A Health Gap: Disparity in Immunity & Well-Being in 2020

As the novel coronavirus has swept through communities around the world, preying disproportionately on the poor and the vulnerable, one disadvantaged group has demonstrated a remarkable resistance. Women, whether from China, Italy, or the U.S., have been less likely to become acutely ill—and far more likely to survive than their opposite sex.

The sex gap in COVID-19 survival became apparent early in the pandemic. Reports from China indicated men were dying at higher rates, but there the disparity was attributed to higher smoking rates. Interestingly though, the outcomes from China were consistent with other countries, with men in Italy dying at higher rates than women, and men in New York City dying at nearly double the rate of women.

According to data from the National Institutes of Health (NIH), men seemed to be affected more severely by COVID-19 than women, with other early studies suggesting men were also dying at a higher rate than women.¹

In a recent article published in the International Journal of Men’s Social and Community Health, Derek Griffith, a professor of medicine, health and society, and founding director of the Center for Research on Men’s Health, found that even though men and women contract COVID-19 at equal rates, men account for 58% of deaths from the virus, and double the amount of female deaths in confirmed COVID-19 cases.² While Griffith acknowledged the reasons for men facing greater health risks from COVID-19 are not entirely clear, he like many others agreed that most health patterns are the result of a combination of biological, behavioral, and psychosocial factors.³

Why COVID-19 affects men more significantly remains a mystery, and health officials are working to determine if the reasons include behaviors, hormones, genes, the immune system, or some combination of factors.

Hormones, Really?
Two examples of possible biological factors include a weakened immune response in men due to the role of immune-related genes along the X chromosome, which women have two of and men only have one. The other biological factor may be a higher level of an enzyme called ACE2 in men’s bodies that the virus uses to enter the host cell in the respiratory system.⁴

Doctors wonder, could hormones produced in greater quantities by women be at work?

Researchers have suggested the female sex hormone estrogen may play a particularly important role in protecting women against diseases like COVID-19. Although estrogen is usually thought of as a female hormone, males also produce estrogen, but at much lower levels. Two clinical trials being carried out right now will dose men with the sex hormones estrogen and progesterone, for limited durations.⁵

Immunity, Possibly?
Some experts who study sex differences in immunity, however, warn that hormones may fail to be the magic bullet that some are hoping for; even elderly women with COVID-19 are outliving their male peers, and there is a drastic reduction in levels of hormones for women after menopause. So while women appear to have more robust immune systems, experts say, the causes are complex and multifactorial, and hormones are only part of the picture.

An emerging body of research has revealed that women’s bodies are better at fighting off almost all infectious diseases than men, possibly thanks to the hormones in their systems and the genes on their two X chromosomes.⁶ For instance, women with acute HIV infections have 40% less viral genetic material in their blood than men. Also, women are less susceptible to the viruses that cause hepatitis B and C.⁷

Behavior, Maybe?
Scientists who study sex differences say that both biological differences in immunity, as well as behavioral factors are at play. Behavioral and psychological examples include the way men are more likely to downplay the severity of the virus and engage in riskier behavior. Additionally, men smoke more in almost every country in the world, and experts note that men also wash their hands less.

Until the complexities of sex differences in the severity of COVID-19 are properly understood, we should use reliable information that we do have. There is currently a need for men to be extra vigilant about their health. Men should be consciously adding multifaceted supplements to their daily regimen that will not only help them stay healthy but will simultaneously help to build up their immune systems. Men looking for a supplement that provides multiple benefits, may look to CBD as a possible solution, but the lack of clinical research into the safety and efficacy of CBD should be a major cause for concern.

Rather, men could look to endocannabinoids, the natural cannabis-like molecules which are produced on demand by the body, that help to support many physiological systems such as memory, pain, mood, appetite, stress, sleep, and immune function.⁸

Palmitoylethanolamide (PEA) is an endogenous fatty acid amide that is produced in the body as a biological response to stress and inflammation, and has been found to have an indirect influence on the endocannabinoid system (ECS).⁹ Also known as the “entourage effect,” PEA increases levels of anandamide—an endocannabinoid with pain-relieving properties.¹⁰ Through these actions, PEA has been dubbed as the safe and legal alternative to CBD, with its ability to act on similar pathways to support mood, pain, sleep, and immunity.

Readily available today, PEA is the “body’s own CBD” that has been demonstrated to be superior in helping the body to manage respiratory tract infections.^11-14 Discovered in the 1970s, researchers found PEA to have immune-modulating properties and the ability to reduce symptoms of influenza and cold and flu.^15-16 Six published randomized, double-blinded, and placebo-controlled trials with approximately 3,000 participants demonstrated the safe and beneficial supportive effect of PEA, specifically for immune health. In addition to studies on immune health, multiple studies have demonstrated that PEA is safe and effective in supporting a balanced inflammatory response and improved gut barrier defense.

Stress, Absolutely!
PEA is a potent grenade in the arsenal for staying healthy during the pandemic, not only because it helps promote immunity, but it can also provide support in other areas such as mental health. The COVID-19 pandemic and the resulting economic recession have negatively affected many people’s mental health and created new barriers for people already suffering from mental issues.

In a KFF Tracking Poll conducted in mid-July, 53% of adults in the U.S. reported that their mental health has been negatively impacted due to worry and stress over COVID-19. Many adults also reported specific negative impacts on their mental health and well-being, such as difficulty sleeping (36%) or eating (32%), increases in alcohol consumption or substance use (12%), and worsening chronic conditions (12%) due to worry and stress over the coronavirus.¹⁷

As the pandemic wears on, people’s mental health continues to be affected adversely due to isolation, job loss, and financial instability. In a survey carried out by the Cleveland Clinic, 66% of men said they rarely talk about the impact COVID-19 has had on their mental health.18 However, almost 1 in every 5 men in the U.S. acknowledged their mental health has gotten worse since the start of the coronavirus outbreak, according to Movember.¹⁹

Everyone is experiencing more symptoms of stress, anxiety, or depression these days, but men seem to be internalizing these issues. Men often find it hard to vocalize their feelings, and they are more likely to keep silent if they are having a difficult time. Hindered by cultural, socio-economic, and gender-based expectations held by country and kin, the pressure for men to maintain these unrealistic standards and still maintain their mental health is often mutually exclusive. The reality is that men often sacrifice their mental health when forced to choose between the two.

For men, COVID-19 has presented additional barriers; coronavirus is another battle for many who were already hurting. That’s why ingredients with multiple benefits are so important. Ingredients like PEA and saffron can be extremely effective in dealing with stress and even addressing other related issues like sleep.

Saffron helps the brain by reducing anxiety and improving mood. Saffron extracts (crocin and safranal) inhibit the uptake of dopamine and norepinephrine in the brain which helps support mood health. Affron is a branded, patented, commercial saffron extract from Pharmactive Biotech Products that has been clinically researched and shown to maintain a positive mood, improve occasional stress, and sleeplessness. 

A COVID-19 world is one with increased risk for even the most resilient. While men might need mental healthcare now more than ever, they are less likely to seek help or receive treatment than any other demographic.²⁰ In the wake of COVID-19, experts warn of a potential spike in suicides as American men struggle to find their footing in its aftermath. For many men, an end to isolation in quarantine does not mean an end to isolation in life.²¹ A natural remedy such as saffron is an extraordinary defender in the battle of mental health.

General Health, Definitely!
Finally, with all health concerns, men should seek the advice of their doctor early to minimize their risk of chronic disease, which we know will not only improve their health and well-being overall, but will also reduce their risk of being severely affected by COVID-19.

In the U.S., men have more health problems to begin with, but get less medical care—one more reason for the disparity. Men tend to be less likely than women to go to the doctor, according to health officials, and in a new survey released by the Cleveland Clinic, the COVID-19 pandemic may have exacerbated this ongoing problem.²²

According to the same survey, many men are struggling to stay healthy during the pandemic; a quarter of the men polled reported gaining weight during COVID-19. Top urologists at Loma Linda University reinforced this notion and said that men are putting off lifesaving screenings, like prostrate and colon tests.²³ Overall health for men means strong immunity, infallible mental health, balanced testosterone, and prostate health.

A decrease in testosterone production is at the root of many issues for men, including fatigue, depression, mood swings, and loss of libido. These symptoms can increase with age, particularly for men experiencing andropause. While a proper diet and regular resistance exercise can help to overcome some of the challenges, supplementation can also be extremely beneficial. Supplementation with an effective and targeted fenugreek extract (such as Gencor’s Testofen), along with regular resistance exercise, can help men maintain healthy levels of free testosterone that are already within the normal range, which, in turn, supports multiple bodily functions.

Vigilance toward health has never been more important for men. The relentless pandemic, raging around the globe, seems to be a much tougher opponent if you have a Y chromosome. Eating a balanced diet, exercising regularly, consulting with a health professional, and adding supplements to your health arsenal, may improve the odds. It will most certainly help with the improvement of overall health, which will be vital to cope with life post COVID-19.

References

1. https://integrisok.com/resources/on-your-health/2020/june/are-men-dying-from-covid-19-at-a-higher-rate
2. https://medicalxpress.com/news/2020-09-awareness-men-health-equity-based.html
3. Derek M. Griffith et al. Men and COVID-19: A Biopsychosocial Approach to Understanding Sex Differences in Mortality and Recommendations for Practice and Policy Interventions, Preventing Chronic Disease (2020). DOI: 10.5888/pcd17.200247.
4. James Smith et al. COVID-19, Equity and Men’s Health, International Journal of Men’s Social and Community Health (2020). DOI: 10.22374/ijmsch. v3i1.42
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12. R. Kahlich, J. Klima, F. Cihla et al., “Studies on prophylactic efficacy of N-2-hydroxyethyl palmitamide (Impulsin) in acute respiratory infections. Serologically controlled field trials,” Journal of Hygiene Epidemiology Microbiology and Immunology, vol. 23, no. 1, pp. 11–24, 1979.
13. V. Plesnik, M. Havrlantova, J. Jancova, J. Januska, and O. Mackova ́, “Impulsin in the prevention of acute respiratory diseases in school children,” Ceskoslovenská Pediatrie, vol. 32, pp. 365–369, 1977.
14. Keppel Hesselink JM, de Boer T, Witkamp RF. “Palmitoylethanolamide: A Natural Body-Own Anti-Inflammatory Agent, Effective and Safe against Influenza and Common Cold,” International Journal of Inflammation, vol. 2013, Article ID 151028, 2013.
15. Kahlich, R., et al. “Studies on prophylactic efficacy of N-2-hydroxyethylpalmitamide (Impulsin) in acute respiratory infections. Serologically controlled field trials.” Journal of hygiene, epidemiology, microbiology, and immunology 23.1 (1979): 11-24.
16. Wang, Junru, et al. “Palmitoylethanolamide regulates development of intestinal radiation injury in a mast cell-dependent manner.” Digestive diseases and sciences 59.11 (2014): 2693-2703.
17. https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/
18. https://newsroom.clevelandclinic.org/2020/09/02/cleveland-clinic-coping-with-covid-survey-illustrates-the-mental-and-physical-toll-the-pandemic-is-taking-on-men/
19. https://www.iesohealth.com/en-gb/blog/mens-health-week-2020
20. Cohen, Rhaina, “Guys, We Have A Problem: How American Masculinity Creates Lonely Men,” Hidden Brain, NPR March 20, 2018
21. https://www.bostoneveningtherapy.com/2020/06/june-mens-health-month-the-current-epidemic-and-its-not-covid-19/
22. https://newsroom.clevelandclinic.org/2020/09/02/cleveland-clinic-coping-with-covid-survey-illustrates-the-mental-and-physical-toll-the-pandemic-is-taking-on-men/
23. https://news.llu.edu/health-wellness/habits-brought-by-covid-19-pandemic-may-increase-men-s-risk-for-prostate-cancer

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About the author: Maggie McNamara is the marketing director for Gencor, which supplies branded, clinically researched ingredients designed to support changing health needs through all stages of life. Gencor’s ingredients and botanicals go through rigorous scientific analysis and are manufactured in GMP-certified facilities. For more information: www.gencorpacific.com.