During a time of heightened potential infection from cold, flu, or COVID-19, favorably modulating immune function can be an important strategy for not only reducing the chance of infection, but for potentially reducing the severity of and sequelae from infections. Since lifestyle factors have a large effect on immune function, the modifiable lifestyle factors below are excellent first steps.
Overall Recommendations: Research indicates that plant-based foods such as those high in phytonutrients (PaleoGreens and PaleoReds), water- and lipid-soluble vitamins (Primal Multi), and other antioxidants, as well as dietary fiber (PaleoFiber), can help down-regulate an overactive immune response.
Specific recommendations for patients:
Inflammation and immune responses often occur together in a viral infection. While inflammation is required in the initial stages of an immune reaction to infection, prolonged release of inflammatory mediators (e.g., interleukins, prostaglandins, tumor necrosis factor-alpha [TNF-alpha]) may cause system-wide perturbations. Low-level chronic inflammation and activation of the innate immune response are suggested mechanisms for increased risk of lifestyle-induced diseases such as type 2 diabetes. Therefore, to lower inflammatory load, clinicians suggest refraining from eating a Westernized diet and shifting toward a balanced dietary pattern resembling the well-studied Mediterranean diet.,,
Furthermore, data from the Nurses’ Health Study suggests that an inflammatory dietary pattern has been identified as one that is high in “sugar-sweetened soft drinks, refined grains, diet soft drinks, and processed meat but low in wine, coffee, cruciferous vegetables, and yellow vegetables.” Therefore, reducing or omitting foods that negatively impact the inflammatory cascade—such as those containing added sugars, salt, or trans fats, as well as those that have a high glycemic index or excessive amounts of saturated fats—would be helpful in lessening the overall inflammatory burden. A systematic review has shown that a single, high-fat processed meal (e.g., a meal consisting of white bread, butter, cheese, and a milkshake) leads to increases in the inflammatory cytokine interleukin-6 (IL-6) of around 100% relative to baseline within six hours of eating. Given that a range of pesticides are also known to impact immune function, where financially feasible, increasing consumption of organically grown produce may lower the inflammatory burden and improve immune function.
As part of maintaining the balance of inflammation, the omega-6 to omega-3 fatty acid ratio needs to be evaluated. A low ratio of omega-6 relative to omega-3 fats can shift the production of prostaglandins from the series-2 (inflammatory) to the series-3 (anti-inflammatory) compounds. Simopoulos recommends an omega-6:omega-3 ratio of 1:1 to 2:1, which is in alignment with traditional diets. Another dietary factor shown to be inflammatory, particularly in those with autoimmune disease, is salt (sodium chloride) intake, due to its ability to induce pathogenic T helper 17 (Th17) cells.
In conjunction with avoiding foods that provoke inflammation, increasing foods with known anti-inflammatory effects may be beneficial. These include plant-based foods such as fruits, vegetables, and legumes, which contain phytonutrients shown to have anti-inflammatory effects such as polyphenols and flavonoids. (Such as PaleoGreens and PaleoReds)In a study of healthy European adolescents, the pro/anti-inflammatory ratio was inversely associated with dietary intake of polyphenols. Even adding plant-based, anti-inflammatory foods to an inflammatory meal may offset the impact. For example, high intakes of fat and carbohydrates have been shown to stimulate markers of innate immunity, particularly the toll-like receptor (TLR) families. However, adding in orange juice to a high-fat, high-carbohydrate meal was shown to blunt the typical release of endotoxin, potentially due to the flavonoid content of the juice.
REDUCING OXIDATIVE STRESS AND INCREASING ANTIOXIDANT LEVELS
One of the initial aspects in viral infection is what is referred to as a “cytokine storm,” or an abundance of oxidative stress, which can produce damaging free radical compounds such as reactive oxygen and nitrogen species (ROS/RNS). To alleviate oxidative stress, it is important to consider a two-pronged approach:
Secondly, including antioxidant-rich, nutrient-dense foods in the daily diet, such as those from plants, may be a helpful measure for crowding out nutrient-depleted foods and reducing oxidative injury., Antioxidants can be vitamins or phytonutrients that are water-soluble (e.g., vitamin C) or fat-soluble (e.g., carotenoids, tocotrienols) in nature. An analysis of 1,113 food samples revealed the following food categories as some of the highest in antioxidants (listed in order of level):
HARMONIZING THE GUT MICROBIOME
Since the gastrointestinal tract harbors a majority of immune system activity, it is essential to keep it nourished with the necessary nutrients for a healthy gut microbiome. Dietary fibers from whole, plant-based foods can be fermented by bacteria for energy, resulting in the production of short-chain fatty acids (SCFAs) that have pleiotropic effects, including positively influencing epithelial barrier function and reducing pathogen cytotoxicity from compounds produced by harmful bacteria. Butyrate is one of these SCFAs with immune-modulating activities, including improving gut barrier function and innate immunity. High-fiber diets can directly modulate immune reactivity by increasing levels of SCFAs, which can activate the G protein–coupled receptors on various tissues, including immune cells. Further, SCFAs have epigenetic effects, which could ultimately alter immune cell function. Recommendations for fiber intake are for a minimum of 14 grams per 1,000 kcal, or approximately 25-35 grams daily for most individuals.
Fermented foods such as yogurt, kefir, kimchi, miso, and sauerkraut may provide microorganisms and secondary metabolites such as alkyl catechols that may help with immune response and even reduce the incidence and duration of respiratory infections. Lactic acid, which is a byproduct of fermentation, has been shown to reduce pathogen growth in the oral cavity, oropharynx, and esophagus. Furthermore, specific strains of microorganisms may impact specific viruses and may be important for targeted actions related to immune function. For example, a kefir containing six lactic acid bacteria strains resulted in increased natural killer cell activity and interferon-gamma secretion in response to tumor cells. In general, probiotic microorganisms within the Lactobacillus and Bifidobacterium species have been demonstrated to exhibit numerous beneficial effects on immunity through their interactions with macrophages, enterocytes, and dendritic cells, as well as Th1, Th2, and regulatory T (Treg) cells.
A NOTE ABOUT PLANT-DERIVED COMPOUNDS AND IMMUNITY
As discussed above, a common thread throughout the mechanisms related to immunity relates to the anti-inflammatory, antioxidant, and gut-balancing effects of plant-based foods. Specifically, plant foods contain thousands of phytonutrients, which have been categorized into phytonutrient families. One of the groups of plant compounds shown to be helpful for immunity is polyphenols, a category consisting of more than 8,000 different compounds such as flavonoids (e.g., isoflavones and anthocyanins) and non-flavonoids (e.g., phenolic acids and stilbenes). These phenolic compounds are ubiquitously found in plant foods like fruits, vegetables, nuts, seeds, legumes, and whole grains. On a physiological level, they can serve as foodstuff for the gut microbiome, resulting in the metabolic production of favorable metabolites for immune enhancement. At the molecular level, they are thought to regulate immune function through several mechanisms, including favorably modifying proinflammatory pathways involving nuclear factor-kappa beta (NF-kB), mitogen-activated protein kinase (MAPK), and arachidonic acid, along with suppressing TLR. Coupled with their anti-inflammatory properties, they can inhibit oxidative enzymes responsible for free radical generation, such as xanthine oxidase and NADPH oxidase, while stimulating the endogenous production of helpful antioxidant enzymes like superoxide dismutase. Examples of food-based polyphenols with immune-regulating activity include quercetin (e.g., apples and onions), resveratrol (e.g., grapes), epigallocatechin-3-gallate (green tea), and curcumin (turmeric).
PLANT DIETARY DIVERSITY
What is key for immunity is not just ensuring the intake of plant-based foods in the diet but getting a diverse blend of plant compounds for the gut microbiome. As stated by Heiman and Greenway, “The more diverse the diet, the more diverse the microbiome and the more adaptable it will be to perturbations.” The gut microflora can be modified through dietary components and, ultimately, significantly impact markers of metabolic health that relate to inflammation. For example, in one clinical trial with Danish adults, it was found that those who had a less diverse gut microbiome also had an inflammatory phenotype and greater metabolic dysfunction, including adiposity and ability to gain weight, insulin resistance, and dyslipidemia. Another clinical trial in overweight and obese individuals indicated that less microbial gene diversity (40% lower) was associated with increased metabolic dysfunction and inflammation. The researchers suggested that dietary intervention may be helpful for improving microbial gene richness.
Unfortunately, our exposure to plant varieties has significantly decreased over time from several thousand to mere hundreds, with most of the food in the world coming from fewer than twenty plant and animal species combined. As is typically advised with food intolerance and/or allergy, rotating plant foods in the diet every three to four days may be important in ultimately conferring greater immune resilience. Having greater dietary diversity may also ensure better nutrient status, and lower rates of allergic disease, as has been demonstrated in children.,
Moreover, some may contend that meeting daily servings of fruits and vegetables is sufficient; however, a study in healthy women suggests that diversity is a major factor. The women were divided into two arms, each consuming 8-10 servings of fruits and vegetables but with different levels of botanical diversity, with one group having five botanical families and the other group having selections from eighteen botanical families. While both diets were helpful in reducing lipid peroxidation, the higher diversity diet resulted in a significant decrease in DNA oxidation specifically. As a general guideline, it has been suggested to encourage patients to aim for 50 unique, plant-based foods in a week.
Overall Recommendations: Both acute and chronic stress can result in dysregulated, suppressed immune function. Under these conditions, susceptibility to illness is more likely. Monitoring stress levels through biofeedback markers such as heart rate variability (HRV) may assist in knowing when to implement stress management strategies and in having a means to assess their efficacy, as well in helping to track resilience-building approaches. Practicing stress-modifying techniques on a regular basis using HRV and other modalities can result in greater resilience when confronted with stressors.
In 1936, Hans Selye defined stress as the nonspecific response to change. Some degree of stress may be healthy for normal functioning and even beneficial for immunity (referred to as ‘hormesis’), while chronic, low-level stress without resolution or coping behaviors may suppress immune function. Hence, the field of psychoneuroimmunology was created decades ago to acknowledge the effects of psychological distress on health conditions, primarily through the mechanism of increased inflammation.
It is now well established that these stress states can significantly alter not just wound healing but exacerbate inflammatory immune states such as autoimmune disease, asthma, and allergy. They have also been implicated in the morbidity and mortality seen in diseases of immune dysregulation, including cancer, HIV, and inflammatory bowel disease. More specifically, chronic stress is associated with increased risk of viral infection like the common cold. Furthermore, stress affects both respiratory disease susceptibility and severity.
There are several proposed mechanisms by which stress impacts immune function. In general, earlier scientific discussion alluded to stress as immunosuppressive. More recent thinking suggests that stress causes immune dysregulation or an ‘inappropriate’ response, such as shifting the Th1/Th2 cytokine balance toward the Th2 side, resulting in lowered defense against infection and increasing hypersensitivity diseases. For example, even a brief mental stress condition in healthy adults can significantly reduce Treg cells, resulting in less self-tolerance and greater propensity toward autoimmune conditions.
The process of stress is two-fold. First, the sympathetic nervous system stimulates the release of epinephrine and norepinephrine. These compounds activate inflammation through the production of transcription factors that bind to genes to increase the synthesis of inflammatory cytokines. Second, the hypothalamus-pituitary-adrenal (HPA) axis produces glucocorticoids like cortisol. Long-term secretion of these compounds can lead to lower proinflammatory cytokines (which are needed at the start of infection), matrix metalloproteinase activity, bacterial peptide activation, hypoxia, and, eventually, higher risk for infection, inflammatory-based diseases, accelerated aging, and even early mortality.
Due to the chronically elevated baseline of stress that most people have and fail to recognize because they have become accustomed to higher levels over time (allostasis), it is helpful to have assessments that gauge stress level. Simple pen-and-paper tests are available through the IFM Toolkit or through the American Institute of Stress. There are also biofeedback and metric devices such as heart rate variability (HRV) technologies and even continuous HRV monitors to provide an indication of the overall balance of the autonomic nervous system. HRV is a known marker for a variety of health outcomes, including loss of vagal activation and heightened release of inflammatory markers. In a study with 30 healthy women subjected to an acute psychosocial stressor, reductions in HRV measurements during the stressor were associated with elevated levels of TNF-alpha and IL-6 just one hour after being exposed to the stressor. Therefore, HRV may provide an opportunity to monitor one’s resilience, or one’s ability to effectively respond to a stressor through production of inflammatory markers.
Whereas an inability to regulate emotional states and labile mood have been associated with immune system suppression and virus shedding,, stress reduction and/or management has been shown to reduce infection and the severity of infection. A systematic review of mind-body practices indicated that several practices such as yoga, meditation, mindfulness, tai chi, qigong, relaxation response, and breath regulation result in favorable gene expression patterns that benefit immune regulation. At the molecular level, these practices downregulate NF-kB and positively influence a set of molecular factors referred to as a conserved transcriptional response to adversity (CTRA), known to be associated with less resistance to viral infections from herpes simplex viruses, HIV-1, Epstein-Barr virus, and cytomegalovirus, to name a few. In a small study with long-term qigong practitioners versus controls who did not practice, it was shown that the qigong practitioners had 132 downregulated and 118 upregulated genes (of the 12,000 genes measured in neutrophils, which are most important in fighting infection) that translated into improved immune response and even delayed cell death. Several studies have also found that gardening may contribute to a sense of mental and physical well-being,,,, as well as improving mood and reducing stress. Overall, the collective literature on these mind-body and stress-reducing practices would suggest that favorable responses come with repetition and consistent practice.
Overall Recommendations: Due to its restorative and regulatory abilities, sleep has a major influence on immune function and inflammatory signals. Therefore, getting good quality, sufficient quantity (seven to eight hours) and adequate deep phasic bouts of sleep is of utmost importance as part of immune maintenance, as well as during times of recovery from illness. It is advised to have patients practice good sleep hygiene and maintain consistent sleep hours by turning off screens, ensuring the room is cool, quiet, and dark, and setting reminders to go to bed on time.
One of the common recommendations from experts when it comes to improving immune function is to ensure good quality (e.g., perceived quality as much as adequate deep rapid eye movement [REM] sleep) and sufficient quantity of sleep due to the bidirectional relationship between sleep and immunity., Sleep is inherently restorative and enables an internal resetting or regulatory aspect of one’s physiology. There is substantial evidence to suggest that sleep disturbance such as insomnia or lack of quality sleep, or even one night of reduced sleep, is associated with disturbances in the innate immune system due to disruptions in the circadian homeostasis of inflammatory cytokines and in the activities of immune cell subpopulations (e.g., CD4+, CD8+, and natural killer [NK] cells)., Viral infections may present with symptoms such as fever and pain that may interfere with sleep patterns. Medications such as corticosteroids and analgesics may also negatively impact one’s ability to sleep. In those with hepatitis C virus–related neurological dysfunction, about half exhibit abnormal sleep rhythms. Moreover, the virus itself may cause physiological shifts in sleep. For example, earlier research with animals showed that intranasal exposure to the influenza virus led to subsequent changes in the proportion of non-REM sleep and REM sleep. In a small human clinical trial with individuals injected intranasally with a particular rhinovirus, those who developed symptoms had sleep time reductions of 23 minutes, consolidated sleep decreases of 36 minutes, and overall sleep efficiency reduced by 5%.
Furthermore, there can be complex interactions between sleep disturbance and other lifestyle factors, such as social connectivity. For example, Irwin and Opp demonstrated an association between improved sleep efficiency and lower IL-6 production, which was particularly enhanced in those with positive social relationships. Conversely, women who had poor social relationships had greater sleep inefficiency and even higher IL-6 levels. Interestingly, there was a compensatory effect for healthy social networks, even in the groups with poor sleep. In other words, even when sleep efficiency was poor, the levels of IL-6 could be modulated through having good relationships. Similarly, those who had good sleep but poor social relations had lower IL-6.
Collectively, while the findings have been mixed, a host of studies have indicated greater inflammatory cytokines occurring with shorter sleep duration (defined as less than five to six hours per night) compared with seven to eight hours.,, Moreover, it is worthwhile to note that perception of the quality of one’s sleep is important, as upregulated white blood cell counts have been shown to be associated with subjective accounts of sleep quality. Even after a bout of sleep restriction, it may take more than a night or even three nights of sleeping longer (such as eight to ten hours) to resolve any neurobehavioral issues related to the sleep deficiency.,, In some cases, immune cell activity of certain types can be restored short-term after sleep depletion.,
Overall Recommendations: Moderate, regular physical activity helps immune system function by raising levels of infection-fighting white blood cells and antibodies, increasing circulation, and decreasing stress hormones. A personalized exercise program can be designed even during homestay by utilizing features in one’s home environment, including apps, the internet, and technology, or by taking the opportunity to experience the calming, immune-supportive effects of being in nature (while, at the same time, social distancing).
Physical activity provides the movement the body needs to oxygenate, circulate blood and nutrients, and eliminate waste from cells, all of which are essential to the function of the immune system. In addition to the blood vessels delivering blood to organ systems, the lymphatic system, present largely in the neck, armpits, and groin, plays a big role in the transport of immune factors. Indeed, the social distancing and home-stay that has been recommended by many states and nations may invariably disrupt people’s activity schedules and lead to more sedentary behavior, such as more screen time or sitting, reclining, or being stationary, which could further negatively impact immune activity.
According to a recent interview with Jeffrey Woods, PhD, a professor who researches the effects of exercise on immune response at the University of Illinois at Urbana-Champaign, it is important and safe to be exercising during the coronavirus pandemic, especially for those who are regular exercisers. For those who are sedentary, he comments, “If you are sedentary, it may be a good idea not to overdo it. Research suggests that unaccustomed strenuous or prolonged exercise might reduce the function of your immune system defenses.” For those who are infected with COVID-19 and have upper respiratory tract symptoms that are mild (e.g., sinus congestion, runny nose), he recommends moderate exercise, but not for those with severe symptoms (e.g., body aches, fever, chest cough, fatigue, or shortness of breath).
Research has shown that a single bout of physical activity can stimulate immune function due to the rapid cellular changes that take place, but regular exercise is much more robust in its effects on immunity., There continues to be debate about the intensity of activity and whether high-intensity activity in untrained individuals is indicated. For highly fit individuals, continuation of intensity may not be problematic; however, for those who are more sedentary or ill, it remains unknown as to whether the initiation of an exercise program at greater intensity of activity would be helpful or if it would be physiologically stressful., While the effects of initiating high-intensity physical activity in a sedentary person remain unknown, it would seem prudent to start some kind of exercise program regardless because of the plethora of findings that support the benefit of physical activity for the immune system. Even in healthy individuals, too much strenuous exercise, especially when it leads to weight loss, has been associated with immunosuppression when compared to controls leading their normal lifestyle. In the absence of rigorous data, it is most likely best to tailor activity duration and intensity to the individual.
The preponderance of data is on the effect of aerobic activity on immune health., At this time, there are preliminary reports of tai chi/qigong and yoga assisting with immune function. In a study with 50 older adults assigned to either a control or tai chi/qigong group for five months, the group assigned the activity had improved antibody response to an influenza vaccine that was administered within the first week of intervention. Furthermore, a systematic review of 15 studies on yoga found that it can lead to a pattern of inflammation downregulation, including lower IL-1beta, TNF-alpha, and IL-6, as well as enhancements in immunity. The authors concluded, “These results imply that yoga may be implemented as a complementary intervention for populations at risk or already suffering from diseases with an inflammatory component.”
Due to the constraints brought on by the COVID-19 pandemic, exercise may need to be adjusted to fit a home-based schedule. Suggestions include stretching, walking in nature, stair climbing, chair squats, and even simple yoga poses since they require no equipment. There are many online offerings through apps and the internet to engage in classes if more interaction is desired. Furthermore, this time of social distancing may be optimal for being in nature to experience the therapeutic effects (referred to as Shinrin-yoku, or forest bathing), such as an increase in NK cell activity, physiological relaxation, immune recovery, and a decrease in stress. Dr. Steven Blair’s quote from Dr. Ken Powell, “Some activity is better than none, and more is better than less,” seems to be particularly relevant during these times of quarantine and the resulting risk of increased sedentary behavior. Ideally, 30 minutes of physical activity every day, or a total of 150 minutes weekly, should serve as a guideline for most individuals.
Overall Recommendations: Social connections are important to consider and evaluate with patients as part of their health status. In some cases, interactions with others will be supportive, and in other instances, there may be conflict or stress. For immune health, the focus should be on reducing exposure to interactions perceived as hostile and non-supportive and, at the same time, on emphasizing and encouraging time with others who are positive or affirming. For those people who may be lonely or isolated, such as the elderly, as well as those who may be at increased risk of immune compromise, providing ideas for regular social connection may be helpful for establishing a routine. Ideas might include participating virtually in local community events or in a religious or spiritual group.
Social relationships are a significant determinant of immune health. The absence of these essential relationships, collectively referred to as social isolation, loneliness, bereavement, and/or conflict, has been implicated in the up-regulation of pro-inflammatory processes, and reduced immune functionality (e.g., NK cell activity). Furthermore, those who are socially isolated have heightened response to stressors. Older individuals may be particularly at risk for the effects of loneliness if their immune system is already compromised.,
Excessive social interaction may confer either immune benefit or harm through increased exposure to potential pathogens depending on whether or not conflict or stressors are present., There is the viewpoint that an individual who is socially interacting with others may, in fact, have the potential for greater antiviral immunity, although much is determined by the individual’s environmental exposures, toxic burden, and even genotype. Interestingly, during bouts of increased inflammation, as during illness, there is some instinctual inclination within most people to socially withdraw. The amygdala region of the brain is part of this sickness-induced social withdrawal process and may even be protective by encouraging retreat from threatening images. Therefore, it may be important to personalize exposure to social influences depending on the circumstances, including the current state of health or illness.
The converse of social isolation is to have support and connection, which can come through a variety of means, such as family and friends, community, and spiritual or religious practices. Overall, research indicates that individuals who feel this sense of interconnection, either horizontally with other people or vertically through a sense of something greater than themselves, have favorable gene expression, decreased stress, increased antibodies, and better health outcomes. In a study of over 8,000 adults, greater social engagement and cohabitation were associated with lower C-reactive protein, fibrinogen, and white blood cells. In a study of 155 adults, a positive relationship was found between sociability and salivary secretory immunoglobulin A, an essential feature of mucosal immunity.
The sum of the research on connection and the immune-inflammatory response is mixed as this connection appears to be influenced by several factors, including the response of the individual and their preferences, personality, and health state, as well as whether or not there is conflict or stress in the interactions. However, if there is a sense of supportive connection through the social network, it appears that immune markers can be favorably influenced.
In general, lifestyle interventions can be an effective means to help patients regain their locus of control during times of uncertainty like those experienced in a pandemic. Substantial research indicates that certain dietary patterns and lifestyle patterns offer viable options for improving overall health, especially by reducing inflammation. The anti-inflammatory effects of foods and aspects of how one chooses to live may, in turn, favorably influence and support immune system function as a preventative measure for reducing the risk of illness. Furthermore, in the case of (viral) infection, implementing these changes could significantly offset the severity and sequelae incurred from illness.
While this unprecedented COVID-19 pandemic may be stressful and have mental-emotional ramifications both short- and long-term for individuals, practitioners can effectively use this time as an opportunity to redirect patients’ efforts into an evaluation of their current lifestyle and motivate to make changes that will reduce the immediate risk from acute viral infection, as well as the long term risk of chronic disease.
SUMMARY OF CLINICIAN RECOMMENDATIONS
Ashwagandha is a bidirectional true adaptogenic botanical. Numerous scientific studies have shown that Ashwagandha improves thyroid function. The herb interacts with each thyroid condition in a way that supports balance and restoration of proper function. Individuals who suffer with hypothyroidism can benefit from taking Ashwagandha because of its ability to naturally stimulate the production of thyroid hormones. It remedies the incorrect process that occurs between the pituitary gland and the thyroid stimulating hormone. More specifically, Ashwagandha has consistently demonstrated its ability to produce more of the T4 hormone. Surprisingly, the same herb that has been shown to stimulate the production of thyroid hormones can also balance an overproduction of these same hormones.
The use of Ashwagandha in the treatment of hyperthyroidism is shown to be effective in many studies. Often times, excess production of the T3 hormone is the cause of the common symptoms of hyperthyroidism. Because Ashwagandha lowers oxidative stress and boosts T4 levels, the overproduction of T3 is slowed dramatically. This often results in the relief of symptoms commonly associated with hyperthyroidism. Ashwagandha and thyroid function are clearly linked in a way that should be encouraging for those who experience thyroid dysfunction. Those who are looking for a natural way to support healthy levels of thyroid hormones should absolutely consider Ashwagandha for thyroid imbalances.
This herb is easy to include as part of almost any wellness routine, and can result in additional benefits that are not related to Ashwagandha and thyroid function.
HPA Adapt - Supporting Stress Hormone Balance via the HPA Axis with Adaptogenic Herbs*
The hypothalamic-pituitary-adrenal axis, or HPA axis, is the central part of the stress response system. It involves a complex set of interactions and feedback loops between the hypothalamus, the pituitary, and the adrenal glands. The HPA axis also plays a role in the regulation of other systems of the body, including the gastrointestinal, neurological, and immune systems. Therefore, supporting optimal HPA axis function is important to maintaining overall health and wellness.
HPA Adapt combines five powerful adaptogenic herbs to help the body better respond to both mental and physical stressors.* With key ingredients, such as Rhodiola root extract, Sensoril® Ashwagandha, and Eleuthero root extract, combined with standardized extract of Maca and Holy Basil leaf, HPA Adapt supports healthy stress hormone balance via the HPA axis.*
Servings Per Container: 30
Take 2 to 4 capsules daily on an empty stomach, or as recommended by your healthcare professional.
Serving Size: Four Veg Capsules
Amount Per Serving
Calories ... 5
Total Carbohydrate ... 1g
Rhodiola Root Extract ... 400mg
standardized to contain 3% rosavins and 1% salidroside
Ashwagandha Root and Leaf Extract ... 300mg
(Withania somnifera)(Sensoril® brand)
Eleuthero Root Extract ... 300mg
Holy Basil Leaf Extract ... 200mg
standardized to contain 2.5% triterpenoic acids including ursolic and oleanolic acids
MacaPure® brand Maca Root Extract ... 150mg
standardized to contain 0.6% macaenes and macamides
Other Ingredients: vegetable capsule (modified cellulose), ascorbyl palmitate, cellulose, silicon dioxide
This product does not contain
Do not use if pregnant. If nursing, diabetic or taking any prescription drugs, consult your healthcare professional prior to use.
Sensoril® is a trademark of Natreon, Inc. and is protected under U.S. Patents 6, 153, 198 & 7, 318, 938.
MacaPure® is a registered trademark of Naturex, Inc.
Staying informed about the spread of COVID-19 and the measures that you can take to protect your health and the health of your loved ones is critical. However, spending too much time researching coronavirus can negatively impact your sense of well-being and compromise your physical health. Reports often contain words like outbreak, pandemic, and quarantine that can stir up a lot of anxiety—and even panic. Growing uncertainty about the virus’s impact in the US has many people feeling worried or stressed. While the concern is warranted, it detracts from what is most important: staying healthy.
Did you know that chronic stress and anxiety can actually make you more likely to catch a cold or become ill? It’s no surprise that stress has negative impacts on a person’s health; after all, no one likes to be stressed! But reducing stress isn’t just good for your mental health, it also improves your body’s immune response.
Why Stress Matters for Immune Function
In modern life, stress can feel constant and omnipresent. The human body perceives and responds to stress both psychologically and physiologically. Stressful events can cause emotional feelings of unhappiness or being overwhelmed. Often, stress is accompanied by very real physical reactions: rapid heartbeat, sweating, muscle pain, and digestive difficulties. Psychological stress can also dramatically increase inflammation in the body. This is because your body—and more specifically your brain—is triggered to produce stress hormones that send signals throughout the nervous system. When the body is responding to stress, it reallocates energy to fight an imminent danger. While this can have short-term immune benefits, chronic stress reduces immune function. Thus your body’s natural ability to fight off infections is lowered.
Stress, immunity, and disease progression have reciprocal relationships. A powerful way for you to reduce your risk and stay healthy is to practice stress management techniques, which researchers suggest have potentially powerful effects on your immune system.
Six Strategies to Reduce Stress
Reducing stress can improve your overall health, especially during these uncertain times. Try a few of these mindfulness and stress management techniques to help support your immune system.
Avoid Information Overload: While it can be tempting to hunt for all of the available information, emerging research may contain errors or inaccuracies that will be addressed over time. Even experts recognize that they don’t know enough about emerging infectious diseases. By taking a deep breath and acknowledging that no one has all the answers, you can avoid unwanted stress and anxiety.
Exercise: In addition to distracting you from anxiety, exercise also changes your brain function and can decrease stress. Exercise can increase expression of feel-good neurotransmitters like serotonin.
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 Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;16:1057-1072. doi:10.17179/excli2017-480.
Liu YZ, Wang YX, Jiang CL. Inflammation: the common pathway of stress-related diseases. Front Hum Neurosci. 2017;11:316. doi:10.3389/fnhum.2017.00316.
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 Schakel L, Veldhuijzen DS, Crompvoets PI, et al. Effectiveness of stress-reducing interventions on the response to challenges to the immune system: a meta-analytic review. Psychother Psychosom. 2019;88(5):274-286. doi:10.1159/000501645.
 Hubner AY, Hovick SR. Understanding risk information seeking and processing during an infectious disease outbreak: the case of Zika virus. Risk Analysis. 2020. doi:10.1111/risa.13456.
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Hand washing: The most well-established way to prevent respiratory infections such as influenza and coronavirus is frequent and thorough hand washing with soap and water. Scrub your hands thoroughly with soap and water for at least 20 seconds.
Hand sanitizer: Handwashing with soap and water is the best way to reduce germs, but if they are not available, alcohol-based hand sanitizers that contain at least 60% alcohol can help to reduce the spread of infection. Note: avoid any products containing triclosan, a known hormone-disrupting chemical.
Covering your mouth and nose: Cover your mouth and nose with a tissue when coughing or sneezing; if your hands are not free or you don’t have a tissue, cough or sneeze into your sleeve, not your bare hands.
Not touching your face: Avoid touching your eyes, nose, and mouth with unwashed hands, which can help provide the virus with a route of entry into the body. Since the average individual touches their face an average of 15 times per hour, remain vigilant!
Keeping surfaces clean: Clean and disinfect frequently touched surfaces, especially when someone is ill. Surfaces to consider include doorknobs, phones, computer keyboards, remotes, and other surfaces that are frequently touched in rooms such as the bathroom and kitchen.
Stress reduction: Chronic stress can negatively alter immune system responses, making you more likely to get sick. Identify your personal stress reduction strategies and practice them regularly.
Sleep: Sleep has a big influence on immune function, so it is essential to get plenty of sleep. Practice good sleep hygiene and maintain consistent sleep hours—turn off screens, ensure the room is cool, quiet, and dark, and set a reminder to help yourself go to bed on time.
Exercise: Moderate, regular physical activity helps to boost immune system function by raising levels of infection-fighting white blood cells and antibodies, increasing circulation, and decreasing stress hormones. Establish and follow an exercise program to not only help prevent respiratory infections but also to improve cognitive and physical resilience.
Nutritious foods/diet: Research indicates that brightly colored vegetables and fruits boost immunity better than most supplements. Eat plenty of fruits and vegetables—aim for 10 servings per day. Include fermented vegetables or other probiotic-containing foods.
Natural Means of Boosting Immunity
Most over-the-counter medications only treat the symptoms of viral infections; most don’t actually help the immune system fight the infection. Although there is no research to determine what is effective specifically for coronavirus, the following are some natural modalities you can utilize to both address symptoms as well as boost your immune system if you do come down with an illness:
Self-care: When battling upper respiratory infections, top priorities are plentiful hydration and rest. Drink plenty of fluids; homemade vegetable or bone broths are also extremely beneficial. Various herbal teas/hot drinks can help with hydration and reducing symptoms; good choices include peppermint, ginger, eucalyptus, chamomile, and hot water with lemon, honey, and cinnamon.
Sore throats: Salt water gargles are excellent for loosening mucus and helping fend off bacterial throat infections. Hot teas and lozenges containing slippery elm are excellent demulcents (to relieve minor pain and inflammation of mucous membranes) for soothing irritated sore throats. Two tablespoons of honey in hot water can also help to soothe and decrease throat inflammation and pain. Chamomile and peppermint teas are also helpful for soothing irritated sore throats, as are teas or infusions made from marshmallow root and licorice root, both of which can act as soothing demulcents. Ginger-Tussin Syrup for dry or inflammed throat.
Respiratory congestion & sinuses: For respiratory congestion, use a humidifier, vaporizers, or steam inhalers, or spend time in steamy baths or showers. Vaporizers and inhalers can also be used with decongestants or essential oils such as eucalyptus, menthol, peppermint, or frankincense. Nasal xylitol sprays are very beneficial especially when mixed with Silvercillin, as is nasal irrigation using a neti pot or nasal irrigation bottle. Buffered saline is easy to make or can be purchased in packets and eliminates any irritation to delicate, irritated mucous membranes.
SUPPLEMENTS, NUTRIENTS, AND FOODS TO SUPPORT IMMUNE FUNCTION
There are several nutrients, plant-based botanicals, and supplements that can boost immune function and provide symptom relief during illness and may help to shorten the duration of illness. For preventing and treating viral upper respiratory infections, consider some of the following:
Vitamin C: Vitamin C may help to prevent infections, including those caused by bacteria and viruses. Regularly administered vitamin C has been shown to shorten the duration of colds, and higher doses of vitamin C during an illness can also act as a natural antihistamine and anti-inflammatory.
Vitamin D: Vitamin D, known as the “sunshine vitamin,” is one of the most important and powerful nutrients for supporting the immune system. Numerous studies have shown that it helps reduce the risk of colds and flu. Unfortunately, a high percentage of the population is deficient, so daily supplementation (ideally in the form of vitamin D3) offers the best protection.
Vitamin A: For short-term use and particularly for those with moderate vitamin A deficiency, supplementation can be extremely helpful in supporting the body’s ability to fight infections, particularly with regard to respiratory infections.
Zinc: Zinc plays a significant role in boosting immunity. Often available as lozenges, zinc can help to reduce the frequency of infections as well as the duration and severity of the common cold when taken within 24 hours of onset.
Selenium: Selenium, a key nutrient for immune function, is also an antioxidant that helps boosts the body’s defenses against bacteria, viruses, and cancer cells. It may particularly help to protect against certain strains of flu virus. Selenium is easily obtained from foods, with the richest source being Brazil nuts.
Honey: Honey, preferably raw, is a good demulcent (it relieves minor pain and inflammation of mucous membranes), has antioxidant properties, and has some antimicrobial effects. It is helpful for coughs and sore throats and can be added to hot tea.
Garlic: Garlic contains a variety of compounds that can influence immunity. Some studies have shown that both fresh garlic as well as aged garlic extract and some other garlic supplements may reduce viral upper respiratory infection severity as well as function in the prevention of infection with viruses that can cause colds.
Probiotics: Probiotics contain “good bacteria” that not only support the health of the gut but also influence immune system functioning and regulation. Studies have shown that probiotic use can decrease the number of respiratory infections, particularly in children.
* This document is only intended to identify modalities that may boost your immune system. It is not meant to recommend any treatments, nor have any of these modalities been proven effective against coronavirus. Always consult your physician or healthcare provider prior to using any of these modalities. For up-to-date information on COVID-19, please consult the Centers for Disease Control and Prevention at www.cdc.gov.
The prevalence of vitamin D deficiency varies from 40-80 percent (general population) to almost 100 percent (patients with musculoskeletal pain) among Americans and Europeans. Vasquez, Manso, and Cannell described the many benefits of vitamin D3 supplementation in a "paradigm-shifting" review published in 2004.
Our review showed that vitamin D deficiency causes or contributes to depression, hypertension, seizures, migraine, polycystic ovary syndrome, inflammation, autoimmunity, and musculoskeletal pain, particularly low-back pain. Clinical trials using vitamin D supplementation have proven the cause-and-effect relationship between vitamin D deficiency and most of these conditions by showing that each could be cured or alleviated with vitamin D supplementation. Per our review, daily vitamin D doses should be 1,000 IU for infants, 2,000 IU for children, and 4,000 IU for adults, although some adults respond better to higher doses of 10,000 IU per day. Cautions/contraindications include the use of thiazide diuretics (e.g., hydrochlorothiazide) or any other medications that promote hypercalcemia, as well as granulomatous diseases such as sarcoidosis, tuberculosis, and certain types of cancer, especially lymphoma. Effectiveness is monitored by measuring serum 25-OHvitamin D, and safety is monitored by measuring serum calcium. Dosing should be tailored for the attainment of optimal serum levels of 25-hydroxy-vitamin D3, generally 50-100 ng/ml (125-250 nmol/l) as illustrated. Image below: Interpretation of serum 25(OH) vitamin D levels: Updated from Vasquez et al, Alternative Therapies in Health and Medicine 2004 Sep
Your immune system is an exquisite orchestra of cells, tissues, and organs that work in harmony to ward off disease-causing microorganisms. But sometimes the system is out of balance, allowing germs to invade and make you sick. Experts say you can restore harmony in your immune system by fine-tuning what you eat, how you exercise, and how you think.
"Our immune system relies on several factors to fight and combat bacteria, viruses, and other invaders," Dr. David Friedman, a bestselling author and syndicated radio and television expert. "To be healthy, you need to eat healthfully."
Friedman, who is board certified in integrative medicine, explains: "Every day, billions of cells in the human body die and get replaced with new ones. The building blocks for every cell in our body come from the food we consume. Eating healthful food protects the cells from disease and increases our lifespan. Consuming the wrong type of food makes our immune system weaker and we become more prone to disease."
Friedman, the bestselling author of "Food Sanity: How to Eat in a World of Fads and Fiction," recommends the following immune boosting foods:
Asparagus. This tasty green stalk is a great source of vitamin K, which helps with blood clotting and building strong bones. Asparagus also provides vitamin A for heart health, vitamin C to support the immune system, vitamin E, which acts as an antioxidant, and vitamin B6, which also prevents heart disease.
Asparagus is also loaded with minerals including iron, which supports oxygen-carrying red blood cells, copper for energy production, and calcium, which improves bone health. Asparagus increases your energy levels, protects your skin from sun damage, and helps with weight loss.
Bell Peppers. Bell Peppers are very high in vitamin C and just one provides 170% of the recommended daily allowance. Vitamin C helps build up your immune system, which is why many healthcare providers recommend taking this vitamin at the first sign of a cough, cold, or flu. Vitamin C from bell peppers is helpful in the production of white blood cells, which is the body's major defense against disease. Friedman notes that yellow and red peppers have more antioxidant benefits than green peppers.
Sweet Potatoes. These sweet, starchy tubers are helpful at building up the immune system. They are rich in beta-carotene, which helps maintain healthy skin, vision, and organ function. Beta-carotene consumption has been associated to a decreased risk of lung and breast cancer. Just one large sweet potato contains more than 850 milligrams of potassium, a nutrient that helps relieve muscle spasms and reduces inflammation, says Friedman.
Brussels Sprouts. These low-calorie miniature cabbages are super immune system boosters. They are rich in vitamins and minerals, including vitamin B6, vitamin C, vitamin K, vitamin A, folate, iron and manganese. Their high fiber content also helps support bowel regularity and gut health, says Friedman, who has been featured on the Discovery Channel, Newsweek, and Reader’s Digest. Brussels sprouts also contain kaempferol, a powerful antioxidant that may reduce cancer growth, decrease inflammation, and promote a healthy cardiovascular system. They also help keep blood sugar levels in check, thus reducing the risk of diabetes. Studies have shown that the alpha-lipoic acid, another antioxidant in sprouts, helps protect brain health and has anti-aging properties.
Broccoli. One cup of broccoli provides more vitamin C than you need in an entire day without causing the blood sugar spike that happens with drinking citrus juice. Many health experts consider broccoli to be the healthiest of all the cruciferous vegetables because of its ability to help lower the risk of lung, colorectal, breast, bladder, stomach, and prostate cancers. Broccoli is a solid source of vitamin K, which again, promotes bone health. Additionally, several studies have shown that broccoli consumption lowers the risk of cardiovascular disease.
Mushrooms. These delicious fungi are one of the few natural dietary sources of vitamin D, which helps the body absorb calcium, promoting bone health. Countless scientific studies have revealed numerous ways that mushrooms can be useful in preventing and treating many health conditions, says Friedman. For example, studies conducted at the University of Florida's Department of Food Science and Human Nutrition found that eating shiitake mushrooms daily improves immunity better than any pharmaceutical drug currently on the market. Lastly, mushrooms are great for cardiovascular health thanks to their high fiber, potassium, and vitamin C content. If you have high cholesterol, eat more shiitake mushrooms. The stem of the shiitake mushroom is a great source of beta-glucans, which have been shown to lower blood cholesterol levels.
Whether you're trying to ward off the coronavirus, or just want to reduce allergies, autoimmune symptoms or your chance of getting the flu, we can all benefit by improving our immune status.
Rather than load you up with a list of different nutrients to take, I want to focus on one important, basic feature of improving immunity: reducing excessive and chronic inflammation. When inflammation is high, uncontrolled, or chronic ('inflammaging'), immune system functioning may have greater risk of suppression. Of course, we need a bit of inflammation to get healing underway, but it also has to be in check and be able to turn off.
One of the ways to keep a pulse on inflammation is to have a proper balance of omega-6 to omega-3 fatty acids in the body. As you can see in the diagram below, there are two categories of ESSENTIAL fatty acids. If we have too much omega-6 fat relative to omega-3 fat, we can produce more inflammatory compounds, which may not be good for immune health.
Here's the summary:
❏ There's competition between them: These two families of fats compete, so when there is more omega-6 than omega-3 fats, omega-6 metabolites will predominate, and some of those metabolites, when produced excessively, have the potential to be inflammatory.
❏ The ratio of the two is important: The ratio determines production of pro-inflammatory or anti-inflammatory molecules. In general, a 4:1 ratio of omega-6 to omega-3 is preferred. The average ("inflammatory") processed diet is about 20:1, just to put it in perspective!
TAKE CARE OF YOUR GUT
Furthermore, we also know that immunity starts in the gut. The mucosal barrier in the gut serves as a barrier for pathogens (see graphic from this article below). Therefore, it's important to keep it intact and not 'leaky'. Similar to the gut, there is also the airway epithelium, which can be protected through omega-3 fats.
(Image Credit: https://doi.org/10.3390/nu11122990)
Therefore, a couple of takeaways to consider and discuss with your healthcare practitioner:
These four conditions are associated with heart disease, cardiovascular disease: atherosclerosis, insulin resistance, high homocysteine and angina pectoris.
Atherosclerosis is a condition in which cholesterol-rich plaque builds up along the arterial walls.
Get more exercise.
This will help maintain the health of the vessels leading to the heart, as well as strengthening the heart muscle itself.
Eat a low-glycemic diet.
b. Nutrition and Supplements
Fish oil. The omega-3 fatty acids in fish and fish oil supplements have been shown to be an effective preventive strategy against heart disease. They can lower triglyceride levels, increase HDL cholesterol, help minimize inflammation and blood clotting, and keep blood vessels healthy. Our products, OmegAvail Synergy and XanthOmega Krill Oil
Coenzyme Q10 (our product Q-Evail). This antioxidant is thought to be one of the most important antioxidant supplements for protection against many forms of cardiovascular disease. It helps protect LDL cholesterol from oxidation, maintain healthy blood vessels, protect against clots and plaque rupture, and support optimal functioning of the heart muscle.
However, one’s ability to convert ubiquinone from Coenzyme Q10 to ubiquinol may diminish with age and with increased oxidative stress in certain individuals. Therefore, these individuals would want to take the product CoQnol. CoQnol™ is a non-GMO form of ubiquinol, which is the reduced, antioxidant form of CoQ10. Both ubiquinone and ubiquinol are critical to the cellular ATP (energy) production cycle. Without the presence of both ubiquinone and ubiquinol within the body’s cells, cellular energy cannot be generated or sustained.
Resveratrol with Quercetin (our product Resveratrol Supreme). This antioxidant combination has demonstrated in research to be cardioprotective, anti-inflammatory, and neuroprotective at nutritional doses.
2. High Homocysteine
A high homocysteine level is primarily a sign of an inadequate intake of folic acid or vitamin B6. In short, if you don’t have enough of certain critical B vitamins, your homocysteine level can rise. At elevated levels, homocysteine is thought to contribute to plaque formation by damaging the arterial wall. High levels may also act on platelets and increase the risks of clot formation. Our product Homocysteine Supreme
a. Nutrition and Lifestyle
Genetics. There are genetic variations in folic acid absorption and utilization. Some individuals therefore need much more folic acid than the RDA of 400 mcg in a genetically acceptable form.
Stress. Epinephrine and norephinephrine are stress-induced neurotransmitters. Their metabolism in the liver involves methylation, a process that uses methyl groups, and can increase need for methyl donors like folic acid.
Coffee consumption. As coffee consumption increases, homocysteine levels increase.
Inadequate amounts of folic acid, vitamin B6 or vitamin B12 in an absorbable form. Our products Liposomal B Supreme or B Supreme caps or Primal Multi.
3. Insulin Resistance
The biggest roadblock to weight loss is blood sugar. So many of us just eat too many carbohydrates and our blood sugar gets way too high. When blood sugar is high, your body changes the sugar into fatty acids and sends it to storage in your fat cells. And then you get FAT!
If you have been in this high blood sugar cycle, then your cells may not be able to use sugar anymore. This causes high blood sugar, high insulin, and high triglycerides. That is called diabetes, or pre-diabetes, or insulin resistance, or metabolic syndrome. There are lots of names for this problem.
Berberine One of the top supplements for helping your cells to learn how to use sugar is called Berberine. Studies have shown that Berberine (a component found in Indian Berries) can help to lower blood sugar and insulin and decrease triglycerides. Our products Berb-Evail or Berberine Synergy.
Alpha-lipoic acid This antioxidant nutrient improves the cells’ response to insulin and can help stabilize blood sugar levels. Our products Berberine Synergy or Lipoic Acid Supreme
EndoTrim contains a powerful blend of vitamins, minerals, and plant extracts formulated to enhance the effects of a healthy diet and exercise regimen and help preserve our hard-earned lean muscle mass while also lowering body fat. By supporting a healthy balance of the hormones involved in blood glucose handling, the stress response, and the regulation of appetite, EndoTrim supports healthy metabolism and improvements in body composition naturally. EndoTrim also helps diminish cravings for refined carbohydrates especially when under stress.
As I’ve delved more into the world of food pharmacology (food as medicine), I’ve come to realize how important proper digestion is to health, particularly for those of us managing Chronic Disease conditions. People with Chronic Disease usually experience some level of nutrient deficiencies, food sensitivities, digestive issues, and infections. These symptoms are often caused by a diminished ability to absorb proper nutrients from the food we eat.
This is where digestive enzymes that help the body break down food, can be a critical tool for improving digestive health, boosting nutrient uptake, and reducing the symptoms of Chronic Disease.
What type of enzymes are best to take?
The answer depends on the symptoms you are experiencing, and the types of foods that are problematic for you. There are five types of digestive enzymes that are helpful for Chronic Disease — in this week’s article, I will focus on vegetable digestive enzymes, which are used primarily after the consumption of vegetables, especially those that may be difficult to digest due to their high starch and fiber content.
In the world of functional medicine, we often refer to the concept that all disease (and thereby all healing) begins in the gut. The gut performs the all-important role of digesting and absorbing the nutrients we take in. I like to say, “You are what you absorb.”
In a well-functioning gut, the body produces the appropriate enzymes to break down the food that is ingested. Enzymes, such as amylase and maltase, begin their work in the mouth as food is chewed. Further enzymes, such as lipase and lactase, are released by the stomach, pancreas, and small intestine to break down the food particles as they move through the digestive tract so that they can be absorbed by the body.
However, compromised intestinal function is almost always a factor in people with Chronic Disease, and oftentimes, the root cause of their thyroid condition.
When the intestinal walls become damaged due to a variety of possible culprits, including high levels of stress, toxins, infections, a deficiency in enzymes, and food sensitivities, the body becomes unable to absorb nutrients, due to the intestines’ inability to break down certain foods. Not only will a person become lacking in key nutrients, but those undigested food particles may damage the intestinal lining, causing or exacerbating intestinal permeability, or leaky gut syndrome (a precursor to autoimmunity).
When toxic substances permeate the intestinal lining and become absorbed into the bloodstream, the body may recognize them as foreign invaders. This causes inflammation in the body as it begins to attack the intruders, and eventually leads to autoimmunity.
When food particles are poorly digested, we are also more likely to become sensitive to them. People with Hashimoto’s are particularly prone to be sensitive to gluten, dairy, and soy because these proteins are among the most difficult to digest and are also the most commonly eaten proteins in the Standard American Diet.
When someone ingests foods that they are sensitive to, they will develop IgG antibodies, (which are the same types of antibodies that target the thyroid gland in autoimmune disease), towards these foods. With regular consumption, the immune system attack becomes up-regulated as the influx of poorly digested foods triggers the immune system to make more of these types of antibodies.
Additionally, the poorly digested foods will continue to feed the potentially problematic bacteria that live in the gut. (An overgrowth of opportunistic bacteria has been linked to autoimmunity!)
That said, there are ways to improve one’s digestion. Supplementing with the proper digestive enzymes can aid the body in digesting food, thereby increasing nutrient absorption and boosting gut health. In fact, a 2008 study published in the Alternative Medicine Review found that supplementing with enzymes provided a safe and effective treatment for various digestive issues, including lactose intolerance, celiac disease, and other digestive malabsorption disorders.
There are five types of enzymes that may be beneficial:
Vegetables and Digestion
We all know how important it is to eat our vegetables. In fact, many of my recommendations for healing the body through nutrient-dense whole foods, revolve around fueling the body with nourishing green vegetables. But for some people with Chronic Disese, a damaged gut and a lack of digestive enzymes can make vegetables difficult to digest, as their high fiber and starch content may be difficult to break down, especially in their raw form.
A 2009 study published in the World Journal of Gastroenterology found that conditions related to thyroid abnormalities, including both hyper and hypothyroidism, can be associated with digestive issues. While all the mechanisms and causes behind these digestive issues are not completely understood at this time, researchers have found that hypothyroidism can delay gastric emptying, and severe cases may lead to disturbances in esophageal peristalsis (which causes large pieces of digested food to be rapidly pushed toward the esophagus by the pharyngeal constrictor muscles). Given that up to 15 percent of hypothyroid patients have fewer than 3 bowel movements weekly, the study emphasizes the need for practitioners to recognize that digestive issues can be related to Chronic Disease conditions.
In some cases of Chronic Disease, an indigestible ball of plant fiber material known as a phytobezoar, which is formed out of undigested vegetable fibers, has been found to cause bowel obstruction. These masses of undigested material commonly consist of vegetable fibers from pulpy fruits, orange pits, seeds, roots, and leaves, but can be formed from any indigestible food fibers. Fibrous foods that are often found in phytobezoars include celery, pumpkin, prunes, raisins, leeks, beets, persimmons, and sunflower-seed shells. Gross, right?
A 2018 study in the Journal of Surgery Case Reports documented an 11 year-old boy who was admitted to the hospital for a bowel obstruction and subsequent surgery to remove the mass from his small intestine. After examining the mass and questioning the boy, it was discovered that he had eaten a large quantity of oranges, including the membrane, a few days earlier. This had caused the mass of undigested fruit fiber to form in his intestines. The authors of the study noted the importance of avoiding large amounts of plant fibers and chewing food thoroughly! While the boy was not noted to have a chronic condition condition, this study highlights the importance of proper fruit and veggie digestion.
Interestingly, insoluble fibers, which are high in vegetables like leafy greens, corn, celery, and bell peppers, have been shown to mechanically trigger symptoms of irritable bowel syndrome (IBS) as they move through the digestive tract. However, certain fibers — particularly soluble fiber such as psyllium — may actually be a helpful treatment for IBS. So perhaps the inability to digest the insoluble fibers is due to an enzyme deficiency, further contributing to the autoimmune cascade and IBS symptoms.
Symptoms of Poor Veggie Digestion
Common symptoms of poor veggie digestion include bloating, gas, constipation, and stomach pain. Symptoms of nutrient depletions that may occur when the body is unable to break down and absorb the nutrients in fibrous vegetables, are much further reaching and may include fatigue, hair loss, muscle pain, and autoimmunity itself.
Deficiencies in antioxidants such as vitamin C (which is found in high amounts in cruciferous vegetables, bell peppers, and leafy greens), vitamin E (Annatto-E by Designs for Health), beta-carotene (a vitamin A precursor), and the minerals selenium and manganese, often result due to poor vegetable digestion.
Folate is another important nutrient that can become depleted when vegetables aren’t properly absorbed. Common sources of folate include broccoli, asparagus, avocado, spinach, and Brussels sprouts. Getting enough folate from food sources is particularly important for those with the MTHFR gene variation, and can become challenging when veggie digestion is compromised.
Another clue that vegetables are not being properly digested is when vegetable fibers are found in stool samples. My collegues used to ask this question of their clients, but never did formal tracking, so out of curiosity, I asked my collegues to ask their clients via a survey about digestive health. Ninety-eight people answered the survey, and 82 percent of the clients that they surveyed stated that they had visible plant fibers in their stool. (While this can be easily seen with the naked eye, it can also be confirmed more objectively through stool testing, such as the GI-MAP by Diagnostic Solutions.
Solutions for Vegetable Digestion
I’d like to share some strategies to help you overcome veggie digestion issues so that you can help your gut heal, eliminate your symptoms, and prevent nutrient depletions.
Tips to Make Foods Easier to Digest
As I mentioned earlier, due to their high fiber content, vegetables tend to be the most difficult to digest when in raw form. However, there are ways of preparing vegetables that may help with digestion and nutrient absorption:
For those who experience bloating and abdominal discomfort after consuming vegetables, or who have noticed undigested vegetable fibers in their stool, a vegetable digestive enzyme that contains fiber-digesting enzymes may help you feel better.
Enzymes commonly used to help break down vegetables for better digestion include:
Designs for Health formulated the Plant Enzyme Digestive Formula supplement with a specific combination of enzymes, including cellulase and amylase, to help with this process. It also contains the enzymes protease, lactase, lipase, and phytase to help break down proteins, grains, and fats for optimal digestion.
I recommend taking one capsule with every meal that is high in vegetables — but be sure to consult with your practitioner before starting them to tailor the dosage to your individual needs.
Getting to the bottom of your own digestive issues can take some time and perseverance, but it is a crucial step toward recovering from Chronic Disease. Veggie enzymes have many benefits that can help to relieve many of the symptoms that are experienced with Chronic Disease, such as constipation, gas, bloating, and abdominal pain. As a bonus, improving one’s absorption of veggies can help increase their absorption of vitamins and minerals and, in turn, address underlying nutrient deficiencies.
If you are experiencing bloating, gas or abdominal pain when you consume fibrous vegetables, supplementing with a veggie enzyme formula (like the Plant Enzyme Digestive Formula) could help you boost your nutrient absorption and allow you to enjoy that spinach salad!
For issues with low stomach acid, I invite you to take a look at my article about the benefits of betaine with pepsin. I’ve also written an article that covers other types of enzymes that you may find beneficial in addressing digestive difficulties that are often times present with Chronic Disease.
As always, I wish you well on your journey to feeling your best!