Although cardiovascular disease is the leading cause of death in the over-65s, poor function of the immune system, leading to diseases including chest infections and pneumonia, is the third highest cause of death (behind cancer) in 55- to 65-year-olds, and the fourth highest cause after the age of 65. Furthermore, immune dysfunction is related to cancer and is the greatest cause of death in people aged 45 to 64.
We are constantly beset with flurries of press coverage regarding immune system dysfunction, particularly during autumn and winter when our elderly population is encouraged to have inoculations against pneumonia and influenza. Unfortunately, up to 75 per cent of the elderly actually don’t respond to vaccination—that is, their immune systems fail to create a defensive response against invading pathogens. What’s more, both its safety and effectiveness are poorly evidenced, particularly in those over the age of 65.1
We need to keep our immunity functioning at an optimal level to maintain healthy longevity. It is particularly important to keep the immune system functioning especially as we get older, owing to its natural tendency to falter at that stage. If immunity fails, it doesn’t matter whether every other part of your body is healthy. You’ll still face a rapid decline.
Most immunologists battle to keep up with advances in our understanding of the immune system, but here’s all you really need to know: how best to maintain immune function into old age.
How the immune system works
Innate immunity describes the body’s first-line and non-specific defence against invading organisms and altered potentially harmful cells, such as cancerous cells.
The first part of the innate immune system requires intact barriers, such as the skin and the inner membrane linings (known as epithelial layers) of the gut, lungs and upper respiratory airways (nose, sinus, throat), and the inner lining of the bladder. The integrity of these barriers stops foreign organisms and toxins from getting in.
These membranes produce defensive compounds that infuse the sebum (the slightly greasy compound in our skin), sweat and mucus made by epithelial cell linings. These defence compounds, known as immunoglobulins, are made by specialized cells—mostly white blood cells—that sit within or close to the barrier membranes.
Secretory immunoglobulin A (sIgA) is made predominantly in the 10 m (33 ft) or so of the adult small intestine. Its production is triggered in the newborn by colostrum, the initial breast milk.
Throughout our lives, sIgA is a vital part of our innate, first-line defence mechanism. Other components of our innate immune system include non-specific white blood cells known as phagocytes, which move through the bloodstream and body tissues while enveloping invading organisms and absorbing damaged and toxic cells.
Still other white blood cells produce chemicals that trigger inflammation, which attracts more blood-carrying defence cells, scar-tissue-forming cells, oxygen and nutrients to aid healing in the affected area. Inflammation is a vital part of our defence and repair process—until it becomes excessive or turns up in the wrong place.
Many of these mechanisms defend us by recognizing and killing off cancer cells.
By producing particular types of white blood cells (some of which produce defensive immunoglobulins), adaptive immunity tackles specific infections and toxic materials. Adaptive immunity is also the linchpin of our allergic response.
Two types of white blood cells, known as T cells and B cells, are active in adaptive immunity, but our bodies don’t go on producing white blood cells forever. As we age, the naïve leucocytes (freshly made from bone marrow), which will become T and B cells and are very active in our youth, become reduced in number as their production is slowed so that, over time, we have fewer white blood cells circulating in our system.
B cells make immunoglobulins known as antibodies, key-like compounds that recognize specific molecular shapes found on bacteria, viruses, other invading organisms and toxins. These specific molecular shapes on their cell walls are called antigens. Antibodies lock into these antigens and cause damage to the cell wall or attract other white blood cells, such as certain T cells, to envelop it.
T cells, so-called because they are made in the thymus gland, are recognized by a particular cell-surface configuration called the T-cell receptor. T cells have many different functions, including:
• helping other parts of the immune system (helper T cells)
• attacking cancer cells directly (cytotoxic natural-killer T cells)
• regulating balance so that a defensive response to a hostile ‘invader’ is not overly aggressive
• memory-cell activity (see below).
As we go through life, we encounter increasing numbers of foreign organisms. Rather than maintaining large armies of T and B cells, we form memory cells. These cells ‘remember’ individual antigens so that, when we are next exposed to them, the memory cells send out chemical messengers to naïve leucocytes, triggering them to start making antibodies.
Why ageing wears down the immune system
Senescence is the term applied to aged and dysfunctional cells, and immunosenescence describes the gradual deterioration of immune cells, which renders an ageing body less capable of fighting infection, less able to maintain innate and adaptive immunity, and less likely to recognize and deal with damaged, cancerous or other, non-functioning cells.
The epithelial wall of the bowel (part of the innate immune system) fights to keep out 100 trillion bowel bacteria, just as the skin defends us against infection and chemical toxins, which land on us in their thousands every day. But as barriers like the epithelial wall and the skin start to fail, our acquired, secondary immune system becomes overloaded. The white blood cells that envelop pathogens and altered (cancerous) cells also lose some of their control mechanisms, such that the correct production of defence and inflammatory control agents (cytokines, or protein messengers) diminishes too.
Throughout life, the immune system builds up memory cells and deals with scores of infections all day, every day. As our exposure to organisms and toxins builds, we produce increasing numbers of memory cells. This means our reserve of naïve leucocytes over time is converted to memory cells so that, eventually, we don’t have enough left to mount an adequate T- or B-cell response to a new infection. In a sense, we have too many generals and not enough soldiers.
Eventually, there comes a point where the body’s immune ‘housekeeping’ registers a lack of response, assumes that the white blood cells present are ineffective and breaks them down. This also includes a loss of memory cells, so leaving us open to infections that we used to be able to deal with.
This is why as we age, and after having had a ‘lifelong’ immunity to, say, chickenpox, we can suddenly develop shingles, or our long-standing defence against the viruses that cause influenza disappears, making flu a much more dangerous infection.
Another vital aspect of ageing is our exposure to viruses that are generally not dangerous, but that insinuate themselves into cells—which means they remain hidden from the immune system. These viruses are not particularly aggressive, but lie there dormant, kept to a low replication rate by our intracellular defences.
But as we age, these viruses can flare up, owing to the loss of intracellular defences, and overwhelm the immune system, including our anticancer defences. The main antagonists include:
• cytomegalovirus (CMV)
• Epstein–Barr virus (EBV), the cause of glandular fever
As we age, the immune system focuses too much attention on these persistent intracellular organisms and is less able to attack new ones. Its ability to recognize new infections is also diminished because persistent infection alters the complex mechanisms of immunity. This all serves to prevent the immune system from functioning optimally as we age.
Reversing the process
All organs and systems of the body are affected either positively or negatively by lifestyle, but the immune system in particular is rapidly and adversely affected by poor habits and nutritional deficiencies. On the other hand, it is also positively and effectively influenced by healthy living and proper supplementation.
So, aside from avoiding environmental toxins and allergens as much as possible, there is a great deal you can do to keep your immune system ‘young’. The amounts of minerals, antioxidants and essential fatty acids we consume govern the health of our immune and defence systems at genetic and cellular levels and, most particularly, the level of inflammation in the body.
Eat in colour. Aim for a high intake of a variety of different-coloured vegetables (red, dark-green, orange, etc.). Members of the Allium food group (onions, garlic, leeks, chives, scallions, etc.) have an effect by controlling tumour necrosis factor (TNF)-alpha—one of the most important inflammatory compounds made by the body—to ensure that the activity of the immune system’s white blood cells is neither too weak nor too strong and that they also produce appropriate levels of immunoglobulins.
Optimal levels of the protein interleukin (IL)-6 will ensure the correct rate and strength of inflammation and white-cell response. IL-6 is positively influenced by intakes of fish oil, a variety of fruit and vegetables, vitamins A and C, and zinc, and is adversely affected by large intakes of carbohydrates, especially refined sugars.
Get puffed every day. By following 1,200 pairs of twins, one study has shown that those who take moderate or higher levels of exercise for 180 min/week can have
a physical age up to nine years younger than their
actual age.2 Exercise can also help boost your immune system by:
• enhancing production of T cells
• reducing excess inflammatory compounds like cytokines
• increasing phagocytic activity (white cells that engulf foreign material)
• encouraging normal natural-killer cell activity
• increasing telomere length in white blood cells (see box, above right)
• delaying the onset of immunosenescence.3
Even those without health issues, particularly heart or arterial disease, are going to gain some benefit from exercise. I agree with the research suggesting that men aged over 40 should aim to get 30 min/day, six days a week, of at least moderate-to-vigorous exercise (brisk walking, moderate swimming or jogging) for the best benefits; if below that age, add 15–30 min/day to the regimen.4
Yet, an eight-year study of more than 400,000 men and women in Taiwan came up with some other conclusions. This paper, published in one of the most prestigious of journals, suggested that low-intensity exercise for just 15 min/day or 90 min/week could increase life expectancy by three years.5
There seems to be less research on the optimal frequency for women and also more variation in the advice given, but the 30-minute mark remains standard, although the frequency can be reduced to four days a week of weight-bearing exercise (being on your feet as opposed to swimming, rowing or floor exercises) to prevent osteoporosis.
Tests have shown that people using a treadmill need only about 10 minutes to get to the point where their cardiopulmonary levels are at peak,6 suggesting that anything beyond that is likely to be beneficial.
This means that, aerobically speaking, 20 minutes up to a point of failing—that is, you just can’t take another step—is where the benefit lies.
Muscle-building, an important part of optimal fitness, is best kept to short bursts of eight repetitive cycles repeated eight times, but the whole workout should be less than 45 minutes.
After that, the body is likely to be releasing levels of cortisol, the stress-coping hormone, which actually breaks muscle down—it’s catabolic as opposed to anabolic—and so nullifies the benefits.
The best maintenance supplement programme
Different parts of the immune system—the skin and epithelial membranes of the body, secretions, immunoglobulins produced by white blood cells (B-type cells) and acquired immunity, including specific anticancer cells like natural-killer cells—are all dependent on a wide range of minerals, vitamins and other nutrients. If you’re already healthy and wish to protect and improve your immune system, take:
• A broad-spectrum multivitamin—choose one high in antioxidants, particularly vitamins A and C; take as directed twice a day
• A broad-spectrum multimineral—take this twice daily along with a multivitamin, as most minerals have some part to play in immune function
• Omega-6 and omega-3—taking these at a ratio of 4:1 seems to be the best mix for controlling inflammatory responses although, if inflammation is already present, a practitioner might increase omega-3 levels with fish oils such as krill oil
• Branched-chain amino acids (BCAAs)—many amino acids are the building blocks of proteins and so have a vital role in the normal function of the immune system; BCAAs are essential for lymphocyte (white blood cell) responsiveness, and a lack of BCAAs impairs the immune system, particularly its fight against invading organisms.7
Given intravenously, BCAAs improve immunity in patients with infections and boost immunity in postsurgical patients. Whey protein is an abundant source of BCAAs due to its levels of leucine, isoleucine and valine, and can be taken in cases of poor healing. Add it to smoothies daily.
Dr Sharma’s advanced programme
For those with immune-system dysfunction or a susceptibility to infection, or those who are over age 65, consider the addition of the following supplements after a discussion with your healthcare provider.
Nutrients in the maintenance programme (see above) plus the following nutrients should all be taken twice daily, and they all have a direct effect on white blood cells.
Nutrients influencing TNF-alpha
• N-acetyl cysteine
• Green tea, as a drink or capsules
• Probiotics, to maintain gut flora levels and benefits (they also support sIgA and bowel epithelial integrity)
• Purified thymus extracts.
Nutrients influencing IL-6 inflammatory activity
• Oligomeric proanthocyanidins (OPCs), powerful antioxidants found in pine bark and grape seed extracts
• Coenzyme Q10.
Meditation has been shown to influence the immune system in a variety of ways. The evidence shows that the innate immune system responds to meditation practices that foster compassion.1 What’s more, many papers cite the benefits of meditation on white-cell responses by altering immune function through the process of psychoneuroimmunology.2
One important study concluded that secretory IgA increases significantly with meditation, so improving the barrier effect of the body’s membranes.3
What are telomeres?
Telomeres prevent chromosomes from fusing together, bending or unravelling incorrectly and also stop chromosomes and DNA from binding to each other. If abnormal patterns occur in chromosomes, instructions to the cell go wrong and these mutations may render the cell useless or dangerous. Cells are supposed to multiply only a certain number of times and then die off, but as we age, the cellular pattern of cleaving off telomeres becomes compromised, thereby allowing cells to multiply with ever-increasing mutations.
Telomerase is an enzyme that rebuilds telomeres, and healthy cells make a certain amount. The hTERT gene turns telomerase activity on or off. Damage to this gene by pollutants sticking to it (adducting) stops normal telomere repair.
Research shows that a plant extract called TA 65, from the astragalus plant (sold as a supplement online), appears to activate telomerase and may be proven to benefit our cells by encouraging normal function of replication in tissues.
Checking the state of your immune system
However well you may feel and however up to date you are, there is a major benefit in knowing whether or not your immune system has a genetic predisposition to weaken due to poor detoxification or a need for higher doses of nutrients, or if you have weak anticancer or strong allergic tendencies.
If you clearly have a condition related to immune deficiency, a family history of cancer below the age of 65, are entering middle age without optimal levels of fitness and body weight or live life to excess, I recommend specific testing for the following measures.
• Nutritional status, particularly of vitamins A, C and B-complex; zinc, copper and magnesium in white blood cells; essential fatty acids; glutathione; and iron/ferritin
• Amino-acids, making sure that you’ve been following your usual diet for at least two weeks to see if you are absorbing enough branched-chain amino acids (BCAAs)
• DHEA levels
• Immune activity status, by testing for herpesviruses, cytomegalovirus, Epstein–Barr virus and Chlamydia bacteria
• Comprehensive digestive stool analysis, to assess whether or not you have a good beneficial bacterial balance and to make sure you’re not carrying parasites
• Full tumour immunity profiles or tests, offered by specialist laboratories and which look at immunosenescence and anticancer immunity, T cells, memory cells and natural-killer cell function, as well as levels of inflammation, important minerals like zinc and immune compounds like glutathione.
Tests in the UK:
Biolab Medical Unit www.biolab.co.uk
Genova Diagnostics www.gdx.net/uk
Tests in the US:
Genova Diagnostics www.gdx.net
Excerpted from Live Longer Live Younger by Dr Rajendra Sharma (Watkins Publishing, 2014), available from Amazon