Immune Support Principles Versus Protocols

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FOCUS Discusses Key Aspects of Supporting Healthy Immune Function with Antony Haynes, RNT, BA(Hons), Dip ION

Antony HaynesAntony Haynes, RNT, BA(Hons), Dip ION, has been in private practice as a nutritional therapist since 1992, working each week from Harley Street, London. He is one of the most experienced registered nutritional therapists in the UK, and he is one of the first practitioners to implement the principles and practices of functional medicine there, beginning in 1994. Antony has been teaching for more than 25 years and is the author of two books, The Insulin Factor and The Food Intolerance Bible. With many years of successful, practical clinical experience, Antony remains focused on the essential requirements for a thriving practice, and he develops educational aids and clinical strategies to help healthcare practitioners achieve their primary aim of improving the health of their patients.

With Michael Ash, he cofounded Nutri-Link Ltd., the UK distributor of Allergy Research Group products. Antony is head of technical services at Nutri-Link Ltd., promoting the understanding of the use of dietary supplements to practitioners through webinars, seminars, podcasts, articles, and detailed case reports, calling on his nearly 30 years of clinical experience. Antony also is the editor and a contributor to Clinical Education, a free, peer-to-peer service that offers clinicians a closed forum to ask clinical questions and receive evidence-based responses by experts in their fields.

 

FOCUS: What are your immune-support staples—the things that almost everyone should be taking to support normal, healthy immune function?

HAYNES: Good question. I do not really have ‘protocols’, but I certainly have ‘principles’. Typically, the only time I give advice to anybody is after having taken a detailed case history. And that means looking at about 435 bits of collated data, or more, about the individual.

So, that being said, I have to say zinc is probably the number-one nutrient I have found to be low in the majority of individuals I have tested over the past 28 years. Although individuals may also have a lack of vitamin D and magnesium, making sure one has enough zinc is particularly important for the immune system. With zinc, I really don’t recommend over 40 mg daily, and I prefer 25 or 30 mg (or maybe higher for the first week), because with zinc you have the antagonism with manganese and copper, as well as iron.[1],[2]

If someone is generally well, then I might recommend a multiple antioxidant–type formula to cover the nutritional fundamentals, including vitamins A and C and selenium. If individuals have a higher need for immune support—perhaps they have a history of frequent infections or maybe they have been ill—then I might certainly consider additional nutrients or other immune supporting agents.

Firstly, I would make sure they have adequate selenium. I am aware that the threshold is 400 mcg daily and I would not recommend supplementation with dosages that high, but I often recommend between 200 mcg and 300 mcg initially. I would also test to make sure that their vitamin D levels were optimal, and the testing for vitamin D is far more available than that for vitamin A. Vitamin A, however, may be equally important, and it may also be made even more insufficient, or become functionally deficient, if consuming higher doses of vitamin D.[3] I consider the application of a multivitamin containing both of these nutrients, or can also consider them as single nutrients so you can control their dose independently.

Some of the cell receptors for vitamin A and D are shared; they both play an important role in immune function.[4],[5],[6] Vitamin A is not to be underrated—it is particularly important for respiratory tract and digestive health. The way vitamin A was described before it became known as a vitamin was as the “epithelial nutrient.” So, vitamin A is important for the healing and health of the lining of our gut—it is also an anti-ulcer agent—and very important for lung health. The whole world is aware now of the need for vitamin D, but at present it seems many are much less aware about vitamin A.

Vitamin D and fish oil have become, in a sense, “green” allopathy, if you will, where healthcare practitioners are recommending them to everyone. But there really are other things that need to be balanced out with these nutrients, and if not, there might be some effects that are contrary to those aimed for if you do not balance them. For vitamin D, one of these balancing nutrients is vitamin A, and for the omega-3s, it is the beneficial omega-6s that might be reduced as a consequence of the preferential sequestration by the body of the omega-3 fatty acids.

So, overall, for the vitamins and minerals, I would say zinc, selenium, vitamin D, and vitamin A, and then vitamin C. I am aware of the liposomal form of vitamin C really being the “Rolls-Royce” of vitamin C, although the straightforward buffered vitamin C, taken through the day, also is of great benefit to support immunity. Typically, your bowel tolerance will indicate that you have hit your current threshold for Vitamin C dosing for overall support, but 2-4 gms a day are normally well tolerated with divided dosing.

 

FOCUS: What are important nutrients for older individuals to be taking to support a healthy immune response?

HAYNES: Bear in mind that the efficiency of the biological machinery, of digestion and absorption, typically lessens as we age, particularly for individuals 70 and above. So, even if one is eating a super diet that is rich in nutrients, there may well be an increased need for immune nutrients that can only be met by supplementation. In terms of assessing diet, I like the Aggregate Nutrient Density Index scoring system from Joel Fuhrman, MD; it works very well for assessing diet and is a good indication of the overall nourishment that food provides you.

In addition to covering the basics, glandulars and mushroom extracts are two additional food concentrates I would certainly consider for older people.

I would have to say that the glandulars for immunity are very useful, particularly in aging individuals. However, after 28 years in practice I find I am now recommending glandulars as support for younger and younger people.

“I like to use a combination of glands: the thymus, spleen, pancreas, and adrenal, possibly also with thyroid gland, or simply a thymus glandular.”

If an older person is ill, I go to one of my favourite supplementations of all: mushroom concentrates or extracts. I use a variety mix of different mushrooms, with cordyceps, reishi, shiitake, maitake, turkey tail, and snow fungus. I am a firm believer in the therapeutic role of mushrooms, and looking back at their history, I understand they are the oldest living organisms on the planet, plant-wise. So, they have had a lot of time to adapt to their environment, and it is these long generated adaptive molecules that can enhance the immune activity within us.

I do enjoy learning about the reasons why broccoli and many vegetables are good for us, and for some of them, how their defence systems get activated when we chew or cut them. For example, with the cruciferous vegetables, the process of cutting or chewing allows them to release components grown in their cells to activate our immune system via the aryl hydrocarbon receptors within the gut. For other things, the highest levels of antioxidants are often in the fruits skin. Blueberry, for example, has many antioxidants embedded in the skin. This is because their seeds are very close to the skin, and the skin is designed to protect it from the strong UV rays.

It is also important to bring up vitamin B12. I am conscious that at any age, people can present having a need for B12 that will not show up in serum B12 testing. I know of many individuals who had their B12 levels tested by their doctor, and I have recommended tests for B12 and methylmalonic acid. In many cases where the serum B12 has been elevated, it has actually been elevated along with methylmalonic acid, and as such, the individual may actually have insufficiency of B12, whilst their serum showed it was high when B12 was tested alone.

 

FOCUS: Do you have a particular protocol that you use to help protect against viral infections?

HAYNES: I certainly do, although again, it is always based on principles, really—not just a ‘protocol’ without further considerations for the individual.

A few years ago, I had the pleasure of visiting Newport Beach, CA, to meet Richard Laub, PhD, to have a conversation with him and see his chemistry lab. Dr. Laub obtained his PhD in chemistry and has done a lot of amazing work in understanding the properties of humic acid. One of the things I learned from him is that not all humic acids are the same, which is one thing I want to highlight.

Humic acid works by effectively stopping the “stickiness” of viruses, keeping them from attaching to neighbouring cells like the sticky burrs of burdock.

Thus, it keeps the virus from penetrating potential host cells and decreases overall viral burden by subsequently reducing replication. According to Dr. Laub, because of its mechanism of action, it is theoretically effective against virtually all virus. And tests in vitro have shown its efficacy against many including herpes simplex virus, human immunodeficiency virus, influenza, and others.[7],[8],[9],[10] However, not all humic acids have the same antiviral activity, which is very important to note.

Taken prophylactically, humic acid can help protect against viral infection. Typically, it is just taken once with breakfast and once with dinner, so it is very easy to implement. At the time, Dr. Laub also confided in me that the group working in his lab, 14 people or so, had not taken a day off sick for five years—because they were taking humic acid every day. So, I am a big fan of humic acid, and think that it is one of the best supplements to help defend yourself against viral infections specifically. However, I am careful to not raise dosages humic acid too much during an active infection, because in some people there can be a Herxheimer or die-off reaction.

With something like the herpesvirus family of infections, from which someone might experience outbreaks of cold sores or shingles, I am also aware of the data supporting the use of the amino acid L-lysine and have found it to be very effective in reducing related outbreaks. However, it may be more effective taken away from food to avoid any competitive absorption with other amino acids present in the meal, although I do recognise that taking it with a meal is often easier to remember.

My third-most used antiviral supplement is olive leaf extract, which contains oleuropein. Olive leaf extract has a wide array of actions: it is an antioxidant and has anti-inflammatory, anti-aging, anti-atherogenic, antimicrobial, and antiviral properties. It has been used for thousands of years now and is a well-studied natural product.

Another supplement on my list is colostrum. It is a fantastic immune-support product, in part because of its quick action on the immune system in the gut. Although most practitioners appreciate colostrum for immune support, not everyone would immediately recognise its antiviral potential as well. Given that some 70% of our immune system is present in the gut,[11] colostrum is particularly helpful in supporting immunity in the gut and for assisting in the resolution of enteric infections. However, it is not only limited to this area, and the immunoglobulins and other compounds found in it help support systemic immunity as well. If you do not have a dairy sensitivity or allergy, colostrum is very well tolerated, and is easy to administer to children.

Sometimes I also recommend lactoferrin, which binds iron in the gut and so prevents the iron from being available for pathogenic microbial use, and it has antiviral activity.[12] Lactoferrin partners well with colostrum, perhaps not surprisingly, as they are both found in the breast milk that infants, with their very underdeveloped immune systems, receive when they are nursing.

I have also worked with many clients using a combination of the mushroom reishi, Chinese licorice, shrubby sophora, and noni. I have found this combination, distilled from a larger traditional Chinese medicine formula, benefits individuals’ respiratory health wonderfully well, and also has anti-inflammatory and anti-infective properties.

Licorice is also an excellent natural antiviral product; I have recommended it for many people with a variety of viral infections. It supports the Th1 cell–mediated immunity and optimises interferon gamma (IFNγ) levels as well.[13] It also raises cortisol levels for several hours after taking it, and accordingly its important to monitor blood pressure if taking it regularly.

 

FOCUS: Is there anything different you would do when supporting someone with an active viral infection?

HAYNES: With an active infection, I would consider a week of higher doses of zinc and sodium selenite, and higher doses of vitamin C. I also often use N-acetylcysteine (NAC) which supports the Th1 lymphocytes.

What I have also found useful in helping people manage viral infections is pancreatic enzymes. Usually I use pancreas glandular from pork (which provides proteolytic enzymes), away from food. I have been an advocate of this approach for 25 years; I find the enzymes can work wonderfully well with humic acid, olive leaf extract, and/or monolaurin.

 

Pancreatic enzymes can help break down the proteins related to the virus as well as the immune complexes, and thus may enhance the efficacy of other immune supportive and antiviral nutrients.

However, as with other supplements, its important to titrate doses slowly to minimise the risk of an immune response to the cell wall fragments – also called a Herxheimer event.

 

FOCUS: Do you have any favourite herbs or nutritional supplements for balancing out the inflammatory response?

HAYNES: Proteolytic enzymes can work well for many things, including this. I really find them to be useful for a wide array of defence generated responses because they lyse and break down many inappropriate proteins in the body. Really, one of the only contraindications is if one is on blood thinners—then they would not be appropriate at a high dose but could still be utilised at a low dose with relevant monitoring.

Other things vary; I might include CoQ10, vitamin E and tocotrienols, and an omega-3/-6 combination. Sometimes I might do high doses of omega-3 with omega-6 for a week in an inflammatory condition such as rheumatoid arthritis.

Often, with inflammation and oxidative stress, the clinical focus is essentially to stop the ‘factory from producing so much toxic exhaust or toxic fumes’. What we must do then is intervene with nutritional support that helps the liver management of toxic compounds. So, I would say NAC would be one of my favorites to support the liver, along with other glutathione support. Intervening at the level of the gut with something like the probiotic Lactobacillus rhamnosus GG can also be useful for reducing inflammation stemming from gut related immune responses.

I also use a brown seaweed, Ecklonia cava, which is high in antioxidants for individuals who have an inflammatory process occurring. I have found it an excellent product for people with fatigue associated with a persistent inflammation state like fibromyalgia or chronic fatigue syndrome.

So by now, you can really see how it is important to capture and integrate the case history with each person to know what the primary drivers of their inflammation is, so you can make choices from interventions such as the ones I have described to address it most effectively. As I have already said, the nutritional choices are developed from mechanisms and the related principles, not a standard protocol.

 

FOCUS: What other activities do you advocate to support immune function and overall health?

HAYNES: Getting your bare feet in the grass. There is nothing quite like it, but of course it is more easily said than done when you are in larger cities or other places where access to clean grass is scarce. I appreciate the famous Dutchman Wim Hof, who has the ability to sit on ice for 40 minutes and claims to see positive changes in health markers — inspired by him, I take cold showers, ending a hot shower with a minute or five of cold. I also practice a breathing routine: breathing out longer than breathing in to engage the parasympathetic nervous system. This seems to confer benefit to your immune system, which is less efficient when the sympathetic system is dominant.

Everyone needs a balance between sympathetic and parasympathetic systems; however, a question I have never found an answer to, is how many hours in the day we need one versus the other. Hopefully when we are sleeping, we have parasympathetic dominance; otherwise, we would be awake, tossing and turning. In my estimation, about 12 to 15 hours of parasympathetic dominance would be ideal.

Moving meditation is something I recommend to virtually everyone to begin to be more in the ‘here and now’. As Eckhart Tolle teaches, rather than being more mindful, it is important to achieve mind-less-ness, to be in the here and now. There is no stress in the here and now. The control of one’s mind, and actively engaging in the mindless or thoughtless process, can be undertaken in a ritualistic process every day. One way to try this would be working for 25 minutes and then finding some moving meditation activity for five minutes, for example as you walk in the grass or outside—then I think you become more productive in the work you do in the next 25 minutes. I have found It is much better to break up the day and decompress during it rather than working nonstop, and then needing a couple glasses of your favourite beverage in the evening to try and achieve the same effect.

I have had the pleasure of acquiring a house with a lovely garden, so I now garden for nearly an hour every morning, just mopping up the weeds. I have really found how gardening transports you to the here and now. Also, I believe that when your eyes see lots of green and lively colours, the experience is vital component for your well-being.

I also recommend tapping on the sternum over the thymus a few times a day, I have found EFT (emotional freedom technique) tapping, visualisation, mantras, and rituals to be a safe and useful therapy. We have really lost some of these things—our daily rituals, that is—not only amid the pandemic, but in our busy modern lives as well.

What I have found works is creating one’s own rituals. The key for me as a practitioner is finding what is best for a client—finding what resonates with them, and then helping them to be accountable for it and instilling it as a practice over the next 30 to 42 days (the amount of time it really takes to make a habit).

Really, if it is not yet evident here, I very much favour daily routine and ritual, and to carry the discipline over—that is, the discipline of the mind—as it is a very, very important thing for health. And again, it is never just protocols, always principles.

References

[1] Sandstead HH. Zinc interference with copper metabolism. JAMA. 1978 Nov 10;240(20):2188.

[2] Lind T, et al. A community-based randomized controlled trial of iron and zinc supplementation in Indonesian infants: interactions between iron and zinc. Am J Clin Nutr. 2003 Apr;77(4):883-90.

[3] Allergy Research Group. No, YOU Complete Me: The Synergy of Vitamins A and D. FOCUS Newsletter. Special 40th Anniversary Issue. 2019:17-8.

[4] Jimenez-Lara AM, et al. Interaction of vitamin D and retinoid receptors on regulation of gene expression. Horm Res. 2000;54(5-1):301-5.

[5] Carlberg C. Lipid soluble vitamins in gene regulation. Biofactors. 1999;10(2-3):91-7.

[6] Zou A, et al. Retinoid X receptor (RXR) ligands activate the human 25-hydroxyvitamin D3-24-hydroxylase promoter via RXR heterodimer binding to two vitamin D-responsive elements and elicit additive effects with 1,25-dihydroxyvitamin D3. J Biol Chem. 1997 Jul 25;272(30):19027-34.

[7] Kloecking R, et al. Anti-HSV-1 activity of synthetic humic acid-like polymers derived from p-diphenolic starting compounds. Antivir Chem Chemother. 2002 Jul;13(4):241-9.

[8] Lu FJ, et al. In vitro anti-influenza virus activity of synthetic humate analogues derived from protocatechuic acid. Arch Virol. 2002;147(2):273-84.

[9] Kornilaeva G, et al. New Humic Acid Derivative as Potent Inhibitor of HIV-1 Replication. Med Gen Med. 2004;6(3):A10360.

[10] Vetvicka V, et al. The Relative Abundance of Oxygen Alkyl-Related Groups in Aliphatic Domains Is Involved in the Main Pharmacological-Pleiotropic Effects of Humic Acids. J Med Food. 2013 Jul;16(7):625-32.

[11] Vighi G, et al. Allergy and the gastrointestinal system. Clin Exp Immunol. 2008 Sep;153 Suppl 1(Suppl 1):3-6.

[12] van der Strate BW, et al. Antiviral activities of lactoferrin. Antiviral Res. 2001 Dec;52(3):225-39.

[13] Wang L, et al. The antiviral and antimicrobial activities of licorice, a widely-used Chinese herb. Acta Pharm Sin B. 2015 Jul;5(4):310-5.

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