0:00

I'm Joe Graydon and I'm Terry

0:02

Graydon. Welcome to this podcast of

0:04

the people's pharmacy You can

0:06

find previous podcasts and more information

0:09

on a range of health topics

0:11

at people's pharmacy calm Millions

0:15

of people are sniffling and sneezing or

0:17

in the middle of flu season. There's

0:20

also RSV covered in colds This

0:23

is the people's pharmacy with Terry

0:25

and Joe Graydon There

0:34

are hundreds of cough, cold and

0:37

flu medicines on pharmacy shelves. Are

0:39

over-the-counter products helpful or counterproductive?

0:43

A long time ago people believed that

0:45

a fever was helpful rather than harmful

0:48

Sauna bathing is highly valued in

0:51

Finland and other Nordic countries. Is

0:53

there any evidence that raising body

0:55

temperature could be helpful against viral

0:58

infections? What about vitamin C

1:00

vitamin D or zinc? Can

1:02

they help? Coming up on

1:04

the people's pharmacy what to do

1:06

if you catch the flu? In

1:15

the people's pharmacy health headlines as Americans

1:18

settle back in at home after

1:20

traveling over the holidays many find

1:22

that they brought home some

1:25

unwelcome presents Infectious disease

1:28

experts are warning that a triple-demic

1:30

appears to be well underway Seasonal

1:33

influenza activity is high and

1:35

still rising in most parts of the country.

1:38

In addition Wastewater surveillance

1:40

shows that COVID-19 cases are

1:42

widespread and surging Cold

1:45

viruses are also circulating along

1:47

with respiratory syncytial virus Other

1:50

infections including strep measles and

1:52

whooping cough are also causing

1:54

trouble It's hardly any wonder

1:56

that so many people are under the weather

1:59

at this time Millions

2:01

of people are now suffering

2:03

from long COVID. Symptoms can

2:05

include fatigue, shortness of breath,

2:08

cough, heart palpitations, brain

2:10

fog, trouble sleeping, joint and

2:13

muscle pain, and inability to

2:15

exercise. A new

2:17

study published in Nature

2:19

Communications reveals that mitochondrial

2:22

dysfunction contributes to something

2:24

called post-exertional malaise. Metacondria

2:27

are the energy factories within

2:29

cells. Many people with

2:31

long COVID can no longer exercise. Even

2:34

modest exertion can result in

2:36

exhaustion. Dutch scientists recruited two

2:38

groups of volunteers. In

2:40

one group were 25 people with

2:42

long COVID. In the other group

2:45

were healthy people who had recovered

2:47

from COVID and had no residual

2:49

symptoms. All the participants worked

2:51

out for 10 to 15 minutes

2:53

on stationary bikes. Muscle

2:55

biopsies taken a week before the

2:57

exercise session and the following day

3:00

showed significant differences. The

3:03

mitochondria of those with long COVID

3:05

were not functioning normally, and as

3:07

a result, they began making lactate

3:09

for exhausted muscles. Muscles

3:12

of healthy people did not need lactate

3:14

for this short exercise bout. The

3:17

biopsy also showed significant muscle

3:19

damage in the people with

3:21

long COVID. The researchers found

3:23

evidence of autoimmune attack within

3:25

these muscles. In addition,

3:27

the muscles of long COVID

3:29

volunteers had lots of microclots,

3:32

especially in the post-exercise

3:34

biopsy. There is

3:36

as yet no treatment for

3:39

post-exertional malaise or any

3:41

of the other symptoms of long COVID. Bottled

3:44

water has become very popular. That's

3:46

because some people believe it's healthier

3:49

and others find it more convenient.

3:51

A significant number of Americans worry about

3:54

the quality of their tap water and

3:56

think that bottled water is better. It's

3:59

estimated that American. Americans by over forty

4:01

billion One liter bottles of

4:03

water each year. But his.

4:05

Water and plastic bottles actually

4:07

safer then tap water. A

4:09

new study published in the

4:11

Proceedings of the National Academy

4:13

of Sciences reports that a

4:15

typical one liter bottle of

4:17

water contains about two hundred

4:19

forty thousand particles of nano

4:21

plastics, nano plastics, or even

4:23

smaller than micro plastics less

4:25

than a micron wide. For

4:27

comparison, a human hair is

4:29

about eighty microns across. The

4:32

researchers believe that these teensy

4:34

plastic bits are coming. From

4:36

the bottle itself as well

4:38

as the reverse osmosis membrane

4:40

silver used to get rid

4:42

of other contaminants. Unfortunately, they

4:44

don't have information on the

4:46

potential health consequences of consuming

4:48

nano plastics. Last

4:50

summer team of researchers published.

4:53

A study of diagnostic errors

4:55

and medicine. They estimated that

4:57

misdiagnoses harm an estimated eight

4:59

hundred thousand Americans each year.

5:01

They concluded that size to

5:03

eleven percent of diagnoses and

5:06

wrong. Now, a new study

5:08

published in Jama Internal Medicine

5:10

suggests that estimate may be

5:12

love. These investigators reviewed medical

5:14

records more than twenty four.

5:16

Hundred patients in twenty nine different

5:19

hospitals. These were people who were

5:21

transferred to the I See You

5:23

or who died. The analysis of

5:26

their records reveal that twenty three

5:28

percent of the initial diagnosis were

5:30

mistaken. These errors harmed or contributed

5:33

to the death of eighteen percent

5:35

of the patients in the study.

5:37

The authors conclude. In this multicenter

5:40

study of a selected group of

5:42

medical patients who died in hospital

5:44

or who were transferred to and

5:46

I see you, diagnostic errors were

5:48

common and associated with patient. Harm

5:50

to lead investigator admitted that diagnostic

5:52

errors were more com is and

5:55

more deadly than the scene had

5:57

expected and both the whole thing.

6:00

On. Welcome.

6:14

To the People's pharmacy. I'm Joe

6:17

Graded and I'm Terry. Great! And

6:19

it's the six season. People are

6:21

coughing, sneezing and wheezing. That's because

6:24

we're in the middle of a

6:26

triple damning flu respiratory syncytial virus

6:29

and covered nineteen. Well, actually, Terry,

6:31

there are even more pathogens making

6:33

people sick. This winter the Cbc

6:36

is reporting strap whooping cough and

6:38

measles. And of course, don't forget

6:40

the common cold. There are hundreds

6:43

of a rhino viruses. At No

6:45

Viruses and Corona viruses that can

6:47

cause cold symptoms And that's why

6:50

we're talking with Doctor Roger. It's

6:52

wealth. He is an associate clinical

6:54

professor at the University of California

6:57

Riverside School of Medicine and and

6:59

assistant clinical professor the School of

7:01

Medicine and Allied Health at Loma

7:03

Linda University. Doctor Swelled is Board

7:06

certified in Internal Medicine, Pulmonary Disease

7:08

is Critical Care Medicine, and Sleep

7:10

Medicine through the American Board of

7:13

Internal Medicine. Welcome.

7:15

Back to the people Spam see

7:17

that Director swelled. Good

7:19

to be that. Thanks for letting me on. Duchess

7:22

Well before we start talking with

7:24

you, I would like to ask

7:27

a little bit about Med Cram

7:29

how it formed. What

7:31

your role is, and

7:34

most specifically. How

7:36

you became so talented at

7:39

explaining complex medical issues in

7:41

ways that people can actually

7:44

understand it as not just

7:46

physicians and nurses and pharmacists

7:49

and all those other health

7:51

professionals. But. Also.

7:54

The. Average walking around person.

7:56

Your ability to explain

7:58

is unbelievable. While.

8:01

I thank you so much. Should say

8:03

the talent I guess but in in

8:05

two thousand and twelve I was a

8:08

the clinical professor and. As such

8:10

I had students that rotator with me and in

8:12

the at that time I had a student p

8:14

a student from La Melinda. His

8:17

name was Kyle all red and does he

8:19

have a knack for understanding the business aspect

8:21

of things and with the needs? Worth the

8:23

time he was in P A school. And

8:26

he was getting Powerpoint presentation After

8:28

Powerpoint presentation. And so he really? He

8:31

then when he when he joined our rotation on

8:33

that the ability for me to teach I guess.

8:36

If. He he came to me with this

8:38

idea of starting a you tube channel

8:40

where we would explain things clearly. In.

8:42

A way that some people not just to memorize

8:45

it but the understand that for life. So we

8:47

started that you Tube channel. In. Two

8:49

Thousand and Twelve quickly grew into a

8:51

a website where we would teach at

8:54

on topics that would be available. And.

8:57

The students would downloaded are they would dodge

8:59

Wayne our our group and in the sort

9:01

of doubt there and then cove it hits

9:03

and of course everybody at that point was

9:05

a student, wanted to learn more and so

9:07

we grew by leaps and bounds and and

9:09

here we are today. And

9:12

I take it made, cram. Suggests.

9:15

That for medical students

9:17

or whatever medical professional

9:19

health professional getting ready

9:22

for an exam. Your.

9:24

Explanations allow them to pass those

9:27

exams that they might otherwise have

9:29

failed. Yeah. It's interesting

9:31

of it's not just if for

9:33

medical students or even you know,

9:36

physicians. although they do I'd certainly.

9:38

Take those classes, respiratory therapists, nursing students.

9:40

All of that. We also have a

9:42

lot of people who are just really

9:44

interested in learning about the human body.

9:47

Who. are interested about their body they may house

9:49

or some medical issues and they want to learn

9:51

more about that from a suspicion standpoint and so

9:54

that they log on on their part of

9:56

our audiences well we we do it in a

9:58

way that really helps just about any anybody who's

10:00

listening? Well, that

10:02

is perfect for us because that's

10:04

our listening audience, too. People

10:07

who are interested in how their

10:09

bodies work and what we can

10:11

learn about health. So let

10:13

me start by

10:16

suggesting that we're

10:18

coming into that time of year when

10:21

respiratory tract infections become

10:24

extremely common. And

10:27

people will be suffering from flu

10:29

and especially from a lot of colds.

10:34

What causes sore throats, stuffy

10:36

nose, and cough? Yeah,

10:40

it's almost certainly viruses.

10:42

And you just reminded me of when

10:45

they come into the emergency room, what we

10:47

do. We swab them and we send off

10:50

a litany of tests. Actually, it's just one test,

10:52

but it tests for a litany of different causes.

10:55

So there's the flu,

10:58

there's all sorts

11:00

of viruses, cold viruses, basic

11:02

coronaviruses, and not the coronavirus

11:04

that we've just went through in the pandemic,

11:06

but regular cold viruses, which are coronaviruses. Human

11:09

metanumavirus is another one. Anyway, there's a list, 16 or

11:12

17 of them. They

11:14

all have a very specific genetic signature.

11:18

And we can literally get a report back

11:20

in minutes that says which virus happens to

11:22

infected this person. Most of

11:24

those viruses we don't have treatments for

11:26

specifically other than supportive treatments. But

11:29

a few of them have been studied and are

11:31

very common. And for things like the common flu,

11:34

for things like obviously

11:37

with COVID-19, we do actually have

11:39

some treatments that are available

11:42

to help those symptoms abate

11:45

more quickly. You

11:47

use the word common, and it

11:49

drives me a little wild because

11:52

we also call the

11:54

average cold a common cold.

11:58

And The average person doesn't. Have

12:00

access to the test that

12:02

you have an Emergency departments.

12:04

There are over a hundred

12:06

and sixty rhino viruses that

12:09

can cause a cold. There

12:11

are parrot influenza viruses and

12:13

Taro viruses that doesn't count

12:15

Influenza or Rs V Respiratory

12:17

Syncytial virus And then there

12:19

are it. Yet there are

12:21

other things out there. So

12:23

when we say oh, the

12:26

common cold were actually talking

12:28

about. A lot of

12:30

different viruses that are contributing and

12:32

I'm just wondering, are there any

12:34

ways. That. We can

12:37

enhance our immune reactions

12:39

to all of those

12:41

nasty infectious agents. Yes,

12:44

Yes sir, absolutely has. In fact, there

12:46

is emerging evidence. That.

12:49

That we can. although we don't have the highest

12:51

level of events, Let me let me tell you

12:53

about. A story that's as

12:56

really interesting. About. This and

12:58

it is the story of Interferon. So

13:00

interferon is a cytokine that your body

13:02

produces when it gets infected with a

13:05

virus. And it could be any of

13:07

those viruses that you just mentioned. It

13:09

could be any of the variance of

13:11

covered nineteen. That we all

13:13

know about and Interferon is a

13:15

major. Block. It's a

13:17

major. Defense. Mechanism

13:20

that our body has against viral

13:22

infection. So much so that has

13:24

any self respecting virus wants to

13:26

infect our body. It has to

13:28

get around interferon and. Sure, Enough

13:30

just or of. Just a few months

13:33

ago, a paper was published showing exactly

13:35

which gene. In. Cold nights

13:37

when I was the mack One

13:39

gene specifically is that is the

13:41

gene that actually helps sars coby

13:43

to incest be human body and

13:46

get around interferon. So.

13:48

A logical explanation or logical conclusion

13:50

would be as if we could

13:53

somehow enhance our body's ability. To.

13:55

increase interferon that might not work

13:58

just for cold COVID-19, SARS-CoV-2, but

14:00

just about all of them. And

14:02

in fact, that is the

14:04

case. So there was a recent trial that was

14:06

published in the New England Journal of Medicine, showing

14:09

that in COVID-19 patients who had

14:11

outpatient forms of COVID-19, if

14:14

they were to be given just

14:16

one injection of a form

14:18

of interferon, that would dramatically

14:21

reduce by 50% the

14:23

number of ER visits and hospitalizations.

14:25

So proof of concept showing that

14:27

interferon is actually very beneficial. Now,

14:30

let's back up a hundred years,

14:34

because there's been recent studies that

14:36

showed that basically if you heat

14:38

up the human body, if you

14:40

heat up the core body temperature,

14:42

this dramatically increases almost 10 fold

14:45

the amount of interferon that

14:47

is released by lymphocytes that

14:49

are under activation from

14:51

an infection. And it's

14:53

interesting because much of the treatments, if

14:55

you look at the turn of the last century, the 1900s,

14:57

1910s, 1920s, in major hospitals, dealt

15:03

with specifically heating up the body

15:05

using something called fomentations or

15:07

hydrotherapy, where people became ill. And there's

15:09

a number of stories that I was

15:12

able to find at

15:14

that time of during the

15:16

influenza pandemic, some

15:18

remarkable stories about whole communities

15:21

that did this type of

15:23

treatment, hydrotherapy, heating up

15:25

the body, enhancing, they didn't know it at

15:27

the time, but enhancing interferon. And

15:29

the results were quite astounding, even to

15:32

the point of they were written up

15:34

in newspaper articles, and you can actually

15:36

get these newspaper articles today. So

15:39

what happened to this? Why did we stop doing

15:41

this? Well, yes, go ahead. I'm

15:44

thinking that some of what people have

15:46

been doing since that

15:48

time has probably been counterproductive, because

15:50

a lot of people, when they start

15:52

to come down with a cold,

15:54

they take something to lower their fever.

15:56

In fact, almost all of

15:59

the over-the-counter Hunter cold and cough

16:01

remedies have what we would call

16:03

a fever reduce or whether it's

16:05

and n said or whether it's

16:08

aspirin and you're like wait a

16:10

minute as a threat That may

16:12

make you feel a little better

16:14

temporarily, but. Could. It have

16:16

been counterproductive. And. Is

16:18

not only could have been, I believe

16:20

it is counterproductive. There's actual very interesting

16:23

dichotomy. A gentleman by the name of

16:25

Wells Ruble who was a a physician

16:27

at the time in the northeast of

16:29

the pandemic and he was comparing what

16:31

he was doing in the sanitarium said

16:33

the time, which was exactly what we

16:35

just talked about. versus. What they

16:37

were doing in the army hospitals are

16:39

treating. The Flu with Aspirin

16:41

and Aspirin as you know as well

16:43

as and said are both are very

16:45

adept at killing fevers and and reducing

16:48

that fever ability. And. The

16:50

the case fatality rates were six

16:52

times higher in the army hospitals

16:54

than they were in the cemetery

16:56

hims in the northeast. Wow.

17:00

I mean, just astonishing. We're We're gonna

17:02

take a short brief. But

17:05

when we come back we're gonna

17:07

ask you. Will is.

17:09

There any way to raise temperature

17:11

in a safe manner? What about

17:14

the since. They. Love Sound

17:16

Bass. Well. Is.

17:19

There any evidence to suggest that might

17:21

be beneficial. Get. Ready We're

17:23

going to ask those questions and

17:26

many more about colds, flu and

17:28

other viruses. You

17:30

are listening to Doctor Roger

17:32

Swelled associate Clinical Professor at

17:34

the University of California Riverside

17:36

School of Medicine and an

17:38

assistant clinical professor. At the

17:41

School of Medicine and Allied

17:43

Health at Loma Linda University.

17:45

He's founder and principal presenter

17:47

as the medical education company

17:50

Med France which provides continuing

17:52

medical education to countless health

17:54

professionals. His passion is d

17:56

mystifying. medical concepts as is

17:58

a break with We'll learn more

18:01

about why raising instead of lowering

18:03

body temperature is helpful. To taking

18:05

a soundabout be good for the

18:08

immune system? We'll find

18:10

out if vitamin D has any

18:12

benefits for the immune response to

18:15

infection. Maybe that's why grandmothers used

18:17

to dose their families with cod liver

18:19

oil. It's a great source of vitamin D.

18:22

Could chicken soup help you feel

18:24

better? My mother used to

18:26

swear by. You're

18:39

listening to The People's Pharmacy with Joe

18:41

and Terry Graydon. Today's

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podcast is sponsored by NutriSense.

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And thank you, NutriSense, for supporting

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today's show. Welcome

20:51

back to The People's Pharmacy. I'm

20:53

Joe Graydon. And I'm Terry Graydon.

20:55

The People's Pharmacy is made

20:57

possible in part by Cocovia Dietary

21:00

Supplement. Cocovia Cardio Health

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health. More information

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at cocovia.com. Millions

21:17

of years of evolution have

21:19

favored raising body temperature to

21:21

overcome infection. Reptiles can't

21:24

mount a fever, so lizards

21:26

bask in the sun to raise

21:28

their temperature if they're exposed to

21:31

pathogens. Prevent that

21:33

defense mechanism and they get sicker.

21:35

Yet pharmaceutical companies brag that

21:38

their cough, cold, and flu

21:40

remedies contain fever reducers. Are

21:43

such products counterproductive? Why

21:46

has modern medicine turned its back

21:48

on Mother Nature? We're talking with

21:50

Dr. Roger Schwelt, an associate

21:53

clinical professor at the

21:55

University of California Riverside School of

21:57

Medicine, and an assistant clinical professor at

21:59

the at the School of Medicine

22:02

and Allied Health at Loma Linda

22:04

University. He's the director of

22:06

a sleep lab and is the medical

22:08

director for the Crafton Hills

22:10

College Respiratory Care Program. Dr.

22:13

Schwelt is co-founder with Kyle

22:15

Allred of MedCram, a

22:18

medical education company with CME

22:20

accredited videos. So

22:24

Dr. Schwelt, what's

22:26

the story on raising temperature

22:28

and the fins and sauna

22:30

bass? Yeah, so

22:32

this is really interesting and you might just

22:35

look at this from a 30,000 foot view. The

22:38

societies that use

22:41

this type of sauna and

22:43

raising body temperatures and hydrotherapy

22:45

are generally societies

22:48

that don't get as much sun as

22:50

perhaps you might at the more equatorial

22:53

cultures. So we see this in, and

22:55

obviously in Finland and to

22:58

some degree also in Germany, Sweden,

23:00

Norway and I believe that this

23:02

is an anthropological

23:05

adaptation to the fact that they don't

23:07

get as much sun to boost their

23:09

immune systems and to enhance their immune

23:11

systems. So as you

23:13

know, the fins are very passionate about

23:16

their sauna. In fact, there

23:18

was a statement made at one point

23:20

that basically if everybody in

23:22

Finland decided to go into a sauna all

23:24

at the same time, there would be more

23:26

than enough saunas to hold the entire population

23:28

at the same time. So

23:31

it's something that they do. When they

23:33

do studies on sauna in Finland, the

23:36

control group is actually people

23:38

that just use it once a week.

23:41

Right. Because they can't find anyone

23:43

in Finland who doesn't

23:45

use saunas. Exactly.

23:47

And most of the research in

23:50

this area has not been in

23:52

the area of treating colds or

23:54

infections, but rather in looking

23:56

at things much bigger actually,

23:58

like all-cause mortality, vascular

24:00

disease. And the reason for

24:02

this is because when you go into a

24:04

sauna and you increase the temperature, your heart

24:06

increases, your heart rate increases, and

24:09

it's basically like an exercise

24:11

equivalent. So if

24:13

you want the benefits of exercise but

24:15

you can't because either you have joint

24:17

disease or arthritis, this is a great

24:19

solution to actually use. Now, you have

24:21

to be careful when you heat up

24:23

the human body. And so the

24:25

two biggest risks of doing this

24:27

is that you could induce

24:30

arrhythmias if you are susceptible to arrhythmias. And

24:32

this is the reason why it's very important

24:34

that we do this not alone but with

24:36

somebody else there. Because if you start to

24:38

feel like you're going to pass out or

24:40

start to have something, you want to have

24:43

somebody there to do this. And I think

24:45

Matthew Perry comes as an example. He was

24:48

in a hot tub and he was alone

24:50

and he was found dead basically. And

24:53

this is something that whenever we do

24:55

hydrotherapy or do sauna, it's good to

24:57

have someone there. It's also important to

24:59

get a note from your doctor to

25:01

make sure that this is okay. The

25:04

second thing in terms of risk

25:07

is burning, obviously. So as

25:09

I was mentioning back at the turn of the last century, one

25:12

of the meccas, if you will, for this

25:14

type of treatment in terms

25:17

of hydrotherapy was the Battle Creek Sanitarium in

25:19

Battle Creek, and

25:21

there are photographs that you can see

25:24

of these huge treatment rooms with multiple

25:26

baths and attendants doing all

25:28

of this. And it showed them. They basically

25:30

heat up these towels that

25:32

are soaked in water, so they're

25:35

almost steaming, and they place this on

25:37

the body to basically cover them with

25:40

these hot towels until they're brought to

25:42

a sweat. And this

25:44

is basically how you know that the body

25:46

temperature is being elevated. And

25:49

this was a treatment for tuberculosis

25:52

before we had antibiotics, is that right?

25:55

This is actually a treatment for many

25:57

multiple issues. So when you

25:59

have residual viruses or infections

26:01

of various sources. There were

26:03

different techniques that were used.

26:06

Probably the height of this

26:08

is a psychiatrist in

26:10

Austria by the name of

26:13

Wagner Jorreg, who noticed

26:15

in his in his insane

26:17

asylum that people with neurosyphilis

26:19

actually got better when they had a

26:22

fever for some reason. So he actually

26:24

took people with malaria, took

26:26

their blood out, injected it into his

26:28

patients to induce a fever. And

26:31

when he did so, these patients actually

26:33

got cured of their

26:35

neurosyphilis. And then he was able

26:38

to quickly cure the malaria with quinine,

26:40

which was well known at the time. This is

26:42

all before penicillin. And for

26:44

this work that he did in 1917, he

26:47

10 years later received the Nobel Prize in

26:49

medicine in 1927. So

26:52

this was something that was well recognized. It

26:54

was sort of on its way. The

26:57

irony is that the very next year

26:59

in 1928, we had the discovery of

27:01

penicillin, something that allowed

27:03

us to give medications to

27:05

people with neurosyphilis specifically, and

27:08

of course, a whole host of other

27:10

diseases with antibiotics. And that was much,

27:12

much labor intensive, less labor intensive than

27:14

than doing hydrotherapy. And so it quickly

27:17

replaced that type of

27:19

therapy because there was quite a

27:21

bit of labor involved with hydrotherapy.

27:25

It's my understanding that there was

27:27

actually a thing called malaria therapy

27:29

and that the US Public Health

27:31

Service actually was involved for a

27:33

few years. Yes, that's

27:35

exactly right now. Not just

27:38

malaria, but anything

27:40

that would raise temperature. Sometimes they would inject

27:42

foreign proteins to induce an immune response to

27:44

get the fever up. Oftentimes they

27:46

use hot baths, as we mentioned, or even

27:48

what they called heat cabinets. Anything

27:51

that would get the body's temperature up,

27:54

this would activate and bypass the

27:56

viral bypass that was trying to

27:59

subvert the Interferon response

28:01

and actually did a very good job of Clearing

28:05

the virus you may notice in

28:07

the last pandemic here that we have Big

28:10

difference between adults and children children have

28:12

very strong innate immune systems you'll

28:15

often notice that children come down with a fever

28:17

very quickly and And

28:19

they're able to clear these viruses very well

28:21

our innate immune systems become less

28:24

strong as we get older they've come more weak and

28:27

As opposed to the original SARS which

28:30

you may recall almost everybody had a

28:32

fever with that with SARS-CoV-2

28:35

the amount of percentage of people that

28:37

had fever was much less and

28:39

it was able to be transmitted asymptomatically And

28:41

that's the reason why we were not able

28:43

to contain SARS-CoV-2 One

28:46

other thing about a fever You've

28:49

probably heard of something called coleus

28:51

toxin which was

28:54

injected into Tumors

28:56

that people had especially sarcoma

28:58

tumors Those are

29:00

cancerous tumors and the

29:03

way in which dr. Coley

29:05

monitored the progress of that

29:07

toxin which was a gimish

29:09

of bacteria Was

29:11

temperature and he he

29:13

would be able to determine When

29:16

the treatment was working by how

29:18

high the the temperature got is

29:21

that something you're aware of no actually

29:23

But that makes a lot of sense The

29:25

temperature is the body's signal it goes

29:28

all over the body and it basically

29:30

Increases metabolism and it signals

29:32

the immune system that there is an invader

29:34

and that certain chemicals need to be secreted

29:37

As I mentioned there was this the study

29:39

that showed that lymphocytes at up

29:41

to 38.5

29:43

degrees centigrade would not have any kind

29:45

of change in interferon secretion once it

29:47

hit 39 degrees Celsius Which

29:50

is about 102 degrees Fahrenheit there

29:52

was a tenfold increase in interferon

29:55

response So it's not surprising

29:58

That is very impressive Dr.

30:00

Schwelt, I'd like to backtrack just

30:02

a bit. You were

30:04

suggesting that perhaps the popularity

30:06

of Sauna in Northern

30:09

Europe might be related to

30:11

the fact that people don't get a lot

30:13

of sun exposure. And, of course, you mentioned

30:15

Battle Creek, Michigan, where there's also not a

30:18

great deal of sun exposure. What

30:20

I'm wondering is what is

30:23

the role of vitamin D

30:25

with respect to our immune

30:27

response? The grandmothers in Sweden

30:29

and Norway and Finland were

30:31

very fond of cod liver

30:33

oil. Tell us about it.

30:36

Yeah, no, it's

30:39

definitely something that we know. So

30:41

if you look at the sort

30:44

of interesting observation here is

30:46

if you look in the country right now in

30:48

the United States, what hospital is probably

30:50

the best suited to treat tuberculosis? It

30:53

happens to be National Jewish Hospital in

30:56

Denver, Colorado. And

30:58

it's not by accident. It's because we've had

31:00

a long history of experts

31:02

that have gone to Denver. Why is that?

31:05

Well, Denver is a very high place.

31:07

And we've known for centuries, actually,

31:09

especially in Europe as well, that

31:12

if you want to treat specifically

31:14

tuberculosis, there's two things that you want

31:16

to have. Number one, you want to have a lot of vitamin

31:18

D. And the thing

31:20

that makes vitamin D is ultraviolet

31:22

radiation. And ultraviolet radiation hates

31:24

the atmosphere because the atmosphere is very

31:26

good at filtering that out.

31:29

So the closer you get to space, the

31:32

higher amounts of ultraviolet B radiation you're going

31:34

to have and the higher amounts of

31:36

vitamin D that you're going to have available. You can also

31:38

get that in cod liver oil as well. You're

31:40

right. John Harvey Kellogg, who was

31:42

the medical director of the Battle Creek Sanitarium,

31:44

had a real issue when he wanted to

31:47

treat tuberculosis. He realized that he was not

31:49

at high altitude. And he

31:51

had something else that he learned. The other

31:53

thing that you have when you're at high

31:55

altitude, by the way, is low oxygen. And

31:58

that, ironically, is very important. important

32:00

in treating tuberculosis because

32:02

tuberculosis loves oxygen. And if you

32:04

get rid of oxygen, if you

32:07

lower the oxygen, it's less likely

32:09

to thrive. So John

32:11

Harvey Kellogg traveled over to Europe

32:15

where he learned a great

32:17

deal from this eccentric guy,

32:19

basically this physician who was

32:21

living up in the Alps of Austria.

32:24

And he had tremendous success treating tuberculosis,

32:26

like 80% cure rates. And

32:29

he had them up in the

32:31

mountains. If they were

32:34

wearing clothes, it was a very small amount of clothes.

32:36

They were being exposed to lots

32:38

of sunlight, lots of ultraviolet

32:41

radiation, and they were getting

32:43

the benefits of fresh air, and

32:45

they were getting the benefits of vitamin D

32:47

and low oxygen. So he adopted that, brought

32:50

it back to Battle Creek. He obviously didn't have

32:52

the same environment there as they did in Austria,

32:55

so he made it for them. He

32:57

created these light boxes and

33:01

had the hydrotherapy and all the sorts of

33:03

things that his health resort had. And he

33:05

was able to get similar cure rates over

33:07

there, but he adopted a lot of what

33:09

he saw in Europe over

33:11

into the United States. He Americanized

33:13

it. He made these contraptions called

33:15

light boxes. He basically

33:19

capitalized it, and then these Europeans came

33:21

over, watched what he did, and then

33:23

took it back over to Europe, where

33:25

they made a lot of money selling these

33:27

light boxes in the late 1800s, early 1900s. That

33:33

is fascinating history. Now,

33:36

we have to jump forward a century or

33:38

so. What about cod

33:40

liver oil? We

33:42

say, well, there was no science. Those

33:45

grandmothers, they had no idea what

33:48

they were doing or why they were doing

33:50

it, but they kind of believed that when

33:52

it came to the winter, those grandchildren needed

33:54

to swallow that cod liver oil as bad

33:57

as it tasted. Were they doing anything helpful?

34:01

There you go. Wet wasn't beneficial.

34:04

The. I is it. There's no question

34:06

that's a vitamin D. Supplementation does

34:08

help in of autoimmune conditions and

34:10

also and tuberculosis to bell lot

34:12

of data on that. And

34:15

there's no question about it, Cod liver oil

34:17

does contain a lot of of vitamin D

34:19

Also, mushrooms, by the way, Contains.

34:21

A lot of Vitamin D as well. So.

34:24

Yeah, there's There's definitely a lot of

34:26

wisdom, or as I start to learn

34:29

more and more in science, I start

34:31

to respect my grandmother even more and

34:33

more. Ssssss. Yes

34:35

indeed. Outwits, we're on that page

34:38

with. Yeah, what else? Did.

34:40

Our grandparents and great grandparents do.

34:42

That might have been beneficial that

34:44

we've lost because today you come

34:46

down with a cold. you're under

34:48

the pharmacy. You get a multi

34:50

symptom cold reliever that has not

34:52

just and said said it but

34:54

in addition it probably has decongestants.

34:56

We just learned that Fennel Efron

34:58

P E is ineffective as a

35:01

decongestant will. Actually, we've known that for

35:03

a long time, but the Ft I just

35:05

decided that. Rice. They also have anti

35:07

system means to dry us out. they

35:09

have dextromethorphan to stop our costs and

35:11

they have new Kalinic so called me

35:14

feel that acts with wire fence and

35:16

so is any that stuff doing anything

35:18

force or should we be taking vitamin

35:20

c and chicken soup. Assets

35:22

Yeah though so this is that. This

35:25

is the the fallacy. The fallacy is

35:27

is that the symptoms that we come

35:29

down with. During a colds

35:31

are somehow the problem as opposed to

35:33

recognizing it. That the symptoms that we

35:35

have our the body's response to the

35:37

problem and there's a way of trying

35:39

to get rid of it. So I

35:41

think if we have that that understanding.

35:44

Than. We would take a little bit different

35:46

approach so a fever is not the cause

35:48

of the problem. The fever is factually the

35:50

the first couple of steps down the road

35:53

to recovery. And. In: I'm In

35:55

In Not. Basically activating the

35:57

immune system so something else they

35:59

are. Grandmother would do often. Is.

36:02

If you had a cold or cold symptoms

36:04

she would she would heat a pot of

36:06

hot water. On. The stove and the

36:08

steam would come out and the steam would

36:10

die with Vegas inhale it may be make

36:13

a little bit of a cone. So.

36:15

That the steam would com i we could breathe

36:17

in that steam. So there's but actually some research

36:19

on that. And. This is a

36:21

very old paper. I don't have access to

36:23

it at the moment, but it was an

36:25

all paper that showed that breeding in inhalation

36:28

of steam. Actually, Accelerated

36:30

the recovery of people with

36:33

a flu. Actually the symptoms

36:35

improves. Our. Would you breed then

36:37

this hot steam we get? We know that

36:39

that viruses for the most part don't replicate

36:41

very well. When. They are at

36:44

a higher temperature. It's one of the reasons why

36:46

our body makes the fever. And. So

36:48

this type of of condition

36:50

actually in improve this type

36:52

of treatment actually improved the

36:54

symptoms of a upper respiratory

36:56

tract infections. Anything.

36:59

Else we can do to speed recovery

37:01

and anything we should be avoiding. Yeah.

37:04

So I highly recommend getting out into the

37:06

sun. There is a real issue today with

37:08

the type of light that we are getting

37:10

are in just sort of from thirty thousand

37:12

foot view. This is the first time that

37:15

him about the last ten or twenty years

37:17

is the first time in human history. That.

37:20

We have been exposed to

37:22

light that is not full

37:24

spectrum light. For. Our biological spectrum

37:26

Light In other words, prior to that. I

37:29

even with incandescent bulbs with a

37:32

candle light we were getting. Light.

37:35

All at the same time in the

37:37

infrared spectrum in the visible spectrum and

37:39

the ultraviolet spectrum of maybe not so

37:41

bunch in the ultraviolet. Today.

37:43

We have L E D lights. We have

37:45

windows that seltzer out on near infrared light.

37:48

And. So we're getting visible spectrum with

37:50

out that other spectrum light and

37:52

we're starting to realize through studies

37:54

doubt that might not be the

37:56

best idea. And. so if you

37:59

want full biological spectrum light you

38:01

really need to get outside and into

38:03

your environment and get that sunlight. So

38:05

there's been a number of studies that

38:07

have looked at the effect of near-infrared

38:10

radiation on our bodies, that

38:12

our bodies are not 100% opaque,

38:14

that light could actually penetrate down into

38:17

the deep recesses of our body, and

38:19

that light can actually have effects at

38:21

the metabolic

38:23

level in the mitochondria. We're

38:26

listening to Dr. Roger Schwalt. That's

38:30

S-E-H-E-U-L-T. He

38:33

is Associate Clinical Professor at

38:35

the University of California Riverside

38:37

School of Medicine and Assistant

38:39

Clinical Professor at the School of

38:42

Medicine and Allied Health at Loma

38:44

Linda University. He practices

38:46

as a critical care physician,

38:49

pulmonologist, and sleep physician at

38:51

Optum California. He's co-founder

38:54

and principal presenter of the

38:56

medical education company MedCram, which

38:58

provides continuing medical education to

39:01

health professionals. His

39:03

passion is demystifying medical

39:05

concepts. After the break,

39:07

we'll talk more about raising body temperature,

39:10

vitamin D, and sunlight.

39:13

Vitamin C has a reputation for helping

39:15

against cold. Is there any evidence? What

39:17

about zinc? Does it help? And

39:19

if so, what's the right dose? Dr. Schwalt

39:22

will tell you all about zinc ionophores

39:24

and quercetin for cold. We'll get

39:26

his tips on staying healthy during

39:28

cold and flu season. You're

39:39

listening to The People's Pharmacy with Joe

39:41

and Terry Graydon. This

39:44

podcast is made possible in part

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41:15

Today we're talking about what to

41:17

do when you catch the flu

41:19

or cold. Is there anything you

41:21

can take to speed? Recovery Zinc

41:23

got a lot of attention during

41:26

the pandemic. Are there any downsides

41:28

to taking sync on a regular

41:30

basis? We're talking with Doctor Roger.

41:33

Sweat and associate Clinical professor

41:35

at the University of California.

41:37

Riverside School of Medicine and

41:39

an assistant clinical professor at

41:41

the School. of medicine and

41:44

allied health at loma linda

41:46

university he's a critical care

41:49

physician pulmonologist and sleep physicians

41:51

at upton california in beaumont

41:54

he's also cofounder with kyle

41:56

all red of med cram

41:58

a medical education company with

42:01

CME accredited videos. So

42:04

Dr. Schwell, let me see if I've got this

42:06

right. We should be

42:09

probably raising our temperature rather

42:11

than lowering it as long as it doesn't

42:13

get too high and we'll ask you how

42:15

much is too much. And

42:18

we should probably be getting some sunlight

42:21

and maybe even some vitamin D in

42:23

the form of either a supplement or

42:25

cod liver oil. What

42:28

about Dr. Linus Pauling and

42:30

all of the confusion

42:32

and controversy around vitamin

42:34

C or ascorbic acid?

42:37

Yeah, so in terms of fever, I

42:39

would not go above 104, certainly 105.

42:44

I've never had a fever of 103 cause

42:47

a problem in one of my patients.

42:51

I would just recommend though that if somebody has

42:53

a risk factor for

42:55

a rapid heart rate like atrial fibrillation

42:57

or something of that nature that

42:59

you be careful with raising the

43:01

temperature too high and just monitor

43:03

the heart rate. And

43:07

the story on colds? Yeah,

43:09

so on colds, I'm not

43:11

aware of randomized controlled trials

43:13

that show that vitamin C

43:15

is beneficial in colds although

43:18

there is other lower levels

43:20

of evidence that are enticing

43:23

and I would say hypothesis generating. So I

43:25

think studies still need to be looked at

43:27

on that. Let me ask

43:29

you about another popular nutritional

43:34

supplement that people often use

43:37

for cold and

43:39

that would be zinc. What's the story on

43:41

zinc? Yeah, so we actually

43:44

do have some data on zinc. We

43:47

used to think and we still might

43:50

look at zinc as being

43:52

an inhibitor of

43:55

a protein that viruses use to

43:57

replicate themselves called RNA, dependent RNA

43:59

pulpitase. polymerase for those

44:02

RNA viruses. And this

44:04

has been actually the source of the

44:06

idea behind using zinc ionophores to

44:08

get zinc inside the cell and

44:11

therefore shut down this protein that the

44:13

virus uses. In vitro

44:15

it seems to work well. The

44:17

levels of zinc

44:19

necessary intracellularly to have that

44:22

happen are estimated

44:24

to be much higher than what would actually happen

44:26

in the human body. So it's unclear whether or

44:28

not that's actually the mechanism how zinc works. But

44:31

we do actually have studies that show

44:33

that in people with cold, those that

44:35

take zinc supplements seem to

44:37

improve more quickly from their cold

44:39

symptoms than those that don't. What

44:43

kind of dose are we talking about? So

44:46

these are pretty high doses of zinc.

44:48

This is the type of zinc that

44:50

you get in a zinc lozenge. If

44:52

you buy zinc over the counter, the

44:54

milligrams that you see in the container

44:56

are based on the

44:59

anion that the zinc is complex with. So

45:02

you have zinc to colonate. That's going to

45:04

be a different amount of milligram than zinc

45:06

oxide or things of that nature. So you

45:09

actually have to look at the amount of

45:11

elemental zinc. And they should mention that on

45:13

the bottle. The thing that

45:15

you have to be careful about though with

45:17

taking more than 4 milligrams of elemental zinc

45:20

on a day over a long period of

45:22

time is that elevated levels of zinc can

45:24

actually reduce your copper levels. And

45:27

that can cause other problems with your

45:29

cardiovascular system. So in a short term,

45:31

taking high doses of zinc over a

45:33

short period of time, no problem. You

45:36

can take how much is on the bottle. I

45:39

don't know exactly what the amount of zinc was in

45:41

that study where they seem to do better. I'll have

45:43

to look that up. But if

45:45

you're taking on a regular basis more

45:47

than 4 milligrams of elemental zinc a

45:49

day, that can over a long period

45:51

of time reduce copper levels. And

45:55

very briefly, you talked about ion

45:57

affairs. And I'm thinking,

45:59

quercetid. and there are

46:01

others that will help zinc get into

46:04

the cell. What do you

46:06

recommend? Yes, so very early on

46:08

in the pandemic, I actually recommended taking Kerstin

46:10

and actually bought supplements

46:12

for myself as well and started taking them.

46:15

It may or may not be the way that

46:17

it works. It is considered to

46:19

be a zinc ionophore as well and so

46:22

in terms of that mechanism, it may

46:24

be beneficial but it also may have other

46:26

effects as well. It's also, you know, an

46:29

antioxidant and does a number of other things

46:31

as well. Dr.

46:34

Schwell, you have an expertise

46:36

in pulmonology so I'm hoping

46:38

that we can move

46:41

away in a minute from

46:43

talking about infections and talk then

46:46

about other conditions that may affect

46:48

the lungs. But let me just

46:51

as the wrapper on the infections, are

46:54

people with chronic lung conditions

46:56

more susceptible to infection? Yes,

47:00

absolutely. So when you have a

47:02

chronic lung condition,

47:04

this affects the immune system in

47:06

your lungs and it opens up

47:09

therefore the ability for certain opportunistic

47:11

infections to come in. Things

47:13

like viruses, specifically

47:16

fungus and certain types

47:18

of bacteria like Pseudomonas

47:21

and I see that quite a bit

47:23

in our patients with COPD with bronchi

47:25

acticis. This is a condition where

47:28

the bronchi are dilated from repeated

47:30

infections and also with

47:32

people who have fibrosis

47:35

of the lungs as well. Now

47:37

you mentioned COPD and I'm going to ask

47:39

you to explain it. Not only what do

47:41

the initials stand for,

47:43

which I do want you to tell us, but

47:46

also what is it? Yeah,

47:48

so COPD is a

47:50

chronic obstructive pulmonary disease and the

47:52

operative word there is obstructive. So

47:55

when you're taking a breath in, your

47:57

lungs are getting bigger and the airway is not as big as the airway.

48:00

airways in your lungs are also getting bigger

48:02

and so they're nice and open and air

48:04

comes in in a patient with

48:06

COPD without a problem. But

48:08

when you're blowing the air out, because

48:10

the lungs are getting smaller, the

48:13

airways are also getting smaller and

48:15

in particular in patients with COPD,

48:17

those airways become very floppy and

48:20

they're very easily collapsed. So

48:23

unfortunately what happens is it takes much

48:25

longer for the air to come out

48:28

of somebody with COPD and in some

48:30

cases the air gets trapped in

48:32

the lungs and doesn't come out. And so

48:34

that effectively limits your ability to

48:37

breathe out and get rid of carbon

48:39

dioxide. And so we typically see in

48:41

patients with severe COPD an

48:43

elevation in their carbon dioxide levels and

48:45

you can imagine that if it takes

48:47

a long time to get the air

48:49

out, then they're not going

48:51

to do well in situations where they have

48:53

to breathe quickly, which is exactly what happens

48:55

when they're trying to exercise and walk around.

48:57

They have to stop because they can't get

48:59

the air out of their lungs. Now,

49:03

Dr. Schwartz, you mentioned fungal

49:05

infections and I'm thinking a

49:09

lot of people who have

49:11

lung problems, whether it's asthma

49:13

or COPD, they

49:15

are often given inhalers with

49:18

corticosteroids, pretty powerful ones like

49:20

fluticasone as an example. Corticosteroids

49:24

kind of suppress

49:27

the immune system and

49:29

make people more vulnerable to

49:32

fungal infections. It seems like

49:36

it's a real challenge.

49:39

How do you as a clinician deal with

49:42

someone with asthma, for example, who then may

49:44

be more vulnerable to a fungal infection that

49:47

may make the breathing problem worse? Yeah,

49:49

this is a very important question and

49:52

it's something that the

49:54

guidelines are trying to tackle. So if

49:56

you can imagine there are two obstructive

49:59

lung disease. diseases. There is asthma and

50:02

there is COPD as we talked about

50:04

before. COPD and asthma are

50:06

basically different flavors of the same

50:08

problem, which is inability to get

50:10

the air out. Asthma

50:12

comes and goes, it's intermittent, and COPD

50:14

is there all the time. Those

50:17

diseases are sort of the prototypes.

50:19

Now, there are three types of

50:21

inhalers that we can give

50:23

patients with COPD or asthma. We can

50:26

give medications that

50:28

block what we

50:30

call the muscarinic receptor, which causes

50:33

constriction. Obviously,

50:36

we don't want the airways

50:38

to be smaller. We want the airways to

50:40

be bigger. So, a long-acting

50:42

muscarinic antagonist, we call it, is

50:44

something that's going to make those

50:46

airways bigger. There's another inhaler

50:48

type of inhaler that we can give

50:51

called a long-acting beta agonist. Beta

50:53

agonists cause the airways

50:55

to become bigger as well,

50:58

to dilate, to open up.

51:00

Those two are pretty easy

51:03

to understand. The third though, is exactly

51:05

the type of inhaler that you just

51:07

mentioned, which is an inhaled corticosteroid. Now,

51:10

as it turns out, COPD does

51:12

have some inflammation associated with it,

51:15

but not nearly as much as

51:18

asthma. Asthma has much higher

51:20

levels of inflammation and

51:22

is therefore one

51:24

of the disease that we use

51:27

these inhalers that are inhaled corticosteroids

51:29

for first. So, in other words,

51:32

if I had an inhaled corticosteroid, I

51:34

would much rather use that on the asthmatic

51:36

than I would on the COPD, or because

51:38

the asthmatic has more

51:40

inflammation. But, as you

51:42

mentioned, inhaled corticosteroids not

51:45

only reduce inflammation in the

51:47

lungs of asthmatics, it

51:49

also knocks out the immune system

51:52

and it can open up the

51:54

risk of getting infections. So, when

51:56

they did a trial study on

51:58

a combination medication, inhaler

52:00

of inhaled corticosteroids and they

52:08

do reduce the rate

52:10

of exacerbations and asthma. They

52:13

do reduce the amount of

52:15

hospital visits. But they

52:17

also noticed that it did increase

52:19

the risk of pneumonia as well

52:22

in these patients. And there are

52:24

some case presentations that I've looked

52:26

at where people have gotten fungal

52:28

infections, specifically aspergillus in

52:31

long-term chronic use of inhaled

52:33

corticosteroids. Now this

52:35

is an interesting topic because GINA,

52:39

which stands for the Global

52:41

Initiative for the treatment

52:44

of asthma, this

52:46

is basically a consortium that looks at all of

52:48

the studies. They've recently looked at data that

52:52

has changed their recommendations to the

52:54

point where they're now saying that for people

52:56

who have asthma, it used

52:58

to be that we would treat people

53:00

with asthma with an inhaled corticosteroid

53:03

if they needed it, but their

53:05

rescue inhaler would be simply albuterol,

53:07

which is a rescue dilator. They

53:11

are now saying, based on the

53:13

studies, that people actually

53:15

do better in terms of

53:17

exacerbations if that rescue inhaler

53:20

that they are taking not only contains

53:22

a bronchodilator like albuterol, but

53:25

also an inhaled corticosteroid. So

53:28

we are actually going to see the likely,

53:30

based on these new recommendations, the use of

53:32

inhaled corticosteroids going up, which

53:35

is really interesting because what we're

53:37

seeing globally is the incidence of

53:39

asthma is also going up. It's

53:41

one of the few respiratory diseases

53:43

that is actually increasing in prevalence.

53:46

Dr. Schwelt, we

53:48

have heard a lot about air pollution in the

53:50

last couple of years, especially

53:53

when we have seen the

53:55

sky get dark. And

53:57

I'm referring now to where we live,

53:59

which is... North Carolina. When there

54:01

were forest fires in Canada, we

54:03

were experiencing the complication as they

54:06

were in New York City and

54:08

in New England. and I'm sure

54:10

in California when there are forest

54:12

fires. They also cause all kinds

54:15

of problems for people with. Asthma

54:17

and C O P D. What?

54:20

About. The. Risk of infection

54:22

said the same time. Yes,

54:25

So we definitely have a

54:28

epidemiological studies that correlates this

54:30

particulate matter of it's called

54:32

Pm and there's different sizes

54:34

discourse particles, fine particles, an

54:36

ultra fine particles and these

54:39

have definitely been correlated to

54:41

the development of C O

54:43

P D have asthma exacerbations.

54:46

And. From there, we see that there

54:48

is a correlation with infections as well, so

54:50

there's no question. That that

54:52

these modern day ambient

54:54

air pollution factors are

54:57

factory and to lung

54:59

disease. Of the other

55:01

aspect of this also is indoor air

55:03

pollution as well. and this is the

55:05

reason why I'm I'm such a. An.

55:07

Advocate for making sure that you have windows

55:09

that are open and that you're getting appropriate

55:12

ventilation in the home. That's of course, provided

55:14

that the air folly outside your home is

55:16

also good. Night

55:19

after swell. As individuals we have

55:21

very. Little. Control over it. And

55:23

the quality of they are outside

55:26

on socially at a big level

55:28

we might have some control but.

55:31

How can we improve the

55:33

quality of air inside our

55:36

homes? Yes,

55:38

There are a filtration devices have

55:40

the filters that can be used.

55:42

They can be a little expensive.

55:45

And so I'm looking at ones that

55:47

are reasonable and placed in places where

55:49

you are most of the time. For

55:51

instance, if you are sleeping in a

55:53

bedroom.might be a place that you'd want

55:55

to have that air filter on. because

55:58

you're gonna be in there for it to eight hours

56:01

every day, hopefully, if you're sleeping. So

56:04

that is one way of doing it. The

56:06

other way of doing it, and this is

56:08

an emerging area that is a little controversial

56:10

because it has to do with fuels,

56:14

and that is the use of basically

56:17

propane or natural gas inside in terms

56:19

of cooking. So one of the major

56:21

areas of indoor air pollution is

56:24

the burning of biomass. And that

56:26

could certainly have to do with

56:28

gas or propane stoves. But

56:31

it could also do globally

56:34

with those that actually have open fires, believe it

56:36

or not, in their homes and

56:39

are cooking and can get significant lung

56:41

disease from that as well. So those

56:43

are the two areas specifically

56:45

that I can think of that impact

56:47

our indoor air quality. Dr.

56:51

Schwell, you deal on a regular

56:53

basis with people who have lung disease, and

56:56

I'm wondering about the addition

56:59

of corticosteroids, whether

57:01

it's orally or whether it's

57:04

inhaled, and the

57:06

potential effect of corticosteroids on

57:08

the immune system. Does it

57:11

make people more vulnerable? And what

57:13

happens when you have a patient

57:15

who develops a fungal infection in

57:17

their throat as a result of

57:20

the medicine they're taking for their

57:22

COPD or asthma? Yeah, this

57:25

is a real problem. Inhaled corticosteroids

57:27

are a double-edged sword. So they

57:30

have a tremendous impact in the treatment of

57:32

asthma where there is a lot of inflammation.

57:35

It brings that inflammation down. But

57:37

the cause of that inflammation is from the

57:39

immune system. And so when it cripples the

57:42

immune system, it also opens the

57:44

patient up to getting these types

57:46

of infections, specifically fungal infections and

57:49

things of that nature. So when we have the

57:52

ability to find the reason why

57:54

someone might have asthma, it's much

57:56

more beneficial to identify

57:58

specific triggers. and get rid

58:00

of them so that we don't have to put

58:03

them on inhaled corticosteroids. But

58:05

if the alternative is that they are

58:07

going to be ending up in the

58:09

hospital and very, very ill,

58:11

sick, maybe intubated, then

58:13

we look at the risk-benefit

58:15

ratio and we're willing to accept that some

58:17

of these patients who get put on inhaled

58:19

corticosteroids will be open to be

58:22

getting these types of infections. The one that

58:24

you mentioned specifically is thrush, we call

58:26

it, and that is where you have a fungal infection

58:28

that coats the back of the tongue. And

58:30

that's mainly because the inhaled

58:33

corticosteroids land on the tongue and reduce

58:35

the body's ability to get rid of

58:37

that fungus. So rinsing your

58:39

mouth out and doing that after each

58:43

actuation of the inhaled corticosteroid

58:45

is very important. Dr.

58:48

Schwell, we all know how to breathe. We assume we all

58:51

know how to breathe. Is

58:53

there any value in breathing exercises?

58:57

Yes. In fact, there's some recent

58:59

data, and I need to explore this a

59:01

little bit more. There are

59:03

some definite benefits in

59:06

specifically learning how to breathe in

59:08

through your nose and

59:10

out through your mouth. And those

59:12

benefits have to do with the way that

59:15

the air flows through, the

59:18

humidification of the air, the

59:20

filtration of the air. Even

59:23

in exercise, I understand that there's

59:25

been some training

59:28

in this area in terms of athletes that

59:30

when they exercise, they're basically trying to

59:32

still breathe in through their nose and

59:34

breathe out through their mouth. There's also

59:36

other breathing exercise techniques

59:39

where you, for instance, breathe in for

59:42

four seconds and

59:44

breathe out for four seconds and then hold it for

59:46

four seconds. These

59:49

are all sort of techniques that are used. I

59:52

wish we had more evidence for some of these

59:54

things, and I think people are actually working on

59:56

that, but there is some at

59:58

least preliminary benefits. in terms of

1:00:00

that type of exercise. It's also, by the way, used

1:00:03

in pulmonary rehabilitation, especially

1:00:06

in COPD. So again, if

1:00:09

you recall that in COPD, you

1:00:12

have difficulty getting the air out because

1:00:14

the airways are collapsed. And

1:00:16

in breathing out through what we call

1:00:19

pursed lips, that pressure causes

1:00:21

a back pressure back on those airways

1:00:23

that are collapsed, cleans them up, and

1:00:25

allows that air to come out. So

1:00:27

there's some definite benefits in

1:00:29

learning how to breathe depending on the

1:00:31

condition that one has. Dr.

1:00:34

Schwell, we are nearly out of time. We'd

1:00:36

love to keep talking with you, but we

1:00:39

just can't.

1:00:41

So we're going to ask you

1:00:43

for your recommendations during this respiratory

1:00:46

infection season, whether it's a cold

1:00:48

or the flu. What

1:00:51

do you recommend for

1:00:53

our listeners to try to stay healthy?

1:00:55

And what should they do if they

1:00:58

start to sniffle or cough? Yeah,

1:01:01

excellent question. So definitely ventilation is

1:01:03

a key. We haven't talked about it,

1:01:05

but if you're going to isolate

1:01:07

yourself in a particular part of the

1:01:09

house or in a room, if you've come down with

1:01:11

a cold and you don't want anyone else to get

1:01:13

it, crack the window open. It may be cold outside,

1:01:16

but put a couple extra layers on. Ventilation

1:01:18

is so important. Secondly, I would make sure

1:01:20

you're getting a lot of sun, even though

1:01:22

the sun may be low in the sky.

1:01:24

If it's up and you can see it,

1:01:26

you can get the benefit of getting outside

1:01:28

and getting some sunlight to keep yourself healthy.

1:01:31

Consider doing hydrotherapy and not treating

1:01:34

a fever if you develop the

1:01:36

actual symptoms. And how would you

1:01:38

do that hydrotherapy? So

1:01:40

the hydrotherapy is if

1:01:43

you go to

1:01:46

hydrothenumber4covid.com, there's a beautiful website

1:01:48

that shows you exactly how to do

1:01:50

that by heating up, by using hot

1:01:52

baths. You could also do hot showers followed

1:01:54

by cold at the end. There's a number

1:01:57

of ways of trying to get that boost.

1:02:00

in interferon, especially when you are

1:02:03

under the umbrella

1:02:05

of an infection. Wait

1:02:07

a minute. You said cold at the end?

1:02:10

Yeah. Yeah. So that

1:02:12

really helps with the boosting

1:02:15

of the circulation, and

1:02:17

it causes constriction of

1:02:19

those blood vessels on the surface that locks in

1:02:21

the heat. But

1:02:25

okay, I get the picture. What

1:02:27

else? Well, also

1:02:29

you can try some of

1:02:32

that steam inhalation. Be careful not to

1:02:34

burn the inside of your airway passages,

1:02:36

so step away a little bit. But

1:02:39

these are all non-pharmacological

1:02:41

ways of treating those illnesses. And if

1:02:44

it gets worse, of course, you can

1:02:46

go get tested, and there are medications

1:02:48

that you can take if it's

1:02:50

not getting better. But these are not like symptomatic

1:02:52

medications. These are things that actually get to the

1:02:54

root cause. And

1:02:56

if you are tested positive for

1:02:59

influenza? Yeah, there's a

1:03:01

number of options that you can do. Tamiflu,

1:03:03

of course, but there's other ones as well.

1:03:06

And of course, getting

1:03:09

appropriate care and making sure that you're looking for

1:03:11

your and your family members to make sure they're

1:03:13

not getting ill as well. And

1:03:16

it probably makes sense to note that Tamiflu,

1:03:18

Relenza, any of those antiviral

1:03:21

medicines for flu

1:03:24

are going to work better if you take

1:03:26

them earlier in the infection. Exactly. Dr.

1:03:29

Schwelt, what have you heard

1:03:31

about what we have heard called viral

1:03:34

reactivation? They've sort of

1:03:37

suggested this as a

1:03:39

possible mechanism for long

1:03:41

COVID, but also with

1:03:44

things like asthma, that if

1:03:46

someone comes down with an

1:03:48

infection, it may

1:03:50

reactivate viruses that have

1:03:53

been dormant in the body. Yeah,

1:03:56

so a reactivation is something that happens

1:04:00

a number of times that we

1:04:02

have herpes simplex reactivations, we

1:04:04

have varicella zoster, which

1:04:06

is the virus that's involved with shingles.

1:04:10

So the main overarching theme

1:04:12

here is that we

1:04:15

get infected with all sorts of

1:04:17

things. Our immune system does suppress

1:04:19

it, keeps it out of the way. And

1:04:21

it's not an issue unless of course we get

1:04:23

to a situation where our immune system breaks down

1:04:25

and is not able to do

1:04:27

that. So the best way

1:04:29

to avoid that is to avoid things that breaks down

1:04:31

your immune system. And the way to make sure that

1:04:34

that doesn't happen is the things that

1:04:36

grandma always used to tell us, which is

1:04:38

getting plenty of sleep. I

1:04:40

would also advocate getting plenty

1:04:42

of sunshine, exercise, and

1:04:45

good nutrition. And that can

1:04:47

minimize those kind of effects. Dr.

1:04:50

Roger Schwelt, thank you so much

1:04:52

for talking with us on the

1:04:55

People's Pharmacy today. Thank

1:04:57

you so much. You've

1:04:59

been listening to Dr. Roger

1:05:01

Schwelt, associate clinical professor at

1:05:03

the University of California Riverside

1:05:05

School of Medicine and assistant

1:05:07

clinical professor at the School of

1:05:10

Medicine and Allied Health at

1:05:12

Loma Linda University. He's

1:05:14

founder and principal presenter

1:05:16

of the medical education

1:05:18

company MedCram, which provides

1:05:21

continuing medical education to

1:05:23

countless health professionals. His

1:05:26

passion is demystifying medical

1:05:28

concepts. You don't have to be

1:05:30

a medical professional to benefit from many

1:05:32

of the free videos about COVID-19 or

1:05:35

lifestyle approaches to good health. Lynn

1:05:38

Siegel produced today's show, Atwoodarsky

1:05:40

engineered, Dave Graydon edits and

1:05:43

interviews, BJ Liederman composed our

1:05:45

theme music. This show is

1:05:47

a co-production of North Carolina

1:05:49

Public Radio WUNC

1:05:51

with the People's Pharmacy.

1:05:54

Today's show is number 1,369. You can find it online.

1:06:00

at peoplespharmacy.com.

1:06:02

That's where you can share your comments

1:06:05

about today's interview. You can

1:06:07

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1:06:19

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1:06:21

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1:06:23

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1:06:36

information about our weekly podcast so

1:06:38

you can find out ahead of

1:06:40

time what topics we'll be covering. In

1:06:42

Durham, North Carolina I'm Joe Graden and

1:06:44

I'm Terry Graden. Thanks for listening. Please

1:06:46

join us again next week. Thank

1:06:59

you for listening to the People's Pharmacy

1:07:01

Podcast. It's an honor and a pleasure

1:07:03

to bring you our award-winning program week

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in and week out. But

1:07:08

producing and distributing this show is

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a free podcast, takes time and

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costs money. If you like

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what we do and you'd

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like to help us continue

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to produce high-quality independent healthcare

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journalism please consider chipping in.

1:07:23

All you have to do

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is go to peoplespharmacy.com/ donate.

1:07:28

Whether it's just one time or

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a monthly donation you can be

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part of the team that makes

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this show possible. Thank you

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for your continued loyalty and support.

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We couldn't make our show without

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you.