Augmenting immunity in COVID-19 era: A perspective

Contributed by Dr. Yashpal Rana
Consultant Radiologist
U N Mehta Institute of Cardiology and Research Centre, Ahmedabad, Gujarat

Can we boost our immune system? Is this something we should be spending our money on?

The answer is NO!

There seems to be a constant stream of articles in newspapers and on the internet suggesting that we can ‘boost’ our immune system by taking vitamins, minerals and probiotics, or by eating particular foods.

The notion that the immune system is something that we can easily influence is cast into doubt when you realise how complicated it is. There’s still a considerable amount that we don’t understand about it. There are hundreds of different types of cells in the immune system doing a variety of jobs, whether it’s identifying invaders, carrying messages, devouring known bacteria or learning how to fight new enemies. The innate response judges friend from foe. It reacts to a problem by trying to flush out or burn out the invader, and it’s this that can make us feel feverish or snotty. The acquired response is more like the body’s SWAT team – when specific invaders have been recognised, this part of the immune system identifies the cells that can kill them and sends them into battle.

So when we are told that something can ‘boost’ our immune system, we should probably be asking ourselves which bit of the system it’s claiming to boost, how it claims to do it, and crucially, what’s the proof? And most of the time robust scientific evidence is hard to find.

Vitamins & minerals: We need vitamins and minerals to keep our immune systems healthy. So those of us who are deficient in say vitamin D or vitamin C, may need to take them as supplements. However, vitamins and minerals can be found in adequate amounts in food, so if we’re eating a healthy diet, chances are we’re getting the quantity we need. There is no evidence to suggest that boosting your vitamin levels any further will give you advanced disease-fighting powers. When it comes to some vitamins and minerals, it’s possible to have too much of a good thing – excess vitamin A, for example, is toxic and can be lethal.

Herbal supplements: Research has also looked at whether things like Echinacea, selenium, beta-carotene, green tea, bioflavonoids, garlic, and wheatgrass supplements can help us see off germs. The problem is that substantial evidence is lacking and existing studies have been criticised for being poorly designed. Additionally, even if these things were shown to alter our immune system in some way, this doesn’t mean that they will improve our ability to combat disease.

Probiotic products: Probiotic products contain ‘good bacteria’ that are supposed to improve our gut health. In the past, these products were thought to enhance the immune system, but the European Food Safety Authority has ruled that they cannot claim to improve immune function because of a lack of scientific evidence. As research on the gut microbiome continues, we will likely come to understand more about how our gut bacteria can influence the immune system, but for now, the jury is still out.

The importance of balance:

Instead of concentrating on ‘boosting’ the immune system, a more useful approach might be to think about ‘balance’, as a healthy immune system is one that sits in balance. We can think about the immune system as a scale running from ‘underactive’ to ‘overactive’. We know that an immune system that is poorly functioning is a not good – for example, it plays a vital role in HIV and Malaria. But at the other extreme, an ‘overactive’ immune system can start targeting our cells and cause autoimmune diseases like rheumatoid arthritis and multiple sclerosis. But an overly vigorous immune response can also cause inflammation – which can be thought of as collateral damage, or friendly fire, from the war between the immune system and invading pathogens.

So should we try to boost our immune system?:

Rather than thinking about boosting the immune system, it is probably better to think about keeping it healthy and balanced. When it comes to deciding whether to buy products to help with that, it’s probably a good idea to maintain a degree of scepticism.

If you are eating a healthy balanced diet and exercising regularly, you are probably already doing enough to keep your immune system in good shape.

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