Viral infections, do’s and don’ts

Go directly to the bullet points further down if you wish to skip the introductory comments and the prelude.

True cure from a viral pathogen comes from developing an immunity and antibodies through exposure, whether it be through a needle or community transfer. 

What we can do otherwise is reduce the chances of getting sick, and prepare to have the best outcome with the least amount of complications if we do.

Right now there is a big movement in people looking for ways to prevent them from getting sick and end up in bad shape. A large majority is trying to find alternative ways to protect themselves from the dreaded COVID 19, aside from the obvious proven measures such as washing hands, wearing a face mask, eye protection and practicing social distancing. 

Are there other things that can be done? The answer is certainly yes. We know that there are asymptomatic people who contract a virus but do not show symptoms. And we know that there are people who seem to never get sick while others around them run a fever and get a slew of symptoms and are bedridden for days once every other month. These individuals are touted to have a strong immunity. Those tough individuals may not have done so well during the Spanish flu, but they likely would fare better against Covid 19 if they are especially young and don’t receive a huge viral load at once as has been shown in some diseases.  

Many ask, so what is it we can do to develop more immunological vitality? A kind of protective vigour that can fight a viral pathogen? Although we can agree that it is certainly important to develop a strong immune system which generally weakens with age, we should be also prepared for when we do get sick. It is much better to be prepared for battle then hope to never get sick. 

So the real question most should be asking is what should they do if they get sick? Admittedly, any support to combat the common cold and seasonal flu would be most welcome. In effect any measure that can help you recover quicker or reduce complications is worth its weight in gold. 

Now is there something that can be done? Are there ways to support you on your road to recovery? What advice is there to help us reduce the severity of signs and symptoms that can hinder our recovery? More importantly, are there things that we should not do?

Surprisingly, there are very few true scientific experiments that have been conducted to prove the effectiveness or better yet to disprove the methodologies in place to combat a viral upper respiratory infection. In reality, many advice we get from our doctors and other healthcare practitioners are anecdotal and just some common sense good old fashioned words of wisdom. 

The reality is that most battles are fought at the home front and not in hospitals. Hospitals are there to provide testing and medical intervention when we truly need it so that they can take the best course of action known and accepted at the time. But until we need medical attention, what can we do for ourselves and for our loved ones, especially when your doctor tells you to just stay home and get better. 

Some advice will be obvious and some seem quite unorthodox. But common sense has to prevail until we can prove these methods are effective.

Some of these methods are traditionally accepted among various cultures and others have some data to back the claims. There are many tried and true ways to support your recovery when you’re sick. 

Let’s now jump into it without further ado. 

  • Take it easy. Lie down, rest. Preserve your energy to combat the infection. Don’t stay up late or finish your work before retiring for the evening. If you’re going to do anything it should be just to get your food and drink ready and rest up. It is okay and good to get up and move around to stimulate circulation. Generally this is not so necessary the first day or couple of days when you first get sick when the symptoms are at their peak. But afterwards it is good to have some movement. For instance you may just flip over on your belly from lying on your back. Remember most of your lungs are in the back, so this can offer much needed circulation. You can also take some deep breaths when lying face down which would also help circulation in your lungs. Also move your legs and knees to promote lymphatic and blood movement. Muscle wasting occurs quite quickly when you’re inactive. Some studies show as much as a shocking 7% per week.
  • Cover yourself. Wear warm clothing or lie in bed with blankets on top. Cold weather would not be helpful. Your body is constantly trying to regulate its internal temperatures as part of the defence mechanism. If you are underdressed, and at the onset of the sickness you go outside and expose yourself to the elements or have cool air or a fan blowing on you, this can potentially exacerbate your symptoms. Your body could keep the pores closed and your internal temperature would rise. Also the circulation with the immune system may be redirected to the surface to keep the body temperature stable instead of focusing on where the infection is highlighted, at the upper or lower respiratory system.
  • Don’t eat foods with vinegar or wine. Many aged foods have high histaminic compounds and they can trigger worsening of symptoms. You may have just a scratchy throat and feel a bit fatigued. And after a glass of wine and having a salad doused with wine vinegar, you could wake up with congestion, chills and fever. Some people swear by the benefits of apple cider vinegar to thwart a sore throat, and this may be so to the stimulation of circulation because of the vinegar. Realistically, you would be better off just having some ginger and lemon tea, or a lemon balm tea to warm up your throat. Some people swear by oil of oregano with a sore throat. I would take that advice rather than ever using vinegar or alcohol. This is traditional advice that was taught to me by my grandparents. And now explained by research it has stood the test of time for me.
  • Avoid greasy, sweet, sticky foods or cold salads. It’s no time to have French fries and hamburgers because you’re under the weather and can use some comfort food. And a light green salad is not the ideal choice either. Foods should be kept light and simple and easy to digest. Warm broths such as chicken soup with ginger and garlic is the perfect choice. You need to keep hydrated as well as light in your gut. Heavy  foods will exhaust your system. The immune system works hand in hand with the digestive system. You don’t want to be sending your circulation and immune system to your gut when your body is fighting a battle. Salads may seem like a good idea, but they are actually not so easy to digest. Your body has to go through the process of “cooking” that food and extracting the nutrients. Chicken soup is time tested to show that it just works. I spoke to a friend who is a vegetarian about his advice. He suggested I stick to chicken soup. Chicken soup to be precise should be cooked bone in with ginger and garlic. You can add some rice and soba noodles and chopped carrots, turmeric and cilantro with celery, and served nice and warm, not cold. It will be very beneficial for the body and support the recovery. Here you get a good load of electrolytes and essential nutrients, and it will warm you up. 
  • Avoid sugary drinks. Even a glass of orange juice might not be ideal. It is full of sugar, and that has shown to negatively affect the immune system. If it is the coveted vitamin C you’re seeking, maybe it’s best to get it in a supplement than a bottle of processed orange juice with over 20 grams of sugar equal to 5 teaspoons. When was the last time you used 5 teaspoons of sugar in your tea or coffee? So don’t fall for the advertisements about vitamin content of products. We have to account for the entire benefit of what we do and not isolate it to its individual parts. It will give us the wrong image. Now, a little orange juice is not bad. Absolutely,  fresh juice would be much better. But to think drinking glasses of orange juice through the day to get lots of vitamin C will be more beneficial for you, think again. The argument becomes if we should get the vitamin C naturally or from a bottle. There is definitely mounting evidence of the benefits. But opening a can of orange juice is not as natural as you may think as it has been boiled and stored for a very long time before getting to you.  Also, contrary to common belief there are many foods that are significantly better than oranges for vitamin C. A slice of lemon in hot water has vitamin C and next to no sugar. Parsley, black currants, rose hips also are high in vitamin C, but that’s not what is advertised. 
  • Avoid cold and raw foods. Soups are some of the best and easiest foods tolerated during a flu. And many report feeling better with hot liquids like ginger and lemon tea, maybe sweetened with a bit of honey to make it tolerable. But drinking cold shakes such as smoothies and juice blends, although nutritious can be irritating leading to cough and digestive discomfort. If you try drinking a cold fruit and veggie smoothie, or a vegan protein shake, it will not work the same as a warm soup. It might even make you feel worse. The cold shake can irritate the chest and throat. And the digestion will get a whoosh of material that it has to quickly deal with. If a person is too ill to consume food then arrangements can be made, but in the meantime, stick to soups and warm liquids. Some tea possibilities are chamomile tea or lemon balm if you can not sleep at night. Traditionally these herbs have been used during colds and flus. Do not drink coffee, especially with sugar and cream. In Chinese medicine ginger is used frequently and is said to warm the lungs. But they used fresh ginger with cold and flu not dried ginger in tea bags. Coincidentally, ginger has been researched for its ability to attach to ACE II receptors. Possibly one of the receptors that COVID19 uses to enter cells. If this holds true and infers any marginal benefit, then that would be great, but until we know more we can still use a nice hot ginger tea and a slice of lemon to help warm up the chest as it goes down the esophagus.
  • Avoid greasy and sweet foods. They are very heavy and very cloying to the system. You want to keep the body operating at full capacity in battling the pathogens. You do not want to be weighed down with food that will run through your bloodstream and slow the body down. Any fried foods in the evening may translate to a cough at night preventing a restful sleep. Thankfully, most people lose their appetite when they get sick and would prefer something light. Avoid dairy. Milk and cheese and whey protein are not only heavy for the body, but they can also affect phlegm and breathing which will have a negative effect on the lungs. Some cultures may recommend a warm glass of milk maybe with honey before bedtime, especially for children. But this can make any phlegm thicker and lead to more cough and breathing difficulties. Also many people do not tolerate the casein in milk very well. Any level of intolerance in spite of notable sensitivities would translate to more obvious symptoms when sick. This is obviously not the case for everyone. Also, we can respect that many nutrition supplements for the elderly and the weak who do not have access to freshly prepared foods or have difficulty eating contain dairy as part of the protein source to ensure they receive sufficient nutrition. But most of us can do without it.
  • Avoid grapes and raisins. These are foods commonly found in most fruit drinks as well which you should try and avoid anyway. Grapes and raisins, like wine, can spike up your histamine levels and can make you feel unwell. These were not foods that were available in winter times much like melons. So eating with the season does hold some weight especially if you get sick in the colder months. I often see children walking around with drink boxes and sipping on apple and grape juice which is not ideal as this can exacerbate many of their symptoms. 
  • Avoid melons. Some cultures tend to avoid all melons such as watermelon, cantaloupe and honeydew which can cause scratchy throat and runny nose. There seems to be a good explanation for this cultural bias. The compounds in these foods have cross reactive allergens similar to ragweed and grass pollen and consuming them will expose you to a large dose at once causing some irritation. Certainly if you suffer from hay fever it would be prudent to avoid those.
  • Don’t just go back to business as usual as soon as you feel somewhat better. It is important to stick to your regimen of healthy foods, rest, minimal amount of work until you have fully recovered. Often people feel the urgency to complete tasks from house chores to work projects . The body is still weak and fighting the battle. We have to ask ourselves what is more important? Our health and our lives or work? There is nothing wrong with enduring a few more days of eating soup and staying away from heavy foods and cold drinks. So what if it gets boring. These days with the threat of COVID19 looming cultural biases about toughing it out and going to work are slowly dismantling.
  • Don’t stay up late. Sleep is very important for healing and recovery. Your immune system does not respond as well when you don’t sleep. Glimpses of research into sleep and immunity have shown that at least one particular substance, melatonin has an important benefit on both cellular and innate immunity. That a reduced amount may compromise our immune system, either under reacting or overreacting. One study has demonstrated that melatonin has a benefit in reducing TNF alpha expression and inflammation as well as modulating CD4 and CD8 response which are potentiating factors of a cytokine storm in ARDS seen in the most severe cases of COVID19 infections. So it is better to put your phone away and reduce blue light emissions so you can fall asleep easier. Some prefer to take commonly known and generally safe natural herbal remedies such as chamomile tea available in the cupboards of most traditional Italian and German grandmothers. Or lemon balm tea. Others use essential oils such as Cedarwood topically or diffused to help with sleep. I tend to have a preference for a simple relaxing tea, especially chamomile. But the choices are endless. Using melatonin is not so straightforward and people often have mixed results, from either feeling groggy in the morning, or waking up with restlessness. So it tends to be safer to get your body to produce something naturally rather than supplementing with a hormone. But if you have trouble sleeping, and if you have experience using melatonin and you’ve had good results in the past, having a good night sleep could be well worth it. 
  • Don’t just take antipyretic medication for the sake of bringing down any fever without justifiable cause. They are not curative. The body has an internal mechanism built in to cure itself. Your body’s immune system is mounting a defence against the pathogen. By increasing the core temperature it is attempting to sabotage the viral ability to replicate itself. Unless there is an underlying issue to consider, such as febrile seizures, or fever escalating rapidly in very young children, there is nothing unusual with having a fever and body aches with a viral infection. It is uncomfortable, but the body is doing this for a reason. Studies are now shedding light on some consequences from using NSAIDS and other fever reducing medication, such as taking a longer time to recovery. In the meantime, if you feel like you are coping with the discomfort of being sick and are tolerating the fever that is not ramping up then it is not wrong to wait on taking OTC medication to treat the symptoms. Probably the most brutal symptom for most is a relentless headache which trumps body aches and joint pain, at least for me. The question is simply one of tolerance. But the key here is not to think you’re helping speed up the recovery by taking NSAIDs such as Ibuprofen. On the contrary, the recovery may be somewhat hindered. At the same time we have to be prudent and seek medical advice if the symptoms persist unjustifiably and not be stubborn when OTC medication may benefit with little to adverse effects. Also we have to seek medical attention and be on top of our symptoms to ensure the best treatment outcome which is a full recovery without sequelae. For instance, persistent night sweats with low fever may be due to pneumonia, but the person could feel otherwise relatively well. So the purpose of taking a medication has to be justifiable and symptoms not ignored. If unsure, seek the advice of a healthcare professional. And if there are complications, do not hesitate to go to an emergency room and have an ER doctor do a thorough examination.

What are some of the do’s when you’re sick? The aim is to give our immune system the best chance to appropriate all the responses in coordination with all the other systems such as the circulatory and lymphatic system to eliminate the pathogen quickly and reestablish an equilibrium. How do we do this? We have to start with a healthy immune system. And we have to maintain it. One thing Covid19 infection has demonstrated is that an aging immune system along with poor health and obesity can lead to more complications.

How do we maintain a healthy immune system? 

What are the studies telling us? Make sure you get enough vitamin D. Some basic essentials for the immune system are Vitamin D, C, A and Zinc. Well researched data supports optimal Vitamin D levels for good immunity. Traditionally the sun was the source, but now with our modern sedentary lifestyles we have to concede and take some vitamin D3. Studies are also showing the benefits of vitamin C as well, in doses well above the daily recommended value. Being a water soluble vitamin it seems to be well tolerated as well if there are no kidney issues such as stones.  Lysine has also shown in studies to be of benefit. This is often employed to reduce the duration and expression of Herpes cold sores. Studies have also demonstrated the benefits of Selenium for immunity. Brazil nuts have been recommended as a high source of selenium. So the above may be some of the important supplements to consider. Other foods high in some of the above nutrients are pumpkin, carrots, cilantro, potato and common ingredients often cooked in a hearty pot of chicken soup. 

  • Do speak with your health care practitioner to be supported through the process and to address any concerns. There are experts in the field dedicated to helping you improve. If in doubt or concerned, just give your family doctor a call and speak to them rather than blindly research articles on the net for answers. 
  • Consider speaking to a Chinese medicine practitioner versed in herbal formulas. There is a rich history of traditional yet well researched herbal formulas that can be suggested in helping you deal with the infection. Some of these herbs have even been studied in recent times for their effect on SARS. Formulas have also been deployed in China against the SARS virus and COVID19 pandemic. It is claimed that over 60,000 patients in China infected with COVID19 were given Chinese herbal medicine. It is believed that Herbs such as Androgaphis, Japanese Honeysuckle and Isatis root have been used extensively in Chinese medicine and in hospitals over the past fifty years to deal with various flu epidemics in formula combinations. Some of these herbs have shown strong antiviral and anti-inflammatory properties. It might be a good idea to speak to someone who can guide you better on what to take, as everyone’s issues and signs and symptoms vary. Some incredible prescriptions to look up are: Yin Qiao San, Xiao Chai Hu tang, and Huo Xiang Zheng Qi Tang.
  • Probably the two most common Chinese herbal formulas developed for treating viral infections are Yin Qiao San and Gan Mao ling. One was created hundreds of years ago to treat virulent infections, and the latter being a more modern rendition of recently studied herbal medication for the treatment of the Flu. There are a few versions of them out there and they are a combination of similar variations of herbals, some having demonstrated antiviral, antibacterial and anti inflammatory properties. Combining them with herbs such as andrographis would create a formidable support team. The aim is that the overall positive effects can mute or mitigate some complications of the infection. For instance, they may dim an autoimmune response that can cause more complications than the condition itself. Admittedly, these herbal medications are not for everyone although it is safe enough to be purchased over the counter. 
  • Oil of oregano, thyme, cinnamon and clove have all been researched for their effectiveness against various pathogens. But when it comes to herbal medicine, I am not one to seek a single remedy for disease. Oil of oregano may be beneficial, and many swear by its potency. But if that oil or single product does not work against what you are treating or has only some effect then it would be of little use. So it is generally better to take a multi faceted approach in dealing with pathogens, as the natural arsenal although potent is not geared for a single purpose such as many modern medications. Also the overuse of some of these single natural substances may lead to resistant organisms or side effects. Throat irritation for instance is not unusual with overuse of Oil of oregano. And often mixed essential oils are rubbed at the bottom of feet to prevent irritation and insure absorption, such as cinnamon, clove and eucalyptus oils. When using natural substances, we cannot simply apply them within a modern paradigm, as many of these substances have multiple effects and various conditions of use. Thankfully many are safe and widely available and less likely to cause harm. But what we want is a positive effect and no side effects. Take in example elderberry flowers. Highly valued for their antiviral effects. They are also tasty and well tolerated in general. So, speaking to a practitioner that can guide you with making some of these choices is always ideal. My focus is Chinese medicine. Many of the herbs and formulas are well tested and studied in clinical settings, so we are beyond folk medicine. They are used in hospital settings, have countless departments and researchers studying them to find new substances for the development of modern pharmacological drugs. They are tested in clinic settings and researched for their overall benefit against diseases from malaria to SARS to Staph infections, and the side effects are better understood by the practitioners.
  • Various formulas were used during the SARS epidemics in China which showed good clinical success in both treating SARS, but more importantly reducing the infection rate amongst healthcare workers who were prescribed medication. One formula discussed and used with other herbs in combination known as Yu Ping Feng San, is well researched for its ability to boost our immune system. The variation of the same formula with other herbs is also used in oncology departments to help improve immunity and blood values in patients receiving chemotherapy. One common herb in the formula is Astragalus, praised for its ability to boost the immune system.
  • When it comes to boosting the immune system, aside from Astragalus (in formulas such as Yu Ping Feng San or Jade screen powder), you may look at herbs they are ascribed with the title Ginseng. Such as Canadian Ginseng, Korean Ginseng, Siberian Ginseng and one of my favourite, Tibetan Ginseng or Rhodiola. Although they are all different species, they have earned the colloquial title because of their effect on the body and strengthening the resistance. These herbs all have different mechanisms of action, but we also have to be careful. For instance a person who has an autoimmune condition such as Lupus should not be experimenting with powerful  immune enhancing herbs arbitrarily. Also, during an acute infection, generally immune enhancing herbs are withdrawn unless there is a clear call that boosting the system is paramount for a patient. For instance, it is known that for some viral infections such as Covid19, the immune system is hindered. This could potentially allow the infection to develop further without sufficient resistance, but may also allow other opportunistic organisms to take advantage, possibly causing pneumonia.
  • Some mushrooms are known to have a bolstering effect on the immune system. Albeit not nearly as potent or as fast acting as a herb such as Canadian Ginseng or Astragalus, mushrooms such as Reishi, Chaga, Cordyceps, Zhu ling, turkey tails and Maitake are well studied for their effects to boost the immune system. But we do not necessarily need a racing horse to win a marathon. Also, some mushrooms  like Reishi may be much better tolerated for someone who can not take a strong immune enhancer. For instance, Ginseng or Astragalus may promote wakefulness which is not ideal for someone who can not easily fall asleep. On the other hand Reishi may promote a better night’s sleep. Cordyceps are especially known for their benefits on the kidneys. So each natural herbal item has a particular function that can be utilized to improve health and strengthen the immune system.

A healthy immune system supported correctly is the key to our recovery. The aim is not invincibility, but resilience. Everyone gets sick sometimes, and that is okay. But we must ensure that we do not mismanage any illness and optimize our resources for a quick and full recovery.

Written by Sarkis Makarians