Preventing Infection - Prevention is the Best Medicine
1. Wash your hands! - making kids wash their hands 4x per day in school cut absences due to illness in half; adding hand sanitizer use made this even more effective
2. Manage stress - Smith NEJM 325:606, 1991 - psychological stress was a better predictor of who got sick after an exposure than smoking, alcohol consumption, white-cell counts, etc. - relaxation techniques, cognitive therapy, adaptogens (Eleuthero, others) and nerviness (passionflower is my favorite for anxiety)
3. Get enough sleep - sleep deprivation decreases immune response; rats who are not allowed to sleep actually die of overwhelming sepsis. Valerian, passionflower, Jamaican dogwood, but first turn off the TV, get enough exercise, etc.
4. Eat a healthy diet - adequate protein and a variety of minerals and vitamins are needed for adequate immune function (zinc, vitamin A are used therapeutically for this); a couple of studies in the malnourished elderly have shown that a multivitamin is helpful, but most studies do not show this; I recommend 5-9 servings of fruits and veggies per day.
5. Avoid excessive sugar - a high-sugar meal suppresses white blood cell function for several hours, and we have seen what happens to diabetics. . .
6. Avoid excessive alcohol - also an immune suppressant
7. Eat garlic regularly (ideally, raw, crushed garlic - I like this in salad dressing) or consider a garlic capsule with allicin. Adv Ther 18(4):189-93 Those taking garlic had 64% decrease in # of colds (24 vs. 65), and shorter symptoms (1.5 vs. 5 days)
8. Use Ginseng extract for prevention. CMAJ • October 25, 2005; 173, J Alt Complementary Medicine. 2006, 12(2): 153-157, Drugs Exp Clin Res 1996;22(2):65-72 Daily Panax Ginseng cut the frequency of upper respiratory infections by 1/2 to 2/3 in multiple studies. Other adaptogens (Eleuthero, Schisandra, Whithania) may also be helpful
9. Use Astragalus regularly. Pharmacology and App. of Chinese Materia Medica 1987 (I love Lois Johnson’s recommendation to cook with this - I use it in a muslin bag when I am making soup or beans - anything that is going to simmer)
10. Larch arabinogalactans - this has been studied in kids for recurrent otitis, is nice because it tastes sweet and they will actually take it
11. Consider a flu shot and/or pneumonia vaccine if you are at high risk
12. Avoid acid blockers - increase susceptibility to infection. (Use DGL, marshmallow, L-glutamine for the gut if needed) (see my article)
Don’t bother:
Echinacea all winter may even increase the number of colds
Vitamin C may or may not be helpful (studies are mixed)
Treating infection - Strengthen the host and kill the bug; also relieve symptoms
1. Strengthen the host:
A. Mushroom extracts - I have had great results with a maitake/reishi/shiitake blend, but there are many good extracts out there. Dose aggressively at the first sign of infection (I keep this around the house to be prepared) - many studies on various mushrooms
B. Andrographis - stimulates white cell function; in cold, reduced symptoms at 2 days, even more dramatic difference by 4 days. Phytomedicine 1999 Oct 6(4):217-23 Also effective in sore throat. J Med Assoc Thai 1991 74(10):824-9
C. Many others - those are just my favorites; I also use Uncaria tomentosa (cat’s claw), Lycium, and others
D. Echinacea - Shown effective in many trials, though some trials are negative. I do not like to use this because of increased incidence of rashes and autoimmunity.
2. Kill the bug
A. Berberine-containing herbs: Consider using Oregon grape root or Barberry instead of goldenseal, which is endangered. Berberine and hydrastine are active against many different bacteria, even tuberculosis and malaria.
B. Essential oils - citrus, myrrh, thyme, eucalyptus, tea tree, possibly horseradish, others - strongly antimicrobial and can be delivered topically to respiratory tract (steam inhalation), to the gums, as well as to the skin
C. Garlic
D. Usnea
E. Terminalia arjuna
Others. . . .
3. For specific infections:
A. For influenza: Elderberry extract - J Altern Complement Med 1995 Winter;1(4):361-9. Improved flu recovery time to 2 days from 6 days in the placebo group.
B. For colds:
1. Zinc Lozenges One lozenge every 2-3 hours while awake. Shortened course of cold symptoms from 8.1 to 4.5 days Ann Int Med 2000, 133:245-52 beware nausea
2. Vitamin C 9% - 37 % reduction in symptom days in multiple clinical trials with > or = 1 gram per day Cochrane Database Syst Rev 2000;
For symptom relief:
a. Nasal saline - 1 dropper each nostril three times a day of:
½ tsp salt + 2/3 C water + Pinch baking soda
b. Steam Inhalations Cochrane Database Syst Rev 2001;(4):CD001728 with thyme or eucalyptus essential oils or other oils as above
Don’t bother:
A recent clinical trial showed that Azithromycin (the popular antibiotic in the Z-pac) is not effective to shorten the course of bronchitis Lancet May 2002, 359:1648-54
C. For urinary tract infections:
Drink lots of fluids and pee frequently, especially after sex
Cranberry for prevention
Probiotics seem to help with prevention
Consider vaginal estrogen if recurrent infections after menopause
Uva ursi, berberine-containing herbs for treatment
D. For herpes:
L-lysine
Melissa officionalis (lemon balm)
What if you do have to take antibiotics?
Use saccharomyces boulardii (or, the poor-woman’s version is Baker’s yeast - the “live active” stuff about ¼ tsp twice a day) while on the antibiotic - this competes with candida and C. difficile in the gut and decreases the risk of antibiotic-associated diarrhea.
After the antibiotic, eat fermented foods (yogurt, kefir, etc.) for 3-6 months or supplement with a probiotic
C. Basch 2008 DRAFT
