Autoimmune disease

How to Boost your Immune System: Everything you need to know

By Kim Crawford, M.D. Last updated: March 24, 2023
How to Boost your Immune System: Everything you need to know

How to Boost your Immune System

We suffered not just from sickness and loss; we have been shut in, shut down, and zoom-fatigued.  Something that has emerged as almost a national obsession has been the urge for lots of self-care, including care that prevents infection. Such care now includes strategies to boost our immune system. We want not simply  to mask up, but to also, well- “immune up!”  Shall we?

Basic Lifestyle Strategies for Immune Health

Diet: I advise all patients to eat some form of an anti-inflammatory diet. To keep it super simple-eliminate highly processed foods, watch your sugar and starchy carbs consumption, and be careful with gut-damaging lectins. Foods that are highly processed or high in lectins such as gluten-containing grains, beans, nightshade vegetables, and low-fat dairy products  lead to gut lining damage which means “leaky gut.” Eating this way then causes inflammation which is one of the root causes of all diseases. I’ll go into inflammation more in-depth in one of the following sections. See the first page of my website for a free, downloadable diet.

Immune-boosting foods include garlic, horseradish, and wasabi. Garlic is anti-viral, and while used as a supplement, I won’t explicitly cover its use in this article.  It’s also essential to eat to support the health of your microbiome. Microbiome health equals far greater immune health; I’ll cover that in a separate section further on in the discussion. Dietary constituents with exceptionally high anti-inflammatory and antioxidant capacity include vitamin C, vitamin E, and phytochemicals such as carotenoids and polyphenols. Let that sentence serve as an introduction to the next topic, oxidative stress, followed by inflammation.

Oxidative stress

What is it? Oxidative stress is an imbalance between the production of free radicals (will explain) and the ability of your body to counteract or detoxify their harmful effects via neutralization by antioxidants. Oxidative stress is the condition in your body when it does not have enough antioxidants to neutralize free radicals. Just as an apple not coated with lemon (an antioxidant) turns brown when exposed to air, our cells can “rust” when we have oxidative stress- caused by unopposed free radicals.

Free radicals are unstable molecules that react with certain substances in your body to damage cells or create abnormal ones. Free radicals chemically react with cell components such as DNA, proteins, or lipids and steal their electrons to become stabilized. This process destabilizes the cell component molecules, seeking out and stealing an electron from yet another molecule, triggering a large chain of free radical reactions.

A proper diet can reverse this unhealthy but common condition. Eat five to twelve servings of organic fruits and vegetables daily or supplementing with a high-antioxidant multi-vitamin. I always measure patient’s levels of oxidative stress with a Raman spectroscopy unit. Other Functional doctors may use blood or urine testing. The bottom line: if you’re aware of this phenomenon, you can prevent it! Here’s what to watch out for and adjust your intake of antioxidants accordingly.

What Causes Free Radicals? Free radicals are simply a byproduct of energy consumption in our mitochondria, the factories that produce energy in each of our cells. When we exercise, we increase our respiratory and heart rate, creating more free radicals that need to be quenched by good levels of antioxidants. However, the free radicals that deplete our antioxidant supply are environmental and result from our lifestyles. Here are the big offenders.

Exposure to tobacco smoke: Imagine this-tobacco smoke contains more than 4,000 toxic chemicals that all can cause oxidative stress. One cigarette produces millions and millions of free radicals. How’s that for incentive to stop? We who use Raman Spec scanners have discussed the data, which shows that smokers score in the lowest range, equivalent to those with active cancer cases!

Consuming a “bad” diet: As referenced in the “diet section,” it’s essential to eat as if your health depends on it (because it does!). Eating too many calories, sugars, refined or starchy carbohydrates, processed and fast foods, and lectins do indeed cause oxidative stress and inflammation. Unhealthy foods force our mitochondria to work harder and release more “exhaust,” creating higher levels of free radicals burning toxic foods for energy. Speaking of diet, let’s look at two other popular lifestyle choices.

Excessive alcohol: Alcohol consumption increases your levels of inflammatory cytokines-inflammatory molecules linked to oxidative stress.

Eating charcoal-broiled foods: These foods-not just meats-contain polycyclic aromatic hydrocarbons, which contribute to oxidative stress. And yes, char-broiled meats are indeed carcinogenic. Now, let’s move onto some other lifestyle factors in oxidative stress levels.

Excessive psychological stress: The stress hormone cortisol increases inflammation, which further increases free radical production. It also causes a leaky gut, an asymptomatic cause of chronic inflammation, and the root cause of autoimmune disease.

Exercising too much: Exercise (which will be discussed in another section) is crucial for optimal health. However, too much of it can increase oxidative stress in our bodies. As a rule of thumb, more than 60 minutes per day is considered excessive. Therefore, all elite athletes need to supplement adequately.

Lack of sleep: Sleep deprivation increases oxidative stress through a complex series of chemical reactions. Yes, I’ll discuss sleep in more depth, too.

Exposure to air pollutants: Air pollution, industrial pollution, and even airborne allergens increase oxidative stress.

Chronic infections: Hidden (asymptomatic) infections will contribute to oxidative stress. One example is a biofilm secreting sinus organism called MARCoNS, found in people with mold and mycotoxin illness. Dental infections are another excellent example. If you have root canals, you will not feel apical abscesses-so get a panoramic X-ray annually.

Ionizing radiation and EMFs: Exposure to x-rays, excessive sun, radon, cellphones, hairdryers, airplanes, electric blankets, and heating pads can all contribute to oxidative stress.

Exposure to fungal toxins: Environmental molds (like those in basements and bathrooms) and internal fungi (such as those colonizing your gut in excess) can produce mycotoxins that increase oxidative stress.

Inadequate GI-tract detoxification: When the liver is overwhelmed with toxins from food (e.g., too much sugar) or the environment (e.g.:exposure to pesticides or toxic mold), it becomes inflamed and then produces more free radicals. And now that you know what causes this problem go ahead and fill your diet with antioxidant-rich food, smoothies, and supplements to combat it. Next, let’s look at OS’s evil twin: inflammation.


What exactly Is Inflammation?: Let me first explain “acute inflammation.”  Think about what happens when you get a splinter in your finger. If you don’t remove the shard, the whole area turns red and gets a little puffy. That’s acute inflammation, and it’s a good thing, as it’s your body responding appropriately to a situation. It’s mostly your immune system rushing to the area to fight off any viruses or bacteria that might have gotten in. With a physical injury, if you leave the spot alone and don’t irritate it any further, the swelling will go down, and everything will go back to normal. The signs of acute inflammation: heat, redness, swelling, and pain will all dissipate.

However, if you keep stabbing yourself with fragments in the same spot, the re-injury would maintain the high levels of inflammation burning. That’s what is going on with chronic internal inflammation, but you can’t  “feel the stabbing.” The inflammatory response is short and relatively precise. When it’s chronic, inflammation can be “silent,” can make you feel lethargic, or contribute to many other health problems. Here are the major causes of chronic inflammation. 

Your weight: Inflammation risk is guaranteed if you are obese or even just overweight. Overweight and obese men and women have higher levels of inflammatory blood markers than men and women of the same age who are not obese or overweight. Inflammation drops when men and women lose weight, according to many clinical studies.

Unhealthy diets: I know you hear this repeatedly from me, but consider that it’s that important to eat a healthy diet. Common foods processed just like sugar and therefore considered”inflammatory” are sugary foods, high-processed carbohydrates, high-industrial fat, and seed oils, high-gluten, and all overly processed and fast foods, save the lone naked salad. I know this is the typical U.S. diet. Toxic foods are why our population is so inflamed!  Further, this poor eating pattern also causes oxidative stress, which in turn worsens inflammation.

Insufficient omega-3 intake: Omega-3 fats are the precursors for anti-inflammatory eicosanoids, an integral part of the inflammatory response. Poor omega-3 status means inadequate production of anti-inflammatory eicosanoids and a lopsided anti-inflammatory reaction to normal stimuli. It’s easy to get good blood levels: eat omega-3-rich fish such as salmon or sardines and take good omega-3 fish oil supplements.

Excessive omega-6 intake: Omega-6 fats form the precursors for inflammatory eicosanoids, which are also an integral part of the inflammatory response. High omega-6 status (especially when combined with poor omega-3 status) means excessive production of inflammatory eicosanoids and a lopsided inflammatory response to normal stimuli. Cut down on your omega-6 intake by reducing your intake of meat.

Chronic stress: Life can be stressful, indeed. Everything all adds up, doesn’t it? Notably, if it becomes too much for you to handle, your body will have a physiological, inflammatory response to emotional stress. This physiological reaction includes a rise in cortisol, as mentioned earlier.

Lack of downtime: When you’re always on your phone or checking your social media accounts, you are not relaxing. When you hear a “ding” and rush to answer a text or email, you are always “on.” You may think you’re relaxing because your body is stationary, but you’re not relaxing-are you?

Lack of sleep: Poor sleep causes elevated blood inflammatory markers. Poor sleep is a chronic problem in the U.S. Either we go to bed too late, wake up too early, or use too many electronics late at night and disrupt the sleep quality we get. I’ll go more in-depth into the topic of sleep further on in this article.

Toxins cause Inflammation: Heavy metals, biotoxins such as mold and Lyme toxins, and more can cause chronic inflammation.

Lack of outdoor time: We all spend too much time cooped up in offices or, worse, in office cubicles, or even at home, doing zoom calls. We just plain don’t spend enough time in nature.

Your exercise and movement patterns: Insufficient exercise and even inadequate “movement” (more below) adds to inflammation.

Lack of movement: Most of us lead far too sedentary lives. A lack of activity causes systemic, low-grade inflammation. We don’t usually need to walk to get to our destinations. We take escalators and elevators. We sit for hours on end and then don’t make time for regular exercise. Suppose this is you-make time to move more. Get up on your feet for two to three minutes each hour you’re sitting. Better yet, do some burpees, jumping jacks, or push-ups.

Poor recovery and Overtraining: On the other hand, some people move, but they exercise too much, with too little rest and recovery. Overtraining is a form of chronic inflammation. Not just elite athletes, but even casual 10K runners and others who train frequently can overtrain. This degree of over-exertion can cause inflammation, as well as elevated cortisol levels, and disrupted sleep. Now that I’ve gone through some ways not to exercise, why don’t I discuss how to exercise?


Multiple studies in both humans and animals have demonstrated the profound impact exercise has on the immune system. There is an overwhelming consensus that regular bouts of short-lasting (30 to 45 minutes) moderate-intensity (e.g., brisk walking, vacuuming, dancing, doubles tennis, and “shooting hoops”) exercise is beneficial for proper immune function. This correlation has been demonstrated particularly well in older adults and people with chronic diseases.

Exercise is probably healthy for intestinal flora composition, so remember this when you read the section about the microbiome. Some investigations have shown that activity is associated with increased microbiome biodiversity with attendant beneficial metabolic functions. Gut microbiota (innately linked to all immune functioning) can, in turn, influence the pathophysiology of several distant organs, including the skeletal muscle. A gut-muscle axis may regulate muscle protein deposition and muscle function. This gut-muscle axis may involve maintaining skeletal muscle with aging and contribute to insulin sensitivity and blood sugar levels, which brings me to the next topic called glycation.


Cellular glycation is the stiffening and aging of all cells. It occurs at fasting blood sugar levels somewhere in the range of 75-85 ng/dL. Research continues to lower the bar at which we set the definitions of glucose-intolerant, diabetes, and simply “cellular glycation.” I don’t think I need to mention that blood sugar levels increase with increased body mass.

Higher blood sugar levels are associated with immune system depression, increased risk of dementia, heart disease, cellular aging, and even cancer. Cancer is an immune-mediated and mitochondrial dysfunction disease that is largely preventable. Some studies demonstrate that certain cancers respond to treatment more effectively when blood sugar is lower, achievable via ketosis or medication. Studies also link better blood glucose control to better sleep. Here’s what you need to know about sleep.


Sleep has powerful effects on immune functioning. Studies show that sleep loss can affect different parts of the immune system, leading to the development of a wide variety of disorders. Here are a few interesting studies to consider before giving you my recommendations for adequate, restful sleep.

Sleep loss is a risk factor for lessened immune response and infection. Restricting sleep to 4 hours per night for six days, followed by 12 hours of sleep per night for seven days, resulted in a greater than 50% decrease in antibody production to influenza vaccination than subjects who had regular sleep hours.

Restricting the time allowed for sleep to 4 hours for one night reduced natural killer (NK) cell activity to an average of 72%, compared with NK cell activity in participants who had a full night’s sleep. NK cells are essential for infection clearance; they also have a significant role in killing tumor cells. Reduced functioning of NK cells is associated with an approximate 1.6 times higher risk of dying from cancer.

In addition, restricting sleep to 4 hours for (again) just one night led to the generation of measurable inflammatory cytokines, which play an essential role in developing metabolic and cardiovascular disease. So, how much “good” sleep do you need?

How Much Sleep Do You Need? There is only a little individual variability in regards to how much sleep we all need. Most adults need  7 to 8 hours of good-quality sleep per night. What’s “good quality sleep?” Good quality means that the “sleeping episode”  doesn’t include frequent arousals and is long enough for the individual to feel refreshed upon awakening. All wrist gadgets aside: most of us move correctly through the stages of sleep depth, including REM, and if we don’t, we don’t feel refreshed-plain and simple.

Researchers have identified genetic mutations in some people who naturally sleep six or fewer hours a day and appear healthy and functional. These people show less deterioration in performance when they are sleep-deprived under laboratory conditions. However, note that the percentage of the population with these gene mutations is minute. Most people who say they do not need much sleep are just pushing themselves to sleep less. As a consequence, they then struggle to stay awake and tend to function suboptimally during the daytime. They are putting themselves at risk for obesity and chronic illness.

Want to figure out your ideal sleeping time? The average sleep times across 5 to 7 relaxed days estimate your required sleep duration. Just record the length of time you sleep during a 7-10 day vacation, when you are awakening spontaneously, without an alarm, and go to bed when you are tired. During this time, remember to keep caffeine intake to no more than 2 cups of regular coffee a day (about 200 mg of caffeine). And speaking of a relaxing vacation, try to do an activity to reduce your stress levels daily at least a couple of times per day to mimic how you feel on holiday. Stress management is not simply to make you feel better; it’s a matter of your health.

Stress Management 

Stress depresses the immune system. It does this via several different mechanisms. First, sustained high cortisol levels caused by stress cause gut hyper-permeability (i.e., “leaky gut”), which causes inflammation and subsequent disease. Cortisol also interferes with T-cell (a type of white cell) production and function, making your body more susceptible to pathogens. Stress is why you get more head colds when you are under pressure. Finally, cortisol kills brain cells (neurons), further interrupting the gut-brain axis crucial for proper immune function.

Manage your stress before it manages you. Incorporate movement and exercise into your day. Activity can be as simple as making sure you get up from your chair and walking around for a few minutes every couple of hours. Exercise should be something you will do, not something you’d like to envision yourself doing. Deep breathing and meditation are great habits to cultivate. If you don’t have the patience, you can activate the vagal (parasympathetic system) nerve by singing and even gargling. Some people also benefit from liposomal GABA supplements and peptides with anti-anxiety benefits. I touched on gut health, and now I’d like to go a little deeper into that topic with a discussion about the microbiome.

Microbiome Health 
The human microbiome is between 10 and 100 trillion genetically unique (mostly) bacterial cells. The healthier your gut microbiome is, the better it is for your immune system, which is also (primarily) located in your gut. Unhealthy gut bacteria thrive on the things that create inflammation in our body, including refined carbs, sugar,  unhealthy fats, and processed foods. Conversely, the healthy foods and activities discussed previously all contribute to microbiome health. To augment all of these healthy habits, we can add prebiotic fiber and probiotics into the mix. First of all, we need to eat good prebiotic foods as “fertilizers” for probiotics.

Prebiotic fiber: This is non-digestible carbohydrates found in fibrous foods that assist in the growth of healthy bacteria in the gut. White and even tastier-red onion, as well as asparagus, chicory, garlic, unripe banana, and artichoke-especially Jerusalem artichoke, are great “gut bug food.” They assist gut health primarily by helping healthy gut bacteria produce substances such as butyrate. Butyrate helps protect the gut lining and has anti-inflammatory properties in the gut. Now let’s seed this fertilizer.  

Probiotics: High-quality kefir or yogurt (home-made) and fermented foods such as sauerkraut can supply a fair amount of good bacteria, but I generally supplement everyone to ensure they get enough probiotics to augment immune function. We see some good evidence that sporulating probiotics are more immune-supporting and microbiome-diversity-supporting than the strains of probiotics we used to recommend only recently.

Immune enhancement with hot and cold therapy

Heat shock proteins form in the body when you immerse your body in ice-cold water or a tub or sauna at 104 degrees F.  They are great for your immune system and will enhance many positive immune modulation functions.

Cold therapy lowers cortisol levels when you do it on a repeated basis. I just reviewed why you want nice, controlled cortisol levels, and this is now another way to get them. As a reminder, bringing down your cortisol will not only help your gut lining stay intact, it will enhance the 70% of your immune system which resides in your gut. In addition, studies show that cold therapy improves anti-tumor white blood cell activity. Finally, NK (natural killer T cell) activity also gets a boost with cold therapy.

Various heat shock proteins induced by saunas (conventional and FIR) trigger positive effects in the immune system regarding infections, autoimmune disease, and even cancer therapy. Suffice it to say, for this article, that hot and cold treatments are fantastic for your immune health. Now, let’s discuss supplementation.

Supplements to boost the immune system 

Multivitamin supplements

Over 10,000 vitamin companies are selling their multivitamins. You want to choose GMP, NSF certified, and high antioxidants, especially forms of vitamin A called carotenoids. Good MVI supplements also contain iodine and selenium, which are important for proper immune system function. The addition of polyphenols is an excellent “add” when you can find them, and they are suitable for the care and feeding of your microbiome. You need more vitamin C  than you get via multivitamins: I’ll address that separately.

Vitamin D

You need vitamin D for a properly functioning immune system. We’ve more than learned that during this past year’s COVID crisis.

Vitamin D inhibits negative (harmful) immune pathways and promotes positive ones. It also positively impacts the composition of the microbiome and enforces the gut barrier. Clinical studies show low vitamin D levels are a risk factor for coronavirus infection. Previous studies correlate low levels of vitamin D with more “flu”; in general.

Vitamin D dosing: You want a level of 75-80 ng/dL which requires most Americans to take doses of 5000-10,000 IU per day.

Vitamin C and Zinc 

Vitamin C concentrations in the blood plasma and white blood cells quickly decline during infections. Likewise, zinc deficiency impairs cellular mediators of innate immunity such as natural killer cell activity, phagocytosis of infectious organisms, and the generation of an oxidative burst.

Supplementation of vitamin C improves various components of our immune system: natural killer cell activity, migration of white blood cells (chemotaxis), the appropriate and proper proliferation of specific white cells called lymphocytes, and overall antimicrobial activity. Vitamin C contributes to the antioxidant status of cells, thereby protecting them against reactive oxygen species generated during the inflammatory response. Supplementation with zinc has shown similar benefits, which, in some studies, are augmented by the flavanoid-quercetin.

Therefore, both nutrients play important roles in immune function and help attenuate the risk of infection when taken as dietary supplements. They have reduced the risk, severity, and duration of many infectious diseases. When taking long-term zinc supplementation, make sure you are ingesting enough dietary or supplemental copper.

Zinc dosing: Ideal dosing is about 25-60 mg per day.

Vitamin C dosing: Liposomal preparations can be taken in doses up to 3 grams (usually 1 TBSP) per dose without GI distress for most people. Many clinical studies use 1.5 grams 4 times per day (6 grams total), but I generally recommend 1 TBSP 2x/day during “flu season,” including during this past COVID-year.  Take regular buffered vitamin C  as a 500 mg dose- just space that out accordingly.


Melatonin is a potent anti-inflammatory and anti-oxidant-not simply a sleep aid. The fact that it helps establish our circadian rhythm is an immune boost– right there. Many people find this surprising, but it’s accurate! When we are infected, It functions mainly to blunt our over-active inflammatory response, limiting tissue damage. It does much more, but for this article, I’ll state that it’s good for your immune system and will indeed help you sleep more soundly. There’s a good reason that the “expanded” use of melatonin won its scientists the 2017 Nobel Prize in “physiology or medicine.”

Melatonin dosing: Studies have the maximal efficacy at 10-20 mg per night.

Reishi mushroom extract

Many types of mushrooms contain polysaccharides called beta-glucans in their cell walls. Beta-glucans boost the immune system via several mechanisms. They enhance the action of macrophages (a type of white blood cell that kills foreign invaders), activate the “complement” component of the immune system, and boost natural killer (NK) cell function. There is an especially immune-boosting species of mushrooms called Ganoderma lucidum or reishi mushrooms. They are not especially tasty but are used to formulate potent immune-enhancing supplements.

Reishi dosing: Find a good brand that uses cracked reishi spores to make the powder put in capsules and take 1000 mg per day.


The hormone DHEA is well known to impact adrenal function positively and, therefore, cortisol levels. It has verifiable anti-inflammatory properties and is most likely immune-supporting via several complex hormonal pathways.

DHEA dosing: Important note: Men with a history of prostate cancer and women with PCOS or a history of breast cancer must take the keto form of this hormone, if at all, since the keto form is not study-proven as an immune enhancer. Otherwise, men should take a daily dose of 50 mg; women-25 mg.

Nitric Oxide

Nitric oxide (NO) is bactericidal, which can act directly as an anti-microbial compound that can destroy bacteria.  Certain families of immune cells called dendritic cells can produce NO, contributing to the resolution of both viral and bacterial infections. The non-proven inference is that higher NO levels contribute to a more rapid and efficient clearing of bacterial and viruses. It’s good for your vasculature and heart, indeed very well might be immune boosting, so because of all of this, it makes my list.

NO dosing: Look for a product with an equal amount of l-arginine and l-citrulline such that you take 1.5 grams of each 2x/day.

The Research Continues

Many organ systems function better by restoring male hormones and female hormones to youthful levels, and we know that human growth hormone is immune-boosting. We understand that the alpha-thymosin 1 peptide is so good at boosting the immune system (increased NK cell activity, increased antibody response to viruses, increased T cell function, and more) that the FDA pulled it off the market. Yes, that happens all the time with compounded products used successfully by Functional doctors. But studies are ongoing with other peptides.

There are other varieties of mushrooms (lion’s mane, for one) currently under investigation for immune enhancement. And finally, the most exciting research involves the use of stem cells and exosomes.

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