If not antibiotics, then what?
Updated: Oct 5, 2019
Every parent knows the cold stone that drops into the pit of your stomach when you feel heat radiating from your child's forehead. Fever. Brace yourself. Give up on your plans for the week now. Say goodbye to sleep for the next few days. Sickness is coming.
I have the privilege of being married to a naturopathic doctor who can diagnose and treat my kids as soon as they show symptoms, but still a shot of anxiety runs down my spine when I realize that my kids are sick. I think its a built in response, etched into our genes by a history where a common cold could mean the end for your child. Thankfully, we have come a long way from that unimaginably hard past. In 1900, infectious disease killed 1 in 40 people even in developed nations. A century later, we’ve slashed that figure by two thirds, and added 30 years onto our expected lives. We owe those extra years mostly to technology: agricultural and industrial technology that made nutritious food cheaper and more accessible, and medical technology, that allowed us to wage war on infectious microorganisms. One of the most groundbreaking advances of the past century was Alexander Fleming's 1929 discovery of Penecillin, the first antibiotic. Within a few decades, we had developed a vast suite of drugs that could target and wipe out bacterial cells whilst leaving the host’s cells largely unscathed.
We had found the magic bullet, and we armed every doctor across the globe with it. It was the health revolution of the century: once deadly infections became minor inconveniences, and infectious disease deaths became a problem of the ill, destitute and elderly. Riding the thrill of conquering infection, prescription rates soared. Today 150 million or more antibiotics are prescribed in the USA every year. It seemed too good to be true... because it was.
The first cloud to darken our sunny perception of antibiotics was the looming specter of antibiotic resistance. It turns out, when you wage war on microbes, they fight back. As we carpet bombed civilization with well-intentioned antibiotic therapies, we inadvertently drove the evolution of superbugs that could withstand them. Species that could survive the onslaught of antibiotics suddenly had an edge. The more we wiped out the competition, the more we promoted their success. These are bugs for which we have no defense, and many of them can be deadly. Methicillin resistant Staphylococcus aureus, or MRSA, typically causes little more than a rash in a healthy person, but it strikes fear into the hearts of hospital staff. It is terrifyingly common, carried passively by almost everyone, and extremely hard to kill. In the weak and vulnerable hospital population it can cause an epidemic of deadly sepsis that is very hard to stop.
Clostridium difficile, a common but dangerous inhabitant of our guts, can be turned into a killer by a few rounds of antibiotics. It is extremely antibiotic resistant, so when we wipe out the good gut bacteria that hold it in check, we give it an open invitation to dominate our gut environment. Once established, it produces chemicals that wreck the gut lining, and bar the good guys from re-establishing themselves. The resulting inflammation, malabsorption and diarrhea can prove fatal.
But the bad news doesn’t stop there. In the past decade, research has exploded into a new and powerful factor affecting our health: the microbiome. When antibiotics were discovered, nobody suspected that we housed within us a 100 trillion strong army of beneficial microbes, many of whom were intrinsically tied to our health and well-being. So far, we know that these tiny allies produce crucial nutrients, feed our brain and gut cells, regulate our immune system, ward off obesity and protect our neural, cognitive and psychological health. Ironically, they are also our best defense against antibiotic resistant pathogens like C. difficile. And we’ve been killing them off by the billion.
Even one course of antibiotics can change your microbiome forever, transforming your immunity, metabolism and mental health at the same time. Today’s epidemic of chronic disease, now affecting even children, has been undeniably linked to the damage we have done to our microbiomes. So what are we to do?
Antibiotics are an extraordinary gift to the human race. They have saved countless human lives. They make life-saving surgery possible, prevent wounds from turning fatal, and often spare infants and children from an early death. They are not going anywhere, and thank goodness for that. They are our fiercest weapon in the fight against infectious illness. But you don’t need to take this bazooka to a knife fight. For most of us, the vast majority of minor infections can be overcome without antibiotic treatment. To slow the rise of antibiotic resistance and protect our precious microbiomes, we need to keep antibiotics as our weapon of last resort, when all other measures have failed. So are the other measures available to us?
Our single best defense against disease is built in: our immune system. In a healthy well-nourished person, this brilliant, complex system has everything it needs to fight off disease. The trouble is, in a world where our food choices are warped by consumerism, poor soil produces nutrient-depleted plant foods, toxic assaults drain our micronutrient stores, and additives and preservatives ravage our guts, who is really healthy and well-nourished?
The first step to getting your immune system back on track is sorting out your diet. Eat the cleanest whole foods you can find, ditch the processed junk and sugar, and feed your microbes with loads of fiber-rich plant foods. Alongside a good diet, there are certain specific nutrients that can give your immune system and edge on its enemies.
These are a few of the most researched natural interventions you can use to bolster your immune health and beat back infectious illness:
This is everyone’s go-to nutrient in 'flu season', for good reason. When your immune cells do battle with invading pathogens, they unleash volleys of lethal free radicals. We take a lot of friendly fire, and much of our symptoms stem from the actions of our immune system, not the invader. Vitamin C is a powerful antioxidant which helps to mop up the damage during and after an attack, and thereby reduce the symptoms we experience. It also supports the movement of the cells of the immune system and strengthens the membranes of your gut and nasopharynx, making you more resistant to infection. Optimum vitamin C status can significantly reduce the frequency, duration and severity of infections. Trouble is, it works best if your levels are optimum before you get sick. Infections burn through your vitamin C supply, so supplementing when you are sick is like pouring water into a leaking bucket. You need to keep your levels set at optimum permanently by including loads of berries, citrus, leafy greens, tomatoes, bell peppers and broccoli in your diet. If that’s a tall task, consider supplementing, particularly when you are sick. Liposomal vitamin C is absorbed best, but buffered calcium ascorbate will do. Don't exceed 1000 mg/day if supplementing daily. Too much buffered vitamin C can cause gastric upset, though this is less likely to occur with liposomal supplements.
As crucial micronutrients go, its hard to top Zinc. It is a co-factor in over 100 enzymes, so there is virtually no bodily process that is not affected by it. Your immune system, however, is a zinc hog. Every branch of your immune system depends on it, from your broad spectrum innate immunity which provides the first line of defense against infection, to your disease-specific acquired immunity which produces antibodies against repeat invaders. But zinc doesn’t just enable your immune system to act against infection. It also keeps it on a tight leash on your inflammatory response, and prevents your immune response from spiraling out of control into chronic inflammation. It is especially important in skin and gut health, your two main barriers to invading germs. Zinc deficiency can wipe out your immunity, predispose you to diarrheal disease and promote eczema and dermatitis. These conditions further waste your zinc reserves, so your health can hit a downward spiral if your zinc status is poor. Worse still, zinc deficiency in childhood is associated with cognitive stunting, growth abnormalities and delayed sexual maturation, especially in boys.
So, zinc supplements for everyone? Not so fast. Too much zinc can be almost as bad as too little. Excessive supplementation can deplete your iron and copper stores, leading to anemia and a range of knock-on consequences. A healthy diet with judicious occasional supplementation is the best path to optimizing your zinc status.
Day to day, you can source your zinc from nuts, red meat, chicken, seafood and dairy. If you cannot tolerate one or more of these foods, suffer from chronic diarrhea, inflammatory bowel disease, kidney disease, or if you regularly consume alcohol then regular supplementation may be worth considering, under your doctor’s supervision. Vegetarians and vegans are at particular risk for low zinc status. If you eat a healthy balanced diet with a variety of animal proteins, then targeted supplementation during illness would be a better approach.
Illness burns up your zinc, and we have no storage mechanism for backup supply. Supplementing with zinc during illness and recovery will help shorten the duration of illness and restore your immune system to optimum function to ward off the next assault. Prophylactic supplementation during high risk periods of exposure may also be beneficial.
The table below gives the maximum daily supplementation by age group:
Tolerable Upper Intake Level (UL) of Zinc
0-6 months 4 mg/day
7-12 months 5 mg/day
1-3 years 7 mg/day
4-8 years 12 mg/day
9-13 years 23 mg/day
14-18 years 34 mg/day
19 years and up 40 mg/day
Turns out, your granny was right about this one. It may have a fishy pong, but quality cod liver oil, or CLO, packs a three part immune-boosting punch. It is high in preformed vitamin A, vitamin D and essential fatty acids, each of which play a role in supporting and regulating immunity. It is cheaper and easier to supplement with CLO than individual supplements, but there are some ground rules.
Rule #1: Don't overdo it. Moderate supplementation with CLO alone is unlikely to exceed safe intake levels, but if you combine it with a multivitamin, you may get too much of a good thing. Excessive vitamin A puts strain on the liver and may cause hypervitaminosis A. Stick to the recommended age appropriate dosage on the packaging to prevent overdosing with CLO.
Rule #2: Get the good stuff. Not all fish oil supplements are created equal, and poorly processed supplements can be filled with rancid and damaged fats that are bad for your health. Make sure the supplement you choose gives a thorough account of its production methods and quality assurances. You can test your batch by opening a capsule and giving it a whiff. It should smell fishy, but not gut-wrenchingly disgusting. Keep your fish oils in the fridge and if you notice awful fishy burps after taking them, stop. Many quality supplements mask the normal fishy smell and taste with natural lemon flavors, so if you you are getting breakthrough stomach-turning flavor it means your supplement’s time is up.
Rule #3: Don't supplement if you are in a risk group. CLO can thin your blood slightly, so don’t use CLO if you are pregnant or taking anticoagulant medication. If you regularly consume liver as a food, you shouldn't supplement with CLO as you may be at risk for vitamin A toxicity.
Herbs have a long history of safe use for supporting immunity and fighting infection. Many of them can easily form part of a healthy diet. Culinary herbs and spices with proven infection fighting benefits include basil, thyme, rosemary, oregano, cloves, cinnamon, ginger, flax seeds, cayenne pepper and turmeric.
Other immune boosting food superstars include alliums (garlic and onions), fresh ginger and green tea. Berries are little phytonutrient bombs that can help to prevent and fight viral infections. Elderberries are particularly potent against Influenza, although it is easier and safer to source it as a herbal tincture (Sambuccus nigra) than as a food. Including immune supporting foods in your diet is an easy first step to arming yourself against illness. For a more targeted approach, there is also an arsenal of potent herbal medications that can rally the immune response, fight infection, and provide a useful alternative to antibiotics.
Echinacea, hydrastis, sambucus nigra, olive leaf tincture and many more offer infection-fighting actions supported by centuries of traditional use and scientific study, but they also have contraindications. Certain conditions, such as autoimmune disease, may be aggravated by various herbal medicines. Pharmaceutical drugs may also interact with herbal constituents. While herbal medicines are usually extremely safe, you should not self-medicate with them without the supervision of a doctor educated in herbal remedies.
Antibiotics are a precious tool in the fight against disease, but they should be our last resort. If we start using the natural weapons at our disposal to fight infectious illness, perhaps we can start winning the war against chronic disease too. Its time to recover our health, protect our kids, preserve our microbiomes and stave off the looming threat of antibiotic resistant superbugs by using the tools that Nature gave us!