions, or want to learn how functional medicine can help with improving your gut, maintaining brain health, and optimizing immune function call our office at (925) 736-9828 or email [email protected]. For more information on our pharmaceutical-grade supplements to boost your immune system click on this link (https://www.allfunctionalhealth.com//probiotics-8-healthy-) or call our office at (925) 736-9828, or email [email protected]. Take Care and Stay Healthy. Jeffrey Mark, M.D. #probiotics #functionalmedicine #guthealth #immunity #hearthealth #traveler #diarrhea #IBD #IBS #moodoftheday #healthylifestyle #boardcertified

All of us can no longer get the same amount of nutrients from what we eat compared to our grandparents or great grandparents. Whether it’s due to overuse of our... soil, eating corn fed animals, and/or exposure to toxins in the environment, certain key nutrients may be missing in our diets. Join me for this first part of a discussion on supplements. We’ll be talking about why I recommend people get adequate amounts of Vitamin D. We'll also discuss the latest study on Vitamin D and the pandemic here (https://www.allfunctionalhealth.com//supplements-efficacy-) . If you have comments, questions, or want to learn how functional medicine can help with improving your gut, maintaining brain health, and optimizing immune function call our office at (925) 736-9828 or email [email protected]. For more information on our pharmaceutical-grade D3 & K2 drops that help build bone health, balance blood sugar, and maintain cardiovascular health as well as boost your immune system click on this link to get my free e book https://jcgmark.clickfunnels.com/offer-wrap-up-pageizwquelk or call our office at (925) 736-9828, or email [email protected]. Take Care and Stay Healthy. Jeffrey Mark, M.D. #functionalmedicine #gastroenterology #Gastritis #vitamind #vitamindtherapy #vitamink #immunity #immunitybooster #guthealth #brainhealth #bonehealth #pharmaceuticalgrade

The number of COVID-19 cases has reached over 32 million cases worldwide as we pass the fall equinox. Flu season is coming upon us and there will probably be a further spike in Covid-19 cases. Here are some things we can do to prepare.

NEW MOLECULAR PPE AND PREVENTATIVE TREATMENT FOR COVID/SARS-CoV-2. A team of scientists at UCSF has engineered a completely synthetic molecule that straitjack...ets the critical SARS-CoV-2 machinery that allows the virus to infect our cells causing the current pandemic. This new technology will be a game changer in halting the spread of COVID-19, as researchers around the world are working on finding a safe and effective vaccine. Details of the research report is in a new paper, now available on the preprint server bioRxiv. The treatment called "AeroNabs" is an aerosolized formulation that will be in the form of a nasal spray or inhaler to be used once daily. Since it is a nasal spray or inhaler, it can be self-administered easily. AeroNabs could provide powerful protection against COVID-19 until a vaccine becomes available, or it can be used in conjunction with a vaccine. Clinical trials will be underway soon and the researchers hope to make it readily available to the public as an inexpensive preventative treatment for COVID-19. AeroNabls will be an effective molecular form of PPE that could serve as a powerful and reliable line of defense against COVID-19 used together with physical PPE and social distancing and wearing mask to decrease transmission of the virus. #COVIDgamechanger #pandemic #Prevention #treatment #aeronabs #Clinicaltrials #inhaler #NasalSpray #molecularppe #mask #UCSFdiscovery #functionalgastroenterology #functionalmedicine #RegenerativeMedicine

The typical American diet is loaded with things that can harm the critical functions of your digestive system, like sugary drinks, artificial sweeteners, and pr...ocessed foods full of additives and inflammatory oils. If you could see inside your digestive system, you’d see about 40 trillion bacteria moving around, mainly in your large intestines. We call these your gut microbiota, and while some are good, others can lead to digestive issues and diseases. If you’re one the millions of Americans suffering from digestive issues such as irritable bowel syndrome, lactose intolerance, gluten sensitivity, or food sensitivities, we can help you improve your gut health. Here’s how to start. Eat foods with prebiotics and probiotics Prebiotics are fibers that promote the growth of healthy bacteria in your gut. Your body can’t digest prebiotics, so they serve as food for the good bacteria to break down like fertilizer for your gut. You can get prebiotics naturally by eating many vegetables, fruits, and whole grains. Probiotics are actual bacteria you consume to help you increase the number of healthy bacteria you have in your gut. Foods that contain these live bacteria include yogurt, kimchi, kombucha, and fermented sauerkraut. Your diet has a tremendous influence on the health of your gut. Our team can give you a list of recommended foods to eat and a list of those to avoid depending on your condition. Dr. Mark offers monthly webinars on functional nutrition so whether you live locally in San Ramon, Danville, Walnut Creek, across the Bay Area or even across all 50 states, just email us at [email protected] and we would be happy to send you a link to our live webinar with Dr. Jeffrey Mark, M.D./Quadruple Board Certified Physician. #FunctionalandRegenerativeGastroenterology #BoardCertifiedInAntiagingAndRegenerativeMedicine #BoardCertifiedInFunctionalMedicine #BoardCertifiedInGastroenterlogy #BoardCertifiedInInternalMedicine #GutHealth #ImmuneHealth #Probiotics #Prebiotics #Microbiome #DigestiveIssues #Inflammation #IBD #IBS #Crohns #LactoseIntolerance #Foodsensitivities #FunctionalTesting

Medical Foods Are Not Dietary Supplements. Many people use multivitamins, minerals and specialized herbs to support good health. But are these dietary supplemen...ts considered medical foods? Why not foods are different than supplements because these formulations are created to uniquely provide more benefits. Medicals foods are specially formulated and used in functional and regenerative medicine specifically as a form of dietary management of a disease or condition that has distinctive nutritional needs that cannot be met by normal diet alone. Medical foods are much more than just a shake". A medical food is formulated to deliver targeted nutrition for the nutritional management of a single, specific condition diagnosed by a trained functional medical physician. Dietary supplements can be purchased over the counter by just about anyone. However, the law stipulates that medical foods must be used under the ongoing supervision of a healthcare practitioner. This is because patients who use medical foods have health conditions that require medical management to ensure that the right amount of medical food / nutraceuticals are administered and adjusted as needed by a medical professional. Additionally, ingredients found within a medical food must be GRAS (Generally Recognized As Safe) while ingredients for dietary supplements are often not tested and have a different standard. All Functional Health medical foods and nutraceuticals offered at our practice are PHARMACEUTICAL GRADE and GMP (Good Manufacturing Practice) certified, which means that the ingredients are tested for purity prior to production; the products are tested after production to ensure that what is on the label is indeed in the product; the products go through an additional step of quality assurance where the product is exposed to high heat to simulate a 2 year shelf life to ensure that the product is stable on the shelf through its expiration date on the bottle. Only pharmaceutical grade products undergo these stringent quality control measures to ensure that there are no contaminants, fillers, counterfeit materials in these medical foods and nutraceuticals. Dietary supplements are intended to provide nutritional support for people already in good health. Medical foods and nutraceuticals are formulated for dietary management of an existing disease/condition as diagnosed by your functional medical physician. Dietary supplements are designed to supplement the diet with one or more dietary ingredients such as vitamins and minerals, amino acids, botanicals, herbs, or enzymes. While dietary supplements may be taken without medical supervision (although it’s a good idea to take any supplement upon the recommendation and guidance of a healthcare expert). Medical foods and nutraceuticals are unique combinations of nutritional ingredients to support the management of a specific medical condition. If you have a health condition that requires dietary management, or you are currently taking prescription medications for various conditions and would like to know if you can either lower your dosage, or switch to a drug free treatment option, give us a call so we can thoroughly evaluate your current treatment protocol with you. Ask us if you could benefit from using a medical food or nutraceutical. We specialize in treating all medical condition with drug free options.

Today, we will be looking at studies on how the heart has been affected by COVID-19 in people with continued shortness of breath and fatigue even 2 months after... the initial infection. The other major organ that can account for the shortness of breath, fatigue, and weakness in post viral syndrome is the heart. The suspicion in the early part of the pandemic that COVID-19 patients complaining of having chronic fatigue with shortness of breath may be from heart disease; some of the symptoms of heart failure overlap. Echocardiograms, however, were not done initially for hospitalized COVID-19 patients unless a major change in management was anticipated. Also other factors were in consideration including the fact that it’s difficult to sterilize the echocardiography machine and hospitals didn't want to expose echo technicians to COVID-19 unnecessarily. Recently a new paper in the European Society of Cardiology paper now makes the case for doing echocardiography for symptoms of fatigue, especially with lower extremity swelling, or shortness of breath when lying flat. These are all symptoms of impairment of their heart or heart failure. The findings in the paper were completely unexpected. They included patients in over 69 countries across 6 continents and looked at over 1200 patients in a number of age groups. 70% were male, 55% of the patients that were admitted with COVID-19 had an abnormal echocardiogram during hospitalization. Patients being admitted to the hospital with covid-19 got an echocardiogram. 55% of those patients had an abnormal echocardiogram that was not just the left or the right sides of the heart but involved both sides with 39% involving the left and 33% right. The conventional thinking was that one would see the majority of the pathology be on the left side of the heart and the minority would be on the right but in fact they were close to being about the same which could be consistent with pathologies including pulmonary thromboembolism or a clot in the lung blood vessels. Other heart pathologies were not seen to any great degree. The actual myocardial infarction or heart attack that was new was only seen in about 3%, myocarditis or inflammation of the heart in only about 3% and cardiomyopathy which is heart failure from a very stressed heart that can usually recover was seen in about 2%. One of the key findings that these authors found was that doing the echocardiography changed management in one third of the patients so these authors are advocating that we shouldn't be holding back on getting echocardiography with any COVID-19 patients with possible heart failure symptoms. So if COVID-19 survivors that had been hospitalized , discharged and then present in the office with any sort of symptoms of shortness of breath especially while lying flat or having increased swelling in their legs should be scheduled for an echocardiogram. Some of these people may have viral myocarditis with reduced ejection fractions or reduced heart function. There are other papers suggesting that over 55% of COVID -19 infections have abnormal echocardiograms perhaps even without symptoms. Those with symptoms may need to be treated and supported for heart failure. In general, people with post viral symptoms should have further evaluations like pulmonary function tests and echocardiograms. In addition to the usual medical treatments and support, starting N-acetyl cysteine or glutathione may also be considered. More studies need to be done to have a better understanding of whether these symptoms will improve over time or if other nutritional and lifestyle changes can help. In a 1997 there was a study that looked at influenza and post viral syndromes with similar symptoms of chest tightness , fatigue , shortness of breath that continued after they recovered from the regular flu. The study looked at those patients who were taking N- acetyl l-cysteine at 600 mg twice a day for 6 months. Even though they had the same number of influenza infections as the placebo group or the group that didn’t take N-acytl L-cysteine , their symptoms were much less. There was a reduction in post viral symptoms from 75% down to 25%. We may not know if this would work for the current post viral syndromes from COVID-19 and more studies may need to be done, but certainly taking N-Actyl L-Cysteine, along with other nutraceuticals as a preventative measure before or during COVID infection would be reasonable without any significant downside risk. If you have comments or questions about this post, or would like to attend one of our health webinars, or want to learn how functional medicine can help with improving your gut, maintaining brain health, and optimizing immune function , contact our office at (925) 736-9828 or email [email protected]. For more information on our pharmaceutical grade nutraceuticals to boost your immune system: MitoMax to optimize mitochondrial function , including N-Acyt L-cysteine 600mg, Natural Allergy Support which includes 400mg of Quercetin, and Zinc Support including 23mg of Zinc Citrate and Zinc Gluconate, call our office at (925) 736-9828 or email [email protected]. We can ship the nutriaceuticals to all 50 states. Take Care and Stay Healthy. Jeffrey Mark, M.D. #functionalgastroenterology #guthealthisallhealth #foodallergies #immunehealth #inflammation #functionalmedicine #fixyourfatigue #insomnia #stressreduction #GERD #STOMACHULCERS #excessstomachacid #antacids #ProtonPumpInhibitors #drugfreeoptions

Stress is needed for survival but excessive unmanaged stress can be harmful to your health. If you can identify with this short video then you may need help managing your stress.

3 Tips for Disinfecting Your Mobile Phone. Something you touch often with your hands and face is your mobile phone. Here are 3 tips for disinfecting it, especia...lly during this time of increased concerns about disease transmission. 1.Turn it off. Turn your device completely off before cleaning. Remove your phone’s case and unplug all cables and clean thoroughly. 2. Clean your phone using at least a 70 percent isopropyl alcohol wipe. Avoid getting moisture in any opening. Never use aerosol sprays, compressed air, ammonia or abrasives. 3. Use earbuds. Minimize the hand phone face triangle by using earbuds or hands-free Bluetooth and wireless options. It is really easy to contaminate your phone as you move from one task to another throughout the day in between making phone calls. Sanitize your phone frequently, or try to not use your phone for a brief period when you know you'll be touching many contaminated surfacing such as while shopping, etc. Did you know as you boost your gut health, you would also boost your immune health? Click here to watch how to boost your immune health in 6 steps. https://jcgmark.clickfunnels.com/webinar-replay1592458931853 Dr. Frances Mark, Pharm.D. AllFunctionalHealth.com 925-736-9828 #guthealthisallhealth #immunehealth #functionalgastroenterology #foodallergies #inflammation #obesity

We have all heard about the recent surge of SARS COV 2 cases across many parts of the United States and involves us here in California as well. We can all help curb the pandemic by wearing masks. People without symptoms are known to cause spread of the virus so collectively if we all wear masks to protect other people and everyone is wearing masks, then we all can be protected. I discuss the recommendations and types of masks HERE. Also, I'm giving a webinar on How to Optimi...ze Gut Health on July 16th, 2020 at 11:00 AM PST. For more information and to attend please REGISTER HERE. If you have comments, questions, or want to learn how functional medicine can help with stress, improving your gut and immune function call our office at (925) 736-9828 or email [email protected]. Stay healthy and take care. Jeffrey Mark, M.D. P.S. If you have issues with any of the above links here are the direct links: For the written and video blog: https://www.allfunctionalhealth.com/blog/guide-to-masks For the Webinar information and registration: https://jcgmark.clickfunnels.com/webinar-registrationshrd7t See more