Everyone wants to know, what can we do to boost our immune systems. I wish we could magically improve our ability to fight viruses, but physicians haven’t been holding out on you miracle fixes. I put together some evidence based takeaways for you to consider this winter.
Promoting immunity:
There is so much misinformation out there. Sleep, exercise, stress reduction, and eating a healthy diet are the best way to maintain a healthy immune system. There is good evidence that people with insufficient sleep have impaired immunity. Individuals who exercise at least five days a week are nearly half as likely to get sick. And eating a healthy diet provides adequate levels of essential nutrients.
Zinc and vitamin C are important for optimal immune function. Most people get plenty through their diet and absorption is best through the diet. These supplements are unlikely to do harm (except zinc lozenges can affect taste buds!), but unlikely to make a significant difference. Having a healthy gut flora probably helps your immune system function optimally. You can achieve this goal by eating a diverse diet rich in fruits and vegetables and some fermented foods like yogurt with active cultures. Multivitamins and probiotics are not necessary for children with typical diets, but if you choose to give them anyway just be sure to keep their teeth clean should you choose a gummy. Healthy nasal mucosa promotes your natural defenses and decreases your risk of getting sick. Adequate air quality, humidity, and controlling allergies can help!
Vitamin D deficiency is common and linked with many chronic diseases. The causation is not clear. Studies demonstrating that fixing vitamin d deficiency will fix a chronic disease are lacking. In asthma for example, we all hoped since asthma is linked with vitamin d deficiency supplementation would help, but it hasn’t. So while patients who get very sick with COVID-19 are more likely to have low vitamin D, we don’t know that vitamin D would have prevented the severity of their illness. When in doubt check a simple blood test can diagnose vitamin d deficiency, and we should treat deficiency with MORE than what’s in a typical vitamin (2000 u/day or 50,000 u/week vs. 400 u/day).
Regarding elderberry, we have a real limitation in our data regarding safety and efficacy for children. Even so, I have elderberry in my house and gave it to my family as needed during cold and flu season in prior years. Anecdotally I think it helped us. But I am not giving it this winter, let me explain why.
Facts about elderberry:
There is no safety data on elderberry for any reason under age 5.
Elderberry seems to help with flu, as it has antiviral properties and increases cytokines (2x-50x!) to activate the innate immune system. For this purpose, elderberry is taken when symptoms begin for a short period of time like 5 days.
However, with COVID-19, particularly in children and young adults, high cytokines have been shown to be markers for MIS-C, hospitalization and death.
Is it possible that early in illness elderberry may help more than it hurts? Absolutely. Is it possible that elderberry may increase risk of immune overdrive and cytokine storm? Yes.
Just because it’s natural doesn’t mean it’s safe. I never recommend giving it daily because I do feel it is possible that the effectiveness would be decreased and that chronic use could increase inflammation or risk of an autoimmune disease.
We simply won’t know without more studies, but I won’t be giving my family elderberry this winter as odds are catching coronavirus may be more likely than catching flu.
I will however vaccinate my family for flu because I want to do everything to reduce the chance of a respiratory illness this winter. We know children with flu and coronavirus at the same time are at risk for getting sicker and ending up in the hospital. The flu strains this year probably will be around next year too so this shot is an investment in our future flu fighting power.
I wrote more about what we can do to protect our families this winter in my book. If you haven’t read it yet, check it out here.
