Terrain vs Pathogen – Strengthen Your Immune System with Adaptogens

Flu season brings out the germaphobe in all of us. Florence Nightingale, the observant nurse of the 1800’s famously perceived “cleanliness is next to godliness” when she noticed good hygiene increased survival rates after surgeries. So, wash your hands and clean up. But paradoxically remember, the weakest immune systems come from isolation and lack of exposure to the world (1).

Terrain versus pathogen debates have been plotted since the first runny nose. What if it’s not terrain or pathogen, but terrain and pathogen? You need exposure to germs to train and advance your immune system. This doesn’t mean drinking out every strange cup you find on the ground. Help your system with immune adaptogens, herbs that moderate or upregulate the body’s own response. Andrographis, astragalus, and echinacea are three of my favorites.

Andrographis – A Top Virus Fighter

Andrographis is a plant native to India and Sri Lanka historically used to stimulate the immune system in early stages of infection. Known as “King of Bitters” this herb has been used in poisonous stings, fevers, diarrhea, flu, and upper respiratory infections. (2) It has antiviral, antibacterial, and anti-inflammatory properties. To fight infection, you need to increase the key immune cells - macrophages and natural killer or NK cells. At the same time, you also need to decrease inflammatory pathways and modulate cytokine (cell signal) production.

Macrophages are the garbageman of the white blood cells, ingesting pathogens, cancerous cells, cellular debris, and pathogen-infected cells. Upregulating macrophages helps you directly fight and improve healing from infection. Macrophages work by identifying, phagocytizing (or gobbling up), and breaking down pathogens through special enzymes and proteolytic peptides. Without strong macrophage activity, inflammation lingers, viral and bacterial infection spreads, and recovery is prolonged. Do you ever get repeated infections? Or take a long time to recover? Or, have a bacterial infection on the heels of a viral infection? You need to up your macrophage game.

NK cells are the first responders of the white blood cells, like macrophages, they help identify and destroy virus-infected cells, stressed cells and even tumor cells without needing prior exposure to the pathogen. They do this by recognizing key proteins on the cell surface, stress signals, and they also release cytokines that help fight infections. Macrophages do this too, but NK cells don’t phagocytize cells, they destroy infected or cancerous cells by causing apoptosis (cell death). So, macrophages and NK cells do very similar things, just in different ways. NK cells and macrophages also come from different cell lineages, NKs are lymphocytes and macrophages are monocytes. Upregulating NK cells helps you fight new infections, like this year’s flu.

The active component in andrographis is andrographolide, this stimulates macrophage phagocytosis and increases NK cell’s activity. Studies show that it also promotes the cytokine signals (IL2, IFN-gamma, and TNF Alpha) to fight infections and reduce tumors.(3)

Andrographis also inhibits inflammatory cell signals, one in particular – NF-Kappa Beta, a transcription factor that regulates inflammation, cell survival and growth, but can be overactive in cancer cells. Andrographis also decreases MAPK – mitogen-activated protein kinase, an inflammatory producing protein that causes tumor development and spread.

I like to use several forms of andrographis, but my go-to is Andrographis EP80 by EuroMedica, because it has the standardized extract of andrographolide. This is important to know, because if you just buy andrographis at your local grocery story, it may not even be andrographis. When things are standardized to an extract, they have been verified and tested to be pure and therapeutic. Don’t waste your money on herbs that are not validated.

Astragalus – Immune Modulator

Astragalus, while not used in such an acute phase illness as andrographis, is an immune-modulating adaptogen. While it does help enhance NK cells and macrophages, it helps balance your whole immune system - the innate immune system (Th1) and adaptive immune system (Th2).

The innate immune system is the body’s first-line defense to pathogens it has never seen before, such as this year’s flu virus. It produces fast, general responses. Adaptive immunity is acquired, meaning it recognizes the virus or bacteria from previous infections, creating long-lasting immune response.

The Th1/Th2 systems have be balanced or we run the risk of autoimmune diseases, chronic illness, histamine dominance, and even cancer. Often, we develop immune system weakness and imbalance from chronic digestive inflammation we may not even know we have.

Astragalus enhances innate immunity while supporting macrophages and NK cell function. It enhances immune cell response by balancing the signaling to the Th2 system. This makes you feel better, less achy, flu-like, regulates your fever, and just helps you bounce back after an infection. It also helps prevent reinfection. You will commonly see astragalus in many autoimmune supportive therapies in naturopathic medicine. (4)

The most frequent astragalus I use is Astragalus Max -V by Douglas Labs. This supplement has a large amount of astraglus that is standardized to the extract of astragalus’s active component, astragaloside.

Echinacea – Immune Stimulant

Echinacea is beautiful pink flower you likely have seen in every flower garden. Native American tribes of the Great Planes historically used this herb for everything from an infected wound to a cough or flu. The root was chewed for tooth aches, sore throats and it was applied topically by natives as a poultice for snakebites, burns, or stings.

All parts of this plant are used, leaves, stems, flower, and roots. Echinacea has a strong affinity for infection involving the mucous membranes (your common upper respiratory infection or lung infection).

Echinacea enhances innate immunity, particularly during early infection. It inhibits viral replication and viral entry (notably respiratory viruses). It also is anti-inflammatory by downregulating inflammatory immune signals. It is a great herb for a sluggish immune system or one that requires activation. Echinacea is not really used long-term, but during the onset and duration of the infection. We use it for about 5-14 days. (5)

I keep echinacea in my desk drawer and use it at the first headache, throat tickle, or sneeze that I think is a viral symptom. I like Echinacea Extract by Vital Nutrients as a pure stand-alone echinacea product.

As you can see, regulating the immune system is a bit complicated. Researchers are always finding ways the cytokines are behaving, influencing, and challenging the cells and tissue. But cytokines also call-to-action healing and responding appropriately to injury and insult. It’s not such a good-or-bad cytokine response, but more like imbalance or lack of key support. While cytokine response is needed to alert the immune system to through inflammatory cues, too much of a good thing creates chaos, disorder, thus pathology.

When we think of viral and bacterial infection, cleanliness and hygiene matter. But strengthening the immune system is just as important. Viral and bacterial illness bring challenges to the system, but ultimately when the immune system gets through the infection, it brings great strength.