Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
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Speaking of Women's Health
Boost Your Immunity: Cold and Flu Prevention
Can you really prevent getting sick this cold and flu season with just a few simple strategies? Join Dr. Holly Thacker as she shares the best practices for boosting your immune system. From nasal and throat hygiene to the vital roles of vitamins like D and minerals like zinc, she'll discuss how to stay healthy this cold and flu season.
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Welcome to the Speaking of Women's Health Podcast. I'm your host, dr Polly Thacker, the Executive Director of Speaking of Women's Health, a reprise of a podcast we did last fall on how to stay healthy during cold and flu season. So one of the sad things about leaving this summer and the warm weather is there is an uptick in respiratory infections and part of that has to do with, as it gets colder, people are inside more, so there's more concentration of people in smaller environments and, with air conditioning and climate control inside, actually the flu season extends even longer than it did in the past, so it's great to be outside and have fresh, clean air. So there's been a lot of talk about a triple pandemic with flu and COVID and RSV, and talk about the avian bird flu, which thankfully so far in the few human cases seems to be pretty mild in conjunctivitis. So I think we're all still reeling from everything that went down during the COVID-19 time period and hopefully we've learned a lot. And since every season we do head into cold and flu season, I thought it would be really good to rerun that episode that I did on preventing respiratory illnesses and after practicing medicine for several years and suffering from numerous colds myself and a bout or two of the flu. It really shocked me that I had never done and practiced such extensive nasal and throat hygiene just in general during flu season and escalate that when I had any kind of symptoms of coming down with something. And since COVID I've done that and, knock on wood, that, along with a lot of extra vitamin D and zinc and attention to fresh air and air filtration systems, I feel better and seem to have avoided my usual number of infections.
Speaker 1:So it is a part of human life and breathing to be exposed to respiratory viruses and thank goodness for immunity that the more that you've been exposed and had infections. The Centers for Disease Control estimate that about 45,000 Americans died from the last flu season and certainly flu illness can make you feel bad, make you have to go to urgent care, have medical visits and can lead to hospitalization. Primarily it's in older persons who already have impaired immunity and perhaps are of advanced age, but anyone can certainly be affected and prompt treatment is important and there are antivirals that can be used with influenza and there are a lot of therapeutic options as well as, importantly, supportive options for treating secondary bacterial infections. So it's very important for us to try to prevent respiratory infections. For us to try to prevent respiratory infections and there is a lot of good news on that front because lots of common sense things that your mother or your grandmother told you to do, like wash your hands, staying hydrated, don't pick your nose, eat healthy foods, exercise. Eat healthy foods, exercise.
Speaker 1:And I think we do really need to teach and focus on the importance of nasal rinsing. Even with just something as plain as saline, you add 1% hydrogen peroxide or 1% provodone iodine, if not iodine allergic, and that is virucidal, iodine allergic, and that is virucidal. Gargling with CPC or a very dilute 1% hydrogen peroxide in water or saline gargles can be very effective, and to do this in the morning, in the evening or after exposure I certainly do this assiduously when flying in an airplane where you're in a small area with, you know, several other people breathing and coughing on a several hour flight, and I also take care to moisturize my nose. There's also plenty of vitamins and minerals that can help maintain good health and a strong immune system. But people who just want to swallow a bunch of vitamins and not eat healthy and not do the nasal and throat rinses are really doing themselves a disservice. Now, unfortunately, immunizations into the muscle, where almost all vaccines are given, does not help stimulate nasopharyngeal immunity the IgA mucosal immunity which we need, and every year the flu vaccine is just a guess on how it's going to be, and some years it's more protective than others and many times it's not even 50%. So you just can't rely on that alone, and staying hydrated and keeping the nasopharyngeal area moist and healthy are important as well, as as soon as you start getting some sniffles or a little bit of scratchy throat, that's when you really need to up the nose and throat rinses. Boost the mucosal.
Speaker 1:Vitamin C and zinc can really make a big difference. So before trying any types of supplements or medications, you of course need to consult with your physician or your healthcare clinician, because there can be interactions, there can be other contraindications and, as my patients know, I ask them to physically bring in everything they're taking supplements, prescriptions because some supplements can interfere with blood work, like biotin B7 is a very common one. So vitamin D, which isn't a vitamin and I devoted an entire podcast to vitamin D, I think it was episode three of the first season last year is really a fascinating pro-sterile hormone, and having a really good level of vitamin D significantly does decrease respiratory infections and in the winter a lot of people are lower in vitamin D and they're higher in the summer. Zinc Zinc is a mineral and it does affect the immune system and it does affect the enzymes that the virus tries to activate, to take over your own cell machinery cell machinery. And after vitamin D deficiency, probably maybe after magnesium, one of the next most common deficiencies I see when I check patients is zinc, and it really surprises me because a lot of my patients say, oh, I have a very healthy diet and I get their zinc levels and they're under 60. I started getting zinc levels more frequently around the time of the COVID pandemic, as well as in patients complaining of hair thinning, because you need adequate iron and zinc and vitamin D to grow hair.
Speaker 1:So some of the foods that are high in zinc include lean meats. A lot of people kind of demonize meat and I can understand how some people, religiously or personally, may not want to eat meat so they have to work a lot harder about getting protein and zinc in their diet. But as a foodstuff, lean beef and boneless chicken breast are high in zinc. One of the classic zinc foods kind of humorously touted as an aphrodisiac is oysters. Oysters happen to be the richest source of zinc. Alaskan crab one of my favorites is a zinc-rich shellfish option.
Speaker 1:Legumes are very vegetarian-friendly and chickpeas and lentils and beans are a good source of zinc, as well as fiber. Pumpkin seeds we're in the fall, it's pumpkin season. Add them to your salad or snack on them. Nuts such as cashews and almonds almonds rich in omega-3, also are a good source of zinc and a healthy snack, and usually pretty inexpensive and easy to store. I like to carry small bits of nuts as a snack. I like to carry small bits of nuts as a snack. Dairy, greek yogurt, cheese and milk contain zinc and lots of bone-happy calcium. If you haven't heard my podcast on cheese, that's a fun one.
Speaker 1:Eggs. Eggs are so protein-rich, rich in zinc and other minerals and substances that are very important, like choline and lutein. They're very vital to brain function, so it's important for eye development, pregnancy and development of your unborn baby. Whole grains, breads, cereals are another possible option for getting zinc. But if you're frequently getting infections, maybe if your diet isn't the best, perhaps you're having trouble growing your hair, you might want to get a zinc level. Growing your hair, you might want to get a zinc level. So apparently, zinc deficiency is pretty common worldwide and it does increase the risk of pneumonia, and about 30% of Americans are thought to be zinc deficient. Now you have to be careful about taking zinc supplements, because too much zinc can lower your copper levels, but if you do come down with symptoms of the common cold many times, a little extra vitamin C and zinc can be helpful.
Speaker 1:Now, vitamin C that is a true vitamin. If you don't have any vitamin C, you will get scurvy. That's why the pirates took the lemons and the limes on their ships with them. It's very important for immune cells and it does enhance the body's ability to protect against infection, and liposomal vitamin C may be more bioavailable. It appears that vitamin C promotes cellular death by clearing out the old bad cells and replacing them with healthy new ones. It does help protect against oxidative stress and some studies have suggested somewhat a reduction in duration and severity of upper respiratory tract infections, including the common cold. I certainly always would give my children oranges and some chicken noodle soup with the spice oregano, which is also known to be antiviral. Now, elderberry a 2018 review found that elderberry supplements might help reduce upper respiratory infections, and I now keep some elderberry gummy bears available and I've given them to my granddaughter when she's starting to come down with symptoms of the cold, along with trying to encourage her to rinse out her nose and eat healthy and get some extra vitamin D. A 2021 review noted that elderberry might help reduce the duration and severity of colds. We really don't have a lot of data in pregnant and breastfeeding women, so there is caution on this. Now another trace essential mineral that is important to enhance antiviral defense against influenza strains, including H1N1 and H9N2, include selenium Selenium people can be low in selenium if they're sick with human immunodeficiency virus, they have GI conditions like Crohn's or they're on dialysis, thyroid disorders, graves disease or other situations where one might be low in selenium.
Speaker 1:I don't know if you had heard my prior podcast with our Center for Specialized Women's Health endocrinologist, the wonderful Dr Ula Abed. She's talked to us about PCOS as well as thyroid disease, and it came up during that podcast that she sometimes will check selenium levels in women that have transient abnormalities in their thyroid function. So I started to do that, and there's different requirements based on age. You can go on our speakingofwomenshealthcom website and put in the word selenium and we list different ages how much you need, and we talk about foods rich in selenium, and Brazil nuts top the list. So one ounce of Brazil nuts contain 544 micrograms, which is like basically over a week of your supply, so that's really a good source. Tuna fish three ounces of cooked yellowfin tuna contains 92 micrograms of selenium. Halibut that's a wonderful fish has 47 micrograms. Sardines a three ounce can and oil contains 45 micrograms. Roasted ham has 42 micrograms. Shrimp is another option three ounces have 40 micrograms and, um, you know, 40 micrograms is, uh, not quite the rda for adults or for lactating or pregnant persons, but it is up there.
Speaker 1:Enriched macaroni I just got some pasta from Italy because I was concerned about some of the substances that are put in American pasta that make it pop in yellow color. If you haven't listened to my podcast, which may not have been posted yet, but my column on speaking of women's health, on banned foods and food freedom really got me interested and being a lot more selective about the breads and pastas that I serve my family, and this pasta from Italy was very high in protein and extra high in selenium. Turkey a three ounce portion of roasted turkey has 31 milligrams of selenium. Beef liver also is a source of selenium. Roasted chicken cottage cheese contains 20 micrograms of selenium, brown rice 19 micrograms. One hard-boiled egg 15 micrograms.
Speaker 1:In terms of super foods that are packed with a lot of nutrients and not much calories eggs are right up there, and good old baked beans the fall's a good time to maybe make some baked beans or some chili. There's other vitamins that are very important for your immune system, like B12 and B6. And we have some columns by our integrative medicine colleagues that focus a lot on vitamins, a lot of information from our functional medicine physicians as well. So in last season's episode, I shared other tips and tricks to help you fight flu and respiratory viruses and colds, as well as the insider tips that I give to my family and my patients, because we want you to all be strong, be healthy and be in charge, and that's hard to do when your nose is all stuffed up and you don't feel very well. So, without further ado, without further ado, here is a reprise of our podcast on cold and flu, and I look forward to seeing you back again in the Sunflower House.
Speaker 1:Welcome to the Speaking of Women's Health podcast. I am your host, Dr Holly Thacker, and I'm back in the sunflower house and it's so great to be back to talk to you about coughs and colds. Or is it just allergies? Could it be the flu? Oh my, it's respiratory season coming up again as well, as we'll finish up talking about the irritating so-called cold sores.
Speaker 1:So how do you know if it's colds or allergies? You've got a sniffly nose. Could it be just the common cold? There's a lot in the news about new strains of COVID. Thankfully, in many people, covidny nose, possible sore throat. The question is what's going on and how can you tell the difference?
Speaker 1:Well, both allergies and colds can cause sneezing and congestion, runny nose, maybe watery eyes, fatigue, even headaches, eyes fatigue, even headaches. But colds often cause symptoms just one at a time First ha-choo and then maybe a runny nose and some congestion. But allergies usually cause symptoms that occur all at once. Now, as far as the duration of symptoms, colds generally last seven to 10 days, whether you treat them or not, whereas allergy symptoms continue with exposure to the allergen which is the symptom trigger, and many times allergy symptoms may subside soon after elimination of the exposure of the allergen exposure of the allergen. Now I've done an earlier podcast about allergies and a lot of different things that you can do medically and also physically and in the environment. So for more information on that you might want to go back to one of our prior podcasts. And if you listen to our podcast on your regular podcast app, I don't think there's usually a search feature, but if you go on speakingonwomenshealthcom and in the upper right search area on the website on your PC or on the mobile version, you can just put in the topic and it should bring up any kind of related podcast on that subject, up any kind of related podcast on that subject.
Speaker 1:So getting back to symptoms mucus discharge. Colds may cause yellowish nasal discharge, suggesting an infectious cause, whereas allergies usually are associated with clear, thin, just watery mucus discharge. Generally speaking, sneezing is a more common symptom of allergy, especially when it's several times in a row. The so-called allergy salute is going like this to kind of deal with the liquid coming out of the nose. Now, time of year can be important because usually colds and respiratory viral infections typically occur more in the winter months, whereas seasonal allergies are usually most common in the spring through the fall, when trees and plants and grasses are pollinating. But indoor allergies can affect individuals year-round, like animal dander, cockroaches, molds many things both indoors and outdoors, can trigger allergies. Now, what about the presence of a fever? Certainly, colds might be accompanied by a fever, but usually not allergies. Now, really bad allergic attacks with a lot of nasal congestion and lack of drainage of the nose sometimes can lead to sinus infections, particularly if there's anatomic or immunologic problems as well.
Speaker 1:So what type of plants produce the most allergenic pollen pollin? Well, trees, grasses and weeds that typically do not bear fruits or flowers. They produce really small, light, dry pollen granules in large quantities that can go through the air for miles. So weeds such as ragweed I'm personally allergic to that. It includes the marsh, elder desert, broom, feverfew and there is feverfew tea and somerysanthemums and marigold families and dog fennel, sagebrush, red root, pigweed, lambs, quarters and goosefoot, as well as tumbleweed, also known as Russian thistle, and English plantain Boy. Reading some of those just makes my eyes water. Boy, reading some of those just makes my eyes water. Grasses, particularly Kentucky bluegrass, timothy grass, johnson grass, bermuda grass, red top grass, orchard grass, sweet vernal grass, per elm, birch, maple hazel, hickory, pecan box, cedar, mountain, juniper, cedar, cypress and sequoia trees can also cause allergies.
Speaker 1:So what does a pollen count mean? Well, it's the measure of how much pollen's in the air and they're frequently included in your local weather reports. They might be reported for mold spores. There's three types of pollen grass, trees and weed and the count is reported as in grains per pollen per square meter of air collected over 24 hours grains per pollen per square meter of air collected over 24 hours. And this number represents the concentration of all the pollen in the air for a specific time. So it's either absent, which is the best low, medium or high. In general, a low pollen count means only people that are extremely sensitive will have symptoms. A medium count means most people who are extremely sensitive will have symptoms. A medium count means most people who are sensitive will have some symptoms, and a high count means most people with any type of sensitivity will definitely experience symptoms. Now, this counts approximate. It fluctuates. It's just a general guide.
Speaker 1:But sometimes, when it's very high, if you're sensitive, you may need to stay indoors to avoid pollen contact. Well, some people ask me should I move to consider decreasing my allergy symptoms? Generally speaking, moving to a different geographic climate does not help cure allergies, cure allergies, although my brother who moved from Ohio to Alabama, swears by it. But most people who relocate to get away from certain pollens, tend to find that they may develop allergies to the plant pollens in the new area. And then there's other airborne indoor allergens like dust and mold that can cause symptoms in many different locations. And certainly to reduce mold you want to reduce any kind of water damage.
Speaker 1:So let's move on to talking about viruses, and it's very important. It's not cold weather that causes people to get more quote cold or respiratory viruses. It's just that in really warm weather or cold weather rather, people tend to huddle indoors and the air is drier, and many times the nasal mucosa can be dry or cracked. Now, in very hot environments where people might cluster indoors for air conditioning, you sometimes see peaks in certain respiratory viruses, actually in very hot weather as well.
Speaker 1:Now, general hygienic measures like keeping the hands clean and washing with soap and water for a minimum of 20 seconds you know, teach your children to sing happy birthday while they're washing their hands helps. Particularly if there's any virus bacteria on fingers and you touch eyes and nose, you don't want to self-inoculate. It's best to use soap and water, but if that's not available, alcohol-based hand sanitizers generally need a minimal alcohol content of about 60%. Now, certainly it's very important to have good air circulation. If you're able to get a good air filtration system certainly in places like operating rooms and in some airlines there's specific air filtration systems that can be very helpful. You know your mom and grandmother who would open up the windows and say you need fresh air. That was actually a very good thing to do.
Speaker 1:And, of course, if you are more frail or predisposed to illness, certainly avoiding close contact with those who experience symptoms of any infectious disease is pretty obvious. That being said, dentists and ear, nose and throat doctors people that are in other people's grills, you know nose and throat all day long, in close proximity have been very good at reducing outbreaks of respiratory illness simply by doing virucidal nasal rinses and gargling. Since the respiratory viruses enter through the nose and the throat and they start to replicate, reducing that burden, whether it's a virus or a pollen or any other kind of irritant in the nose and throat, is very important. We talk so much about hand hygiene, which is very important. Semmelweis was a medical student in Vienna and he noticed that if people wash their hands before going to deliver babies, there was much less maternal death and sepsis. And when he suggested this it was terrible. He was just drummed out of the medical field and the poor man died in an insane asylum because he realized there was something that was being spread through the hands. And so certainly hand washing now is so obvious to us. Before we do procedures or operate, we spend a long time scrubbing hands and putting on sterile gloves, and we're trying to reduce any type of infectious disease transmission in a sterile situation.
Speaker 1:That being said, I don't think there's been enough attention on the importance of nasal and throat hygiene and in general, I think, to rinse out your nose and sinuses, like when you're taking your shower in the evening or the morning, or rinsing with nasal saline, or if you've got allergies or sinus problems, perhaps under the advice of your physician, using a neti pot. With young children I know I've talked to my son Stetson about using a neti pot, all the respiratory infections last winter that his daughter Artemis got, especially when she was around other children in daycare, and I said here's some nasal saline. Oh, she doesn't like it squirt up her nose and so sometimes a steamy bath, a very humid environment can help wash out the nares. But for children that can be cooperative, and certainly adults, some pretty simple, inexpensive, virucidal nasal washes like 1% hydrogen peroxide to water or, if you're not iodine allergic, provodone iodine. You can get a big bottle for a couple dollars and just put a tincture in water, um, and you can take a nasal bulb and lavage the nose twice a day. You can gargle with it, certainly.
Speaker 1:Whenever I think I've been exposed, um to a virus, whether it's COVID or just any other uh respiratory virus, uh, I've been around sick people. I might actually increase the lavages and the gargling to four times a day. I keep some in my office. To mix it up and use a bulb isn't all that convenient. So when I travel or I'm in places where it's not that easy to do that, there are over-the-counter nasal sprays. One of them that's popular has xylitol in it, grapefruit seed extract, exler I've used that. It's kind of stinged a little bit at first but now I'm completely used to it. Cofix RX is providone iodine in the right dilute percentage, although it's a lot more expensive than if you just mixed it up yourself, gargling with anything that has CPC, and there's a number of over-the-counter mouthwashes that have it.
Speaker 1:When I travel in a plane I always do the nasal gars and I make sure that my nose is moisturized, that I am staying hydrated. I think that's also very important. If you are sick or coughing or sneezing, you know, do it into the sleeve you know, not your hands and then touching everyone and everything of course your hands, and then touching everyone and everything of course Vitamin D, and one of my first podcasts was extensively on vitamin D and everyone should be familiar with vitamin D3, cholecalciferol. It's very important for the immune system In people who were studied, who had good vitamin D levels. Many of them weathered even the original strains of COVID-19 pretty well and didn't have the cytokine storm that led to hospitalization in many. So keeping a really good vitamin D level is important not just for bone health and mood, but also other immunologic conditions and infectious conditions and even several cancers. So it's very important to get adequate vitamin D3. You might need to up it in the winter because there's not the same sunshine and even if you live in a warm, sunny climate closer to the equator, when you're over 40, your skin doesn't make it as well in the skin and there's not a whole lot of food sources that are rich in vitamin D. So making sure that you take your vitamin D supplement is important.
Speaker 1:Now, vitamin C is a very popular vitamin. It's a true vitamin, whereas vitamin D is not. A true vitamin is something you cannot make on your own and if you don't ingest vitamin C you will get scurvy. That's why the pirates brought the lemons and limes and oranges on board with them, but higher doses of vitamin C. There's some research that suggests that that might help. There's many popular over-the-counter combinations of zinc and vitamin C and certainly I always keep a little container of the little vitamin C Zinc melts and if I get any type of sore throat, scratchy throat, I start sucking on that and it's amazing that, along with the gargles, how many URIs I believe that I have averted. Now it's most important to eat a healthy diet, of course, rich in the antioxidants, and get enough sleep not just beauty sleep, but sleep so your body can recover. It's important not to overdose on mega doses of vitamins or think you can just pop a pill or take a substance instead of eating healthy. It is very important to follow a Mediterranean diet, really rich in fruits and vegetables.
Speaker 1:There's many herbs that have antibacterial and antiviral effects. Oregano is one of them. I think it's part of the reason why some of mom's home-cooked soups chicken noodle soup can be so soothing and certainly in times of emergency or concerns about infections, pandemics etc. Don't panic. Seek reliable, credible information from reputable sources and also be wary of scams during times of panic and many times when people talk about all the people young people that died during the Spanish flu of 1918, and many people that died after other respiratory virus epidemics, many times it was because of secondary causes, bacterial causes, of which thankfully we have many antibiotics and classically we say that antibiotics are to treat bacterial infections.
Speaker 1:But there are some anti-inflammatory effects and potentially antiviral effects of some antibiotics, such as azithromycin and doxycycline. But these have to be prescribed under a physician's supervision. Certainly doxycycline cannot be used in children or people who are growing teeth or pregnant women. There can be life-threatening allergies to antibiotics. One of my friend's son was treated with a sulfa antibiotic for you know, an infection regular infection and had anaphylaxis and luckily had enough wits to call 911 and get that treated, which included intubation and high-dose steroids.
Speaker 1:Certainly high-dose glucocorticoids like solumedrol, prednisone-like medications given by vein sometimes, are used to treat secondary cascade immunologic problems that happen when the body just overreacts intensely to a viral infection. In general, after having a respiratory virus, usually the virus is gone within like five to seven days. I mean again, it depends on the virus. There are some different characteristics but when someone still stays sick after that it's usually all the cascade of secondary things that happen in the body's response to it. As I said, we're seeing certainly a comeback of different variants of COVID. It's part of the coronavirus cold family virus.
Speaker 1:There's interesting a lot of just common substances that may actually have some antiviral effects and may maybe make you feel better. Staying hydrated with green tea, black cumin seed is kind of another old remedy. Pepsid, which is over-the-counter, seemed to have some anti-SARS activity, and melatonin, which decreases particularly in people over age 67 and is sometimes used over-the-c counter to treat some insomnia or jet lag, seems to have some pretty significant anti-inflammatory activities. People that are predisposed to lung problems, bronchitis, asthma many times they'll be very hyperreactive to any kind of irritant allergen virus trigger and many times they'll need inhaled corticosteroids like budesonide or other nasal steroids. And nasal steroids can be very potent, very effective for treating nasal allergies and reducing nasal inflammation. But again, these agents should be supervised under your trusted healthcare clinician.
Speaker 1:So let's move on to talk about our last topic, cold sores. You feel that weird tingling on your lips and before you know it, you have an outbreak of what people term as cold sores. These cold sores are actually herpes simplex vesicles on your lips, and this common condition affects almost 90% of all people. So if you have a cold sore or the symptom of one starting, certainly you can be shutting the virus. So you want to avoid kissing or oral contact with other person's mucosal surfaces. So why are they called cold sores? Well, because some people get them when they're sick and have a cold, but really they're not caused by a respiratory virus. It's caused by the herpes virus that lives in the nerve roots. Stress is a big trigger, ultraviolet light having a cold if you just have reduced immunity from poor diet, not enough sleep, and one of the triggers certainly that I have found and others have noted is if you have increased intake of the amino acid arginine, and arginine is in yummy things like chocolate. We'll be back after a quick break.
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Speaker 1:If you haven't heard my chocolate podcast on neurotransmitters and why a lot of women crave chocolate, that's a good one to listen to. And also milk. There's a lot of common foods that I like to eat that are rich in arginine and it seems like if the lysine arginine amino acid balance is off in many people that can trigger it. Certainly ultraviolet light, you know. When I go skiing in the winter, high in the mountains, close to UV light, it's very important to put sunscreen on and protect your lips. The same thing, of course, in the summer. So what are some of the treatment options? Well, it's best if you don't ever get a primary infection, but that's kind of difficult when 90% of us are infected with the condition and cold sores and the virus are present in the saliva and people might shed it prodromally before they even know that they're coming down with that itching, burning or tingling. So maybe you're a baby and your aunt gives you a little kiss and a little bit of the herpes virus gets in and affects the nerve roots. Most oral cold sores from herpes simplex is so-called type 1, whereas genital herpes generally is type 2. But either type can be present in either location and it can be present, even in someone who has never been sexually active. Some people can accidentally infect themselves genitally, and so my husband's always complaining about like why am I in the ladies room so long when we're out? Well, every time I go to the restroom, I always wash my hands first. I always want to have clean hands, go to the bathroom, wipe myself, then, of course, wash my hands afterwards, and then, of course, you have to fix your hair and makeup, so that's part of the reason I take a little bit longer in the bathroom. But it is important to, of course, keep your hands clean, not to the point of having eczema or rashes or being obsessive about it, but good hand hygiene and nasal and throat hygiene is very important, as well as just all the general things that help your immune system function like it's supposed to. Now, genital herpes are generally more serious and painful, and if they affect your urethra they can be excruciating and cause trouble with urination, and usually genital herpes require prescription oral antiviral agents, such as with acyclovir, also known as ovirax, valcyclovir brand name Valtrex. And if you have genital herpes and it occurs and recurs during labor and delivery, that sometimes does necessitate a cesarean section to avoid the baby's head and body being delivered through the infected vaginal birth canal, but thankfully that's not very common. Thank goodness Now I do tell my patients who ask me during their annual visit, because when you come in obviously you want your problems addressed.
Speaker 1:You know you may need to look to the future for just general prevention. That needs to be done as well as plan ahead for things that might happen, you know when you're maybe on vacation or the weekend or traveling, and so I will have patients who have cold sores ask me can I please have a prescription to have on hand for when I get a cold sore? And I caution my patients that even though cold sores can be annoying, they're generally not serious. And so I don't think it's medically a good idea to take systemic strong antiviral therapy for something that's minor, I think, to save those antiviral agents for something much more serious, such as herpes of the eyes or brain or lung or painful genital herpes or very bad flares of shingles, which is the chickenpox virus, herpes zoster coming out coming out Certainly anytime herpes gets close to the eyes or if it happens in someone who's immunocompromised, that's a different story. Those folks may require systemic therapy.
Speaker 1:But for most of us, regular people who are just bothered by a cold sore. It's really overkill, but there are things you can do. So some of the over-the-counter treatments but there are things you can do. So some of the over-the-counter treatments. The amino acid L-lysine over-the-counter is available in 500 to 600 milligram tablets. I certainly start to pop those at the first hint of any telltale lip tingling. I always recommend that you prevent cold sores by using lip balm with UV light protection under sunscreen when you're going to be out in the sun or at very high altitudes and, of course, wearing a big hat. Umbrellas are also important as well, not just for herpes, but also for your skin, your hair, your retina, your your eye lenses.
Speaker 1:Now, once you get a blister using a very soothing skin balm, I really like cicalfate c-i-c-a-l-f-a-t. It's a zinc and sucralfate protective paste. Now abriva is the brand name of endocosal cream and that's now over the counter and that helps a lot of people. It needs to be applied every two hours during awake time and started as soon as you get those telltale prodromal symptoms. And you're not supposed to use this agent if you're pregnant or breastfeeding. And another common over-the-counter agent that I didn't mention with respect to respiratory viruses elderberry, which can be rich in zinc and vitamin C and has the elderberry in it. Many times children can take little gummies. I was just talking to a neighbor who said that when she had COVID she was eating so many of them that she actually got a rash from the elderberry and found out that she was allergic and really pregnant and nursing women. We don't really have a lot of data about elderberry, but we do in children and there are some elderberry over-the-counter cough syrups. So again, don't use abreva if you're pregnant or breastfeeding.
Speaker 1:But L-lysine would be fine, certainly cold compresses to give temporary relief. Sometimes people are in a lot of pain and they need topical numbing agents. Kanuka honey has been reported as an effective antiviral medication in treating cold sores. That's an interesting one. I have not tried that. I think I should try to put that on my list of things. Now.
Speaker 1:Some prescription options for cold sores include Denevir is the brand name of pencyclavir. It's a prescription cream and it is FDA approved to treat cold sores. Acyclavir, brand name Zovirax, is also another prescription that's available in an oral form as well as a cream and, generally speaking, rather than just for a simple cold sore, I prefer not to prescribe it, but it is prescribed for more serious conditions like chicken pox, shingles, genital herpes. Like chicken pox shingles, genital herpes. My son, who had the chicken pox vaccine, still got chicken pox because sometimes these vaccines don't last or don't work in everyone, and having him treated with an antiviral was very helpful as annoying and unsightly that cold sores can be.
Speaker 1:Generally speaking, they're a passing annoyance and just a good reminder to take better care of yourself and not to overreact or overtreat, but discuss over-the-counter options that are available and talk about it in advance with your physician or your nurse practitioner or your nurse practitioner, and I think that as we're approaching you know this winter flu and cold season, making sure you have a kit of the things that you need. Also, it's a good idea to have enough prescription medications if you're sick and you need to be at home. Enough prescription medications if you're sick and you need to be at home for a week or so, certainly getting diagnosed in early treatment. There are some antivirals that can be prescribed in the first day or two with influenza. You know if you're high risk for secondary complications. Talking to your physician and having a treatment plan on what to do.
Speaker 1:Generally, it's always better to intervene early and don't forget those nasal virucidal rinses and the gargles, just in general, twice a day, I think, for just general hygiene, like I brush my teeth twice a day. Doing that is a good habit, just like regularly washing your hands, staying hydrated, having fresh air, getting good air filtration and then treating any secondary health conditions, and it's so important to maintain physical activity and physical fitness and normal body weight. People that have elevated blood sugars definitely cannot fight off infections nearly as well, and I think that in someone who has trouble with their blood sugar, if they're sick with any virus or bacterial infection, you have to take all the sugar out of your diet. Virus or bacterial infection you have to take all the sugar out of your diet. Consider intermittent fasting, because you need your white blood cells to be able to fight infection and we just want you to be strong and be healthy and be in charge.
Speaker 1:You have been listening to the Speaking of Women's Health podcast. I am your host, dr Holly Thacker, the Executive Director of Speaking of Women's Health, and please, if you don't already subscribe to our free podcast, hit the follow or subscribe button. You can catch us anywhere you listen to podcasts. If you've listened to this on our website, be sure to go to your podcast app and just put in Speaking of Women's Health, hit the subscribe or follow button and I'll look forward to seeing you in the Sunflower House again.
