One and a half months into the epidemic that is the novel coronavirus—now called the Covid-19—and there is still no vaccine developed to help us combat it. So far, the best we can do, as the World Health Organization (WHO) and the Department of Health (DOH) often reiterate is to protect ourselves from contracting this contagious virus: practice proper handwashing; observe coughing etiquette; avoid being in close contact with people who have flu-like symptoms; cook food thoroughly; keep away from wild and farm animals; and immediately consult with a doctor when you experience symptoms.
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Health experts have likewise emphasized how important it is to have a strong immune system. We are advised to take vitamin C, have enough rest, exercise regularly, and eat a healthy diet. Are these tips fool-proof? Are there other things we can do to ensure our well-being? Two experts on immunity and nutrition enlighten us on this matter.
Do you have a weak immune system?
Dr. Michelle De Vera, a Fellow of the American Academy of Allergy Asthma and Immunology who holds clinic at The Medical City, points out that the whole idea of boosting our immune system assumes that it is weak in the first place. “A normal person technically has a competent immune system. You can’t make it better than normal. If it is not weak, you cannot boost it,” she says.
De Vera explains that the immune system is composed of many sophisticated microparts, which makes it challenging to evaluate. “We cannot measure all the parts of your immune system. We can measure certain things like the amount of antibodies that you make. If a test reveals that you have lower than the normal values, then it means you might have a problem with your immune system,” she mentions.
The complete blood count (or CBC) test can measure the amount of white blood cells that help our body fight off infections. There is also a way to measure the number and function of the B-cells (bone marrow- or bursa-derived cells) and T-cells (thymus cells), the major cellular components of the adaptive immune response. (The National Center for Biotechnology Information describes the adaptive immune system “saves us from certain death.”) But for the other microparts of the immune system, science has yet to develop technology to measure those.
Hence, De Vera debunks the notion that there is a magic bullet that can boost our entire immune system. For instance, while antioxidants such as vitamins C and E, and zinc help neutralize the oxygen radicals in our body, these don't extend to the whole immune system. “That is why when people say, ‘take vitamin C so you don’t get colds,’ that actually doesn’t work. There is no evidence saying vitamin C will prevent you from getting a cold because it doesn’t boost your entire immune system,” she explains.
While taking anti oxidants and correcting bad lifestyle habits (e.g., lack of sleep chronic stress, lack of essential nutrients) help a great deal, these aren’t fool proof. “The biggest thing that can boost anyone’s immune system is vaccination,” she stresses. “For any disease na meron ng preventive vaccination, we should get those—that’s how we can boost your immune system for a particular bacteria or virus.” As for Covid-19, there’s none at the moment.
Red flags to watch out for
There are certain indicators that show a person has a weak immune system. “Do you experience recurrent infections? Three pneumonias in a year, or frequent ear infections. Are you always on antibiotics? And even if you take antibiotics, you don’t get better right away. You need to take three to four antibiotics before you get well,” she cites examples. She also notes that children whose growth is stunted, or who are not gaining weight could possibly have a weak immune system as well.
Another crucial red flag to watch out for is a person’s family history. For instance, if there are many deaths in your family due to diseases, many die young, or you have sickly family members, there is a possibility that you could also be immunocompromised.
“There are two reasons why your immune system may be weak. One, because you are born with it. These are usually the ones who are sickly even as a child. Two, you have an acquired disease that is making your immune system weak. For instance, HIV will kill your immune system. Cancer cells will also weaken your immune system,” she points out.
Do you need an immunological test?
If any of the above-mentioned red flags are present and after undergoing a physical exam, the doctor can then recommend whether you need further tests to find out if you have a weak or abnormal immune system.
After finding out what is making your immune system weak, the next step is to find out why. “If it’s genetic, mas mahirap i-treat. We have to look for the availability of genetic therapy such as bone marrow transplant. If there is an underlying medical condition, then this should be treated first, before you could strengthen your immune system. While undergoing treatment, you can also be transfused with antibodies.”
What else can you do?
Dr. Maria Isabel O. Quilendrino, a Health Optimization Medicine (HOMe) Specialist and Developmental Pediatrician, provides a list of things that can help boost and maintain a strong immune system.
1. Vitamin D
“It was previously known to be important for calcium metabolism and bone health, but is now known to also play an important role in regulating the innate and adaptive immune responses of the body. Deficiency in Vitamin D puts one at increased risk for autoimmune disorders and susceptibility to infection.”
2. Sunlight exposure
“UV light from the sun triggers the production of Vitamin D in our skin. Vitamin D modulates certain immune functions that fight infections. It also improves immune function through a separate mechanism. Scientists from Georgetown University Medical Center discovered that low levels of blue light, found in sun rays makes T cells move faster. T cells are immune cells that protect the body from pathogens and cancer cells.”
“Zinc balances the immune response by preventing excessive inflammation. Researchers discovered that if there is not enough zinc available at the time of infection, immune response can spiral out of control. This explains its benefits when taken at the start of an infection like a common cold.”
4. Positive emotions
“Numerous studies have demonstrated the intimate relationship between mental and physical health. A wealth of evidence in the past decade has shown that positive emotions enhance the immune functions, while negative emotions suppress them. Some researchers have proposed that just like emotional responses, our immune response allows us to adjust to our ever-changing environment, and that the two are intimately linked.
“A brain study demonstrated the direct relationship between the electrical activity in the prefrontal cortex and the immune response to a flu shot. The study established ‘that people with a pattern of brain activity that has been associated with positive emotions are also the ones to show the best response to a flu vaccine.’
“Results from another study, comparing two groups (hedonic versus anhedonic) also showed significantly higher innate immune system level counts in the group with pleasant emotions (hedonic).”
5. Stress management
“Psychologists in the field of psychoneuroimmunology have shown that the state of mind affects one’s state of health. A group of psychologists from the Ohio State University College of Medicine, found out in their 10-year study on medical students, that the student’s immunity went down every year under the simple stress of their exam period. At this time, the test takers had fewer natural killer cells, which fight tumors and viral infections.”
6. Social connection
“Intimate social connection mediates improved immune function in several ways. It is proven to help improve mood and to help individuals cope with stress. In a study that examined students’ response to flu shots, small networks and loneliness were shown to independently weaken immune response to a core vaccine component. The researchers concluded that a combination of loneliness and small social networks weaken the immune response.”
Tips for the special population
Quilendrino also provided three tips to ensure the immune system of infants, the elderly, and the immunocompromised.
1. Breastfeed your baby.
“Breastmilk contains many elements that support the baby’s immune function. It is the most efficient way to prevent infectious disease in early life as the mother’s milk confers passive immunity to the child, while his immune system is not yet mature.”
2. Keep baby’s immunization updated.
“Keeping baby’s vaccines updated prepares his or her body to fight diseases without exposing it to the disease symptoms.”
3. Manage diseases and other medical conditions.
“A meta-analysis revealed that people who are older or already sick are more prone to stress-related decrease in immune function.”