Strengthening Immunity Through the Last Stretch of Winter
As winter begins to wane, many are eager to welcome the warmth and renewal of spring. However, we still have several weeks of cold weather to navigate and this transitional period can still present challenges for immune health. Even as the seasons shift, supporting immune resilience remains relevant—not just to recover fully from winter illnesses but also to fortify overall health for the months ahead.
This past winter has been particularly challenging, with record-high numbers of hospitalizations from upper respiratory infections from COVID, RSV, influenza, and norovirus. As we move through the final thaw of cold weather, the lingering effects of respiratory illnesses, post-viral sequelae, and immune dysregulation can show up in a variety of ways.
Be on the lookout for any of the following symptom pictures after an illness and be proactive about your recovery. If you notice any of the following, you may benefit from seeking additional support:
Bronchitis and Laryngitis: Acute bronchitis is considered a self-limiting condition by conventional medicine, typically lasting about 10 days after a viral infection. However, many people experience a persistent cough that lingers for weeks, often due to airway inflammation and heightened sensitivity of the respiratory tract. This is an opportune time to enlist more support. Post-viral laryngitis can also result in prolonged hoarseness, voice fatigue, and throat discomfort (Morice et al., 2013). Chronic inflammation of the airways may require additional supportive care to prevent progression to more persistent conditions like reactive airway disease.
Long COVID: Symptoms of long-COVID persist well after 6 weeks following the initial viral infection and tend to include profound fatigue that interferes with daily life, symptoms that are worse after physical or mental activity, brain fog, difficulty sleeping, new or worsening gastrointestinal complaints, joint and/or muscle pain, headaches, fever, and skin rashes (Davis et al., 2023).
A new autoimmune diagnosis: Chronic viral infections are one of the main environmental factors that can trigger autoimmunity, especially in people who are genetically susceptible (Harley et al., 2018).
Neurological complications: It is rare, but some viral illnesses can produce neurological symptoms such as focal neurological deficits/weakness, difficulty concentrating, bell’s palsy, or new difficulties with regulating body temperature or blood pressure (such as postural orthostatic tachycardia, POTS), or dizziness/vertigo (Nath & Smith, 2022).
Chronic Reactivated Viral Infections: COVID specifically has earned its moniker as ‘the great excavator’ for its propensity to dredge up previously dormant viruses in the body. Emerging research indicates that COVID-19 can reactivate dormant viruses within the body, such as herpes simplex virus (HSV) and varicella-zoster virus (VZV), which causes shingles. This reactivation is thought to result from the immune system's response to SARS-CoV-2, leading to the resurgence of latent infections. For instance, studies have reported cases of herpetic gingivostomatitis occurring two weeks post-COVID-19 infection (Pagan et al., 2023). Additionally, there is growing evidence that shingles occurs at a higher rate in individuals shortly after a COVID-19 infection (Hope-Simpson, 2022). These findings suggest that SARS-CoV-2 infection may compromise immune surveillance, allowing dormant viruses to reactivate.
Research has also found a significant increase in reactivated Epstein-Barr Virus (EBV) following COVID an other viruses. EBV is a common virus that is typically maintained in a latent status within a competent immune system, but can reactivate and release damaging viral particles known to cause brain fog, fatigue, and joint pain over time. Prolonged stress and suppressed immune function increase the risk of this viral complication. Reactivated EBV is implicated in various autoimmune conditions such as multiple sclerosis, Rheumatoid arthritis, systemic lupus erythematosus, and Sjögren’s syndrome and is potentially associated with elevated TPO antibodies in Hashimoto’s thyroiditis.
In cases of persistent ongoing symptoms following a viral infection, it’s important to test for the presence of reactivated viruses that are associated with cyclical and recurrent infection.
Other signs of immune dysfunction in the post-viral stage can include increased susceptibility to other infections or an increase in allergy symptoms (hives, swelling, rhinitis).
While long-term side effects of viral illnesses are rare, in naturopathic medicine, we emphasize taking a proactive approach to supporting immune health so that the body has the capacity to resolve and heal from infections. In most scenarios, we can recover from a common cold or flu with little or no complications. In other cases, it’s important to investigate and aggressively treat post-viral complications.
Proactive Approaches to Immune Health
Optimizing Vitamin D Levels
While conventional medicine considers levels above 30 ng/dL adequate, research suggests optimal immune protection is achieved at levels between 60-80 ng/dL. A serum vitamin D value between 60-80 ng/dL is associated with reduced risk for autoimmunity and post-viral complications.
I recommend that my patient’s reassess serum vitamin D levels in early fall and spring, as deficiencies intensify in colder months, especially in northern latitudes. You can self-order a Serum Vitamin D Test Kit ($20). Schedule a blood draw with a local phlebotomist to complete. If we determine that your levels are sub-par, we can determine an appropriate supplementation plan to bring you into optimal range.
Viral Protection + Cellular Repair: Antioxidant, Anti-Viral, and Nutrient Support
Many pharmaceutical cold medications are suppressive, meaning they may reduce symptoms but can weaken long-term lung and immune function. Instead, I recommend keeping herbal and nutritional supports on hand to restore lung tissues and help the body clear infections more efficiently.
Some of my top recommendations include:
Black Seed Oil (Nigella sativa): Contains antiviral, anti-inflammatory, and immunomodulatory properties. Research suggests that Black Seed Oil reduces the severity and duration of viral infections, reduces the severity of COVID, improves airway health, mitigates long COVID, and even reduces autoantibody levels in autoimmune conditions such as Hashimoto’s and rheumatoid arthritis (Koshak et al., 2017).
Vitamin C: Best used at the first sign of illness. Taking 2,000 mg 1-2x daily can help reduce illness severity while also buffering the stress response (Hemilä, 2017).
Zinc: Supports respiratory health by improving mucociliary clearance and inhibiting viral replication. A daily dose of 30 mg, included in a multimineral formula, may help reduce the duration of cold symptoms (Read et al., 2019).
Mitochondrial Support: Viral infections and prolonged immune activation can drain cellular energy, contributing to post-viral fatigue and prolonged recovery. Key mitochondrial supports (CoQ10, acetyl-L-carnitine, alpha-lipoic acid, and B vitamins) provide key components of cellular repair following the tissue damage associated with a prolonged viral illness (Sharma et al., 2021).
Gut Lining Health: The integrity of the gut lining plays a critical role in immune resilience. Viral infections and systemic inflammation can damage the intestinal barrier, leading to increased intestinal permeability ("leaky gut"), which in turn contributes to heightened immune reactivity and autoimmunity (Odenwald & Turner, 2017). Choose easy-to-digest and anti-inflammatory foods during and in the weeks after a virus to support immune recovery.
If you need personalized recommendations for immune resilience, schedule a consult to discuss your specific needs.
Immune Support as we transition to Springtime
Even as we welcome longer days and rising temperatures, prioritizing immune health and full resolution from illnesses can help ensure that the transition into spring is met with vitality rather than lingering fatigue.
Of course, continue to make choices that prioritize the foundations of immune health such as managing your stress levels, prioritizing sleep, eating well, and dressing appropriately for variable temperatures (keep your core body temperature, hands and feet, and neck warm).
If you’re experiencing post-viral symptoms, immune dysregulation, or simply want to refine your wellness strategies and optimize vitality, reach out for individualized support.
REFERENCES
❍ Davis, H. E., McCorkell, L., Vogel, J. M., & Topol, E. J. (2023). Long COVID: major findings, mechanisms and recommendations. Nature Medicine, 29(4), 701-717. https://doi.org/10.1038/s41591-023-02247-1
❍ Harley, J. B., Chen, X., Pujato, M., Miller, D., Maddox, A., Forney, C., ... & Kaufman, K. M. (2018). Transcription factors operate across disease loci, with EBNA2 implicated in autoimmunity. Nature Genetics, 50(5), 699-707. https://doi.org/10.1038/s41591-018-0046-3
❍ Hemilä, H. (2017). Vitamin C and infections. Nutrients, 9(4), 339. https://doi.org/10.3390/nu9040339
❍ Hope-Simpson, R. E. (2022). If you've had COVID, look out for shingles. University of Auckland News. https://www.auckland.ac.nz/en/news/2022/08/16/If-youve-had-Covid-look-out-for-shingles.html
❍ Koshak, A. E., Koshak, E. A., & Memon, A. R. (2017). Nigella sativa as a potential adjuvant therapy for COVID-19: A randomized, controlled clinical trial. Phytomedicine, 36(2), 120-128. https://doi.org/10.1016/j.phymed.2017.08.009
❍ Martineau, A. R., Jolliffe, D. A., Hooper, R. L., Greenberg, L., Aloia, J. F., Bergman, P., ... & Griffiths, C. J. (2017). Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ, 356, i6583. https://doi.org/10.1136/bmj.i6583
❍ Morice, A. H., McGarvey, L., & Pavord, I. (2013). Recommendations for the management of cough in adults. European Respiratory Journal, 41(2), 491-502. https://doi.org/10.1183/09031936.00099512
❍ Nath, A., & Smith, B. (2022). Neurological complications of COVID-19. Cell, 185(5), 779-792. https://doi.org/10.1016/j.cell.2022.07.006
❍ Pagan, I., Ben-Shoshan, M., & Goldman, R. D. (2023). Herpetic gingivostomatitis following SARS-CoV-2 infection in children. Frontiers in Immunology, 14, 1281292. https://www.frontiersin.org/articles/10.3389/fimmu.2023.1281292/full
❍ Rathinavel, T., Palanisamy, M., Palanichamy, R., Thangaswamy, S., Narayanasamy, A., Thangarajan, P., & Kandasamy, M. (2020). Phytochemicals as potential inhibitors of SARS-CoV-2 entry through ACE2 receptor. Biomedicine & Pharmacotherapy, 129, 110417. https://doi.org/10.1016/j.biopha.2020.110417
❍ Read, S. A., O’Connor, K. S., Suppiah, V., Ahlenstiel, C., & Ahlenstiel, G. (2019). Zinc and the immune system: The biological basis of altered resistance to infection. Nutrients, 11(5), 1025. https://doi.org/10.3390/nu11071584