Doctor’s Secrets For Immune System Boosting. COVID-19 Edition.
With COVID-19 fear gripping our society, I felt compelled to share some thoughts about ways to boost our immune systems. To be clear, these tips are by no means a substitute for home-isolation, social-distancing, hand-washing, and other recommended measures. We should all do those things too.
Author’s disclaimer: I think COVID-19 is going to be worse than most experts think and I am taking this pandemic extremely seriously, both professionally as a physician and personally as a parent and son. I wrote an article in Medium about this last month. That being said, there are jokes in this post. Humor is not a reflection on the seriousness of this pandemic but rather as a ploy to get you to keep reading.
Backstory: I have spent most of the past ten years in hospitals, taking care of patients with contagious diseases like pneumonia, influenza, the common cold, and syphilis. It’s a regular occurrence for people to cough, sneeze, bleed, and vomit on me, and not just while I wait in line at Walmart, but at work too. Also, I have two small children at home, who attend elementary schools, which have rates of communicable disease higher than Charlie Sheen’s poolhouse. Despite this, I never get sick.
First disclaimer, I am fully vaccinated and I wash my hands a lot, but I am by no means a germophobe.
Second disclaimer, I wasn’t blessed with an iron clad immune system. As an adolescent, I was twice diagnosed with pneumonia and as a child, suffered from frequent ear infections. In college, twice I got…Nevermind, it’s not important. The point is, my baseline immune system is average at best.
Immune system overview and COVID-19: Besides barriers like skin and nose hairs, we have two parts to our immune system. The innate immune system and the adaptive immune system. The innate system is always working against all potential enemies. The adaptive immune system only reacts when alerted by known threats and when activated makes antibodies to help identify and attack invaders. We have found that with COVID-19, those with weakened innate immune systems tend to do poorly, while those with weakened adaptive immune systems do fine. Transplant patients are an example of the latter whereas those on long term corticosteroids and the elderly are examples of the former.
Children have strong innate immune systems, but not fully developed adaptive immune systems, which may be why we see less severe illness in them as well.
Sometimes, we can sort out the right way to do something, by finding the wrong way and doing the opposite, like George Costanza. Two groups of people who suffer from terrible immune systems, are poorly controlled diabetics and meth abusers. Why is this the case? High blood sugar lowers our innate immune defenses. One study showed for five hours following a high sugar/carb meal, non-diabetics had their immune response reduced by 90%. Diabetics get extra immunizations because their constantly elevated blood sugar weakens their immune system and serves as a breeding ground for infection. Anyone who has ever cultured anything in a lab knows that bacteria grow best on a material called agar, which is basically a sugary gelatin.
What about the meth users? Besides a poor diet, meth users go days and days without sleeping. This wrecks their immune system and they are prone to all sorts of infections, and not just the sexually transmitted ones. Rat studies show that sleep deprived rodents die of infection after a week of no sleep because their innate immune systems shut down entirely. Human studies show that only a few nights of suboptimal sleep dramatically lowers the body’s defenses.
Here’s my previous article discussing sleep and immune function.
So avoid sweet tea and meth? That’s not breaking news. Actually, I recommend we try to get the proper amount of restorative sleep and keep our blood sugar at a normal low level. Here are some more things that help.
Increasing our levels of vitamin D helps our immune system a great deal, but it must be the D we get from sunlight and diet, because there isn’t convincing data for taking vitamin D supplements. So take the time to get outside and eat a diet rich in vitamin D. Also, I’ve never seen a super sick person with a great tan, so there must be something to this sunlight thing.
Managing stress has shown to be helpful in immune strengthening. I wrote about how bad chronic stress is for our weight but it’s also really bad for our immune function. When doctors want to turn off someone’s immune system, we give them corticosteroids, which is essentially cortisol, our stress hormone. This is not good for fighting off viruses. Keeping our cortisol (stress hormone) low is key to healthy immune function. My patients report getting sick during stressful periods. This may be partially due to the effects of stress and cortisol.
Exercise, but skip the ultramarathon. Reasonable amounts of exercise are immune enhancing but if you find yourself regularly crapping yourself during training or if your nipples are currently bleeding, that’s not good. Studies show that prolonged, intense, endurance workouts can temporarily weaken our immune systems.
Our bodies can only operate in one mode at a time. We can’t run from a tiger and maintain an erection or train for an ironman triathlon and fight off a cold. Yoga, weight lifting, brief HIT (high intensity training), light jogging, and brisk walks are great though for both physical, mental, and immune health.
Take vitamin C but stop drinking OJ and other things that are high in sugar. That goes back to the diabetes thing. Orange juice(even the fresh squeezed with no sugar added) is loaded in sugar. Oranges are healthful, but when we juice them (and other fruits) we take out the fiber and are left with a sugar bomb (fructose) with some water and admittedly a modest amount of vitamin C. Plus, it’s unnatural. There’s no way you would eat 10 oranges at once, but you’re drinking the sugar equivalent of 10 oranges in one glass minus the fiber. 2000mg of vitamin C per day has been shown to help our bodies recover from illness, but even this is controversia.* higher levels can cause diarrhea and haven’t been shown to be helpful.
What about other anti-oxidants? Don’t they help our immune system? Yes, but not in the way most people think. Imagine a virus as an axe-murderer in your home. Your immune system is you with a machine gun, but you are a terrible shot. So in the process of defending yourself, you shoot up your house and hopefully kill the axe-murderer. The machine gun represents our white blood cells and the bullets are “reactive oxidative species (ROS)” which are deadly to intruders but also cause a lot of damage to our home (AKA our body). In fact, these bullets keep bouncing off of our walls until neutralized by anti-oxidants. Every bounce could be a hit to your DNA, leading to damage, loss of function, aging, or even cancer.
So, it’s the anti-oxidants that clean up the damage that the bullets (ROS) inflict to our home (body). Without anti-oxidants, our immune system would do a lot more damage to our body every time it’s activated. Anti-oxidants also protect our cells against other damaging influences like UV damage, pollution, cigarette smoke, chemical pesticides etc. The point is that anti-oxidants are great, but technically they only assist the immune system, and you should get them from a source other than juice. Also, I recommend taking 40mg of oral (not inhaled) zinc daily to further boost your immune system.
Tumeric is a tasty spice that has some evidence that it helps inflammation and immune function. I like it in food, but also coffee and tea. If you are on blood thinners, you need to ask your doctor before starting supplementation. I feel the same way about garlic, except I don’t put it in my coffee and tea, and you don’t have to ask your doctor.
Chicken soup. This is not just something your grandmother says. Real scientific studies have shown that there is something immune boosting in chicken soup. I like mine hot and spicy because it mobilize my mucus secretions in my face and helps to drain and open my sinuses.
Hot and Cold. Sauna has shown incredible benefits for immune function, but since the COVID-19 shutdown, my sauna has been closed to the public. I’m experimenting with hot baths but I don’t have the same post-sauna euphoria, maybe it’s the lack of hot sweaty dudes. Periodic cold exposure, contrary to popular belief, can also boost immune function. I hate cold showers, so I’m regularly jumping in a cold pool which is also great for getting deep sleep.
Vinegar and honey tea. Apple cider vinegar lowers blood sugar and has some anti-oxidant properties and honey is great for sore throats and cough. Combined, they form a magical elixir. I often add fresh ginger, turmeric, and garlic at the first sign of a throat tickle or sniffle.
Fun Fact: When drug companies were trying to make a cough syrup for kids, they used honey as the “control” drug and honey’s cough suppression was found to be better than any cough medicine big pharma could safely offer kids. Also, don’t give honey to children under one or anyone with a severe honey allergy. Incidentally, I get a rash from honey when it’s applied at high temperatures to my feet and ankles.
In conclusion, to maintain a strong immune system, we must keep our body’s defenses strong and ready for a fight. Vince Lomabardi said, “The best defense is a good offense”, but with COVID-19, I say that an even better defense is just staying the fuck home. Some of us have to go out and see the sick people, if that’s you, stay strong with the above tips. If that’s not you, and you can stay home, please do so. Thanks for reading and God Bless.
*Vitamin A and E, also help immune function but both are fat soluble and the body can reuse these vitamins. Supplementation of A and E is generally not needed, whereas vitamin C can only be used once and is water soluble, so it’s tough to overdose and our supply needs to be replenished daily in the form of a healthy diet and/or supplements.