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Supporting and Boosting Your Immune System

Jul 6th 2020 | By Craig P. Tanio, MD, FACP, IFMCP

Boost Immune System

In these times, understanding how to best support and boost your immune system is critical knowledge. Given the newness of COVID-19, unfortunately there are no peer-reviewed research regarding the clinical effectiveness of strategies to boost your immune system specifically for COVID-19. However there has been research in many of the interventions discussed below on other viruses. These are supplemental to the current CDC recommendations that emphasize regular hand washing, physical distancing, mask wearing and obtaining testing in presence of symptoms.

Sleep: A study1 in 2015 showed that less than 5 hours of sleep increased the risk of developing a cold by 350% compared to individuals who slept at least 7 hours a night. It is important to practice good sleep hygiene. Ensure your bedroom is cool, dark, and quiet. Turn off all screens at least an hour before bedtime.

Stress management: Chronic stress can adversely affect the immune system response such as increasing production of pro-inflammatory cytokine IL-6.2 A variety of mindfulness and stress management techniques such as meditation and breathing exercises have been shown to reduce cytokines such as CRP and NFK-Beta.

Nutritious foods: Research shows that a spectrum of brightly colored vegetables and fruits have a positive impact on immunity in part due to the natural flavonoids that they contain. Cytokines that are positively affected include NLRP3 inflammasome signaling, NFK-B, TNF-A, and IL-6 among others. We recommend eating 7 to 10 cups a day.

The Institute of Functional Medicine has conducted a systematic review of nutraceutical and herbal interventions to support the immune system.3 There were five interventions that were listed as having strong evidence in supporting the immune system on respiratory infections and minimal harm. 4

Immunity Boosting Collection of Foods
  • Andrographis Paniculata
  • Beta Glucans
  • Elderberry
  • Vitamin C
  • Zinc

Andrographis: Andrographis has been used in Chinese medicine systems for centuries for the treatment and prevention of upper respiratory tract infections. It has been shown to reduce the expression of COX-2, inhibit platelet activating factor inflammatory responses and to decease the activity furin protease, a step in COVID-19 protein insertion.

Beta Glucans: Numerous human trials have shown that beta glucans decrease upper respiratory tract infections and symptoms compared to placebo. They modulate immune activity through its affect on the innate immune system through interactions with pattern recognition receptors.

Elderberry: A evidence-based review of elderberry conducted by the Natural Standard Research Collaboration concluded that there is level B evidence to support the use of elderberry for influenza. It can significantly increase (not decrease) inflammatory cytokines including IL-B1.

Vitamin C: Vitamin C may help to prevent infections, including those caused by viruses and bacteria. Regularly administered vitamin C has been shown to shorten the duration of colds, and higher doses of vitamin C during an illness reduce inflammation. 5

Zinc: Zinc contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. There is evidence that it suppresses viral attachment and replication. There is also evidence that zinc supplementation both prevents viral infections and reduces their severity and duration. Zinc itself is able to inhibit coronavirus RNA-dependent RNA polymerase activity. It has been hypothesized in multiple publications and demonstrated in one published study that zinc may enhance the efficacy of hydroxychloroquine in treating COVID-19 patients. 6

There are 3 other nutritional interventions besides these “top 5” that can be particularly of benefit.

Vitamin D: Multiple studies have shown that Vitamin D helps reduce the risk of colds and flu. Multiple studies have shown that hospitalized patients with COVID-19 have a lower Vitamin D level than controls.7 We recommend a target Vitamin D level between 50 and 80.

Vitamin A: Supplementation can be helpful in supporting the immune system, particularly respiratory infections. Vitamin A is involved in the development of the immune system and plays regulatory roles in cellular immune responses and humoral immune processes through the modulation of T helper cells, secretory IgA, and cytokine production. Vitamin A should only be used in this manner for short-term use. Patients with moderate Vitamin A deficiency will particularly benefit.

Probiotics: Studies have shown that probiotic use can decrease the number of respiratory infections, particularly in children. Probiotics contain “good bacteria” that not only support the health of the gut but also influence immune system functioning and regulation.8

For more information on the herbal and supplement therapies and what might be right for you, please email us at or call the office. You may also request a Consultation on these immune-boosting herbals/supplements available at Rezilir to help guide you on what would be best for you and your health journey.


  1. Prather AA, et al. Behaviorally assessed sleep and susceptibility to the common cold. Sleep. 2015; 38(9): 1353–1359.
  2. Godbout JP, Glaser R. Stress induced immune dysregulation: implications for wound healing, infectious disease and cancer. J Neuroimmune Pharmacol.2006 ;1(4):421.
  4. Strong evidence is defined as 2 independent human studies demonstrating a correlation between intervention and patient-oriented outcome; mechanistic plausibility or one additional independent human study required.
  5. Hemilä H. Vitamin C and infections. Nutrients. 2017;9(4): E339. doi:10.3390/nu9040339
  6. Hulisz D. Efficacy of zinc against common cold viruses: an overview. J Am Pharm Assoc (2003). 2004;44(5):594-603. doi:10.1331/1544-3191.44.5.594.hulisz
  7. Bergman P, Lindh AU, Björkhem-Bergman L, Lindh JD. Vitamin D and respiratory tract infections: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2013;8(6):e65835. doi:10.1371/journal.pone.0065835
  8. Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015;(2):CD006895. doi:10.1002/14651858.CD006895.pub3

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