Category: Immunity Blog

While oral antihistamines like Claritin, Allegra, Zyrtec, and Xyzal alleviate some mild allergy symptoms, several patients remain symptomatic despite their use. This is where a patient would want to use a nasal spray or combination of them depending on the severity of the allergy symptoms.  Study after study over the last several decades shows that using nasal sprays can provide superior relief.

Nasal Steroids. Common names include Flonase, Nasonex, Nasacort, and Rhinocort or their generic equivalents.   They usually perform best in studies to control the four major symptoms of allergies like nasal itching, running, sneezing, and nasal congestion.   They tend to work best with routine usage and may take a few days to improve symptoms although as needed usage has shown some benefits but just not as good as routine usage.  Intranasal nasal steroids can help with viral infections as well as shown in many studies. The downsides include local nasal membrane irritation like nose bleeds and occasionally they can dry up mucus production too much leading to nasal membrane dryness.  One can mediate this effect by moistening the nasal membranes with edible oils and nasal saline.  Very few people (3-5%) are sensitive to nasal steroids causing increased intraocular pressures but this can be monitored if used routinely with an eye examination where intraocular pressures are checked. 

Nasal Antihistamines.  Common names include Astepro, Azelastine, and Olopatadine.  These are essentially liquid forms of antihistamines that can be used alone or in combination with nasal steroids.   When applied topically, nasal antihistamines can also help with nasal congestion and viral infection symptoms.   There are nasal sprays that combine both nasal steroid and nasal antihistamine in one bottle as they have a synergistic effect.   They can taste bitter.

Nasal Anticholinergics. Common names include Ipratropium.  Not a favorite of mine in the desert as these medications tend to decrease mucus production (too drying) and require frequent usage. Ipratropium is generally used for clear thin nasal rhinorrhea or a runny nose.

Nasal decongestants. Common names include Afrin, Vicks, or Dristan.  The ingredients are either oxymetazoline or phenylephrine.  They are vasoconstrictors but when used alone and longer than 3-7 days become habit-forming due to rebound blood vessel dilation or engorgement.   If followed with nasal steroids, this is much less likely to happen and was studied with no rebound out to 12 weeks.   So in combination, these sprays can be used longer than what the box states.  Patients with sleep apnea or sleep-disordered breathing from nasal congestion may want to try nightly with nasal steroids for better sleep patterns. 

Nasal Salines.  So many choices, but I like xylitol containing nasal saline without preservatives like Xlear and Xynase.  The trick here to stop the allergy drip is to keep taking a nip into the nose to help keep your mucus flowing backwards into the gut where your mucus is intended to go.  I try to encourage using nasal saline to keep pushing our mucus flow backwards as blowing our nose relieves nasal congestion only temporarily and does not address the dysfunctional mucus flow.  Spray and make that mucus slip away as opposed to using a tissue to blow and ruin the flow.

The best way to use most allergy nasal sprays is to look down at your toes, so “NOSE TO TOES” and place nasal spray tip just into nares pointing about 10 degrees away from the middle nasal septum. Spray up while gently sniffing.  Then bring your eyes and nose forward back to the horizontal.

MUCUS DOES NOT NEED TO BE A PAIN IN THE“TUCHUS” by DJFMD PC

Are you “blowing” the opportunity to improve the health of your sinuses when you reach for a tissue and blow your nose? It is a bad, misguided habit traumatizing your sinuses and only offers temporary relief.

Most people with allergies and/or sinusitis are no stranger to tissues and carry them on their person. We tend to react by blowing our nose when our respiratory mucus does not flow nicely into the stomach/gut natural destination. Most patients have a reactive thought process and reflex that “stuck” nasal mucus is “bad” and needs outward removal by blowing one’s nose into a tissue or “hankey”.  We think its gross stuff that should not be swallowed. However, I would like you to stop/reduce this habit and consider this proactive approach:

Mucus generation in several body systems acts as protective shield. Our gut and airways are constantly secreting mucus that is destined to flow into and through the gut. Airway mucus becomes a nuisance when it does not flow correctly because of several factors. The biggest factor is when inflammation such as allergies, poor air quality, or viral infections destroy the architecture of the underlying sinus membranes that interface with or “see” the outside world. Your sinuses need to generate mucus to coat these interfacing “walls” to protect from the “toxic” outside world. Nasal and sinus mucus are there to catch particles that can harm us and separate these harmful particles from the valuable, delicate human tissues that lie beneath. In fact, depending on your size, the sinuses usually generate 1-2 quarts of mucus daily. When mucus flows smoothly into the gut, we do not feel trouble or have mucus gathering excessively in the back of the throat known as postnasal drainage.    

The cell wall linings just below our mucus layers have cilia or “hair-like” tentacles that rhythmically sweep and emulsify your mucus to trap particles and bring down to the acidic, hostile gut. If barrier integrity exists, the flow is smoother. If the barrier is “cracked”, your mucus cannot flow well. We then have the feeling that we need to blow it out or throat clear.    Think about driving smoothly on a freshly paved road as opposed to our famous Tucson roads full of potholes and imperfections. It is a bumpy ride. Mucus flow is “bumpy” when the underlying surface is inflamed. This encourages more mucus secretion as an attempt to repair the cracks and fill in the “potholes.” Blowing your nose is a missed opportunity to improve the situation and does not create a smooth “silvered lining.”

As an analogy to a 2-story house, I think about my mouth as the downstairs and my nose/sinuses as the upstairs. We know how to take care of our mouth like brushing, flossing, rinsing a dry mouth, and generating saliva with physical stimuli like gum or lozenges. All these benefit our downstairs oral health. But when our upstairs sinuses misbehave or become dysfunctional sticky “Velcro” we just aggravate the situation by blowing our nose which traumatizes an already broken system. If you blow, you ruin your mucociliary flow!! It’s better to spray and make the mucus slip away into our guts. Just as “wetting your whistle” with a sip of water or so, improves comfort for your mouth and vocal cords, spraying your nose with high quality nasal saline (see med sheet for examples) helps your mucus flow in the correct direction. The trick is to spray your nose very frequently like 6-8 times a day as the arid climate of Arizona challenges our sinus mucus functionality. If your mouth is dry in the desert, your upstairs nasal cavity is dry and could use a nasal saline “drink”.  When “boogers” tenaciously adhere in your nasal passages, try and push it back as opposed to expectorating. Contrary to what you may believe or were taught, it is ok to swallow thickened mucus. In fact, mucus has tons of potential probiotic germs that may benefit our immunity if swallowed as opposed to blowing in a tissue and throwing in a waste basket. I tend to place edible oil (coconut, olive, and/or several other products like organic lip balms or non-petroleum plant-based oil products that are safe to ingest) in my nares/nose every morning to augment the “fresh smooth pavement” and “seal the cracks.” I spray Xlear nasal saline throughout the day to help my muco-ciliary clearance continue to carry my mucus in the proper direction. If you “slick” up your sinus linings, allergens, particles, and virus may not “stick”.  These habits create a non-stick Teflon-like barrier (A SILVER LINING) as opposed to a VELCRO catch all and sticky, glue-like lining.                                                                                                                                     05-2025

7 Ways to Reduce Respiratory Viral Infection complications

1. Support Your Microbiome – Maintain a high-fiber diet (40–50g/day) to nourish probiotics in the nose, throat, and gut for better immune defense.  If you do not routinely consume 40-50 grams of fiber (95% of Tucsonans) then you need to gradually increase.  See SuperDooperPooperTrooper Handout on YourOpportunityForBetterImmunity.com.                 Reference: Trompette, A. et al. (2018). Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nature Medicine, 24(4), 487-494.
2. Ibuprofen as Needed – Helps reduce inflammation, relieve symptoms, and may prevent severe complications. If allergies, we can possibly use Celebrex or meloxicam cox-2 type inhibitor. Clotting is a huge problem for severe viral infections.
3. Intranasal Steroids – Use Higher Dose (8-10 sprays a day) Flonase, Nasacort, or Store brand-like heal sinuses, relieve congestion, and reduce hospitalization risk. Routinely, using Xylitol-containing nasal saline (Xlear) and gargling with dilute (never full-strength) hydrogen peroxide(H2O2) like 1-part H2O2 and 10-19 parts water can reduce viral replication in those sites. Reference: Chalmers, J. D. et al. (2021). Inhaled corticosteroids and COVID-19 outcomes: A systematic review and meta-analysis. European Respiratory Journal, 58(3), 2101009.
4. Antihistamines – Both old and new types help with symptoms; Pepcid (famotidine) 40–80 mg has shown additional benefits.    Reference: Janowitz, T. et al. (2020). Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalized patients: A case series. Gut, 69(9), 1592-1597.  I believe famotidine works better when added to other allergy antihistamines like Claritin, Allegra, Zyrtec, or Xyzal.
5. Melatonin (Night Only) – High doses (~4 mg/kg) in short-term use may speed up recovery from viral infections. Doses like 20-50mg can be used. Reference: Zhang, R. et al. (2020). Melatonin as a potential adjuvant treatment for COVID-19 beyond sleep disorders: A systematic review of current progress and mechanisms. Frontiers in Pharmacology, 11, 1221.
6. Taurine (3–6g/day) – Supports anti-inflammatory and anti-clotting functions, vital for preventing severe illness. 2 grams 3x daily.               Reference: Marcinkiewicz, J. & Kontny, E. (2014). Taurine and inflammatory diseases. Advances in Experimental Medicine and Biology, 775, 3-12         
7. Azithromycin – Well-studied antibiotic with potential benefits for RSV, asthma, and RNA respiratory viruses.  It’s better to take within first 5 days but may help at any stage since helps put chronic allergic asthma into remission.

Polly wants a phenol Polly don’t want a cracker

I’ve learned not to follow nutrition science blindly. Chasing the next “superfood” or miracle nutrient can drive you crazy. We’re constantly marketed to believe we’re deficient in something—whether it’s protein, omega-3s, vitamin D, or the latest trendy polyphenol.

Everywhere you turn, there’s a new supplement: protein powders, omega-3 capsules, fiber gummies. While I do agree that increasing fiber intake is crucial, obsessing over every nutrient can be exhausting. I strongly recommend gradually increasing fiber intake to over 40–50 grams per day. See the Super Dooper Pooper Trooper handout or check out our educational handouts at YourOpportunityForBetterImmunity.com for guidance on how to build up fiber intake safely. The goal? Get at least 20 grams from supplements and another 20–30 grams from whole foods. This isn’t easy—after all, a cup of broccoli only has about 4 grams of fiber. But fiber, along with the phytonutrients in foods like cruciferous vegetables (broccoli, cabbage, bok choy, Brussels sprouts), plays a crucial role in health.

Polyphenols are one of these valuable plant compounds. These anti-inflammatory powerhouses are naturally found in fruits, vegetables, herbs, spices, tea, dark chocolate, and wine. They act as antioxidants, neutralizing harmful free radicals that contribute to cancer, diabetes, and heart disease.

There are different types of polyphenols, including bioflavonoids like quercetin, found in apple skins, onions, and red cabbage. Quercetin has shown promise in lab studies for suppressing allergic reactions by inhibiting mast cells from releasing histamines. Other polyphenols, like phenolic acids, are abundant in berries, while polyphenolic acids are found in spicy foods. While you can find these in supplement form, I question whether the cost justifies the benefit. Whole foods remain the best source.

That’s why Polly needs to eat whole seeds instead of low-nutrient saltine crackers. You find the best food choices by color. Focus on blacks, blues, purples, reds, and leafy greens. These pigments can’t be replaced by pills. Many supplement claims don’t translate to real-world benefits, and positive human trials are often exaggerated or inconsistent.

The supplement industry thrives on positive-publication bias, nudging consumers toward products that may not deliver real health benefits. Many studies are small, short-term, or inconclusive. Take multivitamins, for example—large-scale studies often show no clear benefits in reducing disease or extending lifespan. In some cases, they may even pose risks. Yet, many people continue taking them as a “health insurance policy.”

I grew up taking daily chewable multivitamins and have experimented with various supplements—probiotics, curcumin from turmeric, and quercetin for allergies and viral infections. But I’ve come to recognize that many of these claims are overblown.

The one supplement I will never stop taking? Fiber. It’s one of the few nutrients where research overwhelmingly supports its benefits. I’ve yet to find a well-conducted study that suggests increasing fiber intake leads to negative health consequences. If there’s one thing to prioritize, let it be that.

DJF 02-15-25

Do your Munchkins Follow the yellow brick road?  Munchkins is my term to describe your probiotics.

Or are they wicked germs or guardians of our health?

I believe promoting silver linings and golden poop optimizes immune and total body health.

A silver lining is an analogy for a fortified interface and a protective barrier functionality for the linings of the human body that communicate with the outside world.  The epithelial cells at your borders are your second line of defense against pathogens besides the guardian Munchkins that are concentrated at these surfaces that “see” the outside world are part of your first line defense.

Golden poop, otherwise known as a healthy gut function, involves harboring guardians of our health or Munchkins.  The ratios of the guardian microbiota (probiotics) have been associated with health and disease.  There are convincing models of treating the microbiome to improve other body systems such as neurological, cardiovascular function, bone function (your bone is where your immune system’s cells are born known as hematopoiesis).  There are convincing studies manipulating the microbiome with medications and formulations to shift them to a guardian state.

There is a potential for millions of factors to affect your probiotics.   You are the Wizard.  They are the munchkins.   Garbage in Garbage out.   Your gut flora is akin to 2 or so trillion passengers on the proverbial international cruise ship. The guardians can produce chemicals that lead to smooth sailing for your immune system.  The probiotics metabolites circulate throughout the whole human body and can act like a medication.   Your gut flora makes butyrate, which is known as a short chain fatty acid (SCFAs). These SCFAs have hormonal and pharmacologic effects.  Your probiotics make chemicals that can suppress appetite, build better muscle, bone, brains, blood vessels, breathing, and bowel function. These chemical SCFAs known as “postbiotics” keep powering the ship and help repair the ship’s structure.

These probiotics need the right environment full of nutrients to develop, divide, and diversify.  You want your ship of guardian Munchkins well fed and getting what they need.  These munchkins are dependent on your lifestyle.  They can be traumatized by several factors including medications like ibuprofen and antibiotics or chemical/pesticide residues in food.  But you can build resiliency of the gut and skin microbiome by catering to it.  See the Super Dooper Pooper Trooper article on habits to build healthy, diverse passengers as supposed to passengers sailing on a “ship of fools”.   Its on our website “YourOpportunityForBetterImmunity.com”

It is foolish to deny humans are supra-organisms made of trillions of germs with endless genomic material that is quick to change given the right opportunity.  Probiotics are like pawns in chess that are first line defensive players forming a shield and secreting antibiotics against potential pathogenic microbes.    The microbes can determine how well your immune system surveys your outer banks as well as your inner core structures.  Foreign DNA is very alarming to our immune system.  The more varieties of the microscopic world of probiotics our immune system sees, the more functional your immune system becomes. 

The facts are clear that most Americans get less than 20 grams of daily fiber due to our commercialization of food production and delivery.  However, probiotics flourish with any type of fiber including supplementation with natural and synthetic fibers.  You need to pave your Yellow Brick Road slowly with grams of fiber, so your wizardry can communicate with your munchkins because of the wonderful things they are!  Probiotics can give your immune system a brain, a heart, and courage to fight invaders.

Inject muscle like deltoid and thigh or Stick a Needle in my Eye?

Where our immune system is trained matters for long-term memory generation. Where we place foreign material for teaching the immune system to understand dangerous pathogens can be important on outcome measures. Vaccination campaigns have only recently switched to injecting myofibrils (muscle cells) in the early 20^th century (1920s-1940s) away from the more immunogenic skin targets of earlier vaccination campaigns.

I believe the smallpox vaccination campaign was successful at reducing morbidity and mortality of smallpox disease.  Edward Jenner injected only skin deep in 1796. The Langerhans cell is an immune presenting cell found in the skin in 1869 among the many layers of skin immunity. Other immune skin cell residents make the skin an ideal target for educating your immune system. The skin already is engaged in protecting you from the pathogens of the outside world, but your muscles are tucked deeper inwards and are more engaged with the function of locomotion. Muscles can generate immunity as demonstrated by antibody formation after injecting them, but they are not the best immune organs because they are not designed to protect you like your skin from the outside world.

Muscles are great targets for injection when you want dispersion of the molecule to the whole body to interfere with receptors as an example. This is where the molecule is a lock in key fit. When you want to teach the immune system to learn from exposure or you want to vaccinate, you want exposure controlled and slowly released over time. You don’t want rapid absorption throughout the body with infectious disease vaccines as side effects are more likely with rapid absorption. 

There are articles and studies supporting mucosal applied vaccines (sublingual, oral, conjunctival (eye drop)). The same human papilloma subunit particles injected into deltoid muscle have been studied as an eye drop.  That is again because the layers of immunity are structured to understand from an “outside in” exposure. When a needle is plunged past the outer layers into muscle fibers you get a different type of immunity as you bypass the outside “skin cell” guardians. You also get faster absorption into the body with intramuscular injections. In my opinion, faster absorption may lead to increased side effects like myalgias (muscle aches), fevers, and blood vessel and neurologic inflammation.

The FDA did approve intradermal flu vaccines in 2014 in the USA. Fluzone Intradermal was the same “stuff” used in the intramuscular vaccine used for decades but dose-reduced to only 0.1 ml, down from the 0.5 ml intramuscular dose. The only reason it was withdrawn was due to cultural/political issues of a slightly more difficult administration technique to hit the layers of the immune skin. We just witnessed an intradermal vaccine campaign in August 2022 with the new Mpox outbreak.  A reduced intradermal dose of 0.1 ml was used to vaccinate 5x the people compared to using 0.5 ml in the muscles. It is the same way Edward Jenner did it centuries ago. It was considered a successful campaign.

As an editorial statement, it is our belief that the intradermal route represents an opportunity for better immunity. It has been studied in small numbers in the allergy literature, as we know delivering allergens to different immune “compartments” like sublingual, oral, subcutaneous, intradermal, and even intralymphatic (directly into the lymph nodes) can be very effective.

My research tells me that there are less systemic side effects but slightly more local side effects with vaccinating the skin as opposed to the muscles. We must remember that our immune system can over-react to any exposure delivered to any body system at any time. We do have some science on underlying conditions that help make vaccination campaigns safer and more successful (see vaccine handout recommendations).

In 2021, I had never witnessed so much politicization of vaccine science. Vaccines will always have controversy as they are not completely risk free. We need more open debate/discussion and better post-marketing surveillance of safety and efficacy.  We should try and find the most effective dose and route again as Edward Jenner did some 225 years ago. Most physicians and pharmacists do not have enough training in vaccine science. They simply rely on our public health authorities since there is so much information in medicine today. Vaccine science is contaminated with several biases. Headlines you see about vaccine studies may suffer from multiple biases. For example, I can find articles that state vaccine recipients have less dementia. While it may be possible, I can see the “selection and life-style bias” in these studies because they are not prospectively randomized. They are retrospective. The reason for the lower dementia may not be because of receiving vaccines but may be from other underlying health conscientious factors like diet, exercise, and socio-economic power. It is likely that these factors are protecting against dementia. It is a difficult study to conduct prospectively, however.

Unfortunately, you cannot easily receive vaccines by intradermal routes. Most pharmacies follow the package insert for intramuscular administration of flu, covid, rsv, shingles, hpv, and pneumonia as a convention. Your voice can ask for better science for safety and efficacy.                                                                                                                                 

DJFMD opined 12-2024

Antihistamines – Over a Century of Pharmacological Wonder!

Most allergy sufferers are familiar with antihistamines such as Benadryl (diphenhydramine), Chlor-Trimeton (chlorpheniramine), Allegra (fexofenadine), Claritin (loratadine), Clarinex (desloratadine), Zyrtec (cetirizine), and Xyzal (levocetirizine).  The newer antihistamines, released since the 1980s, have much better characteristics with respect to efficacy and safety.  Older ones like Benadryl and Chlor-Trimeton are much more sedating, drying, and should have limited roles in daily use.  Furthermore, long-term use of older antihistamines such as Benadryl and Chlor-Trimeton are associated with dementia in the elderly and impaired learning in the young and emphasize need for limited use.

The evolution of improving the pharmacologic actions of antihistamines started with the de novo synthesis of histamine in 1907, which lead to the research to understand histamine’s actions in the human body around 1910/1911.   Histamine is an important chemical messenger exerting its effects through 4 different known receptors throughout the body.  As a comparison, serotonin, an important chemical messenger/neurotransmitter, has 15 known receptors.   Histamine has several functions such as neurologic transmission, cell proliferation, and wound healing to name a few.  Wounds sometimes itch due to excessive histamine. Excessive histamine release perpetuates inflammation through this cellular proliferation (cell growth).  Histamine is “kindling” for an inflammatory fire – antihistamines help put out the fire.

The first antihistamine was synthesized in 1937 and used clinically in 1942 but was “too drying” and toxic for continued use.  Benadryl was introduced in the USA in 1946.  Today, there are over 45 antihistamines available world-wide.   Interestingly, selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine), were discovered by tweaking the Benadryl (diphenhydramine) in the early 1970s. Of note, SSRIs have recently been shown to be antiviral as well.

Antihistamines have very good evidence for helping allergies including rhinitis, conjunctivitis, and itching.  They are also used for several other conditions such as nausea, migraines, insomnia, viral infections. Of note, recently and most exciting is the potential for antihistamines to help the immune system fight cancers and virus by changing the chemicals surrounding the cancers and virally infected cells.    It has been shown that excessive histamines distract the “killer T cells” which have been shown to “kill” cancers and “kill” “virally infected cells”.  Antihistamines are not a primary treatment for viral infections or cancer but may support the immune system’s healing ability by “mopping up” excessive histamines that may be counter-productive to healing.

Since antihistamines have been around a long time with a good safety record, I believe allergy sufferers benefit from their usage.  They are associated with improved outcomes of food and inhalant allergy immunotherapy. I recommend usage of the newer non-sedating antihistamines (Zyrtec, Allegra, etc.) while taking allergy shots.  I also recommend taking them when fighting a virus or cancer. However, always check with your prescriber before taking therapy even though they are over the counter medications.

Obviously, any medication can have unwanted side effects.  Allegra (fexofenandine) and Clarinex (desloratadine) have no sedation properties and commercial airline pilots are permitted to take them while flying.   With other antihistamines such as Zyrtec and Xyzal, some patients feel sedated, foggy, experience dry mouth, weight gain, urinary retention, or constipation.  Again, the newer ones are less likely to cause these untoward effects.

In summary, in my opinion, there are several immunologic benefits of antihistamines when considering the allergy relief, anti-viral, and anti-cancer effects.  Allergy immunotherapy has been shown to markedly reduce the need for antihistamine usage in the long-term. However, while building up in your allergy shots, one should strongly consider taking newer, safer antihistamines for better long-term outcomes.

ANTI-VIRAL and ANTI-ALLERGY DEFENSE

By David J Friedman, MD

SEAL THE CRACKS, SO THE VIRUS and ALLERGENS CAN’T ATTACK!! IMMUNITY HAS YOUR BACK!!

As viruses are everywhere and transmission dynamics are not fully understood, it is a “genius move” to prepare your immune system for “bad” microscopic particles. These particles include hostile virus or inflammatory allergens like pollen.  The world is covered in them.  Thank you, “Immunity”!!

Boost your immunity with the tools below.  Go to resistantstarchresearch.com to read further.

1. Prebiotic fiber at least 20 grams in supplementation extra, beyond your food. More grams of fiber equal a better immune system. Resistant starch(RS) like potato starch (Bob’s Red Mill Potato Starch(approx. 2 tbl dissolved in water @night). Don’t heat) is totally different than the highly glycemic modern-cooked potato and is currently being studied for COVID-19.  It is more tolerable on your gut and better than other fibers at turning into short chain fatty acids(SCFA) like BUTYRATE.  I use both inulin and resistant potato starch. IT IS IMPORTANT THAT IT IS RESISTANT “STARCH” AND NOT “FLOUR”.  Resistant starch like fiber is not digested and is broken down by probiotics in the colon.  THIS IS THE MOST IMPORTANT HABIT TO OPTIMIZE HEALTH!!  It improves the agility of your immune system to react in a reparative way as opposed to a destructive tone.  It is very kind to your probiotics!!
2. Probiotic-containing foods like yogurt, kefir, kombucha and/or any probiotic capsule or supplement. I buy the cheapest supplements but feel cultured foods/drinks are better.
3. Barrier maintenance-Olive, Coconut, or Medium Chain Triglycerides (MCT) oils applied to the inside nostrils with a finger, swab, or dropper. Oleic, Caprylic, and Capric acid are the active ingredients in oils that “seal cracks” and are anti-viral. The sinus secretes these oils (fatty acids) to kill bad germs. Oil in the nose protects from dryness, infection and irritation.  Ingest Olive and MCT oil most days. Nasal saline is very helpful. Xlear contains xylitol and is better than just nasal saline. Saliva contains IgA antibodies that protect.  Make more saliva with xylitol gum especially when in   Dry mouth is very bad for respiratory health and helps you get a respiratory infection like pneumonia.  Xylitol is good for the mouth in gums and mouthwashes.
4. Vitamin D shouldn’t get low. If it does get low, you advantage wayward inflammation, allergy, asthma, and cancer.  1000-5000 IU per day is fine but be prudent about getting 50% of your skin in the sun at least 20 min 1-2 weekly.  Sun exposure also raises anti-viral melatonin.
5. Melatonin (5-600mg) is used to treat viruses. It helps HIV, Ebola, Influenza, and Covid-19. Much more than a “sleep” hormone. It improves “vaccine” responses and is an “immune booster”.
6. Curcumin is the active anti-inflammatory agent of Turmeric. Trademarked active ingredients that are reliable are C3, BCM-95, Meriva, and Theracumin. Don’t take if on blood-thinners.
7. Fuel your body on short chain fat(Ketones) that comes from the fiber/starch you eat and supplement. More is better.  Oleic acid in olive oil and Omega-3s are obviously healing fats. Running on glucose is the fuel of allergy, inflammation, and cancer.  Fasting helps increase fatty acids or ketones in your blood.  MCT and Coconut oil helps nutritional “ketosis”
8. Resveratrol (grapes, wine(contains probiotics), peanuts, and berries) activates genetic components called “sirtuins”. If you call upon these when ill, they will heal you. Sirtuin activation slows or even can prevent age-related illness as well as “acute” illness.
9. Beta-Glucan fiber found in mushrooms, nutritional yeast, seaweeds, and insect shells like roasted crickets. Any one of them will do 3 days or more a week with meals is a good base.

Should one become ill with respiratory troubles such as sore throat, coughing, shortness of breath or fever one should consider the following:

1. Yale University, in 2020, tried giving Bob’s Red Mill potato starch at 20 grams (approximately 2 tablespoons) 2x daily dissolved in water within 48 hours of COVID-19 symptom onset. I put a few ounces of pomegranate juice in the solution.  Don’t heat it or it becomes “sugar”.  Once daily on the first 3 days, then 2x daily to aide in fighting the virus. I think this is a study that may elucidate the importance of the microbiome in maintaining health. So, with an active virus, the study is giving 40 grams of resistant starch. Increase supplemental fiber and resistant starch(RS) before you get sick!! Butyrate regenerates!!! Fiber and good fats manipulate your microbiome in a diversity-inducing, healthful fashion.
2. Probiotics 2x day with travel or illness. Your microbiome is your first line of defense.  It is unknown what probiotics do to your microbiome, but there are studies showing less severity with viral infections when taking them.  Extra fiber or RS is more important.
3. Eat more beta-glucan fiber in mushrooms. Turmeric if not on blood thinners.
4. Vitamin C and Quercetin at 1000 mg is safe. They have a wide therapeutic index.
5. Zinc at 50 mg may help hasten viral infection recovery. Zinc is the second biggest element behind iron in the human body.  Eating foods high in zinc is proactive.  Tree nuts, seeds, legumes, shellfish, and meat are highest.
6. Spicy food- Capsaicin is anti-viral and 3 big studies lately out of USA, Italy, and China show longevity. Capsaicin can kill virus and cancer. Intranasal capsaicin helps allergies!!
7. Vitamin D- Vitamin D has a wide safety index. 2 million IU can damage or possible even kill you, but large doses like 100,000-500,000 have been given in studies.
8. Cold exposure- Activates sirtuins and puts your body in survival mode. Lowers oxidation or “internal rusting”.  Cold showers, plunges, ice packs galore when sick can hasten recovery in the second week of illness.  Raising body temperature (warm bath) may assist viral clearance in the first week by stimulating interferon (an immune hormone that blocks virus and cancer)
9. Sleep- Make sure you get enough, and it is efficient. You can take “big” doses of melatonin(6-8 mg/kg/day) if sick.  It has a wide safety profile. It has a “plethora” of immune effects.  Melatonin has multiple health effects beyond sleep.  Your gut can make melatonin if given fiber
10. Do not delay an evaluation with a health care provider. Earlier diagnosis and treatment can prevent severe complications. Urgent cares and ERs are places that quickly get data like labs and x-rays to help diagnose the problem.
11. Please remember that you may incubate virus that can infect others. Generally speaking, transmission of virus occurs when people are at high “viremia” states. More copies of the virus are produced usually when symptomatic. Asymptomatic and pre-symptomatic transmission can occur but there is usually less virus to spread at that time than when symptomatic.  Hand washing and proper hand etiquette is important.  Don’t cough into your hand.  Don’t touch the front of your mask when you wear one.

PREBIOTICS, PROBIOTICS, and POSTBIOTICS ARE THE TRIFECTA OF HEALTH!

The pre-pro combo is smart but those who make the post are the host with the most!!

PREBIOTICS- A “coined” phrase that means fiber.  It is the nutrition or energy that your probiotics depend upon for their livelihood. Good fats like olive oil, MCT oil, and omega-3 help your probiotics as well as more fiber grams.  The human body was designed to see 70-150 grams per day of prebiotics otherwise known as fiber.  On average most Americans get 15-25 grams of fiber per day from our modern foods.    If one does not consume the fiber they were designed to, they run the risk of suffering from chronic diseases in all arenas of health in all body systems.  If your gut biotics are not fed appropriately with 30-50 grams of daily fiber you compromise your healing ability. Taking extra fiber can cause gas and bloating if too much is taken too soon. Go slow and try taking supplemental fiber in the evening before sleeping as it may reduce gas and bloating.  Building up to 20 grams of extra fiber per 24hrs over several weeks is your ultimate goal!!!  Your microbiome depends on plenty of good fat and plenty of fiber!  RESISTANT STARCH LIKE POTATO STARCH IS VERY VALUABLE AS WELL.  GO TO RESISTANTSTARCHRESEARCH.COM for further reading.

PROBIOTCS– The actual microbial species that confer a health benefit to the host or humans.  The market for PROBIOTICS is vast and built on overstated benefits.  It’s fine to take a probiotic and eat cultured foods like yogurt, but doing so does not create microbial diversity that is essential to health. Also, do not fall for marketing claims that one brand is the ideal brand, because we only know the tip of the iceberg on species diversity.  Doing both prebiotic and probiotic supplementation is prudent and safe.   One needs to drastically increase their total fiber consumption in a day to get closer to at least 30-50 grams per day. 50 grams is better than 30 grams per day, but one has to do it very slowly to accommodate the gas and bloating when bringing your gut “alive”.  Most people believe they can do it with food but there is no need to stress about fiber grams since your probiotics are blind and don’t mind fiber supplementation.  It’s very hard to grind 50 grams of fiber per day.  Use supplementation!  The probiotics thrive just as well on fiber supplementation, as they can’t tell whether the fiber came from a powder, gummy, bar, wafer or foods like apples and artichokes.

POSTBIOTICs– What happens when one takes a medicine like ibuprofen for joint pain or headache? The medicine absorbs through our gut and goes to the liver, where it is processed or metabolized and redistributed to the whole body where it exerts its action.  POSTBIOTICS are the same but do not come from a pill or your human cells or body.  POSTBIOTICS comes from the fermentation of prebiotic fiber by your probiotic gut germs. Butyrate is a well-known short-chain fatty acid (SCFA) postbiotic metabolite that results from fermentation. BUTYRATE circulates through your whole body including your brain.   Your probiotics turn prebiotic fiber into postbiotic metabolites that are extremely valuable to your health.  If butyrate is elevated in your blood relative to glucose, you will heal better.  If glucose remains relatively high compared to butyrate, you are fueling infection (bacterial, fungal, or viral), neoplasm or cancer, and inflammation like rheumatic and allergic inflammation.  You want to fuel on SCFAs like butyrate, acetate, and propionate.  All three SCFAs are elevated when fiber grams/resistant starch are elevated by any means either food or fiber supplementation.    Generating butyrate in the gut directs your immune system to heal and directs cells to behave as they were designed to behave.   Butyrate supplements exist, but don’t buy them, as you should calculate fiber grams to elevate butyrate. You would rather have your microbiota make your butyrate along with many other helpful postbiotic molecules that you would miss out on if you rely on butyrate supplements.  The skin germs also generate butyrate, but human skin cells don’t make it.  Soap and ultra-hygienic behavior lower butyrate levels.  Butyrate’s purpose is to guard all your surface area.   05-21

Tips to keep you well anywhere you go!

by David J Friedman MD.

Prophylaxis

1. Bob’s potato starch 1-2 x day. 2 heaping tablespoons dissolved in water.  Do not heat as it will turn into sugar.  There are no calories to the human body, as it is resistant to digestion, acts like prebiotic fiber, and gives your probiotics a big boost.  Can use an alternative fiber like psyllium, inulin, or wheat dextrin (Benefiber).  Regular usage of 20 extra grams of supplemental fiber is best.  COM for more info.
2. Melatonin every night. 10-100 mg is very safe.
3. Probiotics 1-2 x daily when travelling or you get sick.
4. Vitamin D 1000-5000 daily. Sun yourself a little as well.
5. Zinc 50 mg
6. Vitamin C and Quercetin 1000 mg daily
7. Nasal oil (mct, coconut, olive). Must be completely edible.  Place in nostrils every day in the morning and before leaving for the airport.
8. Nasal Saline. Xlear is best because xylitol may help kill viruses. Don’t get dry mucus membranes.  If cracked, you get attacked!!
9. Chew or Hold gum in your mouth to create more saliva which protects you from pathogens either bacterial, fungal, or viral through antimicrobial lipids, peptides, and IgA.

If you get sick

1. All the above still plus:
2. Get going on electrolyte fluids but keep calories on the lower side. Take in only ketogenic, when possible, as raising blood sugar when ill promotes illness and worsens intensity and duration.  Chicken soup is good but reduce the noodles
3. Bigger doses of melatonin 50-100 mg have been used to treat viruses with some success
4. Warm tea. Honey is ok as it calms cough and is a good prebiotic
5. Probiotics 2 x daily. TAURINE (an amino acid) 3-6 grams per day
6. Ibuprofen 400 mg plus acetaminophen 1000 mg every 6 hours
7. Antihistamines may benefit viral infections as histamines are elevated with tissue injury. Famotidine (PEPCID) and Zyrtec are currently being studied for COVID-19 illness. Antihistamines help allergies, viral infections, and cancer.
8. Gargling with 10% hydrogen peroxide salt-water solution as gargling with an anti-septic can reduce viral replication. 1-part H2o2 9-parts water. This has been proven to reduce respiratory viruses in dental literature
9. End your shower cold as cooling the body prevents oxidation
10. Wear a mask and treat it like a biohazard when not wearing it as it likely contains infectious agents on it. Wash your hands after touching it.  Don’t touch your mask much while wearing it.
11. If you start to get nasal congestion, sinus pressure, less sense of smell, then start an intranasal steroid like Flonase, Nasacort, Rhinocort at 2 sprays each nostril 2x daily for a total of 8 pumps followed by nasal oil (coconut/olive oil) to avoid dry membranes. Sniffing Vicks or fragrant natural essential oils may help with return of sense of smell known as olfactory training.
12. If wheezing or bronchitis-like symptoms like a “chest cold”, then start inhaled-corticosteroids like Flovent, Symbicort, Budesonide by nebulizer. 2 sprays 2-4x daily rinsing and spitting after use.
13. If very sick, you can consider dexamethasone or prednisone, but this is only if you have severe immune responses (cytokine storm). Try topical steroids first before oral/injectable steroids.
14. Azithromycin has shown anti-viral and anti-inflammatory properties and could be considered as well. There is a rare risk of cardiac arrhythmia.
15. SSRI antidepressants like Fluvoxamine, Fluoxetine, and Sertraline have anti-viral properties. Evidence to support this notion that SSRIs are anti-viral goes back about 20 years just like melatonin research.