​Immune Health – Cold and Flu Support

With COVID-19 still on the table and the upcoming seasonal occurrences of cold and flu, targeting the immune system and improving one's overall wellness is critical. The right vitality and nutrition plan during this time has the potential to help decrease the frequency, severity, or duration of cold and flu symptoms.

We can decrease this risk with:

1. nutrition
2. supplementation
3. sleep
4. exercise
5. stress management

This is even more important for high-risk populations, such as the elderly, those who are overweight, those with diabetes and other comorbidities causing compromised immune systems.

Want tips and tricks on keeping your body strong during this upcoming cold and flu season? Are you sick now and wish you were more prepared to fight off the cold or flu virus so you can more quickly return to what you enjoy? Then follow along with this protocol developed using only quality evidence.

The following protocol and ingredients below are a reflection of what current research findings show support for when trying to prevent or treat the immune system affecting by cold and flu viruses.

Vitamin C
Adults: 1 g daily as an ongoing maintenance dose3,4, or 3 to 4 g daily at the onset of symptoms and for the duration of illness2,4
Children: 1 to 2 g daily as an ongoing maintenance dose4,2

• Reduces the duration of the common cold by approximately a half-day2, or by 8% in adults and by 14-18% in children4
• Reduces time of confinement by approximately six hours and fever duration by approximately a half-day, relieves chest pain and chills by approximately eight hours when given an extra therapeutic dose at the time of onset of cold2
• Improves antimicrobial and natural killer (NK) cell activities, lymphocyte levels, chemotaxis, delayed T cell responses, sympathetic nervous response, and induces anti-reactive oxygen species activity2
• Decreased duration of cold by 59% and increased weekly activity levels by 39.5% when compared to placebo in otherwise healthy adult males3

Zinc
75-100 mg of elemental zinc as zinc acetate or zinc gluconate lozenges, once per day, within 24 hours of the onset of common cold symptoms, minimum 1 to 2 weeks cold15,16,17,18,19

• Reduces cold duration by 33%15, or by approximately 1.65 to 3 days in healthy adults cold16,17,18,20,21
• Zinc acetate equivalently reduces the duration by 40% and zinc gluconate reduces the duration by 28%15, while other sources indicate greater efficacy with zinc acetate in healthy adults20 
• Reduces the incidence of cold symptoms after 5-7 days in healthy adults and children19,21
• Reduces the duration of muscle soreness by 54%, cough by 46%, voice hoarseness by 43%, nasal congestion by 37%, nasal discharge by 34%, scratchy throat by 33%, sneezing by 22%, and sore throat by 18% in healthy adults19,21
• Reduces the incidence of common cold development, absence from school, and antibiotic use in children1,17
• Improves anti-inflammatory and antioxidant profile via reductions in plasma interleukin-1 receptor antagonist (IL-1ra), intercellular adhesion molecule-1 (ICAM-1), TNF-ɑ, MDA, HAE, and 8-oHdG, and increases in IL-2 mRNA in mononuclear cells in healthy adults21,22
• Reduces duration of symptoms particularly when given within the first 24 hours of symptom onset1,23

Probiotics
Probiotics may reduce the incidence of colds with minor effects on prevention, as well as improve influenza vaccination efficacy for A/H1N1, A/H3N2, and B strains, but is dependent on strain and population.24,25,26
Pediatric: 
Common Cold

• 5 billion CFU of Lactobacillus acidophilus NCFM (ATCC 700396), twice per day, minimum 6 months27
  • Reduces the incidence of fever by 53%, cough by 41%, and antibiotic use by 68%
  • Reduces the duration of fever, coughing, and rhinorrhea by 32%
  • Reduces days absent from childcare by 32%

Influenza

• 10 billion CFU of Bifidobacterium animalis subs. lactis Bi-07 (ATCC PTA-4802) & Lactobacillus acidophilus NCFM (ATCC 700396), twice per day for 6 months27
  • Reduces the incidence of fever by 73%, rhinorrhea by 73%, cough by 62%, and antibiotic use by 84%
  • Reduces the duration of fever, coughing, and rhinorrhea by 48%
  • Reduces days absent from childcare by 28%

Adult:
Common Cold

• 1 billion CFU of Lactobacillus paracasei 8700:2 (DSM 13434) & Lactobacillus plantarum HEAL 9 (DSM 15312), once per day for 3 months28
  • Reduces the incidence of developing more than one common cold episode and number of days with a cold
  • Reduces total symptom scores & pharyngeal symptoms of cold
  • Reduces B lymphocyte proliferation

Influenza

• 10 billion CFU of Lactobacillus fermentum CECT5716, once per day for 2 weeks before influenza vaccination and two weeks after29
  • Reduces the incidence of influenza 5-months after vaccination compared to vaccine alone
  • Increases natural killer cells, T-helper response, and IgA levels
• 10 billion CFU of Lactobacillus rhamnosus GG, twice per day for 4 weeks after influenza vaccination30
  • Increases seroprotection for the H3N2 strain during the supplementation period
• 500 mg of Saccharomyces cerevisiae (EpiCor®), once per day for 12 weeks31,32
  • Reduces the incidence of cold/flu symptoms with or without prior vaccination
  • Reduces the duration of symptoms with prior vaccination

Echinacea purpurea
Prevention: 0.9 mL, three times per day (equivalent to 2400 mg of extract), minimum 4 months9 
Acute: Up to 4.5 mL liquid extract (equivalent to 4000 mg), once per day at the first stage of cold development9

• Reduces the relative risk of cold development by 10-58%10,11
• Reduces days with symptoms by 26% (1.4 days)9,12 and symptom scores by 23%13
• 52% fewer patients requiring concomitant use of aspirin, paracetamol, or ibuprofen9
• Reduces the incidence of cumulative viral infections by 26% and recurring infections by 59%, including influenza virus and parainfluenza virus9
• Increases associated counts for white blood cells, monocytes, neutrophils, and natural killer cells, and suppresses superoxide production in the later-phase of the cold by neutrophils14

American ginseng (Panax quinquefolius)
​400 mg, once per day, minimum 8-16 weeks in healthy adults as a preventative measure5,6,7

• Reduces the duration of colds or acute respiratory infections by approximately 5-6 days5,7
• Reduces the incidence of colds by 25%4, the incidence of influenza and respiratory syncytial virus, and the relative risk of respiratory symptoms by 48%6,8,7
• Reduces total symptom severity score for sore throat, runny nose, sneezing, nasal congestion, malaise, fever, headache, hoarseness, earaches, and cough6

Disclaimer
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Did you know we have a supplement protocol designed with the above cold and flu support topic discussed above. Check it out!
https://us.fullscript.com/protocols/spokane-wellness-immune-health-cold-and-flu-support

References
​1https://www.ncbi.nlm.nih.gov/pubmed/30069463
2https://www.ncbi.nlm.nih.gov/pubmed/23440782
3https://www.ncbi.nlm.nih.gov/pubmed/19592479
4https://www.ncbi.nlm.nih.gov/pubmed/16247099
5https://www.ncbi.nlm.nih.gov/pubmed/16566675
6https://www.ncbi.nlm.nih.gov/pubmed/14687309/
7https://www.ncbi.nlm.nih.gov/pubmed/23024696
8https://www.ncbi.nlm.nih.gov/pubmed/24554461
9https://www.ncbi.nlm.nih.gov/pubmed/16678640
10https://www.ncbi.nlm.nih.gov/pubmed/17597571
11https://www.ncbi.nlm.nih.gov/pubmed/14748902
12https://www.ncbi.nlm.nih.gov/pubmed/16177972
13https://www.ncbi.nlm.nih.gov/pubmed/28515951
14https://www.ncbi.nlm.nih.gov/pubmed/22566526
15https://www.ncbi.nlm.nih.gov/pubmed/27378206
16https://www.ncbi.nlm.nih.gov/pubmed/23775705
17https://www.ncbi.nlm.nih.gov/pubmed/28480298
18https://www.ncbi.nlm.nih.gov/pubmed/25888289
19https://www.ncbi.nlm.nih.gov/pubmed/18279051
20https://www.ncbi.nlm.nih.gov/pubmed/17344507
21https://www.ncbi.nlm.nih.gov/pubmed/23372900
22https://www.ncbi.nlm.nih.gov/pubmed/29416317
23https://www.ncbi.nlm.nih.gov/pubmed/29077061
24https://www.ncbi.nlm.nih.gov/pubmed/19651563
25https://www.ncbi.nlm.nih.gov/pubmed/20803023
26https://www.ncbi.nlm.nih.gov/pubmed/17352961
27https://www.ncbi.nlm.nih.gov/pubmed/21285968
28https://www.ncbi.nlm.nih.gov/pubmed/20180695
29https://www.ncbi.nlm.nih.gov/pubmed/18335698