May 15, 2020
Getting Your Immune System Ready After Lockdown Ends
There has never been a more important time to focus on underlying health conditions and immune strengthening.
There has never been a more important time to focus on underlying health conditions and immune strengthening.
As we now begin to see the possibility of life beginning to slowly head back to normal after lockdown, many of us are worried about going back into the world with the threat of coronavirus still looming.
Many of the patients that I have been speaking to this week are focussing on strengthening their immune health. However, with more information emerging daily, we begin to understand how many underlying health conditions put certain people at higher risk. There has never been a more important time to deal with underlying health issues, especially hypertension, diabetes, cardiovascular disease, blood sugar imbalances, microbiome imbalances, respiratory problems, and obesity.
In my practice, I have never seen people more motivated to make positive changes to deal with niggling health issues that have been put off in the past. This has been one positive effect of this very tragic situation. Those that are doing this are feeling better in terms of energy and wellbeing.
I am seeing a variety of patients who have had very little or no symptoms with Covid-19. I am unfortunately also seeing many who are struggling to fight back after developing vascular and kidney damage as complications after the infection.
Developing complications appear to be the result of having had a prior underlying health condition as well as an immune system that is not able to defend the body as the virus wreaks havoc.
The Functional Medicine approach to this pandemic is to firstly prevent complications by helping people strengthen their immune systems but even more importantly, deal with health issues such as inflammation by treating them at the root. If you become infected, the full focus moves to supporting the immune response and then on curtailing inflammation and preventing blood clotting. After that, although inflammation remains a priority it is also necessary to inhibit fibrosis and other forms of tissue damage, and finally restoring and reoptimising organ function.
For each person the strategy is slightly different, depending on their current health situation. Everyone can benefit though from following the strategies set out in the upcoming blog posts:
Healthy Diet - Why Nutrition is Important in Strengthening Your Immune System
Immune Boosting Treatments, Herbs and Supplements
Exercise -How Keeping Fit Can Improve Immune Function
Sleep - Why Getting Quality Sleep is Important For Your Immune System
Emotions and Stress - Why Managing Stress is Important For Your Immune System
But first, let’s look at the causes of low immune function.
Here are just some of the major reasons why immune function may be lowered:
Sugar is by far the most destructive weapon to damage immune function. In most cases of low immunity, just taking sugar out of the diet can greatly improve immune function. But we now have even more reason to focus on sugar control as evidence emerges that people with poorly controlled blood sugar are at much higher risk of dying from Covid-19. There are two reasons for cutting sugar from your diet:
Firstly,sugar directly inhibits the uptake of vitamin C, rendering white blood cells unable to function for several hours after ingestion. Without this essential vitamin, white blood cells lose their ability to combat infection. In one interesting study, researchers looked at how much vitamin C was absorbed when they added glucose (sugar) to a group of white blood cells. They were astonished to note that as the level of sugar increased, the absorption of vitamin C reduced to the point where the white cells could no longer function.
“to the point where the white cells could no longer function”
A second reason to avoid sugar is that it fuels the bad bacteria in the intestine, providing a fertilizer for bad germs to grow! Not many people are aware that your digestive system is your first line of defence. The digestive tract, because it deals with what we ingest through the mouth, comes into contact directly with many viruses/bacteria. The stomach acid will kill most of these but those that manage to get through that first challenge, will be tackled by the immune cells in the intestine. The good bacteria in the intestine support the immune system by creating a barrier of defence. Sugar consumption creates an imbalance in the healthy levels of intestinal bacteria allowing ‘bad’ bacteria to grow and thereby creating an immune disruption.
The modern diet is laden with hidden sugars and people are often surprised to find that even things such as sauces and salad dressings can contain large amounts of hidden sugar.
The reason why I also mention grains here is that processed grains can also have an immune suppressing action by creating an acidic environment in the body. Especially troublesome are baked goods such as breads and pastries. The wheat products that we consume today have been grossly altered through genetic modification as well as bleaching etc. They are far from the natural grains that we once consumed and have been directly linked to trigerring inflammation and driving a very unhealthy immune response. Read more.
There is plenty of evidence that disordered sleep yields increased inflammation and also that healthy sleep is directly anti-inflammatory. Our natural sleep hormone, melatonin, has also been identified as a potential therapeutic drug in SARS-C0V-2.
We have known for a long time that people with poor sleep suffer from lower immune function.
A 2009 study took more than 150 volunteers and tracked their sleeping habits for 14days in terms of total hours as well as quality of sleep. The researchers then inoculated the volunteers with the rhinovirus, which is the common cold, and waited 5 days.
Although they were all inoculated, not all the participants came down with the cold. Blood tests confirmed that all participants had been infected, however not all of the volunteers developed symptoms. Some of them were able to fight the infection off. This is called inapparent infection.
When researchers looked at the sleeping patterns of the participants, interesting data emerged. The individuals who slept less than 7 hours were more than 3 times at risk for coming down with a cold. The study was not a surprise to functional practitioners who always advocate healthy sleep patterns. The study found that the ideal level of rest was between 7 and 8 hours. More than 8 hours sleep seemed to have no further benefit on immune function.
Most people are very aware of the link between immune function and sleep. However, it is necessary to stress that sleepis a vital part of our body’s repair mechanism and without sufficient sleep ourbodies are unable to cope with the demands that the environment place on it. Read more.
Stress has been called the number one universal health factor contributing to major disease. The majority of illness can be linked to some form of stress and the immune system is no exception. Our body's defence system is highly sensitive to stress.
During times of stress the body will raise its production of the stress hormones, such as adrenalin and corticosteroids. This gives the body the capacity to cope with heightened demand; however one of the well-known effects of excessive adrenal output is that it suppresses immune function. These hormones inhibit white blood cell formation and function. Over the past 20 years a battery of research has demonstrated that stress has very detrimental effects on immune function, including reduced white cell activity, proliferation and antibody production.
Such effects on the immune system have severe consequences on health such as delayed wound healing, impaired responses to vaccinations (reactions) and even the development and progression of cancer.
During times of stress, when cortisol levels become raised, immune system cells disappear from the blood and the body is left defenceless. Whether the stressis physical or mental, when it is excessive, it has a detrimental effect on the optimal functioning of the immune system.
Think of it like the card that finally tips the balance on the house of cards,bringing everything crashing down.
Interestingly, several studies have shown links between a person’s emotional state and the level of immune function. It appears that bereavement, depression and stress can significantly and measurably reduce immune function.
Conversely, positive mental and emotional states are linked with enhanced immune function.
It is important here to say that if the immune system is functioning optimally, it will only be minimally affected by stress. A lowered immune system, however, will be toppled by even minor stresses. Read more.
Dietary deficiency, without question, is the major cause of a depressed immune system. For healthy immune function, the body requires certain nutrients for its defences. Most of us will be aware of the role of vitamin C in immune function, but several other nutrients such as Zinc and Vitamin B are also critical to immune responses. Without adequate levels of these nutrients, the body either does nothave the building blocks to build healthy immune cells or does not have the ‘energy’ to activate immune cells.
Until dietary deficiencies are addressed, a weakened immune system will not repair.
Interestingly, overnutrition (eating too much) is also associated with diseases such as diabetes and obesity which are known to affect immune function. Read More
Many medications are linked to low immune function. Two of the most researched, however, are drugs in the statin groups (Simvastatin, Lipitor etc) and drugs that suppress stomach acid.
A research group in Switzerland found that in transplant patients who were taking statin drugs immune function was markedly more suppressed. In this case, it was a beneficial effect as in transplant patients we do not want the immune system to function in a healthy way as this would cause it to reject the foreign organ. But the study did show that this medication has a very powerful effect on suppressing immune function and those individuals taking this medication need to be more careful in maintaining their immune function.
By blocking the secretion of stomach acid, Proton Pump Inhibiting drugs that are used for heartburn and nausea blocks the body’s main defences against bacteria and viruses. These medications, such as Omeprazole and Lanzoprazol are linked to higher rates of infection. One American hospital study showed that patients who were given these medications had a 30% higher risk of developing pneumonia than those not on the medication. PPIs have also been shown to raise the risk of infection by the organism Clostridium difficile, a bacteria that causes severe intestinal disease.
If you are reliant on either of these medications, you will need to take special care of your immune system or speak to your doctor about alternatives.
Many other medications have an immune suppressing action, so check your medication side effects carefully.
A healthy gut equates to a healthy immune system. The gut is one of the major physical barriers between your internal organs and the outside world. You can think of it as an internal skin. Because it comes into contact with everything that you consume (food and drink), it contains the largest number of immune cells of your entire body. This constitutes more than 60% of your entire immune function. In fact, more than 100 British researchers have come together urging the government to encourage healthy eating to support the gut micriobiome.
A growing body of research shows that people with poor gut health are at higher risk of suffering severe COVID-19. For us in the functional community, this is not a surprise but many people are surprised to hear that the gut plays such a powerful role in immunity. This is because it is constantly exposed to a large number of different molecules and organisms through the food and drink that we ingest, deciding thousands times a day whether molecules are friend or foe. Moreover, your gut must figure out how to deal with harmful organisms (bacteria and viruses), while letting the bacteria that are helpful to its function grow. Thus, we get what we call good bacteria vs. bad bacteria in the intestine. The barrier that your gut provides is critical to immune function.
The foods that you eat can help support this barrier or it can damage it. Also, more recently there have been some good quality studies that show the importance of good bacteria in the gut to keeping a healthy immune system.
The lung microbiome has been closely linked to chronic lung diseases and lung inflammation. Both the lung and gut microbiomes both have an intimate relationship to their respective mucosal membranes, which are critical players in early immune protection. Therefore, maintaining a healthy lung and gut microbiome, and maintaining the integrity of the mucosal linings of both systems is critical in decreasing overall inflammatory burden. The use of a high fiber, polyphenol rich diet, prebiotics, and probiotics can be considered to promote a healthy microbial ecosystem. Obviously, avoiding smoking and air pollution also makes sense.
In addition to purely supporting the immune system, many of the vitamins, minerals, and botanicals recommended in these blogsfor their immune supporting roles also have roles in supporting the microbiome and mucosal membrane integrity and immunity. For example, Vitamin D plays an important role in mucosal immune function and vitamin A is critical in maintaining epithelial barrier integrity. N-Acetyl Cysteine protects intestinal and respiratory health via a number of different mechanisms including tight junction signaling.
Over the next few weeks, I will be exploring what you can do to improve immune function:
Immune Boosting Supplements
Exercise
In conclusion, taking care of your body has never been more important. The small changes that you make can translate into long-term health benefits that will lead to long-term benefits.