Optimizing Metabolism

by Ingrid Kohlstadt, MD, MPH

Rethinking Your Medicine Cabinet’s Cold and Flu Products

Introduction

Start an autumnal equinox ritual: check your medicine cabinet by September 22 each year. Use your cabinet to prepare for the cold and flu season. Even better, include prevention. Here’s a 10-item list to assist you in your new celestially linked tradition.

1. Tylenol Recall 2010

   Do you use Tylenol but for the rare headache? If so, check your medicine cabinet for recalled products. The Tylenol recall of 2010 has extended to include some Zyrtec, Benadryl, aspirin, Rolaids, and Motrin products. The reason for the recall is sometimes-severe gastrointestinal symptoms from moldy-smelling 2,4,6-tribromoanisole, a contaminant that entered the products from the wooden pallets used to transport packaging material. Discard the products, or confirm the recall at 888-222-6036 or McNeilProductRecall.com. Removing these products from shelves around the world – Antarctic research stations, emergency boxes, and home medicine cabinets – requires worldwide participation.

2. Pediatric Acetaminophen-Containing Products

   A second public health concern involving Tylenol or any other acetaminophen-containing products is liver damage. Acetaminophen is the most common cause of medication-related liver damage. Children are at risk because of their small size and because they may unintentionally receive double doses when Tylenol is combined with cough and cold products that contain acetaminophen among the active ingredients. Be vigilant of acetaminophen that is “hidden” in prescription and over-the-counter medications.

3. A Context for Expiration Dates

• So, is it OK to use an over-the-counter product past the expiration date? Keep in mind that not only does the medication expire, so does the manufacturer’s obligation to the consumer. Distinguish among the “best before” date, the manufacture date, and the expiration date. Some nutritional supplement and vitamin companies now choose to mark bottles with a manufacturing date instead, leaving the decision for appropriate length of use up to the individual or practitioner. The lack of uniformity can be confusing. Storage conditions matter. While most medications if kept in a cool, dry place are adequately potent beyond the labeled date, products not stored under these conditions expire sooner. Sometimes overlooked conditions include: products stored in a bathroom used for steamy showers; added to a day bag left in a hot car; or kept in a kitchen cabinet over the stove. Heat and moisture cause damage.

4. Safe Handling

   So how do you safely discard medications? Flushing them down the toilet prevents unintentional ingestion or later untoward uses, but it also can present an environmental hazard. One choice is to return them to the pharmacy where they were purchased. Another choice, depending on the medication, is to discard them in the trash out of harmful reach. Keep in mind that some medications, especially those with abuse potential, have an illegal market and a following of enterprising scavengers.

5. Vitamin

   D

   So now that you have cleared the medicine cabinet, what should you put in? If you don’t live in the tropics, stock bottled sunlight, so to speak. Vitamin D helps the body resist cold symptoms. At the first sign of cold symptoms, some people reach for their vitamin D supplements, taking 3000 IU a day for 3 days. The science of immune-system benefits from vitamin D may be new, but the benefits of heliotherapy (harnessing the sun’s energy for vitamin D synthesis) for fighting infections dates back centuries. The equinox is also the time to reinitiate a vitamin D supplement, since in most of the US the sun’s ultraviolet light no longer has enough punch by October. You can store the vitamin D summer harvest. However, safe summer sun exposure and supplementation alone are not always sufficient to sustain vitamin D in the 32–60 ng/ml range associated with optimal cold and flu-fighting health. Adding vitamin D to a midwinter blood draw may be prudent for prevention.

6. Probiotics Especially for Children

   Shelve healthful bacteria. Intestinal bugs are a lot like the sun, essential for our survival and usually overlooked (by those other than Townsend Letter subscribers!). Among their many functions, the microbes that live in our linings help protect us from virus infections. Probiotics taken daily may be especially helpful for young children, in addition to a daily serving of yogurt, kefir, or other fermented dairy.

7. The Epsom Salts Comeback

   Stock your shelves with minerals. Mineral-containing water is like bugs and sunlight, essential for our survival and usually overlooked, even though life emerged from the mineral-rich sea and all biology remains tied to it. One practical, inexpensive, in-home source of two minerals, magnesium and sulfur, is Epsom salts. Don’t use salt baths only for the occasional strained muscle; consider them a mineral source worth soaking in to help relieve the muscle aches of cold and flu symptoms. Just as salts leave the skin in the form of sweat, they can enter the body through the skin. Salt-containing nasal sprays are a good choice for early signs of cold. Keep several on hand because they should be used by only one person and only for a few days.

• Also keep in mind that the first cranial nerve which “hardwires” our sense of smell is especially vulnerable to any chemicals entering the nostrils and sinuses, even if we are too congested at the time to notice the chemicals.

8. Healing Oils

   Oils of mint, eucalyptus, lemongrass, and other plants can be applied to the skin or added to water for steam inhalation. I recommend plant oils over petroleum derivatives such as Vaseline, Vicks VapoRub, and A+D ointment (named for the fat-soluble vitamins that it contains), because we take in the oil-based plant nutrients through skin and linings.

9. Phytonutrient Capsules

• Harvest some plant energy. Phytonutrients exert strong influences on the human immune system, which is the reason that some phytonutrients have been developed into anticancer and antiallergy medicines. Most of our phytonutrients should come from eating a plant-based diet. However, with onset of cold and flu symptoms, supplemental phytonutrients offer added benefit. My top 4 phytonutrients for the medicine cabinet are:

• olive leaf extract, 500 mg

• curcumin, 400 mg

• grape seed extract 100 mg

• quercetin 600 mg

Take each twice daily with food at first onset of cold symptoms.

29. Your Refrigerator As an Extension of Your Medicine Cabinet

• Some probiotics, oils, and nutritional supplements require refrigeration upon opening. So in a practical way, your refrigerator should be part of your medicine cabinet. Go beyond that and include healing foods. Elderberry and blueberry juices have antiviral activity, and only a small amount of sugar. Drink two 4-ounce glasses (diluted to 8 ounces) daily with the onset of cold symptoms. Ginger root stored in the freezer can be easily grated to make tea or flavor food, to help reduce cold symptoms. Greens improve the body’s acid–base balance, critical to fighting viruses and bacteria. Alternatives to fresh greens are herbs, frozen wheat grass juice, and unsweetened powdered greens drinks. Keep oral rehydration salts on hand as well, or some frozen homemade chicken soup.

Conclusion

Here’s wishing you a season without a need to open your medicine cabinet following your equinox preparations. Please send comments and checklist additions to Ingrid@Ingridients.com.

Ingrid Kohlstadt, MD, MPH, is an FDA Commissioner’s Fellow, using diet to improve drug safety. She has been elected a Fellow of the American College of Nutrition and is an associate at the Johns Hopkins School of Public Health. She is the founder and chief medical officer of INGRIDients Inc., editing Food and Nutrients in Disease Management (CRC Press, 2009) and Scientific Evidence for Musculoskeletal, Bariatric and Sports Nutrition (CRC Press, 2006).

Disclaimer:

The views expressed in this article are her own and do not necessarily reflect the views of the FDA.