COVID-19. It's everywhere in the news, and so many of us, even the experts, seem uncertain how serious the risk actually is, especially for otherwise healthy adults.

No matter what, the risk of contagion is high, even for healthy adults, so we brought together our Chief Medical Officer, Dr. Rebecca Dunsmoor-Su, and Gennev Menopause Coach, Sports Dietitian, Exercise Physiologist Stasi Kasianchuk, to talk about the risks and the best ways to minimize them.

One good practice is to minimize your exposure, so Gennev is stepping up its HealthFix and Telemedicine programs to better accommodate the demand. If you have questions about how menopause changes your risks, or if you take medications or have health conditions that concern you, or you need to renew an HRT prescription, you may want to make an appointment with one of our physicians.

For detailed information on how to reduce menopause symptoms and boost your immune system with nutrition, exercise, stress management, sleep hygiene, and supplementation, check out our HealthFix program. Talk with a Menopause Coach to create your personalized plan for better health during the coronavirus outbreak and well beyond.

 

Watch the video of this COVID-19 and menopause conversation on YouTube.

Read the full transcript:

Gennev:

Welcome to the Gennev podcast. In this series we talk with the experts about women's lives and health and menopause. Our mission is to empower you with information that puts you in control of your health. We're glad you've joined us. Let's get started.

Dr. Rebecca Dunsmoor-Su 

Hi, this is Dr. Rebecca Dunsmoor-Su. I'm the Chief Medical Officer here at Gennev, and we're doing a podcast today to talk a little bit about a coronavirus and what populations we need to take special care in. I'm here today with Stasi. Stasi, you want to introduce yourself?

Coach Stasi 

Yes. Hi, I'm Stasi Kasianchuk and I am a menopause coach at Gennev and also a registered dietitian  nutritionist and exercise physiologist. So I will also bring some insight in terms of lifestyle recommendations that we can do to support our immune system during this time.

Dr. Rebecca 

Excellent. So we wanted to put this podcast together today to talk a little bit about people for whom this virus and this infection is a bit more of a risk. We've all seen lots of blogs and podcasts, even from us, about how to protect yourself and how to wash your hands, things like that. And all those things are great and really applicable to the general public, but there are certain aspects of the public for whom that's just not enough of a precaution. And who really need to think about themselves as being at slightly higher risk and might need to take additional precautions. So in my mind, and the reason I wanted to do this on Gennev, is that one of the things we know about this virus is that it increasingly is more difficult to handle for your body and for your immune system as we age.

And what we're seeing from the WHO is that, you know, the death rate in children is exceedingly low if not zero under a certain age. And the death rate is very low as far as we can tell up through middle age. But as we get into late midlife and even older, the death rate starts to climb. And some of that is just that as we age, we have more comorbid conditions. So people with over … who already have cardiovascular disease, people who already have respiratory disease are at higher risk. But there may also be something to do just with how the immune system responds as we age because it does become less robust as we age. But also, you know, this is a population in whom there may be many reasons why the immune system is not as strong. So when I'm talking to my patients, the things that I think about are women especially who are on biologics.

Women are more at risk for rheumatologic disease, for autoimmune diseases, which means they're much more likely to be on those medications that suppress the immune system. And so, you know, you may feel great and feel great in your life and you know, your biologic medication is keeping you very healthy, but it is suppressing your immune system and that puts you at higher risk. I think about women getting cancer treatment. I think about women who are, who've just had surgery and their immune system is busy dealing with that and may not be up to the task of also combating this virus. So it's certainly something that we need to think about if you're at higher risk. And I think these are the populations where we need to really address social isolation or quarantining yourself. These people should not be going on vacation right now, not be getting on an airplane right now and really trying to avoid public places as much as possible.

None of us have immunity to this virus. So as it starts to spread through the community, everybody's going to get it and they're going to transmit it. So what we're trying to do as a public health community is not prevent people from getting the virus. Eventually people are most likely going to get the virus unless we managed to invent a vaccine before you get it. What we're trying to do is make sure we get it in very small staggered stages so we can take good care of those people who get sick when they get sick. What we're seeing right now in Italy is an overwhelming of the medical system. It's the same thing that we think we saw in Wu Han, China. So many people got sick all at once. And so many people got so sick, there weren't the resources or the physicians or the nurses. In Italy, they're talking even about running out of ventilators for people. There's just not the resources there to take care of them. So if we, if we practice good social isolation, hopefully we can spread out the spread of this disease such that we can care for you if you do get sick. And then Stasi's here because we really want to talk about, okay, now those are some risk factors, but what are some things can we do as a general population, even those who might be slightly less immune, to really boost our immunity during this time? And I think you have some great recommendations for that.

Stasi 

Awesome. Thank you, Dr. Rebecca for the, the insight you have there. I think it's helpful to have reputable information right now. There's a lot of information out there and I think it's important that we're giving information to our listeners and to the women that we work with through Gennev that they can trust. And that's something that we pride ourselves in doing. So I appreciate you clarifying. And providing evidence-based scientific information around that. So I think from some of the standpoints, you know, going back to the immune system, there's a lot of things we can do in our life to support our immune system day to day.

And putting a slightly silver lining, positive spin to coronavirus, I'd like to say that it's highlighting and even some of the women I'm working with are paying more attention to things that, Oh, I should be doing these things. Nothing new. Washing hands, a great example. We know that that works and that's something that didn't just come up for a Coronavirus. This is something we should be doing all the time, washing our hands regularly. So that's a basic one obviously, but looking at things that can really support the immune system's function, especially from a nutrition standpoint, exercise, stress, I'd like to touch on some of those.

So first, from the nutrition standpoint, this is a great time to focus on how you can increase the nutrient density of your nutrition. So thinking about brightly colored fruits, vegetables, more whole foods, this doesn't mean, and even increasing these in small amounts can make a difference. Think about every bite that you take with meals that you have as an opportunity to support your immune system. So focusing on incorporating more of these foods into your day, into your week in a way that is convenient for you and realistic for you is a great start to provide additional support.

Another one is exercise. Now this the, this can be a little bit interesting during the coronavirus. I'm working with a lot of women, especially in the Seattle area where they go to group exercise classes. That has actually been something where some of them have decided, I’m not going to do group exercise class right now. It's a lot of people, a lot of sweating going on. So maybe I'm not going to go to my group exercise class, but I'm going to go outside. I'm going to get some fresh air. I'm going to walk in a place that maybe there's not a large crowd, a lot of people. But moving your body and especially if you're someone that doesn't need to be in isolation right now, taking advantage of that time to move your body can actually help your immune system. So exercise is something … regular exercise that supports the immune system.

Dr. Rebecca

And I want to just break in here and say that I 100% support that. I find that regular exercise not only itself supports your immune system, but it decreases stress, especially in a time that's so stressful for us. Getting out of the house and away from the TV and the news and hearing about every new case of coronavirus is huge for supporting the immune system.

Stasi 

Yeah, that's a great dovetail into just stress management. I think we forget. You know, we live stressful lives. So a lot of times our baseline level of stress might be already elevated. So our body is used to fighting all the time and we don't want to. And in a situation day to day when there's not a coronavirus apparent, our immune system may do just fine fighting things we've been exposed to. But as you mentioned, none of us are immune to the COVID-19 virus. And so now if your immune system is stressed from day to day family, life, work, and now it's stressed because you're concerned about getting the Coronavirus, that can put another, it's just more taxing. It's more work for your immune system to do. So taking a deep breath, deep breathing, getting some exercise. And even, you know, meditation apps or mindfulness techniques, taking five minutes, 10 minutes to you know, remind yourself that what it control what you can. I that you can speak more to the statistics right now, Becca. But you know, like you said, most people are not dying from this. It's unfortunate that there have been some deaths, but we are … generally healthy individuals are able to fight this. Correct?

Dr. Rebecca

Yes. Generally healthy individuals will fight this off. But even some proportion of generally healthy individuals do get very sick. So certainly being able to support your immune system helps to prevent you from becoming one of those people. Most of us who are healthy and don't have other underlying conditions are probably going to experience it as a fever and a cough that lasts for a while. Some we're seeing some nausea, some muscle aching. So very much like a flu, but even in 20, 30, 40 year olds who we consider underlying healthy, we are seeing some people get to the point where they need to be hospitalized and/or even in intensive care. And what the difference between those people is we don't always know. Some of its underlying conditions, but some of it could very well just be the level of stress they’re under regularly or the state of their immune system. What I will say is, you know, in 60, 70 and 80 year olds, the numbers are much higher for those who get very sick and get critically ill. So really as you work your way up that age spectrum, you need to be thinking more and more about how to avoid a lot of contact right now. Because it's, you're at higher risk of getting very sick and therefore at higher risk of dying.

Stasi 

Yeah, that’s a good point. And for those people too, when you're thinking, you know, I talked about nutrition being very important and if you're isolated in your home, it can be hard to find those. But certainly meal deliveries could be options. So things like Sun Basket is a great one that does have a lot of whole foods, fruits, vegetables, colorful antioxidants of immune fighting nutrients. That's one that I do recommend to clients working on that. But even something like, Hello Fresh, Blue Apron, they all have vegetables. And that's a way to get those nutrients delivered to you so you don't have to necessarily go out to the grocery store or areas with a lot of people.

Dr. Rebecca 

And you know, you know, we're in, we're in Seattle, which is the hub of everything electronic and delivery. However, you know, I've noticed that our local grocery store does delivery service. Whole Foods does delivery service, Amazon Fresh does delivery service. There are ways to get ingredients so that you can eat healthy during this. In most places. We totally understand that some people just don't have access to those services and you're going to have to go out. But definitely focusing when you do take those times out on getting the best and most healthy food you can is the best option.

Stasi 

Yeah, that's a great point. And then the other piece you know, looking at sleep, that's another thing coming to for supporting our body's immune system. Immune system function. When we're sleeping, our body gets to reset and rest, rejuvenate so that it can take on everything we face throughout the day. So that's something too I work with a lot of clients on. And during menopause it can be hard because those changing hormones change the sleep cycles. With added stress, certainly that can alter things. So working to develop a sleep routine especially, you know, before getting sick so that you can support your body in that and that might have you know, chamomile tea, sleepy time tea is something that really works for a lot of women as a part of their wind-down routine. Also helps with getting more nutrients to you from the, the teas and then also more fluids. So that's something. And then the meditation apps, a mindfulness practice, those can be helpful for falling asleep, especially for, you know, when you lie down, all you can think about is the coronavirus, maybe having something that's a little bit distracting but soothing can help to calm things down for you before going to bed so you can get the most out of the sleep as possible.

Dr. Rebecca 

Yeah. I've also found that there's an app called Deep Sleep, which tends to be very helpful for people who really struggle to both get to sleep or get back to sleep in the middle of the night. You know, a lot of these things you can find online and they're not tremendously expensive. Some are free, some are, you know, a few dollars but definitely can be very helpful. The other thing I find is very stress relieving and helps both with relieving stress, supporting the immune system, and sleep, is making sure that while we are not seeing each other face to face, that we're still having social interaction. So having a conversation with your friends via FaceTime. It's important not just to talk on the phone. It's actually important to see people's faces and look them in the eyes even if it's online. So if you have access to FaceTime or Zoom or any of those things, make base with your friends and talk with them, you have tea together, you don't have to be in the same room. Social interaction can be very supportive and really help us to de-stress.

Stasi 

Excellent. Yes, there is such an importance to that around being able to see each other and reassure each other that even if we can't interact, cause maybe that's not the safest thing. Hey, I'm okay. Are you okay? That could also bring peace of mind to help decrease that stress. And then like you said, the benefit of the social interaction.

Dr. Rebecca 

Yeah. The one thing I do want to address with you and I want to put out there is that, you know, in times like this, there will always be people who take advantage and want to sell you something new and special and the best, newest, immune-supporting drug, supplement, you know, whatever they want to call it. What I typically tell my patients is if you are eating a well-balanced diet, there are very few supplements that you need. And certainly in terms of immune support you know, there are things, there are herbals out there that claim to be immune supporting. I don't know how much data we truly have on those. I think there's some things that are considered harmless such as echinacea, chamomile can be good. But definitely, you know, take any of the recommendations you see right now with a grain of salt.

Dr. Rebecca 

People are out to make money. So my most common warning and you know, I agree with a lot of influencers such as Dr. Jennifer Gunter on this, is don't buy the thing from the people telling you it works well. Don't get your advice from the same place that they are selling it. You know, look for your advice elsewhere. They may be telling you the truth. It's not that they're necessarily lying to you, but you, they have a vested interest in you purchasing from them. So if you think something might be helpful to you, go somewhere else, look it up, see what the data says, find a reputable source and then maybe go back to it. Yeah. I don't know if from your nutritionist perspective, or dietitian perspective rather, if there are any things that you generally recommend other than just sort of a well balanced diet and bright, colorful foods in terms of supplements.

Stasi 

That's going to be the I would say the, the nutrition's going to be the, the foundation. And what I find works best. Individuals that do have a strong immune system, they have a good foundation in those foods. It doesn't mean they're perfect, but it means that those foods, the whole foods, fruits and vegetables, we can all, myself included, eat more vegetables. There's always potential for that. And then limiting those processed foods, I typically see that those individuals have a generally healthier track. You know, some exceptions there, but that's the trend I see. And we do see that in the research as well. Individuals from that, that maintain that type of nutrition longterm. So I would say that's the best foundation.

And then again, like, like you mentioned, you know, things like herbal teas may be supportive. Is it the fluid? Is it because it makes people, you know, stay more hydrated? Is it the actual herbals? We don't know, but it's probably not going to harm you if you're having tea form versus supplements. The body deals with supplements different than whole foods. And we have to keep that in mind that a pill will never be the same thing as a colorful plate. And so I think focusing on the food first right now is your best option and being cognizant of who's promising you those magic pills. If it's too good to be true, it probably is.

Dr. Rebecca 

Very true. The things I often see people using in terms of preventing colds and flus are things like zinc, vitamin C. They're not harmful. If you take huge high doses of vitamin C, most of it exits via your urine. So you're just paying for very expensive pee, as we like to say in the medical community. So taking, you know, eating an extra orange a day is probably your better bet than taking a large dose of vitamin C. In terms of zinc, the data's not bad. It's not great. I don't think going to hurt you to take a little extra. But I don't think it's, you know, it's not a cure all. It's not a protect all. So certainly don't think if you're, you know, you're having three zinc lozenges a day, you can go out and, you know kiss people in the community. It's not gonna, it's not going to keep you from catching this thing. So while I don't think it's going to hurt you, I don't think, you know, we can count on that to prevent things.

Gennev 

You can now manage your menopause with Gennev. We've helped thousands of women take control of their health with our team of doctors, coaches and products. Join our membership program called HealthFix and work with one of our menopause coaches on your personalized menopause plan. Learn more at Gennev.com.

Stasi 

Vitamin D may help in certain ways with immune function, but I think there's again, mixed research on that. It's hard to distinguish, does vitamin D exactly, you know, especially when it comes to immune function and something like the coronavirus. There's a lot of things we don't know about this right now. But certainly that could be something if you have been, had low vitamin D in the past, which a lot of people in the Pacific Northwest have, making sure that you're sticking to that supplement routine. Whether it was something that your practitioner provided a recommendation for you. That would, that could be something that you know right now is not going to hurt you to meet your Vitamin D requirements. It may not be the the magic pill though.

Dr. Rebecca 

Right. Well, there is no magic pill. I think that's the thing we want to make very clear for everybody. You know, there's no one thing that’s going to prevent this from happening to you, but doing the right collective things all together to make your immune system as functional as possible is your best protection. I do want to make an important point cause we've talked, we've talked a little bit about, you know, who is at higher risk in terms of people taking immune modulating medications for a variety of reasons. The one thing I want to make quite clear is I'm not saying that you should stop these medications. You need to continue these medications. They're important to keeping you healthy longterm. If you have concerns about medications like that or if you think for some reason that it would be better for you to stop, please do not do so.

Go and talk to the doctor who prescribed them and have a genuine conversation or even see if you can talk to them online if, you know, they’re doing video visits now. But those medications are a long-term health benefit. And so in the, in the short term, fear of coronavirus is not a good idea to stop medications that you really do need.

And then the last thing I wanted to ask Stasi to comment on is, okay, so say you are one of those people at higher risk, you're getting chemo, you're on a medication that makes your immune system a little bit less strong and you want to exercise for stress relief, but you really feel like going outside is unsafe. What are some things someone can do at home to really get that the blood moving and get themselves healthier?

Stasi 

Good question. And that's where, you know, technology does come in place here. We, there are a lot of app options, so things that I like one of 'em can be done on your app or your computer. It’s called Fitness Blender. It's a website which has free workout videos and you can do everything from body weight and you can filter through your level of experience. So if you're just getting started or you're someone that's new to exercise, there's things that are appropriate there, all the way to advanced. So if you have a home gym, you want something new to try out, there could be some different options there. Some other ones that are out there are the Peloton app, you don't need to have a bike. They have an app that does give you exercises even without the bike or their treadmill. Obviously if you have those resources at home, that can come in handy right now.

Dr. Rebecca:

Yeah, I have to, I have to cut in there cause I actually use that app. I have the bike or the treadmill.

Stasi:

What do you think?

Dr. Rebecca:

I use it actually for outdoor running, because they have audio, outdoor running apps. They have body stretching, they have meditation, they have yoga. I actually think it's actually a very good app. They have very motivating people on it. And you know, it's on the more expensive side for some of these apps. But I think they, they do tend to keep up the variety of things. So that is a nice, you can sort of cycle through the variety of different types of exercise. And if you do have a treadmill or even are planning to walk outside, it can be very motivating.

Stasi 

Absolutely, yeah. The variety could be key there. And then there is devices that you can use at home, something like the Excy bike where you are able to, and this can work for individuals that may not be either immune compromised or certainly if you're having chemo treatment this can be a better option where you can, it's a little bit less intense. You can increase the intensity but there's a lot more variation there and it can help with keeping limbs moving so you can use it for your upper body, you can segment to your lower body. You don't have to be doing a full body workout to be able to use this and that might be helpful for blood flow. Or individuals that may be new to exercise or really can't get outside right now. It needs something where they're moving more in, in home and don't have a stationary bike or treadmill option.

Dr. Rebecca

That's a great point. Anything, I always, well, we used to use it to learn how to tell the size of babies when I was in obstetric training. But I do know that that a bag of sugar is five pounds. That makes a great weight if you don't have weights in your house.

Stasi:

Yes, exactly. And even walking around with more, well you know, put a backpack on and walk around, that's going to be a little bit higher intensity than just walking alone so you can get really creative with what you have in your house. An opportunity to just do an exploration exercise. No one said we have to go to gyms to exercise. That just became the thing we did. So doing that as well. And then the other thing right now, if you're looking for more support in how to, you know, manage menopause and the coronavirus and how to strengthen your immune system, our HealthFix program is a great option. It's all remote. So they’re calls that you take with a menopause coach like myself. and we can talk about menopause symptoms as well as if you have concerns with strengthening your immune system during this time what strategies are going to be specific to you and what you have available in your lifestyle.

Dr. Rebecca 

I think it does and definitely don't sell yourself short. You can also help people with sleep issues, with stress issues. You guys are very, you're just incredible resources for women to have. Telemedicine is good at this time and I won't recommend just us, although I think our telemedicine program is excellent. We do tend to focus on menopause and menopause symptoms,  we’re obstetrician-gynecologists with a  menopause focus. We can do some basic medical care too, but certainly if you're worried about your immune system and you're about to run out of your hormone, please feel free to call us. We'll happily give you a refill online. But there are other great telemedicine groups as well that do more primary care if you just have a question and don't want to go into a doctor's office. Many doctor's offices are actually adding video visits as well during this time to keep people out of their offices. So there are a lot of great options out there now.

Stasi

Yeah. And, and we collaborate. So my, the menopause coaches and the healthcare providers that we have, the OB/GYNs with Gennev, we work together. So that's something also that when I'm working with my clients, if I see that working with an OB/GYN is going to help to benefit you to feel better, I will certainly recommend that and vice versa. So a unique opportunity all from the comfort of your home bedroom, living room, wherever you feel most safe right now. Know that you could get support for menopause symptoms as well as if you have questions on how to best support your immune system.

Dr. Rebecca 

And one last thing I want to bring up because I think it's a very fearful time for many people right now and fear is not a bonus to your immune system. So as much as you can try to manage that fear, turn off the news at night. You don't need to know where the last case ended up. You'll find out tomorrow. So just take a break from the news every day. Take a break to meditate or read a good book or just not think about what's going on in the world because you need to let your, your stress response system calm down a little bit. If you're struggling to manage that fear, if you're feeling anxious all the time, if you're feeling panicky, please, please reach out. There are providers online who can help talk you through that. And that is while a maybe perhaps a normal response, something that can actually be dealt with and managed. There are therapists online. There are doctors who can prescribe online if necessary. So please don't feel like that anxiety you have to live with it. It can be helped.

Stasi

Good point. We have all this technology, might as well take advantage of it. And good thing it's coronavirus in 2020 not 1920.

Dr. Rebecca:

Yeah. So thank you so much for coming to this podcast and/or video. We really enjoyed talking to you today about how to really boost your immune system and how to protect yourself during this time that is, can be fearful but is also a time that we can all manage.

Stasi:

Yes. Thank you so much for listening. Hopefully this information is helpful for you and of course if you have more questions, we're here to support you.

Dr. Rebecca:

Yep. We have a community, we have chat, and we have HealthFix where you can talk to wonderful coaches like Stasi.

Stasi:

Or our Telemedicine where you can talk to Becca.

Gennev:

Thank you for listening to this episode of the genetic podcast. Remember, you can subscribe on iTunes, Google Play, Spotify, and just about anywhere you get your podcasts. Gennev is your online destination for menopause, doctors, coaches, products, and education. You can find us at Gennev.com. Thanks for joining.

 

Shannon Perry

March 11, 2020
Director of Programming & Media

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