The Viral Recovery Blueprint: Cold & Flu Season

It's that time of year and the bugs are back in town. I'll tell you what, this has been something already of an experience for me. Uh, started last Friday, uh, with a little sore throat, and it has graduated through the process. Here we are 5 days later, Craig, and I still am, uh, rocked by this thing. Went to urgent care. Um, no strep, no COVID, no flu. Um, but not really a cold either. Sort of a strange, strange thing. Can't seem to shake this thing no matter what I do. So, skipped two train— training days. Let's get into it. It's happening.

Absolutely. Yeah. I mean, this is the time of the year that we have a lot of spread of communicable disease, and, um, you know, a lot of that is correspondent to kids being back in school. Uh, kids are great vectors for things like respiratory viruses and whatnot. You know, there's a lot of close contact. They have really sort of imperfect hand hygiene skills. Um, they — you know, kids are interesting too because they have prolonged viral shedding periods compared to older teens and adults as well. So there's a lot of factors that go into it, but, um, yeah, this is the time of year, and, uh, commonly it's the respiratory viruses, sometimes GI viruses, that are also circulating in the mix. Um, there's several different ones that, that we can touch on today.

Uh, it's interesting to note that, you know, the CDC releases, uh, frequent reports on, on what's circulating. Uh, they just had their last report as of September 18th, and there is an increased circulation of COVID-19 right now, uh, compared from where it was previously, still working with the Omicron virus, uh, lineage. And, uh, there's also been an uptick in seasonal viruses that, um, you know, the, uh, rhinovirus and enterovirus. So those, those are up from where they had been previously, and things like the flu and RSV, which we often associate with, uh, this time of year, uh, is still relatively low. So, that's, uh, encouraging in some respects.

Um, but I feel you, man. I, I'm sorry that you've been dealing, uh, with this illness. I'm sorry you've been feeling unwell. As we mentioned, very common this time of year. And it's not uncommon for these viral symptoms to really last sometimes a week, sometimes up to three or four weeks for all the symptoms to effectively dissipate. Um, this is an area that I, I really enjoy working in because, of course, my background in both hospital medicine and urgent care, you know, this was my bread and butter. Um, so it's, it's sort of fun to, uh, revisit that on this podcast and see where we can take of a thing.

I mean, when I think about it, um, you know, part of me thought, well, this has got to be some sort of variant of COVID, uh, because, you know, it didn't test for it, but I've also had — taken a COVID test, and then 3 days later it came back and it was positive. So how possible is it for something to, uh, mutate into something that's undetectable but still is CO—

So, I think that, you know, with the PCR tests that we're using now, polymerase chain reaction tests, these are very accurate. I mean, these are going to pretty much detect an infection. So I would say that unless you're testing too early or outside of the window in which you're feeling symptomatic, very good chance that if you actually tested negative, you're pretty likely to be negative. I think it's a good, reliable test. Um, but, you know, it — going back to what I said, there are a lot of different viruses out there. Um, COVID is increased in circulation right now, but, um, you know, you got to think about it. If you're dealing with sore throat, could be anything and everything from, you know, adenovirus to rhinovirus and, and for other coronaviruses, right? We know that, uh, COVID-19 is certainly not the only coronavirus out there. Uh, all of the other coronavirus subtypes, or, or several of the other coronavirus subtypes, uh, contribute regularly to common cold type symptoms. So, uh, it's very possible that, uh, you're, you're dealing with something else besides COVID. And I think that that's, that's probably true. So, it's good that you did the testing, um, because in certain circumstances, you can go ahead and avail yourself of the appropriate treatment if it were to be positive for one thing or another.

I mean, I literally thought it was strep throat because I just could not swallow. It hurt so bad. Um, that it started on Friday morning and then it just progressed. By the time I got to going to bed, I was like, "Okay, this isn't good. Maybe I'll wake up tomorrow and be better." By midnight, I woke up and I was like, "Whoa, this is just not, not happening." The worst part about it is that it just really is exhausting. So, the next day I said, "Hey, look, got to find out what this is." The only way to really do that, um, today is to go into an urgent care, um, attached to UCSF, so it's part of my, um, you know, my network. But I went in and, uh, did all the tests and nothing comes back. So, you know, it's, it's interesting to hear that just there's just a myriad, a plethora, a whole multitude of other, you know, potential things that we just don't know what it is. You sort of just have to ride it out, I guess.

Yeah, there are some key indicators, right? I mean, uh, getting down into the, the various different viruses, each sort of have their own symptomatology, their own symptomatology that, that we can sort of, you know, uh, sift through and try and nail down the diagnosis. I think we should try and do that here with you while we're, um, you know, on the podcast. Did you have any glandular swelling or any redness of the eyes?

I don't know. I think I probably had some redness of the eyes. Glandular swelling, probably.

Yes, both of those things would definitely track with adenovirus. You can also have some GI, uh, symptoms associated with that too. Couple days of, of loose stools. So, you know, that certainly tracks. And interestingly, that's, that's one that you sort of want to be aware of for bacterial conversion down the road, right? Or, or, you know, was a bacterial infection, bacterial pharyngitis, sort of missed, because there's a lot of symptom overlap there. So if you get to 7, 8, 10 days of symptoms and you're really not feeling better, you should definitely go for a re-evaluation.

But, you know, I do, I do like this area because, as I mentioned, there's several different symptomatologies that you can nail down, and a lot of this relates to kids because they are really the, the great viral vector this time of year. Uh, and so, just, you know, sort of looking at what's common out there. Of course, you know, there is, um, you know, flu, right, which is oftentimes associated with sort of an abrupt onset of fever, headache, myalgias — that's muscle ache — arthralgia, joint ache, um, as well as the symptoms that we would usually associate with upper respiratory infection: congestion, sore throat, there can be a cough. Flu is well treated with Tamiflu. That's a 5-day course, uh, twice-daily medication. Uh, generally you want to start treatment for these individuals within 48 hours of symptom onset.

Um, you know, when it comes to other infections that are, that are very common in kids, uh, young adults — well, you know, look at things like parainfluenza virus. Um, this is, you know, your quintessential croup virus, right, associated with, uh, you know, a barking cough, right, in its most severe state, really like an inspiratory stridor. Um, this is amenable to a course of dexamethasone, uh, sometimes just a one-time course. Uh, you know, patients do very well. We're really looking at, like, younger kids, uh, who deal with this. Um, but, uh, they do well with, like, cooler environments. You hear about, you know, exposing the kid to the freezer, opening the freezer door, letting them just sort of breathe in that cool air to cool down some of the inflammation in the throat. But again, uh, that is usually very amenable to, um, a short, uh, burst of dexamethasone.

Um, there's, um, you know, RSV, right? Respiratory syncytial virus. This is the one that is definitely going to be associated with bronchiolitis, uh, which is essentially airway inflammation in the bronchioles, or the smaller airways of the respiratory tract. Um, and this is supportive care, right? Supportive care. In fact, you know, corticosteroids, even things like bronchodilators, are not regularly first line for these things, but airway support, monitoring the patient, and continuing to make sure that they're getting the fluids and the nutrients and the rest that they need to get them through that illness. Um, it is one of the — one of the viruses that we can target effectively in older adults with, uh, the, the vaccine, right? So, anybody over 75 years of age is recommended to get the RSV vaccine. And if they are, uh, between the ages of 50 and 74 and they're at risk for more complicated disease from, uh, an RSV infection, certainly they can, um, you know, undergo, uh, vaccination for that as well.

Um, you know, a lot of these things are obviously self-limiting, as viral infections are. And so some of the others that we deal with, you know, human metapneumovirus. Um, this is — this is very common, causes fever, can cause bronchiolitis, can cause pneumonia. One of the funny things is, like, people often, or in, in hospital and medical settings, uh, the, the whole idea of, um, community-acquired pneumonia. Well, what are the most common causes, you know? And number one, it's viral pneumonia, right? Um, but if you're looking at, like, the, the respiratory microbial or bacterial pathogens, really dealing with things like strep, um, and, uh, you're looking at Moraxella catarrhalis, and, uh, Chlamydia pneumoniae, um, and Haemophilus influenzae. You know, these are things that are going to require, um, treatment with antibiotics as well. So, it's good that you went to urgent care. Um, did you have any shortness of breath, any cough, anything like that?

Yeah, definitely had a cough, and it was, uh, productive and also kind of burning. So, um, that's been intermittent. Um, the sore throat has dissipated, but the, um, you know, the stuffiness in the nose and, um, then the, um, burning kind of raspy cough subsided as of yesterday, but still feeling really weak, like, have, like, a sort of a low-grade headache, a general feeling of just feeling, like, hot. When I got here into the studio, um, I had to have them put the AC on because, you know, I'm wearing t-shirt and shorts, and, uh, and I'm feeling warm.

So, yeah, it's been one of those things where, um, you know, it's kind of funny. It hits me right in the middle of a data tracking, um, evolution. So, we're in the Calibrate here, and we're like, you know, hey, into the second week, about to really, you know, hit it and take a look at these numbers. Got the scans back, about — was about to go do my InBody scan. Couldn't get over there to do that, simply because, you know, it's just not a good idea to expose people. Once you get to a certain point, it's like, mm, I don't think it's really cool to go over and start training in a gym where you're going to be touching a bunch of stuff and breathing out around a bunch of other people. I mean, we use hand sanitizer in the gym all the time, uh, just because you kind of feel like you have to. You know, there was that — I don't know, some study that came out said that there's more bacteria on a dumbbell than there is on a toilet seat. Uh, I'm not sure if that's really true or not, but that was something that was going around. And, um, you know, just think about it, the gym environment, when you're in proximity to all these other people. You have great ventilation in there, but that's why a lot of times Zack and I are just training outdoors, trying to stay away from people, uh, as much as possible. And also, you know, just trying to bring the fresh air to the table, which I think is really great.

But yeah, the, the hardest part of it was when you're keyed up to really train, you know, you're trying to go through it. Okay, I'm going to keep going. I'm still going to ride the bike to get my, my numbers in, because I'm trying to actually track these numbers. And, you know, when you get hit with that, you're almost like, "Okay, gosh, do I just start this whole evolution over again?" Um, and just take this one as a — uh, got to call it a mulligan, um, and start the entire evolution over, because the tracking is so important in this particular evolution, to take a look at the data. Uh, got all the blood work back. You saw it. Uh, pretty solid, right? I mean, like, there's not that much that, uh, that there's off there. So, um, you know, it's interesting to feel like a super healthy person in great shape and have these things just come and kind of rock you in a way where it's like, you know, when you can't exercise, when you're used to exercising, it has a huge impact on your mood, um, and just overall sense of everything. Like, I think you kind of in some ways lose sight of things. I'm not — I am, admittedly, the worst patient ever. There are two things that are definitely going to put me in a bad mood. That's lack of sleep, that's present in this, and then, uh, feeling sick like this. I am just not good.

Yeah, absolutely. So, I've got a couple of questions for you. Number one, you know, how are you doing in your recovery? Like, what was your prescribed regimen? What, what was their official diagnosis? And, and what did they give you for treatment?

You know, here's the difference in working with a provider like you. Uh, because if I were just in proximity to you, I would have just seen you, right? Uh, but I see you — I fly to see you, right? It's a — for different things. Um, the difference here is that you're dealing with an urgent care that's overwhelmed. Uh, they don't have a lot of time. I question whether or not, you know, they're even following up on some of those labs, um, you know, given the volume that they're dealing with. And it's not, you know, to — a knock at them. It's just, you know, you just wonder, right? Has anybody really followed up on that stuff, or is that stuff coming through, or somehow did I miss it? You know, where did it go? That could be a question. So, um, there has been no follow-up from urgent care, which could be one or two things. Hey, you don't have anything that they can determine based on the test that they took, or it's just time for me to go back and take a look at, hey, what, what are the other — other things? And at that point in time, I guess we can start to take a look at, like, RSV and other things, or, uh, what was the other one that you mentioned?

You know, anything from, um, rhinovirus to enterovirus, adenovirus. They can usually do a respiratory panel, um, for these tests. Um, you know, that, that's — that's looking — a viral PCR test for, for these, but they're pricey, and more often than not, for your average sort of, uh, cold, flu type symptomatology, you know, they're not running these panels unless you're in the emergency department and really showing some abnormalities in your vital signs, your blood work, something like that. So, um, you know, the, the likelihood that they did any sort of testing like that is, is probably low. Um, but yeah, a follow-up would be worthwhile if you're not getting better within, within a few days, since it's been 5 days now, basically. So, did they give you any recommendations for treatment? Anything that they suggested to help you manage your symptoms?

Rest and fluids.

Yeah. Yeah. And those are the common ones, right? And going back to what you said about being very, uh, proactive and vigilant and doing everything you can to optimize your health, and then something like this comes along and it sort of hits you like a truck. You know, we wonder why, right? Everything seems dialed in. So why am I getting sick? And we have to go back, at the end of the day, to all these things which we cover at length. You know, it's sleep, it's adequate nutrition and protein intake, it's hydration, it's what's your recovery like on a daily basis, what's your strain level been, how much stress you under. All of those things are going to influence the immune system. So, um, and then, you know, some of this is just unavoidable. I mean, we're all going to get sick and come down with, uh, viruses at various different points in our life.

So, you know, using this time to, to really lean into your recovery, right? And doing things like using antipyretics as needed, something like Tylenol, if you pop a fever. You can use an anti-inflammatory if you don't have, uh, contraindications to that. Rest, getting adequate fluids. We talk about other things, you know, like, uh, zinc, right? I mean, there's good, good data for anywhere from 75 to 90 milligrams of elemental zinc a day can generally shorten the duration of a respiratory viral infection by one to two days, right? So, if you're feeling better a couple days earlier, that, that's generally a win. Um, now, regular use of high-dose zinc is not a good idea, and it's not shown to prevent infection. It can disrupt copper levels, which is necessary for iron transport and other things in the body. Um, and you can actually develop some component of zinc toxicity. So, um, you know, it's got to be like a zinc loz— lozenge that you're using intermittently throughout the day in the beginning of your illness. Um, there's products that are intranasal zinc out there, which are generally a no-go. A lot of people don't know this. They can actually cause anosmia, which is the loss of, of smell. Uh, so I don't recommend those.

You know, it's interesting because we talked about vitamin D last week. Uh, not on the podcast, but just in our communication with each other. We talked about the idea of, uh, vitamin D and in improving health outcomes for patients and what that looks like in the context of somebody's levels. And interestingly enough, you had had shared an interesting video with me from a neurosurgeon who really did an excellent deep dive into the data. And it seems like a lot of practitioners, myself included — I'm, I'm guilty of this — are often chasing a number because of mixed evidence out there that shows that there are some improvements in, in health outcomes when somebody's vitamin D is what we would consider optimized, you know, in 60 to 100. Um, but, you know, over the past week, diving into some of this information, what we know is that observational data — and this is recent, within the past 5 years — observational data does show that significant deficiency of vitamin D, in the realm of, you know, 30 nanomoles per liter or less for your 25-hydroxy vitamin D, does associate with an increased propensity for people to have suffered a respiratory infection recently. So there is a correlation there. Uh, that being said, evaluation of the evidence does not show that having optimal vitamin D is actually going to prevent, um, you know, illness, right? So it's sort of a, a mixed review there as well. Now, vitamin D that's insufficient or, or, uh, deficient should be treated for all of the other concerns related to overall health, um, immune balance, skeletal, uh, system preservation. Um, so it is important, right? And I think that there's going to be continued ongoing evaluation of that. But, um, you know, a lot of times it is just supportive care — is supportive care, with rest and hydration, using, um, the medications to bring down temperature if it's there, using some anti-inflammatories. Things like echinacea and elderberry and vitamin C — the, the data really just doesn't support that these things do too much to reliably improve someone's course of illness. And, uh, so it's, it's not a good idea to just, you know, start pounding those things.

For the people that are not taking care of themselves, you would imagine these things hit a lot harder. We certainly saw that in COVID, where you had people who were, you know, morbidly obese, um, high blood pressure, the list goes on. Uh, they didn't fare well in these, uh, in these viral infections, and, uh, the mortality rate was much higher. Um, it seems. So, let's get into prevention and talk about what can we do to sort of put the walls up as much as we possibly can. What are the things we could do on a daily basis? If you're talking to an adult, you're talking to a parent, you're talking to the kid of the parent. How do we — maybe we break it all down into just two categories, adults and kids. What are the things that we can do to, uh, make sure we avoid this as much as possible?

Well, not on a daily basis, but on an annual basis, people can consider vaccination for some of these viruses, right? So, looking at things like the flu vaccine. Uh, there's several different types available. There's inactivated flu vaccines, which are really the most common. These are like Fluarix and Fluzone. Uh, there is a high-dose Fluzone that's available for patients who are 65 years and older. Um, there is, uh, FluMist, right, which is attenuated, um, flu vaccine that's taken intranasally. This is, you know, good for kids and, and, and adults can use this one as well. Um, now we have the new mRNA vaccines against, against the flu that are targeting, you know, the, the hemagglutinin, uh, protein as an antigen, basically the mRNA encoding, uh, that.

When we think about flu strains, right, we think about, like, H1N1, H3N2, H5N1, things like that, right? The H stands for hemagglutinin, which is really the protein that the, the virus uses to attach and enter into the cell. And then the N is for neuraminidase, and neuraminidase is basically viral exit. So all the varian— the, the little, um, uh, basically, you can think of them as, like, baby viruses, uh, can actually exit and then spread. So, uh, those are the strains of, of, uh, influenza A, and we target those, uh, with the vaccine every year based on the previous year's, uh, sort of circulation data. So flu vaccine is, is definitely an option.

COVID vaccine is something that people who are at risk, uh, should consider. This should be something that they discuss with their provider, to see if there's benefit, uh, for those people, because we of course know that there are, uh, some things that would contraindicate the use of that vaccine, uh, and we know that there were certainly some complications associated with, with COVID vaccines as well. So, you know, RSV, you can get the RSV vaccine, right? So, vaccination is sort of like the, the first place to start. Then obviously the next big thing is hand hygiene, right? You want to make sure that you're washing with a, with a good soap, doing really good scrubbing for, you know, 20 to 30 seconds. Uh, certainly after using the bathroom, if you're out in a public space and you're touching all these things that would otherwise be considered fomites, or, you know, items that will harbor and be possible places of transmission, where you get something on your hands and then you rub your eye or you, you know, put food in your mouth, anything like that. So you want to use good hand hygiene. Uh, and then everything else that we've basically already touched on thus far, which is you need to make sure that you're getting good six to eight, six to nine hours of sleep, that you're recovering well, uh, you're taking in adequate nutrients, and, um, you know, doing things that are not going to stress your immune system. So, alcohol use, you know, uh, alcohol being cytotoxic, being pro-inflammatory, uh, smoking, right? When we think about endothelial damage, damage to, um, you know, the tissues lining our airways and some of the mucociliary changes that happen when we're, you know, taking in tobacco smoke or vaping or anything like that. That's obviously going to put us at risk. It's going to inflame our tissues. It's going to put us at risk because our body's already going to be in a stressed state trying to deal with those things. So avoiding those things as much as possible, that's, you know, basically what I recommend to people, to really do what they can to curb their overall risk.

Going back to the diet side of things, you know, eliminating sugar, anything that's going to be super inflammatory in that way, is going to, uh, kind of open things up, if you will, um, for this. So, you know, I look at my diet and it's really — I mean, it's like a — I'm not a bodybuilder. I'm not trying to be a bodybuilder, but my diet is very much like a bodybuilder's diet. You know, it's very lean protein, some white rice, sweet potato, those types of, you know, maybe some potato, uh, lots of greens. Really, after that, it's just olive oil for the fat. And, um, and that's going to be a high-grade olive oil that's cold-pressed, organic, extra virgin, that sort of thing.

It's delicious. Yeah.

You know what I tell you is, like, you take a spoonful of that, you know it, right? When you get the good stuff, you're like, "Okay, this is way different." And then, you know, my supplementation is just on point. So, if you take a look at everything that I'm doing, you know, I, I seem like the least likely person to pick something like this up. However, you know, um, there are people who work with me who have small kids. Uh, there are lots of exposures inside of the gym. You could just get it, like you said, touching a doorknob. And, uh, so all of those hygiene things are super important.

And then I think also the last piece is I have a tendency to continue to push through on things, because that's kind of who I am. And I think that what I learned in this particular cycle was that it's probably better just to try to take it a little bit more easy. Um, even though, you know, nothing I was doing was outrageous, starting training at the level that I was training before, that showed in the data. Um, and actually I was looking at the data last night going, hm, this is really weird. A week before, um, had a significantly higher caloric output, uh, or burn, in the same workout that I had. Um, it wasn't quite half, but it was maybe, like, 30, 35%, uh, less. You know, you're, you're training and it just — it shows up, shows up in the numbers and, like, what your outputs are going to be and how, how hard you can push it, how your body's actually responding to the stimulus, which to me is fascinating. Um, I, I was, like, blown away by that. I'm like, wow, you know, to think, like, that was the exact same workout, no different in terms of, like, output. Maybe in all reality, maybe wasn't pushing it quite as hard, but the body was struggling. You know, it's fighting one thing over here and then it's trying to deliver for you over here. It can't do both at the same time. Or it can, but it can't do it all that well.

Yeah. Absolutely. You know, I think that that's one of the things that we've really come out of COVID with a good awareness of. Before COVID, there was a lot of, you know, power through. Go to the gym when you're sick. Uh, you're going to beat it, you're going to boost your immune system. And then we saw this trend of people who were catching COVID and they tried getting back into their routine, but they were finding they were, like, struggling to get up a flight of stairs, right? Or they were going back to the gym too early, or sometimes, you know, weeks, months after their infection, and really just lagging, still very much struggling with overall energy. And, and we've sort of seen all this data come out, particularly with, like, chronic fatigue syndrome and myalgic encephalomyelitis, you know, where these people, uh, are, are really just struggling with their energy because their mitochondria are suffering. There's, there's bottlenecks there. And, uh, you know, you're ultimately inducing just more oxidative stress when you don't let your body recover, when you're trying to, as you mentioned, fight something over here, also fight hard in the gym, keeps a workout strong. Um, it's going to do you more harm than good.

So, yeah, I mean, if you take a look at it, the mitochondria, right, are pumping as hard as they possibly can, and then there's some mitophagy that's got to take place there when those start to burn out. Um, and then you're sort of in this sort of, like, whoa, uh, the cell's being attacked, doesn't quite know what to do. I'm not exert— you know, I'm not exactly sure what the mechanism is there, but one thing I can say for sure is I definitely felt it this week. And so much so that, I mean, even coming out of that deload, where just feeling like, man, I was just — you know, it was like pins and needles to not train at that level. I got to Sunday, where I would normally do my stair workout, which is a strenuous workout. I mean, let's call it like it is. Those, those flights of stairs that I do are far steeper than, um, what you're going to find in a commercial building. So, um, there's that one long set that I do in my loop, and it's a burner. I mean, it is hardcore. And I just was like, you know, there's no way I'm going to be able to do this. And then the other side of it is I'll be disappointed in myself, and I have a tendency to just go ahead and push through anyway.

So I know that, you know, like the other day, we talked about, I was doing a zone one, zone two, and all of a sudden I look up, I'm in zone three, zone four. And so I know that I'm going to get to a certain spot where I'm like, "Yeah, I'm — I'm, but I'm going to go, I'm going to push through it." Just knowing myself, I think getting to know who you are and how you're going to function in that sort of — what your training is, and, and what, you know, what how you — how you approach things, the way the mindset is. You know, there are certain environments where, you know, look, you're going to make it or you're not going to make it, and if you don't make it, you don't make it. So there's a thought process there about, got to get through, got to make it happen. And so limiting your exposure to those types of things, it just comes with maturity to say, "Hey man, the only thing I got to do is make it up," you know, make — show up to these shows and show up to work and, uh, do the right thing for ultimately. Also, I think there's a certain point in time where that just becomes dangerous. You know, you get dizzy on those stairs, fall backwards, and that's it.

So, it was a tough week. It's been one where I've been extremely frustrated. Just absolutely frustrated. So looking forward to going into this period of time, really having all of the data points lined up to really track everything. Uh, it was interesting to see, like, HRV after that first, uh, first day in, in the gym. We got 1100 calorie output. Uh, and then HRV took a hit, and it took, like, three, 4 days to come back up, and then pushed it the next day, push it the next day, but then sort of trim back up out of it. Interesting just to see how, um, you know, that desire to train and the disappointment associated with that creates frustration. And I think you just got to let yourself have a break and say it is what it is.

Yep. Definitely lean into it. And, you know, just anecdotally, I mean, a lot of times when people catch something early on in, in flu and cold season like this, a lot of times they're good for the rest of the — rest of the year, and, and they don't catch much else. So, you know, maybe you'll fall into that category. Hopefully you will. I mean, I'm sure — I think that that's going to be the case for you, uh, that you won't have to deal with too much, but, but you never know. And I agree, I think just lean into it. Let your body recover. Do right by your cells and, and help them get, you know, get back to the other side of the infection, and, uh, you'll be back at it in no time. I mean, you know, this isn't going to keep you down, and you've built a strong foundation, uh, for yourself, wherein when you restart your training regimen at the intensity that you were at, or that you were trying to achieve, um, you'll, you'll be right back there within no time. So, I wouldn't take too much concern or, or get too shaken up about it. You know, got to give yourself time to recover.

Yeah. Few days, it is what it is. Oh, you know, the one thing I found was that, uh, raw local honey, uh, game changer. Wherever you can find it that doesn't have glyphosphate, or glyphosate for those. Um, holy mackerel, what a game changer in terms of seasonal allergies. I really didn't know anything about that until about 5 years ago.

Yep.

Clued into that, and wow, all of the things that I was starting to experience, um, you know, like in the spring, and then in the fall we'd have these changes in the pollen. If you just stay on just a little bit, like the — the hard part is not taking an entire tablespoon of it because it tastes so good. Just trying to stay with, like, a half teaspoon, a teaspoon, um, and really use it medically, is just an absolute game changer. So powerful.

Yeah. Honey is great for the — dealing with hay fever and, and seasonal allergies, absolutely. It's, it's great for cough. One of the things to note about that is that, you know, kids under the age of one should not, um, receive honey, uh, because there is a, a botulism, uh, risk, um, botulinum toxin, uh, which is, is neurotoxic. Uh, so kids under the age of one should not receive honey. But after the age of one, a little bit of, uh, honey used medically absolutely has good evidence to, uh, support that it can be therapeutic for reducing cough. It can help to, uh, soothe some sore throat, uh, some hoarseness there. So, yeah, totally, totally on board with that.

Yeah. And the whole time I thought it was just that my parents dropped me on my head when I was a baby, but, um, apparently it was more — more to do with botulism.

That's funny. That's funny.

Well, you know, it's one of those, uh, episodes where I could go on and on, and I'm sure there's tons more to talk about. But, you know, I think it's probably just like the training, time to wrap this one up. Uh, anything you want to — any words of wisdom you want to share with the, uh, the audience before we go?

Just, uh, you know, talk with your practitioner about whether you would be a good candidate for vaccines based on your health record and what you're trying to achieve. Um, consider all the things that — what we talked about in terms of prevention: getting optimal sleep, adequate nutrition, focusing on low inflammatory foods, focusing on diverse, uh, you know, food groups, uh, plenty of leafy greens, plenty of colors in your, in your, uh, on your plate. Um, not a lot of processed foods, not a lot of sugars, uh, simple carbohydrates, keep them all to a minimum. Um, and, uh, do the hand hygiene. You know, these things are going to be circulating. You're going to know people who are going to get sick. Obviously, we've all been through it. Um, so, you know, do your best to support your overall health as we move into the colder months of the year. And, um, you know, hopefully you can avoid some infection, and if you get through it, you'll know what to do, or if you do acquire an illness, you'll — you'll get through it. You'll know what to do.

Yeah. Well, I'll tell you what, I am — I am raring to go. I can't wait for — I feel like tomorrow I'll feel better, and of course, you know, the first thought is, hey, got to get back after it, get after it and make it happen. Um, so we'll see what happens, and of course I'll be in touch with you.

You got it.

You know, it's interesting, in this episode we really have gone off of the beaten path here from where we normally go, which is into, you know, cellular medicine, health span, performance-based medicine, and we're just taking a look at the basics. But if you think about it, it makes sense, because if you can't take care of the basics, you can't get to those other levels. And so dealing with this stuff is really important right now, as we think about just what happened to me, right? I can't continue to train. I can't continue — I mean, I kept the diet in check. I did not veer off.

Yeah, 100% agree with you. I think that, uh, this, this is an important area to focus on when you're thinking about trying to perform at your best and, and reaching peak or optimal health. I mean, you are inevitably going to counter— encounter people who are, are sick in your day-to-day life. There's a good chance that you'll come down with something, uh, annually or, or every so often, that sets you back a few days. And it really drives home the whole notion of how we need to prioritize all the fundamental and foundational elements of our health in order to have a better recovery, to achieve the recovery through an infection, and ultimately, uh, bounce back to our baseline and, and continue along that journey of performance optimization. So, 100%, it's a worthwhile topic. Uh, these things circulate — these viruses, these pathogens circulate. We're going to be exposed to them. You need to fortify your body and get to a state of, you know, absolute resilience, uh, so that if you come down with them, you do okay, and, uh, you can increase your chances of not getting sick in the first place.

Craig, along those lines, people talk about multivitamins. I always kind of look at multivitamins and I think to myself, how much is in there to really make — it doesn't seem really — really covers the whole spectrum of things. There have been these products that have been out there that are sort of like high-potency vitamins that you're taking. They're usually in liquid form. Um, how important do you feel supplementation is around these types of things, multivitamins and the mineral components that, uh, generally are separate?

Certain people do very well with the multivitamin. Uh, there are individuals whose labs that I see that are deficient in essential B vitamins, and, uh, sometimes they're low on copper or zinc, maybe iron is a little bit deficient. Um, they're going through protocols where they're looking to improve their overall thyroid health and thyroid signaling and other hormones in the body. So adding certain mineral elements into their regimen, um, and things like boron and whatnot, can be very beneficial. But it is always going to come down to that individual, what they're dealing with. At the moment, I don't do a lot of multivitamin prescribing. I like to pick apart a regimen and have a few things that are dialed in with the dose and, and formula, uh, to help tailor that supplement regimen to the patient's unique needs. But, um, I — there are certainly patients out there who benefit from a good, well-rounded multivitamin.

I always work with a couple of different companies here in my practice that I feel are very well vetted, um, have, you know, excellent ingredients. The ratios and percentages of the minerals and multivitamins, um, are in adequate range. All right? A lot of times, you know, you're, you're not getting nearly enough of what you need, or if it does have enough, maybe something else that you're taking is inhibiting the absorption of that, or maybe it's a gut-related issue that's sort of inhibiting absorption. Timing around foods, right? A lot of people don't know, um, you know, that certain things need to be taken with a fat-containing meal, other things need to be taken just generally with food. Other things need to be taken on an empty stomach or away from calcium or caffeine. Um, so it's important to really work with somebody who knows how these things should be taken, and, um, you know, find a regimen that is uniquely suited to your needs.

Um, just out of curiosity, what are those products that you do recommend inside the practice?

The companies that I work with most are Thorne and Designs for Health. Designs for Health, from a multivitamin standpoint, has a few, uh, great products. Generally, it's the DFH, Designs for Health, Complete Multi. Now, you can get this with copper and without iron. You can get it with copper and iron. You could get it free of copper and iron. Uh, so I really love to mix and match those products across my patients, um, in situations where they need a little additional, you know, iron support or, or thyroid support, this, that, or the other thing. So, um, that's really the multivitamin that I use most commonly, if I'm going to —

Yeah, I think that's one that you suggested for me. Actually, it's interesting to see too, Thorne selling to Procter and Gamble. And you just sort of think about, like, anytime a big company tends to buy a high-grade performance brand, it just kind of, like, going to go down.

Yeah, I've really moved away from them. Like, everything pretty much that I do is, is Designs for Health now. Um, you know, from the standpoint of, like, if I'm going to implement probiotics, I use a lot of Pendulum probiotics. I use, um, uh, Researched Nutritionals for ATP support and energy metabolism. Um, they have a great product that can enhance BDNF. Uh, they've got a Renew Gut Thrive product that works really well for overall, um, improving SCFA production and reducing mast cell activation and histamine response, uh, throughout the gut, as well as, um, Akkermansia, uh, which, you know, can help with motility and overall production of, uh, the mucous layer throughout the gastrointestinal tract. So I like Researched Nutritionals. They're — incorporated them a lot.

Body Bio makes some good phosphatidylcholine products, uh, as well as, like, omegas. They, they have a good blend of, uh, of omegas, and they have a nice, uh, sodium butyrate, um, product as well. And then Healthgevity, I think, is a cool one for people that are looking to target very specific things in their health routine, because you can find a lot of really interesting proprietary blends with some, uh, novel agents and therapeutics that are — that are really sort of emerging in their data for certain things like sleep and cognitive support.

And yeah, you told me about those. I, I'm super excited to try that out. Yeah, thinking about the — all the different things that you — you had mentioned a couple of those before, and I'm taking some other products right now that I have on hand that are sort of gut related and then butyrate related. Um, and, um, I'm interested in the switch to those other products and trying to see how that actually works. I mean, it's worked really well for me, but, you know, I was going to sort of lean towards the stuff that you recommend. So, it'll be interesting to see.

Researched — Researched Nutritionals Renew Gut Thrive is, is fantastic. Um, the DFH has one too, which is, uh — I think it's called, like, Daily Commensals, uh, and you can buy it in a, uh, package that, um, you know, also has, like, you know, a prebiotic fiber supplement, um, and then keystone bacteria in, in the other, uh, which is pretty cool. So those are the two that I use most often, um, for the gut.

You know what's amazing always to me is, like, how much you know about that particular area. Um, you know, I talked to a lot of people, and a lot of times they just don't have the level of knowledge in that particular area that you do. Um, and clearly you just have spent a ton of time really digging into it and taking a look at what's really behind the products, which is, I think, so, so important. Because for so long in the supplement industry, you know, there's been lots of products that have got out there, when they go take it to a spectrometer, there's nothing — the product doesn't even have it in it. This is speculative, um, but there was this rumor that the Amazon supply chain had been infiltrated by counterfeits. So much so that you — you couldn't tell. I mean, the, you know, the label was perfect, but the product — there was nothing. It was just not the same. Think about how dangerous that could be. You think you're taking something that you really need at a very specific time, and things that you mentioned, like, your ability to absorb something could be inhibited, or you're just not getting what you need. Um, not good.

All right, everybody. This has been an outstanding episode, as usual. Craig, thank you so much. Uh, my co-host, and crazy information coming out in the next episode. Don't want to really talk about it just yet, but I think it's going to be something you're really going to be interested in. Please remember to like, share, and subscribe. And if you know someone who may be, uh, thinking about what's going to happen around this flu season, or this, uh, virus season, I guess what we should call it, um, this is a good episode to share with them, because this is the kind of information that they'll need to know. Until the next time, we'll see you on Cell to Systems.