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More Boosting

Topics, as I noted a fortnight ago in my uniquely misspelled and ungrammatical way, never die**. Or even fade away. There are popular ideas that persist in the world that have little to do with reality. In the reality based world of medicine there are concepts that refuse to die. Atelectasis causing fever or the need to ‘double cover’ Pseudomonas. Neither are true, yet every year medical students tell me that is what they have been taught. It is said the only way new ideas take hold is for those that hold the old ideas to die off. So maybe 50 years from now those medical myths will be gone.

Popular culture also its myths. Take the immune system. Please. It is not a bicep that can be made stronger with a little exercise. It is a complex network of cells and proteins. There are antibodies (IgG (with five subtypes, IgM, IgA, IgE),the complement pathway, polymorphonuclear cells, monocytes, lymphocytes in a profusion that rivals beetles. God, I think, has an inordinate fondness for lymphocytes. There is the Toll system, the cytokines and lymphokines, the non-specific defenses like cilia and mannose binding lectin and on and on and on.

I have a journeyman’s understanding of the immune system, what is needed to understand why a given patient has an infection, although there is little I can do to reverse the immunologic defects: abnormal antibodies from Waldenström’s or low mannose binding lectin levels from liver disease are not amenable to clinical intervention.The most interesting discoveries concerning the immune system over the last few year has been the elucidation of the many polymorphisms in the immune system that can increase or decrease the risk of a variety of infections.

The fault, dear Brutus, is not in our stars,
But in ourselves, that we are underlings.

Often what determines health or infection, life or death, is a single amino acid substitution, say, in a Toll like receptor or the structure of our snot.

Of course these variations in the immune system are not absolute risks, they are relative risks. Health and illness are complex and a career medicine and infection control has continually emphasized that it is rarely one thing that leads to health or illness. It is the confluence of multiple factors, death by a thousand cuts.

There is no validity to the concept, the myth, of boosting your immune system. Metaphor time. Think of the body as a meat machine, like a car made out of steak. Mmmm. Steak. You can be properly tuned and maintained, the fluids and gas topped off, the air in the tires at the proper pressure. It will run optimally. You can’t over tune the car or fill tank past capacity. There is an optimum you can’t go beyond.

It is similar with the immune system. There are certainly habits that will have everything running suboptimally, and by altering those habits get the function close to its theoretical optimum. That is the things you learned in second grade: good diet, exercise, avoid tobacco, a good nights sleep. All the things we know we should do but, the flesh being weak, we often avoid.

Also, in my world, we call the boosted immune system an inflammatory response: when, in response to assault from the microbial world, the body gets a bit of a turbocharge, kicking the Batmobile into high speed. For the short term, it is of benefit. The infection is removed or suppressed. But because the immune system is not a clean, beautiful system but the result of that ever sloppy process called evolution, kicking it into overdrive is not without its downsides. As I have mentioned ad nauseum in my infectious disease podcasts, inflammation is prothrombotic and the downside of many infections is an increased risk for stroke, heart attack and pulmonary embolism. If you really, truly, could boost your immune system, you would almost certainly increase your risk for thrombotic events.

So when someone says they can boost your immune system ask yourself, are they offering advice that takes what is probably a sub-optimally functioning human characteristic and nudging it towards some closer approximation of improved function or are they offering to make you better than an optimal baseline.

As I have spent the last 5 years in the world of Supplements, Complementary and Alternative Medicine (SCAM) I have also tried to come up some classification system, with little success.

There are two kinds of people in the world: those who divide the world into two kinds of people, and those who don’t. – Robert Benchley.

There are, broadly, two kinds of SCAMs. There are those that are based on total hooey: acupuncture, reiki, homeopathy, and Mitt’s health care plan*.  And there are the SCAMs that take a wee bit of in vitro laboratory work or small clinical trials and conflate the results out of all proportion, usually translating into products sold by the proponent of the intervention. I am always amused by the accusation of being in the pocket of big pharma, when I do not get dime one for any antibiotic or vaccine I prescribe, but so often those that suggest various supplements for your illness somehow also sell them. Go figure.

If you are offering some SCAM advice it is important to mix and match with legitimate, effective therapies.  It makes the SCAM look more reasonable, but if you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.

The Natural News is good  source for all the above: useless therapies, overblown therapies and even, shock and horror, reasonable advice, all wrapped in a cocoon of really weird paranoia about government and big pharma. I am not conspiracy prone, preferring Hanlon’s razor: “Never attribute to malice that which is adequately explained by stupidity.”

The Natural News wants to boost your immune system.  Of course part of the purpose of boosting your immune system, but to avoid vaccines:

…illogically claiming that your lack of a vaccine somehow causes other people who are already vaccinated to catch the flu. Yeah, I know, it makes no sense, but then again the entire vaccine industry is based on the same fantasy logic as unicorns, fairies, leprechauns and garden gnomes.

And, for the record, all the healthiest people walking around who don’t catch the flu are the ones who refuse flu shots while taking care of their immune system. It’s the vaccinated people who always seem to be sick for one reason or another, have you noticed?

In any case, it’s important to find ways to boost your immune system and shield yourself from colds and the flu without resorting to jabbing yourself in the arm with a cocktail of mercury, formaldehyde, aluminum and MSG.

OK. Hanlon’s razor? Or perhaps we should call it Pauli’s Razor: Not only is it not right, it’s not even wrong.  But I and others have written extensively on this blog about the flu vaccine and my purpose is not to discuss the flu vaccine. Instead I want to take a look at

The top 20 ways to boost your immunity to colds and flu without using a vaccine

There is no cold vaccine. I know. Picky. But I get the feeling the author doesn’t understand basic microbiology. At one point they suggest an air filter to remove bacteria and molds, neither of which cause flu or colds nor suppress the immune system.  You can see the entire hodgepodge of the good, the bad and the ugly over at NN. I’ll hit some highlights.

1) Take a vitamin D supplement every day.

This is interesting and not yet completely worked out. Some groups who are vitamin D deficient have an increased risk of viral infection. However, those with normal levels get infections as well, but at lower rates. And it may not be the vitamin D level that is modifies your risk, but whether there are polymorphism in the vitamin D receptor.

It is safe to say that being replete in vitamin D will lower your risk of some infections. Unless, of course, you are a proponent of the Marshal Protocol. Newtons law of Alternative Medicine: For every SCAM there is an equal and opposite SCAM. In the Marshall protocol you avoid vitamin D as part of a complicated intervention where it is thought that bacteria and vitamin D act together to shut down the immune system and the bacteria take off to cause disease. Go figure.

But as a recent JAMA article demonstrated, taking vitamin D as a preventative for upper respiratory tract infection does nothing, although it may be of benefit in high doses to tuberculosis.

It is not as simple an idea as take vitamin D and not get infected. It is, as with all vitamins, important to be replete. Outside of TB it is unlikely to be of help as a pharmaceutical.

2) Get as much sunlight as you can for as late into the year as you can manage. Even getting sunlight on just your face helps produce more vitamin D in your body.

Always follow an overstatement with homey common sense advice. And he gives other good advice: wash your hands, get enough sleep, and avoid stress, as if anyone can do that after reading the rest of the advice. Trying to live up to all the other pieces of advice from the Natural News would be time consuming, expensive, ineffective and as a result be very stressful:

Drink immune-boost beverages like organic Cocoa Mojo, which contains a blend of 4 medicinal mushrooms. Take Lomatium, Osha, Elderberry and more, avoid cleaners and cosmetics, eat more pungent spices, avoid cheese as it makes your nose stuffy (which is due to a lack of sinus circulation), Take Zinc and selenium. Take immune-protective herbal tinctures such as goldenseal, garlic, echinacea, osha root and elderberry. Eat more live vegetables.

All of which, he says, is better than the flu vaccine, which works in 1 in 100 people. I read it on the Natural News: the flu shot works. He has the numbers wrong for efficacy, but he agrees it is effective. That is the take home message from the Natural News, the one that should be spread, “Flu shots work…” since even at the mistaken number of 1 in 100, the vaccine is better than the nostrums and concoctions suggested, which have no proven utility.

Most of the products are offered by the Natural News and most of which will do nothing. I didn’t see the essay as an infomertial, but isn’t that whole site?

15) At the same time, demand high levels of hygiene by those around you. Ask them to wash their hands, for example. Ask them to boost their immunity with herbs, nutrients and supplements that really work. In fact, when others fail to boost their immune systems, it’s actually highly irresponsible on their part.

To paraphrase the author from the beginning: “They’re even starting to lay a guilt trip on those who refuse to boost their immunity, illogically claiming that your lack of immunity boosting somehow causes other people who are already boosted to catch the flu.”

Then there is the dangerous advice such as

8) Get off all medications that you can safely eliminate! Work with a naturopath to accomplish this, of course, as quitting medications cold turkey can also be dangerous. Most medications suppress your immune system, liver function, kidney function and even your reproductive function.

and

16) Have an emergency supply of colloidal silver available. Not only do you want the liquid colloidal silver, you may also want to consider an inhalable form of silver like what you’ll find in the Silver Lungs product. At the Natural News Store, we currently carry GHC’s colloidal silver product called Silver Fuzion, and we’ll soon be carrying Sovereign Silver products.

and the just plain goofy:

12) Move your lymph! Rebounders (mini trampolines) are great for this purpose. Jumping rope also works, as does just hopping in place for a few minutes each day. You can also do arm rotations and other simple movements to keep your lymph circulating. Lymph movement is crucial for immunity.

It is not, although there is this belief that lymph can stagnate, build up toxins and degrade immunity. This concept has as much basis in reality as qi and meridians. Finally there is

20) Laugh a little! Watch some comedy movies, or spend some fun time with family and friends. Laughter boosts immune function at many levels. It’s good for your body and your mental health. Find creative ways to expose yourself to comical situations and you’ll benefit as a result. :-)

Well, after reading the Natural News I should be immune to everything forever. Nothing incites laugher more than this odd collection of the good, the bad and the ugly.

** The Duck-Arizona football game is more interesting, so blame any errors today on my alma mater. Go Ducks.

* Ha. Just put that in there just to get your goat. An observation. I have given lectures for over 30 years. During the Clinton and Obama years I would make snide jokes about the powers that be and never had a complaint in the evaluations. Crack wise about a Republican and you will ALWAYS get a complaint. From that I conclude that Republicans are thin skinned whiney babies, although there may be other interpretations. Lets see if the comments confirm my bias.

Posted in: Herbs & Supplements, Humor, Science and Medicine, Vaccines

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