Best Way to Treat Sickness When Immune Suppressed

Well I’m still sick with this damned cold.  I thought that I’d broken its back and was over the worst a few days ago, however yesterday (Saturday) I woke up feeling terrible.  Sore throat, headache and flushes were back.  So whoever is throwing me off the small cliff when I’m asleep and pouring hot broken glass and sand cocktails down my throat is still around.  When I’m sick I always wonder what the best way is to deal with it, since I’m immune suppressed.  To confuse things a little, I also suffer from gym withdrawal.  So where to begin?  Well the usual advice when one is sick is to rest – physically and mentally.  The physical rest enables the body to focus on using its energy to fight the illness.  This keeps me from going to the gym.  The rationale being I’d rather have my body use my energy to fight the bugs than using it build back muscle tissue damaged during gym training.  In the past I used to wonder if this was the best method, since some people swear by going to the gym and “sweating out the sickness”.  Is there any evidence to support this?  Well there is a lot of advice going both ways.  Confused!  You bet.  However I think that ultimately it appears like exercise does not affect cold recovery time (it stays the same), and actually may make you feel a little better, if your cold isn’t too serious.  Firstly, let’s look at the advice from the US Military which states:

The rule is if your chest is congested, you have a fever, chills, dehydrated, or any other cold ailment from the neck down, DO NOT WORKOUT. Chest congestion and any type of exercise do not mix well. Aerobic or anaerobic activity can overwork your heart and can cause your chest cold to develop into a bronchitis or pneumonia. Lifting weights can naturally increase blood pressure. Combined with over working your heart, you can really cause damage if not careful when exercising while ill. Plus – you don’t want to bring your germs to the gym either.

There are many sites out there supporting this statement. However, there are other sites that state that “working up a sweat” does not change the amount of time to get over a cold (i.e. it will still be several days to weeks, the same as if you didn’t workout), and may actually help you feel a little better by giving you a burst of adrenaline:

Dr. William Schaffner, an infectious disease expert at Vanderbilt University, likes to “sweat out” a cold.  “It gives you some short term relief. It will help open up your sinuses, provide some drainage.”  Researchers tested people on a treadmill at the peak of their colds, and it did not limit their ability to exercise. There was no difference in lung function or exercise capacity.  But will exercise make you get better more quickly?  Dr. Michael Joyner, an exercise researcher at the Mayo Clinic, says it just might.  “Exercise causes your adrenalin levels to go up. Adrenalin is a chemical related to all the drugs used to treat cold symptoms. So when you exercise, you get a free shot of a natural drug.”

The above article uses this New York Times article as its source of information.  That article states regarding working out when sick:

“That question has not been actually studied,” said Dr. Aaron E. Glatt, a spokesman for the Infectious Diseases Society and the president of New Island Hospital in Bethpage, N.Y

So, Dr. Glatt states that there is no scientific evidence to answer that question.  However later in the article it states that there was a study done (that Dr. Glatt must have been unaware of) over a decade before the article was published (it was published in 2008), that found:

The investigators found no difference in symptoms between the group that exercised and the one that rested. And there was no difference in the time it took to recover from the colds. But when the exercisers assessed their symptoms, Dr. Kaminsky said, “people said they felt O.K. and, in some cases, they actually felt better.”

I had a look around to see if I could find the original publication (to ensure that these guys are being quoted accurately on the study outcome) and actually found one other study that also supported the assumption that exercising with a cold does not affect the duration of the cold (it is the same as someone who doesn’t exericise).  That article is here.  If you are interested I found an extract for the Dr. Kaminsky study here.

So in summary it appears that there is some evidence that exercise does not affect cold duration.  Now some caveats.  The studies were done with people who had “head colds”, that is they had runny noses and sneezing, and did not have chest congestion or a fever.  Would the same results be found with people who had chest congestion?  I have no idea.  I’m pretty sure though that exercising with a fever would not be good.  The other caveat is that these studies were done with ‘normal’ people, i.e. they were not immune suppressed.  So for people like me who are immune suppressed through the use of biologics we will just have to wait until they do a study.  Any volunteers?  And finally, these studies were done with one group who didn’t exercise, and one group who did exclusively cardio.  That is they did not do any weight resistance work.  I presume though that a study with weight resistance would show much the same outcome.

I know what my doctor would say.  She will advise no exercising, plenty of rest and fluids, and will prescribe me antibiotics “just to be on the safe side”.  Now it should be noted that in Asia antibiotics are pretty much given out like candy by doctors, so I can’t just assume that I wouldn’t get the antibiotic if I wasn’t immune suppressed – athough it is possible.  The doctors here know that Westerners are not so keen on getting antibiotics unless really indicated.  Asians are different – they need to have something “tangible” to show for the price they pay to see the doctor.  They will feel cheated if they leave with the advice “go home, rest, and take plenty of fluids, you just have a virus”, and will not go back to see that doctor again.  So doctors ensure that Asian patients go home with a little doggy bag full of multicolored pills.  Antihistamines, mucosolvents, vitamins, and typically broad spectrum antibiotics.

So I haven’t seen the doctor yet because I know what the routine will be.  I will just treat this like a viral cold unless I get worse.  The way I deal with it is plenty of water, good healthy food (even if I’m not feeling hungry) to ensure my body has high energy levels (i.e. chicken and vegetables), rest, vitamin c (even though there is no evidence it helps reduce the duration of a cold, it helps me with a placebo effect), and lactoferrin (since it may have some immune helping properties).  I also make sure I keep up with my usual multivitamins etc.

How do you deal with a cold?  Aware of any other scientific studies on treatment?  No quackery old wives tales please… unless they are really hilarious.

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