Men’s Health Approach to the COVID-19 pandemic with Dr. Geo Espinosa: Rational Wellness Podcast 151
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Dr. Geo Espinosa provides a Men’s Health Approach to the COVID-19 pandemic with Dr. Ben Weitz.
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2:24 Dr. Espinosa provides a men’s health perspective on how to protect oneself from the Coronavirus. Men are twice as likely as women to die from the corona virus. Men were two to three times more likely to die from the 1918 influenza. Men were also more likely to die from SARS and MERS. If someone is male, over 60, and smokes, they’re in trouble. Men are more likely than women to smoke and less likely to wash their hands. Testosterone has an immuno-weakening component to it compared to estrogen. While there is a tendency for men to want to have as high a testosterone level and as low an estrogen level as possible, Dr. Espinosa likes his male clients to have an estrogen level of between 20 and 30 and not less. Estrogen has immune stimulating benefits, which is why women are less likely to succumb to infections and more likely to suffer with autoimmune diseases.
9:05 One other reason that men are more prone to infections is because the X chromosome is involved in the processing of T cells and B cells while men have one X chromosome, women have two.
13:23 The coronavirus tends to target certain organs, including the lungs, the heart, and the kidneys. Some patients end up with a myocarditis, which is why they may succumb. A percentage of patients get GI symptoms. Some of the symptoms are typical cold and flu symptoms. Some patients have a loss of smell and taste. They may get a rash around their eyes. Most patients get a fever. Since testing is not widely available, if you have the symptoms, you should assume that you have it until proven otherwise.
20:20 Some of the most important things we can do to strengthen our immune system include making sure that we get
- Quality sleep
- Melatonin has both antioxidant and anti-inflammatory properties
- Vitamin C–500 mg every 2 waking hours, which works out to a total of 4-5,000 mg per day. The importance of vitamin C is often under appreciated. IV vitamin C should be used in the more critical phase of the viral infection.
- Spray botanical mixtures with echinacea and other herbs that you spray into your throat throughout the day
- Moderate levels of exercise
- Eating healthy, which means avoiding refined carbohydrates and sugar, which which weaken your immunity.
- Intermittent fasting and the fasting mimicking diet both stimulate immunity.
44:00 The World Health Organization (the WHO later reversed its position on this) and the French health minister have both recommended that we avoid using nonsteroidal anti-inflammatory medications (NSAIDs) because they may increase the ACE2 receptors where the coronavirus attach to the cells. And NSAIDs are often used to lower fever, but we should really let the fever stay, since this is how the body is fighting the virus, unless the fever gets dangerously high. It is recommended that if a medication is needed to lower the fever that acetaminophen (Tylenol) is recommended. And of course the downside to taking acetaminophen is that it inhibits glutathione production, which is super important for immune function and acetaminophen can also be liver toxic.
50:40 Other nutraceuticals to consider taking to strengthen our immunity include the following:
- Selenium is immunomodulatory and has antiviral properties. 200 mcg per day is recommended. Selenized yeast is preferred.
- Zinc up to 60 mg per day, though he usually recommends 30 mg per day. If you take 60 mg per day you need one mg of copper per day.
- Vitamin D 4000-5000 IU per day to start with along with vitamins K1 and K2.
- N-Acetyl Cysteine or liposomal glutathione.
- Glycyrrhizic acid from licorice.
- Andrographis, echinacea, and astragalus are herbs that are very helpful in fighting viral infections.
- Larch arabinogalactan
- Quercetin–300-500 mg once or twice per day
- Resveratrol–200 mg twice per day. It may have anti-coronavirus properties and it helps with male sexual health through nitric oxide production in the endothelial cells of the blood vessels.
Dr. Geo Espinosa is a Naturopathic Doctor, licensed Acupuncturist and Certified Functional Medicine practitioner recognized as an authority in holistic urology and men’s health. He is a professor and holistic clinician in Urology at New York University Langone Medical Center and faculty for the Institute for Functional Medicine. As an avid researcher and writer, Dr. Geo has authored numerous scientific papers and books including co-editing the Integrative Sexual Health book, and author of the best selling prostate cancer book: Thrive, Don’t Only Survive. Dr. Geo is the Chief Medical Officer (CMO) and formulator at XY Wellness, LLC and lectures internationally on the application of science-based holistic treatments in urological clinics. His website is DrGeo.com.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com.
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting-edge health information. Subscribe to the Rational Wellness Podcast for weekly updates, and to learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast. Hello, Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy the podcast, please go to Apple Podcasts and give us a ratings and review. If you’d like to see a video version of this interview, you can go to my YouTube page. If you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.
Today, I will be talking to the go-to expert on men’s health in the functional medicine world, and my friend, Dr. Espinosa. Today, we are not going to be talking about prostate or men’s health. We are recording this while we’re in the midst of the COVID-19, coronavirus pandemic, and Dr. Geo will be giving us his perspective on the situation, what steps we can take from a preventative perspective to help strengthen our immune system, and to increase the likelihood that we will have a positive response if we do get infected.
Dr. Geo Espinosa is a naturopathic doctor, licensed acupuncturist, and certified functional medicine practitioner, recognized as an authority in holistic urology and men’s health. He’s a professor and holistic clinician in urology at New York University Langone Medical Center and faculty for the Institute for Functional Medicine. As an avid researcher and writer, Dr. Geo has authored numerous scientific papers and books, including co-editing the Integrative Sexual Health book and author of the bestselling prostate cancer book, Thrive Don’t Only Survive. Dr. Geo is also the Chief Medical Officer and Formulator at XY Wellness, and he lectures internationally on the application of science-based, holistic treatments in urology clinics. Geo, thank you for joining me today.
Dr. Espinosa: Ben, it’s such a pleasure, such a pleasure. We may have to start this conversation from a men’s health perspective.
Dr. Weitz: Oh, that sounds good.
Dr. Espinosa: And we need to take-
Dr. Weitz: Yeah, why don’t we do that?
Dr. Espinosa: … preventative action. There is a connection.
Dr. Weitz: Okay, cool. Let’s do that. Tell me how the present coronavirus pandemic has impacted men’s health and how it’s affected your practice. What’s your perspective on that?
Dr. Espinosa: It turns out that men are more prone to getting the coronavirus. They’re more prone to dying from it than women about almost twice as much. That’s the data that came from China, and the data that’s coming from certainly Italy, and even South Korea. Historically, men are always more prone to dying from viral infections including the 1918 influenza, which that affected younger people between the ages of 20 to 40. Most that succumbed to dying from the Spanish flu, they were men. Two to three times as much. SARS in China a couple of years or several years ago mostly affected men. MERS mostly affected men. Even the human papillomavirus in terms of when it converts into different cancers, even like lymphoma, affects men more times than or at least the mortality rate is higher in men more so than it is in women. I find that to be very interesting. If someone is a male patient, 60 years old or over, who smokes, they’re in trouble. They’re in trouble. That particular population is in trouble. I guess it begs a question why is that. Why are men more prone to infections and viral infections? Why do they succumb to it more so than women?
Dr. Weitz: Is that because estrogen helps stimulate our immune system?
Dr. Espinosa: There are several theories. Most of these theories have been looked at by scientists involved in looking at behavioral changes in populations. One of the reasons is that men tend to do more things that affect their health negatively than women around the world. About 50% of men in China smoke contrasted to about 5% of women who smoke in China.
Dr. Weitz: Really? Wow. That’s a big drastic difference.
Dr. Espinosa: That’s right. In Italy, about 40% of men smoke. Men tend to wash their hands less and do all kinds of less hygienic things than women on average. That’s one version. Some of it is behavioral. Some of it is just lifestyle. Some of it is-
Dr. Weitz: When you talk about smoking now, we’ve got vaping is the new version of it, especially among younger people.
Dr. Espinosa: Right. When you talk about the fact that coronavirus affect mostly aging people. I have 80-year-olds that are in better shape than 40-year-olds. It’s not so much that. It’s that, on average, those who age are less strong, more feeble than those who don’t. But when you see the cases coming out now, some of these younger people, it’s not affecting so much as much kids yet. I mean it is, but the percentage is much less than 1%. Once it gets to 40 years old, it’s really affecting mostly people that are between their 40s and 80s and, again, mostly men.
The other reason why that you alluded to, Ben, is that the hormone that makes us men, and that we love, and is dear and near to our hearts, and our… literally near and dear to our hearts because its cardiovascular benefit, and makes us strong and healthy is testosterone. However, testosterone does have an immuno-weakening component to it compared to estrogen. So that’s how when I’m reading estrogenic levels in men, I really like them to be about between 20 and 30 nanograms per milliliter, not less. And so sometimes in our world, treating men’s health, many people think less is more. Less estrogen is more. Well, there’s an important benefit, osteoporosis prevention in men as well as much as in women. Estrogen plays an important role in men as well. So, yes, estrogen, the predominant hormone in women, they have more of that, so then they succumb to these viral infections and even bacterial infections a lot less than men.
Dr. Weitz: Yeah, I’ve had-
Dr. Espinosa: Of course, that’s why women-
Dr. Weitz: Yeah, I’ve had-
Dr. Espinosa: I’m sorry. One more thing. That’s why women are more predisposed to autoimmune diseases as well.
Dr. Weitz: Right, right. Yeah, I’ve had a few patients who were going to see anti-aging doctors come in. They were on testosterone, and they put them on these anti-estrogen drugs, and sometimes their estrogen gets driven down so low. So now, we see one example of why that’s problematic.
Dr. Espinosa: Yeah, I like my ratios to be 10 or 12:1, testosterone to estrogen and/or roughly, the estrogenic level to be around a 20 to 30 nanograms per milliliter.
Dr. Weitz: Is that for total estrogen or estradiol?
Dr. Espinosa: Total estrogen.
Dr. Weitz: Okay.
Dr. Espinosa: Total estrogen. That shouldn’t be a problem if they’re converting properly. Life is good with total testosterone being high because then all things kind of normally take care of themselves. You don’t want to produce too much DHT, but DHT is also important. So there’s no thing as bad hormones in people in general. It’s all about ratios. If total testosterone is a good number, then everything else normally takes care of itself. There more be more 5 alpha reductase activity in some places, more aromatase activity, but all in all, everything takes care of itself including the conversion of testosterone to estrogen.
One other reason that it seems that more men are prone to infectious diseases is because the X chromosome is involved in the processing of immune cells, T cells, and B cells, and so forth. Women have two of those. Men have one. Men have XY, right? So the X chromosome is involved in that process. Again, these are all the theories. I read about this phenomenon around three years ago. I have actually the book here. I’m always reading male books, as you can imagine. This is a great book called How Men Age by Richard Bribiescas right here. I read this book about two years ago. It was the first time I was drawn to the idea that men, they succumb to infectious diseases more and things like that. I really didn’t know that information, and this concept about testosterone being not great for immunity, and things like that.
Dr. Espinosa: Then now, we’re seeing a lot more cases. There was a article published in The New York Times, The Guardian as to this connection of men being more vulnerable to COVID-19 than women. There’s the connection there.
Dr. Weitz: Interesting. Other than making sure men don’t have their estrogen level too low, are there any strategies around that concept?
Dr. Espinosa: I don’t know, right? We cannot undo our genes, and we wouldn’t want to. Again, testosterone’s a very good hormone, does a lot of really good things for us. If our total is in normal to optimal, then everything takes care of itself including estrogen. Testosterone’s a very important hormone. We want to optimize that for sure. What I would say one of the takeaways is, in my opinion, thus far is, look, we know that immuno-compromised patients are succumbing to COVID-19, right? Even the younger population, they have sometimes comorbidities. There’s only very few cases that people are saying, “Well, this person was healthy, and they are on a ventilator.” There’s very few of those cases. Sometimes you hear it in the news, you hear it on CNN or Fox. First of all, how we describe or define healthy, it’s… right? It’s-
Dr. Weitz: Exactly. I was listening to one of those discussions. It was talking about some gentleman who’s in the news. I guess he’s a friend of Biden’s. He said, “Oh, he was perfectly healthy.” He had a big gut on him. Right away, my first thought is from my perspective is, “That guy’s not healthy. He’s got metabolic syndrome without even doing any testing.”
Dr. Espinosa: I would assume so. I don’t know these people, but I would assume so. Everybody’s definition of healthy is very subjective. I think the takeaway for men is, first of all, knowledge is half the battle. So knowing that we succumb to all these things more than women is something that should be a driver for us, take better care of ourselves. The other is that we need to do some things. We need to work to keep our immune system up. We do the right things, it’s very unlikely that we’ll succumb to things like viral infections of any kind, even new ones, newer strains because I think one of the lessons here is that it’s not only viral infections in general. It’s that you don’t know when a new strain is going to come about, right?
Dr. Weitz: Correct.
Dr. Espinosa: And then our bodies are just not immune to this new strain. That’s part of what’s happening now with COVID-19. It behooves us to do the right things. The right things is not gender-specific. We can discuss some of those things when you’re ready.
Dr. Weitz: Sure. Let’s see. What else do we want to talk about? The latest research on the coronavirus, I guess we know that it tends to target the lungs. Then there’s some literature that it tends to target other organs like the heart seems to be a prominent factor. Some patients end up with a myocarditis. That seems to be one of the reasons why people end up succumbing to it.
Dr. Espinosa: Yeah, yeah.
Dr. Weitz: We’ve also seen a percentage of patients now who get GI symptoms.
Dr. Espinosa: That’s right. That’s right. The novelty of this virus is what makes it a challenge, right? Some of the symptoms, mild symptoms can include things like cold-like symptoms or flu-like symptoms. Other symptoms that are more associated with COVID-19 includes things like loss of smell and taste. I am monitoring a few patients actually with COVID-19, although, again, it’s not my specialty, but some of my male patients, I’m monitoring with this case. So far, they’re doing well, thank goodness. Some fair-skinned people get a little rash around their eyes that is like a red rash around their eyes. It’s patchy and so-
Dr. Weitz: What are you thinking-
Dr. Espinosa: … it looks like anything, and it could feel like anything. The fever, 101 fever, that my daughter had three weeks ago could have been COVID-19. I wrote on drgeo.com this article that I wish my prostate articles gain as much popularity as this COVID-19 one. It did spend a good time. It’s kind of very simple way of knowing what it is and what one can do naturally, but I wrote that one should assume they have it or had it until proven otherwise, I think. It will be prudent to do so.
Dr. Weitz: Well, we know the test that the CDC has, came out with, which is the most common test, still I think has about only a 60% sensitivity rate. So there’s a lot of false negatives.
Dr. Espinosa: That’s if you have access to testing.
Dr. Weitz: If you can even get it, exactly.
Dr. Espinosa: Yeah. If you have access, then you’re right. It’s only 60%. I saw something online. I don’t know. I didn’t verify it. I didn’t fact-check it. There’s a lot of confusion with this whole thing, as I continue to touch my face. The other thing that I wrote about is how are we supposed to do everything? It behooves us to do everything possible to keep our body strong and our immune system strong because I’m not going to turn every doorknob with my elbows. I touch my face. I don’t even know when I’m doing this. Wasn’t there a politician talking about what we should not do and touch our face, and then she licks our hand?
Dr. Weitz: Yeah. Oh, yeah.
Dr. Espinosa: These are just habitual things that we do.
Dr. Weitz: And once-
Dr. Espinosa: We aren’t going to be-
Dr. Weitz: Once you have a mask on, there’s even more of a tendency to want to move it, and touch your face.
Dr. Espinosa: All these things. Now, yes, I am washing my hands a whole lot more than… I’m one of those natural doctors that believes that I want to be one with bacteria, and I think bacteria makes us stronger, and we need some exposure, and things like that. So other than after using the bathroom or going from exam room to exam room, and, yes, I wash my hands after every prostate exam. I just want to make that clear. Other than that, I wasn’t that obsessed about washing my hands. Now, I am, for example, but a bunch of other things. People say, “Well, do this.” That’s just impossible. It goes back to the point of make your body strong. We are going to be exposed. We’re going to be all exposed to COVID at some point.
Dr. Weitz: Yes, 100%. I know I am because I’m still interacting with patients. There’s no way we can perform a chiropractic adjustment and keep six feet of distance.
Dr. Espinosa: If you can figure that out, my friend, you’re onto something. You’re onto something. The other thing is there’s nothing like… I mean there’s healing aspects through touching a patient. I teach all my students to do a physical exam even beyond prostate like check for the glands and a pelvic exam around the lower abdominal area, look for things. Look, 99% of the times, you’re not going to find anything, but the healing component of touching patients, I think is critical. I think it’s part of the art, I think, that many have lost.
Dr. Weitz: Yes, absolutely. It’s really super important, one of the lost arts of doing a really detailed, physical exam in which you really touch the patient. You hear about some of these doctors who’ve been doing those kinds of detailed physical exams and similar remarkable results. I know there’s a prominent doctor in town. He’s always done a very thorough exam. He was just palpating his patient’s abdomen. He said, “There’s something funny I feel around your kidney.” And turns out, they had a kidney tumor and were able to remove it. Yeah, I think-
Dr. Espinosa: After thousands of patients… And we’re bouncing a little bit. I’m sorry. I tend to do that, but we’ll bring it back to COVID and everything else.
Dr. Weitz: Yeah, I do too.
Dr. Espinosa: Out of thousands of patients that I’ve had in my life, I had one case where one person was having an aortic aneurism. He didn’t even know.
Dr. Weitz: Wow.
Dr. Espinosa: I send them right to the ER, and they were able to treat it successfully. I think it was a lifesaver for him. Just one case. That’s all that’s needed. So going back to touching and everything like that, so both-
Dr. Weitz: And did you detect that from listening to his heart?
Dr. Espinosa: Yeah.
Dr. Weitz: Okay.
Dr. Espinosa: Yeah, and his abdominal area actually, listening to his abdominal area.
Dr. Weitz: Okay.
Dr. Espinosa: Yeah, yeah. There some abnormal sounds there that were clear or at least to me, I had to think back to when I was in school, but I was like, “Well, this is abnormal. This is very abnormal. As best as I can tell as a non-cardiologist, I think you should get this checked.” No symptoms. No symptoms.
Dr. Weitz: Right.
Dr. Espinosa: Yeah. We’re always doing these things. Just to kind of hit on that point and kind of strengthen, highlight the point of it behooves us to take care of ourselves and our immune systems, and for us to keep doing what we do as functional medicine and integrative doctors to help our patients build their bodies up.
Dr. Weitz: Right. And so what is some of the most important things we can do to strengthen our immune systems?
Dr. Espinosa: All right. We are also at risk of recommending too many things for patients and where we set them up for failure. Just like we’re recommending them to wash your hands, and turn the knob with something other than your hands, and keep six feet away, don’t touch your face,… We’re also as, sometimes I feel as functional medicine doctors, setting them up for failure. I take a lot of supplements, so my bias is-
Dr. Weitz: I take about 30 pills twice a day, and now, I’ve just added 20 more to it.
Dr. Espinosa: Right. That’s my bias. Everything I do with science, based all on experimenting. Before I start giving things out to people, I experiment, and I try things, make sure that I don’t grow an extra scrotum or something, but-
Dr. Weitz: Well, I do a lot of testing, so I’m constantly manipulating variables and trying to hit targets. For me, it’s a fun exercise in trying to optimize health.
Dr. Espinosa: Correct, but I understand that many patients are not going to do what I do, and I don’t know that they actually have to. So I have to prioritize what to do, but before we talk about supplements, I got to say if I have to prioritize… That’s the other thing is prioritizing all the right things to do is almost like asking me which one of your three kids you love the most. It’s like, “Well, I don’t know. One day, I may love one more than the other. The next day, it may change depending on how they were behaving, so I don’t know.” But I would say sleep is very important. Certainly, in the patient population that I see, as a male population, type A personality, these are successful people, and sleeping is a waste of time. You want to keep grinding, right? You want to keep working. I understand that as a man, right? I understand making things happening, and accomplishing things, and being productive. Sleeping takes away from that, at least we think. Of course, it doesn’t. You’re more productive when you get good sleep and all these things. So I think that teaching men to sleep well, it’s pivotal for this. We know now that there’s antiviral aspects to melatonin, right? I believe it has some anti-coronavirus activity. I don’t know about COVID-19, but certainly others, SARS, and MERS, and things like that. Melatonin is a really important hormone for building immunity. I think it behooves us to sleep better, but if-
Dr. Weitz: Yeah, melatonin also has antioxidant and anti-inflammatory properties. When you get into that inflammatory cascade that can happen in the lungs, having better melatonin levels can only help.
Dr. Espinosa: Correct. And has anti-cancer properties as well. Melatonin, that’s a monster hormone that I still… I know in our world is something we talk about often. I think it’s undervalued.
Dr. Weitz: By the way, I’ve been recommending melatonin lately, and I had several patients say, “Well, isn’t this going to be a problem? Aren’t my natural melatonin levels going to go down?”
Dr. Espinosa: Right, the answer is no. Even from my cancer patients, I give them 20 milligrams of melatonin. You’re going to think, “Well, is that too much? Am I going to sleep too much? Am I going to be narcoleptic or anything?” The answer is no, but there seems to be some anti-cancer properties or activity in that dosage, and that’s why we do it. In any of them, melatonin is important. Sleep is very important. Look, I have patients that sleep four, five hours a night. I’m just trying to get them to do one more hour a night. That’s it. One more hour. Of course, I have patients that pee at night and so they wake up couple of times to pee at night, so we try to address that. Whatever one needs to do to have them sleep better and longer at night. One of the things with quarantining is that I am sleeping more at night. Things just start later including getting my kids up for school, which school is in my house right now. So-
Dr. Weitz: Do you monitor sleep to see how much time you spend in REM and deep?
Dr. Espinosa: I do. I have a Fitbit. I use Fitbit to do that. I think it’s pretty accurate. At least, it’s giving me some idea of my patterns. It tells you deep sleep. I know some people have the Oura Ring, which is very good too. I think any good gadget to help you as objectively as possible. This is what happened with my Fitbit when I first got it. Of course, I’m thinking, “I sleep seven hours a night.” Well, it was showing me that I sleep really five and a half hours a night. That other hour and a half, I don’t know exactly what I was doing. Hopefully, I was doing interesting things, but you don’t really know how much you sleep unless you get it measured. That’s a good point. Then it tells you deep sleep, and REM sleep, and things like that. Then you can see what it is that you do. For example, when I started introducing magnesium and some mitochondrial things that I started taking, my deep sleep got improved, and my REM sleep improved. I saw that. It was pretty obvious to me. It was very linear kind of how I measured that.
Dr. Weitz: Yeah, magnesium’s a wonderful nutrient, and very few people have enough.
Dr. Espinosa: Yeah, yeah. So sleep is very important. Now, sleep and exercise. Sleep, exercise, eat right, supplements. Wow. So do everything perfectly. Well, that’s impossible. Which one do you love most? God, that’s very difficult because they’re all so important. If you put a gun at my head, and you asked me to prioritize, I would say exercise, sleep, food including some fasting, and then the right nutraceuticals in that order. That’s the way I would put it. Now, again, the right nutraceuticals as fourth, and I’m one to take 25 pills twice a day. So I’m just trying to optimize what I do and taking that many pills is easy for me. For many patients, it’s just not. So for many-
Dr. Weitz: Yeah, same thing with me. I can swallow-
Dr. Espinosa: Right?
Dr. Weitz: Yeah.
Dr. Espinosa: No problem.
Dr. Weitz: Six, eight, 10 at a time.
Dr. Espinosa: Let’s jump to vitamin C because I have this little gadget here. I keep only vitamin C, 500 milligrams. I’m taking about 500 milligrams of vitamin C every two hours, every two waking hours actually as I take one right now. We’ll go into the other life stuff, but just since we’re talking about vitamin C, I find that vitamin C undervalued as well. Now, there’s a lot of talk on vitamin C right now with COVID as there should be. I can’t believe-
Dr. Weitz: And there’s-
Dr. Espinosa: … that it take… Now, us crazy, natural doctors are actually getting notoriety of some sort because we’ve been talking about this for decades. I mean Linus Pauling was a genius. We’ve been talking about vitamin C for decades in terms of its use and, oh, poo-poo it. Now, in many hospitals, certainly, here in New York, they’re giving IV vitamin C as they should.
Dr. Weitz: Yes, 20 grams a day. Yeah.
Dr. Espinosa: 20 grams. Well, they’re doing one to six grams a day here so far because they need… They’re being [crosstalk 00:28:10] vitamin C.
Dr. Weitz: Well, the reports I’ve heard is, I think, in China, they’ve been doing 20 grams, and I think some of the hospitals here are starting to do 20 grams as well.
Dr. Espinosa: That’s amazing, right? That’s a huge step. IV vitamin C and oral vitamin C works a little differently, but here’s the deal. The way I prescribe vitamin C is the following. Based on my studies, Ben, some people taking 1,000, 2,000 milligrams a day. The body cannot absorb more than 500 milligrams at one time. So when people talk about, “Hey, isn’t vitamin C just expensive urine?” Yes, it is unless it’s not. Your body is saturated, and then the kidneys with its innate ability, innate, wonderful abilities, it kinds of removes the amount that you don’t need once your plasma’s saturated with vitamin C. So then it comes out in your urine. That’s why I recommend if you are infected, to take 500 milligrams every two to three waking hours. I am doing that just to optimize my situation as I’m still trying to do things and interact with some people when I go to work or anything like that.
Dr. Weitz: By the way, just because you’re urinating out… You’ve got vitamin C in your urine doesn’t mean on its way out of the system, it’s not scavenging free radicals and having a beneficial effect. If you were-
Dr. Espinosa: Exactly.
Dr. Weitz: If you were going to conclude because there’s vitamin C in your urine that you shouldn’t take vitamin C, then as long as you’re pooping, we might as well stop eating because it’s just coming out in poop.
Dr. Espinosa: How about this? Let’s talk drinking water.
Dr. Weitz: Exactly.
Dr. Espinosa: Why drink water?
Dr. Weitz: Exactly.
Dr. Espinosa: You’re peeing it all out.
Dr. Weitz: Exactly.
Dr. Espinosa: Right. Vitamin C is oral and IV. There are two phases with viral infections. You have the initial phase and you have the more critical phase. The initial phase is when the virus is somewhere on your nasal cavity, going down your trachea, and heading down to the bronchi, to the bronchioles. Your body needs to do a good job before it gets to the air sacs, right? Before this virus gets to the air sacs, your body needs to get this thing, get rid of this thing. So that’s the initial phase. That initial phase, you have sneezing and coughing, all good things because all your body’s trying to do is take the irritants out of its respiratory system, right? All good things. That’s great. That’s perfect. During the initial phase, you want to take 500 milligrams of ascorbic acid. I mean I don’t know. I’m not that fancy with my vitamin C. Ascorbic acid is great. I know that people use buffered and things like that, which is fine too. 500 milligrams every two to three waking hours. It comes up to 4,000 to 5,000 milligrams a data by the time it’s all said and done. There is no softening in the stool in many patients that I’ve done this with with up to 5,000 milligrams a day. I think it’s about 10,000 that you start seeing softening in the stool, which is just a sign to back up a little bit.
Dr. Weitz: Right.
Dr. Espinosa: Right. IV vitamin C, whole different story other than you can use it for prevention. You can use it during its initial phase. Certainly, it’s the main thing I would use during the more critical phase of an infection, which everybody is realizing that now, that you can use IV vitamin C in the more critical stage of a viral infection like COVID-19.
Dr. Weitz: When you talk about the fact that initially, the virus ends up in our respiratory passageways, and our nose, our month, et cetera, I’ve seen that you’ve recommended some of these spray, herbal products. That’s one of the reasons why you like those, these sprays with the-
Dr. Espinosa: Man, I practice what I preach, brother. I practice what I preach. Here you go. This is one of them. I’m spraying every couple hours.
Dr. Weitz: Yeah, I’m doing the same thing. I wasn’t actually doing it until I read your article. Now, I’ve got some of those products on backorder. Should be coming soon, but I got the Wise Herbals, Wise Herbal women one that has echinacea and a few other herbs.
Dr. Espinosa: It has a-
Dr. Weitz: And I’m using that.
Dr. Espinosa: It has several botanicals that just… The reason why I’m not out of stock is because I order about 10 of these bottles or 10 and the Wise Women every year right around late September, getting ready for flu season. I have a flu season protocol for my own personal use and my family’s that I order. That’s the only reason because all these things are out of stock.
Dr. Weitz: Yeah. No, I know.
Dr. Espinosa: Yeah.
Dr. Weitz: Yeah. We’ve been trying to order some of those. I do have some Immunitone, and I got some ImmuCore® coming from Metagenics, which is kind of nice combo product.
Dr. Espinosa: Awesome, awesome, awesome.
Dr. Weitz: Yeah. We’ve been recommending those quite a bit.
Dr. Espinosa: So going back to lifestyle, and we’ll hit nutraceuticals again, but going back to lifestyle.
Dr. Weitz: Yeah, so exercise.
Dr. Espinosa: First of all, if you’re not exercising right now, you are going insane, right? You’re going insane.
Dr. Weitz: You can’t go to movies.
Dr. Espinosa: I mean-
Dr. Weitz: You can’t go to the beach.
Dr. Espinosa: What-
Dr. Weitz: There’s a million things you can’t do. Can’t go anywhere.
Dr. Espinosa: Can’t go anywhere, can’t do anything. This is your time to figure out how are you going to make… I don’t care what kind of a space you live in. This is a time to create something in your home so that you become a no excuse person with regard to exercise. There is absolutely no excuse. The physical benefits are extraordinary. The psychological benefits might be even better than the physical benefits, believe it or not. So we were talking about this, Ben, before we started recording. I’m exercising every day, sometimes twice a day just because… Nothing to do with aesthetics. Anything that I get physically from an aesthetic perspective is great, but just from my mental well being as I’m here in my home office, and I have three kids. They’re going crazy, right? So they go out in the back. They go out on the trampoline. They come back. They even know, “Hey, I need to get some movement in,” right? So the kids go to the trampoline. They go to my garage. We make something happen. They go for a quick run or something. So exercise is access for the immune system. Running marathons or anything extreme actually weakens the immune system. Okay. Not that you should not do it. I mean I’ve done those things. I’ve done obstacle courses. A lot of fun and there’s other benefits that is not related to the immune system, but as it relates to physical health and the immune system, ultra marathons, and marathons, and these extreme exercises actually weakens the immune system.
Dr. Weitz: So the key for now is really moderate levels of exercise.
Dr. Espinosa: Moderate and, again, that’s subjective, right? So what does that really mean? Moderate exercise for anybody is five minutes. Now, five minutes is even fine in between, I don’t know, work. Every 90 minutes or so, I stop working, and I do something for five or 10 minutes, whether it’s burpees or something. Here’s what I’ll say. The intensity should be high, but the amount of time should be not exceeding 30 or 40 minutes, 45 minutes. Sometimes I am in the gym for an hour. I take longer between sets. I work on strength training. When you work on strength training, you want a bigger gap between sets and things. It depends what you’re trying to accomplish.
Let’s not make it too difficult for people because then it’s just an excuse to not do it. Get to exercising. Figure out how you can create a gym in your… I had a gym in my apartment where I lived in a two-bedroom apartment with two kids, a family of four. I had a pull-up thing, and I had some kettlebells, and some bands, and some things that didn’t even take a lot of space. I really wanted to make a Ninja Warrior type of facility in my house, but my wife knocked that down. She was not trying to hear that, rings and everything, but, no. That didn’t fly. She said, “You have the garage. You can do whatever you want in there in the one-car garage, the other garage for the other car. you can do whatever you want there.”
Dr. Weitz: Yeah. I was never able to turn the backyard into a putting green either.
Dr. Espinosa: I wanted to, man. I still want to. We’ll see. We’ll see. Exercise very important, then food. Now, this is debatable. Somebody may say to me, “Geo, you’re crazy. You mean to tell me eat like crap, but exercise and sleep, and you’re fine?” Look, again, it’s very difficult, but people need to… We, as practitioners, need to set up our patients for success, not failure. Sometimes we just add too many things to the mix, and I think that becomes challenging. So that’s that. From a food perspective, intermittent fasting is a good thing, intermittent fasting. The more and more I read on this, the better it is, certainly from a longevity perspective. Whether it has immuno benefits, I’m not exactly sure. I know that when we have a viral infection, we want to eat less, right? So that’s the less taxing to our system so that the body could do its work and get rid of the infection.
Dr. Weitz: Yeah. Essentially, the body has so much energy, and if it’s not spending that energy on breaking down, digesting, assimilating, absorbing your food, it can use that energy for immune function.
Dr. Espinosa: Correct, and just healing in general. So intermittent fasting is good. Now, I probably said how I use my supplements, and I do my sprays, and I exercise. I do intermittent fasting, but definitely the biggest challenge for me is… I’m just being transparent. The beginning challenge for me is not eating. I love to eat. I love to eat. When I’m doing intermittent fasting, I have to be super, super mindful of doing it. I actually like the ProLon approach, doing the five days, they send your meals per day, make it easy. Fasting Mimicking Diet, I actually like that approach as well. I have no financial connection with FMD or ProLon. I wish I did, but I don’t. I like their program because it just… For people like me, which that is my biggest challenge, it just makes it a little bit easier. That’s that.
Refined carbohydrates, and sugars, and things like that, those are your immune weakening foods. There’s no other way around that. Now, holistic, but realistic. Everybody’s at home. Where are you doing to counter the anxiety and distress from being at home? Many people are just eating a lot, anxiety eating, and many people are eating crap. Look, my 15-year-old daughter comes back with a bag of Pepperidge Farm chocolate chip cookies the other day. She’s like, “Dad, don’t even try it. Just leave me alone.” Guess what? I left her alone. I get it. I’m like, “Honey, I get it. Pass me one of those cookies. I get it. Just pass me one and take it away from me.” I get it. I get it.
What I would say is everybody has, I don’t know, four things that are important, the four things that they’re able to do, they’re willing to do. Have at least two things that you are on it, that you are, “I don’t even have to think about exercise. I’m going to do it. I don’t even have to think about sleeping at least seven hours. I know I’m going to do it.” Then the other two, you work on it. You don’t have to be perfect, but you work on it. Likely what would happen is that all the right things that you do counteract the things that you don’t do right. Look, Ben, in our field, I’m behind the stage with many people giving talks and everything. Let’s just be real here. We have the guy that eats perfectly and plant-based, but drinks like a fish, right? Or the other guy that does… and smokes pot like a maniac. I don’t care what you think about pot, its medicinal values of cannabis, you do too much of it, it’s not a good thing.
Dr. Weitz: Absolutely.
Dr. Espinosa: We all have our vices, and so it’s very important to be aware of the vice. Look, when I have a 73-year-old person that smokes cigarettes, I can’t tell them to stop smoking. I mean how-
Dr. Weitz: Why can’t you?
Dr. Espinosa: Well, I don’t, and here’s why. 73 years old. This is actually a real case. He smokes a half a pack to a pack a day. That’s a hard sell. He’s been smoking for 50, 55 years. I cannot guarantee that at that age, I will prevent him from lung cancer, emphysema or any… even if he stops smoking right now. I understand what the smoking does and the instant gratification that it provides. Now, 53 years old, different story. Young, different story. You have to stop smoking, but a 73-year-old, this is my opinion, I just don’t want to set them up for failure. What’s going to happen in that situation is the one-
Dr. Weitz: Maybe the coronavirus though is an excuse to recommend not smoking because even if he’s already setting himself up for cancer, for smoking for 30 or 40 years, he might increase his ability to recover from the coronavirus if he’s not actively smoking.
Dr. Espinosa: Oh, recover from the coronavirus, 100%, but that’s exactly right. You’re already diagnosed with something. When they come in, he’s 73 years old, relatively healthy, “I smoke a half a pack day.” There’s no real incentive. Plus the cigarette smoking brings him so much pleasure and relief. So I have him take vitamin C. Those that smoke have less vitamin C, lower vitamin C levels in their bodies relative to those that don’t smoke. So selenium and all those things that we can talk about. I have him do that, and I do have him be mindful so that he does not smoke. I think the poison is in the dose. The poisonous dose may be anything, but certainly, the more you do, the better. I’m just bringing a scenario where I think it’s very important for us not to… be real with ourselves as practitioners who practice lifestyle functional medicine, integrative medicine. Let’s be real with ourselves. Then let’s be real with our patients to not set them up for failure. I do believe in the power of nutraceuticals even though they’re fourth on my list. I do believe that between two or three things that you do really well, it counteracts a little bit of the other stuff that you don’t do perfectly well.
Dr. Weitz: Sure. That’s a reasonable approach and then-
Dr. Espinosa: I think so. I think so. It’s worked out, and my patients do amazing, amazingly well. Whether it’s prostate cancer or prostate issues, they just do really well. I guess with the food component, I don’t want to harp on because that could be a podcast all in its own. The main thing is what you stay away from is refined carbohydrates as much as possible. Intermittent fasting is a good thing. General recommendations are plant-based diet that includes some sort of high-quality animal products, primarily fish. That’s just general immune-boosting, immune-enhancing protocol in general.
Dr. Weitz: Yeah.
Dr. Espinosa: Then we could dive right into nutraceuticals if you want.
Dr. Weitz: Okay. Hey, just before we do that, I know there’s been some discussion, and I know you’ve written about the issue, about some of the blood pressure meds and ibuprofen and whether or not those increase or decrease your likelihood of getting infected or your response. It seems to be going back and forth. What’s your latest perspective on that?
Dr. Espinosa: All right. We know that the virus gets into our system. It attaches to the ACE2 receptor in our lungs. That’s how it gets into the cell, right? We know that. There’s certain things that increases ACE2. There are other things that decrease ACE2 receptors. Then a few weeks ago, French government said, “No more ibuprofen.” Then so did-
Dr. Weitz: World Health Organization.
Dr. Espinosa: … World Health Organization. Then they kind of, a day later or so, “I take that back. We jumped the gun. There’s no evidence to support that.” The truth of the matter is that just if you have more ACE2 receptors does not mean that you’re more prone to a COVID-19 infection relative to having lower ACE2 receptors. There’s nothing to prove that. More ACE2 actually can be protective in another, different mechanism where there’s less inflammatory response by having more ACE2 than not having as much ACE2 receptors. That’s that. What the French government said is, “No more ibuprofen,” because ibuprofen was shown in The Lancet to increase ACE2 receptors in The Lancet. My overall takeaway is this with NSAIDs in general. It’s not a good idea to… First of all, let the fever ride. Let the fever ride. Lord, are you seeing this?
Dr. Weitz: Our society has such a problem with that. I talk to mothers all the time, and they’re freaked out. Their kid has a fever. What is the fever? 101. That’s okay.
Dr. Espinosa: What I tell parents, and I don’t see kids, but friends and things. “Geo, my kid… Oh, god. He looks horrible, 102.” I said, “Well, give him Tylenol. When you’re giving them Tylenol, you’re giving it to yourself. You’re not giving it to him. I just want you to be aware of that. You’re giving it for you to feel better, not for the kid to feel better. As long as you understand that because they’re going to look better once they take Tylenol, okay? I’m prescribing it to you, not to the kid, but you give it to the kid.” You got to let the fever ride. That’s number one, and the aches and things. I had a patient with COVID who was taking Tylenol and excessively. I said, “Look, there’s no way of us to know if you’re doing better or not because you’re disguising what’s really happening. The fever actually tells you that you’re still fighting something, and it’s actually helping you fight the infection.” He was taking it too much. I said, “Well, look, just take it at night before going to bed so you can sleep better. That’s it. You’ll be able to sleep better by taking Tylenol at night, acetaminophen.” He did. He took it once a night. Then he stopped taking it, and he’s doing much better. Now, we know that he’s doing better from COVID. So take-
Dr. Weitz: Of course, the potential downside is acetaminophen can inhibit glutathione production and that’s super important for immune function.
Dr. Espinosa: 100% and not to mention in higher dosages, above 3,000 milligrams per day, liver hepatotoxicity. Look, let the fever ride. Look, I’m agnostic. I am agnostic. I only care for what works. It just so happens that in my, yeah, biased opinion and even unbiased opinion, natural therapeutics work very well before you need the stronger guns. I’m very agnostic as it relates to what is it the patient needs and how can we provide them with whatever it is they need that has the least amount of side effects. That being said, but I don’t recommend NSAIDs in patients who have fevers because that does weaken the immune system. It weakens immunity. NSAIDs do, so I do not recommend NSAIDs for that purpose. I recommend, if anything, acetaminophen, but even then, let the fever ride, the certain nutrients, hydration, and just sleep, and rest. That takes care of its own right there. Yeah, that’s the ACE2, ibuprofen response then.
Dr. Weitz: Then I guess we’re also going back and forth on whether taking ACE inhibitors and ARBs, angiotensin response blockers, which are blood pressure medications, whether they also play a role, positive or negative.
Dr. Espinosa: Well, I’ve had that scenario. Again, we don’t know. Some would argue that having ACE inhibitors actually helps.
Dr. Weitz: Yes.
Dr. Espinosa: So that’s beyond my pay rate. In that scenario, I said, “Don’t get off your ACE inhibitors since we don’t know, number one. Number two, your body may be very dependent on it. Just talk to your cardiologist. Apply the other things that I know they help with blood pressure of the [crosstalk 00:49:31].”
Dr. Weitz: Right. The last thing you want to do is survive COVID and die from a stroke or something.
Dr. Espinosa: That would be horrible. That would be horrible. You don’t want to be liable as a practitioner. That’s a scenario. Yeah, I don’t know whether ACE inhibitors help or hinder the process and at this point. I just have them talk to their… Again, what we do for blood pressure is amazing, Ben. I mean we can really treat blood pressure. I’ve done it.
Dr. Weitz: Absolutely.
Dr. Espinosa: I come from a family history of high blood pressure, everybody, brother, sisters, parents. My blood pressure has been roughly 120/85 for a long time. I measure it all the time. I drink a decent amount of coffee, so this is not affecting my blood pressure much. I think it’s because many reasons. Other things that I do that’s beyond what we’re talking about now, but we can bring down blood pressure very effectively and efficiently with natural therapeutics. Other nutraceuticals?
Dr. Weitz: Okay.
Dr. Espinosa: My go-to so mineral-wise is selenium and zinc. Selenium actually has antiviral properties as well. So it’s not only immunomodulatory. It also has antiviral properties. There’s a lot of research on selenium, some of which I highlighted on my article on drgeo.com, and I have links to papers. I have actually a book that I wrote several years ago on selenium that I never published, kind of put it on the shelf. So I’m pretty versed on selenium. Bottom line is this. You could do 200 micrograms a day. That’s plenty. If you go up to 400 micrograms, that’s fine. It’s very difficult to get the disease called selenosis from too much selenium. The symptoms are brittle nails, and very flaky skin, and sort of extreme fatigue. Very difficult to get to that point, but more than 400 micrograms a day is just not necessary. There might be no return on that investment. So 200 micrograms a day is perfect of selenium.
Dr. Weitz: Good.
Dr. Espinosa: Zinc, very important. You could do zinc lozenges are good. You could go up to about 60 milligrams a day. Some would say maybe even up to 100 milligrams a day without needing extra copper. Once you go up beyond, in my opinion, 60 milligrams a day, you need about one milligram of copper just so that there’s no copper deficiency. I only do about 30 milligrams of zinc a day actually. I don’t do more than that.
Dr. Weitz: Yeah. For example, I have a gene that it makes it difficult for me to absorb zinc.
Dr. Espinosa: There you go.
Dr. Weitz: So typically, if I do a micronutrient or I do a NutrEval, a lot of times, zinc’ll be one of my biggest deficiencies, so I have to hit the zinc a little harder.
Dr. Espinosa: Thank you for sharing that. Everybody has their own individuality as it relates to… How did you find out about your genetic ability to not absorb zinc?
Dr. Weitz: I took my raw data from 23andMe, which I did a few years ago, and I put it through that PureGenomics® analysis. If you have an account with Pure, they have that software. That works pretty well.
Dr. Espinosa: Yeah, yeah. Good, good, good. Vitamin D, particularly during this time of the year, I know that over there in California, it’s so beautiful and sunny. Over here, it’s not as much. Even if it was beautiful and sunny, we still need some vitamin… We spend too much time indoors.
Dr. Weitz: I got to tell you. Despite being in Southern California where we have lots of sun, we’re seeing 60% of people have either borderline or moderately low levels of vitamin D. It’s weird. They should be high, but they’re not. Then you often hear doctors make these modest recommendations to take 500 or 1,000. There are a few patients who the levels’ll shoot up, but for the most part, I find it’s really difficult to get into that what I consider the ideal, optimal range. Depending upon the person, somewhere is between 50 and 70.
Dr. Espinosa: Yeah, yeah. Modest between 40 and 60, but I think doesn’t really matter. Let’s say between 40 and 70, let’s just say. As long as they’re-
Dr. Weitz: I know for women, there was that paper that showed that women who had their vitamin D level above 60 had a lower risk of breast cancer, and that made me kind of want to push it.
Dr. Espinosa: There you go. Maybe I just missed that paper because I don’t see many women at all actually in my practice. I just kind of stay in my lane and try to get the-
Dr. Weitz: Absolutely. Well, that’s why you’re a genius about men’s health. You got to-
Dr. Espinosa: Thank you. Thank you.
Dr. Weitz: There’s so much data. It’s hard to keep track of it all.
Dr. Espinosa: That’s right. That’s right. I start everybody between 4,000 and 5,000 units a day, period. I don’t care how much you weigh.
Dr. Weitz: I-
Dr. Espinosa: I don’t care anything. 4,000, 5,000 a day.
Dr. Weitz: And always include vitamin K with that to prevent the arterial calcification.
Dr. Espinosa: Yeah. I include K1 and K2 with vitamin D. Yeah, that’s right. Super important for immunity. If we’re looking for prevention, then vitamin C… I’m sorry to go back, but it just does so many things. It actually helps with stress. Vitamin C helps with stress. It’s a precursor to certain endorphins and certain hormones that are really important to help us modulate stress, so vitamin C. I’ve always been a big fan, and I’m glad that this is getting the notoriety that it deserves because I think that everybody should have vitamin C a day. I think just normal, it’s 1,000 milligrams a day. Maybe 500 twice a day. If I had to prioritize the nutraceutical list, I would do something that contains… A good formula contains all the minerals you need, selenium. I like selenium from selenized yeast as I touch my face again. You’re not supposed to do any of that, right? I mean come on. I’m about to take another vitamin C. You can’t. You just can’t stop. Man, all right.
Dr. Weitz: On the other hand, it’s kind of fun. I’m good now pushing the elevator buttons with my knee. It’s kind of an exercise. Get up to that up level.
Dr. Espinosa: Right, exactly. It’s a challenge, right? I got to open that slim doorknob with my elbow. Let’s see if you can do this. We all have more time in our day now to figure things out and make things interesting. We use a lot of the different formulas that have your selenium. Oh, selenium. I use selenized yeast, high selenized yeast as my favorite form of selenium. Again, mostly because 1996, the was a JAMA paper that showed that this particular form of selenium reduced the risk of prostate cancer by up to 60% in a group of patients. They were looking at other things, but they saw a reduction risk of different cancers including prostate cancer by about 60%. At least the prostate cancer arm, that was the conclusion. So this is the type of form that I use. I don’t use a lot of selenomethionine in and by itself. High selenized yeast has a couple of different types of selenium, selenomethionine, and things, and Selenocysteine that kind of work together. It’s more food-like in the sense that it’s not just one type. They work synergistically together. So that’s the form that I like best, and I use formulas for that. That includes zinc. That includes vitamin C and the biggies for immuno support.
Dr. Weitz: You include vitamin A in your immune support?
Dr. Espinosa: I don’t. But it is good. It was one that I was going to mention. Vitamin A, I don’t include it. I think it’s just bias. No real good reason, right? Back in the day when I was studying nutrition, too much vitamin A does this, that, and the other. I was like, “Yeah, I’m not going to use it. Hopefully-“
Dr. Weitz: Well, they say the same thing about vitamin D too.
Dr. Espinosa: Yeah, exactly. Correct. I don’t use vitamin A unless there is some in a multi that I would use, and I don’t use more than that. I can’t even say that I am that versed. I know a lot of our colleagues have written about it, and it’s one of the things that I use. It hasn’t been mine. Yeah, yeah. I don’t have a good reason. I don’t have a good scientific, unbiased reason for not using vitamin A actually.
Dr. Weitz: Right, okay. So-
Dr. Espinosa: I have to say. Plus I also look at everything, including viral infections from a prostate perspective. So specializing is a good thing, but your lens tend to be everything looking at it from that perspective, either a prostrate or a penis perspective. If we could take care of the prostate and the penis, we know we can take care of the whole body. Sometimes it just gets a little bit silly, that form of thinking. That’s why zinc and prostate, strong connection. Other than thymus, in a man’s body, it’s mostly… The other place where you’ll find a lot of zinc is in the prostate. Selenium for selenized yeast, anti-cancer properties and things like that. So botanicals-
Dr. Weitz: What about NAC for immune support?
Dr. Espinosa: Good. Optimizing glutathione levels are good. I use actual glutathione like-
Dr. Weitz: Liposomal, yeah.
Dr. Espinosa: Yeah, yeah. Then NAC actually can reduce the fluid accumulation in the respiratory system in the lungs. Yeah, NAC is actually very good for that specific purpose actually, so I would use it. I have not had to, but in cases where some patients, you can hear that they’re very phlegmy and very congested, I use NAC for sure. Yeah, that’s very good. Yeah.
Dr. Weitz: There seems to be some data showing that glycyrrhizic acid from licorice fruit has some benefit in cases like this, right?
Dr. Espinosa: Yeah. Moving onto botanicals, yeah. Glycyrrhizic acid is… and it seems to be helpful. However, glycyrrhizic acid can increase blood pressure as well, so [crosstalk 01:00:55] of that.
Dr. Weitz: I think the benefit can be because it could support cortisol levels. So you get that anti-inflammatory effect.
Dr. Espinosa: Right, right. Correct, correct. What I prescribe from botanical perspective is, uh oh, get ready for this, elderberry. Oh my god. Elderberry. Wait a minute. Cytokine storm, cytokine storm, no, no.
Dr. Weitz: Well, what’s the-
Dr. Espinosa: Unbelievable how bad information can get-
Dr. Weitz: Yes.
Dr. Espinosa: Can get so much attention. It’s unbelievable. I can’t tell you the amount of emails and texts I got once that… having to answer elderberry. So much so that I just had a copy and paste little thing for email and texts. I was like, okay, just copy. Paste it, paste it, paste it. Unbelievable. Unbelievable.
Dr. Weitz: Yeah. Fortunately, our friend, David Brady, did a webinar that was posted on Facebook where he really, I think, set things straight on that. He along with Todd LePine and Dr. D’Adamo.
Dr. Espinosa: Yeah, I saw it. Very good. These are brilliant guys, and it was very, very good. Also, Donny Yance, he’s a herbalist out in Oregon.
Dr. Weitz: Yeah, I’ve heard of him. I’ve heard him speak.
Dr. Espinosa: He wrote something very good on this whole thing. I just wrote one or two sentences because my intention is not to focus just on that. The bottom line is this, it does not do that. First of all, no botanical can induce a cytokine storm. It doesn’t do that. First of all, it has great antiviral benefits. Whether it has good COVID-19, we don’t know. We don’t know what works, so we just trying to build the body. I do use elderberry because it may indeed have anti-COVID-19. If it doesn’t, it’s doing other things that are fine. It can induce some cytokine scenario in the body, but it does it during its initial phase. Cytokines is a very important situation. Cytokine production is very important across draw in more immune cells to fight the infection, so cytokine is a good thing until it’s not in its later phases and stages. The production of cytokines during its later stages, it’s like 1,000 times more than during its initial phase, which elderberry does not do. So it’s a little bit silly to… I use elderberry. A couple of other herbs that I use is botanical is Andrographis. Great. It’s been around for a long time. Certainly, in our pharmacopeia, we’ve used it for a long time during flu season and things like that. So Andrographis is one that one should consider. Astragalus, excellent. Excellent immunostimulatory antiviral benefits. Echinacea’s very good. I like larch arabinogalactan as an antiviral. It’s been around. Good research on that too. I have a couple of links on drgeo.com with regards to larch arabinogalactan as well. Actually, the person who introduced me to larch arabinogalactan back in the day was Peter D’Adamo. Before I went into naturopathic school, I actually worked with Dr. D’Adamo with his-
Dr. Weitz: Oh, cool.
Dr. Espinosa: His book had just come out in 1997, and he hired me around 1998 as I was taking pre-requisite to go to naturopathic medical school.
Dr. Weitz: Interesting.
Dr. Espinosa: He’s the one that put me onto larch arabinogalactan back in the day.
Dr. Weitz: Cool.
Dr. Espinosa: He wrote a lot of papers on it. Yeah, I’m surprised he didn’t mention it during that… Actually, I have to ping him. I say, “You are the larch arabinogalactan guy. Why didn’t you mention it?” Actually, I’m actually going to ping him and ask him about that. That’s another one that I find useful. I use formulas, Immunocore or Immunitone Plus by the good companies. Daily Immunity by Pure Encapsulations I find to be helpful. Biotics Research has a couple of good ones. ViraCon by Vital Nutrients is actually very good. By the way, I have no connection with any of these companies financially. I just mention them because I use them quite a bit. Those are good-
Dr. Weitz: Quercetin has gotten some attention for its potential ability to fight viruses. I think it’s been shown to help fight some other coronaviruses.
Dr. Espinosa: And it’s good for prostatitis.
Dr. Weitz: Okay. There you go.
Dr. Espinosa: I’m working on a benign prostate formula to help men who have prostate issues that include urinary, and quercetin is a major component of that formulation. Yes. Quercetin, there again, you look at quercetin, and you don’t acknowledge it for its antiviral benefits, but it’s… First of all, I haven’t looked into antiviral botanicals specifically. Yeah, I knew astragalus, but specifically in a long time because we have not had this issue. Now, people are like, “Wait a minute.” I have old textbooks, and I’m looking at this. So quercetin. Resveratrol, which I use for male sexual health because it helps with nitric oxide production in the endothelial cells of the blood vessels. Resveratrol actually may have anti-coronavirus properties.
Dr. Weitz: Absolutely, absolutely. It’s actually used in some botanical antimicrobial, anti-Lyme formulas. I know Stephen Buhner uses it in his protocol for Lyme.
Dr. Espinosa: Right, right. Again-
Dr. Weitz: It’s usually referred to as Japanese knotweed.
Dr. Espinosa: Japanese knotweed, right. Or it’s usually referred to as red wine except that you need a couple of bottles to get enough resveratrol. Some people say, “That’s no problem. You bottle the [crosstalk 01:07:13]. Awesome. I can do that.”
Dr. Weitz: There you go.
Dr. Espinosa: I can do that. I have had to look. Really, I had to go back. I wrote about how viruses work, and I forgot a little bit. I’m not an infectious disease doctor, right? So I had to go back and think because that’s how my… How do these things or how do they get in in general? Okay, how does this particular virus gets in? Then we learned about ACE2, and ACE2 receptors, and so forth. Fascinating. So I had to look at everything that’s possible from a natural, a materia medic perspective, and resveratrol came up, quercetin. I know there’s a link there. Quercetin, very good. About 300 to 500 milligrams once or twice a day is what I use there. Resveratrol, I use attribute 200 milligrams a day or 200 milligrams once or twice a day. I don’t know what’s a dosage for antiviral benefits, by the way. This is just, in general, what I would use.
Dr. Weitz: Right, cool.
Dr. Espinosa: Yeah.
Dr. Weitz: Well, that’s been great. Dr. Geo, we’ve covered a lot of really good, useful information. Hopefully, some information help people calm down a little bit and feel a little more secure about strengthening their bodies to deal with whatever might come their way including coronavirus.
Dr. Espinosa: I think that’s the biggest takeaway, Ben. I believe this is the biggest takeaway. Starting now and certainly, once this is over, hopefully over, whatever that means, we need to take better care of ourselves. We need to strengthen our bodies. The more we do that, we would reduce our risk of almost anything. Whenever we are affected by anything, our bodies will be able to fight it, and even if we need a surgical procedure or something, our bodies will be best able to manage that. So it behooves us to sleep well, eat well. I don’t even talk much about stress because if you sleep well, exercise, and eat well, and take the right nutrients, you don’t stress as much because your perspective changes.
Dr. Weitz: Right. By the way, just one more thing, another role that I think functional integrative medicine’s going to be really important is the data seems to be showing that a percentage of these patients who recovered from the coronavirus actually have some damage to their lungs. That’s a natural approach could potentially be beneficial in helping to get them back to full health.
Dr. Espinosa: That’s right. We’ll wait and see what the data shows years from now, but so far, we’re seeing there is continuous damage to the lungs even after they recover from the coronavirus. I think that this is prime time for our field, and all the wonderful things, and all the tools we have in our toolboxes to help our patients and to help ourselves too. I’m pretty excited about that. By default, I’m becoming a little bit of a COVID-19 expert. Everyone is, I think. I’m going to stay in my lane. I’m going to do prostates and men’s health, but again, there is a connection just because men are just more predisposed to all infectious diseases, and they die from almost all of them more so than women. That’s my next piece that I’m writing, the connection between viral infections, COVID-19, and men. So stay tuned for that.
Dr. Weitz: Oh, excellent, excellent. For patients and viewers who want to get a hold of you, seek you out for men’s healthcare, how would they get a hold of you?
Dr. Espinosa: Drgeo.com is the best contact and the best page from me. It’s D-R-G-E-O dot come, drgeo.com.
Dr. Weitz: Great. Thank you so much, Geo.
Dr. Espinosa: Hey, Ben, thanks so much. It was a pleasure.
Dr. Weitz: It was fun. Be safe.
Dr. Espinosa: You too.
Dr. Weitz: I’ll talk to you soon.
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