Dr. Madalyn Otto
So far, the year 2020 has been one like no other. We are more aware of our immune systems and the way bacteria and viruses spread among us than we ever have been before. While COVID-19 is the main bug on everyone’s mind, let’s not forget that we are nearing cold & flu season generally, and all signs point to co-infections (more than one infection occurring in one person at the same time) being a threat during the COVID era.
The first thing we want to do is reduce the risk of exposure to viruses and bacteria in the environment. I think we’ll be doing a much better job of that this year than in years past due to mask-wearing, frequent hand-sanitizing and up-regulated protocols for disinfecting surfaces. This exposure-reduction aspect of protection is the best-studied, most evidence-based, and most effective way to prevent infections of all kinds.
- Wear a cloth mask when around others
- Avoid others when you are feeling ill
- Sanitize your hands often. Make a habit of washing your hands immediately upon entering a new location, like returning home from work, or entering your workplace from outside.
- Disinfect commonly touched surfaces like desks, cabinets, countertops
The second thing we need to do is ensure a lifestyle foundation for strong immune system health. In order to efficiently fight off microbes that your body is exposed to, it needs to have the fundamentals in place. This includes a consistent micronutrient-rich diet full of vitamins and minerals such as vitamin C, zinc, selenium and vitamin A. Note that certain nutrients like vitamin C cannot be made within the body and therefore must come from the diet, so if the diet is insufficient, the immune system (among other body functions) will suffer greatly. A micronutrient-rich diet typically includes at least 6 servings of fruits and vegetables daily, though if you are my patient, you know that my expectations are much higher than this for a healthy body!
Food sources of key immune-supportive nutrients:
- Vitamin D: Cod liver oil is a source of vitamin D, and mushrooms contain a precursor to vitamin D that your body can utilize.
- Vitamin C: Vitamin C is found in high doses in plant foods such as bell peppers, grapefruit, citrus fruits, leafy greens & broccoli.
- Vitamin A: Vitamin A is found in highest quantities in organ meats, but can also be converted to from plant foods that contain beta carotene as long as your genetics allow you to make the conversion. Beta carotene is found in orange vegetables like sweet potatoes and carrots.
- Selenium: Selenium can be found in highest quantities in Brazil nuts. It is also found in organ meats, eggs, seafood and whole grains.
Your body also needs adequate sun exposure for immune system health at least in part because it stimulates the body’s production of vitamin D. You also need enough sleep in order to maintain circulating immune cells or “soldier cells” that are alert and ready to attack viruses and bacteria. If you are sleeping fewer than 7 hours per night, your immune system is at risk. Melatonin is an important hormone made in the brain’s pineal gland that is one of two hormones regulating your circadian rhythm. This particular hormone is your body’s natural sedative and it also acts as an antioxidant and important regulator of other key processes that occur during sleep. In a dose-dependent manner, it may help those with poor sleep achieve better quality sleep.
If your diet or lifestyle does not allow you to gain access to these essentials, then you will need to supplement. We often prescribe vitamin or mineral supplementation of vitamin D, vitamin C, zinc and selenium to ensure adequacy of these nutrients. We also use supplements to boost levels above the “recommended daily allowance”. This process of “supraphysiologic dosing” enhances plasma and cell levels of nutrients above what they could reach through diet alone. We may do this preventively, or we may ramp up dosing during acute illnesses as the level of benefit nutrients provide may increase during these acute states. Vitamin C is a great example of this as people’s requirement of and tolerance for high doses increases when they are acutely sick or are highly stressed. This is because the more stressed the body is, the more vitamin C it wants to absorb to combat that stress. When vitamin C is not needed by the body, a person will notice loose stools or diarrhea from even 1 gram of supplemented vitamin C daily indicating that it is not being absorbed. That same person may notice that they can take up to 10 grams daily of vitamin C when they are acutely sick, suggesting that the body is utilizing more of it.
Make sure you are stocked up on your immune support nutrient plan prescribed by your doc! That may include:
- Vitamin D3: We generally recommend that this nutrient is packaged in a gelcap as it will have fat added to it to maximize absorption. Your vitamin D levels can be tested for optimal dosing schedule, though may not be covered by insurance.
- Vitamin C: We recommend ascorbic acid by itself, or packaged with bioflavonoids such as rutin for potentially greater absorption and soldier cell (WBC) support. There is no direct test for Vitamin C, but a low ALP (alkaline phosphatase) level may indicate inadequate Vitamin C levels.
- Vitamin A: This nutrient must be strategically dosed if supplemented outside of food as it can be toxic in high doses. At Whole Health Concord, we only recommend this nutrient to certain patients and at specific doses.
- Selenium: We recommend the form selenomethionine for greatest absorption and usability. It’s important not to dose this too high. Your total intake of selenium daily should not exceed 400mcg. RBC Selenium can be tested, but may not be covered by insurance.
Don’t forget about herbs! Above and beyond their vitamin and mineral content, certain herbs provide direction for the body’s immune system: they can enhance the function and number of circulating soldier cells in the body, support the body’s ability to regulate internal temperature, and reduce the severity and duration of illness. Herbs we at Whole Health Concord often think of to support the immune system in various ways include Andrographis, Astragalus, Elderberry/Sambucus, Larch/Larix, Goldenseal/Hydrastis, Mushroom formulas, Boneset/Eupatorium and Echinacea. These herbs contain specific phytochemicals and compounds that ramp up or modify the immune system response. Combinations of these herbs together or with nutrients can be helpful in keeping the immune system healthy.
Some of our favorite herbs and herb combos for this cold & flu season include:
- Astragalus Supreme by Gaia Herbs
- Mycotaki by Metagenics
- Arabinogalactan powder by Vital Nutrients
- Super Biovegetarian by Priority One
- Innate Immune Support by Pure Encapsulations
- Andrographis Plus by Metagenics
- Sambucus liquid extract by Protocol For Life Balance
Remember to let your doctor know of any and all medications & supplements you are taking so that they can prevent too-high dosing, inadequacies, and prevent interactions with medications. Note that pregnant women should not take any supplements (herbal or nutrient) without checking with their doctor first. Also remember that in the COVID-19 era, keeping on top of your chronic health issues is essential to protect you and reduce your risk of severe disease.
