Influenza and Viral Resistance from Paul S. Anderson, ND

Here is an article written by Dr. Paul Anderson, a doctor who is favored by many a Bastyr student. Courtesy of Anderson Medical Specialty Associates.

Influenza and Viral Resistance
Paul S. Anderson, ND
Medical Director – Anderson Medical Specialty Associates
Introduction:
Seasonal Influenza, H1N1, and even the “common cold” are seemingly inevitable. Questions arise regarding the ability to lower the risk of infection as well as measures which may shorten the duration of illness should one become infected. This paper will look at known and less known measures particular to influenza and generally to viral infections.
Immunity and Hygiene:
Hygienic measures are common to human general immunity. Things such as hand washing, avoidance of infected persons, and staying home if infected are well publicized measures. Other measures which can affect the ability of the human body to resist infection, and fight infection in a more efficient way include the following.
Sleep: Proper rest is essential to the removal of oxidants and toxins from the body (all of which can slow immune function) but also sleep is involved in the regeneration of immune cell function in the human body (Lange). Sleep deprivation is known to increase the chance of becoming infected if exposed.
Exercise: General exercise or movement daily is associated with improved immunity. In some studies extreme levels of exercise are associated with decreased immune function however, so cold and flu season is likely not the time to start a strenuous exercise program you are not used to(UI).. Taking a walk daily is an excellent way to get your body moving, and will help circulate your blood and aid the body in removing toxins and oxidants
Stress: Stress has varied presentations and varied effect on the human immune system. The best way to summarize thirty years research into stress and immunity (Segerstrom) would really be that your response to the stress makes a very big difference in how it affects your immunity. Generally stress has negative effect on immunity; however some stressors are more damaging than others. Keeping a healthy relationship to your own stressors (not feeling like a victim, talking about it, changing your surroundings, exercising etc.) is the best way to minimize any negative effect stress may have on your body.
Diet: A few basic principles can guide healthy eating habits. Sugar is a stressor on the immune system, so any excess sugars should be minimized in order to improve immune function. Simple sugars and refines processed foods are the worst offenders, but all sugar intake should be limited (Bernstein) (Sanchez). In general lean protein sources, high fiber carbohydrate containing foods and lots of brightly colored vegetables offer the most nutrition per calorie, and the least likely negative effect on immunity and health.
Additionally, a diet supportive of proper GI flora balance (the bacteria that live in the GI tract and maintain digestive and immune function there) may have a great impact on your general immunity (Huffnagle, Rees). In general occasional supplementation with lactobacillus acidophilus, bifido bacteria and fructo-oligo saccharides (FOS) are enough to aid this portion of immunity. Antibiotic use orally and long illnesses can decrease these good bacteria, so supplementing after those events is recommended.

Nutrients, Botanicals and Viral Immunity:
(This section synthesized from Cannell, Cathcart, Huffnagle, Reese, Serkedjieva, Thorne and Zakay-Rones)
Vitamin D:
Vitamin D has known anti-viral properties [1] and has been directly associated with fighting influenza in a recent scientific review. 
If a person has vitamin D levels on their blood testing that are less than the upper 25% of the listed reference range they should take 5000 IU vitamin D daily to raise those levels. During an active infection extra vitamin D is required. Cannell recommends 2000IU per kilogram of body weight, but at least 50,000 IU per day while ill is a good start. In a viral infection, the body can draw on vitamin D stores to supply the increased needs of the immune system. Supplementation with 4,000 to 10,000 IU/day doses for a few days after an illness can replenish the body stores of Vitamin D if the person had good levels prior to the illness. 
Vitamin C:
Quote from Cannell: “Strong evidence shows that high doses of vitamin C prevent common colds and reduce a cold’s severity and duration. Given the similarities between cold and influenza viruses, the scientific case for treating influenza with vitamin C has been investigated and shown to have merit. Fighting influenza with vitamin C has been tested in the clinical setting and reported to be effective at very high doses.”
Dr Robert Cathcart was one of the pioneers in oral high dose vitamin C during acute infections. He would have patients take 2000 mg vitamin C every one to two hours at the first sign of illness, until their bowels became loose (or “to bowel tolerance”) (Cathcart). High dose vitamin C (20,000 and 100,000 mg/day) are surprisingly well tolerated during periods when the immune system is fighting viral infections. This kind of acute dosing is best divided into as many doses per day as possible, beginning immediately at the first sign of a viral infection. 
The B-Vitamins:
The B-Vitamins in general, and Niacin (B3), Thiamine(B1) (Cannell) have important effects in immune function in humans. Once illness begins the use of B vitamins by the body increases due to metabolic demand so even if one has reasonable levels of these vitamins prior to a viral illness they may become deficient during the illness. At the very least one should take a high potency B-complex during illness, and for general prevention.
Botanical (Herbal) extracts:
Sambucus (elderberry):
Black elder extracts are likely the best studied for influenza, and have some impressive studies behind their use (Serkedjieva , Thorne, Zakay-Rones). Due to these studies as well as general information from the media sambucus has become a well known and easily available in health food stores. Generally the commercially available sambucus syrup has been used at a dose of 2 tablespoons (children) and 4 tablespoons (adults) during early exposure to influenza, or during exposure. These doses conferred a significant reduction in time of illness in those infected.
Mushrooms:
Mushrooms can be quite helpful in supporting immunity. Those best to incorporate into your diet are the shitake and mitake mushrooms. Other strong mushroom extracts can be used in supplement form but are often not very palatable in culinary applications.

Antiviral Medications:
Currently, in addition to the use of influenza vaccines) there are few true anti viral medications available for influenza. The two groups available are zanamivir or oseltamivir (used to treat and prevent influenza A and B infections) and amantadine or rimantadine (used to prevent or treat influenza A infections). These medications are used early in an infection to decrease the time symptoms are present during an influenza infection, by slowing viral replication. All have various activities against influenza strains, but influenza can mutate to be resistant to these medications. As CDC recommendations change for the use of these medications in specific instances a physician should be consulted to decide if they are appropriate for your situation.

References:
Bernstein, J., et al, Depression of lymphocyte transformation following oral glucose ingestion, Am. J. Clin. Nutr., 30:613, 1977
Cannell JJ; H1N1 Flu and Vitamin D; The Vitamin D Newsletter May 2009;http://www.vitamindcouncil.org/newsletter/h1n1-flu-and-vitamin-d.shtml
Cannell JJ, et.al.; Epidemic influenza and vitamin D; Epidemiol. Infect. (2006), 134, 1129–1140. f 2006 Cambridge University Press doi:10.1017/S0950268806007175
Cathcart RF; VITAMIN C, TITRATING TO BOWEL TOLERANCE, ANASCORBEMIA, AND ACUTE INDUCED SCURVY; Medical Hypotheses, 7:1359-1376, 1981. 
HUFFNAGLE GB; GI microbiota and regulation of the immune system (Advances in experimental medicine & biology, Vol. 635): 09-2008
Lange T, et.al.; Shift of Monocyte Function Toward Cellular Immunity During Sleep; Arch Intern Med. 2006;166:1695-1700
Rees L; Immunity and the infat GI-tract; SA Fam Pract 2005;47(5): 56-58
Sanchez, A., et al, Role of sugars in human neutrophilic phagocytosis, Am. J. Clin. Nutr., 26:180, 1973.
Segerstrom SC, Miller GE; Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry, Psychological Bulletin Vol. 130, No. 4, 601–630;2004; DOI: 10.1037/0033-2909.130.4.60
Serkedjieva J et al TI: Antiviral activity of the infusion (SHS-174) from flowers of Sambucus nigra L., aerial parts of Hypericum perforatum L., and roots of Saponaria officinalisL. against influenza and herpes simplex viruses SO: Phytotherapy Research VL: 4 NO: 3 PG: 97-100 YR: 1990 CP: Copyright © 1990 John Wiley & Sons, Ltd. ON: 1099-1573 US:http://dx.doi.org/10.1002/ptr.2650040305
Thorne Research; Sambucus nigra (Elderberry) – Monograph; Alternative Medicine Review ; Volume 10, Number 1 ; 2005
University Of Illinois At Urbana-Champaign (2003, July 7). Scientists Focusing On How Exercise Raises Immunity. ScienceDaily.
Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1995;1:361-369.
Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res 2004;32:132-140.

Introductions

Hello,

I am Dr. Teresa Richter. I am a Naturopathic Physician. I am happy that you have found me and are reading this. You may be wondering what a Naturopathic physician is, and/or why you should see one.  Simply put, Naturopathic physicians are primary care physicians.  Naturopath's can do just about everything an MD can do. We can diagnose and treat just about any disorder, prescribe drugs if necessary (although not a first choice of treatment if not absolutely necessary), perform yearly physical exams, and help with almost any other ailment. Naturopath's are really integrative medicine specialists as we are trained in both Allopathic and Naturopathic Medicine.  We have the best of both worlds, and have many modalities to chose from to provide the most individualized care and treatment possible.  The stomach ache that you get may be drastically different than the stomach ache of the person sitting next to you.

Naturopathic medicine is based on a different philosophy than the type of medicine practiced by general MD's.  The Naturopathic principles are:

1. First Do No Harm (Primum non nocere)-use medical treatment in the gentlest way first to avoid causing harmful side effects.

2. The Healing Power of Nature (The Vis Medicatrix Naturae)-the body's inherent ability, which is ordered and intelligent, to heal itself. 

3. Identify and Treat the Cause (Tolle Causam)-Instead of suppressing symptoms, Naturopathic doctors seek to find and cure the underlying cause of the disorder/disease.

4.  Treat the whole person (Tolle totem)-Naturopathic doctors take into account all aspects of a person's mental, physical, emotional, health and environment when approaching the treatment plan.

5. Doctor as Teacher (Docere)-To provide education to the patient, and to empower the patient to take responsibility in their health care.

6. Prevention-Emphasis on disease prevention by taking necessary action to reduce risk factors.

7. Wellness-(from Bastyr University) Wellness follows the establishment and maintenance of optimum health and balance. Wellness is a state of being healthy, characterized by positive emotion, thought and action. Wellness is inherent in everyone, no matter what dis-ease(s) is/are being experienced. If wellness is really recognized and experienced by an individual, it will more quickly heal a given dis-ease than direct treatment of the dis-ease alone. (This principle was adopted by Bastyr University and added to the six principles.)

A typical visit with a Naturopathic doctor is typically anywhere from half an hour to an hour and a half. Naturopathic doctors ask a lot of questions and want to know about all aspects of your life in order to assess where any obstacles may be.  It is important to identify and remove these obstacles as they may be blocking your path to healing and optimum health. Our physical, mental, emotional and spiritual beings are connected, so it only makes sense that all things should be considered in the cause and treatment of disease.  Naturopathic doctors focus on certain aspects of health and lifestyle that other doctors may not. 

 As a Naturopathic physician, I want to help people on their path’s to healing and optimal health. I look forward to connecting with all types of patients to help them achieve their health goals. Although my training is primarily general practice, I have solid interests in the relationship between food allergies, environmental allergies, gastrointestinal disorders, and dermatological conditions. I have an intense desire to help those who are suffering by giving them the information and tools so that they may also help themselves. I am very interested in endocrine disorders and women’s health. I strongly believe in removing the obstacles to cure, and starting with the therapeutic order when approaching treatment. I want to employ the naturopathic principles and keep them alive in my practice. I enjoy educating my patients about their health and wellness, giving them opportunities to take responsibility for their own health care.