Time -Tested Ways to Strengthen the Immune System

Stress

This seems a good place to start!

It is well documented that stress can negatively affect the immune system (and everything else…), but that is only part of the story.^[i]  There’s also the concept of hormesis^[ii], the term that basically means, in Nietzschean terms: “what doesn’t kill you will make you stronger.” This is dose-specific, however. In other words, it needs to be the just the right amount of stress. Too much (and chronic) stress will kill us. But just the right amount, along with enough rest afterwards, and we get stronger. Remember, humans are anti-fragile.^[iii]

I believe that the crisis we are in is enough stress to be of hormetic benefit, to help us grow and be stronger – as individuals and as a society. But, this means that in order to benefit from the opportunity of acute stress, we need to decrease all the other stress around us. Easier said than done, of course. How to achieve this?

The immune system and the emotional system are inextricably linked.^[iv] In other words, our (negative) mood will (negatively) affect our immune system, and the converse is also true. So be happy! And the way we perceive a stressful event can impact our health and our performance – studies^[v] show that if we can reframe our thinking to perceive that a particular stressor is beneficial or that we will benefit from it, we actually will!

^[i]Enhancing versus Suppressive Effects of Stress on Immune Function: Implications for Immunoprotection and Immunopathology

^[ii]https://microbialcell.com/researcharticles/when-less-is-more-hormesis-against-stress-and-disease/#ITEM-2988-6

^[iii]https://www.amazon.com/Antifragile-Things-That-Gain-Disorder/dp/B00A2ZIZYQ/ref=sr_1_1?dchild=1&keywords=antifragile&qid=1586392956&s=audible&sr=1-1

^[iv] Affective immunology: where emotions and the immune response converge

^[v] Does the perception that stress affects health matter? The association with health and mortality.

Food

Eat well. Stress can make us want to seek comfort food, but the best thing we can do for our bodies now is to be putting in the best fuel we can. This doesn’t mean we should feel guilty for buying Cheez-its or chocolate. It just means that the base of our food pyramid should be nourishing and anti-inflammatory. Just see Dr. Greger’s work at https://nutritionfacts.org/

In general, I recommend using food as medicine, and trying to limit the “medicines” we take, whether prescription or supplement. Plenty of good resources on how to get all your “supplements” through healthy foods^[i].

Things that contribute to inflammation will put a drain on our resources, and make us less capable of fighting the important battles that our immune system may be called to do. So its a two-pronged approach – eat more foods that decrease inflammation (garlic^[ii], leafy greens^[iii], turmeric^[iv][v], fresh fruits, etc.)^[vi] and fewer foods that contribute to inflammation^{[vii][viii] [ix] [x]}(highly processed foods, fried foods, meats, dairy, etc.)^[xi]. Nuts and healthy fats are also essential^{[xii] [xiii]}

I usually recommend incorporating 1/4tsp turmeric^[xiv] (truly a superfood when it comes to fighting inflammation and pinch of black pepper daily^[xv], however you can. You can mix it in water and drink it down if you’re the get-it-over-with-quick type, or you can make a tasty tea (goldenmilk^[xvi]) or incorporate into cooking. Doesn’t matter. The more garlic the better!

Probiotics have also been shown to boost immune function^[xvii]. Try the live versions in Kefir or sauerkraut.

Interestingly, and perhaps paradoxically, fasting^[xviii] can also be helpful but we will get more into that in a different section. Intermittent Fasting (IF) as well described by Fung^[xix] is excellent, but fasting for too long can also be too stressful.

^[i] Supplements – Perfect Health Diet

^[ii] The Immunomodulation and Anti-Inflammatory Effects of Garlic Organosulfur Compounds in Cancer Chemoprevention

^[iii] Eating green veggies improves immune defenses

^[iv] Immunomodulators Inspired by Nature: A Review on Curcumin and Echinacea

^[v](PDF) “Spicing Up” of the Immune System by Curcumin

^[vi]Xenohormesis

^[vii] Designing and developing a literature-derived, population-based dietary inflammatory index.

^[viii] Low-grade inflammation, diet composition and health: current research evidence and its translation

^[ix] The Messy Facts about Diet and Inflammation

^[x] Stress, Food, and Inflammation: Psychoneuroimmunology and Nutrition at the Cutting Edge

^[xi]https://www.amazon.com/Inflammation-Nation-Definitive-Preventing-Anti-Inflammatories/dp/B07HCRZ5WL/ref=sr_1_1?dchild=1&keywords=inflammation+nation&qid=1586390256&s=audible&sr=1-1

^[xii] Mammalian Sirt1: insights on its biological functions

^[xiii] https://pubmed.ncbi.nlm.nih.gov/23329830/

^[xiv] The Chemistry of Turmeric – Fluorescence, Indicator, and Health Effects

^[xv]https://www.amazon.com/How-Not-Die-Discover-Scientifically/dp/B016CME5B4/ref=sr_1_2?dchild=1&keywords=gregor+how+not+to+die&qid=1586390174&sr=8-2

^[xvi]Turmeric latte: the ‘golden milk’ with a cult following

^[xvii] Daily intake of fermented milk with Lactobacillus casei strain Shirota reduces the incidence and duration of upper respiratory tract infections in healthy middle-aged office workers

^[xviii]https://www.amazon.com/The-Longevity-Diet/dp/B07B79F6WV/ref=sr_1_1?dchild=1&keywords=longo+longevity+diet&qid=1586390198&s=audible&sr=1-1

^[xix]https://www.amazon.com/Obesity-Code-Unlocking-Secrets-Weight/dp/B01MRKEO0U/ref=sr_1_2?dchild=1&keywords=jason+fung&qid=1586390230&s=audible&sr=1-2

Exercise^[i]

For exercise, I am not a huge fan of stressing the nervous system with high intensity workouts in the environment we are in. High intensity workouts trigger our fight-or-flight response and adrenaline, which we would ideally like to engage less. Again, remember hormesis. Less is more. Too much stress and you’ll end up doing more harm, increasing likelihood of injury or illness.^[ii] I’m more a fan of low-intensity exercise to get cardio up a little – a vigorous walk or light jog, bodyweight exercises, or of course Tai Chi and Yoga^[iii]. The common theme in all of this is to down-regulate the autonomic nervous system. To take us out of our fight or flight and into the mode where our bodies can rest, restore, and heal if needed. Don’t deplete your reserves. The occasional vigorous workout (maybe once per week) should be fine, but the key here is to not continually overdo it. There is plenty of evidence for resistance training, and I really like the McGuff method spelled out in Body by Science.^[iv]

The bottom line is, keep moving. Every day you must engage your physical body, even if you are quarantined in a small apartment, there are wonderful workouts that can be done, even in a short time!^[v]

Continuing in the theme of getting our bodies into a state where our bodies can rest and heal, meditation, breathing exercises, and vagus-nerve techniques are all relevant.

^[i] Exercise and stress reduction.

^[ii] https://www.lesmills.com/research/

^[iii] The Effects of Tai Chi Chuan Relaxation and Exercise on Stress Responses and Well-Being: An Overview of Research

^[iv]https://www.amazon.com/Body-Science-Research-Strength-Training/dp/B07VT6LX38/ref=sr_1_1?dchild=1&keywords=mcguff+body+by+science&qid=1586390281&s=audible&sr=1-1

^[v] 7 Intense Workouts You Can Do in Small Spaces

Meditation^[i]

A broad term used here, I am referring to any number of methods used to calm the mind. Without needing to become a devout Buddhist, there are many ways and reasons that meditation and “mindfulness” can not only boost your immune system, but help you feel better, happier, healthier, and more robust and resilient. A win-win.

The idea here is to get the reader familiar with a number of techniques. The plan is to offer virtual classes for CSAcu community in each or all of the methods listed here. Please inquire if interested.

• Meditation
  • Vipassana^[ii]
    • Vipassana means “to see things as they are”, as opposed to seeing what we want them to be. This bare-bones Buddhist technique allows us to get to the fundamental habit pattern of the mind – craving or aversion – and to change it at its roots.
  • MBSR^[iii]
    • For those who love the science, this has all the “woo” taken out of it and looks at how practicing mindfulness can contribute to well-being, happiness, less stress, and improved health.
  • Forest Bathing^{[iv] [v]}
    • Just fun! Get in tune with nature with this Japanese technique.
  • QiGong^[vi]
    • 1000 Hands Buddha QiGong Self-Massage
    • Shaking from Tendon/Muscle Changing QiGong^[vii]
      • This will get into cleansing the lymphatic system, see Acupressure section
    • Tai Chi
  • Breathing
    • The benefits of any breathwork practice range from
      • improved cardiovascular health ^[viii]
      • More energy^[ix]
      • Better sleep^[x]
      • Improved cognition and memory^[xi]
      • Strengthen immune system^[xii]
      • General relaxation and decrease anxiety^[xiii]
      • Enlightenment :)
    • Perhaps one of the most relevant benefits in the context of the immune system and in particular the Covid19 is the concept of nasal nitric oxide^{[xiv] [xv]}
    • Buteyko^[xvi] Breathing
      • This will be a webinar!
      • Gist is to attempt to exclusively breath through the nose
      • The science is very cool, you’re actually attempting to slightly increase blood CO2 in order to facilitate oxygen transfer to the cells.
    • Pranayama^{[xvii] [xviii]}
  • Vagus Nerve^{[xix] [xx]} (Polyvagal theory) Techniques
    • HRV
      • Heart Rate Variability Good objective, quantifiable measurement of the state of your nervous system. Polyvagal theory (Stephen Porges^[xxi]) tells us all about the minute variation between heart beats can be an indicator of the flexibility and adaptability of the nervous system.
      • There is very cool, easy technology^[xxii] to accurately measure, including an app on your phone, or using the HeartMath technology.
    • Accessing the Healing Power of the Vagus Nerve^[xxiii]
      • One of my favorite books on very specific exercises to relax by targeting vagus nerve and re-educating the nervous system.
      • Gargle, chant or hum, self massage – its fun!
    • HeartMath^[xxiv]
      • HeartMath is one of my favorites. It takes the hard science of HRV and research on the physiologically and psychologically beneficial effects of gratitude and combine them into an elegant and simple meditation technique.
    • Gratitude
      • Emmons^[xxv] book gets into it, but so do many of the ancient spiritual teachings across time and cultures. Genuine gratitude is the key here, though. You can’t force it. So start small, with things that are simple to feel grateful about so that you can generate positive and honest feelings of gratitude (think: purring kittens before mother-in-law or angry neighbor). You’ll get there, but at first it is very important to not force yourself to feel grateful for things that you aren’t genuinely grateful for. This will simply leave you feeling empty and defeated. Be happy about identifying the things that you are truly, deeply grateful for and journal or take mental notes. Do this daily!

^[i] Randomized Controlled Trial of Mindfulness-Based Stress Reduction Versus Aerobic Exercise: Effects on the Self-Referential Brain Network in Social Anxiety Disorder

^[ii]https://www.amazon.com/Art-Living-Mandarin-Vipassana-Meditation/dp/B008H3HNES/ref=sr_1_4?dchild=1&keywords=the+art+of+living&qid=1586390299&s=audible&sr=1-4

^[iii] Randomized Controlled Trial of Mindfulness-Based Stress Reduction Versus Aerobic Exercise: Effects on the Self-Referential Brain Network in Social Anxiety Disorder

^[iv]The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan

^[v] Effects of Short Forest Bathing Program on Autonomic Nervous System Activity and Mood States in Middle-Aged and Elderly Individuals

^[vi] Managing stress and anxiety through qigong exercise in healthy adults: a systematic review and meta-analysis of randomized controlled trials

^[vii] Trampoline Workout: Benefits of Rebounding Exercises

^[viii]Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers

^[ix] How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing

^[x] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361823/

^[xi] Respiratory training as strategy to prevent cognitive decline in aging: a randomized controlled trial

^[xii] Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans

^[xiii] The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults

^[xiv]Nitric oxide and virus infection

^[xv] [Nasal nitric oxide].

^[xvi]https://www.amazon.com/Oxygen-Advantage-Scientifically-Breathing-Techniques/dp/B01BLV3T9A/ref=sr_1_1?crid=H62H03TAQOX&dchild=1&keywords=oxygen+advantage&qid=1586390337&s=audible&sprefix=oxygen+adva%2Caudible%2C198&sr=1-1

^[xvii] Health Impacts of Yoga and Pranayama: A State-of-the-Art Review

^[xviii]https://www.amazon.com/Prana-Pranayama-Swami-Niranjanananda-Saraswati/dp/8186336796/ref=sr_1_1?dchild=1&keywords=prana+and+pranayama&qid=1586390365&s=audible&sr=8-1

^[xix]https://www.amazon.com/Polyvagal-Theory-Neurophysiological-Communication-Self-regulation-ebook/dp/B00BZMP5T8/ref=sr_1_2?crid=32144X3MVQNKC&dchild=1&keywords=polyvagal+theory+stephen+porges&qid=1586390386&sprefix=porges+pol%2Caps%2C196&sr=8-2

^[xx]https://www.amazon.com/Polyvagal-Theory-Therapy-Engaging-Regulation/dp/B07QMXBMXD/ref=sr_1_2?crid=3FYAENMWOYFTF&dchild=1&keywords=the+polyvagal+theory+in+therapy&qid=1586392774&sprefix=the+poly%2Caps%2C196&sr=8-2

^[xxi]https://www.amazon.com/Polyvagal-Theory-Neurophysiological-Communication-Self-regulation-ebook/dp/B00BZMP5T8/ref=sr_1_2?crid=32144X3MVQNKC&dchild=1&keywords=polyvagal+theory+stephen+porges&qid=1586390386&sprefix=porges+pol%2Caps%2C196&sr=8-2

^[xxii] https://www.hrv4training.com/

^[xxiii] https://www.amazon.com/Accessing-Healing-Power-Vagus-Nerve/dp/1623170249

^[xxiv]https://www.amazon.com/HeartMath-Method-Steps-Confidence-Creativity/dp/B00OH78XIS/ref=sr_1_1?dchild=1&keywords=doc+childre&qid=1586392792&s=audible&sr=1-1

^[xxv]https://www.amazon.com/Thanks-Practicing-Gratitude-Make-Happier/dp/0547085737/ref=sr_1_4?crid=3HRZVQP8DU8XF&dchild=1&keywords=gratitude+works+by+robert+emmons&qid=1586390408&sprefix=emmons+grat%2Caps%2C188&sr=8-4

Sleep^[i]

Plenty of sleep is not just a luxury but a necessity, so 7-9hrs is the recommendation. And being in tune with nature’s circadian rhythms is also enormously beneficial.^[ii]

L-Theanine^[iii], Kava kava^[iv], and melatonin^[v] all contribute to relaxation, improved sleep, and improved immunity.

Again, entire books are written on the importance of sleep as well as how to get better sleep. The purpose of this section is to merely highlight it as a critical area if you are concerned about improving your health in general and in particular your immune system.

^[i] Sleep and immune function

^[ii]https://www.amazon.com/Circadian-Code-Supercharge-Transform-Midnight/dp/B07F16S85B/ref=sr_1_1?dchild=1&keywords=panda+circadian+code&qid=1586392822&s=audible&sr=1-1

^[iii] Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial

^[iv] https://pubmed.ncbi.nlm.nih.gov/12383029/

^[v] Melatonin: Buffering the Immune System

Read

Reading things that are not related to the imminent collapse of society are helpful. A reading list is included at the end of this paper. Remember, the immune system and the emotions are inextricably linked.^[i] You can read things just for fun, too :)

^[i] Affective immunology: where emotions and the immune response converge

Supplements

This is last on the list because, while I value supplements, I consider them just that – supplementary. They should not be our first line of defence, and should just be used to fill the gaps left in the shortcomings in our diet and lifestyle. We should strive to get all we need from the food we eat and the way we live. I really prefer that most of our immune-boosting come from foods. The science shows that we best absorb nutrients in their natural forms and with the “entourage effect”^[i], essentially meaning that the active ingredients are more beneficial in the context of their natural environment (i.e. Vitamin C is better from an orange than from a pill).

That said, there are a few things which I commonly recommend:

• Magnesium^[ii]
  • Relaxes muscles, eases tension, promotes deep sleep, essential in production of 800+ enzymes, helps detox liver, contributes to healthy bowels, improves mood. What else do you need??
  • See Dr. Carolyn Dean’s book
  • I am a magnesium snob. The only magnesium I recommend is liquid picometer, ionic magnesium. There are two sources that I trust (I have no financial interest in this):
    • ReMag – Dr. Dean’s formulation
    • Good State Health Solution – Liquid Ionic Magnesium
  • Dosage: This is typically done by body weight, consuming 10mg/kg/day. Don’t start at this dosage, it is recommended that one begin small, at around 100g, and gradually titrate up every three or four days until reaching a therapeutic threshold, likely around the 10mk/kg/day. For example: If you weigh 150lbs, you weigh 68kg. This means you will gradually increase your daily magnesium intake to approximately 680mg/day. This is approximate!
  • Please email or call if you have any questions about magnesium dosing, or read Dr. Dean’s excellent book.

• Vitamin C
  • Shown to possibly boost immune system^[iii], but given the trajectory of the course of Covid19 it is recommended to cease taking Vit C once showing symptoms in order to avoid the “cytokine storm”^[iv]
  • I still recommend trying to get mostly from foods^[v]
  • Liposomal Vitamin C is the preferred vehicle for supplementary Vit C. Can take up to 2000mg/day.
• Elderberry^[vi]
  • An immune boosting fruit. Wonderful to be taking when well. Tinctures or capsules, take as directed.
• Quercetin
  • My favorite. Lots of research indicate that this may be extremely beneficial in the case of Covid19^{[vii] [viii] [ix] [x]}
  • Recommendation is taking 500mg twice daily. If you have a sensitive stomach, take with food.
• Vitamin D
  • Jury is still out as to whether Vitamin D, known to have immune boosting benefits^[xi] is beneficial in cases of Covid19. Try to get 20-30 min sunlight daily or check your levels, should be in the 40-80ng/ml range
  • My recommendation is that if you would like to take it, best to discontinue if showing symptoms
• Chinese herbal formulas
  • Study showing hospital workers during SARS outbreak in Hong Kong didn’t contract SARS while taking these formulas^[xii]
  • Use under guidance of a qualified practitioner :)
• Probiotics^[xiii]
  • Remember, you can get these from fermented foods like kefir, sauerkraut, and some yogurts. Try the natural, live versions before buying the pills.
• Zinc^[xiv]
  • Zinc is another powerhouse here. Can take up to 50mg daily. Remember, if taking long-term, is best to make sure you are getting enough copper. This can be done with cacao :), but a supplement can be helpful here as well, such as a balanced Zinc/Copper pill that is formulated to the correct ratio

^[i]Beyond Synergy The Entourage Effect in Nutrition & Herbalism | Herbal Medicine

^[ii]https://www.amazon.com/The-Magnesium-Miracle-Second-Edition/dp/B078C8WXCN/ref=sr_1_1?dchild=1&keywords=magnesium+miracle&qid=1586392874&s=audible&sr=1-1

^[iii]Vitamin C and Immune Function

^[iv] The cytokine storm of severe influenza and development of immunomodulatory therapy

^[v] Synthetic or Food-Derived Vitamin C—Are They Equally Bioavailable?

^[vi] Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses

^[vii] Quercetin as an Antiviral Agent Inhibits Influenza A Virus (IAV) Entry

^[viii] Flavonoid-mediated inhibition of SARS coronavirus 3C-like protease expressed in Pichia pastoris.

^[ix] Characteristics of flavonoids as potent MERS-CoV 3C-like protease inhibitors.

^[x] https://www.hindawi.com/journals/ecam/2018/5813095/

^[xi] Vitamin D and the Immune System

^[xii] The efficacy of Chinese medicine for SARS: a review of Chinese publications after the crisis.

^[xiii] Probiotics and immune health

^[xiv]Nutrients | Free Full-Text | Zinc in Infection and Inflammation