Tamiflu and the Flu: Is it worth it?
Posted on March 6, 2017 12:48 PM by Dr. Zimmer
Tamiflu, or oseltamivir, is pushed big time by doctors during the flu season. One of the biggest reasons why is because they really have nothing else to offer a patient in terms of treatment for the flu. But, is Tamiflu really worth taking if you have the flu when it cost upwards of $140? Should you take that prescription for 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 and if they are treated very early on in the infection (within 48 hours of the onset of symptoms). MANY doctors give a prescription for Tamiflu after the person has had the flu for longer than 48 hours. It is completely worthless after this time. 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 can 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 benefit/risk ratio 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 they have nothing else to offer in the way of treatment. Thus, doctors prescribe and over-hype the potential benefits to the patient in taking Tamiflu. I say over-hype 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, saves lives, and is so safe that you should disregard any potential side-effects dissuading you from taking the prescription. I had a virologist, who was the director of virology at a distinguished medical research facility, tell me that the medical benefits of taking Tamiflu are enormous both in reducing the duration and severity of the infection. He noted that it works and that it saves lives. Let's see if this position is supported by the studies and facts.
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’t it be great if the one day that Tamiflu reduced your symptoms by was one of those days? But, it cannot because you do not even take Tamiflu until you have had the flu for at least a couple of days. Thus, the one day you may experience a reduction in your symptoms will be one of the more tolerable days anyway.
Another benefit touted by advocates for Tamiflu is that it can stop people from having their flu turn into pneumonia, especially in older patients and patients with chronic cardiac disease. This is the stance taken by the virologist who contacted me. He claimed that without question anti-viral drugs save lives. The problem with this stance is that it is not supported by the studies which have been done. It is simply "want it to be true because it supports my belief" logic.
The maker of Tamiflu reports that in three double-blind studies there was no difference in the effectiveness of Tamiflu between those older than 65 compared to younger subjects. Another peer-reviewed study showed that "the risk of hospitalization for respiratory diseases was not reduced" by Tamiflu (Impact of oseltamivir on the incidence of secondary complications of influenza in adolescent and adult patients: results from a retrospective population-based study.) The makers of Tamiflu also report that, "A double-blind, placebo-controlled, multi-center trial was unable to demonstrate efficacy of TAMIFLU in the treatment of influenza in adult and adolescent subjects with chronic cardiac or respiratory diseases."
A different study concluded, "Oseltamivir has no protective effect on mortality among patients with 2009A/H1N1 influenza." (Neuraminidase inhibitors for influenza: a systematic review and meta-analysis of regulatory and mortality data.) Thus, the claim that taking Tamiflu will saves lives during serious flu infections of H1N1, in the elderly and with those with chronic cardiac symptoms is simply not well supported by the facts. Again, it is "want it to be true because it supports my belief" logic.
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. This is becoming more true each year as more and more resistant strains are being identified. 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 at least 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’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. This example illustrates exactly why it is impossible to interpret the benefit of taking a drug like Tamiflu in the patient population through testimonials.
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 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 like vomiting, nausea and headaches are common, occurring in one out of ten. Some of these are very serious side-effects.
|Face Swelling||Tongue Swelling||Allergic Reactions|
|Toxic Epidermal Necrolysis||Stevens-Johnson Syndrome||Hepatitis|
|Liver Function Abnormality||Heart Arrhythmia||G.I. Bleeding|
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 typically 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 spend $140 per person 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 and only if it is taken within the first 48 hours of having symptoms. 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 serious flu viruses like H1N1, it does not significantly reduce the progression of the flu to pneumonia, and there is NO evidence that it saves lives. If you disagree, send me the list of studies which support the opposite and I will be happy to revise my position appropriately. 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 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.
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
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