Almost three years ago the CDC reported the first case of COVID-19 in the United States, and upended our lives as we know it. Quickly, terms such as “social distance” and “quarantine” permeated our language, as we adapted to greeting our friends and family with masked smiles. The news devoted (seemingly) all of their time to COVID-19 updates, from infection rates to new symptoms. As the pandemic surged on, one symptom began to gain more and more attention: something we call a cytokine storm.
About two and a half years ago, a few months into the COVID pandemic, we released a blog called Calming Your Cytokine Storm. While the term was novel to many, we were aware that for our patients who worked with an LLMD (Lyme literate MD)- cytokine storms were anything but new. Throughout the blog, we discussed the basics of a cytokine storm, as well as ways you can break the cycle at home. Now, two and a half years on we thought it was the right time for Part 2. Read on to remind yourself of the basics- and update yourself on what we’ve learned.
What Is A Cytokine Storm?
A cytokine itself is a signaling molecule, secreted by immune cells to stimulate some sort of action in the body. Any time our immune system is called into action, whether to fight the flu or repair a broken bone, these cytokines help begin the process. There are many types of cytokines- some with the ability to slow the immune system, and some that spur it into action. This makes cytokines a vital tool in fighting and recovering from just about anything the world can throw at us.
Unfortunately, the problem with these particular signaling molecules is that in some cases the body fails to turn them off- the inherent "shut off valve" just doesn't work. Essentially- a cytokine storm is a normal immune response gone haywire. This means that what can start as a gentle shower of response can very rapidly increase 1000x into a sudden, severe thunderstorm (see what I did there?)- complete with pouring rain and pounding hail. This storm triggers a continuous reaction that can overwhelm the body, sometimes leading to severe disease and even death.
COVID-19 brought cytokine storms to the media forefront, because many medical professionals observed a similar cytokine rush in COVID-19 patients. In scientific terms, the SARS-CoV-2 virus triggers excess production of the inflammasomes NRLP3 and NF-kappa B, leading to an increase in the cytokines IL-1b and IL-18 and IL-6. In turn, these signal the body to create inflammation. One of the side-effects of this reaction is an increased amount of fluid in the lungs (which is what causes the cough and shortness of breath that we have come to associate with this infection). For the majority of patients, the storm is controlled. However, for some, the infection multiplies so rapidly that the body releases far too much cytokine all at once. The resulting chain reaction fills the lungs with so much fluid that the patient essentially drowns.
What Does A Cytokine Storm Look Like?
A cytokine storm is typically the result of an infection, an injury, or other stressors. They can vary greatly in intensity, but generally speaking, cytokine reactions are responsible for those cold and flu symptoms we love so much! Think anything from fever and chills, to nausea and vomiting, to headaches, cough, and shortness of breath. I know, fun. Again, cytokine storms vary greatly, and symptoms can range from mild to quite severe.
As always, if the symptoms are severe, debilitating, or you feel worried, please seek out care and contact your physician or urgent care. Remember, it’s always better to be safe than sorry, and cytokine storms can quickly spiral out of control.
You’re Having A Cytokine Storm- What’s Next?
Because this whole process is a large chain reaction that feeds on itself, breaking any single link will stop the whole process in its tracks. Unfortunately, there isn't a medication that can instantly halt the reaction and make you feel better. The first thing to remember if you’re having a cytokine storm is that your immune system is simply doing its job! Thank it. It’s keeping you alive right now. Make sure to rest, drink plenty of water, and try to eat (if you are able). Think of it as a great opportunity to catch up on all your favorite Netflix shows.
At our practice, we deal with cytokine storms daily. (For example: Lyme or Borrelia burgdorferi has been shown to increase the cytokines TNFa, IL-6, IL-8). In an effort to calm worried thoughts, know this: for those with chronic infections, the reaction rarely ever balloons, and generally doesn't become fatal. We work with our patients to help them become adept at spotting a cytokine storm that is starting, and taking steps to keep it "tolerable". You can read more about that here.
To start, here are some of my supplemental recommendations:
AllerDHQ 2 pills 1-2x/day
Dhist 2 pills 2 2-3x/day
Specialized Pro-resolving mediators
SPM Active 2 pills 1-3x/day
Curcuplex 95 1-2 pills 2x/day
Turvia 1 pill 2-3x/day
Vitamin D: Look for 5,000iu daily
Magnesium: Look for 400-800mg daily
Chromium: Look for 200mg daily
Zinc: Look for 25-50 mg daily
EGCG (lowers IL-1b as well): Look to take 225mg per day
Melatonin: 5-20mg daily
Vitamin A: Take 10,000-25,000iu daily
Combo of: NAC, Quercetin, C, D, Zinc
Orthommune 2 pills 2-4/day
What We Know Now
The COVID-19 pandemic has been an unprecedented and undoubtable tragedy. However, it has prompted immunologists to take a deeper dive into the elevated (or depressed) cytokines we have observed in COVID-19. They have been able to create AI algorithms to diagnose and monitor conditions such as long-hauler COVID. Information like this has helped many patients achieve recovery, and start feeling better faster. We’re also seeing this information being used far and wide in the medical community for other chronic disorders such as Lyme Disease and Chronic Fatigue Syndrome. This immunological work brings promise and hope to those of us working and living in the tick-borne disease world. We have known for a long time that tick-borne disease causes immune changes, which are a leading source of dysfunction. The more ways we have to test and treat these imbalances the better!
Disclaimer: None of the information listed above is not intended to supersede or replace a plan you have created with a healthcare professional already.