Fall is upon us, and so is the beginning of the long flu season. The flu is caused by the influenza virus that can cause fever, muscle aches, sore throat and a dry cough. Although the flu usually lasts only three to five days, in more severe cases it can lead to pneumonia and death. The Centers for Disease Control and Prevention estimates that the flu kills 36,000 people each year, most over the age of 65.

An integrative approach to your health may help ward off this nasty infection or reduce how long you have it should you get sick. First, it’s important to strengthen your immune system. Getting a flu vaccine is one way to do this, is readily available and recommended for many people. The effectiveness of the flu vaccine varies widely from year to year. CDC data evaluating vaccine effectiveness from 2005-2017 showed that the ability of flu vaccine to prevent flu varied from only 10% to 60% effective, with an average effectiveness of 41%.

There are several reasons why the flu vaccine is not more effective. It takes many months to manufacture and distribute medicines, and there are many different strains of flu virus, so researchers must make their best estimates as to which strains of the flu will be the most problematic the following winter. Complicating the matter is the fact that the flu virus can mutate, so what they thought would cause the greatest illness could be wrong, rendering the flu vaccine they manufactured ineffective. Since each year the effectiveness varies, if you decide to get the flu vaccine it’s not wise depend solely on the medicine to protect you.

A huge part of staying healthy includes decreasing things that weaken the immune system while increasing those that enhance it. Stress, sleep deprivation and poor diet can wreak havoc on your immune system. Admittedly, we sometimes have little control over sleep and stress. And if you’re the parent of a young children (like I am), adequate sleep isn’t always possible. The point is to get as much sleep as possible and to work towards decreasing your stress.

Unlike sleep, you likely have complete control over our diet and exercise. To big dietary culprits that weaken the immune system are sugar and alcohol. Eliminating added sugar from your diet and limiting alcohol intake can help keep your immune system strong. Eat whole foods rich in vitamins and minerals. And make sure you’re getting adequate amounts of protein and water. If you do start getting sick, eliminate dairy products, which are mucous forming and can trap viruses and bacteria and provide a hospitable environment for them to replicate.

Nutrient requirements vary depending on your age, activity level and any medical conditions, so you may want to discuss this with your doctor or a nutritionist to receive specific immune-boosting dietary advice.

Exercise is crucial for a healthy immune system, but exercising too much can weaken your immunity. One principle taken from Ayurvedic medicine, a more than 3,000-year-old system from India, states that to boost immune function, exercise just to the point of perspiration and then stop. Doing so stimulates circulation and the immune system. For tips on working exercise into your daily life, read Dr. Neustadt’s blog, 5 Simple Ways to Work Exercise into Your Life.

If the full-blown flu does take hold and you start a fever, it may actually be counterproductive to take medicine to decrease it. Fevers are your body’s way of enhancing immune function. It’s generally recommended in otherwise healthy adults not to reduce a fever unless the oral temperature goes above 101 degrees Farenheit. Children can frequently run higher temperatures safely. Since what is considered a safe temperature varies with age and medical conditions, you should discuss your child’s individual situation with your healthcare provider.

There are some warning signs in children that may require immediate professional attention, including convulsions, difficulty breathing, a stiff neck, inconsolable crying, lethargy, difficulty waking up, drooling, difficulty swallowing or if your child has a history of febrile seizures. If any of these occur, call your healthcare provider immediately and/or take your child to the emergency room.

Natural products may also be helpful. A 2004 study in The Journal of International Medical Research showed that adults taking 60 milliliters (mL) daily of the dietary supplement Sambucol, an elderberry extract, significantly decreased the severity of their flu symptoms compared to people who didn’t take it. In 2017 the Journal of Evidence-Based Complementary and Alternative Medicine published a review of the research into using natural products. The researchers concluded that there is scientific evidence regarding the effectiveness of several complementary approaches for colds, including the use of oral zinc, vitamin C and probiotics. Oral zinc and regularly taking vitamin C supplements may reduce the length and severity of a flu. An earlier, 2011 review of the research published in the journal Canadian Family Physicians came to the same conclusions.

Whether or not dietary supplements are a good option for promoting your health is something to discuss with your healthcare provider. If you decide to take dietary supplements, however, it’s important to make sure you’re taking the form and amount shown in clinical trials to work. For example, the clinical trial using Sambucol gave volunteers 60 mL daily (15 mL four times a day); however, the packaging on the Sambucol standardized elderberry syrup available in stores recommends adults take 40 mL per day of the product, which is less than what was used in the clinical trial. To learn more about how you can evaluate dietary supplement quality and the questions you should ask to ensure you’re getting your money’s worth, read Dr. Neustadt’s article, When it Comes to Dietary Supplements, it’s Buyer Beware.

The best way to avoid or treat the flu is to actively participate in your own health on a daily basis. Simple, practical approaches can decrease the likelihood that you’ll get sick or speed your recovery. I hope you and your family have a healthy, enjoyable and powder-filled winter.