Concerned about coronavirus?
Your immune system is key.
With current concerns regarding the COVID-19 coronavirus, the Coho Health team have put together this resource, highlighting nutritional, supplement and lifestyle interventions that can help keep yourself and your family safe.
***Please note that as COVID-19 is a novel virus, the science and reports from the field are evolving quickly. We’ll therefore be updating this article, and providing updates on our Facebook, Instagram, and Twitter pages, as the understanding of COVID-19 develops.***
These recommendations form part of a ‘self-care’, preventative protocol.
This is not a treatment protocol for COVID-19 / coronavirus.
If you have, or suspect you have, COVID-19, you should seek medical advice.
This information does not replace any medical advice.
What you'll find in this article
- The skinny: one page summary
- Immune System 101
- COVID-19 prevention strategies that you’re likely already aware of
- Immune supportive drinks with recipes
- Foods to support immune function
- Natural strategies to managing symptoms
- Nutritional and herbal supplements
- Medicinal botanicals
- How Coho Health can help
The skinny: brief summary
As COVID-19 is a new virus, at the time of writing there is no research yet on what can specifically help treat this infection.
The recommendations below are some natural strategies that may help to help support a healthy immune system and increase resilience:
- Follow local government advice around taking appropriate measures to avoid spread of infection.
- Reduce non-purposeful inflammation, now. Avoid sugar, caffeine and alcohol, and increase fruit and a wide range of coloured vegetables, for an array of vitamins, minerals and antioxidants. Frozen fruit and vegetables are absolutely fine to consume. Support sleep duration and quality. Avoid stress and introduce regular relaxation strategies. These factors can bring our baseline inflammation down.
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- Increase immune supportive foods and nutrients; ginger, turmeric, raw honey, lemons, lime, kiwi, red pepper, strawberries, garlic, pomegranate, fermented foods, onion, apple, garlic, asparagus, Jerusalem artichoke, endive, chicory, cocoa, dandelion greens, aubergine, flaxseed, leek, legumes, coconut oil, oily fish, bone broth / vegetable broth.
- Help sore throats with honey and warm water or salt gargles. Try teas or infusions made from mashmallow root and licorice root (avoid licorice if you have high blood pressure). Try chamomille and peppermint teas. Try fresh thyme tea, and zinc lozenges.
- Support congestion / respiratory function by using humidifiers, vaporisers, steam inhalers, steamy baths or showers. Consider vaporisers and inhalers as decongestants or essential oils such as eucalyptus, menthol, peppermint, or frankincense. Nasal xylitol sprays, saline sprays, or nasal irrigation using a neti pot can help.
- Consider supplementation with Vitamin A, C, D, zinc, selenium, quercetin, astragalus, saccharmocyes boulardii, n-acetyl cysteine, probiotics, beta-glucans, olive leaf extract and medicinal mushrooms e.g. reishi.
Further information, recipes, and references can be found in the full article below.
Immune system 101
We have two arms of the immune system:
– our innate immunity
– and our acquired immunity
The innate immune system is essential for the initial detection of viruses and then the subsequent activation of the acquired immune system.
The acquired immune system
The acquired immune system (also referred to as adaptive immunity) is activated by exposure to pathogens (e.g. bacteria and viruses).
The acquired immune system is composed of B cells and T cells.
It learns about threats based on the memory of previous exposures, and enhances the immune response to threats accordingly.
The acquired immune response plays a major role in the re-infection with viruses.
This explains why most of us only have chicken pox once. After the first incident, our acquired immune system builds a ‘tolerance’ (antibodies).
This ensures that a second exposure is dealt with quickly before you experience symptoms.
The innate immune system
Cells of the innate immune system and macrophages (large white blood cells) detect viruses and activate various signalling molecules that;
- are responsible for killing infected cells, and building resistance to viral infection on uninfected cells
- are critical for eliminating viruses by initiating inflammatory processes
- signal for more innate and acquired immune cells to the infected area
- activate T-cells which lead to acquired immune reactions (1)
The innate immune system serves as our ‘first line of defence’.
It is activated quickly when it senses something ‘foreign’ or ’non-self’, and provides a general, non-specific immune response.
The innate immune system consists of our physical barriers (e.g. skin, gastrointestinal tract, respiratory tract) and different types of white blood cells such as phagocytes, macrophages, dendritic cells and Natural Killer cells.
The innate immune system is essential for the initial detection of viruses and then the subsequent activation of the acquired immune system.
The innate and acquired immune systems: how they work together
The innate and acquired immune systems are closely associated.
What happens in one area can impact what happens in the other.
For example, T cells (T-helper cells) from the acquired immune system, provide signals that affect innate immune system responses.
We have three sub-types of T-helper cells; Th-1,Th-2 and Th-17. (2)
Th-1 cells produce immune responses that help fight viral infections.
We can either have a balanced Th-1 and Th-2 response (i.e. we have equal levels of Th-1 and Th-2 cells), or an imbalance (so we have either more Th-1, or more Th-2, think of a see-saw, one goes up, the other comes down).
The balance between Th-1 and Th-2 is important because it influences how your immune system responds to different threats (such as COVID-19).
For example, in asthma, hayfever and eczema, people generally have more Th-2 cells.
We therefore need to promote Th-1 activity that includes the Natural Killer Cells that are essential in the early phases of a viral infection.
Immune system & your microbiome
So, where does the microbiome fit into all of this?
With over 70% of our immune cells residing in the gut, our focus also needs to be on gut health, and more specifically on our gut bacteria.
There is constant ‘cross-talk’ between gut bacteria and immune cells.
The gut microbiome (all the genetic bacterial material in the gut) has been shown to modulate innate immune responses, and Th-1, Th-2 and Th-17 responses.
The important role of inflammation
Inflammatory processes are what help us overcome a viral infection.
We absolutely need some inflammation when we have an infection – this is a sign of our immune system being activated and working hard to clear the infection.
However, too much inflammation (too high, or for too long) is when things can become problematic, resulting in chronic symptoms and tissue damage.
Prior to an infection, if our inflammation levels are nice and low (healthy levels), then we have more band-width for the inflammatory processes to go higher.
This means we can respond to and deal with an infection, without causing serious outcomes.
The take home point is that we must do what we can to reduce non-purposeful inflammation, now.
This is ensuring a healthy diet, avoiding sugar, alcohol, promoting good sleep and reducing stress.
Please read on for further suggestions around these factors.
Prevention strategies that you’re likely already aware of
Frequent handwashing with soap and water for at least 20 seconds, on multiple occasions throughout the day, to help prevent respiratory infections
Using hand sanitiser when unable to handwash with soap and water – alcohol based hand sanitiser that contain at least 60% alcohol can help reduce spread of infection (ideally, avoid products containing triclosan)
Keeping surfaces clean especially if someone in the home is unwell, considering surfaces that are frequently touched such as doorknobs, phones, computer keypads, remote controls, and surfaces in bathroom and kitchen
Avoid touching your face particularly eyes, nose, and mouth with unwashed hands (common routes of entry of virus)
Avoiding contact with those who have symptoms of coronavirus, social gatherings and unnecessary travel – follow local government recommendations
Using tissue to cover mouth and nose when coughing or sneezing
- further details on the above, and more, can be found on the NHS website
Minimising stress as much as possible.
Stress can impact the immune system and leave us more vulnerable.
If you’re short on time, you can keep things simple by remembering to take some deep breaths throughout the day.
Or set an hourly reminder on your phone to take a break for some deep breathing exercises or meditation.
If you’re at home, take a bath, listen to music (and switch screens off), play board games or spend some time making nutritious meals (a few ideas below).
Good quality sleep can support our overall health and well-being and support our immune system, preventing us from feeling ‘run down’.
Make it a priority to have a regular sleep routine and bed time, to ensure you get adequate, good quality sleep.
Focus on your nutrition.
Eat as many freshly prepared meals as you can with a high amount of vegetables that grow above the ground, including green leafy vegetables, and also fresh fruit.
Emphasise immune supportive fruit such as berries, pomegranate, apples and pineapple.
Aim for 8-10 portions of fruit and vegetable daily (a portion being a handful).
Frozen fruit and vegetables are absolutely fine to use.
Batch cook to help save time. Make use of a slow cooker (quite literally you can throw in lots of chopped vegetables, some protein-rich food, tomatoes, herbs, spices and seasoning, into a slow cooker in the morning and leave it on a low setting).
8 hours later, your nutrient dense meal is ready to be served, ensure enough liquid to cover meat, fish or chicken if using.
Natural strategies to boost immune system health
As COVID-19 is a new virus, there is no research yet on what can specifically help treat this infection.
The below recommendations are some natural strategies that can help to support a healthy immune system.
Stay well hydrated, on average around 2 litres of filtered water daily for adults.
Avoid alcohol and caffeine which can affect immune function.
Switch to filtered water, green tea, vegetable juices or homemade immune boosting drinks.
Honey, lemon, ginger, turmeric and cinnamon can be used to make hot drinks to ease symptoms and help to stay well hydrated.
There are many variations of these hot, soothing drinks, here’s just a few of our favourites that use a large amount of these foods to increase potency.
Fresh ginger tea
To save time, if you have a juicer, juice 0.5 to 1kg of fresh ginger, place in a jar and refrigerate.
To make; add 50ml of ginger juice to a mug, with juice of half a lemon and a tablespoon of honey (honey has anti-viral properties as well as helping to make this more palatable). Add 1/8 (eighth) of teaspoon of cayenne pepper and top with hot water.
Sip on 2 to 6 cups of this throughout the day. You’re not likely to enjoy this unless you’re a fan of strong flavours – but it’s medicinal and good for you!
If you don’t have a juicer, then grate ginger into a pan with hot water and simmer for 5 minutes, strain into a mug and then add the other ingredients.
Ginger and turmeric shots
- 2 tablespoons chopped fresh ginger (with or without peel)
- 2 tablespoons chopped fresh turmeric (with or without peel, can temporarily stain hands)
- Pinch black pepper (to aid absorption of turmeric)
- ¼ teaspoon virgin olive oil (to aid absorption of turmeric)
- Juice of 1 large lemon (or 1 small lemon and 1 small orange)
- Water – for desired consistency
Add all above ingredients to a blender e.g. Nutribullet (or any other blender), add water to make it easier to blend.
This can then be strained through a tea strainer. Divide into shot glasses.
Can be stored in a fridge for 24 hours or can be frozen. The above ingredients can also be juiced. Please note turmeric can stain!
- 2 cups milk (e.g. coconut, almond or oat, unsweetened)
- 1 teaspoon turmeric powder
- ¼ teaspoon ginger powder
- ¼ teaspoon cinnamon powder
- 1 teaspoon honey
- ¼ teaspoon black pepper
Combine all ingredients in a pan and bring to a simmer.
Turn off the heat and let sit for 5 minutes for the spices to mellow and combine.
Enjoy while still warm. Can multiple the ingredients to make multiple cups.
We’ve used fresh ginger and turmeric also instead of powdered, and even our daughter, Tia (age 5), is happy to drink this.
Hot Immune Drink
- 1 litre boiling water
- Juice from 1 ½ lemons
- ½ sliced lemon
- 2-3 tablespoon honey
- 4 tablespoon grated fresh ginger
- 4 crushed dried juniper berries (do not use if pregnant or if history of kidney/liver disease)
- 4-5 stars of anise
- 2 cinnamon sticks
- ⅛ tsp dried chilli flakes (optional)
Bring water to boil and add ginger, cinnamon sticks, juniper berries, chilli flakes if using, star anise and simmer for about 7 minutes.
When it is ready, strain the liquid.
Then add lemon juice and honey.
Pour into large mugs, add lemon slices and enjoy!
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Foods to support immune function
Garlic has a variety of compounds that can influence immune function.
Fresh and supplemental forms of garlic may reduce viral upper respiratory infection severity as well as having a preventative role, but you need to use a lot of it.
Ginger has been shown to have antimicrobial and antiviral effects.
Ginger has immune-boosting benefits, for example it can prevent adhesion of viruses to the upper respiratory mucosa – but again, you need to take a lot of it (see recipes for fresh ginger tea and ginger and turmeric shots).
Turmeric, fresh or powdered, may have antiviral benefits and has significant anti-inflammatory properties and anti-oxidant action.
Citrus fruits, kiwi, red peppers (uncooked) and strawberries (frozen is fine) for vitamin C. Pomegranate (fresh, frozen, or the juice of) has antimicrobial properties and is also rich in antioxidants.
Fermented foods that include beneficial bacteria to support your microbiome. Include sauerkraut, kimchi, kombucha, miso or kefir.
Prebiotic rich foods support the growth of beneficial bacteria in the digestive system, supporting a diverse microbiome.
This in turn helps to support immune function.
Include apple, onion, garlic, Jerusalem artichoke, asparagus, chicory, cocoa, dandelion greens, aubergine, endive, flaxseed, leek and legumes.
Coconut oil also has antibacterial and antiviral properties.
A particular component of coconut oil, monlaurin, has been reported to have antiviral activity against a variety of common viruses.
Honey (ideally, raw) helps soothe irritated mucous membranes, has antioxidant properties and some antibacterial effects.
It’s a great simple home remedy for sore throats and usually a big hit with children too.
Oily fish (wild salmon, mackerel, sardines, pilchard, herring, trout) for immune support, providing essential anti-inflammatory omega 3 fatty acids.
Great for the whole family, aim for 2 portions weekly, increasing to 3 portions if including wild salmon.
8-10 portions of fruit and vegetables daily, of a wide range of colours (‘eat the rainbow’), for an array of anti-oxidants.
To consume this amount of vegetables daily you need to start at breakfast, e.g. kale, spinach, celery or bell pepper in your smoothie.
Or scrambled eggs with spinach (only takes a few minutes).
Snack on nuts and fruit and/or vegetable crudités.
Don’t waste calories on biscuits, cookies, cakes or chocolate.
Immune Supporting Bone Broth or Vegan Broth Recipe (serves 4-6)
- 3 litres filtered water (if using bones, add more to cover all ingredients)
- 1 tablespoon coconut oil or extra-virgin olive oil
- 1 medium red onion cut into 4 pieces
- 8 smashed cloves of garlic
- 1 chopped, thumb size of, fresh ginger
- 1 cup greens, such as kale or spinach
- 3-4 cup mixed chopped vegetables (for example carrot, red cabbage, fresh mushrooms, leeks and celery)
- 1/2 cup dried shiitake mushrooms
- 30 g dried wakame seaweed or any other seaweed
- 4-8 peppercorns
- 2 tablespoon ground turmeric or 1 thumb size of fresh turmeric root
- 1 small bunch of fresh coriander
- 1 chopped chilli (with seeds) (optional)
- Beef marrow bones (about 500g) or chicken carcass (for Bone Broth)
- If using bones, add a splash of Apple Cider Vinegar
- Add everything to a large pot, bring to a boil. Then simmer with the lid on, for about 1-1.5 hrs (vegan option) or at least 12 hours when using bones. You can also use a slow cooker.
- When it is ready, strain the liquid into a large bowl.
- Serve with some fresh herbs, cool for later or freeze.
Salt water gargles to loosen mucus, is also anti-bacterial
Try a tablespoon of honey in hot water to help soothe a sore throat. Raw and/or local honey would be better.
Teas or infusions made from marshmallow root and licorice root, can help improve irritated sore throats, they can act as soothing demulcents.
Avoid high doses of licorice if you have elevated blood pressure. Chamomille and peppermint teas may also help. Choose organic brands where possible.
Thyme can also help to soothe sore throats and supports the mucosal lining, helping to clear congestion, rub fresh thyme leaves between your palms to break the leaves, add to a mug and pour over boiling water to make a fresh thyme infused tea.
Zinc lozenges can shorten the duration of common-cold associated nasal discharge by 34%, nasal congestion by 37%, scratchy throat by 33% and cough by 46% (according to a study published in 2015) (3).
Respiratory congestion & sinuses
Humidifiers, vaporisers, steam inhalers, or steamy baths or showers, can help.
Vaporisers and inhalers can also be used with decongestants or essential oils such as eucalyptus, menthol, peppermint, or frankincense.
Nasal xylitol sprays can be very beneficial and available from Amazon, eBay or some pharmacies.
A saline spray can be used with younger children and available from pharmacies.
Nasal irrigation using a neti pot may also help.
Nutritional and herbal supplemental support
It is possible that high, mega doses, of vitamin A and vitamin D may not be beneficial in COVID-19.
This is because research has found that COVID-19 is entering cells through a receptor called ACE-2 and high doses of vitamin A or D can potentially increase ACE-2 receptors.
However, an insufficiency / deficiency in these nutrients is also potentially negatively influencing immune function, and the ability to launch an appropriate inflammatory response to viruses.
Please see below for guidance.
Vitamin A is key for immune function and works synergistically with vitamin D.
Vitamin A can enhance white blood cell activity, increase antibody response and has anti-viral properties (4).
Short term supplementation may be very beneficial in helping the body to fight respiratory infections.
Careful with the dosing however, around 1,000 – 2,000 IU daily for 1-2 months is a good therapeutic dose for adults.
If your current protocol includes vitamin A supplementation, please liaise with your practitioner.
Vitamin C may well be one the most frequently considered immune supporting vitamins.
It plays a critical role in immune cell function (5,6).
Vitamin C supports production of lymphocytes (white blood cells) (7), is a potent antioxidant (8) and supports the integrity of mucous membranes (9).
Regular dosing has been shown to reduce the duration of colds.
Clinical research has found high doses to have significant antibacterial and antiviral action.
Aim for 1,000mg one to three times daily. High doses are safe but may cause looser stools.
Vitamin C has a short half-life (how long it’s active in your body), so regular intake is important.
Vitamin D is key for immune modulation (10) (for a balanced and appropriate immune response).
Insufficiency is widespread to the point that in the UK, the NHS advice is that we all should be supplementing with vitamin D.
For the time being, our recommendation is to keep intake to around 1000 to 2000 IU daily .
Avoid extra daily doses unless you have a known vitamin D deficiency (private home testing is easy and cheap).
If our recommendation changes, we will let you know.
Zinc is intricately involved in many aspects of immune function.
It is a potent antioxidant (11), is required for proper white blood cell function, and supplementation has been found to be of benefit in patients suffering from viral infections (12).
Short term, high doses of zinc may help to reduce duration of common colds.
One study noted an average reduction in common cold by 7 days in those taking a zinc lozenge compared to placebo (13).
A study performed in the elderly, found that 45mg of zinc supplementation daily led to significantly lower infection rates and less upper respiratory tract infections (14).
Even a mild zinc deficiency can negatively affect natural killer cell function (15).
Interestingly, a 2010 in vitro study, demonstrated that zinc inhibits coronavirus replication (16).
Selenium is another key mineral, and the immune system depends on adequate levels of selenium.
Selenium exerts its effects mainly through ‘selenoproteins’, which have far reaching functions.
These range from antioxidant activity, protecting fats from being oxidised, supporting innate immune function, regulating immune cell function (17, 18) and in impairing viral replication (17).
In a 2019 study, selenium was found to restore the antioxidant capacity of the lungs in patients with acute respiratory distress syndrome (19).
Just 2-3 Brazil nuts (grown in South America, where the soil is high in Selenium) are sufficient to provide the daily recommended intake of selenium.
Probiotics help support the microbiome, which in turn influences our innate immune system.
A history of antibiotics, stress and poor diet are just a few reasons why the microbiome can be compromised.
Probiotics act on the innate and the acquired immune system and can reduce the severity of upper respiratory tract infections (20, 21).
Numerous strains of probiotics have been studied in different populations.
Lactobacillus casei has been found to modulate activity of natural killer cells which are one of the first lines of defence mechanisms against viral infections (22).
Lactobacillus rhamnosus GG is the most extensively studied strain and safe for all ages, this strain has been found to also increase immune response to rotavirus (23).
Lactobacillus plantarum can reduce the incidence of upper respiratory tract infections (24).
Bifidobacteria is the predominant species of bacteria in children below 2 years of age (25).
Consider a probiotic supplement, each capsule providing a minimum of 5 billion CFU.
Mycotherapy (‘medicinal mushrooms’).
Medicinal mushrooms have long been used in traditional medicine and now have robust scientific supportive data.
Many contain compounds that can affect viral replication at various stages (26).
Mycotherapy has immunomodulatory and antiviral benefits (and is used as an adjunct in oncology in some countries).
Consider Chaga, Reishi, Cordyceps, and Shitake. Cordyceps may also protect the alveoli (air sacs in the lungs).
We’re big fans of the professional, well-researched brand, Hifas da Terra (a company heavily focused on research and innovation).
Beta-glucans, found in mushrooms, uniquely enhance immune function, without over-stimulating it (which is not desirable in some conditions).
There is consistent research highlighting the benefits of beta-glucans.
They have been found to influence monocytes (types of white blood cells), cytokines (immune messengers) and improved mucosal immunity (27), as well as improving upper respiratory tract infections (this study was in females) (28).
Astragalus, commonly used in Chinese herbal medicine, contains polysaccharides, flavonoids, multiple trace minerals, and amino acids.
The herb has can activate macrophages (29) and promote Natural Killer Cell activity (30), boosting anti-viral effects
Olive Leaf Extract has antioxidant benefits and has been found to have antiviral activity.
A study published in 2019 demonstrated olive leaf extract’s antiviral activity against Herpes Simplex Virus Type 1 (31).
Quercetin is a phytochemical (flavonoid) derived from foods such as apple, onion, broccoli, tea and wine.
Quercetin has significant antioxidant activity, antiviral activity, inhibits histamine release, reduces inflammation and has anti-allergic properties (32).
With multiple immune roles, quercetin may help support the immune system and improve Th-1 cell response.
NAC (n-acetyl cysteine) can help support glutathione levels in the body.
Glutathione is the body’s ‘master antioxidant’ and may support the immune system in infections.
Glutathione plays a pivotal role in viral infections.
As well as being a potent antioxidant, it can support the function of macrophages (33) and a deficiency may shift the immune response away from Th-1 responses, increasing respiratory tract inflammation (34).
NAC has demonstrated an immune modulating role, and NAC / glutathione levels can be lower in autoimmune conditions.
NAC can influence lymphocytes, neutrophils and cytokine levels, and has mucolytic properties (35, 36) (the thick mucus in the lungs of COVID-19 patients has been implicated in breathing difficulties).
Studies have noted the potential benefit of NAC supplementation in the elderly (37).
NAC has also been shown to reduce the inflammation induced by Epstein Bar Virus (38).
Saccharomyces Boulardii is a beneficial yeast strain that forms a key part of our therapeutic protocols for many of our clients at Coho Health.
Saccharmocyes Boulardii can support secretory IgA (SIgA) levels (39).
These are immunoglobulins that provide ‘first line of defence’ support in our mucosal membranes (nasal, oral, and intestinal).
Medicinal botanical protocols (seek advice from a Naturopath or Herbalist).
Stephen Harrod Buhner’s Botanical Formula
For this formula, you’ll need to combine:
- Three parts Cordyceps
- Two parts Angelica sinensis
- One part Rhodiola
- One part Astragalus
Take one teaspoon of this formula three times per day for protection against infection.
Take one teaspoon six times per day if you’re experiencing symptoms.
Shuang-Huang-Lian Antiviral Formula was used during the SARS outbreak in China.
Recent preliminary lab based in vitro studies against COVID-19 have been positive.
Further research is ongoing.
For this formula, you’ll need to combine:
- Two parts Forsythia suspensa (also known as lian qiao or weeping forsythia plant)
- One part Lonicera japonica (also called jin yin hua or Japanese honeysuckle)
- One part Scutellaria baicalensis (also known as huang qin or Chinese skullcap)
Take one teaspoon of this formula three times per day. Seek advice from a herbalist.
It’s best to take it in combination with immune-boosting herbs.
These are all modalities that may support immune function.
We are not claiming they will treat a COVID-19 infection, and this does not replace medical advice.
However, we believe there is plenty that we can do to strengthen our immune system and resilience.
How Coho Health can help you
Please note: The above recommendations are intended for healthy adults who do not have a medical condition and who are not taking prescribed or over the counter medications.
Please note that not all recommendations are suitable if one if suffering from a chronic medical condition or taking medications, as there can be negative interactions.
Book your free 15 minute Discovery Call with Dee Brereton-Patel now
Please also rest assured that we are able to provide advice for all chronic conditions.
This includes those suffering with an existing chronic condition (e.g. asthma, eczema, rheumatoid arthritis, osteoarthritis, psoriasis, vasculitis, Crohn’s disease, ulcerative colitis, thyroid dysfunction, depression, anxiety, IBS, cardiovascular disease etc).
We can also help those currently on medications, those who may be immunosuppressed, have a weak immune system, the young and the elderly.
We can also advise around appropriate supplementation.
This is a complementary service available to everyone.
To your optimised, healthy future,
Dee & the Coho Health team
How can we help you? Send us a message below and we’ll come right back to you…
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