Are oral supplements healthy or hype?
I see patients nearly every day who take one or, usually, more over-the-counter herbs, minerals or proprietary supplements, including such things as Echinacea, vitamin C, goldenseal, turmeric, green tea extract (read my warning on this one in the May 2019 issue of Healthy Living), garlic, zinc and an endless variety of proprietary supplement mixtures containing a dizzying number of herbs, minerals and more. All of these claim to improve health and prevent disease by “boosting” our immune system. Exactly what does that mean?
“Boost,” as used in medicine, is a weasel word; it sounds great but really doesn’t mean anything. Boosting our immune system conveys the idea that doing this is a good thing that will make us healthier and more resistant to illnesses and disease. Is this true?
Our immune system comprises a wide array of tissues, such as the spleen, lymph nodes and thymus gland. It encompasses many cell types, such as lymphocytes, plasma cells and white blood cells. It includes chemical mediators in our blood, such as histamine and complex proteins known as antibodies, as well as an intricate network of complex chemical reactions. All of these work in a coordinated fashion to protect us from everything from bacteria and viruses to cancers. Imagine the most complex, intricate system yet devised by human intelligence and ingenuity. Our immune system makes that look positively simple.
We have barely scratched the surface of understanding it. Our immune system can recognize our own unique body from any “other.” It detects invasion of our body by foreign agents and mobilizes our defenses to isolate or destroy the invader. A single exposure to a bacterium, virus or foreign protein can produce a “memory” for life so any future exposure to that agent will trigger a rapid immune response. This is the basis for the effectiveness of vaccinations for a variety of diseases. Our immune system can even kill cancer cells. Left to itself, in an otherwise healthy individual, it is extraordinarily effective.
To appreciate how important the immune system is, look at someone whose immune system has ceased to function effectively; someone, say, like a patient with HIV/AIDs. Untreated, such patients die quickly from infections or cancer, including infections and cancers rarely seen in patients with healthy immune systems. Cancer patients on chemotherapy often have a suppressed immune response and are subject to infections they would otherwise be able to resist with ease.
We also know what happens when the immune system is more active or sensitive than normal, in other words, boosted. We have an entire category of diseases that result when this happens. We call them autoimmune disorders and they include such terrible diseases as rheumatoid arthritis, lupus, scleroderma, Sjogren’s, temporal arteritis and a host of others, all of which are poorly understood and nearly all of which are incurable. In many of these conditions, the immune system actually attacks the normal tissues in the body of the individual. Allergies and anaphylaxis, which can be fatal, also are due to a hyperactive immune system.
The purveyors of herbs, supplements and other nostrums to “boost” the immune system never explain exactly how these work. Ads promote these with little evidence beyond testimonials, which are always suspect, in large part because of the placebo effect and because testimonials reflect subjective impressions, not evidence. What studies there are typically are flawed, clearly biased or wrongly interpreted to support the effectiveness of the particular product. Taking supplements you don’t need basically gives you expensive urine as your kidneys will eliminate anything in your blood that is not needed.
It has not been demonstrated that, in an otherwise healthy individual with a normal immune system, taking any oral supplement makes this function better in some way. If this were so, physicians would use such products on patients whose immune systems are compromised in some way. Medicine’s ability to “fix” the immune system is a crude, dangerous and complicated affair. Some patients, such as those with leukemia, can be cured only by destroying the cancerous immune system completely with radiation or chemotherapy, then restoring it from scratch using grafts of bone marrow, which contains all of the cells of the normal immune system. When these fail, as they sometimes do, death usually is the end result.
The best way to “boost” your immune system is to eat a healthy, clean diet of high-quality protein, healthy fats and plenty of fresh fruits and vegetables; get plenty of rest; de-stress your life as much as you can; get regular exercise; and avoid unhealthy habits like smoking, drug use and excessive alcohol consumption. It really is that simple, but patients continue to look for that magic bullet, and manufacturers of supplements are happy to supply them at a price.