Whether or not to get a flu vaccine is an individual choice. Vaccine proponents claim that the flu shot protects against ­influenza infection and, if contracted, lessens the severity of the flu. However, there are concerns about the flu vaccine.

More than 500 different viruses can cause flu-like symptoms and these ­viruses are constantly changing. Each year, the flu vaccine is formulated from the three most common strains seen in the previous year, which may or may not be specific for the current year's flu.

Vaccines contain many ingredients including a preservative, which is made up of either egg protein or thimerosal (a toxic mercury-containing compound), and formaldehyde (a carcinogen). ­Allergic reactions to these ingredients can ­occur. It takes about two weeks after the flu shot to develop enough antibodies to offer protection from the influenza virus. These antibodies start to lose their effectiveness within a few months.

In today's society, many people fear getting sick. The reasons people give vary from not having enough time to get sick to the perception that any form of illness is an inherent ­personal weakness. What many people don't ­realize is that getting sick may actually be a good thing because it gives the ­immune ­system a chance to work.

The body's immune system is intricately designed as a kind of "policing" system to distinguish between foreign and internal "invaders" such as the bacteria, viruses, fungi and cells within the body that are no longer functioning properly. If you never get sick, how will you know that your immune system is working as it should?

Don't get me wrong-I am not advocating that you run out and contract deadly viruses just to challenge your immune system. However, getting a benign cold or flu every couple of years is not a national emergency. Instead, it is a natural opportunity for your body to form the defenses, or immunity, it needs so that the next time you come into contact with the same bug, your body knows exactly how to take care of it.

The good news is, if you do get a cold or flu, many dietary strategies, herbs and supplements can complement the natural effectiveness of your immune system.

Immunity and lifestyle
Eat a diet that is low in sugar, caffeine, fat and alcohol as these substances reduce immune system function. Focus on eating five to 10 servings of fresh fruit and vegetables daily and include garlic, onions, thyme, cayenne, ginger and oregano in your food preparation to help boost your immune system and fight off microorganisms.

Often times, we simply get sick because we don't take the time to care for ourselves when we are well. Aim for balance in your work and other activities. Stress decreases the immune system's ability to protect against bacteria and ­viruses.

Do not touch your mouth, nose or ears without washing your hands first, as these are portals of entry for ­microorganisms. If you develop cold or flu-like symptoms, stay home, ­limit exposure to others, stay well ­hydrated, get ­plenty of sleep and allow your body time to ­recover.

Support immunity
Cold and flu viruses are ­constantly mutating and dividing to form new strains. Our bodies have never encountered these strains before, so as they say in sports-the best offense is a good ­defense.
When you support the natural processes of your body, you bounce back and recover quickly from any cold or flu virus that you may contract. There are many natural treatments available to boost your immune system, such as ­vitamin C (with bioflavonoids), zinc, vitamin A, garlic, probiotics, essential ­fatty acids, and herbal and homeopathic ­remedies.

Some of the options available may also help to prevent infection or, if taken before getting ill, reduce symptom intensity. Others may be useful to take if you do get ill. Let's take a closer look at a few of these options.

Vitamin D
Flu is generally a seasonal disease, with outbreaks increasing in the late winter as vitamin D levels in the body decline. Flu outbreaks decrease in the summer as vitamin D levels rise.

British epidemiologist Edgar Hope-Simpson was the first to notice a relationship between sunlight and flu. He theorized that ultraviolet light had a protective effect against infection. Eventually, John Cannell suggested vitamin D was the missing piece in Hope-Simpson's theory. Exposure to ultraviolet rays from sunlight triggers vitamin D production in the skin and this, in turn, protects against flu infection. People make vitamin D in the summer and use it up during the winter. By late winter, many people are deficient. Cannell argues that's why ­infections ­increase.

Vitamin D was once thought to be toxic in high doses. Current research, however, says this is not true. The recommended daily allowance for vitamin D is 400 international units (IU) per day, but doses as high as 10,000 IU per day are now considered safe. The ­Canadian Cancer Society recommends 1,000 IU per day during the fall and winter to r­educe risk of cancer.

In 2008, Cannell reported that high doses of vitamin D-2,000 IU per kilogram of body weight-should be taken for three days at the first onset of upper respiratory disease. For someone weighing 100 pounds (about 50 kilograms) that would be 100,000 IU per day! Supposedly, this is useful at fighting off bronchitis, pneumonia and the flu. I am unaware of published research confirming benefit of this high-dose technique.
Low vitamin D levels in the body are correlated with increased risk of upper respiratory tract infections. Vitamin D does appear to prevent and treat infectious disease. A review article (Endocrine Practice, July 2009) examined randomized, controlled, clinical trials that studied vitamin D for treatment or prevention of infectious diseases in humans. The authors identified 13 trials conducted from 1948 to present, 10 of which were double-blind, and reported that "the strongest evidence supports … adjunctive vitamin D therapy for tuberculosis, influenza, and viral upper respiratory tract illnesses."

Although not definitive studies, these are promising and, as there is little risk in taking vitamin D, I am encouraging all of my patients to do so.

N-acetyl-cysteine (NAC) or glutathione
NAC provides the body with cysteine, the raw material needed to make glutathione internally. Glutathione is the main antioxidant used within cells. Increasing antioxidant activity inside the cells does a surprising number of useful things, including protect against oxidative damage, of course.
In a double-blind, placebo-controlled trial (The European Respiratory Journal, July 1997), 262 participants who were 65 years of age or older took 1,200 milligrams (mg) per day of NAC for six months, during the winter. Those taking NAC reported far fewer episodes and milder symptoms of flu that winter. Yet, when tested in the spring, a similar proportion of the NAC group tested positive for having been infected as the group of people taking only placebo. The NAC didn't prevent people from catching the flu; it simply prevented them from suffering with it.

Probiotics and herbs
Several studies tell us that probiotics also decrease flu and cold symptom intensity even if they don't always protect people from getting sick. The most recent study in the August 2009 issue of Pediatrics suggests significant benefit from taking daily doses of probiotics.

Since the flu changes every season, the treatments that we know worked well in previous years may not work as well this year. This seems especially true when seeking to treat these illnesses with either herbs or homeopathic medicines.

Lively discussion has occurred amongst professional herbalists over the last few months on this year's flu. Paul Bergner of the North American ­Institute of Herbal Medicine in Boulder and publisher of Medical Herbalist suggests several herbs to consider using, including elderberry (Sambucus nigra), boneset (Eupatorioum perfoliatum) and echinacea. All three have a long history of successfully reducing the symptoms and discomfort of flu both historically and in recent years.

I often use boneset for just what the name implies-to help fractured bones set faster. The keynote symptom that leads us to prescribe it for cases of the flu is bone pain, that deep ache felt in the bones. This symptom is common in HIN1, a virulent flu virus that I am sure you are well aware of.
Recently, a proprietary extract of elderberry developed by a virologist in Israel became popular after studies demonstrated that it significantly shortened the duration and intensity of flu infections. This product and other ­elderberry extracts are also being considered for cancer treatment because they reduce ­inflammatory cytokines. Reducing ­inflammatory cytokines is also a goal in treating these H1N1 viral infections. A paper in Phytochemistry (July 2009) ­reported that elderberry extracts have ­direct antiviral activity on the H1N1 flu virus, an effect that is comparable to ­antiviral prescription drugs.

There are several other herbs and plant extracts to consider for treating flu infections. They include garlic (Allium sativa), ginseng (Panax quinquefolium), olive leaf, Siberian ginseng (Eleutherococcus senticosus), larch arabinogalactan (Larix), astragalus (Astragalus membranaceous), and Baptisia tinctoria.

Homeopathy
According to homeopathy, one does not pick the correct homeopathic medicine based on the disease but on ­specific and unique symptoms. Thus, homeopathic books may list a ­dozen or more medicines to choose from to treat the flu. Picking which one is a matter of picking out the unique symptoms of the ­individual patient. Practitioners look at the patient's mood, body temperature, thirst and so on. Having said that, let me contradict myself and say that it is nevertheless common to see a particular homeopathic remedy used more often during a given annual flu season. The problem is that the particular remedy seems to vary from year to year.

Dr. Paul Herscu, author of the Homeopathic Treatment of Children (North Atlantic Books, 1993) and founder of the New England School of Homeopathy, has been teaching about this phenomenon for several years. Herscu surveys homeopathic practitioners to see which medicines are proving most effective each flu season. ­Homeopathic Phosphorous was the most common ­homeopathic medicine for the 2007/08 flu, while last winter in 2008/09, Nux-vomica won the award. The biggest difference in symptoms is that the person who will respond to Phosphorous is cheerful despite being ill, while the Nux-vomica patient is quite irritable.

Nutritional supplements and herbal medicine are important but are only one aspect of health during cold and flu season. A positive mental attitude, healthy diet and managing stress is critical to achieving and maintaining good health in the long run.

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