AGING, ILLNESS, AND COVID-19

It is widely publicized that people over 60 years of age are more susceptible to serious illness from the coronavirus which is causing the current pandemic.  Associated illnesses increase the risk of morbidity and mortality in elderly people who become infected with COVID-19.

What is the problem that makes the demographic of the elderly more vulnerable than younger people?  What happens during aging that reduces and damages resistance to disease?

Disease resistance depends, to a large extent, upon the health of the cells.  There are some 37 trillion cells in a human body.  Each has a degree of independent function.  Proper levels of nutrients inside these units are important contributors to their well-being.  Deficiencies promote the defects of aging, leading to cellular senescence.

Blood levels of the vitamins and minerals are important because they affect the functioning of organs.  Low circulating levels of Vitamin C, Vitamin D, calcium, magnesium, and others contribute to tissue injury and organ malfunction.  Furthermore, when the serum concentrations are down, the total body store is severely compromised.

The body’s supply of vitamins and minerals are found mostly inside the cells.  The intracellular actions of these micronutrients are to maintain the metabolic efficiency and biochemical vigor of each cell.  When deficiencies of these nutrients develop inside the cells, aging occurs.  In addition, bodily vigor and resistance is decreased.

There is very little factual data on intracellular concentrations of vitamins and minerals.  Only calcium has been extensively researched in this regard.  Being radio-opaque (able to be seen on radiological imaging studies, like a bone density scan), calcium levels in bone are readily quantifiable.  No other vitamin or mineral has this property.  To correctly evaluate intracellular concentrations of any of the non-calcium micronutrients, direct sampling would have to be done.  This is very difficult to accomplish.  The resulting hypothesis has been to assume that serum levels accurately reflect the levels in the cells.

But the example of osteoporosis contradicts this theory.  Such a model holds validity because life consists of a limited number of patterns that are repeated on many levels.  Patterns are the nature of existence.  (More on this subject in a future blog.).  The illness known as osteoporosis defines such a pattern. 

This disease teaches us that the natural history of cellular micronutrient levels is to decrease.  Hence, the reduced density of calcium in the bone that is seen with aging.  There is no inherent mechanism in the body to prevent this phenomenon. 

On the other hand, there are multiple processes to prevent the blood calcium levels from decreasing [or increasing].  There is sense why this should be true.  Abnormally high or low levels of circulating calcium can cause serious heart problems.  This is not a good thing from an evolutionary perspective.  Young people getting sick or worse because they cannot control serum calcium would interfere with the prime evolutionary directive of maintaining the species.  On the other hand, if elderly people are breaking bones because of osteoporosis, that will not compromise the evolutionary need.

In my practice of Internal medicine, I have helped many people to feel better by advising they take a vitamin/mineral supplement.  There are a few studies to back this observation.  Most of the studies of supplementation involve single nutrients.  This approach denies the obvious fact that humans have always ingested these nutrients as a whole complex.  It makes sense that all the vitamins and minerals should be taken together because they support each other in their functions.  Imbalances result in illness.  Serum imbalances are easily measurable.  Scientific studies of intracellular nutrient imbalances are very difficult and costly to perform.  The result is that there is little information on this subject. 

Thus, our understanding of micronutrients and health comes mostly from extrapolation, as described above.  But it is critical knowledge that helps prevent and overcome illness by strengthening resistance. 

The problem of micronutrient deficiencies and imbalances begins when we are children.  From the time we are born, dietary goals have been to assure adequate weight gain.  It is assumed that eating a “well-rounded diet” (an ever-changing concept) is all that is necessary.  Then, adjusting the intake to prevent overweight, diabetes, and hypertension becomes the goal.  I want you to know that we must also concentrate on vitamin and mineral consumption to encourage lifetime health. 

The current recommendation to prevent osteoporosis is for high risk individuals to start taking calcium and Vitamin D as teenagers.  That is quite an expectation.  Yet maintenance of intracellular vitamins and minerals is much more effective than trying to correct imbalances once they are established.  This general strategy is optimal for all aspects of health and aging.

We need high doses of these supplements to avoid the losses.  The earlier this habit is instituted, the greater the protection.  Being healthy is a lifetime endeavor.  Relying on the diet to supply these needs is risky.  For example, preventing osteoporosis requires 2 supplement pills a day or the same support from drinking 3 glasses of skim milk a day.

Why is it not easier to prevent deteriorative diseases?  Because deterioration is the way of the world.  A passive program to maintain cardiovascular fitness just does not work.  The same is true for keeping up the needed levels of intracellular micronutrients.

A good one-a-day vitamin supplement is much better than nothing.  But it does not satisfy the need.  A six-a-day pill will likely have adequate quantities to promote aging with vigor.  (Never take more than a single one-a-day pill because of Vitamin A toxicity.)  Such a supplement may contain vitamins, minerals, antioxidants, vitamin cofactors, and similar entities.  I shy away from herbs.  

This quantity may sound like a burden.  Being healthy is hard work.  It must be made a priority in life.  The alternative is poor health and susceptibility to illness.  Do not accept loss of vigor and well-being as a natural part of aging.  We can strengthen ourselves against all illnesses.  This is especially true of enhancing resistance to infectious diseases.  This includes dealing with COVID-19.