Cold Wars


Here we are at the end of 2017, and Mother Nature has mercifully taken her sweet time getting Old Man Winter up out of bed.  But at last, snow has come to New England!  To avoid “catching cold,” generations upon generations of moms have insisted upon scarves, hats and mittens for their kids when the temperature drops, insisting that failure to don the extra attire could even lead to pneumonia.  Now, we have long since learned that respiratory illnesses are caused by microorganisms rather than an infiltration of low temperature into the body, but even medical and public health professionals strongly recommend everyone get vaccinated for the “flu season” between September and March, so it is well understood that there is a link between seasonal shift and infectious illness.

We clearly can’t stop the weather from changing, so must we helplessly fall victim to this cause-and-effect phenomenon of cold-to-sickness?  Or is there a missing link between “cold” and “sickness” that we can do something about?

Allow me introduce you to the missing link: our Immune System.

I would dare say that our vast array of medical research worldwide has barely begun to scratch the surface of understanding all the hormonal biochemistry influencing two major human body systems – the immune system being one and neuropsychiatry (i.e., the physiology of the thinking mind) being the other.  These are both extremely fun topics to me in all my geekdom, but we’re going to stick with the immune system today!

Let’s think of our immune system as the military forces of our body, hell-bent on keeping us safe from microscopic harm.  There are numerous branches of this system, each with its own set of functions and tasks, just as the U.S. has an Army, a Navy, Marines, Air Force, and Coast Guard.  Even within one branch, there are subdivisions such as the infantry, the airborne units, special forces, etc.  Similarly, there is a complex and vast array of features biologically set in place to protect us, all of which comprise our immunity.  Maintaining the protection that the immune system provides us requires proper leadership and maintenance.  That is, all the cellular and biochemical elements of the immune system need to stay organized and strong in order to efficiently and effectively fight off the enemy.

I should say enemies, because there is no shortage of offenders out there.  Virus types alone – at least to our knowledge — easily number in the thousands, and each virus type rapidly and frequently mutates.  In other words, the enemy adapts and adjusts with the objective of infiltration.  Microorganisms live all over us all the time, you know.  It’s not that they disappear in the summer and appear in the winter.  It’s just that our protective forces are better supported and coordinated when the weather is warm and the sun is shining, so the microorganisms have less opportunity to multiply.  It is the strength of numbers that gives the enemies a tactical advantage.  When our immune system is ill-equipped to keep the population of offenders at bay, they abound and overcome.

What is it about Winter that weakens us so much?

For starters, the immune system is part of the living, breathing, organism that makes up a human being.  It requires energy in order to function.  When energy is low, the system is less functional.  As a quick grade school science review: humans are mammals, and mammals are “warm-blooded.”  When placed in a cold environment, warm-blooded creatures are preprogrammed to maintain a certain internal body temperature.  As briefly as I can, here’s the general process: the warm blood shunts away from the cold exterior of the body (away from skin and distant extremities like fingers and toes) towards the heart to keep the core warm for survival.  Cold skin/toes/fingers are uncomfortable and we generate more heat by moving to reopen the clamped peripheral blood vessels and send warm blood back to the extremities.  When we are cold enough, this movement can occur involuntarily in the form of shivering.  Movement burns up energy.  Energy expended on staying warm results in less energy available to maintain the immune system.

Hopefully the rest of the story pulls together on its own here: less energy to immune system means weak and tired immune system which is less capable to fight off enemy.  The end.

But well, it shouldn’t be the end, because wouldn’t we like a happy ending?  Keep in mind, too, this is just one of many story lines regarding the maintenance of a strong and efficient immune system.  Temperature is not the only piece of wintertime that compromises our immune health.  Lack of natural light, poor diet (oh, grandma’s holiday cookies!), dry air leading to fragile respiratory lining and relative dehydration, disrupted sleep patterns, and on and on.  The point is that these are all factors we can influence.  It just takes a little education, and some extra attention and effort.  We need not be victims.

None of it really requires any interface with the health care industry at all, if carefully planned for in advance and addressed with aggressive measures to support the immune system at the slightest sign of enemy infiltration.  Truthfully, these are things we have intuitively known (or, let’s give credit where credit is due: MOMS have known) for decades, even centuries.  Bundle up, go to bed on time, eat your fruits and veggies, etc.

As much as we wish it were, no human fortress is perfectly impenetrable.  So if you do “catch cold,” here are my basic suggestions for re-upping the front lines for battle:

  • Get plenty of rest, try really hard to sleep at least 6-8 hrs every night.
  • Please make sure you are staying well hydrated ideally with clean, fresh water.  My general recommendation is to take your weight in pounds and try to drink 1/3 to 1/2 of that number in ounces of water.  Try to minimize your intake of sweetened or caffeinated beverages.
  • Take Vitamin C 500mg at least twice daily. Better yet: eat citrus!  It’s in season this time of year.
  • Use Zinc lozenges (available over the counter), feel free to try this as often as you can tolerate
  • STAY WARM! 😉 Bundling up saves your body from having to expend energy to keep itself warm. Your immune system needs that energy to fight off the infection.

It is also important to manage symptoms that are otherwise impairing your ability to rest and revive:

  • For a sore throat: Gargle warm salt water twice daily — take 1 cup of water, microwave for 1 minute, add 2 tsp table salt, make sure it is fully dissolved and gargle as far back in the throat as you are able.  Don’t swallow any!
  • A nasal steroid like flunisolide (Nasonex) or fluticasone (Flonase) can be helpful for post nasal drip.  Use 2 sprays in each nostril twice a day for 7 days then just as needed thereafter.
  • Acetaminophen (Tylenol) is the most effective medication for suppressing fevers and the body aches that go along with fevers.  Ibuprofen (Advil or Motrin) is also effective but can be tough on the stomach.  As long as you do not have known allergies or intolerances to these medications, you can consider alternating doses of these medications every 4-6 hours.

Finally, you want to recognize when it’s time to seek medical attention.

Important note:  ANTIBIOTICS ONLY TREAT BACTERIA.  Bacteria are larger than viruses and slower to mutate, so we have medications that can be effective against them.

Another educational point:  Antibiotics don’t “treat bronchitis” or “treat the cold” – they target bacteria.  An antibiotic that worked for you in the past might not be a slam dunk every time because at a different time you might be infected with a different microorganism.  Taking antibiotics for viral infections only helps quiescent bacteria to mutate into something stronger – in other words, it aids the enemy.  So it is important to seek a medical evaluation when you aren’t sure.

But here are basic rules of thumb to suspect a bacterial infection:

  • If you have fevers that go above 101.5’F or if your mucous/phlegm becomes thick and dark yellow, green or bloody, call your doctor immediately, your infection may have converted to a bacterial cause and it would be appropriate to take an antibiotic.

Finally, after just about any major illness or injury, your immune system gets tapped from the long battle and it takes a while to re-tool the depleted arsenal.  Good leadership (that is, our personal decision-making about managing health) can help this along:

  • Have a goal of eating a diet heavy in fresh vegetables and lean proteins, and low in processed carbohydrates; let fruits and nuts be your ‘treats’ for a while, consider learning some tasty “green smoothie” recipes to make it easier to consume fresh produce.
  • Try to reduce your intake of refined sugar as this can really cripple the immune system.
  • Take Vitamin C, zinc, and/or Vitamin E, or perhaps megadose a multivitamin for 1-2 weeks (not something I would recommend longitudinally).
  • Drink plenty of water: calculate 1/3 to 1/2 of your body weight in pounds and drink that many ounces of water a day, to help flush out residual toxins.
  • Finally, as you can tolerate it, slowly step up your cardiovascular activity, try to do 20-30 minutes a time as many days a week as you feel you can, but try to increase this weekly.

Depending on the severity of the illness or injury, feeling completely “normal” again can take some time (at least a good 3-6 months sometimes) and plenty of personal effort, but it is worth it to feel better and stronger without medications that can cause side effects.