Vitamin D and the flu.

This just in from one of my vendors.

"Vitamin D has been in the news a great deal lately. Last year the Public Health Agency of Canada (PHAC) started a study investigating the role of vitamin D in severe seasonal influenza. With the recent outbreaks of swine flu, PHAC confirmed that it would be adapting this study to investigate the role of vitamin D in the protection against swine flu. PHAC will measure vitamin D levels in the blood of H1N1 patients and compare the blood levels with uninfected individuals. The rationale behind this study is based on earlier work in the 1940's that indicated mice on diets low in vitamin D were more susceptible to experimental swine flu infection than those with adequate vitamin D levels (Young, et al., Vitamin D intake and susceptibility of mice to experimental swine influenza virus inf ection. Proc Soc Exp Biol Med. 1949 Dec;72(3):695-7.) How vitamin D might protect against influenza infection is not fully understood. However, research suggests that vitamin D may induce the production of antimicrobial substances in the body that may possess neutralizing activity against a variety of infectious agents including influenza virus."

I run a 25-OH vitamin D on all of my patients. Although the "normal" range is 32-100, I personally prefer to see levels closer to 70 or 80, with 50 being bare minimum. Some physicians are just prescribing 2000 iu daily with the idea that everyone needs vitamin D but I've seen patients who are taking 5000 a day with levels of 30, and others taking 2000 a day with levels of 60 (for the record this is uncommon.) We tested our almost 3 year old and at the end of a long summer of days half naked in the sun with no sunscreen plus 1000 iu daily of vit D, and his blood level was only 32. It is best to get your levels checked.

Huffington Post Article on Swine Flu.

Read it here.

So what about the flu shot?

Every year a few patients ask me about what I think of the flu shot. This year a few people haven't asked me what I think about the flu shot.

My answer to this has not changed in recent years, and it won't change this year, even in the face of H1N1 (which you and your child are more likely to catch at the mall than from licking a pig.)

I am not pro or anti-vaccination on principal. I do believe that there are risks with vaccination and I weigh each vaccination very carefully before I move forward with any of them, recommended or not. Whether or not to get vaccinated is a decision that each person needs to make based on both facts and personal values. There is no one right answer for everyone.

With a healthy immune system, most people fare the flu reasonably well, and this includes young children. If I personally was not at high risk for complications of the flu, I would not get the vaccination(s.) If my child was not at high risk for complications of the flu, I would not get him the vaccination(s.)

Re: H1N1 though, there is a bit of a catch. The greatest concern with this particular flu is its affinity for the lungs, and the risk of what is called a 'cytokine storm.' This is an overreaction of the immune system which causes a cycle of inflammation in the lungs. This can happen to people (and may even be more likely to happen to people) with strong immune systems. And, for people with existing lung conditions, such as asthma, this situation is particularly concerning.

So do I think that all people with asthma should get the H1N1 vaccination? I'm not going that far yet. Although they are making the majority of the H1N1 vaccine in the same manner that they make the regular flu vaccine, we understand that backup supply may contain the chemical squalene. This is a potent chemical that increases one's immune response to the vaccination. Although it is too much to get into here, there are many folks in the medical community who have concern about this chemical causing an overreaction of the immune system that may be harmful to the body. Additionally, the last time a vaccination was prepared for the swine flu, there was a slight increase in the risk for a condition where the body attacks its own nerve cells causing muscle weakness or paralysis. The catch is that we don't yet know if that will happen in this case, and if it does, how much risk is worth taking? 1 in 100,000? 1 in 50,000?

Feel free to make an appointment to discuss your own concerns or questions about the flu or about the flu vaccines. We are happy to work with patients to come up with a game plan to help prevent the flu, as well as a game plan to treat it if it does occur.

* Please note, we are not currently treating active flu patients at the clinic as we do have staff and patients who are at high risk for complications. We are happy to do phone consultations to discuss treatment, or refer you to a practitioner who can see patients who are currently experiencing flu symptoms.*

Cook This: "Cream" of Veggie Soup

Today is Sunday, and here is my first official installment of "Cook This."

Cream of Veggie Soup.

This recipe is an adaptation of a recipe I first made about 20 years ago from The American Vegetarian Cookbook from the Fit for Life Kitchen by Marilyn Diamond. There have been many incarnations of this soup in my life, including as a staple at the health food deli where I worked to finance an 8 week trip to an ashram in India (a story for another time.)



Lately I've simplified the soup to the bare bones for a quick and delicious low allergen delight.

Ingredients:
2-3 TBSP olive oil
1 large yellow onion chopped
3-4 cups of chopped brocolli
1 cup of chopped carrots or baby carrots
3 TBSP roasted tahini
3-4 cups of water or chicken stock or combination (I wouldn't use chicken soup though, as it is too strong.)
Salt and pepper to taste.

How to make it:
1. Sauté onion in olive oil for 5 minutes.
2. Add brocolli and carrots and continue to sauté for 3 minutes.
3. Add water or chicken stock and bring to a boil.
4. Simmer until veggies are soft (you should be able to just barely mash with a fork.)
5. Put the tahini in a bowl with an equal amount of broth and mix with a fork, then add another few TBSP of broth and mix again. Continue until the tahini liquid is a similar temperature to the soup so it doesn't clump up when you add it. Add it to the soup.
6. There are 2 options here:
a. The easy option: Use a hand blender to blend the soup to your preferred texture. You can always add more broth or water if you like.
b. Put a few cups at a time of the soup into a blender and add it back into the soup until it is the texture you like.
I prefer the hand blender because it mixes well, is easy to clean up, and doesn't make the soup pasty.

You can also vary the veggies. I find that leafy greens don't work very well but I have made the soup at one time or another with various combinations of cauliflower, peas, broccoli, carrots, sweet potato, potatoes and leeks, carrots, and other veggies.

Better hot but also good cold.

Edited to add: My 3 year old was just spitting out requesting something other than his catfish for dinner so I put a few tablespoons of this soup (now sauce) on it. He gobbled it right up!

Enjoy!
-Dr Samantha