02 May 2020
Digressing from my usual posts on skin health and skincare reviews for a topic that might be more relevant to most of you: how you can improve your immune system. In light of the ongoing spread of the 2019 novel coronavirus (Covid-19) in Singapore and the Disease Outbreak Response System Condition (DORSCON) level to Orange from Yellow- the heightened fears among Singaporeans is very understandable.
I understand and can see why the spread of the spread of the novel coronavirus, Covid-19 from Wuhan has brought out both the ugly and good side of Singaporeans. On a personal front, I can empathise with the concerns and fears. My heart is with my fellow healthcare staff who put themselves at the front line and put themselves (and their family members) at risk. Based on statistics, the majority of patients who were infected with the novel coronavirus Covid-19 from Wuhan recovered fully and the quoted fatality rate is 2-3%. It may not seem high; but this statistic is nonetheless significant.
Reporter’s Notebook: Life and death in a Wuhan coronavirus ICU is a heartwrenching read. It shares the insights and personal experiences of one of the doctors in the front line in Wuhan fighting Covid-19, Dr Peng. His situation, like many of his colleagues, is very precarious. They navigate the outbreak and bureaucracy with limited equipment and time. if you have a couple of minutes, it’s worth the read. It’s not an easy read either, your heart will break although Dr Peng’s resilience and resolve will have your faith in humanity restored.
It’s easy to allow our fears to overwhelm rationality and our social responsibilities. How we frame the narratives will also affect how we approach the issues that are at hand. In this context, I hope to be constructive and so I’ve put together this short post on some of the things that you can do to improve your immune system.
Our immune system is our body’s defense against infections. There is no cure or vaccine for the novel coronavirus Covid-19 yet, so improving our immunity is our best hope against infections. I’m sure that many of you are familiar with the precautionary measures against the spread of the novel coronavirus Covid-19 from Wuhan, which are equally important. There is enough visibility in the media on these measures so I won’t rehash them. Instead I’ll focus on lifestyle habits and interesting anecdotes about improving our immunity. I hope that you will find these tips useful.
Update March 2020:
Proper hand washing is crucial to reduce spread of Covid-19. This blogpost Covid-19: How to Treat Dry Hands from Washing will share about correct hand washing techniques; how to choose sanitisers and how to prevent and treat dry hands from washing
Micronutrients- such as vitamins A, B6, C and E; magnesium, zinc, iron and selenium are essential for functioning of the immune system1,2. A deficiency of micronutrients has been linked to poorer immune responses and complications from infections1,2.
Most of these micronutrients can be found in fruits, vegetables, legumes, whole grains, and lean sources of protein, nuts and olive oil. The data for nutritional supplements is equivocal; so the best way to load up these immune boosting micronutrients is through your diet. Covid-19
Update April 2020
Do Intravenous (IV) Vitamin C Drips Cure Covid-19 infections?
The use of intravenous vitamin C drips to treat infections including the flu has been controversial. Intravenous (IV) vitamin C drips deliver larger amounts of vitamin C directly into the bloodstream, as opposed to consuming oral vitamin C supplements that may not be 100% absorbed by the gastrointestinal tract.
Most of you might have heard of the advice to take vitamin C if you are unwell. The popularity of this piece of advice rose in the 1970’s when Nobel Prize winner, Dr Linus Pauling, advocated consuming vitamin C as a cure for cold. This quickly took off because it seemed to be an easy and cost effective way to strengthen one’s immunity against the cold. Now that the global spread of Covid-19 (Coronavirus) has reached unprecedented levels in modern times and there is still no cure or vaccine against Covid-19 in sight; high doses of intravenous vitamin C seem to be making a comeback in the news.
The big question is: Do IV vitamin C drips cure covid-19 infections? The short answer is no; that has yet to be proven. Research on the effect of IV vitamin C drips and the cold have also been equivocal and so the role of IV vitamin C drips in treating colds, infections and Covid-19 is not a part of mainstream treatment. There are currently trials underway to study the effects of IV vitamin C in infections, including whether IV vitamin C reduces the severity of infections. However, for now, IV vitamin C is not considered a cure for Covid-19. You can click on this link to to read a succinct summary by the Australian government on IV vitamin C and Covid-19 (Coronavirus) treatment.
However, Vitamin C, as a micronutrient, is essential for our body’s systems including our immune system to function properly. My advice is to maintain a healthy diet that also includes vitamin C to protect yourself.
Exercise hasn’t been shown to improve the immune system directly however, regular exercise improves cardiovascular health and mood. Being healthy in general is essential and patients who have preexisting medical conditions and/or are elderly have a higher risk of complications from the flu. This link from the Center for Disease Control and Prevention gives a summary about the risk factors that are known to increase a person’s risk of getting serious complications from the flu.
If you have a respiratory tract infection, avoid exercising as there is a small risk of myocarditis.
Sleep deprivation has been linked to multiple medical conditions, such as heart diseases and impaired immune responses. Immune response and responses to vaccines can be dampened by sleep deprivation.
Studies have also shown that a lack of sleep increases the risk of developing a cold after exposure to rhinovirus3. Another study also showed that a lack of sleep caused decreased Influenza vaccine response, indicating that sleep deprivation may be a factor for lowered immunity to the influenza virus4.
Probiotics are ‘good’ bacteria that are considered beneficial for gut and overall health. You can easily find probiotics in over the counter supplements and drinks. Depending on the reports that you read, probiotics may or may not be useful in boosting the defenses of your immune system.
Our understanding of probiotics is not complete at this point; probiotics might be useful but it is also likely to be strain specific. The 2 most common strains in probiotics are Lactobacillus or Bifidobacterium. Probiotic drinks and supplements are generally safe, but if you have conditions related to immune deficiency or chemotherapy, probiotics may not be safe, so speak to your doctor first before getting started.
Smoking and vaping release tobacco smoke into the respiratory tract. Smoke directly increases the exposure of lung cells to at least 60 carcinogens with the potential to cause DNA damage and cancer5. Besides damaging the respiratory tract, tar and nicotine also suppress the immune system’s defenses5-7. Second hand smoke is also detrimental to the people around smokers including the elderly, young and people who have infections. I hope that you have found today’s blogpost to be useful.
Please stay safe. To our healthcare heroes and everyone who’s working to keep all of us safe, salute! I’m rooting for you.
This post is part of a series of dermatological posts related to Covid-19. If you enjoyed this post, you might also enjoy the following blogposts:
1. Immune Function and Micronutrient Requirements Change over the Life Course. Maggini et al. Nutrients. 2018 Oct; 10(10): 1531.2.
A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Gombart et al. Nutrients. 2020 Jan 16;12(1).
3. Sleep habits and susceptibility to the common cold.Cohen et al. Arch Intern Med. 2009 Jan 12; 169(1):62-7.
4. Is Insomnia a Risk Factor for Decreased Influenza Vaccine Response? Taylor et al. Behav Sleep Med. 2017 Jul-Aug; 15(4): 270–287.
5. Tobacco carcinogens, their biomarkers and tobacco-induced cancer. Hecht. Nat Rev Cancer 2003;3:733-44.
6. Nicotine inhibits apoptosis induced by chemotherapeutic drugs by up-regulating XIAP and survivin. Dasgupta et al. Proc Natl Acad Sci U S A 2006;103:6332-7.
7. Association of cigarette smoking with decreased numbers of circulating natural killer cells. Tollerud et al. Am Rev Respir Dis 1989;139:194-8.