Measles, Vitamin A, and Immune Health: What You Need to Know

Measles, Vitamin A, and Immune Health: What You Need to Know

by | Apr 19, 2025 | Immune Health, Naturopathic Medicine, Nutrition, Prevention

A recent confirmed case of measles at Dulles Airport has raised concerns among patients about how to protect themselves and their families. While measles is less common in the U.S. due to high vaccination rates, it can still spread in certain populations, particularly among unvaccinated individuals or those with weakened immunity.

Vaccination is undoubtedly a highly charged topic right now. This post isn’t here to dive into that debate. Instead, it’s intended to focus on the current evidence regarding immune support—specifically the role of vitamin A in measles outcomes—as several patients have reached out with questions in this area. My goal is to offer clarity, not controversy, and to highlight practical, well-supported steps you can take to support your health.

One critical factor in measles severity is vitamin A status. The World Health Organization (WHO) and the CDC recommend high-dose vitamin A supplementation in measles cases to help reduce complications and mortality, particularly in children. But what does this mean for people in the U.S., where vitamin A deficiency is considered uncommon? Let’s break it down.

Measles and Its Risks

Measles is a highly contagious viral illness that spreads through respiratory droplets and can remain airborne for up to two hours (CDC). Symptoms typically include:

  • High fever
  • Cough and runny nose
  • Red rash spreading from the face downward

While many people recover, complications can be serious, ranging from mild (ear infections, diarrhea) to severe (pneumonia, encephalitis, blindness, and even death) (WHO). Vitamin A supplementation has been shown to reduce the severity and mortality of measles, especially in children with vitamin A deficiency (CDC).

Vaccination Rates in the DMV Area

High vaccination rates are critical in preventing outbreaks. The MMR vaccine (measles, mumps, rubella) is typically administered in two doses during childhood. According to the CDC’s National Center for Health Statistics:

  • The national MMR vaccination coverage for children aged 19-35 months is around 90%.
  • Virginia and Maryland have vaccination rates close to this average.
  • Washington, D.C. has made significant efforts to maintain high coverage among school-aged children.

While these rates are relatively high, measles outbreaks still occur when unvaccinated individuals introduce the virus into a community, as seen in past U.S. measles outbreaks.

Historic Measles Outbreaks in the U.S.

Although measles was declared eliminated in 2000, outbreaks continue due to declining vaccination rates in certain communities and travel-related cases (CDC).

  • The most notable outbreak in recent years occurred in 2019, with over 1,200 cases, primarily affecting unvaccinated populations (CDC).
  • The current case at Dulles Airport serves as a reminder that measles can still spread even in highly vaccinated areas if exposure occurs.

Vitamin A and Measles: Why Is It Recommended?

Vitamin A plays a crucial role in immune function, reducing complications, and lowering mortality rates in measles infections.

How Does Vitamin A Help?

  1. Supports Immune Function – Essential for T-cell function, antibody production, and maintaining epithelial barriers, helping the body fight infections (NIH).
  2. Reduces Severity and Complications – Lowers the risk of pneumonia, diarrhea, and eye damage associated with measles (WHO).
  3. Lowers Mortality Rates – Significantly reduces measles-related deaths, particularly in malnourished children (American Journal of Clinical Nutrition).
  4. Prevents Measles-Associated Blindness – Deficiency increases the risk of keratomalacia (severe eye damage) in measles (WHO).
  5. Shortens Disease Duration – Some studies suggest vitamin A reduces hospital stay and speeds recovery from measles (SagePub).

WHO Guidelines for Measles Cases

🔹 Children over 12 months: 200,000 IU of vitamin A for two consecutive days
🔹 Infants (6-12 months): 100,000 IU over two days
🔹 If eye involvement or vitamin A deficiency is present, an additional dose is given 2–4 weeks later (WHO).

Vitamin A Deficiency in the U.S.: Who Is at Risk?

While severe vitamin A deficiency is said to be rare in the U.S., marginal or subclinical deficiency is more common than many realize. Up to 45% of the US Population were found to have marginal vitamin A levels based on reanalysis of 2005–2016 National Health and Nutrition Examination Surveys (NHANES) (Nutrients). In my clinical experience, I frequently see low vitamin A levels in patients with gut health issues and poor dietary intake.

Populations at Higher Risk

  • People with fat malabsorption disorders – Those with celiac disease, Crohn’s disease, small intestinal bacterial overgrowth (SIBO), or liver disease often struggle to absorb fat-soluble vitamins like vitamin A (National Library of Medicine StatPearls).
  • Individuals with low dietary intake – Those who eat low-fat, low-animal-product, or highly processed diets may not get enough vitamin A or its precursor, beta-carotene.
  • People who struggle to convert beta-carotene to vitamin A – Some individuals, due to genetic variations (like BCMO1 mutations), have trouble converting beta-carotene from plant foods into active vitamin A (retinol) (Front Nutr).
  • Those who wear glasses or have poor night vision – Vitamin A is essential for eye health, and some patients who require glasses or have night vision issues may have higher vitamin A needs.

Should You Supplement with Vitamin A?

While vitamin A is critical for immune function, vision, and overall health, high doses should not be taken without medical guidance (NIH).

Would you like guidance on how to assess your vitamin A status or the best food-based sources for your needs? Reach out for a consultation!

Dr. Sarah Giardenelli is a naturopathic doctor, acupuncturist, principle clinician and founder of Collective Health Center based in Leesburg, Virginia, with a deep passion for helping individuals and families build lasting health through thoughtful, evidence-informed care. In her practice, she emphasizes immune resilience, nutritional foundations—including the role of key nutrients like vitamin A—and personalized strategies tailored to each patient. Dr. Giardenelli approaches healthcare with curiosity and discernment, steering clear of dogma from any side of a debate. She is committed to critical thinking, careful evaluation of the research, and empowering her patients to make confident, informed decisions about their health.

Photo by CDC on Unsplash

 Collective Health Center

Excellence in Naturopathic Medicine, Acupuncture, and Integrative Medicine in Leesburg, Virginia for Complex Conditions and Chronic Pain in a Warm and Nurturing Environment.

Are you frustrated of dealing with your symptoms?

Are you ready to look for the answers & optimize your health with natural medicine?

This is how we help.

Contact Us!

9 + 3 =

The Veggie Mash

The Veggie Mash

by | Oct 23, 2021 | Immune Health, Nutrition

We’ve all been told at least once in our life to make sure to finish all the veggies on our plates, and though they aren’t the most appealing part of the meal for some, they truly do make a world of difference to our health! Vegetables, greens, and even seeds are all packed with the nutrients our bodies need to move and, more importantly, flow the ways they should! There are a couple of different ways you can make sure to get both the right amount and the right types of vegetables into your diet without worrying about making your meals boring.

Since it is October and the “spooky season” I’m going to introduce you to the Naturopathic Doctor’s rendition of the Monster Mash – The Vegetable Mash! Just like that graveyard bash, this is a wonderfully fun concept to get you and your family eating more veggies in a way that is healthy AND delicious! The Veggie Mash is exactly what it sounds like, a blend of veggies that is then frozen and added into different meals such as smoothies and soups! It is a way to easily get our proper intake of vegetables for each meal without actually eating just vegetables.

You may be wondering, wouldn’t that taste overwhelming or not very good? And the answer is simply, no! These cubes of frozen vegetable mash can be served with delicious flavors such as chocolate and coffee to make sure that you actually enjoy the new meal you’re creating with them! Aside from adding to bone broth, soups, and smoothies, some of my favorite dishes to add the mash to are roasted root veggies - can be mixed in with the hot root veggies; warm quinoa - can be mixed in or added to in the very last minutes of when the quinoa is cooked, or to the pesto on top of my rice/ quinoa or almond pasta or spiralized zucchini. 

The Benefits:

So now that you know WHAT the Veggie Mash is, let’s talk about WHY you should utilize it to increase the amount of vegetables in your diet. The well-respected physician, Dr. Datis Kharrazian (link to his website) who inspired the veggie mash, has closely studied the benefits of vegetables in our diets. Some of the studies have shown that most chronic diseases such as diabetes, heart disease, and even Alzheimer’s are all associated with low amounts of vegetables in diet! 

Vegetables are our body’s primary source of fiber in our diets, making them great detoxifiers – leading us to better bowel and gut health. The natural bitters in vegetables naturally stimulate bile production in our bodies. The bile then delivers toxins from the liver to the gut, once there, the bile breaks down dietary fats in small micelles. These micelles then bind to the fiber created allowing them to be excreted from the body through the intestines. Without adequate bile production and fiber from consuming vegetables, toxins will build up in our bodies. The vegetables also create phytonutrients that are needed for our gut microbiomes to stay healthy, more diverse, and more immune robust.

A Clinical Win!

One amazing clinical win that I’ve had in my practice was with a patient who had been constipated for YEARS. This was a patient who already had a stellar diet and lifestyle practices on hand and in use. They had tried so many different approaches to getting regular prior to discussing her issues with me. They had gone through dietary changes, various herbal remedies, supplements, and even enemas and colonics, but nothing seemed to help their situation. When they came across the Veggie Mash, they were a bit pessimistic simply due to all the previous treatments they tried out. However, within a few weeks of simply introducing more vegetable diversity into their diet through this method, they were able to rid themselves of their struggle with consistent constipation! Simply adding more plant diversity to their diet shifted the health of their entire gut and body!

While educating all my patients about increasing their dietary diversity, particularly of vegetables and culinary herbs, can be a bit challenging for most patients to implement, this simple hack has made it much easier! My patients are my best teachers and seeing their success helps me to find more fun and reliable ways to grow my practice and encourage new things to help everyone live a healthier life!

The Veggie Mash Recipe:

Select 15 to 20 of your favorite veggies and culinary herbs - sample list below

Chop them up

Blend in small batches

Mix together in a large bowl

Add to silicone ice cube trays (I like to use the candy molds that craft stores have that come in fun shapes)

Freeze and add one cube to smoothies, broths, soups or other dishes 

  1. 1 beet with greens
  2. 3 asparagus spears
  3. 3 celery sticks 
  4. 3 small brussel sprouts
  5. 1 carrot 
  6. 1 small zucchini
  7. A few heads of broccolini  or 1 small broccoli bunch
  8. 5-6  kale leaves
  9. 1 handful of spinach
  10. 2 Swiss chard leaves
  11. 1/2 head of cauliflower 
  12. 1 wedge of red cabbage
  13. 1 handful of sugar snap peas
  14. 1 handful of green beans
  15. 1 small bunch of basil
  16. 1 small bunch of cilantro
  17. 1 small bunch of rosemary
  18. 3 green onions

Note: For those with food sensitivities or intolerance, the problem veggies can be removed and just increase the amounts of the other tolerated veggies. Other culinary herbs like parsley, thyme, and mint can be used. Other veggies can be used instead as well. For this recipe I typically avoid corn, nightshades (potatoes, tomatoes, eggplant, pepper), which not everyone can tolerate and potatoes and eggplant are just not good raw.

sarah_giardenelli_nd_lac_veggie_mash

veggie mash step 1

sarah_giardenelli_nd_lac_veggie_mash_2

veggie mash step 2

sarah_giardenelli_nd_lac_veggie_mash_3

veggie mash step 3

Dr. Sarah is a naturopathic doctor, acupuncturist, and owner of Collective Health Center in Leesburg, Virginia. She loves helping patients learn how to optimize their modern lifestyle with simple and easy hacks, such as the veggie mash and teaching patients to learn how to use food as medicine. Learn more about her practice by filling out the form below.

Contact Us!

3 + 1 =

Back to School/ Work with the Bento Box

Back to School/ Work with the Bento Box

by | Aug 25, 2021 | Children's Health, Naturopathic Medicine, Nutrition

It might be heartening to know that the challenge to pack easy, portable and exciting lunches is not a new concept. In Japanese cuisine bento boxes, a single portioned either take-out or home prepared meal in a multi-compartment container, have been a solution for centuries. A traditional bento box holds noodles or rice with fish or meat, along with pickled and cooked vegetables. The traditional bento boxes can be adapted to a Western palate. In Japan there are character boxes, where each container of the bento box takes on the theme of an anime character, cartoon, or video game. Children enjoy variety and certainly engage better when the food resonates with them. Theming a meal can help the kiddos engage with their food, especially for the vegetables and proteins, that can be difficult to make kid friendly. Even if you are kiddo free the same rules can be applied to the adult bento box.

Top 8 Healthy Bento Box Tips:

1) Select a variety of containers. Purchasing multiple different containers can helps with batch preparing meals and diversity. One example that several local moms have recommended, is PlanetBox, an eco-friendly and dishwasher safe bento box, however, there are multiple other options that are well reviewed on https://mindfulmomma.com/reusable-lunch-containers/. There are options that include insulated containers to keep food cold or hot.

2) Mix and match. Make a list of your child’s protein, vegetable, and carbohydrate preferences and then use this to take time to do a weekly or monthly meal plan with your child.

3) Schedule for success. Choose a day(s) with your child to batch prepare several bento boxes

4) Include your child. Even the pickiest of eaters will be more likely to consume their food if they were involved in the process of planning and preparation.

5) Focus on veggies, protein, healthy carbs and healthy fats. Use the largest containers of the box for the vegetables, protein, and healthy carbs and a smallest container for nuts, seeds, nut or seed butter, or hummus for those healthy fats.

6) Disguise, hide and excite. If your child is picky with their proteins and vegetables, consider ways to disguise these or make them more exciting, a few of my favorite recommendations include:

  • Quinoa and edamame noodles provide both carbs and protein compared to standard wheat noodles
  • Hide blended veggies in a traditional or vegan meatloaf
  • Blend veggies such as spinach, carrots, beans into a tomato sauce or make homemade veggie muffins with zucchini or carrots
  • Make “extra special” dipping sauces with yogurt, nut or seed butters, salsa, or hummus. Framing even the most mundane dipping sauce to your child as “special” can make it more enticing to eat their chopped veggies or salads.

7) Avoid added sugar. It’s easy to avoid added sugar if you opt for wholefoods, such as fruits, vegetable, nuts and seeds and sometimes dairy for the snacks/ sides as much as possible. If going for a processed convenience snack, choose the most minimal processed, and nutritious options, and alternate them as a side to the whole food stars. Some minimal processed snack options:

  • Simple Mills or RW Garcia brand gluten free crackers
  • Organic corn chips + salsa or hummus
  • Organic apple sauce or fruit/ veggie/ chia seed pouches
  • Aussie bites
  • Figgy pops

8) Aim for organic. To minimize pesticide exposure, aim for organic foods and/ or follow the Environmental Working Group’s Dirty Dozen guidelines.

Top 5 Nutritious Bento Box Ideas:

1) The Quick and Easy Deli Meat Roll-Up: No nitrate lunch meat with romaine lettuce and Sir Kennsington’s brand mayo roll-ups + veggies + fruit + crackers

2) Taco Tuesdays: a few taco shells + seasoned sautéed meat or beans + shredded cabbage, lettuce + salsa + cheese/ plain Greek yogurt + fruit

3) Holiday or Seasonal Theme: roasted turkey + sweet potato fries + fresh apple or apple sauce or cranberry dipping sauce + green beans OR roasted turkey sandwich on bread + cranberry sauce + apple sauce or sliced apples with cinnamon + edamame.

4) Leftovers: main dish + extra veggies + fruit + cheese, nuts and/ or seeds

5) Nut or Seed Butter and Jelly Sushi: wrap with nut/ seed butter and favorite jam, then roll up and cut into equal sized pinwheel slices + chopped veggies + fruit + crackers

Dr. Sarah is the principle naturopathic doctor and acupuncturist at Collective Health Center in Leesburg, Virginia. She aims to meet patients where they are at, including kiddos. She is never without creative solutions to assist patients in optimizing their health. Learn more about her practice by filling out the form below.

Contact Us!

8 + 13 =