Monthly Archives: March 2020
A number of compounding chemists have contacted me and reassured me that they are well stocked with the hormones for your troches and creams – which is reassuring. However, I still think it wise to keep a spare in your fridge, because delivery could be problem if we go into complete lock down. There is no need to get a new script from me – just ask the chemist to give you one of your repeats early. I encourage those of you who visit me at the clinic to wait in the cafe area, or out in the car-park, after letting the receptionists know you are there. I will find you. As you are aware, I tend to be on time so you should not have to wait around too long. I still encourage telephone consults if possible. I can assure you that I am in good health and intend to stay so. I do follow all the healthy advice I have given you all these years in my blogs, and my books, and can tell you it certainly works.
The new season flu vaccine should be available in early April. The article below concerns the USA, as they are at the end of winter. However, we will soon be there.
COVID-19 vs seasonal flu: What you need to know about both
Mayo Clinic | March 13, 2020
SARS-CoV-2, the virus that causes COVID-19, continues to spread into communities worldwide. Many are worried, as officials and medical experts urge people to take precautions to contain the virus. Dr. Gregory Poland, a Mayo Clinic infectious diseases and vaccine specialist, says that the threat of the coronavirus is real, but the seasonal flu still remains a bigger issue for most people.
“Right now, seasonal flu is causing many more deaths than COVID-19, and the tragedy is that many people die because they consider it ‘just the flu,'” says Dr. Poland.
The numbers are constantly changing, but as of now the Centers for Disease Control and Prevention (CDC) estimates that more 34 million people have been sickened by the flu, from 350,000 to 620,000 people have been hospitalized, and from 20,000 to 52,000 people have died from it.
“Right now, the number of COVID-19 cases pales in comparison to the number of flu cases,” says Dr. Poland. “Unlike COVID-19, seasonal flu is in every state and every community in the US. Your best defense agains the flu is to get the flu vaccine. If you haven’t gotten it yet, it is not too late. Go get it.”
Dr. Poland compares the flu vaccine to being a safety device similar to the seat belt of your car.
“It won’t protect you from every type of crash, but it will protect you from getting hurt in many kinds of accidents. And it will also reduce your chances of getting severely injured in a crash,” says Dr. Poland. “similarly, The flu vaccine can’t protect you from all flu viruses, but it can reduce your chances of contracting one. And if you do get sick, the vaccine will help reduce the severity of symptoms.”
Dr. Poland says that while most people remain at higher risk of contacting the flu than COVID-19 at this time, he recommends people take these measures, to protect themselves against both:
- Wash your hands with soap and water or use hand sanitizer.
- Use hand sanitizer. Cough into a tissue and immediately discard and wash your hands. If a tissue is not available, cough into your elbow.
- Stay up to date on travel restrictions and other protective measures set up by national organizations such as the CDC and your local government.
- If you develop symptoms such as cough, fever, body aches, shortness of breath, and fatigue, stay in your home and contact a health care provider who can advise you.
- Stay away from others who are ill with cough and fever
5 ways nutrition could help your immune system fight off the coronavirus
March 17, 2020 6.01am AEDT
- Clare Collins Professor in Nutrition and Dietetics, University of Newcastle
Clare Collins is affiliated with the Priority Research Centre for Physical Activity and Nutrition, the University of Newcastle, NSW. She is an NHMRC Senior Research and Gladys M Brawn Research Fellow. She has received research grants from NHMRC, ARC, Hunter Medical Research Institute, Meat and Livestock Australia, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute and the ABC. She was a team member conducting systematic reviews to inform the Australian Dietary Guidelines update and the Heart Foundation evidence reviews on meat and dietary patterns.
University of Newcastle provides funding as a member of The Conversation AU.
We believe in the free flow of information
The coronavirus presents many uncertainties, and none of us can completely eliminate our risk of getting COVID-19. But one thing we can do is eat as healthily as possible.
If we do catch COVID-19, our immune system is responsible for fighting it. Research shows improving nutrition helps support optimal immune function.
Micronutrients essential to fight infection include vitamins A, B, C, D, and E, and the minerals iron, selenium, and zinc.
Here’s what we know about how these nutrients support our immune system and the foods we can eat to get them.
Read more: What is a balanced diet anyway?
1. Vitamin A
Vitamin A maintains the structure of the cells in the skin, respiratory tract and gut. This forms a barrier and is your body’s first line of defence. If fighting infection was like a football game, vitamin A would be your forward line.
We also need vitamin A to help make antibodies which neutralise the pathogens that cause infection. This is like assigning more of your team to target an opposition player who has the ball, to prevent them scoring.
Vitamin A is found in oily fish, egg yolks, cheese, tofu, nuts, seeds, whole grains and legumes.
Further, vegetables contain beta-carotene, which your body can convert into vitamin A. Beta-carotene is found in leafy green vegetables and yellow and orange vegetables like pumpkin and carrots.
2. B vitamins
B vitamins, particularly B6, B9 and B12, contribute to your body’s first response once it has recognised a pathogen.
At a football match, this role would be like security guards intercepting wayward spectators trying to run onto the field and disrupt play.
B6 is found in cereals, legumes, green leafy vegetables, fruit, nuts, fish, chicken and meat.
B9 (folate) is abundant in green leafy vegetables, legumes, nuts and seeds and is added to commercial bread-making flour.
B12 (cyanocobalamin) is found in animal products, including eggs, meat and dairy, and also in fortified soy milk (check the nutrition information panel).
3. Vitamins C and E
When your body is fighting an infection, it experiences what’s called oxidative stress. Oxidative stress leads to the production of free radicals which can pierce cell walls, causing the contents to leak into tissues and exacerbating inflammation.
So the role of vitamin C here is a bit like cleaning up the football ground after the game.
Good sources of vitamin C include oranges, lemons, limes, berries, kiwifruit, broccoli, tomatoes and capsicum.
Vitamin E is found in nuts, green leafy vegetables and vegetables oils.
4. Vitamin D
Some immune cells need vitamin D to help destroy pathogens that cause infection.
Although sun exposure allows the body to produce vitamin D, food sources including eggs, fish and some milks and margarine brands may be fortified with Vitamin D (meaning extra has been added).
Most people need just a few minutes outdoors most days.
People with vitamin D deficiency may need supplements. A review of 25 studies found vitamin D supplements can help protect against acute respiratory infections, particularly among people who are deficient.
5. Iron, zinc, selenium
We need iron, zinc and selenium for immune cell growth, among other functions.
Iron is found in meat, chicken and fish. Vegetarian sources include legumes, whole grains and iron-fortified breakfast cereals.
Zinc is found in oysters and other seafood, meat, chicken, dried beans and nuts.
Nuts (especially Brazil nuts), meat, cereals and mushrooms are good food sources of selenium.
Putting it all together
It’s true some supermarkets are out of certain products at the moment. But as much as possible, focus on eating a variety of foods within each of the basic food groups to boost your intake of vitamins and minerals.
While vitamin and mineral supplements are not recommended for the general population, there are some exceptions.
Pregnant women, some people with chronic health conditions, and people with conditions that mean they can’t eat properly or are on very restrictive diets, may need specific supplements. Talk to your doctor, Accredited Practising Dietitian or pharmacist.
And beyond diet, there are other measures you can take to stay as healthy as possible in the face of coronavirus.
Stop smoking to improve your lung’s ability to fight infection, perform moderate intensity exercise like brisk walking, get enough sleep, practise social distancing and wash your hands with soap regularly.
The emotion of lassitude might help your body fight off infection by making certain adjustments. Kalinka Georgieva/Shutterstock.com
Feeling sick is an emotion meant to help you get better faster
December 18, 2019 12.53am AEDT
- Joshua Schrock Ph.D. Candidate in Anthropology, University of Oregon
Joshua Schrock has received funding from the Wenner-Gren Foundation.
University of Oregon provides funding as a member of The Conversation US.
We believe in the free flow of information
Republish our articles for free, online or in print, under Creative Commons licence.
You know what it’s like to be sick. You feel fatigued, maybe a little depressed, less hungry than usual, more easily nauseated and perhaps more sensitive to pain and cold.
The fact that illness comes with a distinct set of psychological and behavioral features is not a new discovery. In medical terminology, the symptom of malaise encompasses some of the feelings that come with being ill. Animal behaviorists and neuroimmunologists use the term sickness behavior to describe the observable behavior changes that occur during illness.
Health care providers often treat these symptoms as little more than annoying side effects of having an infectious disease. But as it turns out, these changes may actually be part of how you fight off infection.
I’m an anthropologist interested in how illness and infection have shaped human evolution. My colleagues and I propose that all these aspects of being sick are features of an emotion that we call “lassitude.” And it’s an important part of how human beings work to recover from illness.
Your body sets priorities when fighting germs
The human immune system is a complex set of mechanisms that help you suppress and eliminate organisms – such as bacteria, viruses and parasitic worms – that cause infection.
Activating the immune system, however, costs your body a lot of energy. This presents a series of problems that your brain and body must solve to fight against infection most effectively. Where will this extra energy come from? What should you do to avoid additional infections or injuries that would increase the immune system’s energy requirements even more?
Fever is a critical part of the immune response to some infections, but the energy cost of raising your temperature is particularly high. Is there anything you can do to reduce this cost?
To eat or not to eat is a choice that affects your body’s fight against infection. On one hand, food ultimately provides energy to your body, and some foods even contain compounds that may help eliminate pathogens. But it also takes energy to digest food, which diverts resources from your all-out immune effort. Consuming food also increases your risk of acquiring additional pathogens. So what should you eat when you’re sick, and how much?
My colleagues and I propose that the distinctive changes that occur when you get sick help you solve these problems automatically.
- Fatigue reduces your level of physical activity, which leaves more energy available for the immune system.
- Increased susceptibility to nausea and pain makes you less likely to acquire an infection or injury that would further increase the immune system’s workload.
- Increased sensitivity to cold motivates you to seek out things like warm clothing and heat sources that reduce the costs of keeping body temperature up.
- Changes in appetite and food preferences push you to eat (or not eat) in a way that supports the fight against infection.
- Feelings of sadness, depression and general wretchedness provide an honest signal to your friends and family that you need help.
Of course these changes depend on the context. Any parents reading this article are likely familiar with the experience of being sick but pushing through it because a child needs care. While it may make sense to reduce food intake to prioritize immunity when the sick individual has plenty of energy reserves, it would be counterproductive to avoid eating if the sick person is on the verge of starvation.
Sickness as an emotion
So how does your body organize these advantageous responses to infection?
The evidence my colleagues and I reviewed suggests that humans possess a regulatory program that lies in wait, scanning for indicators that infectious disease is present. When it detects signs of infection, the program sends a signal to various functional mechanisms in the brain and body. They in turn change their patterns of operation in ways that are useful for fighting infection. These changes, in combination with each other, produce the distinct experience of being sick.
This kind of coordinating program is what some psychologists call an emotion: an evolved computational program that detects indicators of a specific recurrent situation. When the certain situation arises, the emotion orchestrates relevant behavioral and physiological mechanisms that help address the problems at hand.
Imagine you’re walking through the woods, thinking you’re alone, and suddenly you are startled by sounds suggesting a large animal is in the underbrush nearby. Your pupils dilate, your hearing becomes attuned to every little sound, your cardiovascular system starts to work harder in preparation for either running away or defending yourself. These coordinated physiological and behavioral changes are produced by an underlying emotion program that corresponds to what you might think of as a certain kind of fear.
Some of these coordinating programs line up nicely with general intuitions about what makes up an emotion. Others have functions and features that we might not typically think of as “emotional.”
Some psychologists suggest these emotion programs likely evolved to respond to identifiable situations that occurred reliably over evolutionary time, that would affect the survival or reproduction of those involved.
This way of thinking has helped researchers understand why some emotions exist and how they work. For instance, the pathogen disgust program detects indicators that some potentially infectious agent is nearby. Imagine you smell the stench of feces: The emotion of disgust coordinates your behavior and physiology in ways that help you avoid the risky entity.
Another example is the emotion of shame, which scouts for signs that you’ve done something that causes members of your social group to devalue you. When you detect one of these indicators – a loved one rebukes you for doing something that hurt them, say – the experience of shame helps you adjust your mental map of what kinds of things will cause others to devalue you. Presumably you will try to avoid them in the future.
Drawing from the emerging discipline of evolutionary medicine, my colleagues and I now apply the idea of these emotion programs to the experience of being sick. We call this emotion “lassitude” to distinguish the underlying program from the outputs it generates, such as sickness behavior and malaise.
We hope that our approach to lassitude will help solve problems of practical importance. From a medical perspective, it would be useful to know when lassitude is doing its job and when it is malfunctioning. Health care providers would then have a better sense of when they ought intervene to block certain parts of lassitude and when they should let them be.
Further to my last post, I must add that most of our medicines, or some ingredient in our medicines, now come from China. What I said about the troches, also applies to any other medications you may be on. Keep adequate stocks before pharmacies run out.
All our Bioidentical hormones come from overseas, especially the USA. If their factories close down, due to this virus, (Lock down) then there could be a short supply of BHRT. I recommend those of you who absolutely depend on it keep extra supplies available in the fridge. Desperate times call for desperate measures. That includes LDN and natural thyroid.
Coronavirus is stressful. Here are some ways to cope with the anxiety
March 13, 2020 6.11am AEDT
- Louise Stone General practitioner; Clinical Associate Professor, ANU Medical School, Australian National University
- Katrina McLean Assistant Professor, Medicine, Bond University
Katrina McLean is affiliated with General Practice Gold Coast and GPs Down Under
Louise Stone does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
We believe in the free flow of information
Republish our articles for free, online or in print, under Creative Commons licence.
One of our patients was recently talking about her anxiety around the coronavirus epidemic. This woman’s stress was understandable. She had survived a serious infection with swine flu, but only with a prolonged stay in intensive care.
I guess we all walk on the edge of a cliff […] anything can happen to anyone at any time. We are never really safe. But people like me? Now we know the edge of the cliff is right there, and we can’t help looking down.
While some people may be more susceptible to becoming seriously ill with the coronavirus than others, none of us are immune to the pervading sense of anxiety that has taken hold around the world.
For Australians in particular, this crisis has come immediately after a horror summer of bushfires, which took their own toll on our collective mental health.
But there are some things we can keep in mind, and some practical steps we can take, to keep coronavirus-related anxiety under control.
A tangible threat versus an invisible enemy
It hasn’t been an easy start to the decade. In the face of the summer’s bushfires, many of us contended with threats to our health, our homes and even our lives.
Even those not directly affected were faced with constant images of charred bushland, injured wildlife, and homes burnt to the ground.
The bushfires put a strain on our collective mental health, and it’s very likely some people are still struggling.
Natural disasters, though, are visible and tangible. There are things we can do to avoid the threat, manage the danger or mitigate the risk. We can see the smoke, check the app, buy an air purifier, prepare our homes. And despite the vivid images of floods, fires and cyclones, we know the storm will pass.
Epidemics are different. A novel epidemic is unknown, evolving and a global risk.
While the bushfires united us, coronavirus seems to divide us
There’s an ugly side to ways we can deal with the stress of an unknown enemy like the coronavirus.
Some people blame potential carriers for their own illnesses, scapegoating people they see as high-risk. This is not helpful.
We also seek to manage our anxiety by trying to prepare ourselves and our families for the possibility of isolation or quarantine.
While this is reasonable to a degree, practices like stockpiling toilet paper and other goods can feed, rather than relieve, anxiety. Empty supermarket shelves can create panic, and further disadvantage people who might be living from week to week.
Epidemics isolate us from each other physically too, and this will only happen more and more.
So how can we put things into perspective?
We can take heart in knowing many people will develop only mild disease from the coronavirus.
There are of course vulnerable members of our community: those with compromised immune systems due to illness or age. We need to protect these people as a community by creating safe spaces for them to live, work and access health care, rather than fostering panic.
Our greatest asset lies in our own bodies. We may not understand how to best protect ourselves, but our bodies are experienced managers of novel immune challenges, and they will manage the risk as effectively as they can.
Ultimately, our best chance at surviving this virus relies on nurturing our bodies: avoiding exposure through hand-washing and isolation where appropriate, eating well, exercising, managing chronic illnesses, and getting enough sleep.
The anxiety a pandemic generates is inevitable. At the end of the day, we all need to learn to live with a degree of risk we can’t avoid.
Practical strategies to keep anxiety at bay
The World Health Organisation has developed some practical tips for dealing the stress of this outbreak. Here are a few of them:
- accept that it’s normal to feel sad, stressed, confused, scared or angry during an outbreak
- find ways to talk about how you feel with others, especially if you are in quarantine
- remember to keep an eye out for your children during this time, and for loved ones who already have mental illness. They may need help dealing with this added anxiety
- if you feel overwhelmed, seek support from a health professional
- don’t use smoking, alcohol or other drugs to deal with your emotions. Keep your body as healthy as possible by eating well, exercising and getting enough sleep
- limit worry by limiting media exposure to a few trusted sources
- draw on skills you have used in the past that have helped you to get through difficult times.
Early exposure to infections doesn’t protect against allergies, but getting into nature might
February 7, 2020 6.04am AEDT
- Emily Johnston Flies Emily Johnston Flies is a Friend of The Conversation. Postdoctoral Research Fellow (U.Tasmania), University of Tasmania
- Philip Weinstein Professorial Research Fellow, University of Adelaide
Emily Johnston Flies helps lead the Healthy Urban Microbiome Initiative, a non-profit developed to understand and recreate the immune-boosting power of biodiverse microbial exposure in our cities. Emily’s salary is currently funded through an Australian Research Council (ARC) Laureate Fellowship (awarded to Prof Barry Brook) at the University of Tasmania.
Philip Weinstein receives funding from The Environment Institute, University of Adelaide.
View current jobs from University of Tasmania
We believe in the free flow of information
Republish our articles for free, online or in print, under Creative Commons licence.
Over the past few decades, allergies and asthma have become common childhood diseases, especially in developed countries. Almost 20% of Australians experience some kind of allergy, whether it’s to food, pollen, dust, housemites, mould or animals.
When people suffer from food allergies, hay fever or asthma, their immune system incorrectly believes the trigger substances are harmful and mounts a defence.
The response can range from mild symptoms, such as sneezing and a blocked nose (in the case of hay fever), to anaphylaxis (from severe food allergies or bee stings) and asthma attacks.
We used to think the rise in allergic conditions was because we weren’t exposed to as many early infections as previous generations. But the science suggests that’s not the case.
However it seems being out in nature, and exposed to diverse (but not disease-causing) bacteria, fungi and other microorganisms may help protect against asthma and allergies.
Remind me, what’s the hygiene hypothesis?
In 1989, researcher David Strachan examined allergy patterns in more than 17,000 children in England. He noticed young siblings in large families were less likely to have hay fever than older siblings or children from small families.
He proposed that these younger siblings were exposed to more childhood illness at a younger age, as more bugs were circulating in these large families and the younger children were less likely to wash their hands and practise good hygiene.
Greater exposure to these childhood infections helped “train” their immune systems not to overreact to harmless things like pollen.
Strachan coined the term “hygiene hypothesis” to explain this phenomenon, and the idea has been appealing to our dirty side ever since.
Strachan wasn’t the first to notice exposure to “dirty environments” seemed to prevent allergic disease. A century earlier, in 1873, Charles Blackley noted hay fever was a disease of the “educated class”, and rarely occurred in farmers or people living in less sanitary conditions.
Ditching the hygiene hypothesis
However, Blackley and Strachan were wrong about one important thing: the association between sanitation and allergies is not due to reduced exposure to early childhood infections (or “pathogens”).
Large studies from Denmark, Finland, and the United Kingdom have found no association between the number of viral infections during childhood and allergic disease. In other words, exposure to disease-causing pathogens doesn’t appear to prevent allergies.
In fact, exposure to childhood viral infections, in addition to making a child sick, may contribute to the development of asthma in predisposed children.
Many researchers now argue the term “hygiene hypothesis” is not only inaccurate but potentially dangerous, because it suggests avoiding infection is a bad thing. It’s not.
What about ‘good’ exposure to bacteria?
For healthy immune function, we need exposure to a diverse range of bacteria, fungi and other bugs – known as microbes – in the environment that don’t make us sick.
Within urban environments, recent research shows people who live closer to green, biodiverse ecosystems tend to be healthier, with less high blood pressure and lower rates of diabetes and premature death, among other things.
More specifically, research has found growing up on a farm or near forests, with exposure to more biodiverse ecosystems, reduces the likelihood of developing asthma and other allergies.
This is potentially because exposure to a diversity of organisms, with a lower proportion of human pathogens, has “trained” the immune system not to overreact to harmless proteins in pollen, peanuts and other allergy triggers.
How can we get more ‘good’ exposure?
We can try to expose children to environments more like the ones in which humans, and our immune systems, evolved.
Most obviously, children need to have exposure to green space. Playing outdoors, having a garden, or living near green space (especially near a diverse range of native flowering plants) is likely to expose them to more diverse microbes and provide greater protection from allergic diseases.
Infants who are breastfed tend to have more diverse gut microbiomes (a larger variety of bacteria, fungi and other microscopic organisms that live in the gut), which makes them less likely to develop allergic diseases in childhood.
Having a varied diet that includes fresh and fermented foods can help cultivate a healthy gut microbiome and reduce allergic disease. As can using antibiotics only when necessary, as they kill off good bacteria as well as the bad.
So keep washing your hands, especially in cities and airports, but don’t be afraid of getting a little dirty in biodiverse environments.
This article was co-authored by Chris Skelly, International Programme Director, Healthy Urban Microbiomes Initiative and Head of Programmes (Research and Intelligence), Public Health Dorset.
I now have Skype installed on my computer. Any telephone calls can now be skyped, if you know how. Otherwise, it will just be a telephone call. I am prepared to reduce my fees for anyone having any financial difficulties as a result of this pandemic. Just let me know if that is the case. .
Times are going to be tough, but we will get through this.
The best advise is to keep healthy, which has been the point of my blog for the last 10 years. Also, follow the hygiene advise that has been well publicized, esp. washing hands.
I return to work tomorrow after a weeks break. The workplace will be very different from when I left – in just 1 week.
Every one is under great stress, especially the staff and doctors. One of the doctors has decided to stay home, and only return when it is all over. One of the doctors had all the signs and symptoms of the corona virus, but fortunately tested negative. The great risk is medical staff getting the virus, leaving sick people unable to obtain medical care- a disaster. Things we have always taken for granted may no longer be available. The medical center is best avoided anyway, as there will be sick people there, increasing the risk of the virus spreading. I encourage as many of you who need to see me to do so by Phone. If you are over 70, or have the virus, or have some other chronic disease, I have the option of bulk -billing you.
Most of my patients are over 50, who are the most at risk of the virus. I will try to speak to as many of you as I can, but that may mean speeding up the consultations, on the principle of trying to do the most good for the most people. These are trying times and I hope everyone will be understanding.
I am taking very good care of my own health, as I am in the high risk category, and will leave many of you high and dry if I should get sick. I am aware of that, so am very careful.
I wrote a book( in conjunction with Michail Borrisenko) in 2002 “Microbe Apocalypse – Man Vs Microbe” – I did not realize I was foretelling this pandemic. The book was about the benefit of colostrum in fighting virus infections. The book is out of print unfortunately. New Zealand Colostrum is best.
I will have more to say in the coming days.
The federal government have just announced that telephone consultations will attract a medicare rebate, if it has anything to do with the corona virus. As many of you are concerned about this, and have booked phone consult with me for this and hormonal issues in the near future, this may lessen the cost to you. I will keep you informed as more information becomes available about this rebate.