Written by Dr. Ruby Rose, MD.

Winter is coming…and so is the flu! Whether you are a medical professional, teacher or office worker, you will be exposed at some point during this winter. This article will help you prepare your body’s best defense -your immune system- for not only the influenza virus but all the other viruses that circulate during the winter months.

Last year the CDC estimated that almost 49 million people got sick with influenza-related illnesses causing missed work and school. While most patients who contract influenza will recover without serious complications, some can progress to serious illness, hospitalization and even death. Those patients at greatest risk include older adults, very young children, pregnant women, and people with chronic medical conditions or those who are immunocompromised by a disease process or medications.

Symptoms of the flu include abrupt onset of fever and chills, cough, sore throat, runny nose, congestion, muscle or body aches, headaches and fatigue and sometimes photophobia. Symptoms of the flu are typically more severe than the common cold. Symptoms can begin within 2 days of exposure and you are contagious sometimes 1 day before your symptoms even begin and up to 7 days after becoming sick.

The other viruses that are rampant during flu season and can mimic the flu include viruses such as Adenovirus, Coronavirus, Rhinoviruses (common cold), and Enteroviruses (Coxsackie A+B, Polioviruses, echoviruses). Paramyxoviruses make up 40% of URI’s in children and include parainfluenza viruses which cause croup, RSV bronchiolitis, and pneumonia.

Getting Prepared Prior To Flu Season

1. Get Vaccinated
The CDC recommends all people 6 months and older to receive a flu vaccination. This includes pregnant women and people with chronic health conditions. There are various forms of the flu vaccine. So speak to your medical provider about which type is best suited for you. People who have a severe egg allergy or a history of Guillain Barre´ Syndrome (GBS) should not receive the flu vaccine. Visit the CDC for more in depth explanation of vaccines.

The vaccine CANNOT cause the flu because it is an “inactivated” or killed form of the virus and it is typically made from a single gene rather than the full virus. The main purpose of a vaccine is to activate your immune system to make antibodies that will recognize and eliminate the virus when you are re-exposed to it in the future. This allows your body to clear out the pathogen before it can cause illness. 

2. Wash Your Hands
Viruses and bacteria are typically transmitted via respiratory droplets where they can be inhaled, touched and subsequently ingested. They can also be transmitted via any mucosal barrier including the eyes and nose.

3. Manage Your Stress
Several studies have shown that people with elevated levels of stress have 3-4 times higher chance of catching a cold.

4. Eat Well
Eating a balanced meal that consists of fresh veggies and fruits and low in sugar and processed foods can help give your immune system a fighting chance.

5. Supplements that can help ward off the cold or limit your symptoms:

• Garlic can reduce the number of colds and the duration of symptoms.
• Zinc (15-40mg) per day can be preventative. Zinc is found naturally in nuts, beans, beef, chickens and especially oysters.
• Probiotics (acidophilus, bifidus) have been shown to decrease the frequency and severity of respiratory infections in children.
• Vitamin D may decrease the frequency and severity of respiratory infections. (1200 IU per day in school kids, 800 – 2000 IU per day in adults).
• Vitamin C has shown some benefit in reducing duration and severity of the common cold but research is limited.
• Echinacea has been shown to reduce the number of colds and duration of symptoms and is generally safe for short term use.

I think I Have the Flu, Now What?

There are several prescription medications for treating the influenza virus once contracted, Tamiflu® is the medication most commonly prescribed. If started within 48 hours of symptom onset, they can lessen the duration and severity of the illness. All types of medications can be prescribed to children but may have age limitations. Most are safe in pregnancy but always consult with your doctor. Like all medications, there can be side effects, with nausea and vomiting being the most common. Your medical provider will discuss the risks versus the benefit of starting a flu medication.

Botanical Alternatives

Along with preventative supplements, there are several botanical options for those who cannot or do not want a pharmaceutical medication. Please consult with your medical provider regarding other medications you take on a regular basis as herbs can potentially interact with certain medications and may not be recommended in pregnancy.

Elderberry Extract (1 Tbsp 4 times per day) has been shown to reduce flu symptoms from 6 days to 2 days due to its potent antiviral effect on the flu viral proteins thus inhibiting the early stages of infection.

Pelargonium (Umcka), an extract of the South African geranium, 30-60 drops three times daily reduced the duration of upper respiratory infections and decreased the severity of symptoms due to its effects on boosting your immune response to a virus.

Andrographis 400 mg three times daily reduced symptoms at 2 days and even more dramatically by day 4 of the illness. Avoid in pregnancy.

Zinc Acetate Lozenges (dissolved in your mouth every couple hours, started within 24 hrs of symptom onset) can reduce symptoms and duration of upper respiratory infections.

Steam Hoods (2-5 drops in a large bowl of hot water with a towel over your head) is a natural way to relieve congestion and sinus pressure, especially if you cannot take a decongestant (history of hypertension, children). Use good quality essential oils of peppermint, eucalyptus, thyme, lavender. These oils can also be placed in a clean cool mist vaporizer.

See also: Flu – Causes, Symptoms, Complications, and ER Treatment.

When Should I Seek Medical Care?

Most cases of the common cold and even flu can be managed at home. However, people can get worsening symptoms requiring a medical evaluation.

You should seek medical care or Emergency Care when you feel profound fatigue, dizziness, pain that is worrisome or different, shortness of breath or anything you are not comfortable with managing at home.

You should also seek care if you are immunocompromised in any way or have a chronic medical condition in which the flu could worsen. If you would like to take an antiviral medication, you can make an appointment with your primary care provider or go to your local Emergency Center.

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Recipe to Help You Recover from Flu

Anti-Inflammatory Chicken Soup

Turmeric root has strong anti-inflammatory activity and suppresses inflammatory cytokines in a similar fashion to NSAIDs. If combined with black pepper, the absorption increases by 1000%. Lemon helps pull the calcium out of the bones and offers vitamin C, an antioxidant. The skeleton of the chicken gives collagen and gelatin which contains healthy essential amino acids that are anti-inflammatory and boost your immune system among many other things. You are also getting vitamins and minerals from the bones such as Vit. D,C, B1 (thiamin), Ca and Iron.

Ingredients:
4-6 cups water in large pot to boil
1 Whole organic chicken placed in a pot
Several cuttings from Thyme, Oregano, or Rosemary plants
1 Whole lemon
2 stalks celery, sliced
Fresh ginger, peeled and grated or cut into chunks
Shiitake mushrooms or dried medicinal mushrooms (reiki, maitake, morels, lions mane, chaga, cordyceps, turkey tail)
½ Onion, chopped
2 cloves garlic, chopped
Tumeric powder or fresh grated turmeric root -1 tbsp
Salt to taste
Black peppercorns ground or cracked

Optional:
Carrots
Red chili flakes
Baby bok choy, kale or spinach
Brown rice

Directions:
1.) Place all ingredients in a large pot or French oven and bring to boil and then simmer until meat falls off the bone.

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References

1) https://www.cdc.gov/flu/index.htm
2) https://www.publichealth.org/public-awareness/understanding-vaccines/vaccines-work/
3) Josling P. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther 2001 Jul-Aug. 18(4):189-93
4) Cannell JJ et al. Epidemic Influenza and vitamin D. Epidemiol. Infect. (2006), 134, 1129–1140 Am J Clin Nutr. 2010 May;91(5):1255-60.
5) Zakay-Rones Z et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1995 Winter;1(4):361-9
6) Lizogub VG et al. Efficacy of a pelargonium sidoides preparation in patients with the common cold: a randomized, double blind, placebo-controlled clinical trial. Explore (NY). 2007 Nov-Dec;3(6):573-84.
7) Cáceres DD et al. Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine 1999 Oct 6(4):217-23
8) Prasad AS et al. Duration of symptoms and plasma cytokine levels in patients with the common cold treated with zinc acetate. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2000 Aug 15;133(4):245
9) Douglas RM et al. Vitamin C for preventing and treating the common cold. Cochrane Dbase Syst Rev 2000; 2:CD000980.
10) Rauš K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an Echinacea-based hot drink versus oseltamivir in influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. Curr Ther Res Clin Exp. 2015;77:66–72.
11) Ross SM, et al. Echinacea purpurea: A Proprietary Extract of Echinacea purpurea Is Shown to be Safe and Effective in the Prevention of the Common Cold. Holist Nurs Pract. 2016 Jan-Feb;30(1):54-7.
12) Kohatsu W. 2013. URI Handout. IM4Us. Santa Rosa Integrative Medicine Residency, accessed Nov. 1 2018 (https://www.srfmr.org/integrative-medicine/.)
 

Other Articles by Dr. Ruby Rose, MD – GERD (Heartburn) – Pain in the Upper Gut.

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Dr. Ruby Rose, MD, is board certified in emergency medicine. Originally from New York City, Dr. Rose graduated from Vassar College in New York before obtaining her medical degree from Tufts University School of Medicine in Boston, Massachusetts. She completed her emergency medicine residency at University of Massachusetts. Dr. Rose has a passion for alternative care and recently graduated from the University of Arizona Integrative Medicine Fellowship in Tucson, Arizona. After relocating to Texas with her family, Dr. Rose worked in St. David’s Healthcare System where she served in several leadership positions. In her spare time, she enjoys watching her kids play various sports and riding her horse in the Texas Hill Country.