Vaccination is a highly polarized and controversial issue. However, in the case of the flu shot, the evidence is relatively straightforward. Several large reviews have been published in the prestigious Cochrane Library on the efficacy of influenza vaccine in various populations. It’s difficult to reconcile the almost hysterical promotion of the flu shot by medical “authorities” with the results of these studies, as you’ll learn when you listen to this episode. I hope this radio show clarifies what the scientific literature actually says about influenza vaccine and helps you to make an informed decision for yourself and your family.
In this episode, we cover:
2:47 What did Chris eat for breakfast?
5:23 Does the flu shot really prevent sickness and death in adults?
19:07 Does the flu shot really protect young kids and the elderly?
35:22 How to prevent colds and flus naturally
44:36 What to do if you get sick
Links We Discuss:
- Scientific American – “Flu Shots May Not Protect the Elderly or the Very Young”
- Estimating influenza vaccine effectiveness in community-dwelling elderly patients using the instrumental variable analysis method
- Antivirals for treatment of influenza: a systematic review and meta-analysis of observational studies
- Vaccines for preventing influenza in healthy adults (a Review)
- Vaccines for preventing influenza in healthy children (a Review)
- Vaccines for preventing influenza in the elderly (a Review)
- How to prevent colds and flus naturally
- Fermented COD Liver Oil
- Jade Windscreen
- Life Extension Lactoferrin
Full Text Transcript:
Steve Wright: Hey everyone. Welcome to another episode of the Revolution Health Radio Show. This show is brought to you by ChrisKresser.com. I’m your host, Steve Wright from SCDLifestyle.com, and with me is integrative medical practitioner, licensed acupuncturist, and healthy skeptic, Chris Kresser. How is everything going, Chris?
Chris Kresser: It’s good, Steve. I’m feeling a little cooped up. It’s been raining for several days, and according to the weather report, no sign of stopping. And being a Southern California native, I’m just not a big fan of constant rain. I like it for a little bit, but then I start to go a little bit stir crazy. I think I’m gonna have to put on some rain gear and just get outside anyway later today. But otherwise pretty good. How about you?
Steve Wright: I’m doing well. It’s also raining in Michigan, but it’s about 35 degrees, and I’m sure snow will be right behind it.
Chris Kresser: Uh-huh. I actually prefer snow to rain. I think it would be easier for me to live in a snowy place than a rainy place.
Steve Wright: Oh, I 100% agree. I mean, living in Michigan — I couldn’t live in one of the middle states. Like, I would rather — if it’s gonna be below 45, I want some snow.
Chris Kresser: Yeah.
Steve Wright: Otherwise, there’s nothing to do.
Chris Kresser: Because you can get out there in the snow and, yeah, ski, snowboard, move around. There’s just something about the rain that it makes it, for me at least, pretty unpleasant to be outside, but I love being out in the snow.
Steve Wright: Yeah, here in Michigan we have some sweet trash hills that we ski on.
Chris Kresser: Haha. Not that I’ve been doing much skiing or snowboarding lately. I’ve been a little too busy. I imagine this is probably good for the snow in Tahoe, though. I might have to check it out.
Steve Wright: Yeah, it’s a lot of fun. I’m not sure if you’ve ever done it.
Chris Kresser: Oh, lots of times, but having a 16-month-old daughter hasn’t been all that conducive to it so far, and I didn’t get up there even once last season. So maybe it’ll be different this time.
Steve Wright: A couple more years, and she’ll be one of those little crazy kids I always see with the helmet on that just bomb past me.
Chris Kresser: Oh yeah. She’ll be tearing it up. I already got her on a surfboard when we were in Costa Rica earlier this year. So, you know, surfing, snowboarding, all that stuff.
What did Chris eat for breakfast?
Steve Wright: Amazing. OK, well, before we get into the hot topic of the day, which is gonna be flu shots, vaccines, and all of the sickness that ensues, what did you have for breakfast?
Chris Kresser: Oh right. Yeah, so this morning I had chicken soup actually. It was kind of a Southwestern-style chicken soup that we made the other day. So I had some sweet potatoes, celery, collard greens, carrots, homemade chicken bone broth made with heads and feet, so extra gelatinous, and then some Southwestern kind of spices. Yeah, it was good. Chicken is my least favorite of all the meats, but one way that I do like to eat it is in soup. And on a rainy day, nothing beats chicken soup for breakfast. You should try it if you haven’t.
Steve Wright: Haha, all right.
Chris Kresser: I know you have, Steve, being an SCD/GAPS kinda guy.
Steve Wright: Yeah, I’m kinda chuckling because that’s actually what I ate today as well. I made like an extreme version of chicken soup where I just emptied every spice I had into the crockpot to see what would happen, and I made this crazy, spicy concoction with turmeric overflowing everywhere, so everything is stained yellow, and I gotta clean it up later.
Chris Kresser: Haha, right. Soup’s a good way to manage leftovers, too. You know, if you’ve got a little bit of this, little bit of that from different dishes and you can put it together with some broth and some spices, it usually turns out pretty well.
Steve Wright: Yeah. It’s pretty tough, I feel like, to mess it up.
Chris Kresser: Haha. Oh, I’ve seen it done, believe me.
Steve Wright: Yeah. Watch out with the fennel seed.
Chris Kresser: Speaking of chicken soup, that’s probably a pretty good segue for the topic today, huh?
Steve Wright: Yeah, I think it is, but first you should probably get some more broth and do a little meditation session, and in the meantime, I’m gonna let everybody know about your program, Beyond Paleo. So if you’re new to this radio show, you’re new to the paleo diet, or you’re just somebody interested in optimizing your health, you’re going to want to check out what Chris has put together. It’s a program called Beyond Paleo, and it’s a free 13-part email series that Chris is gonna send right to your inbox on his best tips and tricks for burning fat, boosting energy, and preventing and reversing disease without drugs. So if this is something you’re interested in — remember it’s free — head on over to ChrisKresser.com, look for the red box, and go ahead and put your name and email in there and sign up.
OK, Chris, are you ready for the subject of today’s show?
Does the flu really prevent sickness and death?
Chris Kresser: I’m ready. Today we’re gonna talk about the flu shot, vaccination to prevent influenza. Some of you who follow me on Facebook or Twitter might have noticed I posted a link to an article by Dr. Briffa, who I sometimes link to. He’s a physician in the UK and shares a pretty similar perspective, and he was commenting on a study that was done at the Center for Infectious Disease Research and Policy at the University of Minnesota, which I’ll talk about a little more in a second. And the gist of the article was that vaccination is — and this is not his quote. This is a quote according to the researchers who did the study — “over-promoted and over-hyped.”
And it’s always really interesting to see the response. You know, I talked about vaccination before on another show and discussed just how controversial and heated and polarized it really is, and it’s one of those issues where it’s not just about calmly discussing what the research says. There’s a lot of emotion behind it. There’s a lot of belief and dogma that is not evidence based, and I’m always curious about people’s reactions when I post things like this, and it happens on both sides of the spectrum, so I’m not just saying that this is present in the pro-vaccination crowd. There’s a lot of hysteria and dogma on both sides.
But you know, I posted the study, and a lot of people have a kind of angry response and indignant response and accuse me of being silly or irresponsible in some way for linking to a study that clearly casts doubt on the efficacy of the flu shot. And I have no problem with someone disagreeing with me, but I would like to at least see some discussion about the evidence rather than just kind of parroting the conventional viewpoint that flu shots save lives and that they’re necessary and we should all get them. And I kinda wonder where people are getting that information and what they’re basing their strong opinions on. Is it based on evidence? Is it based on something they’ve heard from somebody else? Is it based on fear? Is it based on a belief system that modern medicine is somehow infallible? Or is it based on an idea, like a distrust of alternative medicine or a distrust of people who challenge modern medicine? I don’t know. I’m genuinely curious about it, because the reactions that I get whenever I post anything about vaccination are much stronger than just the actual information would suggest.
Steve Wright: You know what’s crazy about this, too, is you also have some professions and especially what we’re talking about, some health professions. I looked at an article from 2009, but I’m sure I saw it again this year, where Spectrum Health Group here in Michigan, which is a really big provider, basically requires everyone in their staff to get these flu vaccinations. And it’s grounds for firing if you don’t comply.
Chris Kresser: That’s right, and you know what the other side of that that’s even in some ways more interesting is that where those flu shots are optional in healthcare settings, a very low percentage of doctors and nurses actually volunteer to get them, something like 26% to 28%. So what do they know that the general public doesn’t know? Why do doctors and nurses who have more exposure to evidence and information on this subject choose not to get the flu shot?
So, let me just preface the rest of this discussion by saying what I always say when I talk about these kind of polarized issues, is that obviously the decision can’t just be made based on the information and the data alone because the data are somewhat equivocal. I actually think that for flu shot they’re not that equivocal, and I’ll talk about that more in a second. But in the case of vaccination overall, you have to consider the information and the evidence. I think any decision made about any health choice should be evidence based, but there are some cases where the evidence is just not clear enough to be the only reason behind a decision that’s made, and personal values come into play and what’s most important to you and which risk you feel is the one that you want to take, because there is risk on both sides. But let me go through some of this information here about the flu shot, and then everyone can decide themselves whether it makes sense for them, based on their values and based on their interpretation of this information. But my goal, as always, is to just give you the facts in as unbiased a way as possible, and I’ll freely admit that I don’t get flu shots myself, and since I’ve looked at the evidence, I don’t feel that it’s necessary, and I don’t think the potential risks outweigh the potential benefit. So if that constitutes bias, then I am biased, but to me, that just reflects my interpretation of the evidence. I didn’t enter into that decision-making process with a strong feeling one way or another.
So, this report from the Center for Infectious Disease Research and Policy was really interesting. They started off by saying that:
“In an effort to reduce influenza morbidity and mortality, over the last three decades the ACIP [Advisory Committee on Immunization Practices] has expanded the populations recommended to receive influenza vaccine. These recommendations, however, often were based on professional judgment and not on scientifically sound data.”
So, in translation, they’re saying that over the past few years, there’s been a lot of pressure on people to get the flu shot with the idea that it’s gonna prevent sickness and death, but that recommendation has been based more on professional judgment than data. And Tom Jefferson, who has done a lot of work in this area, he’s been the lead author on several of the papers, the meta-analyses and reviews that were published by the Cochrane Collaboration, which is an independent group that does meta-analyses of studies on various topics to try to reach some consensus. And over the last several years, Tom Jefferson and his group have published a number of papers in this area, so he says:
“We have conducted four reviews since the late 1990s. We calculated that you need to vaccinate between 33 and 99 people to prevent a single case of flu, depending on the match between the vaccine and the circulating strains of the virus. I want people held accountable for wasting taxpayers’ money on these vaccines. The reviews have been available for years and nothing has been done.”
Now, those are really strong words from an independent researcher. For anyone who’s read scientific papers, you will know that that kind of strong language is seldom used, and even in interviews outside of the papers themselves, researchers are very wary of using language like that because, of course, if their viewpoint evolves over time, then that could look bad. Just the nature of science, a good scientist is to keep an open mind, and so that will sometimes preclude making a strong statement like that, but nevertheless, that was the statement he made, and he’s the one who’s been doing these reviews.
So, this leads to one of the main problems with vaccine research, and that’s bias. In a 2010 review that Jefferson and his group at Cochrane published, they actually included a warning in bold text that was underneath the authors’ conclusions, and I want to quote from this as well. It says:
“Warning: This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found that industry-funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size.”
Meaning the rate at which studies were cited had nothing to do with how good they were. It had everything to do with whether they were funded by the industry or not.
Steve Wright: No!
Chris Kresser: Haha, yeah. He goes on to say:
“Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines.”
That is a well-known phenomenon in the world of medical research. There’s something called the “file drawer” phenomenon where if a drug company does a study and the results are not favorable to the drug, then that study will end up in, you guessed it, the file drawer. He continues:
“The review showed that reliable evidence on influenza vaccines is thin, but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies. The content and conclusions of this review should be interpreted in light of this finding.”
So, basically he was giving a huge caveat to the results of this study, but even with that caveat, even considering the fact that we very likely can’t take the results of those trials at face value, they found that you would need to treat between 33 and 99 people to prevent a single case of flu.
Now, one of the problems with flu vaccination is that it tends to not work very well if the strains of flu in the vaccine don’t match the strains of flu in the environment, but even when the match is perfect, 1% of flu-vaccinated individuals end up with an infection, compared to 4% of unvaccinated individuals, but that’s very rare actually to have a perfect match between the strains of the flu and the vaccine because viruses adapt and evolve very quickly, and it’s hard for vaccine producers to keep up. So, when there’s only a partial match of the vaccine with infecting strains, which is usually the state of affairs, the figures are even worse. One percent of vaccinated individuals end up with an infection versus 2% of unvaccinated individuals, so in other words, the true reduction in flu risk in the population in the vast majority of cases in healthy adults is a mere 1%.
So, let’s put this in perspective. I’ve talked before about the difference between relative and absolute risk reduction. The news media report on this study might say: Flu vaccine cuts your risk of getting the flu in half! Now, that’s technically true because the risk relatively went down from 2% to 1%, but what they don’t tell you is that the absolute risk reduction went down from 2 in 100 to 1 in 100, which is an overall absolute risk reduction of 1%. So this means that you’d need to treat approximately 100 people to prevent a single case of flu, or put another way, of 100 people that get the flu shot, 99 of them won’t benefit at all.
Now, in the words of a physician who blogs at Frugal Family Doctor, if the number needed to treat, which we’ve just been covering, the number of people you need to treat to get one outcome, is above 50, it’s at best “a lottery-type bet that you might be the lucky one who is benefited more than you are harmed. If you are of that mindset, you would probably also play the horses, vacation in Vegas, and not wear seat-belts. You are gambling.”
So, if the stakes are really high, like preventing death, and there’s a nonexistent risk and the treatment has no cost either to the patient or the health care system, you might be able to justify a number needed to treat of 100. And the argument is often made for the flu shot that it prevents complications like pneumonia or transmission to other people, you know, this idea of herd immunity that if healthy people get vaccinated, that will protect people that are less healthy. But the Cochrane review actually found that “There’s no evidence that flu vaccines affect complications, such as pneumonia, or transmission” in healthy adults, so that kind of eliminates that argument.
Does the flu shot really protect young kids and the elderly?
But what about the idea that flu vaccine protects the most vulnerable populations? This is another reason that people — You know, they might say: OK, well, maybe adults don’t need to get flu vaccines, but young kids and the elderly should because they’re at the biggest risk if they get the flu. Well, what does the research say about this? According to Jefferson’s group, they actually published a study just in 2012 a few months ago on influenza vaccine in kids both over 2 years old and under 2 years old. Now, in kids over the age of 6, there was a slight decrease in influenza with the flu vaccine, but in kids under 2 years old who are thought to be the most vulnerable, they had this to say:
“Inactivated vaccines in children aged two years or younger are not significantly more efficacious than placebo.”
“We could find no evidence of effect on secondary cases, lower respiratory tract disease, drug prescriptions, otitis media [aka ear infection] and its consequences and socioeconomic impact.”
They also said:
“Extensive evidence of reporting bias of safety outcomes from trials of live attenuated influenza vaccines (LAIVs) impeded meaningful analysis. One specific brand of monovalent pandemic vaccine is associated with cataplexy and narcolepsy in children, and there is sparse evidence of serious harm (such as febrile convulsions) in specific situations.”
So, this suggests that these are not free of risk. These vaccines are not completely benign, and you’ll know that if you look in the insert of the packages for the vaccine. They go on to say:
“It was surprising to find only one study of inactivated vaccine in children under two years, given current recommendations to vaccinate healthy children from six months of age in the USA, Canada, parts of Europe and Australia. If immunization in children is to be recommended as a public health policy, large-scale studies assessing important outcomes and directly comparing vaccine type are urgently required. The degree of scrutiny needed to identify all global cases of potential harms is beyond the resources of this review.”
So, translation: Why are we recommending routine vaccination to kids 6 months of age in the US when there’s no evidence to support it, when there are very few studies confirming that it’s safe? That’s not an evidence-based recommendation. That’s a recommendation based on a belief system. And kids’, very young children’s health is potentially being put at risk by doing this.
Steve Wright: Sounds like a billion-dollar question.
Chris Kresser: Yeah, exactly. So to me, it’s like if we’re gonna have an informed discussion and debate about the validity of this practice, we need to understand what the evidence actually says, and it actually says that there’s no evidence that supports flu shots for kids that age, and there’s some evidence that suggests that they could cause harm. Now, that’s not conclusive, but the authors of this review are clearly suggesting that we need more safety data before we start recommending this as a routine practice. It’s not an insignificant risk, and the stakes are high when you have kids that are that young.
Let me actually read one more paragraph that was part of that study for kids. The authors wanted to reiterate that: “This review includes trials funded by industry.” They go on to remind us of that systematic review of 274 studies that showed that vaccine studies that were funded by industry were cited more than independent ones, and then they said: “The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.” Again, I think I already read that, but good to be reminded!
Steve Wright: Haha, write it down.
Chris Kresser: So, the elderly. There was another review actually just published, I think in 2012, by the Cochrane, except instead of being on kids, this one was specifically on people over 65 years of age. And they wanted to find out not only if the influenza vaccine prevents influenza but if it prevents complications, like hospitalization and death, because that’s, of course, the main argument used for using the flu vaccine in elderly people. So here’s the conclusion:
“The available evidence is of poor quality and provides no guidance regarding the safety, efficacy, and effectiveness of influenza vaccines for people aged 65 years or older. To resolve the uncertainty, an adequately powered publicly-funded randomized, placebo-controlled trial run over several seasons should be undertaken.”
So, basically they’re saying there’s not enough evidence either way to say anything about the efficacy of vaccines in this population. And this is what’s really interesting to me: The way that the FDA is set up in theory — in practice, it’s much different than this — but in theory, the burden of proof is on the manufacturer of a treatment. So, it’s not that all treatments are considered safe until they’re proven unsafe. That would be a disaster. Think what would happen if a drug company could just introduce a treatment and then just find out, you know, a year or two later that they were unsafe because people were dropping dead after taking their treatment.
Steve Wright: I’ll keep my mouth shut, but yes, go on.
Chris Kresser: That has actually happened several times, of course. We could name many examples of that.
Steve Wright: Yeah.
Chris Kresser: But that’s not how the process is supposed to work. The process is supposed to be a company introduces a treatment. They have a hypothesis that it has a certain effect. They go through an extensive, long period of trials. You know, animal trials, then going into clinical trials of different phases to prove not only the efficacy of the treatment versus placebo, but also in many ways more importantly, the safety of that treatment. And the mandate of the FDA is to protect the health of consumers, people like us. Unfortunately, because of massive conflicts of interest in the medical system, it often does not happen like that, and when you start to read the flu vaccination literature, you’ll see several comments by people suggesting that somehow vaccines, in particular, have completely escaped this normal process of drug development and drug approval. In many cases, the vaccines that are used do not have the quality of evidence, the standard of evidence that would be required for other kinds of drugs. In fact, someone left a comment on my blog or Facebook — I can’t remember which — who is actually a former FDA employee, and he said — You know, this is anecdotal, of course, but he just said what a joke the approval process for vaccines is, that they don’t put them through any of the same protocols that they would for normal drug development.
One of the main problems — getting back to the research in the elderly, in particular — with vaccine research is that it’s epidemiological in nature. We’ve talked a lot about this. If you’ve been listening to the show or you read my blog, you know that epidemiological studies are very good for generating hypotheses but not for confirming them, because there’s just a high potential for confounding. An example of this would be if an elderly person who gets a flu shot is less likely to get the flu — You know, if we see an association between elderly people getting flu shots and lower rates of flu, that does not prove that the flu shot was the cause of those lower rates of getting the flu. It might seem like that’s the case, but there’s nothing that can prove that in an epidemiological study. For example, it could be that the elderly people that get flu shots happen to be more health conscious than those that don’t get them. And there’s actually some evidence that suggests this is the case. Some studies have shown that flu vaccination is associated with a lower risk of death even outside of the flu season. Now, deaths from flu outside of flu season are so low they’re almost nonexistent, so getting the flu vaccine outside of the flu season should not cause a significant reduction of deaths. The fact that there is an association between flu vaccine and lower risk of death outside of the flu season suggests that there’s another factor causing reduction of deaths in elderly that get the flu shot, like, for example, what I just mentioned, a higher health consciousness.
A study published in the Archives of Internal Medicine attempted to take this into account. The researchers looked to see whether flu vaccination reduced the risk of hospitalization due to flu and/or pneumonia as well as the overall risk of death. Now, in contrast to the Cochrane review, this one study found that vaccines led to a slight reduction, 14% I think, in the composite outcome. So, a composite outcome is when you put all of the different outcomes that are measured together into one, so hospitalization due to flu and/or pneumonia plus the overall risk of death. But when they analyzed the risk of death separately, there was no difference in people who received the vaccine and people who didn’t. So, this directly contradicts the argument that flu vaccine saves lives in the elderly, which again is one of the main arguments that’s advanced for giving them to elderly people.
Finally, what about antiviral drugs like Tamiflu for people who have already acquired the flu? There was a large review of studies, 74 studies, published in the Annals of Internal Medicine that found that Tamiflu “may provide a net benefit over no treatment of influenza. However, as with the randomized trials, the confidence in the estimates of the effects for decision making is low to very low.” And they issue a similar caution to what was issued by the Cochrane Group, which is that:
“The studies were probably biased because of confounding. Neither cost nor targeting strategies were evaluated. The studies focused on drug-sensitive infections, so the results may not be applicable if resistant viruses are prevalent.”
Regarding that last bit, they went on to say:
“The included studies focused on antiviral treatment of drug-sensitive influenza virus infections; therefore, caution should be used when applying these results to the current treatment of circulating influenza viruses, which are generally resistant to [these drugs], or in the future, when the prevalence of antiviral-resistant viruses could increase substantially and unpredictably.”
So, let’s summarize everything that we’ve covered so far. Number one, in general, flu vaccines are not effective for adults. You have to treat between 33 people when the vaccine and infecting strain are well matched, which is rare, and 100 people when they’re not well matched, which is much more common, to prevent a single case of flu. Nor have vaccines been shown to prevent complications or transmissions. Vaccines have not been shown to be more effective than placebo in kids under 2 years old and may have significant risks that are not yet well understood. As for the elderly, the most recent Cochrane review suggested that there’s no evidence vaccines are effective, and randomized clinical trials are needed to clarify the issue. So, almost all of the evidence in the case of the elderly is epidemiological in nature, which as we know, is not sufficient to prove the safety or efficacy of a drug. The FDA could never come out in public and say — You know, imagine for a drug like an antidepressant or something for heart disease that they would just take two groups of people and give one group the drug — or just let the drug out in the general population and then 10 years later do a study and see, did the people who took the drugs fare any better than the people that didn’t? That’s not how drug approval works. That would be a disaster for all the reasons that we already said. And yet that’s exactly what’s happening in the case of flu vaccine and the elderly.
As always, you have to make your choice. But it’s important that you have the right evidence before you do make a choice. And unfortunately, I just don’t think that that’s happening. I think a lot of the people have the wrong impression about what the evidence actually says about the efficacy of the flu shot. So, I hope that this has been helpful in that regard. And there’s no judgment here about what decision you make around it. I just really want people to have the accurate information before they do make that decision.
Steve Wright: I think you’ve provided an amazing overview of what’s been published, what the facts are. And I think one thing that, from my perspective anyway, probably the biggest fear is what you hit on with the elderly, but we didn’t really talk about it for young children or adults, which is the fear of complications leading to death from the flu. And I was curious if you had any statistics on the percentage of people who get the flu and end up dying.
Chris Kresser: I did mention that in both the studies on young children and the study on adults that I opened with that there was no evidence that the flu prevented complications or transmission. So, that would suggest that getting a flu shot isn’t gonna make you any less likely to develop complications from the flu.
Steve Wright: Makes sense. And because I didn’t hear you say it, I went to the CDC’s website while you were talking, and I pulled up the numbers, and they’re saying that between 15 and 60 million Americans, so 5% to 20%, will get the flu on average per year and that they don’t really know how many people die from the flu, but over the last 30 years, the range which might die in any given year is 3000 to 49,000. And so if you do a little dividing, you take the 15 million and the 49,000, your risk of death would be 0.0032. And if 60 million people get it and 49,000 die, your risk is 0.00084.
Chris Kresser: That’s three-tenths of a percent and less than that, which is — You know, we could do some interesting comparisons on risk of death from other things, like car accidents and flying in a plane and stuff. That’s some good detective work there, Steve.
Steve Wright: Well, yeah. I think it’s important because when you talked about the risk of — I’m big on thinking about the risk of taking a treatment route. And so you talked about, especially in young kids, that there’s definitely evidence that there are some severe side effects here. And so when you’re talking about risk this low, I think it’s very important to think about that.
How to prevent colds and flus naturally
Chris Kresser: The risk for those side effects is probably very low too, but if the risk of side effects is equal to or greater than the risk of benefit, then that doesn’t bode very well for a treatment. You know, a treatment like that would not be approved if it went through the normal regulatory process. So yeah, once again, I’m completely open to looking at more evidence about this if people have evidence that suggests otherwise. A single trial that suggests vaccines are effective that’s sponsored by a drug company that makes the vaccine, however, is not that convincing. That’s why I prefer to rely on independent reviews. I will give more weight to independently done studies for that reason. So, if you do send evidence, just keep that in mind. And if you’re looking at evidence, keep that in mind yourself.
So, one of the obvious questions that can come up in this discussion is, all right, so I’m not gonna get a flu shot, I never did get a flu shot, or maybe you’ve convinced me not to get a flu shot, but I don’t want to get the flu, so what should I do? A while back, I wrote an article on my blog called How to Prevent Colds and Flus Naturally, and you can look that up, but I’ll give you some of the tips that I put in there as well as some additional tips for what happens if you get the flu and other things that I’ve found to be helpful both in my own life and in my practice with patients.
So, the first step is pretty much always the first step when we talk about preventing illness, and that’s a nutrient-dense, low-toxin diet. So, that means avoiding foods that tend to weaken the immune system such as excess sugar, refined flour, unprepared grains perhaps and legumes, industrial seed oils, and other highly processed and refined foods. And it means favoring foods that are extremely high or very high on the nutrient density scale. So, we’re talking about organ meats, which pretty much blow almost every other food out of the water in terms of nutrient density. I just read a very interesting study about that that I’m gonna include in my book, by the way. Organ meats are between 7 and 10 times more nutrient dense than whole grains, according to this study, which is really great to see that in the peer-reviewed scientific literature. But organ meats, cold-water fatty fish are extremely nutrient dense, red meat, all different forms of meat, vegetables, fruits, starchy tubers, and then nuts, especially if they’re soaked to break down the phytate and make the minerals more absorbable. These are the foods that you want to focus on.
Fermented COD Liver Oil with or without the butter oil are good choices. We’ve talked about this a lot. It’s rich with fat-soluble vitamins, particularly retinol. Retinol, which is the active form of vitamin A, plays a really important role in the immune system. And it’s been shown that people who are vitamin A/retinol deficient, which is actually a significant number of the American population, are more susceptible to infectious disease. So, that’s really important. I’ve personally found that just as a prophylaxis, taking fermented cod liver oil helps keep me from getting sick. But if I feel like I’m starting to get sick, if I double or triple the dose for a few days, it usually knocks it right out. The cod liver oil also has fatty acids like EPA and DHA that can be helpful in that situation.
Bone broth is another good choice. It’s rich with easily absorbable minerals like magnesium, phosphorus, sulfur, and trace minerals that are difficult to obtain elsewhere. There’s, of course, a big anecdotal tradition, Grandma’s chicken soup when you’re sick, and there’s definitely something to that from a nutritional perspective.
Fermented foods and/or a commercial probiotic. Seventy to eighty percent of our immune system is in our gut, the gut-associated lymphoid tissue, or GALT. So, if you have intestinal dysbiosis or poor gut flora, that’s gonna make you more susceptible to viral and bacterial infections and thus colds and flus.
A lot of people swear by a neti pot, which is something you can use to irrigate your nasal passages. This isn’t something that I do personally, but a lot of people swear by it.
Vitamin C is really important for immune function. I don’t supplement with it throughout the year, but when cold and flu season rolls around, I’ll often take about a gram a day as a precaution. A food-based form is preferable. Something from rose hips or Acerola cherries is a good idea.
And then vitamin D plays a potent immunoregulatory role. For some people, the fermented cod liver oil/butter oil blend is enough to maintain adequate D levels, but other people require additional synthetic D3 to keep their levels in a range of maybe 35 to 50. And this is especially true of people with obesity or inflammation because those conditions can impair the conversion of sunlight to vitamin D. So, someone who is overweight and/or dealing with inflammation, they could spend the exact same amount of time in the sun as someone who doesn’t have those conditions, and they won’t convert as much sunlight to vitamin D, so they’ll tend to need more supplemental vitamin D.
And frequent hand washing makes a huge difference. I’ve seen this personally. I posted a little question on my Facebook page about what people’s best tips were for preventing colds and flus, and a large percentage of people said that they’ve had a lot of success with just washing hands frequently. Of course, haha, one of the other most popular comments was stay away from children! Which is easier said than done for some people, right? I don’t get colds that often. I’ve had more since Sylvie was born, definitely, and especially when she’s around a lot of her friends, so I think there’s some truth to that.
Steve Wright: When Sylvie’s having her tea parties and her friends come over, you should probably pick up some zinc gluconate because I was just in the zinc rabbit hole the other day, and if you’re dealing with a cold, you can definitely, according to the research, lower the duration by a couple days, like one to three days, if you start either doing zinc lozenges or just supplementing with oral zinc gluconate.
Chris Kresser: Yeah, you must have read my mind. That was my next thing to talk about. And that tends to work better when you catch it early than it does if you’re already further advanced into the cold. But there’s definitely solid research on that.
It probably goes without saying, but getting adequate sleep and rest is one of the most important things you can do to optimize your immune function. Just a few nights of not sleeping well has been shown to elevate inflammatory markers and reduce the protective capacity of your immune system. The natural rhythm, if we’re gonna talk about things from an evolutionary perspective, would have been for humans to go to bed earlier during the winter because we didn’t have artificial light, so once it got dark, we would probably just have eaten and gone to bed shortly thereafter. So, it’s a good idea to try to have some approximation of that natural rhythm since that’s the one we evolved in over millions of years.
The last thing for prevention, there’s a formula in Chinese medicine called Yu Ping Feng San. My Chinese is terrible, so I apologize to any of you who are Chinese and just heard me slaughter that. It’s an immune system tonic. The Western name for it is Jade Windscreen, which is a pretty cool name, I think. And it’s made up of botanicals that enhance the immune system and have antiviral, antimicrobial properties like astragalus, atractylodes, ledebouriella. Those are the traditional ones, but the modern preparation usually includes cinnamon and silver root, Chinese yam, and white peony. You can usually buy Jade Windscreen at a health food store like Whole Foods or something where they have all the supplements, and you can also buy it online. A good company for Chinese herbs is Kan, and they have a tincture. You take about 10 to 20 drops of that two or three times a day. This is contraindicated during pregnancy. And in some people with autoimmune disease it’s probably not a good idea because it stimulates the immune system. So, if you already have an overactive immune system, it may not be the best idea.
What to do if you get sick
So, let’s talk about a few things if you find yourself with a cold or the flu already. Now, of course, all the things that we mentioned for prevention are also helpful for treatment, so you could just bump up all of those things. For example, instead of taking 1 gram of vitamin C a day, you could bump that up to 3 grams. Some people swear by taking a big dose of vitamin D for three or four days, like 25,000 IU per day. I’ve never seen any evidence that supports that in the scientific literature, but anecdotally I’ve heard a lot of people say that it helps them, and I don’t think there’s that much danger to that, especially if you’re just doing it for three to four days. You wouldn’t want to do that for any significant period of time.
But also there are a few additional things you can add to your routine. One is lactoferrin. Lactoferrin is a protein that’s present in mother’s milk, and one of its roles in mother’s milk is as an antiviral. It also chelates excess iron, which can be harmful to the fetus. I’ve talked about lactoferrin before in the context of a way of reducing iron overload for people who can’t donate blood or even for people who can who want to further reduce their iron levels. But studies have shown that lactoferrin is able to inhibit the replication of rotavirus in a dose-dependent manner. It hinders the virus attachment to cell receptors since it’s able to bind to viral particles and prevent both rotavirus hemagglutination and viral binding to susceptible cells. And one study showed that lactoferrin markedly inhibited rotavirus antigen synthesis and yield in a cell culture. And I’ve, again, heard some really strong anecdotal reports from people that when they started taking lactoferrin when they had a flu or even for prevention, it made a huge difference for them. I’ve been experimenting with it myself, but I haven’t had a cold or flu lately to really know if it’s helping or not. It’s always difficult to tell when you’re doing different things.
It’s really important to take the apolactoferrin form. There are different forms of the lactoferrin protein, and the apolactoferrin form is the one that you want to get. And there are different options. The one I tend to use in my practice and myself is from Life Extension Foundation, and I think it’s even called apolactoferrin on the bottle, but even if it’s not, you’ll see on the label that it says apolactoferrin. If it doesn’t specifically say apolactoferrin, then it’s probably not, and you should avoid it.
Lauricidin, which we’ve talked about several times before, is an antiviral. It’s monolaurin, and monolaurin is an extract of lauric acid, which is another substance that’s found in breast milk. Nature is very smart, you see? And it’s found in coconut products, too, but it’s more concentrated and has a stronger antiviral effect.
And then you’d want to up your intake of probiotics, fermented foods, kombucha, things like that. Ginger, garlic, those things are antiviral. So like a ginger, lemon, honey tea. Honey has some antiviral effects, especially manuka honey. And adding extra garlic to your food. Some people even eat raw garlic. I’ve never really been able to tolerate that, but if that works for you, you can do it. And if your partner and everyone else in a two-mile radius around you doesn’t mind, haha, go for it!
Steve Wright: Yeah, it makes you smell pretty bad, for the record.
Chris Kresser: So, those are a lot of options. And many of them are evidence-based in the modern scientific literature. Some of them are more anecdotal and more along the lines of traditional wisdom. But when you put them all together, I think that you could argue that their efficacy would be superior to the flu shot, which hasn’t proven to be very efficacious at all. And the risk is extremely low. Everything that I mentioned is very safe.
So, I think that’s it. That’s a good place to stop. I hope this was helpful to everybody. And again, I’m open to any good-quality, peer-reviewed research on this topic, and I’d like to hear about everyone’s experience with flu shots and just with natural flu prevention in general. Come leave a comment on the show. We’ll put all of the studies that I mentioned in the show notes. We’ll link to the previous blog post that I wrote about preventing colds and flus naturally. Make sure to check the comments. There are, I don’t know, 60, 80 comments or something with other people sharing their recommendations, which is the great thing about being part of a community like this. Yeah, I think that’s it.
Steve Wright: And they can also find you, Chris, on Facebook at Facebook.com/ChrisKresserLAc, and you can also tweet Chris at Twitter.com/ChrisKresser. You probably check those on an often enough basis, right?
Chris Kresser: Yeah, we’ve never really talked about that. If you’re on Facebook and Twitter, you should definitely come check me out there because there is a lot of information that I share on Facebook and Twitter that never gets shared anywhere else, because I tend to write a couple blog posts a week, and they’re more research-based and in-depth, but if I come across a study that I think is really interesting or one of my colleagues does, I might just link to that on Facebook and provide a little comment. And then other people join in, and we get into a really interesting discussion. The same thing happens on Twitter. So, if you want to stay really current and know what I’m thinking about and get my feedback or reflection on current events, health-related stuff, Facebook and Twitter are good tools for doing that.
Steve Wright: Awesome, well this has been a great podcast. I know that I’ll be forwarding this to a lot of people that I know to hopefully get through the flu and cold season of 2012/2013.
Chris Kresser: Yeah. Good luck with that, and I’ll be curious to hear how all of these natural prevention and treatment strategies go for people if they start doing it.
Steve Wright: Awesome, well, we want to thank everyone for listening today. We hope that you keep sending us your questions at ChrisKresser.com. Use the podcast submission link, and we’ll get those. And if you enjoyed listening to the show today, please head over to iTunes and leave us a review. Leaving us reviews gets us more exposure to people who might need these types of tips to have a better health and a better life, so we really appreciate you taking the time to do that. And as always, again, thanks for listening, and we’ll talk to you on the next show.
Chris Kresser: Thanks, everyone. Have a great holiday period.
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