It is important to keep your natural immune system strong especially in the winter months to maximize your health and protect against upper respiratory infections (URIs).  There are several effective and integrative techniques you can implement in your daily lifestyle.

Daily Routine and Nutrition

  • Optimize diet and nutrition with a focus on anti-inflammatory foods, like the Mediterranean diet.
  • Get recommended daily exercise and adequate sleep.
  • Reduce stress as best possible.
  • Encourage recovery with Epson salt hot baths, cold water plunges (or even a cold shower), or dry sauna bathing (Finnish-style, infrared or other dry sauna forms). These modalities can help improve adaptation to stress and have immune boosting effects. 
  • Exposure to sunlight for 30 minutes daily in the winter months, if possible. 
  • Wear a scarf to protect your neck. In traditional Chinese medicine, the neck is considered the “wind gate” and vulnerable to wind invasion that can cause either a “wind-cold or wind-heat” URI to enter through the neck area. Wear a scarf on cold days to protect this vulnerable area. 
  • Wash hands when you enter your home.
  • Lastly, do not forget bone broth and chicken noodle soup.  Many studies have shown that the ingredients in chicken soup can boost the immune system, reduce the severity of colds, and aid in recovery. Some researchers believe the amino acids, like arginine, cysteine and glutamine found in broth may help reduce the inflammation. I recommend a bone broth that is slow cooked over 12 hours.

Vitamins and Minerals

  • Adequate vitamin D level is a strong immune booster.  The goal is to have a blood level ranging from 35 – 80 ng/ml.  I recommend having your level checked and then adjust vitamin D dosing as needed. 
  • Vitamin C has long been recognized to help treat upper respiratory infection. This vitamin has antioxidant and anti-inflammatory qualities, and boosts the immune system. Doses range from 500 mg for prevention to 500 – 1000 mg three times daily for treatment
  • Zinc helps boost the immune system and is helpful in the treatment of URIs. It is important not to use zinc for long periods because it can induce copper deficiency due to competitive binding in the gut.  Many forms of zinc exist.  I recommend zinc gluconate, a bioavailable form with a dosage ranging from 9- 24 mg every few hours while symptomatic or zinc lozenges. A common brand is Zicam.  Or Zinc 50 mg tablets twice daily WITH food.
  • N-acetylcysteine (NAC) is the precursor of glutathione. It has a broad range of antioxidant and anti-inflammatory properties. Recommended dosing is 600-1200 mg orally, 2 times daily.

Oropharynx Cleansing

  • Prevention can include targeting the nose and the mouth which are the entry points for respiratory viruses. This includes nasal hygiene with nasal sprays and rinses. They act as a barrier against the virus and alter the environment of the nose and throat reducing viral load. These products can be used regularly and/or in response to exposure.  
  • I recommend the ingredient Xylitol which has been used in dentistry for years. Xylitol has antiviral properties against SARS-CoV-2 and other respiratory illnesses.  In addition, Xylitol has been shown to have anti-inflammatory and antimicrobial properties as well as being helpful for chronic rhinitis. The product I recommend is called Xlear. 
  • 1% povidone-iodine nasal spray is also a potent inhibitor of SARS-CoV-2 and influenza virus. You can use nasal spray daily as needed.   A product to consider is Immunemist, which can be found at Remember, DO NOT share ANY nasal sprays.   
  • Nasal irrigation with salt-water saline may also provide benefit.  
  • Antiseptic mouthwashes also reduce viral respiratory infections.  Look for mouthwash products containing ingredients like chlorhexidine, povidone-iodine or cetylpyridinium chloride. 
  • If you feel the start of an URI, then increase nasal spray and mouth wash gargle to 2-3 times daily to reduce the viral load of the infection.

Herbal Therapy for Adults. (Do Not Recommend in Pregnancy)

  • Andrographis has medicinal properties.  Data shows Andrographis paniculata is superior to placebo in reducing the severity and duration of symptoms. Side effects are minimal and best to start within 48 hours of symptoms. A reasonable dose is 400 mg tablets 3 times daily.
  • Echinacea comes from the coneflower plant. It has shown antiviral and immune-stimulating effects.  It may reduce the severity of symptoms. Note: Echinacea can cause a tingling and numbing sensation on the tongue. A liquid formulation dose is 20 drops 3 times daily for 3 days. 
  • Elderberry comes from the dark purple berry of the elder tree. Elderberry has shown anti-inflammatory, anti-viral and immune stimulatory properties. Some studies have shown that it can reduce symptoms of URI and influenza by 2 – 4 days. I recommend the syrup form. A great homemade syrup can be found at Arrowroot health store in Bryn Mawr. 
  • Use anti-inflammatory ingredients like fresh garlic, ginger, and turmeric when cooking.

There are many evidence-based and integrative techniques you can implement to strengthen your immune system and help prevent and treat upper respiratory infections. A focus on lifestyle factors like nutrition, exercise, stress reduction, and adequate sleep form a solid foundation. Vitamin D, vitamin C, zinc, NAC, and targeted use of herbal medicines like andrographis, echinacea, and elderberry can provide added immune support and symptom relief. Nasal hygiene measures, antiseptic mouthwashes, bone broth, and chicken soup round out a comprehensive URI prevention and treatment plan. As always, check with your doctor before starting any new supplements, especially if pregnant. Stay healthy this winter season!


Sara Slattery, MD 

Concierge Medicine, Integrative Primary Care 

IM | Health

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