"I really haven't been ill," said the 50-year-old dermatologist from the Indianapolis suburb of Carmel. "I think I'm healthier when I exercise. I think it's positive for me."
Experts say she's right -- to a point.
Research shows moderate amounts of aerobic exercise such as jogging, brisk walking and cycling during the cold and flu season boost the body's defenses against viruses and bacteria.
But at a certain point, the physical stress of a long workout undermines the immune system and leaves the endurance athlete even more vulnerable to infection than before a workout.
"The general consensus, I believe, is that 30 minutes, three or four times a week, is generally considered to have positive effects," said Michael Flynn, who studies exercise's effects on the immune system at Purdue University in West Lafayette.
One study showed that jogging about 10 miles a week was beneficial to the body's defenses, but 20 miles was associated with an increased risk of infection, Flynn said.
"There's pretty good evidence that the intensity of prolonged exercise suppresses certain aspects of the immune system," Flynn said. "If someone is just doing fitness exercise, it seems like their resistance is better."
So should marathon runners simply scale back their workouts during the cold and flu season?
The problem is that marathons are held every month of the year, and many athletes' workout schedules are dictated by the events they compete in, Flynn said.
David C. Nieman, director of the Human Performance Laboratory at Appalachian State University in Boone, N.C., and a former president of the International Society of Exercise Immunology, said his research shows that moderate exercise increases the recirculation of important immune cells, especially from bone marrow, the lungs and the spleen. It has the effect of cleaning up the body.
"Over time this adds up, much like a housekeeper who comes to your house every day for a half hour. At the end of a month, your house looks a lot better," Nieman said.
But to achieve such beneficial effects, someone has to exercise about five times a week, Nieman said.
Too much of a good thing
Nieman agreed with Flynn that grueling endurance training can hurt the immune system: For athletes running 60 miles a week, research shows, their odds of sickness double compared to those who run less.
"You can push it too far, and the body says, 'This good thing is hurting me here,"' Nieman said.
Nieman recommends that endurance athletes working out in the winter take certain precautions: Keep mental stress low, avoid sleep disruptions, eat well-balanced diets, and be aware of the two major sources of germs: your own hands (wash them frequently) and the air in confined spaces such as a bedroom or car.
And for those athletes who do come under the weather, Flynn suggests they follow the "neck-up" rule: If the symptoms are all above the neck, such as a runny nose or sneezing, it's generally OK to work out. Fevers, body aches and chills call for more caution.
Some experts recommend athletes not train at all if they show any symptoms, Flynn said. "The problem is, I don't know of a single athlete that adheres to that," he said.