The Dr. Hyman Show - Exclusive Dr. Hyman+ Functional Medicine Deep Dive: Winter Immune Resilience

Episode Date: January 3, 2023

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Hey podcast community, Dr. Mark here. I'm so excited to offer you a seven-day free trial of my revolutionary new platform called Dr. Hyman Plus. For seven days you get special access to all the private content included in Dr. Hyman Plus entirely free. It's so easy to sign up. Just go to Apple Podcast on your phone and click try free button on the Doctors Pharmacy podcast. You'll get exclusive access to ad-free Doctors Pharmacy podcast episodes and functional medicine deep dives where a practitioner dives into topics like heart health, muscle health, insulin resistance, and more to help you understand the root cause of specific ailments and walk you through the steps to improve your health today. You'll also get access to all my Ask Mark Anything Q&As where

I answer the community's biggest health and wellness questions. Because I'm so sure you're going to love this platform, I am offering you free access to all of this content for seven days and a teaser of my brand new functional medicine deep dive episode diving deep into one of the most important topics in health. Head on over to the Doctors Pharmacy podcast on Apple podcast and sign up for your free trial right now. Okay, here we go. Hey there, I am Dr. Lisa Song and I'm honored to be here with you today to discuss a functional medicine approach to winter immune resilience. Just to give you a little bit of background about who I am, these are two of the things I am the most proud of, of course, being a mom to my amazing

kids and also being an integrative and functional medicine pediatrician in the San Francisco Bay Area. You can take a look at some of my background, but I started Healthy Kids, Happy Kids in 2016 after being an integrative pediatrician for nearly 20 years as an online holistic pediatric and pediatric functional medicine resource for parents and practitioners who are looking for an evidence-based approach to integrative pediatrics. Today, we're going to cover winter basics, what you should know about all the winter, quote, crud that's going around, whether it's cold, influenza, COVID, RSV, and other respiratory viruses, and how to support your child and your immune system to protect them from serious disease all year long. As I talk, I am a pediatrician, and I will say that this will benefit your child or how to help your child. This will all apply to

you as parents or grandparents or non-parents as adults, this can apply to anyone of all ages. We're also going to dive into why Tylenol and Tamiflu may not be your child's best options. And we'll go into the top superfoods and supplements to support your and your child's immune system during the winter. And also importantly, we're going to talk about what not to do when your kids are sick. As a disclaimer, this is for informational purposes only. Please do check with your physician if you are starting any new treatment protocol. So let's get into building immune resilience for the winter because the crud is here to stay and it's always the right time to build immune resilience. So do we currently have an immunity debt? There is a theory that the lack of exposure

to otherwise self-limited and very common childhood infections when kids are young may be driving some of the increased severity of what we're seeing this winter with our current infections. And are we seeing this possibly with RSV? Before the pandemic, virtually all kids will have had RSV by the time they're two years of age, 97 to 100% of kids in different studies. And according to the CDC in November of 2022, most of the time RSV will cause a mild cold-like illness. But as you are aware, we are seeing more and more kids with more severe RSV than we had anticipated from pre-pandemic experience. Now, remember the cases of acute fulminant hepatitis in children that was noted midway during the pandemic. This was another thing that was striking fear in the hearts of

pediatricians like me and parents like me. We were seeing these severe cases of acute hepatitis, mostly in young children under five years of age, some leading to transplantation of the liver. The leading theory for why this was happening is that there were two very common viruses, adenovirus 41, which is a quote, common cold virus, and herpes 6, which is roseola virus, one of the most common childhood infections. So these two have been found in many of those children affected by this acute hepatitis. Another virus that was also found was this adeno-associated virus or a dependovirus because it can't replicate in host cells unless another virus is present like the adenovirus 41 and the herpes 6. And of course, there is genetic susceptibility for severe acute hepatitis. So the

theory, according to most of the researchers now is that during the early days of the pandemic, when we were in complete lockdown, there was a lack of training for infants immune systems. We all saw that I kept my kids indoors, The playgrounds were closed. We didn't have exposure to any germs. And many parents in my practice commented on how amazing it was that their kids were not getting sick with anything. We can see now that perhaps maybe that was not necessarily the best thing. So these young children who otherwise would have been exposed to these very common germs at the playground, in preschool, from family members that they didn't see during this time. What then occurred was this lack of training caused a lack of know-how for the immune system to handle these very common viruses. And as pandemic restrictions eased, these young children were suddenly exposed to these common viruses, this adenovirus F41 and herpes sick simultaneously with this dependovirus,

all of which by themselves should have been benign and self-limited. What the researchers noted in one paper was that two years of reduced exposure have lowered individual immunity to diseases and made society as a whole more vulnerable. That is especially true for young children who are typically germ amplifiers, who missed opportunities to gain antibodies against common viruses and get that cross protection that we all know occurs. We all know this. If you have children, or if you work with children, whether you're an educator or a pediatrician or a grandparent, we've experienced this personally. As soon as our kids start daycare or school, or as soon as we start teaching or start seeing kids in our practice, we all experience an increase in

viral infections. In fact, I don't think I was ever as sick as that one year, my first year of my pediatrics residency. But over time, each year, we and our kids get sick less and less frequently. So why is that? These germs don't suddenly disappear when our kids are older or disappear as we teach for or practice for more years. Our immune system has built immune resilience. And immune resilience doesn't mean never getting sick. Immune resilience is the ability of our cells to cope with stress of any kind, whether it's an infection or psychological stress or physical trauma or environmental toxins. It's the ability of ourselves to cope with this stress and recover rapidly and completely. Immune resilience is the

ability to bounce back and be even stronger for the next hit. There's a concept called cellular meesis, which is this idea that our cellular memory of overcoming a stressor makes our cells learn and know how to do it even better the next time. So every time we take that hit, our immune systems get stronger and stronger and stronger and know how to deal more effectively with the next hit, the next infection. Because if anything is true in life, there's always going to be a next hit. Our cells differ less in their vulnerability than in their resilience. There's a really thought-provoking paper called Food for Thought, Cellular Resilience. And the authors note, it's not important whether you fall, but whether you get up again, meaning it's not important. It's not as important whether you actually get sick.

It's more how you recover and build resilience for the next illness. During the pandemic, we've tried so hard in the beginning to not ever, ever get sick. And we need to rethink what we're doing now. There is a silver lining. We're all going to get through this together. And this winter has been very rough and continues to be rough. But as we get through this and build more immune resilience, we are going to get stronger and stronger for the next winter and the next winter. So again, we're all vulnerable to these infections. What would make our immune systems more resilient?

And that's what we're going to discuss today. There is so much we can do to build immune resilience from a functional medicine standpoint. So let's talk basics right now about all of these different winter respiratory viruses. What in years past was called, quote, the crud, because there are so many of these viruses going around and so many of them that we just can't identify and name. We've always had the crud during the winter. We've always had RSV. There's always been influenza and many, many influenza-like illnesses. And of course, the common cold, which is caused by over 200 different viruses, the most common being the rhinovirus, but there are other

human coronaviruses and adenoviruses to name a few. And now, of course, we have COVID in the mix, and there's always a stomach flu going around. Now, stomach flu is not to be confused with, quote, the flu. When physicians and the CDC talk about the flu, we're really talking about influenza virus-induced illness. And there's always throat infections, pharyngitis caused by viruses or bacteria. If it's bacterial, it's often caused by group A strep. So strep throat does come around and also, you know, as part of the winter crud mix. Now, this chart here is a chart of the variety of different CRUD viruses that are going around. And you'll notice that there are on top here, you know, the cause of the type of CRUD, how contagious it is, some of the common symptoms, who's at risk for severe disease,

and what our conventional treatments are. Now, what you'll notice here is that there is nothing quite as contagious as SARS-CoV-2. We know that the R-naught, if you go back way to the beginning of the pandemic when the R-naught was being discussed, probably something that you'd never heard of before, but the R-naught is basically how many people one person who is infected can then be expected to infect. And the R-naught of BA4 and BA5 is estimated to be around six to 10 people. So one person sick with BA5 might be expected to infect six to 10 other people. Of course, that depends on the level of immunity, both acquired and vaccine induced in the community. But if you look at the common cold, the R-naught is less than one. So if you have a cold, you're going to infect fewer than one person around you, which we see in the family,

right? If we have a family of four, and let's say Johnny brings home a cold from school, maybe mom gets the cold, but dad and little sister may not. And the R-naught of influenza actually is not terribly high either. It's about 1.3 to 1.5, depending on the season. And RSV is a bit more contagious, R-naught of about three. Now, what you'll also notice, though, is quite a few, and these are child data, but quite a few children are asymptomatic. So as a parent, we're hearing that, oh my goodness, these viruses are going around, and our kids are getting so sick. But just know that at least half of kids who get

infected with these viruses are not going to get, quote, sick from these viruses. And the risk factor for severe disease, now SARS-CoV-2 is still hands down, at older ages, the biggest risk factor of any other risk factor. Children by and large have been spared of severe disease from COVID-19, thankfully. However, with RSV and influenza, it's very young children, you know,

under two years of age that might be more affected, especially if you're a baby under six months of age. That is the biggest risk factor for more serious disease in children, but it's typically children who are born prematurely or have other chronic conditions or immunocompromised. Now, let's take a look at the conventional treatments. From a conventional standpoint, now, if you have a child with RSV, they might benefit from an albuterol inhaler or nebulizer. Steroids have not been found to help. So the treatment is mostly supportive. And we're going to talk about Tamiflu just a bit, but for the most part, most of the common respiratory infections are going to have as their first line of conventional

treatment, supportive care. What does that mean? Fluid, rest, and then you wait and watch. But while we're waiting and watching, is there anything else we can do? Absolutely. As an integrated pediatrician, I also incorporate conventional treatments along with herbal medicines, acupressure, nutritional supplements, homeopathic medicines, and essential oils in my practice. And I teach parents how to use these so that they have the tools while they're waiting and watching. And conventional medicine doesn't really have much to offer so that their kids can get better faster and feel better faster. So given that conventional treatments are mostly supportive, should you bother testing for COVID, for RSV, for influenza? Now, there are no home tests for RSV or influenza. This does need to be at the doctor's office or the emergency room.

And then potentially you get exposed, your kids get exposed to all the other germs that are floating around. So should you go? Well, you know, I would recommend if you are going to, you know, be traveling during the holidays or, you know, during the winter season to see family, especially elderly, elderly family members or vulnerable relatives, I would test because we don't for sure want to bring anything that is going to be much more serious for them. On the other hand, you know, what I've had some some parents comment is, oh, it's not COVID. It's just a bug. And I have to counter that with what do you mean? It's just a bug. These are all bugs. These are all germs. These are all respiratory viruses. And just because it's not COVID doesn't mean that we can just throw all

caution to the wind and not be concerned. So still, when you're sick, no matter what it is, we want to use our common sense and stay away from people until we're no longer contagious, which is generally about 24 hours after there is no fever. Now, the reason to test in my mind, and we're going to talk about this in a little bit, is that specifically for influenza virus, there is a treatment called Zofluza or Biloxivir that could be a potentially good option for anyone over five years of age. All right, so let's get into that and talk about influenza specifically. This information is specific for influenza A and B viruses. And talk about Tamiflu, Zofluza, and some vaccine basics to keep in mind. So what about the flu vaccine? Most people refer to the flu as any

flu-like illness because there are many, many non-influenza viruses circulating that cause flu-like symptoms. And so, you know, we as adults and children, if you have the flu with a sudden high fever and headache and body aches, and you're just feeling terrible, it could be influenza, but it could be any number of other influenza-like illnesses. Now, as far as influenza goes, there are several types of influenza A and influenza B viruses, many, many different strains that change. There's antigenic shift. They change every season, sometimes even during a season. Influenza A virus strains typically cause more severe disease. And

what we're seeing now in the northern hemisphere is mostly influenza A H3N2. There's a little bit of influenza A H1N1 floating around, a little bit of influenza B, but the vast majority of influenza we are seeing right now is the H3N2 subtype of the influenza A virus. Now, the flu vaccine only protects against, potentially, the influenza virus. It is not going to do anything for other flu-like illnesses. It doesn't do anything for RSV or the common cold or SARS-CoV-2. So the way the flu vaccine is made, which many of you may be familiar with, is during a particular winter flu season, researchers and scientists from around the world get together and try to predict which three or four strains of the flu influenza virus are going to be most

prevalent the following year. So it's not completely random guesswork. They have some prediction models that they use, but some years they get a good match. Other years they don't get a good match at all. The thing to know is that even with a great match, at best, the flu vaccine is about 40 to 60% effective. And what does effective mean? 40 to 60% effective in reducing influenza symptoms. So reducing severe disease and morbidity and mortality from influenza. So a large review of studies, a meta-analysis from the Cochrane Review in 2010 looked at over 50 flu vaccine studies and concluded that influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There's no evidence that they affect complications such as pneumonia

or transmission. So they don't necessarily prevent you from transmitting influenza if you do get influenza, and they may not reduce your risks of serious complications like pneumonia. Well, I hope you enjoyed that teaser of exclusive content that you get every single month with Dr. Hyman Plus. If you want to listen to the full episode and get access to ad-free podcast episodes, plus Ask Mark Anything episodes, plus monthly functional deep dive episodes, I guess that's why we call it Dr. Hyman Plus, then head on over to The Doctor's Pharmacy on Apple Podcasts and sign up for your seven-day free trial. understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search

their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.