It was touched upon in my post N-Acetyl-Cysteine (NAC) & COVID-19, but let’s revisit blood clotting associated with COVID infection in greater detail, the current hypotheses on how it happens, and why it is likely to be the “real cause” of the serious cases. Most of the varied and seeming strange symptomology can also be explained as a result of this abnormal clotting.
I want to re-emphasise how NAC can likely help mitigate this process to some extent because of its antioxidant and anti clotting properties. And, in my research for the perfect COVID herbal formula based on herbs I can easily procure in Mexico, I found Ginkgo biloba could also hold promise to address the oxidation, the clotting, and there is research to suggest that it interrupts the viral replication process of COVID specifically.
Let’s start with the current hypothesis on how this clotting occurs in COVID infection. For a more in depth explanation and the review of current research, check out these MedCram Videos:
Current Clotting Hypotheses
It is extremely likely that both of these hypotheses are in play with COVID infection as there is current research to support both (see video links above). Hypothesis 1 is probably the greater problem as autopsy studies of COVID patients show clots mostly form and remain in place which is more consistent with Endothelial Cell dysfunction. However, cases of stroke may be more a function of the “catching and clumping” of red blood cells in Hypothesis 2. Either way – NO BUENO!
Hypothesis 1: Endothelial Cell Infection and Dysfunction
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Endothelial cells are the thin, flat cells that line the surface of blood (and lymph) vessels. The COVID-19 virus infects these cells at the ACE 2 receptor.
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This infection process leads to the production of superoxide (free radicals).
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The huge amount of “oxidative stress” and inflammation from the free radicals leads to dysfunction and damage to the endothelial cells.
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When the thin layer of cells that make up the vessel wall are damaged, platelets adhere to the damaged areas by binding to von Willebrand factor – a protein that has a variety of impacts on clotting essentially acting as a “glue” that sticks platelets together.
Hypothesis 2: The CD-147 Receptor on Red Blood Cells
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The CD-147 receptor on red blood cells is also a binding site for the spike protein of the COVID virus.
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Fortunately the virus can’t replicate with red blood cell infection because red blood cells don’t have a nucleus (which has the “machinery” for replication).
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The bad news is the virus can essentially “catch and clump” red blood cells by binding them together. This accumulation is essentially a clot.
Lethality and Seemingly Strange, Different, and Long Lasting Symptoms Explained?
This clotting can likely explain why severe cases of COVID-19 are so difficult to treat when compared to other flus with respiratory infection. While the pneumonia alone in these cases does have the potential to be severe and lethal, autopsy studies are showing clotting in the blood vessels of the lungs also.
So in addition to pneumonia, and maybe the larger problem, this clotting likely impairs the lungs ability to absorb oxygen and is an added factor in lung fibrosis (scarring). It is also speculated that this is the reason why ventilator and oxygen therapies aren’t more successful – even though the air/oxygen is getting into the lungs, it can’t be absorbed into the bloodstream effectively.
Clotting may also explain the varied symptomatology among those infected and the reason why some are having long term effects well after infection is over. All the blood vessels of the major organs are susceptible to clotting.
This could explain why some patients show hypoxia (the body is deprived of adequate oxygen), but without any symptoms of pneumonia. If severe, this or clotting in the vessels of the heart can lead to heart attack.
So infection can show symptoms of any organ dysfunction (like liver and kidney) and in bad cases can lead to a cascade of organ failure. Clotting may also explain some of the strange neurological symptoms like loss of taste or smell, headaches and migraines, “fuzzy” thinking, etc.
And finally, clotting may explain the long term symptoms well after infection is over. Clots essentially become fibrosis and scarring. Unfortunately this can take a long time to resolve or may be permanent (however Chinese medicine can do some good in this area and we’ll get to that in upcoming posts). So depending on the severity and where it is located, function in those areas and organs may be chronically impaired. 🙁
NAC Re-emphasised!
This all sounds pretty grim huh? First of all remember severe cases are relatively rare and happen mostly in those with existing health problems and/or low vitamin D status. At the same time, it’s a good reminder of the importance of staying (or getting) healthy and being prepared in any way we can.
N-Acetyl-Cysteine (NAC) is a relatively cheap and safe supplement that may mitigate the “oxidative stress and damage” of infection and also has an anticoagulant (anti clotting) effect. For detailed information on NAC see my earlier post.
NAC Dosage Reconsidered? I’m rethinking my dosage strategy with NAC. My previous recommendation to family, friends, and patients was 600mg 1-2 times a week as long as there are no cold or flu symptoms.
What we are seeing now is many people are asymptomatic in the early stages and may not necessarily get flu symptoms like nasal congestion, sore throat, cough, or even fever. That first symptom could be the loss of smell, extreme fatigue, headache or something that could actually be a sign of clotting (or at least that the progression is much further along than we knew). It would be much better to have some level of antioxidant and anticoagulant “protection” before things progress.
So I’m thinking (assuming one isn’t on medications that interact with NAC or have a health condition where NAC is inappropriate), that at least 600 mg a day may be a good idea with an increase to 1200-1800 mg with any sign of infection.
Could Ginkgo biloba be the “herbal NAC” plus?
Since access to Chinese herbs is limited in my location, I’ve been on an ongoing quest for the perfect COVID formula made of herbs I can obtain easily in Mexico. While I think I have the antiviral, infection, cough, and pneumonia parts pretty well covered (more on this in an upcoming post), I realized as this new research comes out that I don’t have anything to address what may be most important – clotting.
A quick search of common herbs with anticoagulant effects led to Ginkgo. It turns out that Ginkgo is one of the most studied herbs in modern research. Like NAC, ginkgo is a powerful antioxidant and anticoagulant. Ginkgo has a protective effect on endothelial cells damaged by Ang-II (the precursor to the superoxide free radicals mentioned in Hypothesis 1) and hypoxia (oxygen deprivation).
Ginkgo is also a Chinese herb that has been used for at least 500 years for cough. The icing on the cake is evidence that one of its main constituents, Ginkgolide A, shows potential as a potent protease inhibitor (virus replication cycle inhibitor) specific to COVID-19. It being the most potent of 9 compounds studied.
NOTE AND DISCLAIMER: Even with all the research, this by no means indicates Ginkgo can prevent, treat, or heal the effects COVID-19 infection. I think it does hold promise though and it’s relatively safe for most people.
For further information on side effects and drug interactions: WebMD: Ginkgo
Warning for Mexico Residents vulnerable to Dengue Fever. In the most severe cases, Dengue can be hemorrhagic (bleeding) and in almost all cases platelets drop well below normal levels. This means that any blood thinners or anticoagulants (like NAC and Ginkgo) are STRONGLY CONTRAINDICATED and can lead to serious complications. Because early symptoms of Dengue and COVID infection (like fever and body aches) can be similar, it’s vital to get medical care immediately to rule out Dengue before continuing with anticoagulant supplementation.
Dosage
Many standardized extracts come in 120 mg capsules. I’m going to start with that amount per day, and like NAC, increase my dosage if I think there is a greater risk of exposure or I have any flu (or strange) symptoms of any sort.
Note: Most sources recommend something along the lines of 6-8 weeks of use followed by discontinued use for roughly a week.
Where To Buy Gingko
Standard extracts (in capsules or tinctures) are widely available at most health food and supplement stores throughout North America. While I am personally working with the whole leaf in combination with other herbs, I highly recommend the standardized extracts for the consistency, quality, and ease of use. Visit my post on NAC for information on purchasing it.
US (Affiliate Link): Nutricost Ginkgo Biloba 120mg, 240 Capsules
Canada: Nature’s Bounty Ginkgo Biloba Pills, 120 mg, 180 Capsules
Mexico: GINKSOR: Ginkgo biloba suspensión
I was able to find GEL pharma Nemoril Ginkgo Biloba 40mg 60 cápsules at Farmacias Similares in Barra. The price was reasonable at $60 pesos but it’s hard for me to judge the quality. Probably can’t hurt, but hard to know how much it will help.