prevent flu

Flu: What’s a Gal to Do? 

The flu is is a viral infection that causes symptoms ranging from mild to severe, and can take you out for days with aches, pains, fever, chills headache, cough, and sore throat. It can make you feel miserable and for some, it can lead to complications including ear and sinus infections (common in kids), pneumonia, and in pregnant women, high fever can be a problem for baby.

Massive public health hysteria around the flu stems from the fact that historically, pandemics of flu have killed  millions of people in a short time, for example, the Spanish Flu of the early 1900s that wiped out large populations, and even more recent scares with Swine Flu, H1N1, and other forms of Avian Flu. Fortunately, the epidemics have not been nearly as bad as scares predicted. but those scares have led to big business for the pharmaceutical industry, to the tune of billions of dollars in stockpiled medications, and widespread promotion of the flu vaccination – which unfortunately, as I discuss here, only works from 24-60% of the time.

Prevention is key – but what’s the best way for you and your family to prevent the flu? 

Should You Get the Flu Vaccine?

Whether to get any vaccination is certainly a very personal decision and my goal is not to sway you one way or the other, but instead, to provide you with the information you need to make an informed decision. In my practice, I do not recommend the flu vaccine for everyone, though I do let my patients know that the flu is no joke – you can feel really awful for a week, and there can be complications.

While anyone can get sick with flu and become severely ill, in most cases it’s a cold like syndrome or a very uncomfortable few days of aches and chills and fever. Some people, however,  are more likely to experience severe flu illness. Very young children, pregnant women, and people with chronic medical conditions including poorly controlled diabetes, lung disease, and heart disease, are at greater risk for complications.

In my practice, I do recommend that those with chronic disease that make them high risk for complications get the vaccination. For pregnant women, the story is more complicated and while again, it’s a personal decision, I believe that the consequences of having the flu in pregnancy need to be weighed agains the unknowns of vaccination safety in pregnancy for the developing baby. I talk about that here.

Effectiveness ranges from 24% as it was a couple of years back, to 60% effective (less so in the elderly) . Based on a thorough review of the Cochrane database, I am not at all convinced of the value of the flu shot in young children.

Keep in mind it takes 10-14 days after getting vaccinated to gain immunity, so if you’ve already been exposed, or get exposed in that 2-week window after getting the flu shot, it might not help.

Whether to get the vaccine is a super personal and difficult decision for many of you. And there is no right or wrong choice. If you do choose to get the flu vaccine, or are compelled to to keep your job as many health care workers and teachers are, I strongly recommend only getting the single injection pre-loaded syringe. The multi-dose vial form, which is most commonly used, contains mercury, and I’ve seen more side-effects, including autoimmune disease that emerged within a couple of weeks of getting the vaccination in otherwise healthy individuals, with the live intranasal form, than with any other form.

For more on making your flu vaccine decision, listen to my episode of Natural MD Radio on flu starting on Friday November 25th.

Prevent with Tamiflu… or Not?

Oseltamivir, or Tamiflu, its trade name, is a particularly interesting medication for me to write about because there’s been a spate of heavy politics surrounding the drug that I’ve been following for the past few years. The medication, a neuraminidase inhibitor, is used to reduce the duration and severity of symptoms when treatment is initiated early after the onset of symptoms, and to prevent shedding of the virus which can infect others even when illness has passed. It is supposed to be given within 48 hours of the onset of flu symptoms to be effective in otherwise healthy people. The manufacturer and medical community have endorsed its effectiveness and safety for years.

But maybe, recent reports suggest, this endorsement wasn’t warranted.

It seems that for 4 1/2 years, not only was the data on safety and effectiveness questionable, but the manufacturer was publicly refusing to release its data. Major actions by the British Medical Journal (BMJ) Editor-in-Chief, who published letters to the manufacturer documenting its lack of forthcoming responses in the journal to force their hand to disclose their evidence for safety and efficacy, as well as The Cochrane Library, an evidence-based repository of medical data used by physicians all over the world for research and clinical evidence, yielded no disclosing of the data.

Only recently has this data finally been obtained, and accordingly to a leading Yale researcher (and a former professor of mine), Harlan Krumholz, the complete evidence paints a much less positive picture of oseltamivir than was presented to regulators, policy makers, clinicians, and the public. Important benefits were overestimated and harms under-reported.

In particular, the review found no compelling evidence to support claims that oseltamivir reduces the risk of complications of influenza, such as pneumonia and hospital admission, claims that were used to justify international stockpiling of the drug.

BMJ 2014; 348 http://dx.doi.org/10.1136/bmj.g2630 (Published 10 April 2014)

So all told, I am not a Tamiflu fan – and did not recommend it to my patient. However, since you have 48 hours from the onset of symptoms, you can take a “wait-and-see” approach and always give it a go if you do get the flu and want to try to nip it in the bud.

6 Doctor-Proven Natural Tips for Preventing the Flu

While pharmaceutical companies may be caught up in deceit about safety and efficacy, and since the flu vaccine is only 60% effective at best, we really do need more of a repertoire of flu prevention than those limited options. Natural approaches can be incredibly safe, effective, affordable, and without side-effects. As as a doctor wit ha 35-year background in herbal medicine, these are the “medicines” and approaches I really use with my own patients (and my family, too!).

These 6 tips are safe for pretty much everyone (exceptions for pregnant moms noted below) and you can get most of the herbs and supplements at your local Whole Foods or other major health foods store, or online at Amazon or Mountain Rose Herbs

Wash Hands

This is especially true if you’ve shaken hands with someone, have been in a public place where you’ve touched a lot of things (i.e., an elevator, the grocery shop), or you’ve been working on a shared computer keyboard (at work, the library), or have exchanged money with someone.

Washing for 20 seconds with soap and water (singing the happy birthday song takes just about 20 seconds), or using an alcohol-based hand sanitizer when you can’t get to soap and water, can significantly cut down on your risk of getting sick or bringing the flu home to your family.  Please don’t use antibacterial hand sanitizers as they can breed scary resistant germs and some also contain chemicals (like triclosan) that act as endocrine disruptors.

I always try to offer a hug over a handshake whenever appropriate (even with my patients!). We can all use more hugs! And seriously, you’re much less likely to get sick that way.

Also, try to avoid touching your eyes, nose, and mouth – a common way we spread germs to our kids and us! It’s not that easy to do – the average person touches their face a couple of hundred times per day!

Finally, if you have symptoms of what might be the flu, stay home from work – or if it’s your kids, keep them home from school.

Keep in mind that your doctor is probably ignoring the advice to stay home if sick – most of us were trained to show up at work unless we were practically dying. So your well-meaning doctor may also be a major germ-spreader! 

Eat Well!

This is a good time to cut down on the alcohol, cut out the sugar, processed foods, dairy, and packaged fruit juice – even if just for a few weeks – and make sure you’re getting plenty of good quality protein and vegetables. The stuff I’m suggesting cutting out, yes, including even the juice, is high in sugar or other ingredients that dampen down your immune system. A whole foods diet, sans dairy and sugar, is great protection against getting sick. 

Get Extra Rest

If you’ve been burning the candle at both ends for awhile, this is a really good time to give yourself permission to pause. A tired body means your immune system isn’t as fired up as it could be and you’re more susceptible to getting sick. Make a commitment to get at least 7 hours of sleep each night, preferably 8 hours, until this wave of the flu passes. Pass on that night out drinking, the extra hour of TV, or getting in just a little more work. Hop into bed with a good book, a cup of hot tea (just the act of sipping hot tea helps to prevent sinus infections, too!) and shut the lights early.

Bust Stress

Perhaps easier said than done, but keeping yourself chill during cold and flu season, which of course, coincides with the stress of holiday season, can make a huge difference in your immune response. Know how to set limits, keep it simple with meals and gifts, get plenty of rest, and keep to a 95/5 Rule of healthy food and habits — 95% of the time do the healthiest thing even if you indulge a little here and there. Even just 3 minutes of meditation once or twice a day can also help keep your immune system – and emotions – more resilient.

Take Your Vitamins

I recommend the following supplements to my patients to prevent colds and flu – during travel, or when there’s a lot of illness going around. For up to 2 weeks take the following for prevention: 

For kids: A Multi-vitamin/mineral is a good way to cover the basics and ensure optimal nutrient intake and immune health, especially in picky eaters

For everyone: 

Vitamin D3: Adequate vitamin D status is critical for optimal immune function and is hard to get enough of from food alone, especially in the winter. It’s also been shown that adequate vitamin D levels reduces your likelihood of getting the cold and flu substantially. The dose for adults is 2000-5000 units daily; for kids its 400-2000 units/day depending on age.

Buffered Vitamin C: Daily use of Vitamin C has been shown to reduce the likelihood of colds and flu, reduce antibiotic use, and school absences in children. The dose is Take 500-1,000mg/day for kids, and 1000-2000 mg/day for adults.

Zinc citrate: Daily supplementation with zinc reduces colds and flu. The dose depends on age. For adults it’s 30-60 mg/day total, For kids over 6 months the daily dose is: 6–12 months 2-3 mg, 1–3 years 3 mg, 4–8 years 5 mg; 9–13 years 8 mg

Probiotics: A healthy gut flora supports a healthy gut, a immune major barrier and taken daily, has also been shown to prevent colds and flu. Use a product that contains Lactobacillus and Bifidobacterium strains.

Cod Liver Oil: High in vitamin A, which is strongly supportive of the immune system and particularly the respiratory passages, is another daily support you can use for your family’s or personal flu prevention plan.

The above doses can be modified for children 2 and over. Pregnant women should omit the vitamin A and take only 2000 mg each of Vitamin C and Vitamin D daily. 

Use Herbs

Herbal medicines are powerful allies for boosting immunity and preventing the flu. They are my primary go-to for health and healing along with diet, rest, and a good outlook on life. Many herbs have powerful anti-viral and immune-boosting effects, yet safe and gentle effects on your body. Herbs to consider for flu prevention include Echinacea, elderberry, astragalus, and medicinal mushrooms such as reishi and shitake.

Here’s my recommended protocol for flu prevention:

  • Echinacea Liquid Extract (Herb Pharm or Gaia Herbs): 1 tsp. twice daily (yes, that much – but modify for children down to ¼ of the dose ages 2-7 years old, and ½ the dose 8-12 years old, safe for pregnant/nursing women).
  • Elderberry Syrup (Herb Pharm, Gaia Herbs, or Planetary Herbals): 1 Tbsp. 3 times daily for adults (modify as for Echinacea for children, safe for pregnant /nursing women).
  • Medicinal Mushrooms: I recommend a good Reishi mushroom product, such as Reishi Mushroom Supreme by Planetary Herbals which also has shitake mushrooms, astragalus, and a few other immune boosting herbs, Host Defense Reishi by Host Defense Organic Mushrooms, or Reishi Mushroom-Double Extracted, Organic, by Urban Moonshine – all great products.
  • Also, make sure to cook with onions, garlic, turmeric, and ginger, all of which have been used historically to prevent and treat infection, and which modern science validates for antiviral and anti-inflammatory effects.

Immune Tonic by Urban Moonshine is a fantastic immune boosting blend of Astragalus Root, Red Reishi, Codonopsis Root, Maitake, Eleuthero Root, Licorice Root, Schisandra Berry and Ginger Root – all organic. The dose is 1/2 teaspoon once or twice a day, or up to five times daily if needed, in a little warm or cold water. It’s what I’ve personally been taking for the past few days with exposure to sick office staff and patients all around me! It is not for use by pregnant women but is ok if you are nursing

If You Get the Flu

A lot of what folks thing is the flu, actually is a bad upper respiratory infection. In a NYS public health review of cases ,for example, in the current flu season, of over 1200 individuals that went in for care for the flu, on 9% actually had the flu on testing. Whether you have a bad cold or the flu, here’s what you can do:

  • Hydration is essential; Drink plenty of hot tea, water with lemon, and broth
  • Stay comfortable and give yourself permission to rest; sleep is healing.
  • Start taking the above nutritional supplements for extra immune support
  • Elderberry Syrup (Herb Pharm, Gaia Herbs, or Planetary Herbals): 1 Tbsp. 3 times daily for adults (modify as for Echinacea for children, safe for pregnant /nursing women).
  • There are specific herbs that can also help you to tolerate the aches and pains, and common viral symptoms that accompany the flu. To learn more about those head over to my popular article https://avivaromm.com/how-7-top-herbalists-and-doctors-fight-the-flu/ and stock up on some of those items ahead of time so you have them on hand if you need them.

 

I wish you amazing health, hope the flu bypasses you and your loved ones, and look forward to hearing your experiences in the comments section below!

With love,

AJR-Sig

 

 

24 Comments

  1. Was wondering what your thoughts are on taking Zeolite daily as a preventative. I have been told that it can greatly reduce the length and severity of any cold/flu virus. Do you know of any science to back this up?

  2. Hello, I was wondering what the modifications would be for children regarding the vitamin regimen you recommend for adults. Thank you!

    • hi jennifer, i dose based on age and weight proportionally to the adult dose — or just give supplement products tailored to kids’ needs – as those will be dosed accordingly. good luck! aviva

  3. Hi there!

    I love receiving your newsletters and reading your blog. You mentioned to please don’t use antibacterial hand sanitizers as they can breed scary.

    Which kinds do you prefer? I usually get mine at The Bath & Body Works or Target. Most say antibacterial. What do I look for?

    Thank you!!

  4. Hi Aviva,
    Thank you for this wonderful newsletter I get so much from it!
    I have a vit D3 question. It is my practice to test my clients for their D levels and if they aren’t between 60-80 in pregnancy and lactation to suggest 5,000-6,000 iu’s to get them up to what I had learned is the optimal level for breastfeeding moms and babes.
    Can you speak to vit d supplementation and why you recommend 2,000 in pregnancy.

    Thank you,
    Hannah

    • hi hannah, thank you!
      the limited data available on vitamin D supplementation in pregnancy suggests more conservative dosing due to changes in prenatal renal threshold and vitamin D renal excretion as well as possible increased risk of stones. there’s also no data on 60-80 being a target goal in pregnancy, to my knowledge. unless someone is quite deficient (i.e. under 30 mg/dl) i rarely dose that high. best, aviva

  5. Hi Aviva,

    Thank you for you informative blog!! As flu season approaches us, I am looking to prevent the flu with herbal medicines. Would you recommend starting to take Echinacea, Mushroom and Elderberry on a daily basis throughout the entire flu season? I was thinking about using the Urban Moonshine Immune Tonic in place of the other herbs so I would actually be compliant. Thoughts?

    Thank you!
    Tomi

    • I do love these herbs for seasonal health, though the science isn’t great for elderberry for prevention as much as flu treatment. Andrographis, on the other hand, has some nice scientific support behind it for prevention. Was working on a blog this morning on cold and flu prevention or autumn and winter. Hopefully out by the end of this week 🙂

    • Like any of the adaptogens, there really isn’t pregnancy safety data, but in the third trimester, I would think it would be ok — but I probably wouldn’t use it preventatively every day — more for a short burst here or there of a week or two.

  6. My sister is about to have twins! I am planning to help care for them for the first couple weeks m. Do you recommend the flu shot and Tdap vaccine in this situation?

    Thanks!
    Sarah

    • Hi Sarah, That’s the classic medical recommendation for sure; it’s a personal choice…and something to discus with your sis, too, and see what she feels safest with… Have fun with those cute babies!

  7. Hey Aviva-

    I’ve been a dedicated follower for years and herbalist myself so I’m all shades of crunchy. However, I’m going back to nursing school this winter and am required to take a flu vaccine. Any recommendations besides asking for the single injection preloaded syringe that I can do to lessen any potential negative impact? I’m very healthy otherwise and haven’t gotten any vaccines in years.

    Thanks for all you do!
    Kodiak

    • Hi Kodiak, so nice to meet you – and very cool name! 🙂 While I don’t usually recommend much other than eating healthy and getting plenty of rest around the time of the vaccine, NAC (n-acetyl-cysteine) is a naturally detoxifier and our body’s natural precursor to glutathione – so for adults I do sometimes recommend it for a little extra support. Dose ranges from 300-600 mg three times daily, and it can be taken for just a few days before and after.

  8. Hi Aviva,

    Thanks again for all the love, support, and information you bring to us, I don’t often comment but I have taken many of your courses and am really thankful for what you do. I was listening to this podcast and I heard you say not to use a netty pot during a cold – I have always used it during a cold, several times a day because it makes me so much more comfortable – should I not be doing this ? Thanks,

    • I am just cautious when giving information out very broadly because in bacterial sinus infection it can be risky. For most folks with common colds, and no other immune risks, if it gives relief, it’s usually just fine. 🙂

    • There’s a great report on flu vaccine from the Cochrane Database that shows very little evidence of effectiveness in kids this age so in my practice I don’t push the flu vaccine in otherwise healthy children with no major risk factors and no one of major immune risk at home. But super personal choice! Best, Aviva

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