TypewriterFrom The Urbach Letter – December 2002

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Girl Blowing NoseHow to Stay Healthy... All Winter Long
Actually, it's amazing that we aren't sick every day of the year. We live in a veritable soup of viruses, bacterial, fungi, and other nasty invisible bugs. It's only because of our amazingly effective immune systems – billions of specialized cells throughout our bodies – we stay well most of the time. However, in wintertime, we're exposed to higher levels of infective agents (other sick people spreading their germs around) while our immune systems are often compromised by a variety of factors. These factors include psychological stress, the environment, and "running on empty" lifestyles, and poor diet. Here's how to boost your immune system and avoid having to take all those sick days again this winter:

Get enough sleep. This is vital. Lack of sleep, even for a single night, will dramatically impair the activity of a key immune system component known as "natural killer cells." Most Americans do not sleep enough; nearly everyone needs seven to eight hours a night. Few actually get that much. Turn off the TV and go to sleep.

Watch What You Eat and Drink. There is good scientific evidence that a diet high in trans-fats (most margarines, commercial baked goods, etc.) and saturated animal fats (butter, cream, eggnog, etc.) will impair your ability to fight off illnesses. On the other hand, bright colored fruits, berries, and vegetables have been shown to boost immune response. Garlic, onions, and other "allium" vegetables have potent antimicrobial and antifungal properties. If eaten raw, they have the added side benefit of keeping other sick people away from you. (If you want the benefits but not the stink, take Garlinase or Garlicin capsules instead.) I'm sure you've been hearing about the health benefits of green tea lately. Green tea is loaded with polyphenols, powerful antioxidant compounds. Alcohol in excess can suppress your immune system. Minimize your alcohol and caffeine consumption (they dehydrate). Your best bet for staying well hydrated is to drink plain water. At least twelve 8-ounce glasses a day.

Wash your hands – every chance you get. Do not worry if other people think you have OCD (obsessive-compulsive disorder). They'll be hacking and coughing while you stay healthy.

Avoid coughers and sneezers. You get sick by picking up live viruses and bacteria from other sick people. Unfortunately, most people don't like to admit they're sick and go around spreading their germs to everybody else without any warning. Most of the time, germs are transmitted when the sick person touches his or her mouth, nose, or eyes, then shakes your hand or transfers the germs to a hard surface that you'll touch too. The other way is via airborne transmission when you're in the immediate proximity of a cough or especially a sneeze. (Most flu is spread this way.) If somebody close by sneezes, try to hold your breath for about 10 seconds. Most of the droplets will fall out of the air by then. However, they will land and linger on hard surfaces in the area, which you should avoid touching. Teach your kids to sneeze into a tissue or their crooked elbow, not their hands.

Avoid touching your face. If you've contacted a germ-laden surface, touching your own mouth or nose, or rubbing your eyes, can infect you. Especially if you have the kind of job where you shake hands with people throughout the day, and feel you must touch your face, get in the habit of using your left hand.

Disinfect! Make your own super-effective disinfecting solution of one part regular chlorine bleach to twenty parts tap water. Use it to wipe down hard surfaces that people touch: telephones, doorknobs, faucets, refrigerator doors, etc. Recent studies show that rhinoviruses can live on hard surfaces for up to three days.

Keep warm. You don't catch a cold from being exposed to cold air, although there is *some* anecdotal evidence that exposure to extreme cold can lower your immune system, increasing the chance you'll pick something up. Cold air may constrict the blood vessels in the mucosa, while the low humidity level of indoor winter air dries nasal passages, leaving them more susceptible to infection.

Humidify. Use a humidifier in your bedroom and in any area you spend a lot of time in during the day. Warm or cool mist, it doesn't matter. Just get your indoor air up to about 35% to 45% relative humidity. (Buy a hygrometer to know for sure. I like this one from Oregon Scientific or this cheaper one). Here's a good tip when traveling: since you can't bring a humidifier with you, make your own by running the shower in your hotel room. Leave the bathroom door open and run the shower on full hot for about 20 minutes (don't forget to turn off the exhaust fan). This will humidify the whole room nicely.

Exercise and Control Your Weight. Regular exercise has been proven to boost your immune system. A recent study showed that men with higher levels of activity experienced a 35% reduction in number of colds. Women had 20% fewer colds. And excessive body weight/fat correlates with reduced immune response. (As if you needed another reason to take some pounds off.)

Get a Flu Shot. Last year's shot won't protect you against this year's flu. Get one every year. Best time to get vaccinated is in October or November, but it's worth doing any time during the winter. The flu shot is highly effective in totally preventing catching the flu and, contrary to popular belief, there is practically no chance you'll catch the flu from the shot itself. The flu shot will also help protect you against pneumonia and other potentially serious complications of influenza.

Keep Away from Smokers. I hope you're too smart to be a smoker yourself. Tobacco smoke paralyzes the cilia, those hairlike cells in the respiratory passages that sweep away infectious viruses and bacteria. If you smoke, you're more likely to get sick and stay sick longer than a nonsmoker. However, even regular exposure to secondhand "passive" smoke from others can affect the cilia in your nose and lungs. Avoid smoky places.

Take Supplements. Although no substitute for a balanced healthy diet, a daily multivitamin is cheap insurance that you're getting the nutrients your body needs. However, there is still debate on the wisdom of taking larger doses of certain vitamins. In addition to a multivitamin, I take extra vitamin C (500 mg) and E (400 iu) daily. There is also debate on the efficacy of the herb Echinacea. Again, following the philosophy of cheap insurance, I take 375 mg daily during the winter months. Because Echinacea apparently loses effectiveness if taken continuously, I go three weeks on, one week off. If I do catch something, I also take Goldenseal and Oreganol (Mediterranean oil of oregano). In some recent studies, these have exhibited effective antiviral properties, and may reduce the duration of a cold. I don't take zinc lozenges. They don't seem to help, and make all the food you eat taste terrible (especially citrus!). I've heard good things about Astragalus Root but haven't tried it yet.

If You Get Sick Anyway Despite all the drug ads on TV, there is only one thing that will cure a cold: time. However, you definitely do things to minimize your discomfort and shorten the time it takes to get well by following these simple instructions: Keep very well hydrated by drinking lots of non-alcoholic and non-caffeinated liquids: water, decaf tea, low-sodium soup, etc. Keep drinking even when you don't feel thirsty. Your body needs hydration to help kill off the bugs that are making you sick. Gargle with warm salt water or hydrogen peroxide every couple of hours if you have a sore throat. It'll relieve the pain and may speed recovery. Take OTC drugs only if necessary. If you're experiencing body aches or a headache, consider taking an over-the-counter pain reliever like Tylenol (Acetaminophen), Advil (Ibuprofen), or Aleve (Naproxen Sodium). However, be aware these symptoms often accompany a mild fever, and some medical experts believe a fever is your body's natural way of fighting off an infection. If you reduce a fever by taking acetaminophen or another similar drug, you'll feel better sooner at the expense of a longer overall recovery. By the way, I rarely buy name brand over the counter drugs. The generic equivalents have *exactly* the same active ingredients and are about half the price of the heavily-advertised name brands. Rest your body and mind. If you feel a cold coming on, don't stress out. Psychological stress triggers the secretion of the hormone cortisol, which will impair your immune response. If you feel the early signs, don't despair and say, "Oh no! I'm going to be sick." Instead, think optimistic, positive thoughts, "I feel something… but if I get some rest and take care of myself, I'll be fine." There is a powerful mind-body connection. If you think you're going to get well, there's a better chance you will. If you don't, you won't.

Here's how to tell the difference between a cold and something more serious, like influenza: A cold will usually come on slowly, about two or three days after you've been exposed (and the viruses have entered your body). It'll usually start with a sore or scratchy throat, and then other symptoms will take over: sneezing, runny nose, and occasionally mild fever. Toward the end, you may develop a cough – which can linger for quite some time after all other symptoms have disappeared. Most colds last between three days and a week. In contrast, the flu will come on fast and hit you like a freight train. The misery index will be a lot higher. Fever, body aches, etc. Fortunately, there are some new antiflu drugs available: Relenza, an inhalant, and Tamiflu, a pill. However, they must be given at the early stages of infection (the first 48 hours) to be effective. Your doctor may also prescribe one of the older drugs Symmetrel or Flumadine, but these are only effective against influenza A (the more common type). Relenza and Tamiflu work against both influenza A and B.

Warning: a cold, even when treated properly, can develop into a nasty bacterial infection. Here's why: when your nose is stuffed-up, normal drainage is blocked, and this can lead to sinusitis. If green stuff is coming out of your nose, you feel pressure in your sinuses, and have a fever over 101° Fahrenheit, it's time for a trip to the doctor. You'll probably need a course of antibiotics and a prescription decongestant. The other thing to be careful about is a very sore throat that persists longer than five days – or is so severe that just swallowing saliva is excruciating. You may have mononucleosis (mono) or a strep throat – a serious bacterial infection that can damage your heart valves or kidneys if untreated. Nonetheless, most upper respiratory infections do not call for an antibiotic. Some people insist on them at the first sign of a cold anyway, despite that over 90% of the time, the cause is viral and not bacterial, and the antibiotic does nothing except wipe out the beneficial bacteria in their digestive systems, causing its own set of problems.

About over-the-counter decongestant nasal sprays: Neo-synephrine and especially Afrin (Oxymethazoline Hydrochloride) provide wonderful, immediate relief of stuffy nose, but are "addictive" if used for more than four or five days. You run the risk of developing "rebound syndrome," where your nose remains stuffed long after the cold is gone. You become a "nose spray junkie," needing a fix several times a day just to breathe through your nose normally. I don't want this for you my friend. You've also got to be careful about blowing your nose. A recent study at the University of Virginia using CAT scans of nasal passages reported that vigorous nose-blowing can force virus- and bacteria-rich mucus deep into the sinuses – leading to sinusitis. You can reduce the chance of this happening by using an oral decongestant and/or antihistamine, using a saline nasal spray (which won't cause rebound) to loosen things up, and blowing gently when you need to. By the way, once you've recovered, you cannot reinfect yourself from the same toothbrush you used when you had the cold or flu – and certainly not from the same tube of toothpaste.

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