Strengthening Your Immune System for a Healthy Winter

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Strengthening Your Immune System for a Healthy Winter

In early fall, squirrels start gathering acorns, honeybees turn to their supply of honey, birds begin to migrate south, and bears get ready for hibernation. Even plants and trees start prepping for the cold months ahead by dropping their leaves to conserve water.  

Humans tend to prepare for winter by winterizing their homes and pulling out warm clothes.  And yes, like birds, many people travel to warmer climates. This year, however, has seen many changes and interruptions to our daily lives, due to the coronavirus pandemic. What’s most concerning is an ongoing COVID-19 surge; to make matters worse, flu season has started, as well. Just like animals and plants prepare for colder months, it’s important to give your immune system a fighting chance to stay safe and healthy over the winter. Read on to learn how. 

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Medical conditions and immunity

It’s no secret that pre-existing medical conditions, including diabetes, cancer, HIV/AIDS and malnutrition, for example, can increase your chances of becoming sick. When it comes to diabetes, though, you’re in the driver’s seat — in other words, it’s not inevitable that you’ll get sick. However, it does require effort on your part. 

With the help and support from your diabetes care team, family and friends, you can better manage your diabetes if your blood sugars and A1C are not at target. A first step is to meet with your healthcare provider and diabetes educator to review your diabetes treatment plan and discuss ways that can help you get back on track. Steps may include changing the amount or type of medication you take, checking your blood sugars regularly, counting carbs and making healthier food choices, and finding ways to fit physical activity into your daily routine. Asking for help from family and friends can make it easier to stay on track, too.   

Vaccinations and immunity

Currently, there’s no vaccine for COVID-19, but there are vaccines that people with diabetes should get according to the Association of Diabetes Care and Education Specialists. These include: 

  • Influenza vaccine: Complications from the flu, such as pneumonia and bronchitis, can be more severe in people with diabetes, leading to hospitalizations and sometimes death. An annual flu shot is the most effective way to prevent complications from the flu. 
  • Pneumococcal vaccine: Having diabetes puts you at risk of pneumonia, bacteremia (blood infection) and meningitis, which are potentially deadly infections caused by the pneumococcus bacteria. Having the flu also increases the risk of pneumococcal disease. The CDC (Centers for Disease Control and Prevention) recommends people with diabetes get a dose of pneumococcal vaccine before the age of 65 and two more doses after. 
  • Tdap vaccine: This vaccine protects against tetanus, diphtheria and pertussis, which can cause lockjaw, croup and whooping cough. A tetanus booster is recommended every 10 years after receiving the Tdap vaccine. 
  • Shingles vaccine: The risk of shingles and postherpetic neuralgia increases as you get older, and having diabetes increases the risk of getting shingles. The CDC recommends that all adults aged 50 or older receive a shingles vaccine. 
  • Hepatitis B vaccine: The hepatitis B virus (HBV) attacks the liver and can cause cirrhosis and liver cancer. HBV is transmitted through blood and other bodily fluids, so it’s important never to share meters, insulin pens or syringesor lancets with anyone. The CDC recommends hepatitis B vaccine for adults under the age of 60.  

Sleep and immunity

Not getting enough sleep can do more than just make you feel groggy and grumpy: it can actually weaken your immune system, making it more likely to get sick after being exposed to a virus, such as the common cold virus and even the flu. In addition, a lack of sleep can lengthen the recovery time if you do become ill. 

When you’re short on sleep, your body makes fewer cytokines, says the National Sleep Foundation. Cytokines are proteins that have various jobs, including promoting sleep; stimulating the production of blood cells; helping to develop, maintain and repair tissue; and regulating the immune system. Not enough sleep means that you have less of these important proteins to ward off infection. There’s also a lower antibody response when you’re sleep deprived, further increasing your risk of becoming sick.  And less sleep can mean higher blood sugar levels. Longer-term, insufficient sleep can raise the risk of heart disease, diabetes and obesity.  

What’s the right amount of sleep? Researchers believe that between seven and nine hours of sleep on a nightly basis can help you better manage your diabetes and lessen the chances of developing other health problems. 

If you have trouble getting enough sleep or getting enough quality sleep, let your healthcare provider know. They can work with you to identify the cause and then recommend a treatment plan, and even refer you to a sleep specialist, if indicated. 

Smoking and immunity

Smokers have more health problems due to smoking and are likely to die earlier by a decade or more compared to people who don’t smoke. Smoking can weaken the immune system, making the body less successful at fighting disease, according to the CDC. Smoking can even disrupt the balance of the immune system, increasing the risk of autoimmune disorders, such as rheumatoid arthritis. This is an autoimmune disease in which the immune system attacks the joints and causes swelling and pain.  

Smoking can cause lung diseases, as well, including chronic bronchitis, emphysema and lung cancer. Current and former smokers are at high risk of severe illness from COVID-19. 

Stopping smoking can be hard, but there are ways to help you quit. Your provider might recommend medications, for example. Common medications include over-the-counter products such as nicotine patches, lozenges and gum, as well as prescription medications. You can also call 1-800-QUIT-NOW (784-8669) or visit for additional help.  

Stress and immunity

Events from 2020 have given all of us more stress than we bargained for, that’s for sure! Stress is a normal part of life and the key is learning how to cope with it. When you can’t cope with stress, however, that’s when it can impact your health.  

Some stress can be good, because it signals the body to release cortisol, a stress hormone. Surprisingly, short bursts of cortisol release can actually enhance immunity. But if stress is chronic, leading to high levels of cortisol, it can negatively impact the immune system, leading to inflammation. Stress also impacts white blood cells called lymphocytes, which help fight off infection. Low levels of lymphocytes can leave you somewhat defenseless in fighting off infections. And if you do become ill, it can take longer than usual to recover.  

Being in a constant state of stress can bring on anxiety and depression, which can also cause inflammation and make it harder to manage your diabetes. Blood sugars that stay high over long periods of time raise your risk of complications and also weaken your immune system. You can see how this can become a vicious cycle. 

There are a lot of ways to reduce stress, such as meditation, deep breathing, physical activity and connecting with others. Even watching a funny movie or TV show can do wonders. Some people find journaling helps them to identify sources of stress and possible solutions. Eating healthfully, getting enough sleep, and avoiding alcohol, drugs and smoking can help, too. Talking with your provider or a counselor can be beneficial if you continue to have anxiety or depression.  

For more tips on how to manage stress, visit HelpGuide. 

Loneliness and immunity

Thanks to social distancing due to the pandemic, many of us are connecting less with family, friends and coworkers. While social distancing can help reduce the spread of coronavirus, unfortunately, it can raise the likelihood of feeling isolated and lonely, as well as stress, anxiety and depression. 

Loneliness, which is the feeling of being alone, regardless of the amount of social contact, can have a number of health impacts, such as higher rates of: 

  • Premature death 
  • Dementia 
  • Heart disease and stroke 
  • Depression, anxiety and suicide 

When you’re lonely, levels of cortisol increase that can impair the immune system, leading to health issues like inflammation and heart disease. Ways to banish loneliness include: 

  • Keeping to a regular schedule of eating, sleeping, housework, etc.  
  • Staying active, either by walking around your neighborhood or a workout out with YouTube videos .
  • Taking an online course to learn a new skill or new language, or visiting museums (virtually, of course!).
  • Connecting with family and friends by letter-writing, phone calls or video chats.
  • Talking to someone else who is stuck at home by using QuarantineChat, a free service that lets you connect with others. For more information, visit the QuarantineChat website. 
  • Volunteering virtually. There are a number of ways to do help others without leaving your house. Check out for ideas. 

Getting ready for the upcoming winter months can help you stay healthy, both physically and mentally, and before you know it, spring will be here! 

Want to learn more about keeping your immune system in shape? Read “Ways to Support Your Immune System: Fact or Fiction,” “Type 1 Diabetes: Meet Your Immune System” and “Type 1 Diabetes: Five Vaccines That You May Need.”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter,, and

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