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Acute and chronic approaches to support immunity

Article-Acute and chronic approaches to support immunity

In order to understand how to support the immune system, it is important to understand how it works and who the players really are. The immune system is a vast network of tissues, organs, cells and chemicals. Our bone marrow, thymus gland, lymph nodes, lymphocytes (white blood cells), phagocytes, natural killer cells, antibodies and interferon all play for the immunity team.

There are two types of immunity protecting our body: innate and adaptive. Innate immunity exists at birth and gives us our first line of defense against disease. The skin, mucus secretions, and the acidity of the stomach are examples of innate immunity.  Adaptive immunity is our second line of defense. We acquire this immunity as we go through life. The adaptive immune system remembers foes from the past and is therefore ready to defeat them when exposed to them again. Unfortunately, some invaders like viruses can mutate and therefore we constantly have to fight them off again and again.

There are two unique ways to approach immune health: acute and chronic. The acute approach is used when we already have an illness and need to stimulate the immune system respond. The chronic approach supports the immune system and its functionality. Creating a supplement or functional food for either approach will in most cases use different ingredients i.e. acute would be for short term use until the illness goes away and chronic would use ingredients designed to support the functionality of the immune system for an extended period of time i.e. prevention.  

Without a properly functioning immune system, a wide variety of health challenges can occur such as; cancer, HIV, allergies, asthma, diabetes, chronic fatigue syndrome, cold sores, bacterial and viral infections, digestive health issues, thyroid disorder, yeast infections and even certain skin conditions.

The following are examples for both acute and chronic nutraceutical ingredients for immune health. Keep in mind these are just a few of the numerous immune support ingredients with scientific substantiation.


  • Vitamin C – acts by increasing lymphocyte activity, phagocyte function, leukocyte mobility, antibody and interferon production.[i][ii][iii]
  • Echinacea – acts by activating neutrophils, macrophages, polymorphonuclear leukocytes (PMN), natural killer (NK) cells, TNF-α,  interleukin-10 (IL-10), interleukin-1 (IL-1), interleukin-6 (IL-6)[iv]
  • Elderberry – has several effects including; antiviral and immunomodulating effects, inhibits the replication of several strains of influenza viruses A and B[v], inhibits H1N1 'swine' flu[vi]. It also increases production of inflammatory cytokines, such as interleukins and tumor necrosis factor[vii] 
  • Andrographis – has activity against avian influenza A and human influenza A H1N1 viruses,[viii] and increases antibody activity and phagocytosis by macrophages[ix] 
  • Zinc – is important for neutrophil, natural killer cell, and T-lymphocyte function[x]. Mild zinc deficiency might adversely affect T-cell functions[xi]


  • Medicinal Mushrooms – Chaga, Reishi, Maitake, Shitake, Cordyceps – these impact lymphocytes, macrophages, T cells, and natural killer (NK) cells[xii]
  • 1,3/1,6 Beta Glucan – increase macrophage phagocytosis of tumor cells, increase the cytotoxicity of natural killer cells (NK), and stimulate the release of interleukin-1 (IL-1) and tumor necrosis factor (TNF)[xiii] 
  • Probiotics – the beneficial impact of probiotics is by different mechanisms. These mechanisms include the probiotics' capacity to increase the intestinal barrier function, to prevent pathogenic bacterial movement and to modulate inflammation.[xiv]
  • Black Seed Oil – antiviral activity has been extensively researched[xv][xvi]. There are multiple mechanisms of action with regard to how the antiviral effect is realised. It was found to suppress viral load.[xvii]
  • Vitamin D – There are numerous published clinical studies confirming that low blood levels of vitamin D are associated with an increased risk of infections[xviii]. National Institute of Health warned that low vitamin D levels are associated with frequent colds and influenza[xix]

[i] Leibovitz B, Siegel BV. Ascorbic acid and the immune response. Adv Exp Med Biol 1981;135:1-25.
[ii] Vilter RW. Nutritional aspects of ascorbic acid: uses and abuses. West J Med 1980;133:485-92
[iii] Smogorzewska, E. M., Layward, L., and Soothill, J. F. T lymphocyte mobility: defects and effects of ascorbic acid, histamine and complexed IgG. Clin.Exp.Immunol. 1981;43(1):174-179
[iv] Manayi A, Vazirian M, Saeidnia S. Echinacea purpurea: Pharmacology, phytochemistry and analysis methods. Pharmacogn Rev. 2015;9(17):63–72. doi:10.4103/0973-7847.156353
[v] Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1995;1:361-9
[vi] Roschek B, Fink RC, McMichael MD, et al. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry 2009;70:1255-61.
[vii] Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6
[viii] Hu XY, Wu RH, Logue M, et al. Andrographis paniculata (Chuan Xin Lián) for symptomatic relief of acute respiratory tract infections in adults and children: a systematic review and meta-analysis. PLoS One 2017;12(8):e0181780
[ix] Puri A, Saxena R, Saxena RP, et al. Immunostimulant agents from Andrographis paniculata. J Nat Prod 1993;56:995-9.
[x] Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr 1998;68:447S-63S.
[xi] Prasad AS. Zinc and immunity. Mol Cell Biochem 1998;188:63-9
[xii] Guggenheim AG, Wright KM, Zwickey HL. Immune Modulation From Five Major Mushrooms: Application to Integrative Oncology. Integr Med (Encinitas). 2014;13(1):32–44.
[xiii] Stier, H., Ebbeskotte, V. & Gruenwald, J. Immune-modulatory effects of dietary Yeast Beta-1,3/1,6-D-glucan. Nutr J 1338 (2014).
[xiv] Plaza-Díaz J, Ruiz-Ojeda FJ, Gil-Campos M, Gil A. Immune-Mediated Mechanisms of Action of Probiotics and Synbiotics in Treating Pediatric Intestinal Diseases. Nutrients. 2018;10(1):42. Published 2018 Jan 5. doi:10.3390/nu10010042
[xv] [xv] Salem M, Immunomodulatory and therapeutic properties of the Nigella sativa L. seed., Int Immunopharmacol. 2005 Dec;5(13-14):1749-70
[xvi] Forouzanfar F,  Fazly B, Hosseinzadeh B,  Black cumin (Nigella sativa) and its constituent (thymoquinone): A review on antimicrobial effects, Iranian Journal of Basic Medical Science 17(12):929-38 December 2014
[xvii] Forouzanfar F,  Fazly B, Hosseinzadeh B,  Black cumin (Nigella sativa) and its constituent (thymoquinone): A review on antimicrobial effects, Iranian Journal of Basic Medical Science 17(12):929-38 December 2014
[xviii] Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E, Epidemic influenza and vitamin D., Epidemiol Infect. 2006 Dec; 134(6):1129-40.
[xix] National Institutes of Health. Low Vitamin D Levels Associated with Colds and Flu. NIH website. Published March 9, 2009. Accessed March 19, 2020

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