What Your Doctor May Not Tell You About Influenza (square)

What Your Doctor May Not Tell You About the Flu (Influenza)

What Your Doctor May Not Tell You About Influenza (Facebook title)

What is Influenza?

Influenza, commonly referred to as “the flu,” is an acute viral illness that primarily affects the respiratory system.  (What is frequently referred to as the “stomach flu” is not actually “flu” at all.)  You can expect symptoms to be similar in nature to a common cold, but more severe in degree.  It usually has a fairly sudden onset.

The most common flu symptoms are fever, chills, cough, sore throat, runny and/or stuffy nose, muscle or body aches, headache, and fatigue.  They may range from mild to severe, and not everyone will have every symptom.  Fever, when present, may be high.  Occasionally, gastrointestinal symptoms (vomiting and/or diarrhea) may also occur; this is more common in children than adults and is not typically characteristic of influenza. 1

There are multiple varieties of viruses that cause the flu, most of which are categorized as “influenza A” or “influenza B.” 2

The flu can lead to complications, such as sinus infections, pneumonia, or heart inflammation (myocarditis), some of which are serious.  Always be careful to watch for signs of difficulty breathing, dehydration, etc. 3

It is difficult to ascertain the actual fatality rate of influenza, because the CDC’s “flu” category for recordkeeping isn’t limited to flu but, rather, includes “influenza and pneumonia.” 4  This is a logical grouping, as pneumonia as a complication is the primary reason for flu deaths, but it’s potentially misleading because we have no idea how many of those cases of pneumonia had other causes.

How is Influenza Spread?

Influenza is spread by droplets of respiratory secretions, distributed by coughing, sneezing, and simply talking or breathing.  It can also be spread by transmission of these droplets when people touch their faces or cough or sneeze into their hands, then touch surfaces, where others pick the droplets up on their own hands before touching their own eyes, mouths, or noses. 5

How is Influenza Treated?

As is the case with most viruses, most of the treatment for influenza revolves around symptom management.  You want to avoid the development of complications such as dehydration or pneumonia, so measures to aid with hydration and the clearing of mucus are desirable.

Sometimes doctors administer Tamiflu™ (oseltamivir), an antiviral drug, which may decrease the duration of symptoms by approximately a day.  There are some reasons to be concerned about the use of oseltamivir, though.  Common side effects include nausea, vomiting, headache, and pain — which makes the benefit questionable, since these are probably some of the same symptoms you’re hoping to reduce.6

Other side effects can be severe, including potential liver inflammation (a double whammy if you’re also taking acetaminophen/paracetamol), and psychological symptoms such as confusion and hallucinations.  Japan banned the drug for minors years ago, after a number of suicides were attributed to it. 78  Industry insiders assure us that oseltamivir does not cause any increase in neuropsychiatric effects.910  You’ll have to use your own judgment regarding whether these study models are appropriate to answer that question.  (Personally, I’m skeptical.  It seems to me one ought to compare those who did commit suicide to those who did not.)

The FDA approved the drug for use, despite being aware that, in their words, “Tamiflu has not been proven to have a positive impact on the  potential consequences (such as hospitalizations, mortality, or economic impact) of seasonal, avian, or pandemic influenza.” 11  According to a Cochrane Review, not only does the drug not have the impacts specified above, it increases the risk of “renal events” (kidney involvement), along with headache, nausea, and vomiting, and decreases antibody production. 12 (So it reduces the duration of symptoms by approximately a day, but in tradeoff,  may result in having less flu antibody once you’re well.  I’m not aware of any studies that investigate this, but logic suggests that might potentially mean less resistance to future flu exposure.)

Another common intervention for the flu is the fever-reducer Tylenol™ — acetaminophen/paracetamol.  Considering a fever is the body’s mechanism for fighting the virus, the wisdom of eliminating it is questionable.  Imagine leaving a soldier on the front lines of battle — but taking away his weapons — and that’s essentially what you’re doing when you eliminate the fever while the body is still invaded by the influenza virus.  Add the effects of acetaminophen on the liver (even a single extra dose can be deadly, and Tamiflu seems to affect the liver, as well, so the two together may have a compounded effect we haven’t considered), and it’s possible that treatment for the flu could be deadly.

So what can you do?  Since it isn’t possible to kill the virus itself outright, there are two basic approaches left.  The conventional approach is to oppose the body’s natural efforts to fight the illness, using drugs that are potentially damaging.  The second option is to support the body’s natural efforts to fight the illness, by strengthening the immune system and working with what it’s trying to do (for instance, helping its efforts to clear mucus as opposed to suppressing a cough).

Vitamin D supplementation may be helpful.  Studies specific to influenza have been mixed or unimpressive, but vitamin D has been shown to have “some beneficial influence on the incidence and severity of” some respiratory illnesses 13, and ensuring strong levels of vitamin D isn’t harmful, so it might help and won’t hurt.

Vitamin C is, according to animal studies, useful for increasing the immune response to the flu virus, while simultaneously reducing lung inflammation and protecting against pneumonia. 141516

It’s also possible to manage symptoms in supportive, rather than oppositional, ways.  Addressing a cough with a decongestant designed to help break up mucus and move it out is helpful; suppressing a cough may be harmful (although temporarily to facilitate sleep it may be something of a “you do what you’ve gotta do” kind of thing).  Gently lowering a fever that’s getting excessively high by methods such as cool cloths or socks is a better choice than attempting to eliminate a fever, leaving the body vulnerable to the unfought infection.

Homeopathic and herbal remedies, such as oscillococcinum and elderberry have anecdotal and/or traditional support, but empirical evidence is mixed.  Some studies have shown elderberry to be beneficial (more effective, in fact, than Tamiflu17).  Evidence for or against oscillococcinum is lacking, but it should not carry any risk.  Low-risk remedies may be worth trying even if evidence is scant for their efficacy.

Research has also shown that moderate humidity levels (40-60%) are beneficial.18

What About the Flu Shot?

The usefulness of the seasonal flu shot is debatable.  Efficacy varies somewhat from season to season, as each year’s flu vaccine is a guess — an educated guess, but a guess, nevertheless.  Health experts predict which strains of influenza they think will dominate the coming season, and those are the strains that go into the vaccine.  Years that the vaccine is a good match to circulating strains, the efficacy is at the higher end of the range; years that it’s a poor match, it’s at the lower end.

Overall, it seems that flu shots, on average, probably reduce your risk of flu from just over 2% to just under 1% — with less effectiveness in pregnant women and babies.19  Continually getting them, year after year, appears to decrease their effectiveness.20

On top of that less-than-amazing track record, seasonal flu shots also decrease overall immunity21, and if you do still get the flu, within the season or two following your flu vaccine, you’re more likely to spread it, due to increased amounts of “fine-aerosol viral RNA.”22

The vaccine is being recommended for pregnant women, but it hasn’t been adequately tested in pregnant women (see the package insert), and studies are mixed.  Some show no major risks, but others show increased rates of miscarriage/stillbirth (this seems to be particularly so with the H1N1 vaccine and/or with multiple vaccines in a single year) and/or increased infections in newborns.23242526

Meanwhile, “experts'” recommendations are that you talk about the evidence but then ignore it and do what they want you to do.

“Health officials say they understand that the information may be of concern to pregnant women. They advised pregnant women to talk to their health-care providers for the most accurate information and to determine the best timing for a flu shot.

The CDC, the American College of Obstetricians and Gynecologists and the study authors continue to recommend that pregnant women get a flu vaccine during any stage of pregnancy because of the danger influenza poses to women and their developing babies.”

Flu shots are cultured in egg protein (something to be aware of if you have an egg allergy), and multi-dose vials contain thimerosal (mercury).27  The nasal vaccine is live, meaning it can shed and spread the flu.  If you get the nasal spray version of the vaccine, please stay home, as you are contagious.

Final Thoughts

Whether or not you get the flu shot, please take basic measures to help protect your own health and that of others. Please STAY HOME if you’re sick. Wash your hands frequently and practice otherwise-good hygiene. Be sure your vitamin D intake is good throughout the season. And keep your indoor air at a moderate humidity level (40-60%-ish).

If you’re interested in reading more about the science and religion of the flu shot, this piece from The Atlantic is excellent(It seems to have an overall pro-vaccine bias, so the conclusions that the flu shot may not be the miracle we’re led to believe it is should not be taken lightly.)


Necessary legal disclaimer: The statements made here have not been evaluated or approved by the FDA. Nothing here is intended to diagnose, treat, cure or prevent any disease. All information provided here is intended for educational purposees and is not meant as a substitute for or alternative to information from healthcare practitioners.

What Your Doctor May Not Tell You About Influenza (pinnable title)

  1. https://www.cdc.gov/flu/symptoms/index.html
  2. https://www.cdc.gov/flu/about/viruses/index.htm
  3. https://www.cdc.gov/flu/symptoms/symptoms.htm
  4. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
  5. https://www.cdc.gov/flu/about/disease/spread.htm
  6. https://www.drugs.com/tamiflu.html
  7. https://www.newscientist.com/article/dn11451-japan-bans-tamiflu-for-teenagers/
  8. https://www.theage.com.au/national/tamiflu-linked-to-suicides-20090530-br4c.html
  9. https://www.ncbi.nlm.nih.gov/pubmed/19026027
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847353/
  11. https://doi.org/10.1136/bmj.e7689
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464969/
  13. https://www.ncbi.nlm.nih.gov/pubmed/31768940
  14. https://www.ncbi.nlm.nih.gov/pubmed/23700397
  15. https://www.ncbi.nlm.nih.gov/pubmed/26898166
  16. https://www.ncbi.nlm.nih.gov/pubmed/25710018
  17. https://www.aafp.org/afp/2014/1001/p497.pdf
  18. https://www.forbes.com/sites/leahbinder/2019/10/17/harvard-researcher-says-this-inexpensive-action-will-lower-hospital-infection-rates-and-protect-us-for-the-flu-season/
  19. http://www.cochrane.org/CD001269/ARI_vaccines-prevent-influenza-healthy-adults
  20. https://www.cmaj.ca/content/187/6/E180
  21. http://cid.oxfordjournals.org/content/54/12/1778
  22. https://www.pnas.org/content/pnas/115/5/1081.full.pdf](https://www.pnas.org/content/pnas/115/5/1081.full.pdf
  23. https://www.washingtonpost.com/news/to-your-health/wp/2017/09/13/researchers-find-hint-of-a-link-between-flu-vaccine-and-miscarriage/?dti=1424300224538112&fref=gc&tid=sm_fb&utm_term=.fd7b607c92a9
  24. https://www.ncbi.nlm.nih.gov/pubmed/30632885
  25. https://www.ncbi.nlm.nih.gov/pubmed/31703366
  26. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

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