Typically April showers bring May flowers, but 2020 has spotlighted a different type of forecast bringing new light to a response the body produces, known as a Cytokine Storm. Just as meteorologists keep eyes on the skies for looming storms, medical professionals are keeping close eyes on cytokines, the driving force behind the spring storms that are currently making headlines.
Understanding The Forecast
Cytokines are small proteins released by many different cells in the body, including those of the immune system, where they coordinate the body’s response against infection and trigger inflammation. Much like a pop up thunderstorm, when many cytokines are released at once the product can be a violent storm in which the immune system begins to attack itself.
When clouds are spread out and behave properly, they are viewed positively. They provide shade, funny shapes, and entertainment on a long drive. However, when clouds come together too rapidly, a scary storm is produced and does more damage than good. This is how cytokine storms happen in the body. When immune cells are produced too quickly and come together very quickly, they spread beyond a central infection and begin attacking healthy cells and tissues.
Just as a tornado will leave a path of destruction, we can see where the cytokine storm moves throughout the body. When a virus enters the body, it will trigger an immune response. Immune cells begin to attack the virus. In some patients, an excessive amount of immune cells (cytokines) are recruited to attack the virus. As these cytokine cells are attracted to the virus, they recruit more and more cytokines on their way there. Just as a violent tornado will pick up anything in its path to grow, a cytokine storm works in the same way, growing as more cells flock to that area.
Activating Storm Sirens
While meteorologists can predict when severe weather can be expected based on weather patterns or data, doctors have a harder time predicting if a cytokine storm is brewing for their patients. There is no fail-safe diagnostic test that points to a cytokine storm. However, there are signs that point to bad weather on the horizon. Your liver may be the best forecaster we have. As changes to proteins made by the liver appear, sirens should be sounding alerting your provider to something big coming. This is why diagnostic testing is necessary. Especially when an acute illness is lurking, or chronic illness hangs around.
Surviving the Storm
As we look at illness such as the flu, COVID-19, H5N1 Influenza (Bird flu) and other non-infectious diseases such as multiple sclerosis and pancreatitis there is no clear weather pattern to follow. Severe reactions in some patients and more mild reactions in others sometimes have no explanation except the presence of a cytokine storm.
In newer illnesses such as COVID-19, the immune reaction rate in younger people has been relatively low. This could be due to the fact that younger people’s immune systems are not as developed, therefore they produce lower levels of inflammation-driving cytokines and thus no cytokine storm. Or perhaps it is that younger individuals generally tend to be healthier overall.
The more we know about a patient’s immune system, the more doctors can use their immune system truly as defense. As soon as signs of an active weather pattern begins, you’ll typically start to hear the notifications of people’s cell phones around you with an “early weather alert”. By alerting people to shelter in place during a storm, survival rates are typically higher.
If signs and symptoms of a cytokine storm begin to progress rapidly, the warning alert should be sent out. The sooner doctors can spot and treat the condition with diagnostic testing, the better the chance of survival. Testing for an elevated serum ferritin (among other tests), is a good first step to detect if a person has been hit by a cytokine storm.
Interim guidelines from the US Centers for Disease Control and Prevention, updated April 3 2020, mention that high CRP and ferritin levels may be correlated with more severe illness (speaking specifically to COVID-19); but interestingly, the World Health Organization guidelines make no mention of markers for a cytokine storm.
After a severe storm, the clouds recede and the sun appears. Neighbors will check on each other with a friendly helping hand for clean up. Much like that, the body will look for ways to reduce the damage done by massive amounts of inflammation. Without the ability to resolve the inflammation, the damage to surrounding cells has the potential to be catastrophic, resulting in sepsis and even death. However, if it is controlled, inflammation can be cleaned up effectively, with little or no long-term damage.
The immune system is a powerful defense agent against foreign invaders, but when storms brew, this powerful tool is used against the body in the most detrimental way. Finding and maintaining balance with good health habits can increase the stability of the immune system reducing excessive amounts of inflammation.
As we continue to learn more about the immune system and how it adapts, we hope that providers on the front lines recognize and treat these first alerts that the body projects. As every storm eventually subsides and balance is restored, there is hope that through understanding and fast actions, the threat of cytokine storms will decrease.
Preventing the Storm
How to prevent a cytokine storm may be the million dollar question right now that no one has an exact answer to. With weather patterns, when the conditions are favorable for severe weather, the risk of storms dramatically increases. It is the same with our bodies. When conditions such as obesity, inflammation, and comorbidities such as diabetes, hypertension and heart disease are already active, the risk of a severe cytokine storm when exposed to a virus is much more likely.
Therefore, the best way to reduce the risk of a cytokine storm is to improve your overall health through better diet choices, better sleeping habits, better exercise routines, and better reduction of stress. Beyond making lifestyle changes, one of the most important things we can do is protect our immune system since it is our most valuable weapon against viral, bacterial, and parasitic invaders. A few products we recommend to enhance your immune system include:
- Mitocore (an Ortho Molecular specific formula for mitochondria support): these are the powerhouse of the cell which enables your immune cells to work much better.
- Vitamin D3: (potent immune modulator): It turns on the right cells needed to fight against invaders and decreases inflammatory cytokines
- Probiotics: Increase your body’s good bacteria to support immune function. 70% of the immune system is in your GUT!
- Vitamin C (antioxidant): It neutralizes free radicals and enhances natural killer cells.
We must all have better immune resilience to continue to battle these invisible enemies and prevent the storms with a balanced and healthy immune system in Springfield Missouri. If you would like more information on what you can do specifically to improve your resilience, please contact our office to schedule a consultation.