Originally published Dec 2015
No reasonable physician (I modestly include myself here) can refrain from crowing delightedly when a new clinical study confirms the value of a treatment he or she had been using for years, even if that treatment had contradicted prevailing standards.
Ever since I learned something about natural medicine, I’ve been reluctant to prescribe antibiotics for respiratory tract infections, such as colds, sore throats, and bronchitis. Many physicians had issues with this question. The debate was really nothing more than “Do we or don’t we?” boiled down to “Are antibiotics actually doing anything?” with the cautionary add-on “Are antibiotics preventing a worse infection, like pneumonia?”
A couple of decades ago, when a spate of antibiotics hit the market and drug reps clogged our offices with cases of freebies, if you looked at a doctor cross-eyed you’d leave with an antibiotic. Even though doctors knew most respiratory infections were caused by viruses (which antibiotics can’t touch), to cover ourselves we prescribed them anyway, worried about so-called secondary infections, malpractice suits, and the economic cost of dissatisfied patients.
Both physicians and patients became victims of this antibiotic delusion. One interesting survey reported that when doctors had a cold or flu, they themselves took antibiotics and acknowledged that any clinical success might be attributed to a self-induced placebo effect. Despite all this, a majority of patients seeing a doctor for a stuffy nose, sore throat, or cough continue today to leave the office with an antibiotic.
Enter alternative medicine
When I began studying alternative medicine some 30 years ago I was impressed that, regardless the modality (natural medicine, Chinese medicine, homeopathy, chiropractic, etc.), each emphasized the human body’s design for self healing. Alternative practitioners didn’t prescribe drugs carrying war metaphors (antibiotic, anti-inflammatory, beta-blocker, proton pump inhibitor), but rather recommended treatments that strengthened innate healing capacities. Acupuncture ramped up your qi (“chee”). Homeopathic remedies supported your élan vital, or vital force. Certain mushrooms were prescribed not to kill viruses or bacteria, but instead to enhance immunity.
When I’d see a patient with a respiratory infection I would no longer write an antibiotic prescription to be started immediately. Instead, I’d specifically tell my patient not to fill the prescription unless things got worse and then offer suggestions on strengthening immunity, but more on that later.
The clinical study I referred to above, entitled “Prescription Strategies in Acute Uncomplicated Respiratory Infections,” (click here for an easy-read overview) appeared last week in JAMA Internal Medicine. It confirmed what I, and probably more and more physicians, had been doing anyway. In the study, the group of patients given an antibiotic with instructions to start it immediately fared no better than those given a prescription but told to hold off and use it only as a last resort.
The study also showed that patients who were prescribed antibiotics for immediate use had a tendency to keep returning to their doctors for antibiotics whenever a symptom appeared (“Hey doc, I woke up with a sore throat. Phone in an antibiotic and let’s catch this early.”) Those who were not given antibiotics learned to take care of themselves. Obviously, antibiotic overuse can lead to superbugs, bacteria that nothing short of Rambo-mycin can kill off.
In addition to a delayed antibiotic prescription, I would also give my patients a quick lesson in immune enhancement using psychoneuroimmunology (PNI). PNI, by the way, is not alternative medicine per se. It lies more in the realm of the mind-body therapies you may have read about.
For years, studies have confirmed that the power of the mind, directed through the nervous system, can affect immunity for better or for worse. It’s well known, for example, that emotional stress of any stripe adversely affects immunity. When surveys are taken of who gets a cold when the virus is romping through a large office, it’s usually those who are having stress issues either at home or in the workplace.
The key is to get your immune system to work for you
You have to get tough. Remember, your immune system is your body’s local bad guy, tackling viruses, bacteria, parasites, and cancer cells. When you talk to your immune system, you must speak its language. Talk Hemingway or Mickey Spillane’s Mike Hammer, not Elizabeth Barrett Browning. No gentle positive affirmations. And don’t whine.
When I hand you a prescription for a “delayed antibiotic,” do the following:
Hold it with the written part facing you and say aloud: “Listen, bud. You haven’t been performing up to snuff. Maybe your back was turned. Maybe you got distracted by a pimple. But I want you to get the hell back to work and get rid of this (insert ailment). See this prescription? If I have to take it, if I have to swallow this, it means you, yes you, have failed. Now get to work.”
In addition, give your immune system a little mushroom boost with the aptly named Host Defense MyCommunity, a blend of 16 types of organically grown mushrooms. Very likely in a day or two you’ll be able to tear my rx into little pieces and you’ll…
David Edelberg, MD