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Can You Protect Yourself from the Flu?

Strengthen your immune system and stay away from sick people as much as you can if you want to protect yourself from the flu this winter.

It’s that time of year. Lots of people are miserable with colds, coughs or the flu. What will you do to protect yourself from the flu and keep from coming down with something nasty?

Will Astragalus or Elderberry Help You Ward Off Infection?

Q. I have heard that astragalus and elderberry are supposed to build up the immune system to aid in flu prevention. Is this just wishful thinking?

A. Astragalus membranaceus has been used in traditional Chinese medicine to prevent infectious diseases such as influenza (Chinese Journal of Integrative Medicine, April 2020). A recent meta-analysis found that this herbal medicine boosts cellular immunity and reduces inflammatory compounds (Complementary Medicine Research, Nov. 10, 2023).

In contrast, elderberry water extract increased production of inflammatory cytokines the body uses to fight off flu (International Journal of Molecular Sciences, April 1, 2022).

According to the authors, this

 “represents the basis for a strong immune-mediated response to viruses including influenza.”

It sounds as though these two natural medicines work in different ways, but they each offer an option to protect yourself from the flu. Here are a few more.

Practicing Cough Etiquette to Protect Yourself from the Flu:

Chances are good that your mother taught you it’s polite to cover your mouth when you cough. How sound was that advice?

Public health officials call this cough etiquette. Covering a cough is frequently recommended to stop the spread of respiratory infections. Unfortunately, a study of how far droplets actually travel after a cough showed that covering the cough with hands or even an elbow did not eliminate the droplets (BMC Public Health, Sept. 8, 2013). The authors found that most of the cough droplets were smaller than one micron in size. This would allow them to easily penetrate into bystanders’ lungs.

They conclude:

“All the assessed cough etiquette maneuvers have the potential to permit direct, indirect and/or airborne transmission of respiratory infections.”

They also note that covering a cough with your hand instills “a false sense of security.” Although they conducted this research long before the COVID-19 pandemic began, we could find no similar studies of efficacy to update this information.

Will Face Masks Help?

So, what can you do to protect yourself from the flu? Face masks are controversial. The authors of the cough study found that even surgical masks allow small droplets through into the air where they can infect others. However, a meta-analysis found that the data from clinical trials shows that surgical masks and respirators prevent influenza-like illness (Clinical Infectious Diseases, Nov. 13, 2017).

Most people assume that viruses are spread primarily by coughing and sneezing. Research shows, however, that people spread infectious viruses simply by breathing (PNAS, Jan. 30, 2018). This became much more apparent and more serious during the pandemic (Journal of Breath Research, Oct. 2, 2020).

Can You Protect Yourself from the Flu by Washing Your Hands?

Another route of transmission is contamination of the hands. Viruses can persist on surfaces like doorknobs, elevator buttons and gas pump handles. Public health experts urge people to wash their hands frequently. But hand hygiene alone does not appear to prevent the spread of influenza (Epidemiology and Infection, May, 2014). In this study a combination of surgical masks and frequent hand washing worked better than either measure alone to reduce infections.

Stay Home When You Feel Sick:

The best way to prevent the spread of colds and influenza is to stay home when you suspect you might be coming down with a bug. The CDC recommends that people with symptoms like fever, cough and muscle aches avoid other people until at least 24 hours after the fever is gone. The trouble with this sensible recommendation is that many hourly employees don’t have any sick leave. If they don’t show up for work, sick or not, they don’t get paid. They may even lose their jobs. In the interests of public health, American employers should re-think that policy.

Strengthen Your Immune System:

Finally, it makes sense to bolster your immune system. That means getting a good night’s sleep (Journal of Immunology Research, online Aug. 31, 2015). Regular exercise may also help you protect yourself against the flu. Mice allowed to exercise respond better to influenza vaccinations (PLoS One, June 25, 2015). The CDC recommends that everyone over 6 months of age should get a flu shot. This year the flu vaccine is quite similar but not identical to the vaccine used last year (Medical Letter on Drugs and Therapeutics, Oct. 22, 2018).

Vitamin D should also be maintained at optimal levels. Scientists have found that vitamin D helps the lining of the breathing apparatus fight off respiratory viruses (Antiviral Research, Jan. 2017). Immune-boosting herbs such as astragalus, andrographis and ashwagandha may also help you protect yourself from the flu (Alternative Medicine Review, March 2007). So can medicinal mushrooms such as shiitake, maitake and reishi. That may be due in part to their vitamin D content (Nutrients, Oct. 13, 2018). In addition, certain mushrooms seem to bolster immune system activity (International Journal of Medicinal Mushrooms, 2018).

Learn More:

You can learn more about protecting yourself and your family from infections this winter through our Guide to Colds, Coughs & the Flu.  This Guide also offers tips on managing symptoms with natural approaches including vitamin C, zinc and herbs.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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Citations
  • Luo H et al, "Can Chinese Medicine be used for prevention of Corona Virus Disease 2019 (COVID-19)? A review of historical classics, research evidence and current prevention programs." Chinese Journal of Integrative Medicine, April 2020. DOI: 10.1007/s11655-020-3192-6
  • Zhang X et al, "The effect of astragalus on humoral and cellular immune response: A systematic review and meta-analysis of human studies." Complementary Medicine Research, Nov. 10, 2023. DOI: 10.1159/000534826
  • Stich L et al, "Polysaccharides from European black elderberry extract enhance dendritic cell mediated T cell immune responses." International Journal of Molecular Sciences, April 1, 2022. DOI: 10.3390/ijms23073949
  • Zayas G et al, "Effectiveness of cough etiquette maneuvers in disrupting the chain of transmission of infectious respiratory diseases." BMC Public Health, Sept. 8, 2013.
  • Vanden Driessche K et al, "Exposure to cough aerosols and development of pulmonary COVID-19." Journal of Breath Research, Oct. 2, 2020. DOI: 10.1088/1752-7163/abb28c
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