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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.
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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.
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