Read This Even If You Aren’t Pregnant or Female: Important Covid Info for All!
The majority of medical effort throughout the world has been focused on Covid-19 for the past few months, and our understanding has grown exponentially. Moderate to severe infection with coronavirus can cause fertility issues (see my blog on that here) Pregnant women don’t seem to be more susceptible to getting the virus, which is good news! But there is emerging information that moderate to severe Coronavirus during pregnancy can cause placental damage. For mild cases, there are steps you can take at home to moderate the problem. For more advanced cases, staying informed means you can make sure your OBGYN can give you effective care.
Even if you aren’t pregnant or female, please read through this; there is information at the end of the blog that is helpful for everyone.
Covid-19 And Its Multi-system Attacks Are Medically Weird
Covid 19 is a difficult disease to treat not only because it is a virus, but because it affects so many body systems: lung, heart, kidney, stomach, and intestines, muscles. That is STRANGE in the medical world: most viruses and bacteria only affect a system or two. The question is, how is the virus affecting so many different organ systems? What do these systems all have in common?
The Answer Is Likely Blood, Through Blood Clotting
Blood clot in a blood vessel
The answer is blood: all these systems need blood to function. There is emerging evidence that Covid-19 is causing micro blood clots in all patients who get ill, and it’s the clotting that is affecting the functioning of these organs.
The emerging thinking is that Covid-19 starts out as a pulmonary (lung) disease, but it’s also a vascular (blood vessel) disease, and the infection of the blood vessels causes the clotting, which creates all the seemingly unrelated symptoms. Here’s a link to an article that sums up the current understanding: Coronavirus May Be a Vascular Blood Disease
But what is it about clotting that is a problem?
Clotting is good when you have a bleeding wound, but highly dangerous in the body in general. Clots are the culprit in heart attacks and stroke by blocking blood flow; if you create a clot (called an embolism) and it breaks off or gets stuck in your lungs you can die of a pulmonary embolism (basically a lung blockage); clots can kill off kidneys or get stuck in a major blood vessel in your arms or legs and cut off blood. Clots are very bad news.
Blood Clots in Coronavirus
If Covid-19 is causing micro blood clots, that would explain why so many systems are affected: the tissues and organs aren’t getting the blood flow they need to function. The clots that are forming aren’t detectable on a scan; they are micro clots, and just do enough damage that organ function is compromised.
So the question is, what is the effect on a placenta, the main organ of pregnancy?
What is a Placenta?
The placenta is a whole new organ that develops in the first trimester in the uterus of the mother, and functions throughout the pregnancy. The placenta is attached to the uterus, and the umbilical cord attaches the placenta to the developing fetus. It functions as a nutrient conduit, a hormone factory and a toxin buffer between mom and baby. Blood from the mother filters through the placenta, which provides oxygen and nutrients to the baby. The placenta creates many of the hormones that are needed in pregnancy to help the fetus develop normally (yep, baby needs a whole new organ to help it grow correctly), and it also removes waste products and protects the baby from infections. (For more on what the placenta is and does, go here: What is the Placenta? )
Coronavirus And Pregnancy And The Placenta
The placenta acts like lungs for the fetus
If the key to the damage done by Covid-19 is blood clots, then how the placenta is affected is critical. The placenta filters blood from the mother, so any blood clotting issues will be evident in the placenta. The concern is the vulnerability of the placenta in providing an oxygen source to the baby. The placenta “acts like a ventilator for the baby,” states Dr. Emily Miller, assistant professor of OBGYN at Northwestern University Feinburg School of Medicine; it provides an adequate flow of oxygen during development. Clotting can affect that critical role.
Blood Clots in the Placenta
A team of researchers studied the placentas of women who had tested positive for Covid=19 either during pregnancy or birth. All of the women in the study had full-term normal pregnancies. But when their placentas were examined post-birth, they all showed signs of clotting and insufficient blood flow to the fetus. (Read the article describing the study here: Placentas Show Injury)
Reduced Oxygen and the Beautiful, Overpowered Placenta
Insufficient, i.e. reduced, blood flow to the fetus at any time during the pregnancy is a deep concern. Reduced blood flow means less oxygen, fewer nutrients, backed up waste, and potentially reduced growth hormones.
Fortunately, the placenta is WAY overpowered for what it does. A healthy woman can generally lose up to half the functional capacity of her uterus and the baby will be OK. (That is some serious redundancy, which is great!) But we don’t really want to rely on that backup power; especially because women who have preexisting conditions or small placentas to begin with are at higher risk.
What To Do If You Get Coronavirus During Pregnancy
In the case of potential placental injury, close and frequent monitoring by an OBGYN is critical, to avoid any potential damage to the fetus. So these latest findings may (should) prompt OBGYNs to pay closer attention and intervene quickly at the first sign of trouble.
If you do get sick, notify your OBGYN immediately, and ask them to monitor you frequently. Tracking your blood oxygen saturation level is the most effective way of monitoring how sick you are.
If you are mildly ill, follow the recommendation below for home care of clotting.
If you are moderately or severely ill, your provider will be able to counter the effects of the illness through medication. Don’t be shy about telling your OBGYN that you want to know what their strategy to counter the clotting issue is. Make sure they know that there are studies that say clotting is a potential issue, and you want to minimize the risk.
What Everyone Can Do NOW to Safely Minimize Clotting
If clotting is the issue, than taking supplements to decrease clotting issues can help. Fish oil/DHA, turmeric and baby aspirin are all known anti-coagulants (blood thinners) which prevent or minimize clotting. They are all generally safe during pregnancy. However, you should contact your OBGYN before taking baby aspirin, because it is a medication.
The Role of Omega 3/DHA in Pregnancy and Coronavirus, and In General
But fish oil/DHA are nutrients you need during pregnancy. Most women don’t eat adequate amounts of foods with Omega 3 in them. FYI, Omega 3 is metabolized into DHA in the body; so you can take either one. I encourage all my patients to supplement with DHA or fish oil to get the right amount. The RDA is 1000 mg.
Fish oil aka Omega 3/DHA gel caps
Omega 3/DHA is considered an essential nutrient for proper cell development and brain growth of your baby. It also is a natural blood thinner. When you eat adequate amounts of Omega 3/DHA, your blood is getting a molecule it needs to function correctly, making it more fluid, less clotty.
One of the reasons I like the Designs for Health Prenatal Pro Essential Packets is that the RDA for pregnancy is included in the packet, so you don’t have to figure out which one to buy. You can shop for Prenatal Pro Essentials at my online store; I offer discount codes on my web page, so start shopping here.
If you want to buy your own fish oil, make sure it’s from farmed small fish, to avoid decimating the population of large fish. Even better, get DHA farmed sustainably from kelp, and leave the fish alone. You can find Nordic Naturals Algae DHA here.
Turmeric: Super Powerful Blood Thinner AND Anti-inflammatory
Turmeric is a yellow spice; you see it often in Indian cooking and Indian curry (yum!) The compound curcumin is what makes turmeric special; curcumin is an anti-coagulant (blood thinner). But only 3% of turmeric is curcumin, so to get a therapeutic dose (a dose that is effective for medical therapy), you will need to get a supplement. Supplements concentrate the curcumin to a high level, concentrating the therapeutic action.
You also need to take your curcumin with black pepper. The body isn’t very efficient at absorbing curcumin, but piperine, an active ingredient in black pepper, increases absorption by up to 2000%.
Turmeric, which has curcumin
Curcumin also improves the function of the endothelial tissue. Endothelial tissue lines blood vessels, and inflammation of this tissue is one way Covid-19 creates heart issues. (Read the article here: Endothelial Cell Infection in Covid 19) AND, curcumin is also anti-inflammatory. So curcumin might be double-protective, from both clotting and tissue inflammation.
There are a lot of curcumin products out there. Make sure you get one that is therapeutic grade, and also has black pepper in it. I like Gaia’s Turmeric Supreme. I take it personally and recommend to my patients: you can order it directly from the manufacturer here.
Blood Thinners and Anti-coagulants (Make Sure To Read This If You’re On Lovenox or Baby Aspirin): Mixing Is A No-No
Anyone on a blood thinner should not take therapeutic doses of turmeric/curcumin. You are already on a blood thinner, so you don’t need the extra boost. It will thin things out too much, and that could be dangerous. If you are on Lovenox or a baby aspirin, then you should not take curcumin.
Fish oil is fine. It’s food, and your baby needs fish oil/DHA to grow its brain. Fish oil is the safest of the three options because it is a food. So it’s generally safe.
The Take-Away
- Covid 19 coronavirus might be creating microclots, leading to the various strange symptoms and multiple-organ involvement.
- Pregnant women who had moderate to severe coronavirus infections showed damage to the placenta
- However, because the placenta is so strong, with adequate care the effects can be minimized.
- Taking natural anti-coagulants such as fish oil and curcumin, or baby aspirin, might give protection against the blood clotting issues
- If you are on any type of blood thinning medication, don’t take curcumin or baby aspirin. Fish oil is fine.
Love,
Dr. Lisa
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Picture Credits:
Pregnant Woman in Green Illustration: Karen Arnold
Fish oil: Pixabay Public Domain
Turmeric: Steve Buissinne
Tree Lungs: Gordon Johnson
Blood Clot: N. Promvichai
