With the world finally opening up, many parents with children with Down syndrome are on edge.
As parents, you know your child's health is fragile. It seems that your child with Down syndrome (DS) gets sick easier, quicker, and longer than their typical peers.
Often a common cold can become just as quickly become pneumonia in kids with DS. So you're always on your guard.
And with many places opening and COVID19 reports spiking, it's more important than ever to keep your child with DS safe.
But how?
Practicing social distancing and proper hygiene is essential during these challenging times but is there more you can do to boost your child's immune system?
Is there a way to make sure that your child with DS stays as healthy as possible without resorting to increased social isolation?
Is it even safe for people with DS to go outside and mingle while the risk of COVID19 is still a possibility?
And why do people with DS seem to get so sick so often?
These ( among others) are some of the questions that you may have as a parent or caregiver of a person with DS.
Well, let's start with answering the last question first.
Why do people with DS seem to get sicker more often than others?
It comes down to the immune system.
People with DS have a weakened immune system. There are a number of different reasons why this happens to be the case but the biggest reason comes down to the effects of having an extra copy of chromosome 21 encoding for upwards of 300 genes [1].
In fact, recent research has actually classified DS as a disorder of the immune system [2] rather than just a vague genetic condition.
This means that interferons, a group of proteins usually only activated when there is a disease like a virus that the body is fighting, are activated all the time in individuals with Down syndrome.
The interferon response is only activated in typical individuals when they are fighting an infection.
So that should mean that people with DS have ultra strong immune systems right?
Sadly this is definitely not the case.
People with Down syndrome often have an overactive immune system that doesn't respond the way typical individual's immune systems respond.
Further more, people with DS have more immune system abnormalities, usually in the form of T and B cell lymphopenia which means an even more increased risk of infection [3].
T and B cells are the primary cells of the immune system recognizing viruses (T cells) and both viruses and bacteria (B cells) as foreign invaders to be marked for destruction.
With decreased capacity to do this, many people with DS, tend to get sicker quicker and longer.
It's also common knowledge that people with Down syndrome are more likely to get respiratory tract infections.
This is due to an increased expression of the protein pericentrin which disrupts the function and assembly of primary cilia [4].
So where does this leave your child with DS? Is there anything you can do to protect your child?
To combat the effects of having an extra chromosome and to help boost the immune system, most everyone with DS needs to be taking these supplements or finding a way to boost them in their diet.
1. Zinc
Zinc is essential for overall good health, especially for those who have DS.
People with DS are usually zinc deficient due to the increased activity of superoxide dismutase. Superoxide dismustase is a metalloenzyme that helps decrease oxygen ions within the cell. This enzyme works against free radical injury.
One of the minerals that SOD needs to do its job is zinc.
SOD uses zinc as a co-factor is a non-protein chemical that helps an enzyme.
In individuals with Down syndrome, SOD is over-expressed [5] leading to a decrease in the amount of zinc available for other processes in the body.
For example, zinc deficiencies in Down syndrome lead to shorter stature [6], lowered sense of taste [7], and lowered immunity in both the number of immune cells and the activity of the immune system [8].
Clearly zinc is one of the most important minerals for health for a person with DS.
For a typical individual, the recommended dietary allowance of zinc for a child range from 3-11mg/day depending on the sex and age of the child.
The optimal daily intake, the amount of a mineral or vitamin needed to look and feel your best, can range up to 20 mg but you should always talk to your naturopathic doctor before supplementing anything with your child to determine what is best for him/her.
2. Vitamin C
IV Vitamin C has clearly come out as a winner in the war against Covid19.
But does your child with DS need to have IV vitamin C just to prevent a covid infection?
Not at all!
While vitamin C is essential for good health, it's secret power is in prophylactic use.
Prophylactic use of vitamin C has been shown to increase the maturation and cell numbers of B and T cells (immune system cells) [9] which in turn lowers the chance of a respiratory tract infections like Covid.
Vitamin C has also been shown to prevent pneumonia [10].
To unlock the preventative power of vitamin C, dietary intake must at least be equal to, if not exceeding, the RDA (recommended daily allowance) of 40-75mg/day.
In fact research suggests 100-200mg/day show a better preventative effect than the RDA.
The optimal daily intake for vitamin C can range up to 3000 mg a day.
While too much vitamin C isn't fatal, it can lead to uncomfortable gastrointestinal symptoms like cramping, bloating, and loose stools or diarrhea.
3. Vitamin D
Vitamin D is so powerful that it can't be left off of this list.
Vitamin D deficiency has been linked to increased influenza and upper respiratory tract infections and acute respiratory distress syndrome in covid19 [11].
Vitamin D helps to activate the immune system by raising cathelicidin levels in the body.
Cathelicidin is an antimicrobial peptide stored in white blood cells that helps to fight against bacterial and viral infections like covid19.
Increased levels of vitamin D correlate with increased levels of cathelicidin.
Increased levels of cathelicidin not only help the body fight against foreign invaders they also decrease inflammation and reduce respiratory tract infections bu increasing anti-inflammatory cytokines like interleukin (IL) 10 [12].
Depending on where you live and the color of your child's skin, he/she could be vitamin D deficient or insufficient. People with darker skin are more likely to have lower levels of vitamin D because melanin, which gives the skin it's pigment, reduces the skin's ability to make vitamin D from the sun.
The recommended daily allowance of vitamin D ranges from 400-600 IU/day but the optimal daily intake can be up to 1000 IU/day for children [13].
Before supplementing with vitamin D, its best to talk to your naturopathic doctor about the best dosage for your child because too much vitamin D can be toxic.
Is it safe for your child with Down syndrome to resume normal activities amidst the country opening up and the covid pandemic?
While that is a question answered best by you and your family, I would say yes, as long as certain precautions are in place which include proper hygiene and supporting your child's immune system with the vitamins and minerals listed above as well as a healthy diet and proper exercise and sleep, which are cornerstones of good health.
As you decide on how best to protect your child with Down syndrome from covid19, remember that supporting the immune system is key to a healthy thriving child.
Your child's immune system is his/her first and best defense against any foreign invader.
Are you going to increase social interaction for your child with Down syndrome?
Contact me and let me know.
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