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Cold, Flu, and COVID Season - Immune-Boosting Basics

Winter is just around the corner, and this year cold and flu season has been taken to a new level - cold, flu, and COVID season.

In addition to frequent hand washing, not touching your face, and proper social distancing, nutrient supplementation may provide an extra measure this winter to boost immune system function and reduce the risk of illness.

We absorb Vitamin D through direct sunlight, which is why vitamin D deficiency is common in northern climates.

Vitamin D reduces inflammation and supports a healthy gut microbiome. Vitamin D also boosts our cells’ ability to fight off microbes, including the cells lining our mouth, throat, and lungs.

Supplementing with Vitamin D has been shown to reduce your risk of developing an acute respiratory infection, and should you become ill, Vitamin D has also been shown to reduce the severity and duration of illness, and reduce complications.

• For prevention, consider 2000-5000IU Vitamin D3 daily with food.
• I routinely check Vitamin D levels in many patients and aim for a 25, OH Vitamin D level of 60-70.



Vitamin C is an immune system powerhouse. This antioxidant reduces inflammation, increases the production of white blood cells, and helps to strengthen blood vessels. Vitamin C is essential in the formation of collagen, which promotes healthy skin and muscle tissue. A lack of Vitamin C makes you more prone to illness, and should you develop a respiratory illness, Vitamin C has been shown to reduce the duration and severity, and reduce complications by protecting your own tissues from damage.

Vitamin C has been used in many hospital ICUs for the treatment of COVID-19.

• For prevention, 500-1000mg daily
• Choose a buffered form of Vitamin C for less stomach upset



Elderberry (Sambucus nigra) has widespread historical use as an anti-viral herb and has been used extensively in the prevention of influenza.

Elderberry is rich in vitamin C, antioxidants, and fiber. Research suggests that elderberry is most effective when used for prevention, or when taken early on in the course of a respiratory virus.

• For prevention, consider 500mg orally, daily (of USP standard of 17% anthocyanosides).
• Caution should be used in those with autoimmune conditions.



Zinc has a large body of research showing its strong anti-viral properties against many viruses, and zinc supplementation has been found to reduce the duration of symptoms of the common cold.

Zinc promotes antibody and white blood cell production and reduces oxidative stress. In addition, zinc has properties that fight infection directly, and zinc lozenges may reduce the risk of developing a respiratory illness.

For prevention (zinc acetate, citrate, picolinate, or glycinate), 30-60mg daily in divided doses for three months, then reduce to 15-30mg daily.

• For acute respiratory illness, begin zinc lozenges at the first sign of symptoms.



There are a number of nutraceuticals that have demonstrated immune-boosting properties. The choice of which and how many nutraceuticals to incorporate into your prevention plan will be different for each person. Factors to consider include cost, underlying chronic medical conditions, and the degree of possible virus exposure.

Subscribe to my blog for future posts highlighting other immune-boosting nutraceuticals.

Please note: Due to the novelty of COVID-19, no peer-reviewed research has been published regarding the effectiveness of dietary or lifestyle interventions for its prevention or treatment. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Consult your healthcare provider prior to use of any nutraceutical.

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. During the COVID-19 pandemic, I continue to see patients from all over the state of Michigan using our secure, video-visit format. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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12 Weeks = Amazing Results

Recently I wrote about Insulin Resistance, a common disorder I see in my practice. This post highlights my recent experience with Beverly*, who lost nearly 30 pounds and dramatically increased her energy in just 12 weeks - simply by identifying where her imbalances were and making a few simple changes that improved her insulin sensitivity.

Meet Beverly*, Age 60

When Bev first sat across the table from me this past August, she said "I feel off balance". She couldn't pin-point it, but something just didn't feel right. She felt more and more fatigue, especially mid-afternoon when she had her energy "slumps". She was gaining weight steadily and was feeling "old".

During our discussion I learned more about Bev. She had her thyroid removed a few years ago due to a large goiter. While her temperature fluctuations and heart palpitations had improved, her energy levels had not. She had also described high levels of stress during the past few years. She had made progress with her stress management but in general felt "worn down".

Bev's medication list included thyroid replacement, and two medications for high blood pressure. On examining her I noted that her weight gain was primarily around her abdomen. I also noted an elevated heart rate and increased reflexes.

We then obtained some data with a blood draw, and Bev's laboratory results confirmed my suspicions. Now remember - I am a Functional Medicine physician - so I often order labs that other doctors may not order. I also interpret the lab results differently, looking for patterns and clues that relate to the individual and their symptoms, and desiring "optimal" results, not "normal" results. Bev's blood sugars were normal, but she had significantly elevated morning insulin (normal less than 10, hers was greater than 50. While her thyroid tests were "within normal range", they showed her thyroid was functioning on the high-end of normal, which explained her elevated heart rate and hyper-reflexes.

Now it was time to get to work. Bev had insulin resistance! This had likely been creeping up over many years, and was made worse the past 3 years by elevated cortisol as a result of the stress she had been experiencing. To make matters worse, one of the two blood pressure medications she was on was known to worsen insulin resistance. My Functional/Integrative approach to Bev's care was simple and straightforward, focusing on:
  1. Correcting her underlying hormone imbalance
  2. Removing the foods that were working against her by limiting the refined carbohydrates and sugar from her diet
  3. Using targeted supplementation to treat her insulin resistance

Hormone balance

While getting to work on treating her insulin resistance, we also had to balance Bev's thyroid. I lowered her dose of thyroid medication and within a week she felt a difference. Her heart rate came down and she began to feel more "at ease". This is an important point because so many women want to add more thyroid medication - but more isn't always better! An overactive thyroid can also contribute to fatigue. It's all about balance!

Removing offending foods

I presented Bev with a meal plan that included real, clean food. Her plan involved 2 prepared meals, two meal replacement shakes, and healthy snack options. Her two prepared meals each included lean, clean protein, lots of vegetables and healthy fat. We limited her starches and grains and had her choose from gluten-free, high-fiber varieties. The timing of her meals was also important! She was not to go more than 3-4 hours without eating (to balance her blood sugars). We used meal replacement to provide adequate protein and help her with meal structure (meal replacement can often help take some of the "work" out of diet change.

Targeted supplementation

Bev's supplementation recommendations were designed to help correct her insulin resistance, and included chromium, ALA, Fish Oil and PGX.

Chromium - helps insulin to do it's job! Chromium helps insulin transport blood sugar into cells more efficiently, providing cells with much-needed energy.

Alpha-lipoic Acid (ALA) - enhances the insulin receptor on the cell's surface, allowing insulin to enter the cells more easily (there is actually a direct binding site for ALA on the insulin receptor). ALA also acts as an antioxidant, reducing cell damage.

Fish Oil - contains two key substances - EPA and DHA - which help form and strengthen cell membranes, keeps them from getting stiff. This improves cellular communication and helps insulin receptors work properly.

PGX - a novel fiber blend, PGX is taken with a glass of water about 15-20 minutes prior to meals. The flavorless granules can also be sprinkled over food or taken as capsules. The PGX fiber expands into a gelatinous "blob" in your stomach. This helps you to:
  • feel full after eating less food
  • release any glucose from your meal into your blood stream more slowly
  • reduce insulin and blood sugar spikes
  • reduce hunger and sugar cravings.

Within 2 weeks Bev had lost over 7 pounds and reported less brain fog and more consistent energy.
At the end of 12 weeks she had lost 29.6 pounds, 5.5 inches off her waist, and 3 inches off her hips!

She felt great and was no longer getting a dip in her energy levels in the middle of the day. Repeat blood testing showed that her fasting insulin level was cut by more than half. She was completely off one blood pressure medication (the one that was making her insulin resistance worse) and was down to a fraction of a dose of her other blood pressure medication. She had lost so much weight that we had to lower her thyroid dose even further!

The best part? She kept saying over and over "I really just can't wrap my head around it, this has been so easy". The changes Bev made were simple and straightforward. She continued to live her life and did not have to remove herself from society in order to make the necessary changes (she even traveled, ate at restaurants and hosted parties). In just 12 weeks, Bev not only changed her life, she created a plan for lasting change.

Yours in Health,

Carin Nielsen, MD

*while this represents a true story, the patient name has been changed to protect his/her identity and privacy

Carin Nielsen, MD Integrative MedicineI use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions. Treating symptoms and chronic disease simply by prescribing medication doesn't address the underlying factors that contributed your problems in the first place, and is not likely to provide lasting results. My approach involves getting "under the surface" to find and correct underlying imbalances. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.
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There goes our daylight - Do you know your Vitamin D level?

Last week I had a follow-up visit with a male patient in his early 40s who had come to see me for muscle aches and decreased muscle stamina with exercise. He was having soreness on a daily basis, particularly in his upper thighs.  Laboratory workup had revealed significant Vitamin D deficiency. He reported at his follow up visit that after only 3-5 days of high-dose Vitamin D supplementation, his muscle symptoms were noticeably improved.

He was surprised to hear that I see this quite frequently, both Vitamin D deficiency and other patients with similar symptoms of muscle aches that improve when Vitamin D intake is increased. My medical practice is in Northern Michigan, and Vitamin D deficiency is quite common. I have been checking Vitamin D levels routinely on my patients for many years, and I rarely find an "optimal" level, let alone a level that isn’t deficient!


Why is your Vitamin D level important?

Did you know that Vitamin D is actually a fat-soluble hormone?  Your body produces Vitamin D in your skin when exposed to sunshine or ultraviolet light. Knowing that, it’s not surprising that north of the 45th parallel Vitamin D deficiency is quite common!

Vitamin D is necessary to absorb calcium, it helps to regulate the levels of calcium and phosphorus in the body, and together with these minerals works to maintain bone strength and integrity. The benefits of Vitamin D intake on bone health and reduction of osteoporosis is well documented by randomized controlled trials and evidence has also linked Vitamin D intake to reduced falls in the elderly.

A growing body of research suggests that Vitamin D intake may be linked to reduced risk of cancer (specifically breast, prostate and colon cancer), depression, autoimmune disease, and heart disease, although further studies are needed to verify these results.  Vitamin D deficiency has been linked to chronic muscle aches and pains, and (as described above) I have observed numerous patients with chronic diffuse muscle pain (especially in the thighs and forearms) get relief when restoring their Vitamin D levels to normal.

Do you know your Vitamin D level?

When testing your Vitamin D level, it is important to order the correct test. There are two tests for Vitamin D – 1,25(OH) Vitamin D or 25(OH) Vitamin D. 25(OH) Vitamin D is the best test as it is the best marker of overall Vitamin D status. 

A level below 30 ng/dl is considered deficient. In my practice we first look to raise levels above 30 into the “normal range”, and then look to get levels in the “optimal range” (those of you who are clients of mine know that this is a frequent topic of conversation, what is normal for one person may not be normal for another, and therefore when interpreting test results we strive for the optimal level for best health). Opinions vary as to “optimal” Vitamin D levels.  I strive to get levels to at least 48 ng/dl, as a comprehensive review of evidence from various studies found this level to be optimal for cancer prevention.

How do you raise your Vitamin D levels?

There are two types of Vitamin D: Vitamin D3 (cholecalciferol – which is the type of Vitamin D synthesized in your skin when exposed to sunlight), and Vitamin D2 (ergocalciferol – found in Vitamin D fortified foods and synthesized by plants).

Vitamin D3 is better utilized by the body than D2, and is the preferred source for supplementing. Vitamin D3 is found in eggs, organ meats, animal fat, cod liver oil, and fish.  It is also available in both liquid and capsule supplements.  If you are considering supplementing with Vitamin D speak with your physician about what dose is most appropriate for you.

Can I get too much Vitamin D?

Yes!  While Vitamin D toxicity is rare, it can happen if you over-supplement. Unlike many water-soluble vitamins, Vitamin D is fat-soluble and excess intake will store in your fatty tissues. Excess Vitamin D intake has also been linked to kidney stone formation.

For more information, or if you are interested in having your Vitamin D levels tested, contact our office at 231-638-5585 or This email address is being protected from spambots. You need JavaScript enabled to view it..





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