<<Disclaimer: Verify this information before applying it to your situation.>>


I am both a long-time Celiac and a primary care provider.  I wanted to add a few thoughts to the Tamiflu/flu issue, because I was very disturbed by some of the responses posted in that recent summary.  I appreciate that everyone has an opinion on this issue, and that the difficult flu season ahead is inciting a lot of fear and uncertainty.  However, while you should always trust your own body, I would also encourage all of you to seek the facts in deciding on these important issues.  

 

1) The two most common side effects of Tamiflu in adults are nausea and vomiting (http://www.tamiflu.com/hcp/side-effects.aspx).  Other common effects include abdominal pain, otitis media, diarrhea, and asthma exacerbation (worsening).  It makes sense that these symptoms may seem very similar to a gluten exposure. However, I suspect that if you polled the general population, many people would report feeling "ripped up" by Tamiflu.  It is not a gentle drug.  It is, essentially, meant to be a "lesser of two evils" option.

 

2) Tamiflu is an anti-viral medication.  Unlike antibacterials (like penicillin, for example), an antiviral generally works by decreasing the virus' ability to multiply.  As such, it is NOT a cure, per se, but something to try to lessen the ability of the virus to grow to be a serious illness.  As such, and according to the manufacturer, Tamiflu is indicated BOTH to prevent and treat (not cure--big difference).  However--and this is important--like most antivirals, it has to be started within 48 hours of the onset of symptoms.  If not, its effectiveness drops dramatically.  I would also note that the manufacturer specially states that Tamiflu is designed for uncomplicated flu cases.  Meaning, if you have other chronic health conditions, this product may not be as helpful for you.  Consequently, this is a decision that you should make with your healthcare provider.

 

3) A flu vaccine is still the best protection against flu.  Contraindications (for those older than 6 months) to receiving the flu vaccine are previous serious (as in, something like you went into anaphylactic shock) reaction, and allergy to eggs (see http://www.cdc.gov/flu/about/qa/fluvaccine.htm if you want to read more on this).  The standard flu vaccine is considered safe during the entirety of pregnancy, as well.  In fact, it is highly recommended that pregnant women receive the regular flu vaccine, as well as the H1N1 vaccine.  The injectable vaccine contains DEAD virus.  This is like a training exercise for the immune system.  It is very normal to have mild flu-like symptoms following the vaccine (and remember that the definition of "mild" can be very subjective from person-to-person).  In fact, this is a good sign--it means that your immune system is gearing up to fight the real deal.  What is actually happening is that you are building up an army of antibodies that are designed just for that virus.  This means that when the actual virus shows up, you already have this army of specially trained "soldiers" ready to go.  This may not mean you don't get sick, but that you have a less severe case, and for a shorter duration.  As a side note, there is another type of flu prevention sometimes used--an intranasal "vaccine" (nose spray).  This type uses an attenuated (or weakened) virus strain, and is not safe for all populations (such as pregnant women, and people outside of the age range 2-49).  It can also cause a more dramatic reaction.  



4) It takes up to two weeks after getting a flu vaccination to be protected.  So occasionlly, there are unlucky people who catch the flu during this window.  They can mistake this for either a vaccine reaction, or an ineffective vaccine.  

 

5) Tamiflu is available in both a capsule, and an oral suspension ("just add water") form.  Sorbitol is not in the capsule form.  There is a "pregelatinized" starch, which I'm told is gluten-free.  I would confirm this with the manufacturer if you have any doubts.  Trust me, they want you to have that information, because they want you to ask your provider for their product!  For all the ingredients, read http://www.rocheusa.com/products/tamiflu/pi.pdf

 

I hope that this helps.  There is so much confusing information going around this flu season that I hate to see it result in someone being unprotected.  There is certainly nothing wrong with keeping your body healthy with rest, vitamins, probiotics, and fluids.  However, the flu vaccine is very well researched, and generally quite safe.  Remember, like with most surveys, that the types of people who respond to these posts *may* be the extremes--the ones who have had either very favorable, or very poor/unusual reactions to the said topic.  I personally have received the flu vaccine for many, many years.  I would not recommend something to my patients that I would not do myself.



Please call your healthcare provider if you have questions or concerns this flu season.  Also, the cdc's website is a great resource, and is updated frequently.  And as a side note, I submit this with the very best of helpful intentions, and I hope not to receive too many angry responses...

 

In good health,

Jessica in Boston (Former research microbiologist, current Internal Medicine NP)


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