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Ivermectin, Monoclonal Antibodies, and Blood Sugar: COVID Strategies

Ivermectin has been in the news lately with headlines like "Man ODs on Horse Dewormer" and "Hospitals Full of Ivermectin Patients." If this is the only perspective you've heard, let me tell you why people DIY their own health. 

DIY Health

Years ago, a commenter at Dr. Davis's Track your Plaque blog recalled when he was diagnosed with diabetes. He researched the illness, found that doctors and veterinarians had completely different views, and he wondered how humans and animals could be so different. He concluded that the veterinarians had it right. For a while, he thought about seeing a veterinarian for his diabetes, but finally decided to take care of it himself.

He's not the only one taking care of his own illness. I'm part of online communities whose members have had to either fix their own health problems or watch them get worse. Dietary guidelines for all Americans include "healthy whole grains," even though too many Americans are overweight and whole grains are used to fatten up livestock. (Maybe we can get people to improve their diets by calling grains livestock fatteners.) Just ten years ago, official guidance for diabetes was a high-carb, low fat diet, even though diabetes is a disease of carbohydrate intolerance. Typical treatment for hypothyroidism is still limited a largely useless test and medication that most patients can't convert to the hormone they need, leaving them cold, tired and overweight. I ended up here because I had gastrointestinal problems that my doctors couldn't solve, but Dr. Google could. It's common for people in these online communities to read studies, order our own labs, and in some cases buy medications from other countries or as supplements because we can't find in-person doctors to help us. In 11 years, I haven't heard of anyone ending up in the hospital because of it.

Why Would People Take Veterinary Ivermectin?

Many others now find themselves in a similar situation: they get COVID symptoms or a positive test. They've read--correctly--that ivermectin is being used by doctors to treat COVID, people in Africa have safely used it for decades, and it's inexpensive. Its discoverers even won the Nobel Prize for it. Yet some pharmacies are refusing to fill doctors' prescriptions for it and family members of dying patients have had to get a court order to make hospitals administer it after it's been prescribed. What would YOU do if you thought ivermectin could save you--jump through hoops or get a $12 tube of veterinary ivermectin you could take at will? While some people have taken a horse-sized dose and ended up in the ER--filling up the ER sounds like a bunch of horse shit*--we're unlikely to hear from many people who took a recommended dose of ivermectin and learn how it affected them thanks to censorship and shaming. 

You can order ivermectin online, but it could take time to get a consultation with the doctor and then get the medication. With overseas vendors, I would be concerned about counterfeit or ineffective drugs. 

Another Treatment: Monoclonal Antibodies

While the media has been denouncing ivermectin, they've mostly ignored a treatment COVID patients could have gotten. Tens of thousands of regular, Jane and Joe Sixpack Americans--if not more--with COVID have been treated with monoclonal antibodies. The treatment is available all over the US, has emergency use authorization from the FDA, and is approved in the United Kingdom and Canada. It's not a new technology--the first monoclonal antibody was fully licensed in 1986--but this particular kind is new.

Monoclonal antibodies are copies of natural COVID antibodies. They are given by infusion on an outpatient basis to COVID-positive patients with mild to moderate symptoms who are at high risk for progression of the illness. Vaccination status doesn't matter, but the treatment must be within ten days of the onset of symptoms--the earlier, the better. Most of the patients who've made videos about their experience report feeling extremely ill before they got the infusion--one woman was too ill to sit up--and feeling better within one to two days. 

The Phase 3 clinical trial for Regeneron (casirivimab and imdevimab) shows a 2.2% absolute risk reduction and 70% relative risk reduction in hospitalization or death. Side effects in the trial included shortness of breath, chest tightness, nausea, vomiting, and rash in 0.2% of the patients. "Anaphylactic reactions were reported. The events began within 1 hour of completion of the infusion, and in at least one case required treatment including epinephrine. The events resolved." Patients in the trial received twice the dose that is currently recommended. There may be other unknown side effects, but I haven't seen any reports of severe side effects like death or disability. 

According to what I've read, the antibodies are free, but there may be a treatment fee. (In Florida, the treatment is free and no referral is needed.) Medicare and Medicaid cover it.

High Blood Sugar Lets COVID Rage

If you're looking for a natural, effective, inexpensive preventive with no side effects, here it is: normal blood sugar. A study that used machine learning to mine 240 COVID articles found that 

  • Elevated blood glucose is the most likely single risk factor to explain why, in otherwise healthy patients, disease severity is associated with age and known comorbidities.
  • Elevated blood glucose can facilitate virtually every step of the SARS-CoV-2 infection.
  • Elevated blood glucose increases glucose in the pulmonary airway surface liquid (ASL), which breaks down the primary innate antiviral defenses of the lungs and facilitates viral infection and replication.
  • Elevated blood glucose causes dysregulations in the immune response that facilitates the cytokine storm and acute respiratory distress syndrome (ARDS).
  • Elevated glucose levels act synergistically with SARS-CoV-2-dependent inactivation of angiotensin-converting enzyme 2 (ACE2) to escalate the disease to multi-organ failure and thrombotic events.

What is elevated blood sugar?

Under normal conditions, FPG [fasting plasma glucose] values range from 4.4 to 6.1 mmol/L (79–110 mg/dL) (average of 5.5 mmol/L), and PPG [post-prandial glucose] values should be lower than 7.8 mmol/L (<140 mg/dL). Hyperglycemia is generally diagnosed when FPG is >7 mmol/L (>126 mg/dL) or PPG >11 mmol/L (>190 mg/dL). Such a high FPG value is sufficient to diagnose chronic hyperglycemia, however normal or modestly elevated blood glucose (FPG ranging 6.1–7 mmol/L or PPG ranging 7.8–11 mmol/L), called impaired fasting glucose (IFG), could reveal an impaired glucose tolerance (IGT) that leads to greater and more frequent glucose fluctuations than normal.

You can test your blood sugar (or "plasma glucose") at home with an inexpensive glucose meter available at drug stores--no need for a prescription. Instructions are here.

A diet that normalizes blood sugar: the best preventive of them all. Leave the oats and apples for horses.

At the Inner Circle (Dr. Davis's site), we strive to meet the no-change rule (no change in blood sugar after meals). We do this by limiting carbohydrates to 15 net grams of carb (all carb minus fiber and anything else that can't be digested). Almost nobody in this group of mostly retirement age people with heart problems has mentioned getting a bad case of COVID. By contrast, almost every COVID casualty I see on the news is overweight, suggesting they have high blood sugar. As I've said before, I'm not trying to be unkind or suggest anybody deserves to get COVID--I am only observing a pattern that now looks like it's verified.

If you take diabetes or blood pressure medication, keep in mind that reducing carbohydrates is so effective in lowering blood sugar and blood pressure that your medication will probably need to be adjusted. Proceed carefully; test before injecting insulin. 

Not only does controlling your blood sugar help you avoid COVID, it will help prevent weight gain, diabetes and heart disease--illnesses you're far more likely to get than COVID. If you've gotten off the low-carb track over the pandemic, it's time to get back on the horse.

*Update: the story about gunshot patients waiting to be seen because the ER was full of ivermectin overdoses was, in fact made out of whole cloth. The hospital issued this statementAlthough Dr. Jason McElyea is not an employee of NHS Sequoyah, he is affiliated with a medical staffing group that provides coverage for our emergency room. With that said, Dr. McElyea has not worked at our Sallisaw location in over 2 months. NHS Sequoyah has not treated any patients due to complications related to taking ivermectin. This includes not treating any patients for ivermectin overdose. All patients who have visited our emergency room have received medical attention as appropriate. Our hospital has not had to turn away any patients seeking emergency care. We want to reassure our community that our staff is working hard to provide quality healthcare to all patients. We appreciate the opportunity to clarify this issue and as always, we value our community’s support.


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