I’ve taken a tremendous interest in the recent deaths caused by the corona-virus infection.  The reason for my interest is high C-reactive protein (CRP), high interleukin-1 (IL-1), high interlukin-33 (IL-33) and high interleukin-6 (IL-6) levels in patients with this illness.  Recent data, literally hot off the press, demonstrates that those with the greatest risk of death had the highest CRP, IL-6 and IL-33 levels.

I have a large population of metabolic syndrome, hyperinsulinemia and diabetic patients in my practice. About 85% of my practice has hyperinsulinemia.  They over produce insulin between 2-30 times normal in response to any form of ingested carbohydrate (simple and complex sugars, fruit, pasta, cereal, oatmeal, etc.) High insulin causes elevated CRP, IL-6 and IL-33.

Why is this a problem?

A very interesting fact was published four days ago in The Lancet. They published a study looking at 191 patients in two hospital centers in China. The authors found that the highest rates of death occurred in those with current hypertension, diabetes, elevated cholesterol (high triglycerides and LDL) and/or coronary artery disease (heart disease or atherosclerosis of the arteries).  This virus traditionally causes a simple common cold.  Seeing this data in this particular viral strain dramatically changed my perspective on this virus.

These maladies (hypertension, diabetes, elevated cholesterol & coronary artery disease) are the four most common medical problems that I seen in my clinic, and they affect 85% of my practice population. All four are caused and driven by hyperinsulinemia.  The higher your insulin response to starches or sugars, the more likely you are to have hypertension, diabetes, elevated cholesterol and heart disease.

Insulin Raises Cytokine Levels

This elevated insulin in response to eating any starch or sugar, hyperinsulinemia, causes a rise in molecules called cytokines.  C-Reactive Protein (CRP), Interleukin-1 (IL-1), Interleukin-6 (IL-6) and Interleukin-33 (IL-33) are the cytokines that are abnormally and chronically elevated in hyperinsulinemia.  These cytokines are responsible for mediating the inflammatory response to illness, injury and stress in the body.  They control how your body responds with release of white blood cells, macophages, and other immune cells.   These molecular hormones are ALWAYS chronically elevated in patients with hypertension (elevated blood pressure), pre-diabetes, diabetes, elevated cholesterol, coronary heart disease and obesity.

C-Reactive Protein

CRP is a reactive protein produced by the liver in response to inflammation.  It is an “acute phase reactant” signaling the body’s immune system to respond to stress, inflammation or infection.  The presence of insulin directly raises CRP.  In my clinical experience, CRP normalizes within about three days of insulin returning to a normal level.

Interleukins (1,6, & 33)

IL-1,IL-6 & IL-33 are all cytokines.  They stimulate increased body temperature, regulate fevers, modulate macrophages and stimulate other immune cells to function in various parts of the body when infection or inflammation occurs.   These dual acting hormones are produced by a number of cells, but predominantly by the adipocytes (fat cells) and pneumocytes (lung cells).

IL-6 has a negative feedback on the liver’s ability to sense the presence of insulin.  Elevated insulin levels over time cause increased size of fat cells.  This causes abnormally high levels of IL-6 production from the adipocytes and decreases the signal of insulin on the liver – leading to insulin resistance, pre-diabetes and diabetes.  Elevation of IL-6 often persists until the fat cells shrink back down to a non-obese size.  IL-6 can also stimulate elevated CRP as well.

Elevated insulin on top of the presence of a viral infection in the lungs stimulates additional increase in IL-33.  A normal rise in IL-33 increases fluid and cells like macrophages around the lungs causing a normal immune response. This is part of the healing process, but if IL-33 is already chronically elevated in hyperinsulinemia, then a burst of IL-33 leads to the pneumonia, hypoxia and blood clotting that commonly occurs in those with severe coronavirus infections.  IL-33 has been implicated as one of the drivers in the “cytokine storm”  found in severe coronavirus infection patients.  The presence of IL-33 increases production of IL-6 leading to a “storm of hormones” (cytokine storm) being overproduced from the lungs and fat cells.

Risk of Death

Patients with elevated IL-1,IL-6, IL-33 and CRP were at much greater risk of mortality when exposed to COVID-19.  Those that died, all of them, from this viral infection had IL-6, IL-33 and CRP levels twice as high as those who recovered from the illness. That is profound.

Temporal changes in laboratory markers from illness onset in patients hospitalized with COVID-19.

What does this mean?

What does this mean to you and me?  It means that those with elevated interleukin levels are more likely to experience a severe complication if exposed to this virus.  That means that 85% of my practice, if not controlling hyperinsulinemia, is at higher risk of mortality.  That’s what got my attention.  Hopefully, it gets your attention.

But, don’t stress out. As of the writing of this post, 9-10% of the population may get sick (that is the current statistical data we have over the last three months).  Relax , because 92% of people who get the virus won’t be severe enough to warrant hospitalization.  And, only 0.4% of people will die from COVID-19.  That’s actually lower than the current influenza numbers of 0.43% mortality. (Statistics taken from https://www.worldometers.info/coronavirus/) .

A recent paper written by Qasim Bukhari and Yusuf Jameel, both from the Massachusetts Institute of Technology, analyzed global cases of the disease caused by the virus, COVID-19.  They found that 90% of the infections occurred in areas that are between 37.4 and 62.6 degrees Fahrenheit (3 to 17 degrees Celsius), and in areas with an absolute humidity of 4 to 9 grams per cubic meter (g/m3).  Absolute humidity is defined by how much moisture is in the air, regardless of temperature. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3556998)

Arizona just hit temperatures of 100 degrees Fahrenheit this week, the last week in April. This means, if the research is correct, there should be a notable decline in the transmission and number of infections in hot and/or humid areas of the country like the south and south west regions.

What can you and I do?

What can be done about it?  Follow a ketogenic lifestyle.  Studies published in November, 2019, reveal that a ketogenic lifestyle has an enhancing effect on immunity by suppressing viral replication and barrier effect through γδ T cells in the lung.

This dietary approach is, also, the only one that I have seen clinically lowering CRP and IL-6 when using it long term.  Ketosis may be the perfect prevention.  Over the last 16 years of using ketogenic lifestyles, I have seen this pattern improve thousands of times.  The presence of ketones immediately suppresses the production of IL-6 and improves the stimulus for CPR production at the liver.  Cutting out carbohydrates lowers insulin back to a normal baseline within 3-7 days for most people.  CRP returns to normal within three days of fixing your diet.  And, IL-6 begins to decline immediately.  In my obese patients, it can take 18-24 months for IL-6 to return back to normal.

Additional Measures

Don’t stress.  The overly hyped fear mongering produced in the media in the last two weeks raises your stress level.  Turn off the T.V. and stop listening to the 24 hour news cycles.  Over the next couple of weeks, while the risk of viral exposure is the highest, the following precautions are essential:

1. Follow good hand washing practices
2. Limit exposure to those who may be carrying this illness through social distancing.  If you have a fever, stay home. If you are ill, wear a mask out in public.
3. Get good sleep (six or more hours of restful sleep)
4. Use a complete pharmaceutical grade vitamin
5. Spend 20-30 minutes outside
6. Do something physical for 20-30 minutes 5-6 days per week

Taiwan and Hong Kong have instituted strict quarantines and you can see their effect in the graph below.

Above all, enjoy some bacon.  Seriously.

You can’t eat bacon?  Have a nice rib eye.  Either way, based on the data above, your ketogenic lifestyle is the very best thing you can do to avoid serious infections, including COVID-19.