Is there really such a thing as boosting one’s immunity? There are lots of people trying to sell you stuff which claim to boost or support immunity. This seems to be even more exaggerated especially in tiring times like the one we are currently facing, which is enabling commercially minded people to cash in on it. With every crisis comes an opportunity, which brings out the snake oil salesmen. There seems to be plenty of questionable medicinal concoctions and folk remedies floating around. But the concept of boosting immunity actually makes little sense scientifically. If anything boosting immune cells is detrimental to health, which is rather evident in Covid-19, where most of the damage is being caused by our own immune system due to over stimulation (cytokine storm). Immune activation should be sufficient, but locally limited and should not lead to over-shooting systemic inflammation.
Add to this problem, our immune system has so many different kinds of immune cells that have different tasks and respond to different stimuli. So how do these so called ‘Immune Boosting’ supplements/activities etc know which cells to boost and to what number? Well I personally could not find any such information in any of the medical literature (Anatomy and Physiology texts and medical journals) I studied so far. On the whole, our immune system does a remarkable job of defending us against disease-causing pathogens. It produces abundant amount of immune cells to protect us. In fact it produces way more than it needs and these extra cells kill themselves off in a process called apoptosis in order to not cause undue damage to our body. So, all of these claims of boosting these immune cells, even if it were to be true, is pretty much working against our body.
B cells are manufactured with random receptor shapes in hopes that any pathogen we may encounter will have a matching B cell. Statisticians argue that the chances of us having a
match are so astronomically high that it’s safe to say there’s one in our body somewhere.
The problem is finding it before the pathogen does irreversible damage.
There’s no such thing as boosted immunity
To really understand how our immune system works you can refer to these blogs to get a crash course on the anatomy and physiology of the immune system or refer to other medical texts so you are better equipped with your own knowledge so you won’t fall prey to such devious and self serving claims.
So lets break down (high level) as to how our immune system works. First lets look into how exactly do we get our immunity.
Passive Natural Immunity
Passive natural immunity results when antibodies are transferred from a mother to her child across the placenta before birth or through the mother’s milk after the child is born. During her life, the mother would have been exposed to many antigens (foreign cell Ids), either naturally or artificially, and she has antibodies against many of these antigens that protect her and the developing fetus against disease. Some of the antibodies (IgG) can cross the placenta and enter the fetal blood. Following birth, the antibodies protect the baby for the first few months. Eventually, the antibodies break down, and the baby must rely on his or her own immune system. If the mother nurses her baby, antibodies (IgA) in the mother’s milk may also provide some protection for the baby.
Active Natural Immunity
Natural exposure (Yes! one has to be exposed to enough pathogens to build immunity) to an antigen, such as a disease-causing microorganism, can cause the immune system to mount an adaptive immune response against the antigen and achieve active natural immunity. Because the individual is not immune during the first exposure, he or she usually develops the symptoms of the disease. Interestingly, exposure to an antigen does not always produce symptoms.
Active Artificial Immunity
In active artificial immunity, an antigen is deliberately introduced into a person’s body to stimulate the immune system. This process is called immunization, or vaccination, and the introduced antigen is a vaccine. A vaccine is usually administered by injection. A vaccine usually consists of a part of a microorganism, a dead microorganism, or a live, altered microorganism. The antigen has been changed so that it will stimulate an immune response but will not cause the disease symptoms.
Once we have acquired our immunity, how does it protect us? As explained in the immune system blogs, we have three lines of defenses.
Physical Barriers
So this includes our skin, eyes, mucus membranes and the acidic environment of our stomach. Physical barriers job is to prevent microbes from entering the body and to ensure whatever gets in is taken care off immediately. If pathogens cannot enter our body, then they cannot disrupt the normal physiological functions and cause a disease.
Any boosting can be done here?: Clearly not, other than keep ourselves clean and tidy. Also eat a variety of foods to keep our guy healthy and make sure it is acidic enough to kill the pathogens. Lemon Juice, Apple Cider Vinegar etc are a good way to ensure your stomach has optimum acid levels.
Innate Immune Response
Once the pathogen gets past our physical barriers, they are met by our innate immune response, which consists of chemicals and cells which can rapidly raise the alert and begin fighting off any intruder. These are non-specific cellular and molecular responses and just like guards/police who do not have special training they do not differentiate between different types of pathogens. Innate immunity includes body defenses that are present at birth and genetically determined.
Adaptive Immune Response
When our innate immune response cannot get the job done or it needs additional reinforcements, our adaptive immune response kicks in. These are special forces who have special training to deal with serious breaches. Although a bit slower to respond they do have a targeted approach. They also form memory cells, thereby ensuring long-term immunity to a particular pathogen so the response to them is faster and stronger each time the foreign substance is encountered. Memory is the ability of adaptive immunity to 'remember' previous encounters with a particular substance. As a result, the response is faster, stronger, and longer-lasting.
What can be ‘supposedly’ boosted in Innate and Adaptive immune response: Leukocytes (White Blood Cells only, so it has nothing to do with iron). A healthy WBC count is 4000-11000/mm3 (4-11). So if your levels are lower or higher than this range than boosting is least of your worries. You need to consult your doctor to figure out why they are off. If your immune system is seriously compromised then you can discuss with your doctor about colony-stimulating factors (CSFs).
There are no supplements or specific foods known to increase white blood cells lets alone targeted WBCs like Neutrophils which pretty much make up 50-70% of our WBCs. Nevertheless, you want to be a rebel and still want to boost these, you know what happens to athletes who try to take short cuts by engaging in blood doping? Well they get banned but more importantly they have serious side effects like running the risk of strokes etc.
So the idea of ‘boosting’ one’s immune system really means that we are trying to make it more active and induce a stronger response. As we discussed earlier, we really don’t want do this because it causes way more damage than an under-active immune system. Its the immune response and not the invader, which produces the well-known symptoms of flu. Runny nose, fever, body aches, phlegm etc are all produced by our own body (in response to the immune cells) and not the pathogen. Mucus helps to trap and flush out the pathogens, fever or in other words a high temperature helps to combat infection by reducing the growth rate of microbes and also increase metabolic activity in body cells and activate heat shock proteins to strengthen the immune response (as and when needed), body aches sends signal to the brain that its time to slow down and rest. The by-products of this inflammatory process instruct our immune cells what to do and where to go.
All of these are healthy responses but you really don’t want this to be turned on all the time or overstimulated, which is what ‘boosting’ is really trying to achieve. An overactive and strong immune response starts leaving a trail of damage (you can get a more in-depth look into this here) and attack our own cells leading to autoimmune diseases amongst other things. One of the key reasons for allergies is this very overactive immune response. A failure of these mechanisms can lead to immunodeficiency on the one hand or septic shock, allergy and autoimmunity on the other hand. So anything claiming to reduce inflammation or boost immunity is pretty counterproductive and detrimental to our health and well-being.
But lets assume and to be fair to the well-intentioned ones, when someone is trying sell the idea of ’boosting’ immunity what they really mean is provide better immune support rather than literally ‘boosting’ anything. In most healthy individuals our immune system does an incredible job of regulating itself and it doesn’t really need any outside help. Taking vitamin supplements (except for Vit-D but even that I would advice to get it naturally if you can) if you are fairly healthy has been debunked ages ago. So unless one has serious deficiencies they are not only useless, they even end up harming you because they are synthetically derived.
The problem is not so much about Immune boosting but rather
things which suppress our immune system.
So what really helps our Immune System – All of these are free and readily available
Sunshine
Vitamin D, a steroid hormone has important roles in addition to its classic effects on calcium and bone homeostasis. It is involved in more than 1000 different gene expressions in our body. Vitamin D can be obtained from the diet however it is mostly synthesized via endogenous synthesis. This process occurs in a sequence that starts in our skin following exposure to ultraviolet light from the sun and continues in the liver and kidneys, where the vitamin's active hormone (Calcitriol - D3) form is made. Since ultraviolet light (and cholesterol) is required for vitamin D synthesis, inadequate amount of sunlight is one of the major causes of vitamin D deficiency.
The beneficial effects of vitamin D on protective immunity are due in part to its effects on the innate immune system but also plays an equally important role in the adaptive immune response as well. It inhibits B and T cell proliferation, blocks B cell differentiation. This control on B cell activation and proliferation is of clinical importance in autoimmune diseases where B cells producing auto-reactive antibodies play a major role in the pathophysiology of autoimmune diseases.
It also modulates immunoglobulin secretion and facilitates the induction of T regulatory cells. These effects result in decreased production of pro-inflammatory chemicals (Cytokines - TNFα, IL2, IL-17, IL-21 etc) and increased production of anti-inflammatory chemicals (Cytokines - IL4,5,10). Vitamin D is required to enhance the antimicrobial effects of immune cells such as macrophages and monocytes, needed to fight pathogens. In response to infections there is an up-regulation of human cathelicidin (antimicrobial peptides) which results in a destabilization of microbial membranes thereby acting against bacteria, viruses and fungi and helping fight infections.
Given the importance of vitamin D for a functional immune system, its widespread insufficiency (and perhaps exacerbated in quarantine conditions, due to limited sunlight exposure); It is imperative to get adequate exposure to sunlight or maybe at least consider temporary
vitamin D supplementation.
Stress
One well-established interaction of the immune, nervous, and endocrine systems is the effect of stress on immune health. In human evolutionary past, stress was associated with the fight-or-flight response, largely mediated by the central nervous system and the adrenal medulla. This stress was necessary for survival. The physical action of fighting or running, whichever the person decides, usually resolves the problem in one way or another. On the other hand, there are no physical actions to resolve in most modern day stresses and hence the build-up, which leads to chronic stress. The effects of stress can be felt by nearly every organ system, and the immune system is no exception. Cortisol is involved in around 20% of gene expressions in our body. Its ability to suppress T-Cells is so strong, it is even administered during transplants to suppress the hosts immune system so it won’t reject the donor organ. It is also used in many anti-inflammatory drugs.
Stress exasperates anxiety and fear, which in turn will release more stress hormones
so, it’s a vicious cycle.
Stress is a normal biological reaction to demands of life. We experience stress when there is an imbalance between the demands being made on us and our resources to cope with those demands. The level and extent of stress a person may feel depends a great deal on their attitude to a particular situation. An event that may be extremely stressful for one person can be a mere hiccup in another person’s life. The more important the outcome, the more stressed we feel.
We can get stressed by:
External situations (too much work, financial problems etc) and by
Internal triggers (the way we think and react (as opposed to respond) to external situations).
Our attitude, personality and approach to life will influence how we respond to stress. When our demands outweigh our resources, we can feel stressed, pressured and overwhelmed. When our demands and resources are in balance, we are likely to feel much more in control and thus,
be able to cope with the stressors in our life.
Stress Management is an entire topic on its own but there are basic things one can do to combat it, like:
Identify your triggers (sources of stress)
Avoid these triggers whenever its possible
When you cannot avoid, try and alter your responses to these triggers
Accept the unavoidable stressors and adapt
Regular exercise is a great way to manage stress
Practice Meditation. Objective of Meditation is to stop the clutter. How one does it or what methods one chooses is entirely up to the individual and there are no set rules!!
Be Positive. Having a good outlook does wonders to our health and well-being.
Watch something funny. Even just smiling will have an immediate effect
Sleep
There's a strong link between sleep and a healthy immune system. But not just any sleep will do. Restorative sleep, which means quality sleep is key. Sleep is a bit of a paradox. From an evolutionary sense sleeping for long hours would leave us vulnerable to attacks and yet not enough of it could prove detrimental to our survival. So, no wonder it stuck around as an integral part of our daily activity. Without sufficient sleep, our ability to learn, the acquisition of new memories, begins to rapidly break down. The brain uses a quarter of the body's entire energy supply, yet only accounts for about two percent of the body's mass. So, inadequate sleep impairs glucose regulation. It also preps the brain for information input, transfer and storage.
Even more importantly it facilitates the brain's self-cleaning mechanism (the glymphatic system). It also ramps up our fight or flight response. Vagus nerve has a direct mainline pathway or provides a mainline pathway from our brain to our gut. And that's why there is a very powerful brain-gut relationship. It could be one of the mechanisms by which the gut is affected by sleep. Sleep and the circadian system act in concert to generate reduced levels of the anti-inflammatory stress hormone cortisol. Their have a strong regulatory influence on immune functions. Some studies revealed a selectively enhancing influence of sleep on cytokines promoting the interaction between antigen presenting cells and T helper cells, like interleukin-12, which indicate a specific role of sleep in the formation of immunological memory.
Just like how our memories get consolidated in our sleep, The same thing happens to our immune system as well where it needs to consolidate information of all of the pathogens it encounters and create memory cells (T and B memory cells), which is part of our adaptive immune response. Immune system activation alters sleep, and sleep in turn affects the innate and adaptive arm of our body’s defense system.
The bottom line is, focusing on better sleeping habits is a good way to keep our immune system in optimum condition and to achieve this we should try and focus on all of the four pillars of sleep. Depth, duration, continuity, regularity. To get better sleep ensure:
Darkness: Darkness signals our body to release melatonin, a hormone which helps trigger the timing of the healthy onset of sleep.
Sunlight exposure: Sun exposure during the day helps us to regulate sleeping patterns.
Avoid caffeine, alcohol, large meals at least 3 hours before sleep: Caffeine, which is a stimulant can affect our sleep even when consumed 6 hours prior to sleeping
Exercise: It is great and should be part of our daily routine but should be avoided 2-3hrs before sleep
Avoid naps 8hrs before sleep time
Temperature: Keep temperature cool during the sleep window - glycine is thought to act in part by lowering body temperature at bedtime, signaling that it’s time to sleep
Magnesium: Increases GABA, which encourages relaxation as well as sleep.
Blue Light: It suppresses the secretion of melatonin. Melatonin is a key hormone that regulates sleep/wake cycle
Unwind: Try to schedule your days so that there is time to relax before bed.
Stick to a routine
Get physical
While there’s no direct link between moderate exercise and keeping the average person’s immune system humming, there are lots of benefits to working out. This does not mean there are specific exercises or yoga asanas that can target our immune system. So anyone trying to sell or promote this idea have no understanding of the physiology of the human body, let alone the immune system. Any form of physical workout (if overdone will have the opposite effect on the immune system),yoga asanas (not a quick fix, it has to be a long term practice and holistic. You can check this blog for more info) in general and certain pranayama practices can indeed help our lymphatic system though, which is a key player that enables and facilitates the immune system. Almost 50-60% of these lymph nodes are located around the viscera. So doing certain yogic techniques like kapaalabathi, nauli are especially beneficial for moving this lymph around. In fact being physically active and incorporating any fitness regiment is very beneficial to keep the lymphatic system in top shape.
Antioxidants
This is a bit tricky because if you read this blog of mine as to how the alveolar wall gets damaged, which eventually leads to our lungs collapsing; it is caused by ‘Reactive Oxygen Species’ (ROS) released by our immune cells themselves. Oxidative damage can lead to a loss of membrane integrity, altered membrane fluidity and result in alterations in the transmission of signals both within and between different immune cells. Our body counters these using antioxidants to rein in the effects of ROS. As long as we are having wholesome and a wide range of foods like bright coloured fruit and veg (antioxidants are often pigmented: they give carrots, eggplants, grapes turmeric, berries etc their hues). On the flip side ROS has a key role to play in signalling (Redox) reactions, cellular proliferation and differentiation.
A basal level of ROS in cells is essential for life. Another example of a crucial role for ROS-driven redox signaling is in the innate immune response. ROS production is required for the release of the pro-inflammatory cytokines interleukin 1β (IL-1β), tumor necrosis factor α (TNFα), and interferon β (IFN-β), that in turn are required for orchestrating an appropriate immune response. Low ROS levels therefore prevent immune-response activation and lead to immuno-suppression, whereas high ROS levels cause autoimmunity through increasing the release of pro-inflammatory cytokines. So its pretty much a double edged sword! The oxidant-antioxidant balance is an important determinant of immune function.
Microbiome
We humans are mostly microbes, around 100 trillion of them. Microbes far outnumber our human cells. The number of genes in all the microbes in one person's microbiome is over 100 times the number of genes in the human genome. The gut microbiome regulates host defenses against viral infections including respiratory viruses. This occurs through the activation of immune antiviral mechanisms and the prevention of excessive inflammation.
It’s hard to do systems biology,
when we ignore 99% of the systems!!
About 80% of our immune system cells reside in your gastrointestinal system, that’s why our health is so dependent on what we eat. Whatever we are eating comes into contact with antibodies inside our gut first. Different species of the gut microbiome have pro or anti-inflammatory properties and play different roles in regulating the immune system. So, adequate nutrition is crucial to ensure a good supply of the energy sources, macronutrients and micronutrients required for the development, maintenance and expression of the immune response.
Our gut bacteria help in development of different immune cells and also distinguish between ’good’ and ‘bad’ cells. Without appropriate amounts and types of gut microbiome, the body’s immune response is pretty much compromised.
Our immunity is built based on our exposure to pathogens not to mention repeated exposure, as our immune cells have a shelf life and we lose immunity over a period of time (hence the booster shot for vaccines). So it is rather imperative to get dirty (pun intended). Getting over obsessed with hygiene, sterilizing everything, not getting exposed to the beneficial micorbiome enough etc is proving to be detrimental to our wellbeing.
Nutrition
Eating a well-balanced diet will keep our immune system pretty much balanced. Protein is key to forming not only immune cells but every cell in the body. It is especially important in T-Cell production. Vitamin C is a co-factor for several enzymes.Vitamin C regulates the immune system because of its antioxidant properties and its role in collagen synthesis is required for stabilization of epithelial barriers (remember lung cell damage?). Vitamin C is highly concentrated in leukocytes and is used rapidly during infection. Additionally, it impacts phagocytic function and has an immuno-stimulant effect on lymphocyte cells. It also leads (low levels) to poor wound healing and a compromised overall immunity. Zinc deficiency can increase thymic atrophy, decrease lymphocyte number and activity, and increase oxidative stress and inflammation by altering cytokine production. There is also some research (inconclusive) that it is able to literally attach itself to the virus, and prevent it from further infecting the person. Considering our gut plays a huge role in immune function so pre/probiotics should play some role as well. So, eating a wide variety of foods should help our body maintain a healthy and stable immune system.
Supplementation should only be considered if you are clinically diagnosed with a nutrient deficiency and if you cannot get the RDI from natural sources.
Fasting
Practicing intermittent fasting to some degree should help in a better immune response. From an evolutionary perspective, our body can spend its energy on either growth and reproduction or maintenance and repair. At any given moment, there is a constant competition between cellular damage and repair. If we can repair the damage as fast as it occurs then we could potentially be disease free and live longer. So, anything we can do to upregulate this repair mechanism is rather beneficial to our longevity and staying healthy. Fasting induces something called ‘Autophagy’, which is part of the innate immune response. This process breaks down old, damaged cells and abnormally developing cells to recycle for energy.
Our body has nutrient-sensors that decide which of these two states should be prioritized. Giving our body a break from digestion and constant energy surplus will gravitate more towards repair and maintenance. Hence some sort of fasting (not prolonged) regiment should have a profound effect on both immune system and general well-being.
Note: This is not applicable to everyone and should only be considered if you are fairly healthy and if unsure should discuss with a doctor!! It is advisable to slowly ease into it rather than making any drastic changes.
Our body’s immune system works constantly to maintain a delicate balance. After all, it is life and death when it comes to certain immune responses. Our Immune systems should decide how strong the response should be. Too strong and it might cause more harm then good and not strong enough and the body can’t fight off the infection. So it’s a fine balancing game between these two extremes.
So how do the immune cells know what is the right amount of response? The answer lies in coordinated decision making. They observe their surroundings to get a sense of their neighbours. This helps them fend off a threat without overreacting. Rather ingenious come to think of it and a lesson for us all about positive cooperation for the betterment of the greater being! So, our immune system is a tightly regulated cohesive unit and we don’t have the tools to boost one part versus another. And even if we did have that ability, it wouldn't necessarily benefit us. We want our immune system to act quickly and effectively when an infection hits and stay dormant rest of the time.
The complex connections and interplay among circadian rhythms, sleep, eating behaviors, the GI microbiome, stress, physical exercise etc is what makes all the difference and ensures our immune system is on top of its game. The focus should be on ensuring our immune system is not suppressed as opposed to boosting it.
We should go out and bask in the sunshine, get stuck into dirt and stop getting obsessed with being overtly hygienic to the point of getting sterile, get physical, eat a wide variety of foods, get quality shut eye, stop letting stress get to us, spend quality time with family and friends, do what gives us joy, smile and laugh often, appreciate the little things in life and learn to be contended. Easier said than done eh but we got to start somewhere. Stay safe and stay healthy. Most importantly don’t fall prey to snake oil salesmen!!
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