Tamiflu, or oseltamivir, is being pushed big time by doctors right now and they will continue to advocate its use during the upcoming flu season. One of the reasons is due to fear of the H1N1 (Swine Flu) virus.  The other reason is because doctors only look at the benefit of using Tamiflu and almost completely disregard the negatives. So, what is the scoop? Should you rush out and get your supply of Tamiflu or should you exercise some concern? As I am fond of doing, I am going to give you some facts and then let you decide for yourself if you think you should dose with this drug…or not.

How Effective Is Tamiflu?

I believe the facts show that Tamiflu can indeed reduce the amount of time the average person experiences flu-like symptoms if they are infected with a strain of influenza that is sensitive to the drug. Therefore, we do not need to debate this point. But, let me ask you to think about an important question. What constitutes a reduction of symptoms significant enough to consider taking this drug? To answer this question I believe you only have to look at two sets of data. The first reveals just how well Tamiflu works and the second deals with identifying the risks of taking the drug. So, let’s investigate the facts so you can make an informed decision.

The attitude of the doctors prescribing Tamiflu is that it is a no-brainer. They see the studies reporting that Tamiflu reduces the time of experiencing symptoms and that is enough for them. Thus, doctors prescribe and over-encourage patients to take Tamiflu. I say over-encourage because every patient I know who gets this prescription has told me that their doctor vigorously endorsed the use of this drug without even mentioning the benefit verses side-effects issue. After listening to your doctor you would think that Tamiflu works very well, works in most cases, and is so safe that you should disregard any potential side-effects dissuading you from taking the prescription.

The Benefit…

The studies are pretty clear that Tamiflu may (notice the word “may”; I will get to that in a moment) reduce the symptoms of the flu on the average by one day. Wow! One whole day! But, you may be thinking that you would like to have one day less of flu symptoms.  I do agree. However, let’s take a logical look at the real life application. If you have ever had the flu, when do you get your worst symptoms? Yeah, the first few days! Wouldn’t it be great if the one day that Tamiflu reduced your symptoms by was one of those days? But alas, it does not. Thus, the one day you may experience a reduction in your symptoms will be one of the more tolerable days anyways.

Now…onto the discussion of how Tamiflu may reduce your symptoms by one day. Tamiflu has absolutely no effect against many of the strains of influenza infecting our population. So, if you have one of these strains of flu you get no benefits from Tamiflu and only side-effects.  How, then, does your doctor know if you have one of the strains that will be sensitive to Tamiflu? The answer is that they have absolutely no idea at all. It is a true crapshoot.

Another problem with trying to determine the benefit one gets after taking Tamiflu is that flu symptoms vary so greatly. Most people experience symptoms for 1-2 days prior to taking Tamiflu. These first two to three days are usually the worst when you get the flu. So, you can take Tamiflu and feel better the next day but it likely would have NOTHING to do with the Tamiflu. Let me give you an example that I can verify because it happened to my wife. Sherri went to the doctor after a day and a half of bad flu symptoms. She was looking to get relief for her congestion and coughing. She was given a prescription for Tamiflu and was told that it would definitely help her. She called me to pick it up from the pharmacy on my way home from the clinic. I didn’t stop to pick it up and explained to my wife that Tamiflu was not worth taking in my opinion. Well, the next morning she woke up and felt remarkably better. What would have happened if she had taken the Tamiflu? She would be one of those who would shout from the mountain-top that this drug was the best thing ever. Of course, I would have been the wacko quack who was obviously in the wrong. For those who are wondering, I did rub in the fact that I was right once again! This example illustrates exactly why it is impossible to interpret the benefit of taking a drug like Tamiflu in the patient population.

The other hot topic of the day is the H1N1 or so-called Swine Flu virus. Has Tamiflu been shown to be of any significant benefit at all for the Swine Flu? The answer is no! And, there is no real reason for any intellectually honest health professional to believe that prescribing Tamiflu will have any beneficial effect on this strain of flu. Personally, I find it disturbing that the federal government and many state governments have spent a lot of taxpayers’ money on purchasing doses of Tamiflu. It gives the false impression that Tamiflu must provide a benefit because we all know that our government would never spend money in a wasteful manner. Need I say more?

Even an expert from the CDC seemed to chastise doctors for not giving Tamiflu to confirmed H1N1 infected patients. The tone of his quote in the USA Today was one of scolding doctors for not giving Tamiflu. Has the CDC shown that Tamilfu works against the swine flu? Nope. Is there any credible evidence that Tamiflu has any activity at all against H1N1? Nope. So, why the glowing endorsement and scolding tone? Well, it must be because the potential benefits out weight the potential risks! Decide for yourself…

The Negatives…

Anyone who has ever been prescribed Tamiflu knows that their doctor never goes through the benefits verses the side-effects. In fact, most doctors grossly downplay any potential side-effects from taking Tamiflu or act as if there are none to be considered. Here is the conclusion of one study looking at the use of Tamiflu in children.

“Compliance with Tamiflu …was high, although likely side effects were common. The burden of side effects needs to be considered when deciding on mass Tamiflu (taken as a prophylaxis) in children especially given that the symptom of A(H1N1) are generally mild.” Compliance and side effects of prophylactic Tamiflu treatment in a school in South West England.  Wallensten A., et al. Euro Surveill 2009 Jul 30:14(30):19285

Here is the list of some of the post-marketing adverse reactions associated with Tamiflu use. These are important because the side effects observed in the limited studies needed for FDA approval do not even come close to identifying the actual side effects that any drug will cause. The occurrence of most of these symptoms is low but some of them are common, as noted in the above study. These side effects can be found on www.drugs.com.

I want to make sure I clarify one important point about flu symptoms to make sure we are on the same page. The flu does not cause digestive symptoms like diarrhea, vomiting or nausea. The flu is a respiratory disease. As a population we commonly say we had the “flu” when we really had a digestive bug. I had one patient tell me they had not gotten the flu the last two years that they had gotten a flu vaccination. When I asked him what symptoms he gets with the flu he said vomiting, diarrhea and fever. This was NOT the flu so the vaccination he received did not affect whether he got a digestive bug or not. The reason I bring this up is that the most common side-effects from Tamiflu are vomiting, diarrhea and nausea. Many would incorrectly think they would have these symptoms anyway because of the flu. They would be wrong.

The Bottom Line

Now that you have the facts about Tamiflu you have to decide whether or not you think it is a good idea to dose yourself or your children with this drug. Tamiflu may help reduce the symptoms of the flu by one day only if you get lucky and have a strain of the flu that is affected by this drug. The one day of reduction will be after you have already experienced the worst symptoms. Tamiflu has not been shown to be effective at reducing the symptoms of H1N1 by one day or at all, for that matter. Experiencing symptoms like nausea, diarrhea or vomiting are not uncommon. Potentially severe symptoms can and do occur, but are very rare.

Here is the conclusion from another recent study published in The Lancet:

“In view of the advantages and disadvantages of different management strategies for controlling seasonal influenza in healthy adults recommending the use of antiviral drugs (like Tamiflu) for the treatment of people presenting with symptoms is unlikely to be the most appropriate course of action.” Prescription of anti-influenza drugs for healthy adults: a systematic review and meta-analysis. Burch J., et al. Lancet Infect Dis 2009 Aug 7

So, is it worth the risk of taking Tamiflu for the benefit? Now you have the facts to make an educated decision.

What Other Options Do You Have?

To answer this question let me tell you what I do as soon as I begin to feel the onset of any respiratory symptoms. I use the following products and they seem to work very well at keeping me from ever becoming seriously ill. I suggest you keep these products in your medicine cabinet so you can start using them as soon as you feel that yucky feeling signaling that your body is fighting something.

I take C-BioFizz, Thorne Vitamin A, Vitamin D and Esberitox. For the kids, I give them either Esberitox or ImuMax and mix C-BioFizz with the Thorne Vitamin A and Vitamin D. You can get these products by clicking on this link:  Immune Support

Here are the doses I use:

Adults:

1 teaspoon of C-BioFizz, 2 capsules Thorne vitamin A, 1 capsule vitamin D 5,000IU, twice a day.  Chew 4 Esberitox, 3 times a day.

Children who cannot swallow pills (2-8):

½ teaspoon C-BioFizz, 1 capsule Thorne vitamin A, 1 capsule vitamin D 1,000 IU, twice a day.  Also, chew 2 Esberitox, 3 times a day or take 1 teaspoon of ImuMax, twice a day.