Author Archives: sararodgers

Staying healthy with A healthy Lymphatic System.

Glenda Bell, LMT of Radical Lymphatic Therapy describes why taking care of our Lymphatic System is so important.

Lymphatic Massage helps clear toxins from the body and support the Immune System. it is an excellent technique to move toxins from breast tissue, decrease inflammation before and after surgery, and perhaps even re-set emotional trauma.

Low Dose Naltrexone: a Pain Management Alternative to Opioids

I recently interviewed Dr. Madison Peach-Keen of Medicap Pharmacy to learn more about a Low Dose Naltrexone (LDN) as a safer pain management alternative to opioid drugs. When people are prescribed opioids following surgery or an accident, they may find themselves unwillingly addicted to these powerful medications. Opioids prescriptions have led to a national epidemic of overdose deaths. Low Dose Naltrexone may be a safe alternative to help reduce the dose or wean off opioids. Watch the interview HERE.

https://youtu.be/1D9lxPsGUro

Why is Vitamin D so important in combating COVID-19?

The answer lies in Vitamin D’s hormone effects. Vitamin D is labeled a vitamin, but most of its properties reside in its hormonal affect. I affectionally call Vitamin D a “Vitamone” because it acts as both a vitamin and a hormone.

As a hormone, Vitamin D is most known for helping to build strong bones.  It is less recognized for its immune signaling affects.  When activated, the Vitamin D receptor signals the immune system and induces anti-viral responses including reducing viral replication, reducing viral penetration of cells, and signaling the immune system to kill infected cells.[1]  

Regarding the current COVID pandemic, Vitamin D may be a crucial nutrient to reduce hospitalization and mortality. When Vitamin D levels are low, COVID-19 has a better chance to trigger an inflammatory cascade, causing significant illness. Studies are now finding that COVID patients with low Vitamin D levels have higher risk of needing intense hospital care,[2] and Vitamin D supplementation may reduce mortality in COVID-19 patients admitted to hospital.[3] ,[4], [5] 

COVID-19 poses further risk for a subset of the infected population that may clear the virus but continue to have symptoms. Post-COVID syndrome, also known Long-COVID, may present with symptoms such as fatigue, headache, lower attention, hair loss, shortness of breath, loss of taste/smell, chest pain, cough, sleep disruption, and joint pain[6] lasting more than 3 weeks following an initial infection.  Long-COVID syndrome may occur in for both vaccinated and non-vaccinated infected individuals.

Some researchers theorize that Long-COVID may be due to the re-emergence of past viral infections, such as Kaposi’s sarcoma-associated herpesvirus (KSHV) and Epstein-Barr virus. [7], [8] With its important role in combating other viruses (Epstein-Barr, Influenza (H1N1), Hepatitis C, Rota, and Dengue), [9], [10], [11], [12] Vitamin D may be an important component in preventing or treating Long-COVID.

Thus, maintaining healthy levels of Vitamin D may reduce the severity of a COVID-19 infection while also reducing the chance of triggering the onset Post-COVID syndrome.

So, what to do:

  1. Testing for Vitamin D levels is important.

In my experience, supplementation and sun exposure do not always correlate with actual Vitamin D levels.  Laboratory blood testing is really the only way to know your Vitamin D levels.

I suggest the following Vitamin D testing schedule.

  • Test both 25(OH) Vitamin D and 1,25(OH)2D3
  • Test in the late Summer/Early Fall to determine how well activities in the summer support your Vitamin D levels.
  • Test in Winter to ensure healthy levels during the period of lowest sunlight exposure and highest viral infection risk.

Always make a note next to your test results about level of sun exposure and the Vitamin D dose/product you had for the previous month. This will help you determine and remember what works and doesn’t work to maintain healthy Vitamin D levels.

  • Supplementation

I usually suggest 1,000-5,000 IU (25-250 mcg) daily, based on individual patient needs. If you are not currently a patient of Dr. Rodgers, please ask your medical provider about your Vitamin D dosage needs.

Dose is based on your blood work results:

  • Vitamin D insufficiency is defined as blood levels <30 ng/dL. However, this level may be insufficient to protect one against the inflammatory storm. Conventional physicians may suggest blood levels between 30-50 ng/dL.  As a naturopath, I was taught to achieve blood levels between 60-80 ng/dL. 
  • As a vitamin, Vitamin D helps to make Dopamine, which breaks down into epinephrine and norepinephrine (types of adrenalin). For some people who can’t breakdown adrenalin appropriately, too much Vitamin D may result in anxiety. For those patients whose anxiety worsens with Vitamin D supplementation, I suggest maintaining blood levels ~30 ng/dL.
  • It is important to remember that ingesting too much Vitamin D may cause calcium levels to rise too much (hypercalcemia) and deposit in tissues, including the kidney (i.e., kidney stones).  Some studies have found this risk to be low,[13] but other studies suggest trends of hypercalcemia occurs at doses ? 2,800 IU/day, but without any adverse events.[14] 

If you test low, please supplement safely and re-test 6 weeks after starting supplementation to ensure you have achieved healthy levels.

Types of Vitamin D supplements

Cholecalciferol (Vitamin D3) is the preferred form of Vitamin D, but if one has liver failure or severe intestinal malabsorption syndrome, Calcifediol (25-hydroxyvitamin D3) may be more appropriate.[15]  Calcifediol is a prescription medication and not available as nutritional supplement.

Conclusions

  1. Maintaining healthy Vitamin D levels may significantly reduce COVID-19 induced inflammatory storms.
  2. Vitamin D may reduce the re-emergence of other viruses, including those responsible for Epstein-Barr syndrome or cancers.
  3. Testing one’s Vitamin D blood levels is the best way to determine if Vitamin D supplementation is optimal or needs adjusting.

[1] Xu Y, Baylink DJ, Chen CS, et al. The importance of vitamin d metabolism as a potential prophylactic, immunoregulatory and neuroprotective treatment for COVID-19. J Transl Med. 2020;18(1):322. Published 2020 Aug 26. doi:10.1186/s12967-020-02488-5

[2] Diaz-Curiel M, Cabello A, Arboiro-Pinel R, et al. The relationship between 25(OH) vitamin D levels and COVID-19 onset and disease course in Spanish patients. J Steroid Biochem Mol Biol. 2021;212:105928. doi:10.1016/j.jsbmb.2021.105928

[3] Nogues X, Ovejero D, Pineda-Moncusí M, et al. Calcifediol Treatment and COVID-19-Related Outcomes. J Clin Endocrinol Metab. 2021;106(10):e4017-e4027. doi:10.1210/clinem/dgab405

[4] Entrenas Castillo M, Entrenas Costa LM, Vaquero Barrios JM, et al. “Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study”. J Steroid Biochem Mol Biol. 2020;203:105751. doi:10.1016/j.jsbmb.2020.105751

[5] Nogues X, Ovejero D, Pineda-Moncusí M, et al. Calcifediol Treatment and COVID-19-Related Outcomes. J Clin Endocrinol Metab. 2021;106(10):e4017-e4027. doi:10.1210/clinem/dgab405

[6] Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep. 2021;11(1):16144. Published 2021 Aug 9. doi:10.1038/s41598-021-95565-8

[7] Chen J, Dai L, Barrett L, et al. SARS-CoV-2 proteins and anti-COVID-19 drugs induce lytic reactivation of an oncogenic virus. Commun Biol. 2021;4(1):682. Published 2021 Jun 3. doi:10.1038/s42003-021-02220-z

[8] Lehner GF, Klein SJ, Zoller H, Peer A, Bellmann R, Joannidis M. Correlation of interleukin-6 with Epstein-Barr virus levels in COVID-19. Crit Care. 2020;24(1):657. Published 2020 Nov 23. doi:10.1186/s13054-020-03384-6

[9] Brütting C, Stangl GI, Staege MS. Vitamin D, Epstein-Barr virus, and endogenous retroviruses in multiple sclerosis – facts and hypotheses. J Integr Neurosci. 2021;20(1):233-238. doi:10.31083/j.jin.2021.01.392

[10] Villar LM, Del Campo JA, Ranchal I, Lampe E, Romero-Gomez M. Association between vitamin D and hepatitis C virus infection: a meta-analysis. World J Gastroenterol. 2013;19(35):5917-5924. doi:10.3748/wjg.v19.i35.5917

[11] Dissanayake S, Tennekoon S, Gaffoor S, Liyanage G. Vitamin D Deficiency in Dengue Hemorrhagic Fever and Dengue Shock Syndrome among Sri Lankan Children: A Case-Control Study. J Trop Med. 2021;2021:4173303. Published 2021 Oct 14. doi:10.1155/2021/4173303

[12] Suares A, Tapia C, González-Pardo V. VDR agonists down regulate PI3K/Akt/mTOR axis and trigger autophagy in Kaposi’s sarcoma cells. Heliyon. 2019;5(8):e02367. Published 2019 Aug 27. doi:10.1016/j.heliyon.2019.e02367

[13] Ganji MR, Shafii Z, Hakemi MS. Vitamin D Supplementation and Risk of Hypercalciuria in Stone Formers. Iran J Kidney Dis. 2019;13(1):27-31.

[14] Malihi Z, Lawes CMM, Wu Z, et al. Monthly high-dose vitamin D supplementation does not increase kidney stone risk or serum calcium: results from a randomized controlled trial. Am J Clin Nutr. 2019;109(6):1578-1587. doi:10.1093/ajcn/nqy378

[15] Sosa Henríquez M, Gómez de Tejada Romero MJ. Cholecalciferol or Calcifediol in the Management of Vitamin D Deficiency. Nutrients. 2020;12(6):1617. Published 2020 May 31. doi:10.3390/nu12061617

ProActive Breast Health

Breast cancer has become a potentially survivable disease, but it remains the second leading cause of death for women (heart disease is slightly higher) and the leading cause of death for Hispanic women. Breast cancer can occur at any age, but prevalence increases with age. Breast cancer rates increase starting at age 30 and then again at age 40.

Breast Cancer in Men.  It is important to remember that men also have small amount of breast tissue under the nipples, including fatty tissue, ducts, and lymph nodes. Male breast tissue can increase during adolescence and adulthood, especially for men over 50.  1 out of 100 diagnosed breast cancers occur in men. (https://www.cdc.gov/cancer/breast/men/index.htm)

Reducing cancer risks

The Center for Disease control has suggestions to reduce the risks of breast cancer including:

  • Maintain a healthy weight and exercising regularly.
  • Avoid or limit alcohol.
  • If taking oral hormone replacement therapy or birth control pills, consult with your doctor about your level of risk factors
  • Learn about the BRCA gene risk factors.[ii] This is important for both women and men.

Additional Proactive Lifestyle Choices

Chose plastic alternatives as much as possible. Plastic compounds such as phthalates are linked to hormone disruption and may be linked to breast cancer. Plastic containers or plastic wrap may leach chemicals into food and liquids.  The more flexible the plastic, the more leaching occurs.

Apply Healthy. Know what is in your personal care products.  Click HERE to learn more about common toxic chemicals and how to avoid them. Skin applications of cosmetics, lotions, and perfumes can contain chemicals that are absorbed through the skin. Repetitive application of products containing chemicals may cause cellular toxicity over time.

Plastic Alternatives

  • Reusable silicone bags: sandwich bags
  • Pyrex-like glass containers: Leftover food storage:
  • Glass or stainless-steel bottles: water bottles
  • Dr. Rodgers does not endorse any specific products or companies, but This Article is helpful to see what the market has to offer in plastic product alternatives.

Relaxation. Constant stress can cause an increase in inflammation and blood sugars. Laughter, relaxation, meditation, yoga, and healthy sleep patterns can help reduce cortisol levels and maintain a healthier you.

Avoid synthetic Fragrance.  A full ingredient list is usually not included under the term “Fragrance”.  There may be dozens of chemicals not listed on the label.  Some products do disclose when referring fragrance as essential oils. If you are not sure what is in the product, leave the product on the shelf, or see the next point below.

Know your ingredients. The Breast Cancer Prevention Partners has a great page to help you decipher what those chemical names are.  Click HERE to learn more about common toxic chemicals and how to avoid them.

Choose organic foods and Be vigilant of other daily exposures to chemicals. Simple solutions can be found at Easy ways to maintain a healthy home and reduce your exposure to chemicals

Move daily. You may already be doing more exercise than you think. The key to exercise is to move in any way you can. Cleaning the house, walking the dog, mowing the lawn, or chopping wood may not be part of a hard-core exercise program, but they do contribute to moving. The key to exercise is to move your whole body daily. If you don’t like to exercise, consider the concept of moving and figure out what activities you can do in your day that make you move more.

Breast Cancer Screening Guidelines  The US Preventive Services Task Force recommends breast cancer screening.

  • Women 50-74 years old with average risk for cancer: mammogram every 2 years.
  • Women less than 40-49 or those with higher risk of cancer should discuss screening schedules with their primary physician.
  • Other medical organizations have different but similar guidelines. Click HERE to see guidelines.

[i] https://www.cdc.gov/cancer/breast/basic_info/prevention.htm

[ii]https://www.cdc.gov/cancer/breast/young_women/bringyourbrave/hereditary_breast_cancer/brca_gene_mutations.htm

[i] https://www.cdc.gov/cancer/breast/basic_info/index.htm

[ii]https://gis.cdc.gov/Cancer/USCS/#/Prevalence/

[iii] https://www.cdc.gov/cancer/breast/men/index.htm

Wheel of Health Immune Basics

Each piece contributes to health.

How many pieces are strong in your life?

   Strengthen HealthWeaken Health
ExerciseExercise 5-6 x per week, at least 30 minutes. Find activities that you like to do. Exercise to the level you are not exhausted immediately or hours after your activity.Sit all day without breaks.
SleepGo to bed at the same time nightly. Obtain 8 hours sleep/night
Strategies if sleep disturbance occurs.
Go to bed after midnight. Use electronics and screens in the bedroom.
DietEat colors of the rainbow in fruits/vegetables daily. Eat organic foods.   Drink clean, filtered water. Choose immune supportive foods. Identify and avoid food sensitivities.Fast foods food, processed foods. Colors, additives, preservatives. Partially hydrogenated oils. Sugary foods. Drink pop/cola, sugary drinks.
Social InteractionsSpend time with friends and loved ones.Continue toxic relationships. Isolate oneself.
Relaxation/SpiritFind quiet time daily such as with prayer, meditation, yoga, tai chi, etc. Mindful Breathing.   Find ways to minimize stress. [i]Fill the day with screens and external, busy, and loud influences.
DetoxificationReduce toxins in your homeAvoid Fragrance and other personal care toxins.. Make your home a healthy sanctuary. Avoid EMF exposure. Consider HEPA air filtration. Avoid pesticides inside and outside home. Consider a guided detoxification program.  Choose synthetic fragrance in personal care products, candle. Apply insecticides and herbicides in and around the home.    Wi-Fi in the home.
SupplementationChoose quality supplements. Choose targeted immune support supplements. Handout:  Staying Healthy during the Cold and Flu Season and Wet Sock technique.Caffeinated products.

[i] Morey, J et al. Curr Opin Psychol. 2015 Oct 1; 5: 13–17. doi: 10.1016/j.copsyc.2015.03.007

Avoiding Covid: Strategies to Reduce Exposure to the SARS CoV2 (Covid-19) virus and variants.

Avoiding Covid means reducing physical exposure to the virus.   Other articles explore the Immune Strengthening Strategies to reduce getting sick once exposed to the virus.

3 main strategies have been shown to help reduce Covid exposure.

Avoiding Exposure to the virus.  Avoid crowds and unmasked individuals. Creating pods of friends who maintain good virus avoiding strategies.

Block the virus from getting into your sinuses and lungs. This includes a physical barrier over the ports of entry. A mask covering your nose (port of entry into your sinuses) and mouth (port of entry into your lungs) can greatly reduce virus particles from entering your body.  N95 masks or equivalent type of masks are significantly helpful to reduce viral exposure.

Cleaning the Air that may contain virus particles. A HEPA or ULPA HEPA air filter can trap viral particles.

HEPA stands for High Efficiency Particulate Air. HEPA will trap 99.97% of particles
0.3 microns and larger in diameter.

ULPA HEPA, (Ultra Low Particulate Air) will trap 99.99% of particles 0.12 microns and larger.

  • The SARS CoV2 virus is approximately 1 micron in size.  
  • Both HEPA and ULPA HEPA filters are good at removing small particles like viruses. Most viruses are carried on larger particles like vapor and will be stuck to the filter.  Electrostatic charge can also reduce viral loads in the environment.
  • A word on ozone emitting filters. Ozone can inflame the respiratory tract.  Avoid ozone emitting devices due to possible damage to the lungs.  (Medically prescribed ozone is used in a different mechanism than that generated by air filters.)  
  • A HEPA or ULPA HEPA air filter is also very handy during poor air quality days, such produced by fire smoke.

Antibody Super Boost

(Please note: This is a highly simplified explanation of one part of the complex immune system.)

Antibodies are one part of our adaptive immunity and are formed to combat specific pathogens, such as viruses, bacteria, or parasites, including the Covid-19 virus. 

Antibody Creation

When exposed to a pathogen, the adaptive immune system starts figuring out what the pathogen is and makes an antibody to that specific pathogen.  These antibodies reduce the ability of a pathogen to function and present the pathogen to other immune cells that further inactivate or kill the pathogen.

For example, every time you get the flu or a cold, your body makes antibodies for that specific virus. Children get more colds than adults because they are being exposed to these viruses for the first time. Over time, the child builds a “library” of antibodies that they use to respond to pathogens quickly if re-exposed. Most adults have a large library of antibodies that reduce their risk of getting ill again.

The reason we have a cold for 7-10 days is because it takes time to mount a full immune response. It is hard to speed this process up.  Supplements, herbs, and a low inflammatory diet may reduce the severity of a disease, but the time it takes for the body to react to a virus is similar for everyone.  If one has the antibody to a virus in the library, the body may resolve the infection before a full immune response is needed.  

Covid-19: A Sneaky Genius

The sneaky genius of Covid-19 is two fold:

  1. The word ‘Novel’ when describing the Novel Corona Virus refers to its debut to the world’s population. As humans, we are all like children in that we are experiencing this Corona virus for the first time. Our immune reactions are like that of children: new.
  2. Covid-19 has an ability to inhibit the initial innate immune response, increasing significant inflammation, and potentially slowing or stopping the communication needed to build antibodies[i],[ii],[iii],[iv].  If you’ve had Covid-19, you created antibodies to the virus, but slowly.  

Out-Sneak Covid-19:   Use an Antibody Super Booster

The vaccines developed following Covid-19 epidemic allow the body to create antibodies before an infection occurs.  The vaccines have the blueprints from mRNA to help a cell manufacture a portion of the virus’ spike protein that is then presented to the immune system. (These mRNA blueprints do NOT integrate into your DNA and are destroyed by the body after 72 hours). The adaptive immune system does not know that this spike protein is not a real threat, it only knows that is it a foreign object and must be responded to.  Anti-covid-19 spike protein antibodies are then manufactured and are ready to quickly deploy the next time a spike protein enters the body, i.e., as the full virus.

The vaccination process allows the body to start fighting a Covid-19 infection from the moment of infection, compared to a delayed and inflammatory response if unvaccinated.

Type of Response to CovidInitial Antibody CreationCovid virus affect
Natural Response / UnvaccinatedSlowly – Antibodies need to be made from scratchCovid-19 suppresses immune response, increasing inflammation and slowing down antibody creation
Vaccinated ResponseQuickly – already in LibraryReduced – the antibodies are already in the library, ready to attack the virus.

Some vaccinated people may still get a Covid-19 infection, but their pre-manufactured antibodies allow them a fighting chance to clear the virus before the virus has a chance to rapidly grow and cause debilitating disease or death.

People who had an Covid-19 infection may benefit from vaccination as well but may only need one vaccination injection. [v],[vi]

Some may argue that the mRNA vaccines are not natural. An alternative argument is that these vaccines stimulate your strongest tools to super boost your natural adaptive immunity before you get exposed to this potentially deadly virus.  

Besides the Covid-19 vaccines, it is important to support your innate immunity by:

  • Eating an anti-inflammatory diet (reduce/avoid sugar, alcohol, and foods you know cause inflammation). Click here[vii] for more information.
  • Supplement your immune system. Click here[viii] for more information.
  • Develop and maintain healthy sleep habits. Click here[ix] for more information.
  • Exercise daily to the level of your capability.
  • Find ways to laugh and relax daily. Click here[x] for information on tools to help reduce stress and anxiety.
  • Avoid toxins in your daily life such as fragrance, chemical cleaners, or pesticides that may damage your immune system. Click here[xi] for more information.
  • Identify and avoid food sensitivities. Click here[xii] for more information.

If you are struggling with any of these issues, please seek care with your naturopathic physician who is trained to help you find balance.


[i] Azkur AK, Akdis M, Azkur D, et al. Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19. Allergy. 2020;75(7):1564-1581. doi:10.1111/all.14364

[iii] Chowdhury MA, Hossain N, Kashem MA, Shahid MA, Alam A. Immune response in COVID-19: A review. J Infect Public Health. 2020;13(11):1619-1629. doi:10.1016/j.jiph.2020.07.001

[iv] https://www.immunopaedia.org.za/breaking-news/how-does-sars-cov-2-evade-the-immune-defences/

[v] https://www.nih.gov/news-events/nih-research-matters/immune-response-vaccination-after-covid-19

[vi] Ebinger JE, Fert-Bober J, Printsev I, et al. Antibody responses to the BNT162b2 mRNA vaccine in individuals previously infected with SARS-CoV-2. Nat Med. 2021;27(6):981-984. doi:10.1038/s41591-021-01325-6

[vii] https://www.idnatmed.com/are-these-foods-in-your-kitchen

[viii] https://www.idnatmed.com/immune-supportive-nutrients

[ix] https://www.idnatmed.com/not-sleeping-well

[x] https://www.idnatmed.com/managing-fear-during-a-crisis

[xi] https://www.idnatmed.com/easy-ways-to-maintain-a-healthy-home-and-reduce-your-exposure-to-chemicals

[xii] https://www.idnatmed.com/got-food-sensitivities

Hormone Support for Immune Health

Hormone balance can greatly affect immune function.  3 hormones are very important in this process.

Dr. Rodgers provides the following tests for her patients.

Thyroid hormones.
When the thyroid system is not functioning properly, the innate immune system may not function optimally[i]. Innate immunity is the part of the immune system that is always functioning to reduce infection. Innate immune cells include natural killer cells (NK cells), white blood cells, macrophages, and other immune cells such as dendritic cells.

  • Testing thyroid hormone: TSH, Free 3, Free T4, Reverse T3.

Cortisol
Cortisol is an important stress hormone produced in the Adrenal glands.  Cortisol reacts to stress by raising blood sugars, activating the immune system, and triggering the release of pro-inflammatory cytokines (inflammatory signaling molecules). Chronic stress can dampen the feedback system that helps to reduce cortisol production.[ii] Chronic cortisol release may lead to chronic inflammation, resulting in a reduced immune response when needed.

  • Testing cortisol levels:  A diurnal rhythm test of cortisol and cortisone (cortisol’s storage form) can be helpful to determine the daily total amount of cortisol and if there are high and low points of cortisol release during the day.  A diurnal rhythm test is usually collected from urine or saliva samples.
  • AM Cortisol. If a diurnal test is not available, an early morning blood draw can be helpful. Obtain the blood sample as early in the morning as possible,  before 8 AM.

Vitamin D
Vitamin D has a significant role in supporting immunity.  Vitamin D helps to regulate innate immunity. Vitamin D influences the immune system in the digestive tract, the location of majority of immune cells.  Vitamin D may also be a key nutrient to reduce inflammatory cytokines.[iii]

  • Testing Vitamin D levels:  A simple blood test can determine Vitamin D levels.
  • Retesting.  Testing 3 times a year for several years may be helpful to determine your levels during high and low sun exposure months. 
  • Test results low:  If you have low Vitamin D levels. Please ask your prescriber how much Vitamin D you need to raise your Vitamin D levels. Also ask for a re-test of Vitamin D 6 weeks after you start supplementing. A re-test will determine if the therapy was successful.

[i] Montesinos MDM, Pellizas CG. Thyroid Hormone Action on Innate Immunity [published correction appears in Front Endocrinol (Lausanne). 2019 Jul 19;10:486]. Front Endocrinol (Lausanne). 2019;10:350. Published 2019 Jun 4. doi:10.3389/fendo.2019.00350

[ii] Morey JN, Boggero IA, Scott AB, Segerstrom SC. Current Directions in Stress and Human Immune Function. Curr Opin Psychol. 2015;5:13-17. doi:10.1016/j.copsyc.2015.03.007

[iii] Sassi F, Tamone C, D’Amelio P. Vitamin D: Nutrient, Hormone, and Immunomodulator. Nutrients. 2018;10(11):1656. Published 2018 Nov 3. doi:10.3390/nu10111656