Dark Covid Surge or the Start of a Bright Future? – A Letter to my patients

Dear Families,

I hope this email finds you all well.

As you well know, we are seeing a surge in COVID cases once again. I don’t think this should be a surprise to any of us. Our country has been spending more time indoors, and as we should remember winter physiology ALWAYS brings higher rates of cold and flu viruses and infections. COVID is sadly part of this picture.

Should you be panicking and distraught? I certainly hope not!

If we all come together and support and protect one another, I am optimistic that this winter can be less worrisome than what some are projecting. I am hopeful that these next few months are the tail-end of our COVID marathon and, as vaccines become available to our general public, we can move into our next phase of COVID society. How this will look is anyone’s guess but hopefully it will be a much better, brighter version of what is there now.

Below, I have included a few reminders and updates of things you can do to protect your family during the next few months. I am also writing to have you start thinking if the COVID vaccine would be right for you and your family. For some of you, this decision is very obvious and easy. For others, it may require a lot of contemplation. Given what I see right now, I don’t believe we will have vaccine mandates. It is really more a matter of how important and useful you believe this vaccine can be in protecting you and your family.

You know where I stand on vaccines. I am clear that when I have enough safety and efficacy data, I will get this vaccine to protect my family, my parents and you, our families. I share this for whatever it is worth to you!

Before the recommendations below, I wanted to share a positive and beautiful blog about the challenging times we face today. We are experiencing an unparalleled level of change, and it has been disorienting to say the least…


I wish you all healthy and wonderful holidays to come. Our experience of them will be different, to be sure, but perhaps they can be just as magical as years past. I, for one, am very optimistic about the time to come. We will have a few challenging months, but perhaps these challenging months can come with a ray of hope, and this ray of hope a reflection of the incredible fortitude, resilience and optimism that is one of the most wonderful qualities of the human being. If we can find a solution to this challenge and heal and repair our society and economy, what else are we capable of?


Pejman Katiraei

SURGE PREPARATION (to be continued until spring): Please review the previous handout I have attached below. There are some updates to this handout which are highlighted below.

Key points:

  • Continue with prior D3, cod liver/fish oils, +/- vitamin C, multi and/or probiotics
  • If you don’t eat egg yolks regularly, consider choline (see below)
  • If you are not sleeping well, consider melatonin
  • Glutathione continues to show promising results. Make sure your family/pod unit has a bottle ready to be deployed if anyone becomes ill.
  • Consider adrenal and thyroid support as needed

Choline: Phosphatidylcholine (choline) is a critical fat that is found in eggs, soy, sunflower seeds, etc. This fat happens to be a potent inhibitor of a pro-inflammatory enzyme called phospholipase A2. From some of the data that is out there, choline seems to be quite helpful in reducing the severe inflammatory response that comes from COVID. Please see this well written review for details.


Dosing (if you/your child eat egg yolks less than 3-4/week): 3-4 times a week dosing is sufficient:

1-3 years:        50-100mg

3-6 years:        100-200mg

6-12 years:      200-300mg

12+:                 300-500mg

We carry a great product at our office. Various types of choline and activated choline (CDP-choline) are also available online. Here are some examples.

–       https://www.pureformulas.com/sunflower-lecithin-powder-1-lb-by-now.html

–       https://www.pureformulas.com/phosphatidyl-choline-60-fish-gelatin-gelcaps-by-thorne-research.html

–       https://www.pureformulas.com/citicoline-cdp-choline-250-mg-120-capsules-by-jarrow-formulas.html



Melatonin: Studies are now confirming that melatonin can be helpful in also controlling the intense inflammatory response caused by COVID. The best way to have optimal melatonin levels is through a healthy sleep cycle. Melatonin supplementation may be useful if that is not possible for you for whatever reason. It is also a useful consideration for the elderly in your life, as melatonin production does naturally wane as we get older. With that said, I don’t believe children need melatonin long-term supplementation. Also keep in mind that there are studies that suggest that long-term use of melatonin can theoretically suppress pituitary hormones, which obviously would not be a fantastic idea for a growing child. I certainly don’t see any problems with short-term use of melatonin in a child.



1-3 years:        0.5mg (brief 1-2 week use)

3-6 years:        1mg     (brief use)

6-12 years:      1-2mg (brief use)

12-18 years:    2-3mg (brief use)

Adults:             3mg nightly if desired. 5-7mg each night in face of an acute infection.



Adrenal support: To achieve a strong immune response, we must have healthy adrenal function to produce a strong cortisol response during an illness. A surge in cortisol is what wakes us up in the mornings. And guess what? Cortisol also happens to be a key chemical to wake up our white blood cells and help mobilize them to confront the invading viruses and bacteria. Happy adrenals = happy immunity! Individuals who have lackluster adrenal glands are those who struggle to get out of bed in the mornings, and a crash 2-4PM and often get a second wind later in the evenings. If this is you or your child, then it is time for you to consider some good adrenal support. Healthy adrenal gland is particularly important during the winter times…

o   Rosemary is an amazing herb to help optimize pancreatic and acts as great anti-inflammatory within the intestinal tract. What many don’t know is that rosemary also helps support the adrenal glands. Add a pinch of this herb to everything you can!

o   Ginger is considered a “heating” plant, which clears “dampness” from within the body. It turns out that ginger boosts cortisol production which is necessary to mobilize white blood cells in the face of an infection. Children over one year of age and adults can consume ginger in the form of tea and food. In older children and adults, you can also enjoy ginger juice in moderation (to avoid GI upset). You should not take ginger during pregnancy, but it is safe otherwise for breastfeeding, etc.

o   Briar rose is perhaps the best tasting adrenal support and decongestant for children (and adults) of any age. It is safe to use in any child over six months of age. It is thought to provide some immune support. You can purchase this from us or online.


  • Dosing:
  • 6-12 months:  10 drops once a day
  • 12-24 months: 10-20 drops once a day
  • 2-4 years:        20-30 drops once a day
  • 4-10 years:      30-50 drops once a day
  • 10+ years:       60 drops once a day

o   Adrenal Mix is a blend of two wonderful adrenal supporting plants (Black Currant and Oak) that we created to help children who have lackluster adrenals. This is available through our office and online: https://store.wholistickids.com/products/adrenal-mix

Dosing is included on the label.

o   Siberian ginseng (Eleutherococcus) is a magical plant for ADULTS to support the adrenals and immune system. This is an outstanding (and inexpensive) plant to support your body during times of high stress, including extensive traveling or lack of sleep. This plant is safe for breastfeeding in the short term (avoiding using longer than 2 weeks per month while breastfeeding). You should not take this if you have high blood pressure. This plant is very “enlivening.” Taking too much may cause you to feel hyper or even anxious. Eleuthero is widely available at most health food stores and online.

Dosing: 1-2 capsules in the morning.

o   Wise Women Herbals Immune Tea is a combination of several different plants that have immune and adrenal boosting properties. I would advise against drinking this while breastfeeding, pregnant or if you have high blood pressure. This tea can be found online.


Thyroid Support: Healthy thyroid functioning is often ignored in discussions about healthy immunity. It has always fascinated me to talk to parents whose children have overactive thyroids, and one thing they always say is that he or she “never gets sick.” These individuals usually tend to run warm all the time, have high metabolic rates (don’t gain weight) and sometimes spike higher fevers (104-105) in the face of a regular infection. Why do these people never get sick? Simply put, the thyroid hormones have SIGNIFICANT influence over the mitochondria (remember the entire discussion of mitochondria and immune health?), and also directly on the immune system. In an overly simplified way, the thyroid acts as the accelerator for the immune system. A beautiful (and very scientific) discussion of these connections can be found here: (http://www.jimmunol.org/content/jimmunol/164/12/6158.full.pdf). How do you know if you or your child has poor thyroid functioning? Here are a few clues: low core body temperature, chronically fatigued, chronic poor immunity and prolonged tantrums or OCD behaviors occurring for no reason (and yes, toddlers actually go through periods of thyroid calibration). The great news is that there is a lot that can be done to easily optimize thyroid functioning:

o   Sage not only does a wonderful job supporting adrenal gland functioning, but also helps boost thyroid functioning. Use sage liberally as a spice or tea. Mountain Rose Herbs (and many other stores) sell sage in bulk.

o   Oat tea is perhaps one of the best thyroid supporters around. Make a tea of oat and drink regularly to enjoy healthy thyroid functioning.  Again, Mountain Rose Herbs is a reputable place to purchase this plant.

o   Iodine deficiency is more common than we realize. Without iodine, thyroid function grinds to a halt. Regular sea salts often lack iodine. Even Himalayan sea salts only have very small amounts of iodine. Fortunately, seaweed is very rich in iodine. A few seaweed snacks per week is all the iodine you will need! At the same time, I need to keep in mind that too much iodine can also cause thyroid problems…

The Power of Tea: As mentioned above, both Sage and Oat can be used in tea form. Other teas to consider are:

o   Agrimony: Quite possibly my FAVORITE plant. Agrimony has potent anti-histamine properties. It reduces congestion and inflammation throughout the body.

o   Licorice: This is fantastic for “decongesting” the liver. The liver is quite important in managing immunity. Furthermore, it has some mild anti-infectious properties and helps clear mucous from the ear-nose-throat area and lungs.

o   Eleutherococcus: As noted above, Eleutherococcus has great immune-boosting and adrenal-supporting properties. When used in moderation, as a tea for example, this plant can safely be consumed by children and adults alike.

Many local markets will sell these herbs. They can all be purchased through Mountain Rose Herbs: https://www.mountainroseherbs.com/catalog/herbs-spices/bulk. These herbs can be combined in equal parts as you wish. Please steep 2-3 teaspoons in a pot of hot water for 10-15 minutes.  Let cool, flavor with honey as needed, enjoy!

How much? Drink 1-2 times a day:

  • 12-24 months:      1 ounce
  • 2-5 years:              2-4 ounces
  • 5-12 years:            4-8 ounces
  • 12+ years:             8+ ounces



COVID Winter preparation and surge (1)