bidengaff

Since I’ve been asked about my take on the swine flu situation a few times in the comments section and numerous times by other people I know, I figured I would post on the subject.  Re the above cartoon: I agree with the President.

I don’t think the situation is nearly as bad as many people – including our esteemed Vice President – seem to think it is.  Whenever I hear reports of panic like those we’ve been bombarded with over the past week, I always think of what H.L. Mencken had to say in such circumstances:

The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.

In this case, I don’t think it is the government that is spreading the panic – Biden’s gaffs notwithstanding – instead I believe it is the press.  The same Mencken quote could easily apply to the media.

You didn’t hear about Biden’s gaff?  Well, the spinmeisters got to it pretty quickly.

luckovich_run_for_your_lives

If, instead of running for their lives, people are running to the internet, glued to CNN, and the other 24/7 news channels and reading every newspaper and news magazine that comes along, the press is extremely happy.  It’s what they live for.  When they get a hot story like this one, they are loath to let it go until they’ve milked it for maximum exposure.  And they are milking this one for all it’s worth.  But remember, the media did this same thing a few years ago and inspired the same kind of panic over SARS, which ended up not amounting to much in terms of a real pandemic.

By now everyone knows that the swine flu in question is the H1N1 influenza A virus that was first thought to be similar genetically to influenza viruses that are found in pigs in North America.  More research has demonstrated that some of the genes involved are those that are found in pigs in Europe and Asia as well as birds and humans.

Based on the recent cases, this influenza doesn’t appear to be all that virulent.  In fact, it looks to be much less virulent than the standard old garden-variety flu that is common in the winter.

This influenza virus, like all influenza viruses, can mutate via a process called antigenic drift, which can make it either more or less virulent.  When we get the flu, we develop antibodies to the particular strain of influenza virus that infected us.  As this virus mutates a little, our antibodies can continue to beat it back because it is similar enough to the strain we got that our immune system recognizes it.  After a number of years of antigenic drift, the virus will have changed enough that our immune system no longer recognizes it, and we get infected again.  Measles, mumps and chicken pox are common viruses that don’t go through antigenic drift, so once we have them, we pretty much have immunity against then forever, but not with the flu.  Which is why once you get it, you don’t get it again for a number of years, then you come down with it once again.
Based on my own experience both being infected with the flu and taking care of patients infected with it has led me to believe that the influenza virus is becoming less virulent in general over time.  Why?  Natural selection.

Remember, natural selection works by spontaneous mutations that confer a survival advantage to the organism that carries them.  Such an organism has a better chance of surviving and passing the mutation along to its offspring.  With this in mind, consider the influenza virus.  It lives in humans, birds, pigs, etc.  It typically spreads via droplets disseminated by sneezing and coughing or close physical contact.  Think about what happens if a virus is extremely virulent.  The person (or animal) infected with it gets extremely ill, stays put, and maybe even dies.  This behavior reduces the chance of the virus’ spreading.  If however, the virus mutates to a much less virulent form, people who are stricken with it continue to work and socialize and don’t die.  The virus lives longer in the host and has a much greater chance of being spread, which is better for the virus.  So a lesser virulence confers a survival advantage to the virus, which is why I think the flu has become less and less problematic over time.

What can we do about this strain?

First, I don’t think it will amount to much because of the season.  I’m a firm believer in the notion that reduced vitamin D levels in the winter predispose us to the flu and other viral infections at that time.  Right now, it is late spring and nice and sunny with longer days.  People are getting out more and building their vitamin D.  For this reason alone, I don’t believe we’re going to see a pandemic.

It takes about 12 weeks to grow the virus in culture and use it to develop a vaccine, which is why the CDC can’t just crank out vaccine on the spur of the moment when a virus such as this one shows its face.  And even if a vaccine could be cranked out, it takes a while after the vaccination to develop the immunity, so it wouldn’t help immediately anyway. Since there will be no vaccine, we need to turn to other techniques to protect ourselves.  How can we do that?  By doing all the things we need to do to bolster our immune systems.

This swine flu is a type A influenza, which is a type that can usually be warded off prophylactically with amantidine (Symmetrel), an inexpensive drug that is readily available.  But from my reading, it looks like this particular strain of influenza A is resistant to that drug.  There are a couple of other drugs that are effective in the treatment of this flu – Tamiflu and Relenza – but I wouldn’t use them as a prophylactic.  Keep them in reserve in the unlikely event that you should actually contract this flu.  MD and I have gotten calls from friends and family all over the place wanting us to call them in prescriptions for these drugs, but we have refused because we don’t want to deplete supplies (which are limited) for those who actually get the flu.

As far as I’m concerned, the single best thing you can do is to make sure your vitamin D levels are where they are supposed to be.  On days that I’m not in the sun, I always take a 5,000 IU vitamin D3 capsule.  If I feel like I’m coming down with something or if I’m going on a long flight, I’ll take a 50,000 IU capsule.

In addition to the vitamin D, the other things you can do are as follows:

Eat plenty of good quality protein and fat.  Your immune system is made of protein and fat, so eat what it needs.

Avoid sugar and refined carbohydrates.  A number of scientific studies have shown that sugars and refined carbohydrates increase inflammation and, consequently, occupy much of the capacity of the immune system.

Get plenty of sleep.  Sleep is a great immune enhancer.  Remember all the times you’ve shorted yourself sleep and ended up catching a cold.  Get your rest.  If you have trouble falling asleep, try some sublingual melatonin.  It’s available at any health food store.  Put 1 or 2 mg under your tongue when it’s lights out.  Don’t use the melatonin unless and until you’ve turned the lights out and are ready to sleep.

Wash your hands frequently and keep them away from your nose and eyes.  This is especially good advice when you are traveling or even just out and about.  Someone with the flu (or other virus) sneezes into his/her hand, touches a door handle, you grab the same door handle, then rub (or pick at) your nose, and Bingo! you’re inoculated.  So I repeat: wash your hands and keep them away from your nose.  Hand sanitizers help.  And, as if I need to tell anyone this, try to avoid having someone sneeze or cough in your face.

I would avoid kissing pigs and strangers.  Wait until this scare recedes into your rear-view mirror before you follow the lead of this youngster.

pig-kiss-blog

Follow the above recommendations, and I think you’ll do all you can to minimize your chances for infection.

If you do get the flu, have your doctor give you a prescription for one of the two drugs mentioned above.

But I doubt you will get infected.  And I suspect this whole thing will blow over in fairly short order.

63 Comments

  1. It’s a big scare over almost nothing. The panic not only feeds the media, as you pointed out, but also became yet another excuse to jack up appropriations. I wrote a piece about it on my “other” blog at http://www.tomnaughton.com

    Hey, I didn’t even know about this blog.

  2. Thank you, thank you, thank you for your wisdom and reassurance. My dh and I stay away from the media for just the reasons your have outlined. We refuse to give energy to this latest “scare”. Btw, when is your book coming out???
    Cheers,
    Jeanie & Bill Campbell

    It’s coming out in September if the publisher doesn’t come up with another reason to push it off.

  3. I’m glad you’ve targeted the media as the source of this panic; I was aghast as the news people were tossing “pandemic” around so early in the game. I view Biden’s “gaffe” more as a common sense approach *if* there was a pandemic underway. The CDC did, after all, put out a level 5 warning. In a way, Biden’s comments and the ensuing ridicule at least made people question, “Is this serious or isn’t it?” In any event, I wish people would follow the “stay home if you’re sick” advice throughout the year. I’m dismayed at the number of people who show up at work coughing and sneezing and spreading their cooties around just because they don’t want to use sick days, thus forcing me to do so. Our children also must go to school ill because they’re at risk of losing credit for classes if they miss more than a certain number of days. This culture encourages people to press on regardless of the health consequences, and this goes for being underslept as well as being sick.

  4. Hey Mike,

    I agree with you – even on the politics (that may scare both of us!) but could you address one more factor. I’ve heard it said that in many real pandemics the most at risk are those with the best, not the worst immune response – ie healthy adults say between 20 and 40, and the reason given is that the immune system can go into overdrive, and the resultant inflammation and by products of the over the top immune reaction can clog up the lungs (hope this story isn’t in the same category as artery clogging!) and thus lead to more serious side effects – pneumonia I guess would be one?

    If this is so, and as low carbers and Vit D adherents I imagine ‘we’ would have an enhanced immune response – is there a danger (perhaps not with this particular virus) of a less favourable outcome ensuing as a result?

    Cheers,

    Malcolm

    You’re talking about the so-called ‘cytokine storm’ phenomenon. This particular strain of flu is not associated with this problem, but the 1918 version was. I wouldn’t worry about it in this case, especially since no one really knows (as far as I know, at any rate) what actually causes it.

  5. Hi Doc,
    Aussie Mainstream Media have a couple of additional arrows in their scaremonger quiver:
    1. The weather here is cold and winter is around the corner, so the risk for us can be hyped more than in the N hemisphere.
    2. We get treated to headlines like: “3rd Australian has confirmed Swine Flu — in London”. They’ve tested over 300 people here in Oz. Not one confirmed case. Not one.
    But then, Doc E, why don’t you cover the REAL medical issues, like this paper:
    http://www.wine-economics.org/workingpapers/AAWE_WP36.pdf
    I don’t want to give the title away, but I warn you: don’t have a mouthful of coffee while reading the paper’s name!
    OK: the name is: CAN PEOPLE DISTINGUISH PÂTÉ FROM DOG FOOD?
    Michael Richards

    Interesting article on dog food as pate. The authors state:

    In spite of its attractive price, commercial dog food is left virtually untouched by human consumption.

    This is untrue based on at least second-hand experience. Way back in the 70s my best friend in engineering school was a chemical engineering major. His first job after graduation was at a dog food canning facility, of all places. (He finally escaped from there and has been with Exxon for years.) He told me at the time that management estimated that about 10-12 percent of sales went to people buying the dog food to eat themselves because of its low cost. Because of this statistic, the plant had to maintain the same standards as a plant canning food strictly for human consumption.

  6. Hi Dr Mike,

    Do you really think it will be necessary to take either Tamiflu and Relenza if we get this flu ? I’m hearing that it is turning out to be milder than seasonal flu so why take one of these meds ? I have a congenital heart defect (bicuspid aortic valve) but I’ve never had to take anything when I’ve been ill with flu in the past, nor indeed when I’ve had any other viral illness, so I don’t want to bother my doctor unless it’s really necessary.

    That photo is riveting…..isn’t it nice, though potentially dangerous, that little children have no discrimination !

    Anne

    We’re I to get this flu, I would probably take the Tamiflu, but it would depend a great deal on how bad I felt. One of the hallmarks of real influenza is that it comes on suddenly at full force. Most people can remember exactly what they were doing when they came down with it. If it came on strong, I would take the drugs. If it came on mild, I probably wouldn’t…unless I had somewhere to be that necessitated my being in good spirits.

  7. My wife just flew to China the other day, everyone on the plane had to submit to inspection by a team of technicians in full white hazmat suits. This is one dangerous flu, I tell ya!

    Apparently everyone was good natured about it, taking lots of picture, laughing it off, ha haaa. What else can you do?

    I hate to hear that as I am flying to China in a few weeks. Then to London, then back. Flying is enough of a pain when everything goes well. I’m not sure I’m up to the white hazmat suit treatment.

  8. Drs. Eades, I thought you all would appreciate this, if anybody does.

    http://wattsupwiththat.com/2009/05/04/sugar-coated-consumerism-or-just-plain-crap/

    Maybe they’ve stumbled onto some healthy form of sugar? Nah…

    Btw, this is my favorite caption for the kid and pig photo…
    http://icanhascheezburger.com/2007/12/03/bacon-not-done-yet/

    No carbon sugar would be great because it wouldn’t be sugar. I’m sure that spin did give the chemists some heartburn.

  9. I think you’re right on about the vitamin D! I’ve always found a couple of days in the sun is the best possible cure for a cold or flu – works every time.

    It’s a little of subject but I had 2 questions I was hoping you could help me out with:
    1) Do you have a low-carb friendly physician you would recommend in New York City?
    2) After a little over a month of low carb, I had a carby lunch yesterday and felt absolutely terrible. My blood sugar sky-rocketed and I couldn’t focus for several hours. Do the effects of carbs become more noticeable when you’re on the diet, or does insulin take longer because it’s not used to working so hard? Just wondering. Definitely going back to low-carb today!

    I know a couple of low-carb friendly docs in NYC: Keith Berkowitz, M.D. and Fred Pescatore, M.D. Both have written low-carb books, and both practice in NYC. There is also Richard Bernstein, M.D., who practices in Mamaroneck, but who mainly treates those with diabetes, although I think he takes other patients as well.

    If you have been on a low-carb diet for some time, you temporarily decrease the levels of the enzymes needed to deal with carbs because you don’t need them. When you start eating carbs again, you will start producing these enzymes again, but there is a little time lag. During this lag, blood sugar levels can run up. This lag is why it is recommended that you follow a higher-carb diet for a few days before a glucose-tolerance test or your results will show glucose intolerance.

  10. I got the seasonal flu this last winter. No, not confirmed with a nasal swab or anything, but the symptoms were consistent; sudden onset of fever, head ache, horrible myalgias, I felt like dying. This time I treated it homeopathically. Yes, the “pixie dust medicine” as my husband calls it. My doctor had me hourly alternate Influenzinum (based on the yearly flu vaccine) and Oscillococcinum (the one you can get at health food stores). Within a few doses I started to feel better, and felt human again the next morning after a restless sleep. I was amazed at the results. For those of you afraid of the antivirals, homeopathy could be an alternative. I know this is a case report and not a double-blind controlled study but there are interesting reports about the utility of homeopathy esp. in epidemic situations. This fast improvement couldn’t be from flu vaccine immunity as I have not had a vaccine in 10 years—I get an idiopathic spontaneous peritonitis with each flu vaccine that lasts <24 hrs, got it every year until I stopped getting the shot.

    I, myself, haven’t had a flu shot in ages. And I haven’t gotten the flu. MD is a huge believer in Oscillococcinum and recommends it to everyone. I haven’t read a lot on it, but she swears by it. If I were to get the real flu, I would take it in a heartbeat along with the Tamiflu.

  11. What are your thoughts on taking Apple Cider Vinegar everyday to make the immune system stronger? Do you take it? (and it’s ok while pregnant, right? I just bought some.)

    This was a great, useful post to pass on to family and friends, thanks!

    I don’t really think much of it. It’s pretty harmless. The acid in vinegar is so weak that it doesn’t really make any kind of impact when it hits the stomach where the acid is extremely strong. As far as I know, there are no gold-standard studies looking at apple cider vinegar as an immune stimulant.

  12. Yup, my thoughts exactly.

    When in trouble, when in doubt, run in circles, scream and shout.

  13. David H – you are so right. Back in the 80’s when the Harvard Business School redefined firings and layoffs to the more palatable ‘downsizing’! Then, reveling in their glory, they decided that sick leave and vacation could be combined, trah-lah! (for the ‘common folk’ anyway) It would ‘reward’ employees for not taking sick leave because they could then take it as vacation. Well, yeah – most people would go to work with the sniffles if they knew they could take that ‘sick’ day as vacation later on! Oh yeah, don’t let me forget ‘outsourcing’. I think that everyone would agree that is best thing that EVER happened to the American public. Sheesh, those Harvard types sure are smart, aren’t they?

    Problem is that most of those (big) companies that went for this big apparent money saver, had given employees a pretty generous sick-leave policy. I worked at one of them. People started coming to work sick enough to warrant bed rest – and were congratulated by management and actually pointed to as examples of diligence. It must have saved money, companies have adopted that policy and have never looked back.

    Harvard. Just gotta love that place.

    Sigh…

    Cap’n Jan
    If ONLY I had gone to Harvard instead of that little tech school up the river… I could be a ‘captain’ of industry instead of just an over-educated boat captain.

  14. “What’s important to keep in mind in assessing the threat of the current outbreak is that all four of the well-known pandemics seem to have come in waves. The 1918 virus surfaced by March and set in motion a spring and summer wave that hit some communities and skipped others. This first wave was extremely mild, more so even than ordinary influenza: of the 10,313 sailors in the British Grand Fleet who became ill, for example, only four died. But autumn brought a second, more lethal wave, which was followed by a less severe third wave in early 1919.”

    -New York Times: http://www.nytimes.com/2009/04/28/opinion/28barry.html?_r=1&ref=opinion

    Would it hurt to take a look back at history? We could possibly learn a few tings. Also, I think it’s worth noting, of the confirmed deaths in mexico, nearly half of them have been healthy-young adults or healthy-older children. Considering that we’re already dealing with a triple assortment H1N1 swine flu clade, who’s to say that this clade and the H5N1 bird flu don’t meet and re-assort and what would be the implications of this event?

    Who knows what the implications would be? But since 1918 there haven’t been flu pandemics that even approximated that one. Why not? I suspect for exactly the reasons I presented in this post, namely a weakening in virulence in the various strains of the virus. That coupled with increased general health and better nutrition today vs 1918 leads me to believe there won’t be much of a problem.

  15. Glad to read something rational on this flu topic; I tend to ignore most mass media news so most of coverage I’ve caught was on The Daily Show’s Snoutbreak ’09, which was hilarious.

    All common sense seems to have gone out the window, though. My neighbor works at a local biotech company with the mother of one of the San Diego kids who tested positive for Swine Flu (or H1N1 as the Pork Industry wants it to be known). Of course the child couldn’t attend school while she was sick. What does this mom do? She brought her child to work with her! Ok, she’s a single mom, so I know it’s tough to stay home with a sick kid, and personal leave time is limited. Sick people belong at home, period. The child recovered just fine, of course.

  16. Your vitamin D theory makes a lot of sense. Do you think there is there any truth to the theory that viruses don’t survive well in warmer weather and that is why people don’t come down with the flu in summer months? I read some dialog between doctors in an interview; it was pointed out that although Mexico is considered a warm climate, it actually can get quite cold where flu outbreaks have been.

    I go more for the vitamin D theory, which isn’t mine, BTW. You can read about it more fully here.

  17. We had a small discussion at church about the flu. Half of the people in the discussion had read books about the 1918 pandemic or other flu books. One person said that the 1918 flu started in the spring. The people who recovered had immunity. The more virulent mutation was the following winter. She added that it would be better to catch it now than next winter. Is that true? I mentioned healthy immune system and vitamin D on deaf ears.

    I read the wiki pages on the history of epidemics and pandemics. It seems to me that plagues are part of the human experience and we’re due for another. There has been so much change in the last 100 years. One thing that sticks out to me is that people have never used cleaning agents (soap, household cleaners, etc…) more than we do now. I believe there is more to human health than germ theory, but for now, it is the most widely accepted understanding of illness.

  18. Great post, Dr. Mike, I totally agree – the media just loves to play on our natural fears. I guess since the Bird Flu didn’t kill everyone, they had to find a new harbinger of death and destruction.

    People don’t remember the Spanish flu in 1918- if they did, they would realize that associating swine flu with the word “pandemic” is ridiculous. In 1918-1919, an estimated 675,000 Americans died of the Spanish flu, ten times as many as has been killed in the world war of the time. The Spanish flu killed 8 million people in Spain, and millions of others all over the world. Estimates put the final toll at a mind boggling 70 to 100 million people killed worldwide. This is the approximate equivalent of one third of the population of Europe. Now THAT’S a pandemic.

    In addition to Vitamin D, the Weston Price Foundation recommended upping consumption of coconut oil, since it contains monolaurin, an antiviral compound.

  19. Dear Dr Eades,

    Another reason why influenza is becoming less virulent over time might be improved public health monitoring.

    If a mild strain of flu is spreading, you’ll take to your bed for a couple of days, and maybe pass the virus on to some colleagues and family members. If virulent strain is spreading, the public health authorities will hopefully detect it, and start taking heroic measures (like closing Mexico City) to prevent contagion. Thus, a mild strain will have more opportunities to spread than a virulent strain.

    I have heard that the current H1N1 will be in abeyance over the summer, and resurge in the fall and winter. One hopes that by then there will be an effective vaccine.

  20. Dr. Eades,
    I apologize for this question being of the topic of this post. I am re-reading PPLP and have just finished the section on TRANS-fats. Since you wrote this, many food products such as margarines, salad dressings and even potato chips are now sold with labels that state they are now TRANS-fat free. Apart from the effect of say, potato chip starch on insulin, does this improve the nutritional status of these products, at least regarding the types of fatty acids they contain?

    Dan

  21. My question: heavily-discounted Mexican tour packages. Where are they? And who isn’t terrified by our VP?

  22. “who isn’t terrified by our VP?”

    Unless they’re a goofball (Quayle) or evil (Cheney), I just don’t think people really give much thought to the veep. . . until they start running for president themselves. That won’t ever happen with Biden, so the best shot he has is to go the goofball route . . . because I just don’t think he can pull off evil.

  23. The media??? You mean like Fox news showing a huge graphic of a skull & cross-bones with the headline “Next Black Death?”

    Love the cartoons!!!

    Yep. That media.

  24. I have lost track of where I saw it, but someone said that most people who died in the 1918 flu epidemic died from extreme strep throat. Strep throat was a big problem back then, but no longer is. So, if we had the same flu outbreak today, many fewer people would die.

    I have also heard that people who get flu often die from pneumonia, rather than the flu itself.

    Pneumonia can be a big problem on its own, so this may be a moot point; the strep throat thing may have a bigger impact.

    Neither of these matter to the one who died, and their kith and kin, but they may affect how the flu is treated.

    Have you heard about either of these, Dr Eades? Do they really matter in treating the flu?

    I’m not sure the ability to diagnose strep throat was available in 1918, so I don’t know how they would have known it was strep. Viruses such as the influenza virus can cause sore throats and pneumonia, so people who had the flu in 1918 no doubt had these manifestations of the influenza infection.

    Often a serious viral illness can indeed reduce the immune response to the point that bacterial infections are easier to acquire. I’m sure that people with the flu in 1918 were prone to bacterial infections as well, but as to whether those infections played a huge role in the large number of deaths recorded, I don’t know.

  25. “I’m sure that spin did give the chemists some heartburn.” – As a chemist, yes it did. I’ve seen worse though, “chemical free” food products, for one. I cracked up laughing in a supermarket one day, people thought I was quite nuts.

    “People started coming to work sick enough to warrant bed rest – and were congratulated by management and actually pointed to as examples of diligence.” As opposed to reduced workplace efficiency? I’ve always been a firm believer that it’s not how much you work, rather how you work that makes you a good employee.

    As for vitamin D, I’m surprised you didn’t mention that it is fat soluble, therefore people that cut all fat would be less apt to take it up, but I’m sure it’s been discussed before. I remember I never got sick in winter, then I moved south (NZ, so that means more polar). We have less sunlight in the height of winter by the order of a couple of hours than I had growing up. Had a couple of horrible sickly winters, started taking vitamin D supplements and it really helped.

    Good point. I should have mentioned that vit D is fat soluble, but you did it for me. Thanks.

  26. Glad you are calling out the media on this one. As for the government’s reaction, I would rather the government overreact than sit on its haunches… proactive is better in this case I think. Although I don’t think the government is overreacting, I think it is the MEDIA that is blowing everything out of proportion. The government is responding exactly how it should in the case of a new pandemic disease – with caution and vigilance.

    As for the comment about “throwing pandemic around” – pandemic is the accurate term defining an infectious disease that has spread to multiple countries/continents. As compared to epidemic which is disease spreading locally/regionally.

  27. @Terrance
    My own paternal grandfather died of the so-called Spanish Influenza in 1919 in the mountain resort town of Katoomba in the poshest hotel there at the time, The Carrington.
    http://www.bluemts.com.au/tourist/towns/Katoomba.asp
    http://www.thecarrington.com.au/news.asp?pid=12
    Family lore says he had pnuemonia. Then, his wife, my grandmother had to take the body out of the hotel quickly before there was “a scene”. My father and his brother never really knew their father and survived an abusive relationship with their stepfather Cecil, which invovled lots of metal cruelty but not as far as a I know any of the other nasty stuff. Anyway, grandfather was reputed to be a punter and a dandy, and on his death his brother came round and demand from Leah, my grandmother, his fancy suits and shirts. Those were the days.
    Anyway, my father survived childhood and Leah’s strange ideas as to what constituted an “all-round education” (i.e. being constantly moved from school to school). He told me that he was beaten up at either Shore or Cranbrook (dad went to both) by the school bully, one Errol Flynn by name, a nasty boy from Tasmania who went on to other things. His generation — I takes me hat of to ’em — had it tough. The Depression (father’s people were well off, though) and then WWII, where my father flew bombers in the RAAF 460 squadron on raids over Europe. He flew 250 missions. I’ve got to say that our times don’t come close to this level of misfortune.
    Why do I get into these raves?? What dark compulsion is operating here??
    Michael Richards

  28. What do you think about taking vitamin K2 with the vitamin D? Have you read Chris Masterjohn’s piece on the X factor? Its here:

    http://www.westonaprice.org/basicnutrition/vitamin-k2.html#interactions

    I took D for a long time, got a kidney stone, read the article, started taking K2 and have had no more trouble. Fascinating that they figured out in 1986 that K2 deficiency causes kidney stones and nobody ever told the urologists.

    This is the first time I have written in but your blog is the only one I never miss and I love the books you recommend.

    Thanks,
    Phred

  29. Two summers after Katrina, the river near where I live was rising. The National Weather Service predicted it would crest at 12 feet below the level of the dikes. But the county commissioners ordered a *forced* evacuation, including of course the many bedridden nursing home patients.

    In fact, the river did crest at the expected level. I was there on the dikes at the peak. The visual impact of seeing the *dangerous* river a full twelve feet below the top of the dikes was astounding. That’s twice my height. Seeing was far different than just reading the figures.

    There were two offshoots of this Chicken Little panic:

    1) the local media refused to show any images whatsoever of how low the river was. They shot at angles that visually hid the truth. I actually asked one reporter if he was going to show the truth.

    2) The public reacted like parrots saying, “better safe than sorry”.

    I think we can expect the same with this, too.

  30. Michelle writes, “As for the comment about ‘throwing pandemic around’ – pandemic is the accurate term defining an infectious disease that has spread to multiple countries/continents. As compared to epidemic which is disease spreading locally/regionally.”

    Yes, the swine flu has affected multiple countries/continents, but according to Merriam-Webster, a pandemic involves more than just geographic location:

    “occurring over a wide geographic area and affecting an exceptionally high proportion of the population.”

    I wouldn’t call the number of cases “exceptionally high,” at least not yet, and expect the media to be more concise in their classifications before they throw the panic switch.

  31. It might be worth mentioning that although people usually equate sun exposure through their skin, it may be beneficial to acquire some eye exposure. Sunlight into the pupil is said to stimulate both the pineal and pituitary glands, responsible for the production of many different hormones, while enhancing immunity. It also stimulates melatonin production especially if exposure is very early in the day. If I can get sun exposure first thing in the morning, I notice that I wake up at the crack of dawn and over time I sleep better. Many of us wear sunglasses all of
    the time we are outdoors and don’t realize that a little
    sun exposure for the eyes may be beneficial. My doctor said no more than 15 minutes though. From what I have read, that is enough to reap benefits. There is a Dr. Mietes and Dr. Ott who have done a lot of research on the effects of light exposure on the brain and general health.

    I agree. I like to get as much sun as I can.

  32. Hey Mike,

    Thanks for the cytokine storm paper – very interesting, and now I don’t feel so bad about struggling with that other issue we’ve been discussing recently (which also involves a dysfunctional immune system), particularly if that was the simple version! However maybe it isn’t a coincidence that the most promising treatment discussed involves a drug class which improves insulin sensitivity and is also possibly anti inflammatory … now, if only there was a drug free way of doing that … Mind you he then has to spoil it all by saying what a pity it is we are so resistant to the obvious good sense behind statins. Sigh.

    Cheers,

    Malcolm

  33. In response to David H’s comment, “People started coming to work sick enough to warrant bed rest – and were congratulated by management and actually pointed to as examples of diligence.”, I must add that the public schools are even worse for they reward mere children who haven’t the understanding of the need to stay home in order to prevent more spread of viruses.

    These children are given “Perfect Attendance” rewards each month of school if they come to school every day. The children are of course quite proud to receive such an award and apparently so are their foolish parents. However, their awards are every one else’s sacrifice as they will go to school coughing, sneezing, sniffling, etc. and not missing one day during the entire length of a cold or mild flu.

    You might think the schools would send such obviously sick children home but they no longer do as in the past. Their modern standards are restricted to vomiting or fever as the only adequate reason to stay home or be sent home. In fact, the schools are quite apt to require doctors’ notes if your child stays home “too often” which is actually the minimum amount of time an average child would need so as not to spread colds and flus. These “too often” absences are also times for which no parent could continually afford or need to take his child to doctor just for the purpose of providing a doctor’s note. This places an unrealistic, expensive burden on the parents and I would guess most decide it’s just easier and cheaper to send a sick child to school… and there you have it — the abundant spread of viruses thanks to the public schools.

    As in the business world, public schools’ motive is no more admirable and the only difference is it is for the purpose of collecting ADA (Average Daily Attendance) money — the money that is allocated to each school from its Department of Education funding based on attendance of number of pupils times number of days. Those they will swear on their mothers’ graves that their only motive is that their students are not jeopardizing their education by missing too much school, when the choice is between keeping sick kids home or ADA (which it truly is), money wins out.

  34. Not to be argumentative, David H, but according to the WHO, a pandemic is an epidemic that crosses borders.

    “A pandemic is basically a global epidemic — an epidemic that spreads to more than one continent,” says Dan Epstein, a spokesman for the Pan American Health Organization, a regional office of the World Health Organization. (http://www.webmd.com/cold-and-flu/features/what-is-pandemic).

  35. Kab, that was a really good post. This surely happens in a number of households. Another thing is when parents don’t believe their kids are sick and send them to school because they believe they are trying to “pull a sickie”, which yes, kids often do. The trouble is, maybe because of the joined sick/holiday leave mentioned earlier, (we don’t have that in New Zealand, but we still get this problem) people don’t take their sick days when they are sick. They keep them in lieu of pulling a sickie when Coldplay or their sister or the worlds largest sweetpea come into town.

    Dr Mike, What is your opinion on people incessantly wearing face masks? To my understanding they are only effective against viruses and the like for about 10 minutes, after which time they actually aid entry. I thought the point of them was to stop globules of blood and phlegm etc from entering the mouth or nose of a doctor/nurse etc., and if any such material was blocked, the mask was discarded and replace, because it was otherwise just holding the offending material close to said orifices… I’d like to hear your thoughts.

  36. Typical media flogging, although the whole thing has brought up many awesome “The Stand” and “Pandemic 2” references, such as:

    M-O-O-N, that spells swine flu

    Baby, can you dig your man?

    Disease spotted in Western Europe

    The port of Madagascar is closed

    “Pandemic 2” is an incredibly addicting game and a fun answer to “what are you doing?”

    “Trying to wipe humanity off the face of the earth, thanks.”

    http://www.crazymonkeygames.com/Pandemic-2.html

  37. @Kab

    I was a sickly kid and often had to stay home. The amount of money my parents had to spend on doctors just to get the proper paperwork for the school was more than my parents could afford and they were forced to go into debt. Of course the doctors figured I was just lying to get out of school so sometimes we didn’t get that little slip of paper. Often when we did get that paper the school decided not to count it as a lesson to me and my mother. Eventually I learned not to mention when I was sick in any circumstance, the pressure from all sides was just too much. Though my grades were excellent I was considered a bad student and a liar. Even my siblings, parents, and other relatives were treated like crap by the school staff because of me.

    I’m crying now remembering all this. Honest to god, the schools do not care about anything but covering their own behinds.

  38. Read in a reply to a comment that you’re going to China! I just returned from a vacation there and had some excellent meat, especially the duck, of course. The skin was crispy and falls away easily from the meat as it is sliced, and most of the people I traveled with left a lot of the skin on their plate. I happily ate their leftovers! We also had half a piglet’s head (I picked some fat off its cheeks) and its back in Hong Kong, which was more fat than actual meat, and one of the most wonderful things I had. The only downside was that I believe it was fried in vegetable oil. Pic: http://i42.tinypic.com/51q2x5.jpg

    Although there were some good meats to be had, I’m also sure it won’t be long before the Chinese and Japanese diets are no longer hailed as being so healthy… in the big cities (I’m not very certain about deeply rural farmers’ access to convenience foods), the availability of sugar laden sodas and teas, dried fruit candy, and general snack foods made with wheat and sugar is very similar to the US, I found. (Difference being, on the labels I saw, the soda is made with sugar and not HFCS.) Of course, I’m sure those delicious fatty ducks will be blamed and not the crackers and sodas.

    The other thing that piqued my interest was when our tour guide was telling us that some regions are very wheat heavy, preferring to eat more noodles than rice, while others are much more rice-centric. I think it’d be quite interesting to see if there’s any significant health differences between those regions; if the wheat regions are unhealthier as we might suspect. But given that both regions now have access to the above mentioned snacks, I suppose it would introduce too many variables to say definitively.

    My only regret is that since we were on a tour that caters to Americans, we were taken to restaurants that tended to serve more Westernized Chinese dishes, so I didn’t get a very true sampling of what may actually be eaten, and how low-carb the dishes may have been if they were true representations, aside from the rice (which sometimes we did have to ask for, so it may not be as widely consumed as we expect). The piglet was eaten when we were on our own in Hong Kong per a local recommendation.

    What is the name of the restaurant in Hong Kong where you got the pig? It look delicious.

  39. “The whole aim of practical politics is to keep the populace alarmed (and hence clamorous to be led to safety) by menacing it with an endless series of hobgoblins, all of them imaginary.”
    Strange, I don’t remember this quote being used by you in the run up to the Iraq War.
    I guess if you’re not a vet, have no children that are vets, a few thousand soldiers dying for no reason isn’t a big deal. But anything Obama does is cause for alarm.
    Interesting

    First, I wrote that the above quote was more applicable to the press in this case than to the government. Second, I wrote that I agreed with Obama on this issue. Third, the run up to the Iraq War took place two years before I started blogging, so it would have been difficult for me to have used that quote (or any other) at that time. You must parse everything looking for some sort of offense against your beloved Obama, because you really had to dig deeply to find anything even remotely offensive in this post. And when you couldn’t you manufactured something. Nice.

  40. Is Vitamin D the new Vitamin C?

    Just an observation: I take Vitamin D now, like lots of other folks. But it occurred to me the other day as I was taking a little extra to ward off a cold, that I used to load up with Vitamin C for the same reason, and to good effect. Now Vitamin C doesn’t seem to get much attention.

  41. Great Post Doc. Off the point, are you and your family (and property) safe from the Santa Barbara fires? We worry when we read the stories.

    Thanks,

    David and Susan Futoma

  42. Not to be argumentative, Michelle, but a “global epidemic” (pandemic) would seem to me to also require a large number of people to have the swine flu before it’s declared as such. Again, the dictionary defines “epidemic” as:

    1: affecting or tending to affect a disproportionately large number of individuals within a population, community, or region at the same time

    Perhaps the outbreak in Mexico was an epidemic, but I still wouldn’t call this a pandemic yet, global involvement notwithstanding.

  43. Dear Mike,

    I have a private question and I hope it’s ok to ask you.

    For the last 10 days I’ve had muscle weakness, ended up in hospital, come back as polyneruopathy. I just wanted to ask if there’s anything I should direct doctors to relating to low-carb as I’ve been on this strictly for the last year… and I gather this kind of condition can be brought about by some vitamin metabolic disorders (as well as so many other things).

    Sorry to ask a person question, but you are the low-carb expert and my doctors think I’m crazy to be on such an “extreme diet”… such that the last 10 days I’ve been on carbs (a “regular diet”) just to be sure.

    Thanks so much,

    Michael

  44. Doc, it was entertaining to see you slamdunk the Obama drone. But watch out, partisans like Charlie Gibson and Katie Couric might decide to do a smear job on you 🙂

    Still, concerning flu hype, the media has willing allies in at least some of the scientists. Your link to the cytokine storm article led me to another article by the same author(s) from about a year ago:
    http://scienceblogs.com/effectmeasure/2008/06/beware_indonesian_health_minis.php

    wherein the Indonesian Health Minister is slammed for not blaring out news of each H1N1 death as it happens. IOW, if anyone refuses to participate in the hype, then the critics blast you as being an evil idiot. The key element is that the save-the-world types get their social status and sense of superiority from saving everybody, whether anyone needs it or not. Oftentimes, of course, the save-the-world types are also making a living at saving us. What’s maximally important is the personal benefit to the saver. Whatever happens to the supposedly saved is of minimal concern. Facts don’t matter.

    To bring everything full circle, that same author also has a blog article describing how wonderful it is that Obama is bringing “hope and idealism” and how his students “want to save the world”. What a riot.

  45. Dr. Eades,

    Since this is a general health post, maybe this is a good spot for this question.

    What do you make of this autism/vaccine story?

    I don’t have kids, so I haven’t had the need to delve into the studies myself, but it seems like the overwhelming medical consensus is that vaccines DO NOT cause autism. Now, the vast majority of the time consensus gets it right, but given how wrong they were with nutrition over the last few decades it makes me wonder.

    It’s kind of sad that the “overwhelming consensus” isn’t enough for me to believe something. If I did have kid, I would first research this issue before taking the word of the experts.

    Is the research behind the consensus solid?

  46. Hi —

    An unrelated question on cholesterol oxidation. I’ve been thinking a lot lately about the dangers of industrial fats. Specifically refined fats meaning (I’m assuming) fats that have been subjected to high temperatures and chemical extraction. Its a logical to me that intake of highly processed and likely oxidized fat is bad news. Therefore one should avoid most modern vegetable oils unless they’ve been lightly treated like extra virgin olive oil. I’m assuming the “damaged goods” argument carries over to processed cholesterol — so powdered eggs and milk should be avoided.

    Which brings me to one of my pantry staples –whey protein. Whatayathink? I use the EAS brand which has 70mg cholesterol per serving — I’ve sworn by the stuff for years but now I’m worried about frequently ingesting small amounts of damaged fat. (after years of unknowingly ingesting large amounts of it — but who’s counting)

    Its a good reason to give ImmunoPro a second thought at least (Sorry I was never sold on the non-denatured protein argument — although I’m receptive to learning more on that as well)

    Thanks-

  47. I hope you are out of the way of the fires in Santa Barbara!

    I was told that I shouldn’t take magnesium and calcium together as the calcium binds up the magnesium. Is that so? I eat some dairy, do I even need calcium?

    Love the book recommendations.

    Make sure the magnesium is of the chelated variety and you won’t have a problem. You can tell it is chelated if it has an ‘ate’ on the end of it, as in magnesium aspartate or magnesium citramate, etc.

  48. Off topic: Krill Oil
    I know that you have absolutely nothing to do – not! LOL

    When you do have a moment to breathe, sure would love to see that info on various Krill Oils. I have great success with NKO, and love it. However, my son has been looking into Superba Krill from Jedwards International. Their CEO’s claims are as follows:

    “Neptune, as you know, is also a supplier of Krill Oil and as you mentioned does have a patent, but that patent is on the extraction process that they use not Krill Oil itself.
    The krill that we offer is Superba brand Krill Oil, which is manufactured by Aker Biomarine, a Norwegian Company. http://www.akerbiomarine.com/ Honestly our specs are pretty similar to NKO but I think we have typically higher levels of phospholipids, EPA, DHA and omega-3 fatty acids, even though their specs claim otherwise. Our Astaxanthin is lower but this is most likely due to the fact that our material is extracted with ethanol (drinking alcohol) while NKO uses acetone (nail polish remover, which is their patent). ”

    The extraction chemicals don’t sound great, but would really appreciate your take on this and possibly other brands/processes, etc.

    Thanks

    Corky

    There are various ways of extracting krill oil from the krill. Neptune has one way, which they have patented, while other companies have other ways. So far, all the published studies on the benefits of krill oil (which are many) have been done using NKO. And NKO has all the certifications for purity, strength, etc from all the various regulatory agencies around the world, which, as of yet, these other companies don’t have. Until I see the studies using the other brands of krill oil and showing positive outcomes, I’m sticking with NKO. I have no affiliation or investment in Neptune Technologies, so I have no self-interest at stake in this.

  49. Just checking in to see how you folks are doing – that wildfire you have sounds like a bad one. Hope you don’t need to evacuate! Keep us posted when you get a chance.

  50. Dr. Eades, you wrote: “MD and I have gotten calls from friends and family all over the place wanting us to call them in prescriptions for these drugs, but we have refused because we don’t want to deplete supplies (which are limited) for those who actually get the flu.”

    Permit me to recommend the column “The Dilemma of Personal Stockpiling of Tamiflu” written by Peter M. Sandman, Ph.D. and Dr. Jody Lanard, M.D. at http://www.psandman.com/col/tamiflu.htm. It discusses the ethical dilemma(s) and considerations of individual “stockpiling” (prescriptions) vs. govt control of antivirals.

    Love your books, blogs, and twittering!

    Thanks for the long, interesting column.

  51. Excellent point about the evolution of the virus towards a less fatal form. AFAIK this has also happened to strep over time, it “learned” to become less annoying so it would not be blatted with antiobiotics and thus spread further. Meanwhile of course staph has taken the opposite evolutionary course, developing antibiotic resistance and becoming more virulent.

    The bird flu “epidemic” in the UK was actually in a turkey factory just the other side of town, we could see the news helicopter hovering above the plant for days. That was tough on the turkeys but a fart in a colander as far as the human population was concerned. Mind you I know few local people who work there and even fewer who eat their product, which may have helped.

    We had a New Manager where I used to work: he pulled in everyone who’d had more than one sick day in three years for a verbal warning. One of my colleagues had a breast removed (cancer) and was so paranoid about losing her job she used to take holiday days for her chemo, which is appalling. Quite illegal too but with unemployment as it was probably very widespread. Said manager used to drag himself in to work coughing and hacking all over everybody else. Another colleague got through his cancer surgery, chemo and radiation and then died of pneumonia. Are these events connected?

    OTOH there may be something to be said for building up immunity over the years through exposure to minor illnesses, mother and other teachers, shopkeepers and others who have wide exposure to the public and their diseases seem to find themselves less prone to catching stuff over time, I suspect this may also apply to doctors? Then again such people may be vectors for diseases they don’t actually catch themselves, a substantial number of people seem to go to the doctor or hospital with one thing and come out with a couple of others. 🙁

    What would be REALLY useful would be to discover why this particular strain appears to have been so virulent in Mexico and so comparatively mild everywhere else.

  52. Dr. Eades, not sure if you mentioned this here or another post: You said you take 5,000 IU Vitamin D3 capsules when you are not in the sun and you take 50,000 when you feel like you are coming down with something or taking long flights. I could only find 2,000 IU Vitamins. Does this mean I have to take 25 of these when I feel like I’m coming down with something? I feel so ignorant when it comes to vitamins.

    We have both the 50,000 IU caps and the 5,000 IU caps on our site (www.mreades.wpengine.com) in the products section. You can also find them other places online.

  53. This is a nice tip of yours to avoid swine flu. In the latest news today, India was the latest country to be affected by swine flu and still increasing on the parts of America, Asia and Europe. Thanks for this great article!

  54. Two different years, an elderly relative and an older acquaintance of mine became extremely ill after having been pressured into getting flu shots. Neither had had a flu shot or even “flu like symptoms” in many years, but as they got older concerned friends and family members would insist more and more that they ought to go in and get one. After all, they’re free right? (In Canada anyway).

    So they did and both—within about a day and a half in each case—ended up sick in bed for about a week, one was moved to the hospital and came within an inch of his life. Since then one has continued getting shots and the other hasn’t ever, but both have gotten sick every year since then (thank God not nearly as badly as the first time.)

    They both regret having those first shots. Maybe they were bad batches?

    I personally haven’t gotten a flu shot in my life (maybe when I was five or six)… I’m 26 now and I very rarely get sick. When I do it’s never a big deal; I never take medication (if it was a matter of life and death I would, of course) and I always feel better afterward than I did before becoming ill.

  55. I guess the scary part of the swine flu is that healthy people seem to get it worst.

    One theory behind this is the cytokine storm – an out-of-control immune response that can be lethal. The Vitamin D Council agrees with you that high quantities (at least 5,000 IU) of vitamin D3 may be good, but they also warn that it may be better to take none at all than to take just a little. So, either take >5,000 IU or stay vitamin D deficient (the latter choice only being a good idea in the case of cytokine storms).

    Usually, preventing inflammation is a good thing, but it’s possible that some anti-inflammatory cytokines are actually a bad thing if you get the swine flu.

    For more information on which foods and supplements may be a good idea and which may not, see this post: Swine flu and the cytokine storm – what to eat and what not to eat. Keep in mind, though, that it’s more speculation than concrete evidence.

    At least green tea appears to be good even for avoiding the swine influenza 🙂

    – JLL

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