Immunity

The Covid-19 pandemic and currently growing concerns about a spike in flu this winter due to reduced social interactions through the pandemic has placed a greater spotlight on immunity. In brief immunity is our body's ability to fight infections. The stronger our immune system is therefore the better able we are to fight infections, and this applies as much to respiratory viral infections such as the Flu as infections of the skin after operations. I therefore thought that this was an apt time to run through ways that we can keep our immune systems as strong as possible. This is applicable to us in general through the autumn/winter months to keep as protected as possible from the more common viral infections, but also around any surgeries. Any stress your body is under - be that from an operation, illness, work/life stressor or other - suppresses our immune system. Therefore, when we can predict some of those stressors, for example in the lead up to and recovery from an operation, it is helpful to consider your immune system and look at ways you can keep it functioning as well as possible.

Below is a run-through of ways you can boost your immune system. If you are planned for surgery I would recommend starting these measures as soon as you agree to proceed to surgery, and continuing them for at least 2 months after.

1) Stay Active - regular heart raising cardiovascular and/or strength based exercise is important to a healthy functioning immune system and for keeping your body stronger should you develop an infection. There are a number of research studies showing a reduction in infections in those who undertake moderate intensity regular exercise, not to mention all the other health benefits we know of from undertaking regular exercise.

2) Adequate sleep - this means ideally 7-8 hours of sleep a night. Research studies show that reduced sleep duration significantly alters the functioning of our immune systems, and therefore our abilities to fight infections (Imeri L, Opp MR. How (and why) the immune system makes us sleep. Nat Rev Neurosci. (2009))

3) Eating a healthy balanced diet low/free from processed foods. There is growing evidence that eating a whole food (i.e. unprocessed) diet incorporating anti-oxidant-rich plant based foods such as leafy greens (spinach/kale/chard), berries (blueberries/strawberries/cherries etc...), beetroot with a heavier focus on plant based foods than animal derived products is beneficial not just for our overall health but also our immune system. See section on Diet for more information.

4) Manage stress. Stress has a negative impact on our immune system and therefore it is important to recognise if you are suffering from stress, and if you are consider ways to help you deal with this. Please see my webpage section on psychology in relation to this.

5) Supplements. There is a wealth of available supplements and a lot of attention in the media is given to them. In principle supplements should not be necessary provided we are mindful of the above 4 key areas, however factors such as our lifestyle's, farming methods, sunlight exposure (or lack of!) can mean that supplements are beneficial for us at certain times. The key supplements important for a healthy functioning immune system are:

- Vitamin D3 (5,000 iu, ideally 10,000iu daily): It is considered that most of us in Western climates such as the UK are deficient in Vitamin D particularly in the winter months. It is therefore recommended that we take vitamin D all year round if our sunlight exposure is low, and certainly in the autumn/winter months. It is best to take Vitamin D at night. In the UK Viridian and BiocareUK both supply good quality vitamin D supplements, however this will be available in most health food stores too.

- Vitamin C: citrus fruits such as oranges are rich in vitamin C. If you are starting to show signs of a viral infection such as a cold, or are in the lead up to your operation or the recovery phase I would recommend taking supplemental vitamin C. What we do not require we pass out, and therefore theoretically there is no maximum amount that we cannot exceed. However, at a certain level most people suffer stomach upset and therefore the recommendation to ensure you have adequate levels is to take this to 'gut tolerance (which means until you have mild diarrhoea'. BiocareUK supply an excellent low cost vitamin C powder that can be mixed in water. The recommended protocol to understand the levels you can take to 'gut tolerance' is to take 2g of vitamin C an hour (for 3 hours), then 1g an hour after that until you start to develop watery stool. Record how much you have taken to get to that point, and from there forward take half that amount daily in 2-3 divided doses.

6) Wash your hands regularly and avoid close contact (where possible) with those who are suffering from active viral infections.