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Upper Respiratory Infection; Colds and Flu

 
The patterns of the seasons often have a significant impact on our health. As the weather cools and the days shorten we spend more time indoors. We are exposed to each other in confined environments. The air we breathe is heated and in the process dehydrated. Our exposure to dust and mold particles and other indoor contaminants is increased.  The shorter days can have an adverse effect on our immune systems. Our increasing need and penchant for travel results in greater exposure to viral and bacterial pathogens. As we jet around in the confined environment of an airplane our exposure increases significantly.

The public is intolerant of feeling ill for even a few days. In our fast-paced world we have no time to tolerate an illness that is asking us to slow down, re-center, recover. People want to get rid of an illness quickly to minimize inconvenience. There is a perception that an outside force has attacked them. They request a medication to expel it. A quick call to the physicians’ office with the right story yields an antibiotic. The person believes that they are on their way to recovery. Should the first antibiotic fail, there is always a second. The belief being that the first antibiotic was the incorrect one. In fact, in more than half of the cases of infections of the respiratory system an antibiotic is useless. Antibiotics designed to fight bacteria do not help when the infectious agent is a virus. It is very difficult to determine whether any group of symptoms represents a viral infection or a bacterial infection over the phone. It is slightly less difficult in person. I believe that it is important to examine a patient before starting an antibiotic.

The over use of antibiotics has resulted in a phenomenon known as antibiotic resistance. Bacterial agents that are a common cause of pneumonia have become increasingly resistant to our commonly used antibiotics. Using antibiotics when not necessary is not just wasteful; it is dangerous. There are reasonable strategies to manage the symptoms of early respiratory tract infections without resorting to antibiotic use prematurely.

Strategies for minimizing incidence and severity of upper respiratory infection can be grouped into Prevention Strategies and Treatment Strategies.

Prevention Strategies:

1. Strategies that reduce exposure to irritating substances include:

1. 1. Avoiding situations where exposure to other infected people is likely. This is the least practical strategy. Nevertheless, under certain circumstances it is reasonable to avoid large crowds in small spaces. This is particularly true when resistance is reduced from fatigue, stress or other illness. This is a strategy that many people with chronic health problems practice with success.
   2. Optimizing the air quality in our home and work environments can be a very effective preventive strategy. Central air filters and register filters are available at a variety of prices. Dust covers for mattress and pillows can be very effective. Forced air heat systems dehydrate the air. The dry air causes injury to our mucous membranes and makes us more vulnerable to infection. An optimal humidity level is 45%. This can be measured with a hygrometer. Air humidity can be controlled with central humidifiers and room humidifiers. Humidifiers can be a source of “white dust,” bacteria and mold products. Special attention should be given to the purchase of products that do not create these problems.
   3. Animal dander is a common cause of persistent upper respiratory problems. In patients with severe problems we advise removing the animals from the home. At the very least, keep them out of the bedroom. This is where a HEPA filter is valuable.
   4. Mold is often a culprit for people with recurrent upper respiratory problems. The mold issue is complex in that mold exposure can occur from molds in the environment or mold in or on the body. Mold sensitivity can cause a multitude of symptoms including respiratory symptoms. A patient history that would lead to consideration of Mold Allergy/Sensitivity includes:
      • A past exposure to a moldy environment
      • Current exposure to a house or work place where there is water damage or dampness as shown by mold growing on a visible or hidden surface.
      • Sensitivity to petrochemicals
      • A history of antibiotic use
      • Excess intake of vinegar
      • Recurring vaginal yeast infections
      • Recurring or persistent skin infections with fungi
      • Onychomycosis or fungus infection of the toe nails
      • Dyshidrosis is a skin condition characterized by tiny blisters on the hands or feet that are itchy.
      • Nummular eczema is a skin condition characterized by round, red or pink, pruritic skin lesions on the torso or extremities. No mold is present in the actual rash; however, it is often a sign of mold irritation from elsewhere in the body or environment.

Strategies that deal with Mold Allergy/Sensitivity include:

• • • Environmental mitigation. This means reducing the burden of exposure.
    • Dietary avoidance of foods that contain molds or mold by-products and foods that encourage mold growth (concentrated sweets and starches and vinegar rich foods)
    • Desensitization is the process of reducing the immune hyper-reactivity through exposure to the irritating product in graduated amounts. This can be done through the classical allergy shots. In the field of complimentary/alternative medicine it can be done through sub-lingual desensitization techniques.

2. Strategies that increase resistance to infection:

   We protect ourselves from the effects of the outside environment in many ways. Some are simple and obvious and some are complex and obtuse. The preventive adaptations of our biology are common to all of us. The strengths and weaknesses of any single adaptive/preventive mechanism vary for each person. This is a preliminary review of these issues.

   Immunologic Imbalance
   Our immunologic systems are complex. We have two basic sub-systems:  Cell Mediated immunity (TH1) and humeral mediated immunity (TH2). The systems must be in proper balance to allow the body to protect itself from infection by bacteria, virus, fungi and parasites. Imbalance and or inadequacy of one or both components of our immunologic system explain the variability in susceptibility and severity of illness between individuals. There are many factors that cause immunologic imbalance. They include: physical stresses, psychological stress, social stress, sleep disturbance, underlying illness and improper nutrition. We have many strategies to improve immunologic balance. Clearly, the most important components of any strategy are under the individuals’ control. Our practitioners aid the individual through practices such as Nutritional Supplementation, traditional Chinese medicine, Western herbal medicine, hormonal balancing and yoga therapy. Products that we have found useful include:

   • • Vitamin and mineral supplements: Vitamin C, Vitamin A, Zinc
     • Herbal products such as Immucare I and Immucare II
     • Oxidative therapy
     • Yoga breath training (Pranayama)

Treatment Strategies
Treatment strategies involve therapies that may help the body fight infection or manage symptoms while the person musters the immune response to fight the infection. Strategies for fighting the infection may include immune stimulation and the use of products known to inhibit bacterial or viral activity. Strategies that involve symptom control will vary depending on the individual and their symptoms. Aside from “taking stuff” to feel better you must remember that an illness is a message from your body and environment. Slow down and get the message. Restorative rest is the key to a good recovery. Illnesses that linger are blamed upon the incorrect diagnosis or treatment. This is often the case. However, just as often the cause is the individuals’ failure to take the opportunity to rest, to take the antibiotics or supplements appropriately or to reduce harmful environmental exposures. “I have a problem and I’ve come to you to take it away.” This is the attitude that results in a poor clinical outcome.

Products that stimulate immune function and may inhibit viral and bacterial activity include:

• Vitamin and mineral supplements: Vitamin C, Vitamin A, Zinc
• Herbal products such as Flu Away
• High dose oral Vitamin C: BioEnergy; 1 tsp every 2-4 hours to bowel tolerance
• IV Vitamin C infusions
• Oxidative therapies

Strategies for Symptom Control:
Many of the herbal and Neutraceutical products that are used for symptom control have antiviral and antibacterial properties. When attempting to treat patients with herbal preparations we attempt to fit the treatment to the individual. Here are some examples of how we approach the process.

Cold damp conditions require warming and drying herbs. Symptoms may include wheezing. There is excessive mucous production. The mucous is typically white or clear. The patient gets cold easily. They get relief from hot drinks and covering up to increase warmth. Herbs that may be considered are Ground Ivy, Horehound, Mullein, Grindelia, Osha and Yerba Santa.

Cold dry conditions require warming and moistening herbs. Symptoms may include wheezing. Other symptoms include a dry mouth and dry throat. There is often a ticklish cough that is not associated with sputum production. When there is sputum production it is very dry and sticky and difficult to bring up. Herbs that may be useful for this pattern include Licorice and Spikenard. One can also consider the Lung Tonics such as Chinese Asparagus Root, Irish Moss, Marshmallow and Slippery Elm. The Lung Tonics are useful in chronic conditions.

Hot damp conditions require cooling and drying herbs. Symptoms may include fever. When a cough is present it is often sharp and painful. The mucous is yellow, green or streaked with blood. Herbs that may be useful are Ground Ivy and Usnia.

Hot dry conditions require cooling and moistening herbs. Symptoms may include fever. There may be a dry irritating cough. The cough may not produce any sputum. When there is sputum it is very sticky and hard to bring up. Herbs that may be useful are Elecampane, Irish Moss, and Marshmallow.

Many herbal preparations have background ingredients that can be used in all types of situations with benefit.

• Herbs that normalize lung function are called Tonics, Amphoterics and Pectorals by different traditions. They include Prince Seng, Chinese Asparagus Root, Irish Moss, Slippery Elm and Marshmallow.
• Herbs with antiviral and antibacterial activity include Elecampane, Garlic and Ground Ivy.
• Horehound is a mild expectorant that can be used in both dry and wet conditions.
• Herbs that may normalize immune function and thus help Allergic Symptoms include Ganoderma, Maitake, Scoot Root and Schizandra Berry.
• Herbs that may be useful for Sore Throat include Elderberry, Licorice and Sage.
• Herbs that may be useful for persistent cough include Licorice, Mullein, Wild Cherry Bark, Sun Do and Blood Root. This mixture should only be used under the supervision of a health practitioner.

A skilled herbalist recommends treatment based on the persons unique condition. The more details the herbalist has the more the formula can be individualized. Taking an individual herb or an herbal formula that does not match the condition can aggravate the situation.  We do not advocate that people treat themselves without professional advice.

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