Lesson 4: Reduce Baseline Inflammation With Rituals

The graph illustrates two scenarios: (A) indicates a modest baseline level of inflammation at onset of infection ("Low inflammatory status @ baseline"); (B) indicates a high baseline level of inflammation prior to infection ("High inflammatory status @ baseline"). If you someone in scenario (A) gets infected, the resulting spike in inflammation is likely to be below the "Fatality risk threshold"; however, if the baseline level is high, as the immune response to the virus evolves, inflammatory cytokines are generated, moving that person further up the vertical "Inflammation" axis into the danger zone, where ARDS (acute respiratory distress syndrome), septic shock, heart or kidney failure, etc could occur. 

The goal, therefore, is to reduce baseline inflammation, so that any extra inflammatory-promoting SARS-CoV-2 does not become dangerous to health.

Much of this course is designed to move you down the vertical axis, so that the inflammatory process inherent in killing this virus doesn’t put you at risk for grave illness.

In Lesson 10, I’ll talk more about how various chronic diseases increase this baseline inflammation, and how that increases one’s vulnerability to getting really sick if infected with COVID-19.

It’s really important that we do what we can to reduce our baseline level of inflammation before we get infected. You want to reduce the risk of experiencing hyperinflammation, the so-called “cytokine storm” if you get infected.

The good news is that there’s plenty you can do. 

The rest of the lessons in Protocol 2 will focus on sleep, stress, nutrition and exercise. These are the various lifestyle factors that can have a big impact on your resistance to infection, as well as how bad the symptoms could be should you get infected.

So, let’s get started with the six daytime and seven nighttime rituals that can help you begin to develop the lifestyle habits that support a well-regulated immune system by taping down baseline inflammation. 

I suggest you choose the rituals you have the least amount of resistance to do. For most people, that’s the best way to get into the mode of acquiring new habits. Start with what you’re most willing to do. Then graduate to the ones harder for you to consistently do once the easy ones have been established.

But don’t dawdle -- this virus isn’t waiting for you to build your defenses.

6 Daytime rituals

1. Establish a consistent routine 

Get up at the same time every day. This helps to set your body’s natural clock, the circadian rhythm, which is one way our bodies regulate sleep. 

In addition to sleep, stick to a regular schedule for meals, exercise, and other activities. 

Knowing what you intend to do on a particular day at a specific time helps ensure that you’ll do it, keeps you active and helps provide stability to your life.

2. Get morning light

Get up, get out of bed, and then get some sunlight. Sunlight is the main controller of your circadian rhythms, and regular exposure to light in the morning helps to set the body’s clock each day. 

Natural sunlight is best, as even cloudy days provide more than double the light intensity of indoor lighting. So, expose yourself to natural light by stepping outside, at a distance from others, for at least 20 minutes every day.

3. Exercise during the day 

Exercise helps improve your sleep quality at night, reduces stress and improves mood. 

Less stress and a positive outlook supports your immune function. You can reduce your stress levels by being active, and that will have a positive impact on your health.

Getting out of the house while the sun is out, and moving your body vigorously goes a long way to preparing you for restful sleep.

4. Take a walk in the woods

Although there is no scientific data proving that regular exercise makes us less susceptible to getting Covid-19, various studies have suggested that it bolsters our defences against other viral infections, including influenza and the common cold. And there’s something in those woods that seems to also increase the immune response to vaccination. [1]

For instance, spending a few days in a forest results in an increase in the number and activity of our natural killer cells, which are the immune cells that help to detect and destroy viruses and cancer cells in our blood. [2]

If you don’t have a forest nearby, go to a park or anywhere outdoors in nature, because spending time there can lower your heart rate and blood pressure. It can also normalize the secretion of the stress hormone cortisol. [3]

And if you’re able to engage with nature on a long-term basis, studies indicate that you can reduce your risk of cardiovascular disease, type 2 diabetes and early death. [4]

I suggest that if you’re willing to exercise, try to do it in a park, woodland or other green space.  

5. Don’t use your bed as an escape

Make your bed a single-service device -- to sleep. (Of course, if you’re coupled up there may be another use for it.) 

By using your bed mainly for sleep, you get conditioned that the bed is a place exclusively designated for sleep, and not for TV, reading, social media, etc.

If you’re a napper, keep it under 30 minutes, and don’t nap at night.

6. Avoid caffeine late in the day

That’s a no-brainer  -- you know you want to avoid the stimulus of caffeine several hours before bedtime, but there’s also the matter of cortisol. 

Cortisol is your body’s main stress hormone. It works with certain parts of your brain to control your mood, motivation and fear. It’s best known for helping fuel your body’s “fight-or-flight” instinct in a crisis. 

When you’re in such a crisis, cortisol is a good thing and you want the cortisol to be flowing. Otherwise, you want your cortisol levels to naturally ebb as the evening approaches. Drinking caffeine will ramp it up again.

Too much cortisol in your system can make you anxious, feel stressed and disrupt your sleep.

7 Nighttime rituals

The reason to consider adopting nighttime rituals is to help ensure you get enough restorative sleep.

Restful sleep is not a luxury, but a necessity when it comes to robust health.

Deep, restorative sleep is essential for a responsive, well-regulated immune system. You need to have deep, restorative sleep to enhance your immune response to pathogens like SARS-CoV-2.

Inadequate sleep increases the risk of all infectious illness. One study found that less than five hours of sleep increased the risk of developing a common cold by 350% as compared to individuals who slept at least seven hours per night. [5]

What about the relationship of sleep to COVID-19?

Studies show that sleep deprivation increases a series of reactions that result in activating something called the NLRP3 inflammasome, which is partly responsible for the hyperinflammatory state referred to as the “cytokine storm”. [5]

Healthy sleep is anti-inflammatory and promotes various types of T cells that can tamp down inflammation. [6]

Now that you know how important sleep is to help you fight off COVID-19, let’s address how to get the sleep you need with eight nighttime rituals. 

Like I said about the daytime rituals, pick the low hanging fruit first. Get yourself in the mode of acquiring new habits by first choosing those that you have the least amount of resistance to do.

1. Minimize mental and emotional stimuli

Whatever gets you cranked up... Avoid that.

So, before bed, don’t fill your head with news that aggravates you, or engage in topics that aggravates you.

If your mind is swirling with thoughts you can’t seem to put aside, try writing down -- pen to paper -- what’s disturbing you. Remind yourself that you can review the list in the morning, and deal with it then.

I say put pen-to-paper because it slows you down. It takes more time to write by hand than to type. Unless you’re a one-finger typer, using pen and paper gives you more time to dig into what you’re grappling with.

2. Reduce blue light

Turn off cell phones, tablets, and all electronic devices. Engaging with screens before bedtime makes it harder for your brain to turn off. 

The reason for this is that any light emitted from various screen-based devices -- which is referred to as “blue light” -- may delay the release of the hormone melatonin. This delay of melatonin interferes with your body clock; the circadian rhythm we reviewed earlier. 

Blue wavelengths are beneficial during daylight hours, because they boost attention, reaction time and mood, but at night blue light disrupts your sleep. While it’s true that any kind of light can suppress the secretion of melatonin, blue light at night does so more powerfully. 

Harvard researchers and their colleagues conducted an experiment comparing the effects of six and a half hours of exposure to blue light to exposure to green light. They found that blue light suppresses melatonin for about twice as long as the green light and shifts circadian rhythms by twice as much: three hours for the blue light vs. 1.5 hours for the green light. [7]

In another study of blue light, researchers at the University of Toronto compared the melatonin levels of people exposed to bright indoor light who were wearing blue-light–blocking goggles to people exposed to regular dim light without wearing goggles. 

The fact that the levels of the hormone were about the same in the two groups strengthens the hypothesis that blue light is a potent suppressor of melatonin. [8]

Another thing you can do to reduce blue light at night is turn off screens between one and two hours before bedtime, or use an app called F.lux. 

The F.lux app makes the color of your computer’s display adapt to the time of day, warm at night and like sunlight during the day.

3. Set a regular bedtime

I covered this already, but it’s worth repeating.

Just like the daytime ritual of getting up at the same time, set a regular time to go to bed. A regular and consistent sleep pattern helps ensure you’re getting the targeted number of hours of sleep every night and keeps your circadian rhythms optimized.

4. Reduce stress

I address stress in the next lesson, but here I want to point out that it’s hard to get to sleep if something stressful is occupying your mind. So, if something is stressing you at your bedtime hour, you need to tamp it down.

You can try slowing down your breathing by concentrating on it, which I’ll cover later on, or listen to some relaxing music. I’ve linked to some in the References tab. 

5. Take an Epsom salt bath

There are three reasons to consider taking an Epsom salt bath prior to bedtime: 

1. If you do this regularly, you’ll be establishing in your mind the intention of proactively doing a ritual for the purpose of getting restorative sleep.

2. Warm water is relaxing and may make you drowsy.

3. The Epsom salt in the bath contains magnesium. One tablespoon of epsom salt has 3.4 grams of magnesium.

Let’s talk about magnesium.

By helping to quiet your nervous system, this mineral may help prepare your body and mind for sleep.

Magnesium activates the parasympathetic nervous system, the system responsible for getting you calm and relaxed. It also regulates the hormone melatonin, which guides sleep-wake cycles in your body.

Magnesium binds to GABA receptors (gamma-aminobutyric acid). GABA is the neurotransmitter responsible for quieting down nerve activity. It’s the same neurotransmitter used by sleep drugs, like Ambien.

If you choose not to bathe with Epsom salts, but want the magnesium, you can take a magnesium supplement. Magnesium can help improve sleep quality in people who have low magnesium levels -- which are many of us --  but it does not have a sedative effect, so you don't need to worry about getting sleepy after taking a magnesium supplement.

The standard dose for magnesium is 200 mg of elemental magnesium, though doses of up to 500 mg can be used. 

There are several kinds of magnesium. Magnesium oxide is not recommended for supplementation because it is more likely to cause intestinal discomfort and diarrhea, and is known to have less absorption than other forms.

If you take magnesium gluconate, do so with a meal to increase its absorption. Other forms of magnesium can be taken either with food or on an empty stomach. 

6. Take a melatonin supplement

Let’s dig into melatonin a bit more. It’s a hormone that regulates the sleep–wake cycle. It’s primarily released by the pineal gland in your brain. 

As a dietary supplement, melatonin is widely used to enhance sleep, but a key reason to consider using it in the context of COVID-19 is that it inhibits NLRP3 inflammasome activation that I mentioned earlier, and it reduces airway inflammation. 

Melatonin has also been identified as a potential therapeutic drug in computer modeling of the effects of SARS-CoV-2 on human cell expression.

In some countries, you need a prescription for melatonin. In others, like the U.S., melatonin is widely available in stores or online. Take around 1 to 5 mg, 30 to 60 minutes before bed. Time release melatonin capsules may be more effective at sustaining sleep throughout the night.

Start with a low dose to assess your tolerance, and then increase it slowly as needed. Since melatonin may alter brain chemistry, it’s advised that you check with a healthcare provider before use.                                    

Remember to check the Nutraceuticals Guide for more information about melatonin, as well as all of the nutraceuticals I cover. If you’d like more information about melatonin, check out References 9 -- 12 under the References tab above.

7. Optimize your sleep environment

You want your bedroom to be cool, dark and quiet. 

To get complete darkness, I simply use an eye mask.  I find that it’s easier to put on then to go around the bedroom and pull down window shades, which still lets in ambient light from outdoor lights.

For coolness, ensure the windows are open or the blanket is light.

I don’t like earplugs; fortunately, it’s quiet in my neighborhood. If that’s not the case where you live, experiment with them.

In the next lesson, we’ll dive more into how to alleviate stress.

Your Takeaway

The daytime and nighttime rituals add up to 13 things for you to focus on and make a consistent part of your lifestyle. 

Six daytime rituals:

1. Establish a consistent routine 

2. Get morning light

3. Exercise during the day 

4. Take a walk in the woods

5. Don’t use your bed as an escape

6. Avoid caffeine late in the day

Seven nighttime rituals:

1. Minimize mental and emotional stimuli

2. Reduce blue light

3. Set a regular bedtime

4. Reduce stress

5. Take an epsom salt bath

6. Take a melatonin supplement

7. Optimize your sleep environment

That’s a lot of new habits to absorb if you now do very few of them, so to get started, select those you have the least amount of resistance to do. Once those are ingrained into your lifestyle, add the others.