Martin Schoenbeck

MartinSchoenbeck

Martin Schoenbeck BSc (Hons) M.N.I.M.H. is a consulting medical herbalist and nutritionist working in Lincoln.


Health is pretty much on everyone’s minds right now and a lot of people are wondering “is there anything I can do to improve my immune system?” We know that COVID-19 is killing some people, while others only have the mildest symptoms, and we are fed a daily up-date of grim figures which gives a sense of urgency to take our own health seriously like probably never before. 

We are all washing our hands incessantly, keeping the recommended two metres distance and feel like running a mile when someone coughs. But a question I keep hearing and seeing on social media is this matter of “improving my immune system”. 

In short there is no “on or off switch” to our immune systems, and it is not something that taking a fist full of vitamins or drowning in kale smoothies will assist us with. The only proven way to reduce our chance of catching COVID-19 is the sensible government advice on social distancing and hand washing. Self-isolation is also now finally having an impact on those desperate numbers, and hopefully in the next week or two we will finally see that much lauded “flattening of the curve”.

The immune system cannot be boosted — indeed if it was to be, we would possibly send it in to overdrive and find that we become unwell. If it was to work like this we would find auto-immune diseases such as allergies, asthma, and coeliac disease become worse, or appear where previously there was none. Indeed, an over-active immune response is responsible for damaging healthy tissues and cells in sufferers of these auto-immune illnesses. 

However, there are numerous nutrients, vitamins and minerals which are required to support the normal functioning of a healthy immune system, and it is here that we can perhaps shine a light on to some of the statistics which have come out during this COVID-19 pandemic. Of particular interest is the role Vitamin D plays in maintaining a healthy immune system. Clues to the effects of deficiencies can be seen in data coming from the USA.

In Milwaukee County, for example, nearly three quarters of those who have died of the virus were black. But only about a quarter of the county’s population is black. The data is here. We can see that all the usual reasons are being blamed, lower socio-economic groups, higher percentage of co-morbidities like diabetes and hypertension, less adherence to social distancing, and the list goes on. But one fact that seems to have had little interest is that vitamin D deficiency in black Americans is significantly higher than for the white population.

Vitamin D is primarily made from a reaction of the sun on our skin, and it is known that darker skins produce far less than their white counterparts in the same levels of sunlight. Given that these darker skins are living in temperate climates with very little winter sunlight and being covered up to keep warm, it is of little surprise that they have these deficiencies. 

But we should all take note… While African Americans show this trend most starkly, the UK population also has high levels of Vitamin D deficiency including in the white population. One quarter (rising to one third in winter) of the UK population are Vitamin D deficient. The data is here.

Vitamin D is obtained in the diet from dairy foods (milk, butter, cheese), eggs, cod-liver oil, oily fish, and to a lesser extent mushrooms. However, without adding sunlight, even diets rich in these foods often do not provide high enough levels. If you are following a restrictive diet, then matters are significantly worse. 

Why is Vitamin D so important?

While there is no specific research yet into COVID-19 and vitamin D deficiency (because this is a new disease and such research takes many years) we can perhaps look at other investigations relating to Vitamin D and respiratory health. Historically is was well documented that tuberculosis sufferers fared well when placed in sunlight, and indeed in the last 1918 flu pandemic, it was noted that patients treated outside in open air field hospitals had lower mortality than those being treated indoors. 

I would strongly suggest that people get out into the sunshine (we’re allowed to exercise outside) and consider supplementing if they are not already doing so. Other vitamins and minerals that help maintain healthy immune function are Vitamin C; B-complex ; and Zinc. These can be obtained by eating plenty of fresh vegetables and fruits; meat, fish and dairy, and whole-grains. Try to reduce processed and refined foods as far as possible, as these are low in essential nutrients, but high in salt, saturated fats and sugars. 

Exercise outside

In addition to the dietary measures mentioned, it is well established that exercise has a role in enhancing the body’s immune response. Regular exercise resets the immune system and it is important not to remain sedentary while we face the current “lockdown”. But it is a question of balance – too much intense exercise can damage immune function, so keeping to a moderate amount and type – which suits you – is important. NHS guidelines are for 150 minutes of moderate to intense activity per week, and no more than 75 minutes of vigorous intensity exercise per week. However, this is an individual thing as some one who is relatively unfit will find even a brisk two-mile walk “high intensity”, so the key is to build up activity levels slowly. This is less likely to stress the immune system. 

There is an abundance of self-help advice on the internet for many types of exercise, but one in particular can help with reducing stress and it is well known that stress can adversely impact our immune systems. It goes without saying that we are all under extra stress as we adapt to this new way of living. 

Walking in nature can really benefit us in times of stress, and it can also help to improve mood. There is strong scientific evidence to show that regular walking in natural surroundings can reduce depression and anxiety.

We are allowed one hour of exercise per day outside – I really urge folks to use it! Residents here in Lincoln are blessed with many beautiful outside parks, commons and lakes and it is easy to observe the two metre rules while outside walking, cycling or jogging  – and you’ll get a healthy dose of Vitamin D even when the sun isn’t shining. Use this time well to make the best of your health – you might even develop new routines you continue when this is all over. 

If you are concerned about either yourself of a member of your household suffering with COVID-19 symptoms, then go to the NHS website for help and advice on what to do for assistance.


— Martin Schoenbeck BSc (Hons) M.N.I.M.H. is a consulting medical herbalist and nutritionist working in Lincoln.

Martin Schoenbeck BSc (Hons) M.N.I.M.H. is a consulting medical herbalist and nutritionist working in Lincoln.

We are bombarded with many health messages; some of them can be helpful, others can be questionable at best, and some are positively misleading.

Here are five of them with an examination of the facts behind the claims:

Aim for 10,000 steps every day

You heard the advice, we’re being encouraged to walk more and there are many apps on smartphones to monitor movement and produce daily activity reports. You can even get sensors to wear on you wrist to supposedly give more accurate monitoring – and help you achieve those movement goals.

While it’s important for everyone to maintain activity, upon closer examination the 10,000 steps recommendation might be just a few steps too far. Upon an in depth analysis of the health benefits of walking carried out by The Harvard Medical School, researchers found that the golden minimum number of steps is just 4,400 and benefits increased up until 7,700 steps – but then reduction in mortality rates plateaued. So walking over 7,700 might help you burn a few more calories but it does not necessarily aid in longevity.

“We were quite surprised that such a relatively small number of steps would be associated with such a substantial reduction in mortality,” said researcher I-Min Lee.

So the message is definitely to walk more if you’re completely sedentary, but don’t obsess on the 10,000 steps! Walking your dog every day, not using the car for short journeys, and walking your kids to school are three ways to easily achieve the 4,400 steps. Steps can easily be accumulated shopping especially if you park a bit further from the store entrance. 

Source: JAMA Internal Medicine, 2019; doi: 10.1001/jamainternmed.2019.0899

Move more and eat less to lose weight

While this mantra is broadly correct, there are a few things to consider. Calories have long been the accepted way of measuring energy in food – they are calculated using a very old fashioned and crude method of measuring the energy required to raise one gram of water up 1º C in temperature. Foods are burnt to test these values. But calories are not all equal. 

Some things to consider: Fibre has calorific value and is classed as a carbohydrate. However, it mostly passed though the digestive tract, and higher fibre actually helps slow the release of energy and can therefore be useful in controlling weight. 

Calories from fat are double those from protein and carbohydrates (by equal weight), and yet research shows that healthy fats from oily fish, nuts, avocados, olive oils etc. can benefit health and because of their high satiety value (making you feel full longer) they too can help with weight control.

The calories associated with sugars and refined carbohydrates carry no nutritional value (no vitamins or minerals) and these cause spikes in blood sugars, which then causes the body to release insulin more quickly. Over time this can begin to lead to “insulin resistance” which is then on the pathway to T2 diabetes. Therefore, limiting sugars and refined carbohydrates has clear health benefits, and can help control weight.

In summary we need to eat less refined carbohydrates, but we could eat more fresh vegetables, nuts and avocadoes etc. with positive benefits. 

Moving more — In reality it’s not just moving more, but how you move that counts. There has been a lot of research into High Intensity Interval Training (HIIT) which shows that short bursts of intense training with rest periods in between can achieve much faster results than hours and hours on cardio-vascular training machines.

Just ten minutes a day can deliver some remarkable results. It is important to consult your medical practitioner before embarking on any HIIT training as this can be dangerous in previously sedentary people. Information on HIIT training is widely available and some research into its effect in reversing insulin resistance can be found here. 

Eggs are bad for your heart

This myth came about during the 1980s when folks realised that the yolks in eggs are relatively high in cholesterol. Advice back then was no more than 2-3 eggs should be consumed per week. However, fast forward to current information, and we now know that eggs are in fact a nutritious “super-food” containing quality proteins, a good mix of fats including omega 3s which can actually lower the risk of heart disease. However, all eggs are not equal. Free-range eggs from happy hens are much more nutritious as well as tasting better.

Free range eggs give: 

  • 1/3 less cholesterol
  • 1/4 less saturated fat
  • 2/3 more vitamin A
  • 2 times more omega-3 fatty acids
  • 3 times more vitamin E
  • 7 times more beta carotene

And for just a few more pennies, you can make a better choice, and help hens enjoy a better life. 

Being cold gives you a cold

No matter what your grandma might’ve told you, spending too much time in the cold air doesn’t make you “catch a cold”.  Indeed, researchers found that healthy men who spent several hours in temperatures just above freezing had an increase in healthy, virus-fighting activity in their immune systems. 

In fact, you’re more likely to get sick indoors, where germs are easily passed around. Cold and flu viruses spread through microscopic droplets from an infected person’s respiratory system. That person sneezes or coughs, and droplets are sprayed onto any nearby surface — or person. If you rub your eyes or nose, you’ve just infected yourself.

Viruses can survive for hours on surfaces and are mainly passed through contact with the hands. Washing hands properly and regularly is one of the best ways to minimise infection. Also cleaning surfaces with a mild bleach solution can help wipe out the viruses that might settle there. Try not to touch surfaces in public places – lift buttons, door handles, and stair rails all harbour these viruses. Some hand sanitizer can help if you’re worried, and is very useful in the winter months. 

Hand washing can reduce your chances of catching a cold by as much as 40%. By comparison the flu jab only reduced your chance of getting flu by 12% in 18-64 year olds during the year 2017/18 according to the UK government’s figures.

You can cure a hangover

Sadly this just isn’t true, and at this time of year many people would wish that there was a magic cure. Many of the symptoms of hangover are caused because the alcohol acts as a powerful diuretic and hence the British slang term “getting pissed” which always amuses our American friends who wonder why we’re all getting angry when we celebrate this side of the pond. 

The diuretic effect over a long period of time means that the main culprit is dehydration in causing the bad head in the morning. However, alcohol is also a depressant and its effects can take some time to wear off. Drinking plenty of water before bed can really help, and as our continental cousins have known for years — interspersing the wine with mineral water is a very sensible move. 

There has been some research to show that Milk Thistle, (Silybum marianum) can help support liver function. Not only is it used to protect against toxins like amatoxin (a subgroup of toxic compounds found in poisonous mushrooms), which can be deadly if ingested, but it’s also used to treat both alcoholic liver disease and non-alcoholic liver fatty disease.

Even more, studies show milk thistle may help reduce liver inflammation and liver damage in people with liver diseases and that it may extend the life expectancy of people with cirrhosis due to alcoholic liver disease. However, I wouldn’t suggest that anyone drinks to the point of cirrhosis before looking for a cure! Unfortunately, there isn’t much research evidence to support the use of Milk Thistle as a hangover cure, but it never hurts to take out some insurance for the liver if you’re out often and party hard.

Martin Schoenbeck BSc (Hons) M.N.I.M.H. is a consulting medical herbalist and nutritionist working in Lincoln.

Statins are one of the most frequently prescribed drugs in the UK. They are a class of drugs that lower cholesterol, which is thought to be involved in the formation of fatty plaques in the arteries, leading to heart attacks and strokes. Interestingly, we actually need cholesterol to function healthily, for example our brains are made up largely of cholesterol. The medical profession is in debate as to healthy levels, and to complicate things further, there is low-density lipoprotein (LDL) cholesterol (often labelled bad) and high-density lipoprotein (HDL), or good cholesterol. The bar for total cholesterol has been set quite low at 5.0 or below, but the ratio of HDL/LDL is important, and therefore if you have more HDL cholesterol, you can safely be higher than 5.0. The question I am most often asked in my clinic is how effective Statins are and “do I really need to be taking these?”

A seemingly simple question, but it is not surprising that patients are confused when they have such a high level of medical endorsement from government-backed authorities. Our own National Institute for Health and Care Excellence (NICE) suggests that these drugs could save 50,000 lives a year if every British male over the age of 60 and female over 65 took them regularly. High praise indeed. As a result of this kind of publicity, GPs are encouraged to prescribe these drugs to their older patients, regardless of whether or not they have had cardiovascular incidents or indeed are even at heightened risk. The cost to the UK taxpayer is enormous — the bill for these drugs runs to some £450 million per year and worldwide revenues for the drugs is estimated to be some £20 billion. Little wonder then that the research (funded by the drugs companies themselves) is so heavily weighted in favour of the efficacy of these pills. 

It is very interesting to note some independent research carried out in 2015 at the University of Liverpool. Results were clearly at odds with these NICE guidelines when this newer research indicated that only 750 lives per year could be saved with Statin drugs. What was interesting was that more research carried out at multiple centres across the UK noted that cardio-vascular deaths had fallen by 38,000 between 2000 and 2007, but that only 1,800 of these fewer deaths could be directly attributable to Statin use by patients. The vast majority of the fall in numbers of deaths was due to improvements in diet, exercise and lifestyle.

Many physicians are becoming increasingly concerned about the seemingly inexorable drive to get ever more older members of the population taking these Statin drugs. Just last month Dr. Kailash Chand (Honorary Vice President of the British Medical Association) voiced his concerns about these drugs in an open letter signed by many leading physicians calling for a full review in to the use of these drugs. He stated that he was “calling for a full parliamentary investigation into Statins”. In response, the recipient, Sir Norman Lamb MP, chair of the science and technology committee, wrote to chief medical officer Dame Sally Davies, calling for a review. The call was based on the lack of clarity on the real benefits of the drug and true incidence of side effects. 

Dr Chand doesn’t end his concerns there. In an open access article for GP magazine PULSE he states  “In the hands of pharmaceutical industry propagandists, outsider studies have become powerful weapons of misinformation. GPs have no problem using high-dose Statins in patients who have already had a heart attack or stroke, as they’re at very high risk of further episodes, and there is some evidence of benefitting that group. Despite this, the data on an individual basis is quite underwhelming. According to non-transparent industry-sponsored studies taken religiously for five years, heart attack patients can at best expect a one in 83 mortality reduction and a one in 39 chance of preventing a non-fatal heart attack.” Dr Chand says that prescribing these drugs without a clear explanation of the risk / benefits to patients, is both unscientific and unethical. 

Side effects

What kind of side effects are being reported? Again, it depends which studies you believe. The pharmaceutical industry’s own data (accepted by NICE) suggests that only 1/100 people get the most common form of side effect – which is muscular myalgia. This flies in the face of other independent research in New Zealand which puts the figures closer to 1/10 people who experience this therefore some ten times higher.

Other side effects from these drugs, according to the NHS, include: nose bleeds, headaches, sore throats, runny nose, feelings of nausea, digestive issues from constipation to diarrhoea, an increased risk of T2 diabetes.

It is also well documented that Statin use robs the body of CO-Q10  enzymes, which are integral to cellular energy production and have also been found to protect against cardio-vascular disease. A reduction in CO- Q10 has been linked to the muscular myalgia many patients experience, yet this essential nutrient is not recognised by mainstream medics of being any value in symptom reduction.

What alternatives are there?

It is clear from studies that the biggest impact by far is from eating a healthy diet, based on the Mediterranean diet. Raw extra virgin olive oil over 30 ml a day on your salad and eating 50g per day of mixed nuts can reduce your risk of cardio vascular incident by a third – significantly beating the success rates of statins.

Losing weight can significantly reduce your risk of developing cardiovascular (CV) diseases, and also reducing the risk of developing T2 diabetes. 26.2 % of the UK population were classed as clinically obese in 2018.  Lack of exercise and smoking are significant contributory factors driving mortality. Taking statins as a substitute for tackling these issues is clearly counter-productive and of limited impact.

Other biopsychosocial factors are important drivers of CV disease. Both loneliness, isolation and stress are mentioned by Dr Malcom Kendrick who published The Great Cholesterol Con (John Blake 2007). Loneliness has increased enormously in the elderly population with the rise of the nuclear family, and modern long term stress from money worries, a bullying boss, racist abuse and relationship breakdown are all examples cited in the book as contributions to an early death from CV disease. Clearly anything that addresses these issues can help – joining an evening class, going to a gym, seeking counselling for stress can all play an effective role in reducing risk. 

Finally, there are safer supplement alternatives. Plant based stanols and sterols which are widely available in products such as Benecol have been shown to reduce cholesterol by 10% in just three weeks.

Another powerful alternative is Red Rice Yeast (Monascus Purpureus), A natural source of statins, but unlike pharmaceutical products, it provides a mix of these compounds rather than a single one. The complex mixture interacts with the body more smoothly and is less likely to cause toxicity. These are only recommended for patients who are at significant risk of CV disease and whose cholesterol levels remain high despite dietary interventions. 

— Martin Schoenbeck BSc (Hons) M.N.I.M.H. is a consulting medical herbalist and nutritionist working in Lincoln

Disclaimer: Do not stop taking any medication without fully discussing your health with a trained medical professional. Medical Herbalists are all qualified to degree level and offer safe advice on alternative and complementary medicines. You can find your nearest practitioner here: www.nimh.org.uk 

Martin Schoenbeck BSc (Hons) M.N.I.M.H. is a consulting medical herbalist and nutritionist working in Lincoln.

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