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Perspectives on Life Changes
Fending off the Flu
Dietary Supplements for Flu
Policosanol and Cholesterol Revisited
Ask Dr. J: Allergies
References
In the Health News
Diet and Disease
Recipe of the Month: Mushroom Medleys
Dear Friends,
I have had an eventful year, with the death of my father
after a mostly healthy life until 95 years old (perhaps helped
by all those vitamins that he finally agreed to take and his
lifelong abhorrence of butter), followed by my heart surgery
to correct a congenital valve problem, selling our home of
20 years to move to Florida during the cold northeastern weather,
and travel to Japan as a consultant. I managed to write all
of my newsletters, almost on time, although with shortened
versions after my surgery and just after the move to Florida.
All of this helps me to maintain perspective on what is important
in life, such as healthy lifestyle, relationships, maintaining
aesthetic interests, humor, and personal growth. In times
of serious life changes, it is valuable to reflect on your
goals, your dreams, and everyday interests, remembering to
appreciate each moment along your path (achieving one goal
just puts you on the next path to another).
Having many major changes in your life usually increases
the risk of developing a serious illness. But this is a statistic,
based on what often happens, and I believe that it is not
inevitable to fall victim to circumstances. Taking good care
of yourself removes you from the statistical norm. Whether
you develop a serious illness or maintain vibrant good health
is almost completely a function of lifestyle choices (but
not always, so there is no reason to feel guilty if you do
become ill).
When going through significant life changes it can be difficult
to make the right choices—who finds it easy to exercise
when overtaken by anxiety for a sick relative, to eat healthfully
when time is limited, or to stay relaxed when changing jobs
or houses? It is certainly helpful to have a good support
system, as I have had, but it is also important to develop
healthy living and personal interests over a long period of
time so they become ingrained in your way of being. It is
never too late to start taking good care of yourself through
good health practices, but it is also never too early to start.
That way, when life changes, good health habits will be as
routine as brushing your teeth, and although you may encounter
more difficulty it will not be impossible.
Fortunately, I have been practicing healthy living since
1975, when I was 31 years old (perhaps anticipating the inevitable
repair of my heart valve). As a result, in spite of all the
changes, I have recovered well from heart surgery, am feeling
good and I’m back to running and other physical activity.
We are starting a Florida garden, hoping for more tomato and
basil crops, as well as flowers.
I hope my own experience can serve as an inspiration to my
patients, my lecture audiences, and my readers. I wish you
all a Happy New Year, full of peace and joy, and vibrant healthy
living.
The question always comes up at this time of year —
“should I get a flu shot?” This is not easy to
answer, as it depends on many variables. A flu shot might
be advisable for someone who is at high risk of developing
serious illness if they do get the flu, such as the frail
elderly, asthmatics, chronic bronchitis or emphysema patients,
those with poorly controlled diabetes, or with compromised
immune systems (AIDS patients and advanced cancer patients).
Flu vaccines contain killed or attenuated viruses that stimulate
the formation of antibodies to the most current strains of
influenza viruses, but not to all of them. It is still possible
to get the flu even if you are immunized. If you are severely
allergic to eggs, you should not get injections of flu vaccine.
Although toxins are present in the vaccines (aluminum, mercury,
preservatives) the occasional exposure should not pose a serious
risk, unless you are particularly sensitive.
Symptoms of the flu are much like a severe cold, with sneezing,
coughing, congestion, and sore throat, usually with muscle
aches, fatigue, and fever. Flu will usually last longer than
a cold, and it is more debilitating. Even if you do get the
flu, it is likely that you will fully recover, just as you
would from a cold, but people at high risk may develop life-threatening
complications.
I have not had a flu shot myself, so I take measures to prevent
communicable diseases which are just good hygiene for everyone.
They should also help protect you if you decide not to have
a flu shot. Wash your hands and use hand sanitizer frequently,
especially after being in public places or contacting people
at parties. Take care not to share drinking glasses or utensils
with anyone who might be ill.
In cold climates, it is important to humidify your home to
prevent dryness of the mucous membranes in your sinuses, airways,
and lungs. Healthy mucous membranes help to ward off infections.
I always recommend, taking care of your health habits to maintain
your immune system and prevent infections. Regular exercise,
healthy diet, and stress management have all been proven to
enhance immunity. Elderly people who do get a flu vaccine
have an improved immune response if they are physically active.
It also helps to take a variety of dietary supplements, not
only to maintain your mucous membranes, but also to support
your immune system and to kill flu viruses.
Vitamin C enhances immune function and improves the ability
of white blood cells to fight off viruses. It also provides
some symptom relief, and reduces the duration of the infection.
Although not all studies agree, it appears that overall high
doses of vitamin C do prevent and shorten viral infections,
including flu. A 1999 report of a placebo controlled study
showed an 85 percent reduction in cold and flu symptoms when
subjects were given 1000 mg of vitamin C every hour for 6
hours and then 3000 mg daily.
Vitamin C has been controversial since Linus Pauling’s
book was published in 1977, and the antagonism to it has led
to some misleading scientific reports. A reassessment of one
of the earlier negative reviews showed that indeed vitamin
C significantly reduced severity and duration of viral infection
symptoms.
A standardized extract of elderberry is effective in killing
flu viruses in laboratory tests. Although laboratory tests
do not always correlate with clinical results, elderberry
does help. In a placebo-controlled study, 93 percent of the
test subjects improved within two days, (compared to six days
in the placebo group), and they were cured in two to three
days (compared to more than 6 days in the controls). Although
the study was small, it was very promising.
Elderberry extract also enhances immune function through
its effect on cell messengers, and it contains antioxidants
and flavonoids, including quercetin. It influences the balance
of inflammation and anti-inflammatory processes. I usually
recommend 1000 mg of standardized elderberry extract twice
a day at the onset of symptoms, or if someone has been exposed
to the virus, and then 500 mg twice a day until symptoms clear.
Echinacea (250 mg of standardized extract twice a day) enhances
immunity and helps clear symptoms of flu more quickly. Garlic,
ginseng, beta 1,3 glucan, and other supplements can also help
immunity. Whatever you decide about the flu shot, it is a
good idea to protect yourself in other ways at the same time.
Policosanol, a mixture of waxy alcohols derived from sugar
cane, rice bran oil, or wheat germ oil, has remarkable benefits
for atherosclerosis that go beyond lowering cholesterol. Doctors
recommend statin drugs to lower cholesterol, often even for
people with normal serum levels, noting that these drugs have
other benefits in stabilizing plaque and protecting endothelial
cells.
A friend told me that she lowered her cholesterol from 224
to 178 by taking policosanol, but her doctor was concerned
that she might not be getting “all the benefits”
of statins (but of course she was also avoiding the side effects).
I suggested vitamin C to protect the endothelium, and then
reviewed the recent research on policosanol.
I found that policosanol is better than statins on many counts.
In a comparative study with pravastatin, policosanol offered
greater protection of the endothelium, better inhibition of
platelet aggregation, and improved HDL levels. Compared to
lovastatin it is better at reducing arterial thickening in
animal studies.
While the most effective statin, Lipitor, is slightly better
at lowering total cholesterol than policosanol, it does not
raise HDL, so the risk reduction is identical. Policosanol
equals Lipitor at lowering triglyceride levels, and it protects
LDL cholesterol from oxidation. Oxidized LDL is a risk factor
for atherosclerosis.
Policosanol has further clinical benefits. In a study of
intermittent claudication (pain in the legs on exercise),
policosanol treatment increased walking distance by 60 percent
within 6 months, and at the end of two years by 200 to 300
percent. A recent 5-month study showed that policosanol was
better than lovastatin for improving claudication, and it
also lowered serum fibrinogen, a risk for heart disease.
Statins can cause a severe muscle breakdown called rhabdomyolysis,
with leakage of cell contents into the circulation. They reduce
the production of coenzyme Q10, increasing the risk and severity
of congestive heart failure, and they may not reduce overall
mortality. The evidence suggests that patients should be given
low-cost policosanol (10 to 20 mg) instead of expensive statin
drugs. It is time for the medical profession to learn and
apply this information.
Q. I take a prescription allergy medication
year round, and would like some natural replacements.
—LW, via Email
A. Allergies can often be managed without
drugs. Cleaning the environment is the first step, with HEPA
air filters and avoiding pets and other allergens. Eliminating
food sensitivities can help. With sinus allergies milk is
a common cause, but other foods may also give you symptoms.
Stress can make allergies (and asthma) worse, and visualization
techniques can help clear sinus congestion. You might also
try allergy shots after serial dilution skin testing.
Supplements may reduce symptoms enough to eliminate drugs.
Quercetin, a flavonoid that helps reduce histamine release
(1200 mg daily), and stinging nettle (500 to 100 mg of standardized
extract) have helped many of my patients. I also recommend
vitamin C (3000 to 6000 mg) as an anti-histamine and anti-inflammatory.
Gamma linolenic acid (GLA, 240 mg) may also help.
Kohut ML, Exercise and psychosocial factors
modulate immunity to influenza... J Gerontol A Biol Sci Med
Sci 2002 Sep;57(9):M557-62.
Gorton HC, Jarvis K, The effectiveness
of vitamin C in...virus-... infections. J Manipulative Physiol
Ther 1999 Oct;22(8):530-3.
Hemila H, Does vitamin C alleviate the
symptoms of the common cold?—a review... Scand J Infect
Dis 1994;26(1):1-6.
Hemila H, Herman ZS, Vitamin C and the
common cold: a retrospective analysis... J Am Coll Nutr 1995
Apr;14(2):116-23.
Zakay-Rones Z, et al., Inhibition of several
strains of influenza virus in vitro and reduction of symptoms
by an elderberry extract .... J Altern Complement Med 1995
Winter;1(4):361-9.
Barak V, et al., The effect of ...elderberry...on
the production of human cytokines... Eur Cytokine Netw 2001
Apr-Jun;12(2):290-6.
Barak V, et al., The effect of herbal remedies
on the production of ...cytokines. Isr Med Assoc J 2002 Nov;4(11
Suppl):919-22.
Bauer R, ...the effect and effectiveness
of Echinacea purpurea extracts. Wien Med Wochenschr 2002;152(15-16):407-11.
Castano G, et al., Effects of policosanol
and pravastatin on lipid profile, platelet aggregation and
endothelemia... Int J Clin Pharmacol Res 1999;19(4):105-16.
Castano G, et al., Comparison of the efficacy
and tolerability of policosanol with atorvastatin.... Drugs
Aging 2003;20(2):153-63.
Menendez R, et al., Effects of policosanol
treatment on ...LDL... oxidative modification... Br J Clin
Pharmacol 2000 Sep;50(3):255-62.
Castano G, et al., A long-term study of
policosanol in the treatment of intermittent claudication.
Angiology 2001 Feb;52(2):115-25.
Noa M, A comparative study of policosanol
vs lovastatin on intimal thickening.... Pharmacol Res 2001
Jan;43(1):31-7.
Castano G, et al., Effects of policosanol
and lovastatin in patients with intermittent claudication...
Angiology 2003 Jan;54(1):25-38.
Omar MA, Wilson JP, FDA adverse event reports
on statin-associated rhabdomyolysis. Ann Pharmacother 2002
Feb;36(2):288-95.
ALLHAT…Research Group, Major outcomes
in...patients ...pravastatin vs usual care... JAMA 2002 Dec
18;288(23):2998-3007.
- Coenzyme Q10 has a wide variety of health benefits, particularly
for angina, congestive heart failure, and brain degeneration.
A recent randomized, controlled, double-blind study shows
that 120 mg of coQ10 daily for one year prevents recurrent
heart attacks. Heart attacks were cut in half in the coQ10
group, and deaths were significantly reduced. Those treated
with coQ10 had an increase in HDL levels and serum vitamin
E. Both groups received the same level statin drug therapy,
but the coQ10 made a dramatic difference. (Singh RB, et
al., Effect of coenzyme Q10 on risk of atherosclerosis in
patients with recent myocardial infarction. Mol Cell Biochem.
2003 Apr;246(1-2):75-82.)
- Mild dehydration is common in the elderly and with extended
or hot-weather exercise. You need adequate fluid, including
water, soups, herb teas, and juices, as well as the fluid
in fruits and vegetables (but not caffeine beverages). (Maughan
RJ, Impact of mild dehydration on wellness and on exercise
performance. Eur J Clin Nutr. 2003 Dec;57 Suppl 2:S19-23.)
Dehydration reduces alertness, and concentration, causes
headache, tiredness, and poor athletic performance, and
increases the risk of kidney stones, some cancers, and perhaps
diabetes and heart disease.
Amazon rainforest dwellers in Brazil accumulate mercury from
fish in their diet. However, those who ate the most tropical
fruit had much lower tissue mercury. The authors speculated
that fruit phyto-chemicals and fiber might prevent absorption,
promote excretion and protein binding, and influence mercury
transport. (Passos CJ, et al., Eating tropical fruit reduces
mercury exposure from fish consumption in the Brazilian Amazon.
Environ Res. 2003 Oct;93(2):123-30.) If you include fish in
your diet, be sure to maintain fiber and fruit consumption
to protect against mercury.
With the flu season in full swing, adding delicious mushrooms
to your diet, such as shiitake, portobello, and others, may
help support immune function, and they can be prepared in
a variety of ways. Cooking increases the nutritional value
by breaking down the cell walls. I like to pan-fry portobello,
shiitake, enoki, and oyster mushrooms with some olive oil,
garlic, pepper, and lemon. You can also try chicken-of-the-woods,
morels, chanterelles, and crimini (young portabellos). These
can all be skewered and grilled, alternating with tomato,
bell pepper, tofu squares, and onion, and coated with crushed
garlic, ginger, and dilute soy sauce. After cooking, they
can be served on a bed of wilted greens (spinach, chard, beet
greens, mustard greens, or radish tops) accompanied by brown
rice or roasted potato. I have asked a local restaurant to
make a meal like this for an evening out–it is amazing
what you can get these days with advance planning.
Year-round phone: 386-409-7747
180 Massachusetts Ave.,
Arlington, MA 02474
225 North Causeway, New Smyrna Beach, FL 32169
3 Overlook Dr., Suite 3, Amherst, NH 03131
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