Dr. Susan Cucchiara: [00:02:35] Thank you so much for having me, I’m so happy to be back.

Dr. Susan Cucchiara: [00:03:05] And I get this question all the time and people say, well, why have people had such intense reactions to acute sicknesses? And when we say acute, we just mean something that’s not chronic, right? It’s something you’re dealing with at this moment. That’s pretty new. And the first thing I always think of, when people say, when we tell them to eat healthy food and they say, Oh, well, my uncle lived till ninety-nine. He had fast food every day and he smoked cigarettes every day. Yet if another person did that at 40 years old, they may have lung cancer, right? They may have a completely different picture.

Dr. Susan Cucchiara: [00:03:42] So we have to remember that everybody has a different constitution. Everybody has different genetic makeup. We’re all wired very differently. And as we know right before and after naturopathic medical school, I did IIN, just like you did and we learned that there’s bio-individuality. And it’s the same thing when we talk about one person’s food is another person’s poison. And they always talk about it where peanuts can nourish someone and then peanuts could cause an anaphylactic reaction to someone else. So I think that’s one big thing we have to remember is we’re not like anybody else. With that being said, there are people who have co-morbidities, which we call metabolic diseases.

Dr. Susan Cucchiara: [00:04:25] When we think of metabolic diseases, we think of diabetes, we think of hypertension, which is high blood pressure. We think of hyperlipidemia, which is high cholesterol. What is your BMI? Is your BMI too high? Is there obesity? What’s your lifestyle? Do you live a sedentary lifestyle? Do you have any other chronic health issues? So, someone who may have an autoimmune disease, these things can exacerbate the intensity or duration or make someone go to the E.R. where someone else may have some sniffles. So that’s two. So Constitution, genetic makeup and then also comorbidities.

Dr. Susan Cucchiara: [00:05:04] And then usually another big one that we both talk about is diet. What does their diet look like? Are they eating clean food? Where are they getting most of their food from? Do they cook their own food? Are they going and getting… are they looking at the Dirty Dozen? Are they avoiding some pesticides, which we know will deplete the immune function, right? Also, are they taking any vitamins every single day? Are they taking basic nutrients? People would say to me, Oh, well I eat a really clean diet and I don’t need vitamins, but it’s almost impossible unless you’re staying home, cooking every meal, every snack and making sure we have seven to nine vegetables.

Dr. Susan Cucchiara: [00:05:43] And throughout our day, it can be really hard. So making sure are they taking care of their body every single day, somebody may not be doing that and they have a worst-case scenario. Are they deficient in these vitamins and minerals? So there is a lot of research that showed that just someone who is vitamin D deficient has actually had more likelihood to have died of a COVID infection than someone not. So looking at nutrient status is really important. And also lastly, I get a lot of patients who say, Oh, my 30-year-old cousin was really healthy and they passed. But being a naturopathic doctor looking at people’s labs, they’re not as healthy as they may think.

Dr. Susan Cucchiara: [00:06:28] So there’s inflammation markers that may come up. There are vitamin deficiencies, right? A lot of people I see are low in zinc. I have patients who come up really high in mercury, heavy metals, which can suppress immune function. So I think that, oh, you’re 30 and healthy type of thing is not necessarily true because there might be things going on and they’re not having symptoms that they’re really inflamed and they’re not even knowing that a symptom that may show that that makes sense.

Dr. Susan Cucchiara: [00:07:19] It really is it is.

Dr. Susan Cucchiara: [00:07:34] Exactly. Oh, a hundred percent. You would be wishing for you to have some symptoms come out so you can know. It’s like the silent killer. It’s like, Oh, my acne was a signal. Some people are just walking around and I do their labs. Their inflammation markers are literally through the roof, and they have no idea. And we can prevent them from maybe having a heart attack or stroke down the line.

Dr. Susan Cucchiara: [00:08:32] So you could feel like what? What do you feel?

Dr. Susan Cucchiara: [00:08:51] So I remember that. That was, Oh my goodness, that was a few years… That was really when we were both in New York.

Dr. Susan Cucchiara: [00:09:00] I remember that too. And I was I remember being like, Oh God, how is she going to take this? Her vitamins are not… This vitamin is not that good. Listen, I don’t want people wasting their money and throwing out things that are not necessary unless it’s really bad. I’ll tell them, just finish off your vitamin unless it’s really toxic for them and then switch over, like you said too. Because why would you? It’s like if I’m going to pay money for a vitamin, I’d rather the vitamin be doing something. Then we call it expensive tea, right? You’re buying this vitamin and it’s literally not absorbing and it’s going right through you.

Dr. Susan Cucchiara: [00:09:53] What I looked for, just to clarify what I looked for in your labs? So I did test you, I believe for and obviously patient is giving permission to share her story. I believe I tested you for MTHFR mutations, A1298 C. and then C6770. I don’t know if you remember those, but I checked you for the MTHFR mutation. Do you remember that? I don’t if you remember, but it is a certain mutation, 70 percent of women do have this mutation. It just affects the way that we absorb our vitamins. It also affects how well we detox. And some women and men have this too. But it just happens to be that 70 percent of women do have this methylation. It’s a genetic mutation, and it’s not a death sentence. A lot of women here mutation and I think about the scary stuff with breast cancers, and it’s just not something that is really severe in the sense of your thinking on that so scary vibes.

Dr. Susan Cucchiara: [00:10:54] But you want to make sure that if you are seeing your heterozygous or homozygous. Heterozygous usually means that you got it from one parent. Homozygous means you got it from both parents, and there are some doctors who actually specialize, this is what they do all day. They love this. They do genetic testing all the time. But one thing that is important to know if you come up homozygous, it means that you’re expressing it a lot more that mutation. So if you were to take a vitamin that had, for example, cyanocobalamin, which is a synthetic form of B12, it’s derived from cyanide, it’s not the best really for you. You’re not going to be able if you have a methylation defect and you do have a homozygous mutation, you’re not going to be able to absorb that cyanocobalamin because it’s basically your body doesn’t have the ability to convert it to the active form if you have that mutation.

Dr. Susan Cucchiara: [00:11:47] So that’s why we tell people to get methyl cyanocobalamin or methyl folate. So you want to make sure you’re getting the methylated forms. And then even if you don’t have a homozygous mutation, let’s say it’s heterozygous, you get it from one parent. You can express that mutation when your body is under stress. So if you are inflamed, which most Americans are right? You said you deal with acne patients and I deal with all types of chronic disease patients. You want to say, OK, so if I’m inflamed or if I’m really stressed…

Dr. Susan Cucchiara: [00:12:20] Most Americans are inflamed and really stressed, I’m probably expressing this mutation more so. I just immediately… Because the testing, if insurance doesn’t cover or let’s say someone doesn’t have insurance, it’s expensive. I’ll just say, you know what, we’re going to just go with all the methylated vitamins, and those are usually the better vitamin blends anyway, because you know you’re getting all the absorbable forms should you have either one of those mutations. Does that makes sense? It’s very confusing. And I try to do it as layman as possible. But those are the main takeaways.

Dr. Susan Cucchiara: [00:13:08] It might have been because I don’t have to pull up your files.

Dr. Susan Cucchiara: [00:13:14] It might have. So I do normally check the MTFHR in every patient. But if I do check, for example, I think I checked folate on you and I think I also checked B12. And then there’s another marker that you can do besides just serum B12 in your blood. You can do something called MMA, which is Methylmalonic acid. And if that is high, it actually means you’re low in B12. So it might have been that that came up for you. So you can kind of look through. As a naturopathic or functional medicine doctor, you can kind of see like, OK, this person probably is not getting enough vitamins and minerals in or they’re not methylated properly or absorbing them.

Dr. Susan Cucchiara: [00:14:24] So patients ask me this all the time and even people on Instagram will say, I don’t know where to start. I see all these amazing vitamins, all these doctors promoting vitamins. Where do I start? So I got this question so much. I developed a basic supplement starter kit, very basic five items I tell everyone to take every single day for optimal health, so it will have a multivitamin that has the methylated vitamins, the B vitamins in there. It also has twenty-five milligrams of zinc in there, which is a great amount of zinc to take every day for your immune system and obviously skin and all sorts of hormonal issues. It has one hundred milligrams of selenium, which is awesome for immune system antiviral. And then has other minerals in there. So it’s a blend of vitamins, minerals.

Dr. Susan Cucchiara: [00:15:15] Then a probiotic. Probiotics, we already know most of our immune system is in our digestive tract, right digestion. It’s going to affect every organ system. So probiotic is also in there. Magnesium. So many people, men and women alike are deficient in magnesium. It’s a relaxation mineral. It helps with so much. Bowel function, nervous system, anxiety, depression, muscle pain, sleep, everything. And then we have vitamin D, we know affects almost two thousand genes in our whole body. Immune supportive. People think, Oh, I get a little sun every day. It’s very hard to get adequate amounts of sun now, right? A lot of people have sunscreen on. They have makeup on. Depending on their skin tone, depending on where they are by the equator, right? It’s really important to get some vitamin D

Dr. Susan Cucchiara: [00:16:05] And then I usually also do some Omegas or a fish oil. So some of my vegan patients, I’ll give them an algae omega just because it’s really important to get those omegas. Because if we don’t eat them in our diet and it’s a hard for some people to get in wild salmon every day, right? We could tell people to add in chia seeds and hemp seeds. But it’s really important because in the omegas, the EPA is really great for inflammation. So we want… That’s a great way to quell inflammation. So those are my top five. And then of course, I say, you know, you can of course, add in vitamin C and then we’ll talk about all the acute… What to take when you’re actually sick. But those are my five main vitamins, I would say someone should take on a daily basis. And then I could talk about other preventative things. But do you have any questions with those?

Dr. Susan Cucchiara: [00:17:13] Especially you just want to start somewhere. And I have to say patients will say they start. I always start people with these five and they can have six symptoms and four of them can go away within the first month just by getting those foundations. So because you’re actually giving the body what it needs to do what it’s supposed to do on its own, opposed to symptom management with the vitamins. We don’t want to do symptom management right. We want to do foundations first. And then when we get blood work where we want to support their hormones, we’re going to go more specific. But if you don’t have those foundations, I don’t see results.

Dr. Susan Cucchiara: [00:17:49] If people go straight for the hormones or straight for… If you’re going straight for hormones and you didn’t even fix your gut, you’re going to end up not feeling well. So those are my five and then obviously clean diet. Adding in lots of garlic and onions and turmeric. Ginger is great. Bone broth. Making sure you’re getting enough colorful fruits and vegetables, as little as possible with sugar. And I know you are a proponent of sugar, especially for skin. And then obviously, prevention, basic hygiene. Washing our hands. I mean, but we also don’t want to become obsessive either, because a lot of people are using these antibacterial soaps all day and we can affect our actual microbiome and how much good bacteria just by washing all these bacteria off all day.

Dr. Susan Cucchiara: [00:18:36] So, you know, obviously you want to use good hygiene, but we don’t want to be, you know, washing constantly, constantly, constantly. And then stress management is really important too. Finding something to reduce your stress because if we’re having cortisol pumping all day, our immune system is going to be in that fight or that nervous system is going to be fight or flight. And we’re never going to have the immune function to attack an invader that’s coming in. So those are, I would say, in terms of prevention, those are the diet and the supplements and reducing stress would be my top ones.

Dr. Susan Cucchiara: [00:19:24] You got it.

Dr. Susan Cucchiara: [00:19:38] So that’s a great question. The first thing you want to make sure is that you have a medicinary In your home of the top things to take when you’re sick. I get messages, I would say 10 to 20 a week. Oh my God, I have COVID. Oh my God, I have the flu. And then I’m like, Well, do you have any stuff in the house I told you to keep? No. Where do I get it? Where do I go? But I’m sick. I can’t do contagious. I can’t go. I can’t get to the store. And then and then and then they’re so frantic that then they’re getting themselves sicker because they’re so anxious that they don’t have.

Dr. Susan Cucchiara: [00:20:12] So I always say, keep yourself prepared so you’re not in fear. When you’re prepared and you know, I have these items at home that are going to help me you’re not going to get scared then if you were completely unprepared. So that was another question I got constantly. What should I take for flu? What should I take for COVID? So I did create a COVID plan that’s on my website and it has every single item and I can go through the main ones that are on there. But the thing you want to do with natural medicine is go attack it right away. That’s what you want to have the items in your house right away because natural medicine is not a drug, so it’s not going to have that instant gratification and it’s not going to have the results that you would.

Dr. Susan Cucchiara: [00:20:54] For example, if you’re going to have, let’s just say, you’re going to take a Tylenol, maybe within an hour of your fever is going to go down, right? But you need to take them right away to get ahead of it before you…A lot of people will say, Oh, let me see how I feel tomorrow and I’ll take my vitamins, and then they’re still sick. And then the natural medicine is not going to work as much as if you took it right away. You want to get ahead of it really, really quick. You want to keep it there to be prepared, and you have to remember also you need to take things in larger amounts when you are sick because your body needs those nutrients. And just like you said before, with the multi right. Twenty-five milligrams of zinc is great. One hundred micrograms of selenium is great, but when you’re sick, your body needs more right. So that’s why we have those individual ones. And then what we do is, and if you want, I can tell you my main ones, what would be helpful? I could tell you my main ones that are on my acute list that we should have.

Dr. Susan Cucchiara: [00:21:53] So we have first the vitamins. So we want to keep zinc at home. I tell people to at least get 30-milligram zinc and ideally Picolinate is really good. Citrate is good. You want to stay away from oxides. Those are salts and they’re not absorbed as much. So we want to do the most superior forms. And then usually I have people do at least 50 to 60 milligrams of zinc, but you want to make sure you’re doing it with food because people get very nauseous when they take zinc without food. So sometimes it can be a little hard because when you’re sick, you don’t have an appetite. And then they are getting nauseous, so I say break it up and do it with food, so we have zinc.

Dr. Susan Cucchiara: [00:23:02] It does not matter, especially acutely. So we used to ask this question in medical school. My mentor told me specifically if you are worried about depleting copper, it’s usually with long-term use of high zinc. So I just had this conversation with a patient yesterday. Zinc is helping her acne at 60 milligrams, but she’s been doing it for about three months. So that’s when I said, OK, we should add and probably one to two milligrams of copper. So if you’re in an acute illness, you have COVID cold or flu you don’t need to take copper. I mean if you did, it’s OK. You don’t need to take copper. You can go straight with the zinc and then it’s helpful to do zinc and quercetin at the same time because it helps.

Dr. Susan Cucchiara: [00:23:47] The quercetin helps drive the zinc, and so you can do those at the same time. Quercetin, people can go up to, and as always, this is not medical advice if you’re not my patient. But people can go up as high as sometimes we’re going up to fifteen hundred. They could do a few caps a day. Again, I tell them to spread it out throughout the day because also, when you’re sick, it’s hard to swallow so many things without feeling kind of queasy. And then we have obviously vitamin D. I do tell patients to do at least ten thousand when they’re sick and then when they’re kind of on the tail end of it and then they’re starting to feel a hundred percent, I’ll even have them do a few days more than that at that, at that amount.

Dr. Susan Cucchiara: [00:24:29] Obviously, if you’re under the supervision of a doctor, they might even go to extreme high amounts. So some doctors will go with COVID, they’ll even go up to fifty to a hundred thousand, but do not do that unless you’re being supervised by a doctor. And then we have Vitamin C. If you don’t have a risk of kidney stones, that’s another one, you can go super high or you can do it to bowel tolerance. What will happen is you’ll just have loose stools, so we would be safe.

Dr. Susan Cucchiara: [00:25:04] So there’s yea, liposomal is highly absorbable, however, when I was sick, I didn’t have it in my house. I had ascorbic acid. I mean, I’ve been using that for how long, right? So if you have stomach issues, you can do a buffered vitamin C, which is ascorbic acid, and then it just has some calcium and mag in it to buffer the ascorbic acid. But you can use whatever you have if you have liposomal, that’s awesome. It’s really, really highly absorbable. But if all you have is regular ascorbic acid, that’s OK too. Just make sure if you have any type of stomach issues, you just do it with food or take a little Cal Mag around it or blend that has some Cal Mag around in it. Mix in with C.

Dr. Susan Cucchiara: [00:25:44] And then what else? We talked about the vitamin… Trying to think, Oh, vitamin A is another one. Vitamin A as well, if someone’s not my patient, I just say stick around 10 to 20 thousand IU a day, obviously you can go much higher if you’re under supervision. You do not want to take more than five thousand IU if you’re pregnant or wanting to become pregnant. And you don’t want to take more than five thousand IU if you’re pregnant or want to become pregnant so be careful of that. So those are like the main ones. And then there’s NAC. NAC is a great one. That’s N-acetylcysteine.

Dr. Susan Cucchiara: [00:26:37] So NAC is N-acetylcysteine. People call it Nac. People call it NAC. And what this is, is a precursor to glutathione. And glutathione is our body’s main antioxidant, main detoxer. And why it’s so important is it helps dry up mucus. It’s a mucolytic, so it helps to dry out mucus and especially good for COVID, right? Because a lot of people are having mucus, right? Sinuses. They’re having, they’re constantly spitting up congestion. It’s great for upper respiratory infections, it’s great for your immune system. And then on a bonus side, it does help detox your liver and it’s great for fertility. It’s great for hormones. So there’s a bunch of other nice aspects of it.

Dr. Susan Cucchiara: [00:27:27] People always ask me, Do I need to take glutathione and NAC together? I don’t think you need to do that because NAC is a precursor. So if you’re already sick, and you want to dry up mucus, just take the NAC. If you have glutathione at home and you want to take it too, you can, but a lot of patients are sensitive and that might be really detoxing for them. So I’d say just tread lightly there and you don’t want someone to spend a lot of money to take both. So you can kind of do one or the other. But personally, in my kit, I have NAC over glutathione because I’m trying to help the mucus and the immune system at the same time. And the liposomal glutathione is not so good in the mucus department. So we kind of need that.

Dr. Susan Cucchiara: [00:28:15] Exactly. It’s 40 to 60 bucks for a bottle, and not everyone can afford that. But NAC, you can get a bottle for under 30 bucks and you get 60 capsules or something, and that’s the precursor. So the other thing is, you just don’t want to take NAC long-term because you can dry yourself out too much. And there was even a doctor, I don’t know if you know of Dr. Ben Lynch. He was even talking about on his on his Instagram once that he noticed because he was taking it for so long, he was getting nosebleeds because it was just drying him so much. So again, if you’re on NAC for a year like you think… And he even said it was causing some odor with urine. It’s almost like it was just drying out things. It was detoxing a little too much. So just don’t do it long-term. Do it more for maybe not more than a few months at a time.

Dr. Susan Cucchiara: [00:29:30] Exactly, exactly.

Dr. Susan Cucchiara: [00:29:36] Then I usually obviously, I always like to add if they’re not taking selenium already if they’re multi doesn’t have it or whatever. Selenium is another immune support. And then if they’re worried about blood clots. With COVID, some people worry about the clotting perspective of it. There’s Nattokinase, which basically can break up those fibrin that could be developed anytime someone’s having COVID. And obviously, not everyone’s going to have that. But as prevention to calm your nerves like, OK, I’m taking something preventatively. And then just the last thing that’s really important is you want to make sure that you’re doing some antimicrobial, too. I think that helps to shorten the duration. The vitamins are great but if you can do like a combo goldenseal echinacea or it’s your colloidal silver or it’s oregano oil, right? So you want to kind of add in some type of antimicrobial that would act almost as if your antibiotic. Obviously, nothing is exact same as an antibiotic, but it’s a natural antimicrobial.

Dr. Susan Cucchiara: [00:31:03] So personally, I took everything I had because I wanted to make sure I was OK and I was going to get my fever to get reduced and the aches and pains. But again, know yourself. If you’re sensitive, don’t be doing… For example, if you have goldenseal echinacea at home, and I tell you, due to dropper fulls three times a day, which is normally what’s a good amount because again, with herbs, you have to do high dose herbs if you want to actually work. But then you also have oregano and you also have colloidal. Don’t do the max of every single one. A little bit, a little bit, a little bit. Just because, just like you said before, too much can be overwhelming too. So it’s totally fine to kind of mix antimicrobials together. But just don’t get yourself to the point where it’s so much that you’re potentially now getting sick because you’re taking too much of the acute ones. You know what I mean?

Dr. Susan Cucchiara: [00:32:19] Yeah, of course. So we call them magic socks, and we always say this because if we called it wet socks, no one would do it immediately. So we say they’re magic because they do. They are magical. So the whole concept of magic socks is you basically wet your cotton socks before bedtime with cool water. So some people can, you could put a little bowl. You can either just go right under with the cotton socks into the faucet of cool water, or you could just do a bowl with some ice cubes in it and dip them in and you put on and then you bring out really, really, really well and you don’t want them dripping or you do not want them so wet because you’re not going to be able to warm them throughout the night.

Dr. Susan Cucchiara: [00:33:04] So you’re put on wet socks with then wool socks over before bed to wake up in the morning with dry socks. And you’re like, What the heck is the point of doing that? So what it does is it helps to move blood and lymph. Your whole circulatory system gets moved. Also, it helps to bring down all the mucus out of the head, neck, respiratory in your lungs. And then also what happens when your feet have to…

Dr. Susan Cucchiara: [00:33:33] When your feet are wet, your body says, Oh my God, my feet are wet, I have to warm up because my feet shouldn’t be wet, right? So in order to warm up, what you’re going to have to have happen is your body’s going to increase its internal temperature. And so when you increase that internal temperature it’s the same thing as when we get a fever, right? The great thing about a fever is it’s killing off what’s not supposed to be there. And that’s why it’s not the best to give a fever reducer when you have a fever unless there are caution groups, of course. But the whole concept is supposed to heat up everything. So it kills off what’s not supposed to be there.

Dr. Susan Cucchiara: [00:34:08] So the one thing you want to make sure before you do the socks is you want to make sure your body is kind of warmed up. You don’t want to be shivering to death and then put on cold socks. So maybe a cup of hot tea, you can do if you want to take a bath, a hot bath. If you want to take a shower or even just sitting on the end of the tub and just putting your feet in hot water just to warm up your body a bit and then you do the socks. So it’s basically cotton socks, thin ones, wring it out really well after you do the cool water. Put them on, and then you’re putting on two pairs of really heavy socks on top, but ideally wool socks.

Dr. Susan Cucchiara: [00:34:47] I asked my patient in Arizona the other day if she had wool socks. She was like, No, I don’t. So just use whatever hot socks you have, but wool just keeps the heat in. So that’s the whole concept of keeping the wool. And then you wake up and I get so many testimonials that people are like, Oh my God, I feel so much better. But if you don’t feel better, the next day doesn’t mean it didn’t work. You just keep doing it during the duration of your sickness. So tell me your experience.

Dr. Susan Cucchiara: [00:35:45] I think you told me you slept better.

Dr. Susan Cucchiara: [00:35:54] You said you had a really good night’s sleep and I said, yeah, because it puts you into parasympathetic, in that mode.

Dr. Susan Cucchiara: [00:36:07] Isn’t that awesome?

Dr. Susan Cucchiara: [00:36:13] Very cool. I love it. It’s great for kids, too who have fevers, especially if you want to… Anyone can use it. But of course, the colder it is, the more intense the treatment. So for little ones or anyone’s older, you want to just make sure you’re not doing freezing, freezing cold socks.

Dr. Susan Cucchiara: [00:36:52] Absolutely. And I do the same thing. You think when I’m sick, I don’t talk to my naturopath. Oh my God, I forget everything I know. I know stuff too. Just like, you know, stuff, right? I mean, you know, a ton of stuff. And when you’re sick, you forget everything that you’re supposed to do. And also it’s the comfort. You just want someone to tell you. Yes, yes. Do it. Even though you know it’s just that comfort that you’re going to be fine. Everything’s going to be OK. Or even for example, if someone gives you specific symptoms about their illness. So we have acute sick care visits. So if they tell me a few symptoms and I’m like, Oh, that sounds like that homeopathic remedy. They can go get some Boron remedy and it can make the healing go so much faster, too. So. When you’re talking to someone, it’s comfort, but you can also get a little bit more specifics for your sickness.