Staying healthy during cold and flu season

Staying healthy and avoiding the cold and flu is a challenge as we enter these months of cooler weather. Why do people get sick more often in the winter? Although a few theories exist, we actually don’t know why people tend to get sick more often during the fall and winter months. One theory suggests that we spend more time indoors when it is cold outside creating a closely shared “breathing zone” which can make spreading viruses easier. Another theory suggests that viruses thrive better in cooler temperatures. While the reason behind seasonal illness may not be entirely clear there are measures you can take that both prevent illness and shorten the duration of illness NATURALLY. Our supplements of the month are a great place to start.

Sinuplex helps support the respiratory system. It is a blend of vitamin C, quercetin, N-acetylcysteine (NAC), stinging nettle root, and bromelain. I want to break down each of these components and discuss their efficacy. When I was in chiropractic school the instructor for Cardiopulmonary Systems was a big fan of NAC. My instructor spoke of how NAC is a great tool for those with chronic obstructive pulmonary disease (COPD) because it helps fight inflammation in the respiratory system. According to WebMD, NAC can reduce flare ups by 40% and improve phlegm consistency in people with COPD. A 2015 Meta-Analysis found that patients treated with NAC had significantly fewer exacerbations COPD (Cazzola, et al). NAC theoretically works the same way in someone with the flu or common cold; it keeps the respiratory tract healthy by reducing inflammation and improving phlegm naturally. Quercetin has been understudied in my opinion; Quercetin is a flavonoid that has antioxidant and anti-inflammatory effects. One study showed that trained cyclist had reduced incidence of upper respiratory infections when treated with quercetin when compared to placebo (Nieman, et al). While the findings of this study were significant there needs to be further studies conducted to show true efficacy. Stinging Nettle has some good anecdotal evidence in reducing sneezing and allergy symptoms but scientific evidence is lacking. Theoretically it makes sense that stinging nettle root can help with allergies and upper respiratory health because it reduces the amount histamine the body produces when faced with an allergen. Finally, Bromelain is a powerful anti-inflammatory proteolytic enzyme that is found naturally in pineapple. In chiropractic school I heard consistently that bromelain was a great tool for individuals recovering from a soft tissue injury, however, I had never considered it for sinusitis or upper respiratory tract infections. A 2018 study found that bromelain was able to penetrate into the blood and sinonasal mucus in patients with chronic rhinosinusitis (Passali et al). Because bromelain is generally safe and tolerated well, further studies should investigate its potential effects on the upper respiratory system and the treatment of sinusitis.

Ultra-Potent C is a blend designed to help the immune system function optimally. Since vitamin C can sometimes cause stomach upset and diarrhea, the manufacturer has buffered it to make it more tolerable for the stomach. Growing up whenever we got sick, my mother would instantly reach for her natural remedies to help us fight off the virus. While some kids may have been given orange juice and chicken noodle soup, we all lined up for high doses of vitamin C, Echinacea, oil of oregano, spoonful’s of elderberry syrup, and either salt water gargles or the Neti Pot. My mom did not joke around when it came to the common cold—at the very sign of a sniffle or sneeze my mom took action with her natural remedies. With all her interventions it was rare for colds to last long in our household. My mom is not alone in reaching for the vitamin C when illness sets in. Vitamin C has long been a remedy for colds; many people swear by it, many doctors recommend it. What does the literature say? When I do a PubMed search and evaluate the research, evidence is mixed. One piece of literature will have significant findings while the next states that there is no clear benefit. Vitamin C has strong immune function properties but just how effective is it? That may not be so clear. Personally, vitamin C seems to make a big difference for me when I get sick, it seems to help lessen cold symptoms and shorten the duration of the illness as well. Thanks to my mom, vitamin C is something I take any time I start feeling under the weather. A meta-analysis of 9 randomized controlled trials found that extra doses of vitamin C at the onset of a cold reduced the duration of a cold (Ran, et al).  Foods high in vitamin C include citrus fruits, peppers, and cruciferous vegetables. Since vitamin C tends to be high in oranges most people reach for the OJ when they start feeling sick. I actually do not recommend drinking OJ when sick, why? Because OJ is really high in sugar, bacteria and viruses thrive on sugars, so it’s actually very important to reduce sugar intake when you are sick.

Zinc Lozenges

Zinc lozenges actually have quite a bit of evidence behind it. Zinc lozenges are tasty and can be used as needed when sick with a cold. A 2017 meta-analysis found that the mean common cold duration was 33% shorter for those in the zinc groups (of seven trials) (Hemila, H). Another meta-analysis conducted by the same author, also found that zinc lozenges reduced the duration of a common cold (Hemilia, et al). Zinc may stop the rhinovirus from multiplying, so ideally the sooner one takes zinc after the onset of cold symptoms the better the outcome may be. According to the research it is unclear whether zinc can help prevent cold or lessen severity of cold symptoms, but it does seem to show that zinc lowers the duration of a cold. When being critical of the literature one may say that the studies available on zinc are small and more research is needed to confirm efficacy. I agree that most of the time more studies need to be done to confirm not only efficacy but safety. Taking too much zinc can be toxic and lead to several different issues, so it is always important to work with a health care provider when taking any supplement. What is the bottom line on zinc? The research seems promising and it is generally safe in low doses.

What are some other things you can do to stay healthy this season?

• Get outside and stay active! Staying active can be a challenge in the colder months but make an effort to do so as regular exercise has numerous health benefits.
• Get adjusted regularly and try out acupuncture! Acupuncture for the sinuses does WONDERS.
• Eat a healthy diet full of fruits and vegetables.
• Get enough sleep and keep stress at bay.
• Vitamin D is something most Minnesotans should consider as we enter the fall and winter months. Vitamin D can help with the immune system and combat the winter blues.
• Probiotics! A healthy gut is essential for a healthy immune system.
• Engage in good hand washing skills. Keeping your hands clean is essential. Most people do not wash their hands long enough; wash your hands with warm water and soap for at least 20 seconds. Wash your hands after bathroom use, after sneezing or coughing, before you eat, and when you get home from an outing.
• Avoid touching your face and eyes as much as possible.

This is intended to be educational and not intended as medical advice. Always consult with a health care practitioner when taking supplements.

Resources

Can zinc zap a cold?

M.D. Bauer – https://www.mayoclinic.org/diseases-conditions/common-cold/expert-answers/zinc-for-colds/faq-20057769, Accessed on 10/04/2018

Emily Sohn – http://www.chicagotribune.com/lifestyles/health/ct-why-we-get-sick-in-winter-20170314-story.html Accessed on 10/04/2018.

Extra Dose of Vitamin C Based on a Daily Supplementation Shortens the Common Cold: A Meta-Analysis of 9 Randomized Controlled Trials. Ran L, Zhao W, Wang J, et al. BioMed Research International. 2018;2018:1837634. doi:10.1155/2018/1837634.

Hemilä H, Petrus EJ, Fitzgerald JT, Prasad A. Zinc acetate lozenges for treating the common cold: an individual patient data meta‐analysis. British Journal of Clinical Pharmacology. 2016;82(5):1393-1398. doi:10.1111/bcp.13057.

Hemilä H. Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. JRSM Open. 2017;8(5):2054270417694291. doi:10.1177/2054270417694291.

Influence of N-acetylcysteine on chronic bronchitis or COPD exacerbations: a meta-analysis.

Mario Cazzola, Luigino Calzetta, Clive Page, Josè Jardim, Alexander G. Chuchalin, Paola Rogliani, Maria Gabriella Matera Eur Respir Rev. 2015 Sep; 24(137): 451–461. doi: 10.1183/16000617.00002215

N-Acetyl Cysteine: Uses, Side Effects, Interactions, Dosage, and Warning

https://www.webmd.com/vitamins/ai/ingredientmono-1018/n-acetyl-cysteine. Accessed on 10/04/2018

Quercetin reduces illness but not immune perturbations after intensive exercise.

David C. Nieman, Dru A. Henson, Sarah J. Gross, David P. Jenkins, J. Mark Davis, E. Angela Murphy, Martin D. Carmichael, Charles L. Dumke, Alan C. Utter, Steven R. McAnulty, Lisa S. McAnulty, Eugene P. Mayer Med Sci Sports Exerc. 2007 Sep; 39(9): 1561–1569. doi: 10.1249/mss.0b013e318076b566

Passali D, Passali GC, Bellussi LM, et al. Bromelain’s penetration into the blood and sinonasal mucosa in patients with chronic rhinosinusitis. Acta Otorhinolaryngol Ital. 2018;38(3):225-228.

Stinging Nettle

https://www.drweil.com/vitamins-supplements-herbs/herbs/stinging-nettle/Why do we get sick in winter? Accessed on 10/04/2018

Images used from Metagenics site with permission.

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