Zen and the Art of Immune Maintenance

This is the first of a planned series of posts discussing our health and ways to improve it. In the introduction, I compared it to the classic novel, “Zen and the Art of Motorcycle Maintenance,” which teaches the importance of building a rapport with our machines. Our bodies are our most important machine, and I want to introduce a few key areas related to our health, and solicit discussions that readers can use to learn from others' experiences. Just as our bodies are complex, so too are the methods to maintain them. But these methods can be reduced to simple guidelines that we can adopt and adjust to improve our outcomes.

Success can be reduced to a short list of solution categories that seem to have greatest impact on our survival. The first is the topic that has terrorized the planet for over a year: viral infection, and the immune response that protects most of us. I also hope to address other major components of our survival, especially heart and brain, and optimizing their performance with diet, exercise and stress management. I don't plan to directly discuss the primary focus of the medical establishment -- pills and procedures -- because they haven't made significant improvements in our lifespan or healthspan despite their amazing technological insights and achievements. They didn't help me.

I also hope we can discuss tools like tests, meditation, and accupuncture; tips for easy techniques to try; reading lists to survey the evolution of health science; and maybe even managing our financial health with investing in the medical industry -- regardless of your opinion of the industry, they make a lot of money, and there's no reason we shouldn't take some.

Last weekend (21-22 August) was the annual 24 Hours of LeMans car race.  Unlike most races, it's not just about who can go fastest, but who can go fastest for longest. Many teams didn't make it. Others survived, but with significant weakness. Some were still running well at the end, and could certainly have continued much longer. We want to be like them.

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Who am i? Not a doctor. I'm a patient. After an exciting misspent youth with no problems and no worries, I began enduring a series of increasingly unpleasant doctors. I assumed they meant well, but each prescription was soon followed with yet another pill or procedure, and my conditions usually worsened. Then epiphany came when I hit the age my dad's decline began, and I decided to become more proactive. I read a lot of research and evolved to a lifestyle that has resolved most of my problems. Then covid arrived and I discovered that despite having been a multiple offender of the advertised co-morbidities, I had mostly resolved them, despite the best efforts of my doctors, and several encounters with the dreaded virus left me unharmed. Maybe I was lucky, but as Arnold Palmer said, the more I practice, the luckier I get. My studies have given me a better understanding of many areas of health science, and an enjoyment of discussing them. Substack generously provided me this forum, so I thought I'd try it out and see if I can learn a few more things, and share my experiences with others who might be interested. I look forward to hearing from you.
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Let's talk about immunity, and optimizing it to help us win the endurance race.

We know a lot about immunity, but there's a lot we still don't know. We can buy over the counter supplements that purport to improve it. Doctors study the basics, but they leave it to a few specialists to try to learn the details. Few pros deal with immune health as a partner in fighting diseases -- they only react to symptoms of failures of the immune system to function correctly. The medical guilds don't profit from our health, only from our sickness, selling us pills and procedures. They’re not really motivated to keep us healthy.

So a better approach might be to take more responsibility ourselves, learning how to prevent those failures and avoid the pills and procedures to patch up our mistakes.

The covid pandemic has been an active laboratory for advancing the science of immunity. We've learned to produce new types of vaccines and therapies that can be designed and deployed much quicker than ever before. We're finding immune reactions that defy conventional understanding and mystify the specialists we expect to protect us. Some of these mysteries seem to reduce our immune response to initial infection, and some accelerate immune response after infection, creating destructive attacks on lungs and other organs. The deaths from covid have been primarily acute respiratory distress syndrome, an autoimmune malfunction where the immune system attacks itself instead of the virus. Preventing the advancement to later stages is important, and is the role of our immune system. It works very well for most of us, moderately well for many, and inadequately for a few.

Apparently a lot of the victims had a common set of conditions detectable and treatable with the right tests, so testing is important. But apparently a lot of the serious cases were associated with known conditions that are also associated with immune deficiencies. We can improve our odds by dealing with those before we get infected.

The first thing to consider is our risk is actually very low, despite efforts to frighten us into hoarding toilet paper and avoiding every other human on the planet. There are almost 8 billion of those fellow humans, and less than 4 million have been reported to die with covid. All of our covid statistics have been a little vague, but as a conservative estimate, it seems around 7.996 billion have not died, which puts our risk of death around 0.05%. That's seldom cause for panic. Like the Jaws movies, it sounds worse than it is. And it's a slow motion attrition, giving plenty of time for most of us to prepare.

Let's see what we can do to prepare.

The immune system is not housed in a central organ, like the heart or brain, but is distributed throughout the body. A key component is bone marrow. A lot of the controls are in the lymph glands and ducts, which are spread around the body like neighborhood fire stations. Of course we have components like skin and mucous membranes that help keep invaders out, but once pathogens do intrude, the internal elements stand guard to identify, capture and expel the invaders before they can do much damage. Success depends on winning the race between destruction by the pathogen and calling reinforcements to stop it. Healthy people have little problem winning the race. Unhealthy people die. Most of us are somewhere in between.

We are born with an innate immune system that guards against intruders, and mounts defenses like fever and pus to defeat viruses, bacteria, worms, cancer, and dead cells, anything that doesn't belong in our bodies. In addition, exposure to pathogens generates memories with T and B cells, called the adaptive immune system, that reacts more quickly to recognized pathogens when they return. This recognition can come from training with an active pathogen, or by vaccination with a crippled version with the same external characteristics.

I found a good summary of this, regarding covid response, in an April 2020 paper titled "Immune response in COVID-19: A review" published by Elsevier, who is providing all their covid research free during the pandemic. It's interesting that although this was from the early stages of the pandemic, we knew about as much then as we do now. The recommendations included hydroxychloroquine, ivermectin, and healthy foods and hydration -- all of which have been banned from use and discussion since then. This politicization of medicine has been directly responsible for most of the fatalities. Individual knowledge is the key to individual success.

More recent and much more detailed introductions can be found in "COVID-19 and the human innate immune system" from February 2021, also from Elsevier, and "Adaptive immunity to SARS-CoV-2 and COVID-19" from January 2021. A key point is "the host itself (that's us) seems to be the major factor explaining disease severity." Adaptive immunity includes protection derived from vaccination, which we have learned is limited and adds additional risks, and from immunity acquired from infection and recovery from active virus, which has proven to be robust and durable. A recent report from NIAID, Dr Fauci’s organization, titled “Lasting immunity found after recovery from COVID-19" (January 2021) identifies durable immune responses in the majority of recovered patients, yet Dr Fauci has persistently downplayed this. One of the many scandals that have arisen in this pandemic is the restrictions of information regarding the superiority of this natural immunity, but many formal studies are now being published. Clearly, sufficient immune strength to overcome infection is our best protection.

It's interesting that a year of experience didn't change much in our understanding of this virus or its treatment -- or outcomes. This is a fairly routine virus with good natural defenses in most people. As these papers describe, the serious cases are largely elderly with basic chronic diseases: COPD, hypertension, malignant tumors, heart disease, and kidney disease were noted. If the virus is not stopped, either by immune response or by effective therapy, the disease progresses to lung failure, as well as damage to other organs. Some of this may be due to genetic abnormalities ("bad luck") or other problems such as obesity or nutrient deficiencies. But the common factor in these chronic conditions is inflammation. That is preventable and reversible.

While it's useful and interesting to get numerical results from lab blood tests, several key factors can be improved with preemptive use of cheap supplements and lifestyle changes. The biggest superficial factor has apparently been age, with most fatalities in the elderly. Age is not a lifestyle we can change, of course, but that story is not what it seems. The risk is high in elderly only with any of a known set of chronic conditions, all of which shorten life expectancies even without rampaging viruses.

One of the key risks is obesity, historically considered a problem of health and appearance, but not usually immunity. It’s actually a form of malnutrition, where food energy is hijacked for fat production ahead of cell energy needs, resulting in the lethargy often seen in the obese. A discussion of obesity's relationonship to immune health is in "Obesity, inflammation and the immune system" from March 2012. It describes why obesity is observed as a consistent co-morbidity for covid. Obesity is also correlated with the other co-morbidities which are in turn correlated with serious covid infections. Obesity has become a “protected class" lately where commenting on overweight status is widely disapproved, as if it's an involuntary condition. Even by doctors. Individual genetics do affect how food is used and whether it is burned as fuel for our cells or stored in fat tissue to accumulate. But we can control it. Read “Good Calories Bad Calories" for a more detailed discussion. The short version is: cut carbs. A lot. Which means we need more fat and protein. The medical bureaucracy has emphasized low fat, more exercise as the solution for obesity for decades, and fat the cause of heart failure, while the both problems have gotten steadily worse. If insanity is doing the same thing and expecting different results, we and our doctors are insane.

We've all seen body mass index (BMI) measurements, but most of us are unaware of our status. It's easy to determine with a scale and ruler and online calculator. I saw stats last year that serious covid illness is roughly proportional to BMI, with few deaths in those less than 30, which is considered the threshold for mild obesity. Also the pinch test, or a full length mirror can tell most of us whether we have a problem. But the fat we can see, subcutaneous fat, is less of a problem than the fat enveloping our organs, visceral fat. Know that excess fat causes a lot of ailments, the most immediate risk these days being covid. Also know it's easier to correct than even the diet books indicate.

I plan to discuss diet more thoroughly in a subsequent post, but in my case I lost weight on a low fat diet, and on a low carb diet. The biggest risks come from combining fat and carbs together. We're designed to operate on either, preferring the much higher energy density of fats from a successful hunt, but capable of surviving on foraged foods if necessary. But they send different signals to the body, and the resulting conflicts from mixing them lead to many of our problems. Over dependence on carbs leads to many of of the metabolic problems associated with serious covid outcomes.

If you want to cut covid risk, cut excess pounds. You want a BMI less than 25.

Next thing to consider is feeding your immune system. Our bodies are an enormously complex chemistry set. Different mixtures give different reactions. There are tests to measure how much of the important nutrients you have, but its likely you're deficient in a few, they're cheap, and difficult to overdose, so supplements are good insurance in a pandemic. A little will help, but too much of a good thing is always risky -- don't overdo it.

Vitamin D is a crucial ingredient for immune health. We get most of our vitamin D from reactions to sunlight on our skin. One of the counterproductive results of locking us in our homes is a reduction of vitamin D. Most serious covid cases where vitamin D was measured showed they were deficient. Also, darker skin reduces the internal production of vitamin D from sunlight, so supplements are especially important. Vitamin D is necessary for most cell processes, especially production and activation of immune cells, including bone health, the core of immune response. It's measured with a blood test that reads nanograms per milliliter. Official deficiency is typically 20 or 30, but recent studies have shown risk is 2.64 times higher for those with 20-30 compared with those over 40. Some studies tried mega-doses and found side effects, so it's declared “ineffectivective" by the medical bureaucrats. As with all these absolutist misdirections, no nutrient is a cure, but may be a risk reduction factor. As a rule of thumb, we get about 1 ng/mL boost per 100 IU of supplement, so the typical drugstore vitamin D supplement at 1000 IU will give about a 10 ng/mL improvement. A pill or two per day, depending on how much time you spend in the sun, might give you a crucial advantage. Vitamin B (especially B6), E, C and A are also necessary nutrients for immune health, as well as minerals zinc and iron. We should get enough of all these in a well rounded healthy diet, but if we get that, we won't be obese or diabetic or cardiac disease, and all the other chronic malfunctions common in western cultures with western diets, which are shown to raise covid risk. So, its reasonable to assume we have deficiencies and should try to improve our diet. If you don't get enough of these critical nutrients you can safely improve your odds with high quality supplements. A daily multivitamin is a good start while you learn what you need. Get metabolic and chemistry blood tests to tweak your nutrients more precisely.

Sleep of sufficient time and quality is critical for immune health. Many of us don't get enough. “Why We Sleep" is a detailed discussion of why it's important and how to improve it, by a leading sleep researcher (I want that job). Making sure you sleep well is largely a question of self discipline. However you address it, know that it's more important in a pandemic than otherwise, but even without rampant viruses, it affects mental and physical health in many ways. Those who chronically work with sleep deficits tend to burn brighter but extinguish sooner. Maybe from covid.

Finally, exercise is important for strengthening our health as well as our muscles. Muscle movement produces chemicals the body needs to keep operating effectively. The expression “use it or lose it" describes the observation that sedentary behavior often precedes broader deterioration than just muscles. Exercise controls how we use the nutrients we eat. Inactivity signals the body that all is well and we have no risks, so they tune themselves down. Maintaining effective systems like immunity requires constant reminders for them to stay on the job. Exercise is an important signal.

None of these approaches assures we’ll be safe from this pandemic, or the next. But suffering the illnesses from pathogen infections is widely variable between individuals. Many factors of protection against the covid virus are within our control. The statistics show the risk for most of us is low, but improving these factors improves our odds against infections, and make us feel better as well. Understanding how out bodies work is important for proper maintenance, which in turn is important for reliable operation. A lot of that can be learned with a little bit more self discipline, but Zen can help, too. Well discuss that, too, in a subsequent post.

--------‐‐-------------------------------------------------------------------------------------------Footnote: My only footnote is to note I have no footnotes. I included titles for several references, which you should be able to find with routine searches if interested. I'll try to develop a more comprehensive bibliography as time permits. If you know other useful resources, please share.