A Country Doctor Reads: February 9, 2019

Feed a Cold, Don’t Starve It – Cell via The Atlantic

“Feed a fever, starve a cold”, the saying goes. But, unlike many old adages, this one is turning out to be dead wrong, literally.

A 2016 article in The Atlantic, number 3 under “Popular” on their website, quotes an article from the same year in Cell with a longer and less catchy title: “Opposing Effects of Fasting Metabolism on Tissue Tolerance in Bacterial and Viral Inflammation”.

The Atlantic staff writer James Hamblin, MD, explains, “Sometimes sugar causes inflammation. Sometimes it does the opposite.”

Researcher Ruslan Medzhitov conducted a series of distasteful experiments on mice with various infections, and found that mice with listeria, a bacterial infection, survived when they were refusing to eat and perished if they were force fed, but only if their diet was essentiallly sugar; they survived if they were fed fat and protein.

Mice with influenza fared better if they were force fed glucose than if they were allowed to refuse food.

The Cell article concludes: [In influenza infection,] “inhibition of glucose utilization is lethal.” Whereas glucose was “required for survival in models of viral inflammation, it was lethal in models of bacterial inflammation… Glucose Utilization Promotes Tissue Damage in Endotoxemia”.

And the article implies that ketosis has a protective effect in bacteremia.

The conclusion: Drink juice and tea with sugar or honey when you have the flu. But don’t eat if you don’t feel like it when you have pneumonia.

https://www.theatlantic.com/science/archive/2016/09/glucose-inflammation/498965/

https://www.cell.com/cell/fulltext/S0092-8674(16)30972-2

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Association of Thyrotropin Suppression With Survival Outcomes in Patients With Intermediate- and High-Risk Differentiated Thyroid Cancer – JAMA

A dear friend and an anxious woman with a history of thyroid cancer is simply not tolerating suppressive doses of thyroid hormone, so with the blessing of my go to endo, she is on suboptimal suppressive doses. This article helps me sleep better at night:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2723409

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Eczema and Our Skin Biome – The Wall Street Journal and the AAAAI

The prevalence of eczema in children has doubled in the past 17 years. Now we are starting to think of our bacterial skin flora as another area where promoting good bacteria can improve health. The Wall Street Journal reports on two small studies that demonstrated that applying healthy bacteria to eczematous skin brought clinical improvement.

“15 pa­tients, in­clud­ing five chil­dren, sprayed their rashes with bac­te­ria that re­searchers sus­pected could im­prove eczema. Two-thirds re­ported less itch­ing, less need for top­i­cal steroids and bet­ter sleep af­ter us­ing the spray twice a week for four months. On av­er­age, these mea­sures im­proved by 84% in adults and 78% in chil­dren.”

https://www.wsj.com/articles/bacteria-may-offer-new-hope-for-treating-skin-disorders-11549394922

This led me to look for more information, and it’s out there:

https://www.jacionline.org/article/S0091-6749(18)31664-6/abstract

2 Responses to “A Country Doctor Reads: February 9, 2019”


  1. 1 Bob Edwards February 9, 2019 at 11:53 am

    I always heard this as “feed a cold starve a fever”. Guess it depends on which old wife is telling the tale.


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