Immunomodulators: review of the best dietary supplements

Section 1: Understanding the immune system and immunomodulation

Fundamentals of the immune system:
- Inborn immunity: The first line of protection, nonspecific. Key components:
  - Physical barriers: Leather, mucous membranes, eyelashes.
  - Chemical barriers: Lysozyme in saliva and tears, hydrochloric acid in the stomach.
  - Cells: Macrophages, neutrophils, natural killers (NK cells), dendritic cells. Functions: phagocytosis, release of cytokines (inflammatory mediators).
  - Squirrels: Complement (cascade of proteins destroying pathogens), interferons (protection against viruses).
- Acquired immunity: A more complex and specific protection develops in response to contact with antigens (foreign substances).
  - T-lymphocytes:
    - T-Helpers (CD4+): Coordinate the immune response, activate B-lymphocytes and cytotoxic T-lymphocytes. They are divided into Th1 (against intracellular pathogens), Th2 (against extracellular parasites), Th17 (against fungi and bacteria).
    - Cytotoxic T-lymphocytes (CD8+): Destroy cells infected with viruses or cancer cells.
    - Regulatory T-lymphocytes (Treg): Sold the immune response, preventing autoimmune reactions.
  - B-lymphocytes: They produce antibodies (immunoglobulins) that are associated with antigens and neutralize them, mark them to destroy other cells of the immune system, or activate complement. The main types of antibodies: IgG, IgM, Iga, Ige, IGD.
  - Memory cells: They are formed after the initial contact with the antigen, provide a faster and more strong immune response with re -infection.
- Interaction of immune cells: The immune system functions as a network where different types of cells interact with each other through cytokines and direct contact. Dandrit cells are a bridge between congenital and acquired immunity, representing antigens of T-lymphocytes.
What is immunomodulation:
- Definition: The process of changing the body’s immune response. Purpose: to optimize the immune function, restore the balance in cases of immunodeficiency, autoimmune diseases, or allergic reactions.
- Types of immunomodulation:
  - Immunostimulation: Strengthening the immune response. It is used in immunodeficiency conditions, chronic infections, cancer.
  - Immunosuppression: Suppression of the immune response. Used for autoimmune diseases, organs transplantation.
- Immunomodulation mechanisms: Various immunomodulators affect different stages of the immune response, including:
  - Activation or inhibiting of immune cells (macrophages, T-lymphocytes, B-lymphocytes).
  - Regulation of the production of cytokines.
  - Modulation of the expression of molecules on the surface of immune cells.
  - Improving phagocytosis.
  - Strengthening products of antibodies.
  - Activation of the complement system.
Factors affecting the immune system:
- Age: The immune system is less effective in infants and elderly people. Involution of Timus (the organ where T-lymphocytes ripen) with age leads to a decrease in the number of naive T cells.
- Nutrition: The lack of vitamins and minerals (vitamin D, vitamin C, zinc, selenium) can weaken the immune system. Protein deficiency also negatively affects the immune response.
- Stress: Chronic stress suppresses the immune function, increasing the risk of infections. Cortisol (stress hormone) suppresses the activity of immune cells.
- Dream: The lack of sleep reduces the activity of NK cells and increases the risk of getting sick. During sleep, the immune system is restored and strengthened.
- Physical activity: Moderate physical activity strengthens the immune system, but excessive training can suppress it.
- Diseases: HIV, autoimmune diseases, cancer weaken the immune system.
- Medicines: Corticosteroids, immunosuppressants suppress the immune system.
- Environmental factors: Air pollution, pesticides can weaken the immune system.

Section 2: Bad as immunomodulators: review and classification

What are dietary supplements (biologically active additives):
- Definition: Concentrates of natural or identical to natural biologically active substances intended for direct intake with food or introduction into food products. Are not drugs.
- Regulation: Bades are regulated less strictly than drugs. Safety and efficiency requirements below.
- Output forms: Capsules, tablets, powders, liquids.
Classification of dietary supplements: In composition and mechanism of action.
- Vitamins and minerals:
  - Vitamin C (ascorbic acid): The antioxidant, supports the function of immune cells, stimulates the production of interferon. Dosage: from 500 mg to 2000 mg per day.
  - Vitamin D (cholegalciferol): It regulates the immune response, important for activation of T-lymphocytes. Vitamin D deficiency is associated with an increased risk of autoimmune diseases and infections. Dosage: from 2000 IU to 5000 IU per day (depending on the level of vitamin D in the blood).
  - Zinc: It is important for the development and functioning of immune cells, is involved in the development of cytokines. Zinc deficiency weakens the immune system. Dosage: from 15 mg to 30 mg per day.
  - Selenium: Antioxidant, participates in the regulation of an immune response. Selenium deficiency is associated with an increased risk of viral infections. Dosage: from 55 mcg to 200 mcg per day.
  - Vitamin E (Tokoferol): The antioxidant protects cells from damage by free radicals, supports the function of immune cells. Dosage: from 15 mg to 1000 mg per day.
- Plant adaptogens: Increase the body’s resistance to stress, strengthen the immune system.
  - Эхинацея (Echinacea purpurea, Echinacea angustifolia): It stimulates the activity of macrophages, increases the production of interferon. Used for the prevention and treatment of colds. Dosage: depends on the type of echinacea and form of release.
  - Ginseng (Panax Ginseng): Improves immune function, increases energy, reduces fatigue. Dosage: from 200 mg to 400 mg per day.
  - Eleutherococcus (Eleutherococcus Senticosus): Increases resistance to stress, stimulates the immune system, improves cognitive functions. Dosage: from 100 mg to 200 mg per day.
  - Rhodiola pink (Rhodiola rosea): Adaptogen, reduces fatigue, improves mood, strengthens the immune system. Dosage: from 200 mg to 600 mg per day.
- Mushroom immunomodulators: They contain beta-glucans that stimulate the immune system.
  - Shiitaka (Lentinula Edodes): Contains lentinan, which stimulates the activity of macrophages and NK cells.
  - Мейтаке (leafy tap): Contains beta-glucans that improve the immune function.
  - Reishi (Ganoderma Lucidum): It has immunomodulating, antioxidant and anti -inflammatory properties.
  - Cordyceps (CordyCeps Sinensis): Increases energy, improves immune function, has antioxidant properties.
- Probiotics and prebiotics: Support the intestinal health, where most of the immune cells are located.
  - Probiotics: Living microorganisms that benefit health, improving the intestinal microflora. The most common species: Lactobacillus, Bifidobacterium.
  - Prebiotics: Interesting dietary fiber that serve as food for probiotics. Examples: Inulin, fruitoligosaccharides (phos).
- Amino acids:
  - L-lutamine: It is important for the functioning of immune cells, especially lymphocytes. Participates in the synthesis of glutathione, a powerful antioxidant. Dosage: from 5 g to 15 g per day.
  - L-arginine: Participates in the synthesis of nitrogen oxide (No), which plays an important role in the immune response. Dosage: from 3 g to 6 g per day.
- Other dietary supplements:
  - Collostum (Colostrum): Contains antibodies, immunoglobulins, growth factors that strengthen the immune system.
  - Omega-3 fatty acids (EPK and DGK): They have anti -inflammatory properties, modulate an immune response. Dosage: from 1000 mg to 3000 mg per day.
  - Curcumin (Curcumin): The active ingredient of turmeric, has antioxidant and anti -inflammatory properties, modulates the immune system.

Section 3: a detailed review of the best diets-munomodulators (with examples of brands and dosages)

Vitamin C:
- The mechanism of action: Vitamin C is a powerful antioxidant, protects cells from damage by free radicals. It is also involved in the synthesis of collagen necessary for the health of the skin and mucous membranes, which are barriers to infections. Vitamin C stimulates the activity of neutrophils (cells that phagocytic bacteria), increases the production of interferon (protein that protects against viruses), and supports the function of T-lymphocytes.
- Indications for use: Prevention and treatment of colds, strengthening the immune system, antioxidant protection, support for the health of the skin and mucous membranes.
- Contraindications: Individual intolerance, thrombophlebitis, tendency to thrombosis, diabetes mellitus, urolithiasis (in high doses).
- Side effects: In high doses: nausea, diarrhea, heartburn, abdominal pain, kidney stones.
- Examples of brands and dosages:
  - Solgar Vitamin C 1000 mg: 1 tablet per day.
  - Now Foods Vitamin C-1000: 1 tablet per day.
  - California Gold Nutrition Gold C, Vitamin C: 1 tablet per day.
  - Liposomal vitamin C (for example, Aurora Nutrascience): Higher bioavailability, it is recommended to be taken according to the manufacturer’s instructions.
- Output forms: Tablets, capsules, powder, chewing tablets, sparkling tablets, liposomal vitamin C. Liposomal vitamin C has a higher bioavailability, since it is enclosed in liposomes that protect it from destruction in the gastrointestinal tract.
- Features of the reception: Vitamin C is better absorbed with food. It is recommended to take it throughout the day in small portions. With colds, dosage can be increased to 2000 mg per day, but not more than a few days. People with kidney diseases should consult a doctor before taking high doses of vitamin C.
Vitamin D:
- The mechanism of action: Vitamin D is a fat -soluble vitamin that plays an important role in the regulation of the immune system. It activates T-lymphocytes, increases the production of antimicrobial peptides (defensins), and modulates an inflammatory response. Vitamin D deficiency is associated with an increased risk of autoimmune diseases (multiple sclerosis, rheumatoid arthritis), infections (flu, acute respiratory viral infections, tuberculosis), and cancer.
- Indications for use: Prevention and treatment of vitamin D deficiency, strengthening the immune system, prevention of osteoporosis, supporting the health of bones and muscles, reducing the risk of autoimmune diseases and infections.
- Contraindications: Individual intolerance, hypercalcemia, hypervitaminosis D, renal failure, sarcoidosis.
- Side effects: In high doses: nausea, vomiting, constipation, weakness, dizziness, bone pain, increasing the level of calcium in the blood and urine.
- Examples of brands and dosages:
  - Now Foods Vitamin D-3 2000 IU: 1 capsule a day.
  - Solgar Vitamin D3 2200 IU: 1 capsule a day.
  - California Gold Nutrition Vitamin D3 5000 IU: 1 capsule per day (recommended after consulting a doctor and passing the analysis to the level of vitamin D in the blood).
  - Liquid vitamin D (for example, Nordic Naturals Vitamin D3 Liquid): It is easy to dose, especially for children and the elderly.
- Output forms: Capsules, tablets, chewing tablets, drops, spray.
- Features of the reception: Vitamin D is better absorbed with fatty foods. It is recommended to take an analysis for vitamin D in the blood (25-OH vitamin D) to determine the optimal dosage. The dosage of vitamin D depends on the age, state of health, level of vitamin D in the blood, and the time of year. In the winter season, when there is little sunlight, it is recommended to take vitamin D daily.
Zinc:
- The mechanism of action: Zinc is an important trace element that is involved in the regulation of the immune system. It is necessary for the development and functioning of immune cells (T-lymphocytes, B-lymphocytes, NK cells), participates in the production of cytokines, and has antioxidant properties. Zinc deficiency weakens the immune system, increases the risk of infections, slows down the healing of wounds.
- Indications for use: Prevention and treatment of zinc deficiency, strengthening the immune system, acceleration of wound healing, treating acne, supporting hair and nails.
- Contraindications: Individual intolerance, renal failure, Wilson-Konovalov’s disease.
- Side effects: In high doses: nausea, vomiting, diarrhea, abdominal pain, metallic taste in the mouth, a decrease in copper levels in the body.
- Examples of brands and dosages:
  - Now Foods Zinc Picolinate 50 мг: 1 capsule per day. Zinc Picoline has higher bioavailability than other forms of zinc.
  - Solgar Zinc Citrate 22 мг: 1 tablet per day.
  - Life Extension Zinc Caps 50 mg: 1 capsule a day.
  - Circus in the form of loafers (for example, Cold-Eeeze): Used to alleviate the symptoms of colds.
- Output forms: Capsules, tablets, chewing tablets, loaves, syrup.
- Features of the reception: Zinc is better absorbed on an empty stomach, but can cause nausea. In this case, it can be taken with food. With prolonged use of zinc, it is recommended to take copper additionally to prevent copper deficiency. High doses of zinc can reduce iron absorption.
SOUTINATEA:
- The mechanism of action: Echinacea stimulates the immune system, increasing the activity of macrophages (cells that phagocytize bacteria and viruses) increases the production of interferon (protein that protects against viruses), and has anti -inflammatory properties.
- Indications for use: Prevention and treatment of colds (influenza, SARS), strengthening the immune system, treatment of skin infections.
- Contraindications: Individual intolerance, autoimmune diseases (multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus), progressive systemic diseases (tuberculosis, leukemia, collagenosis), pregnancy, breastfeeding, children under 12 years of age.
- Side effects: Allergic reactions (skin rash, itching, urticaria), nausea, vomiting, abdominal pain, dizziness.
- Examples of brands and dosages:
  - Nature’s Way Echinacea 400 mg: 2 capsules 3 times a day.
  - Now Foods Echinacea 400 mg: 2 capsules 3 times a day.
  - Herb Pharm Echinacea Extract: The liquid extract of echinacea, the dosage depends on the concentration of the extract (follow the manufacturer’s instructions).
  - Echinacea Cold & Flu Relief (например, Boiron Oscillococcinum with Echinacea): Homeopathic remedy with echinacea to alleviate the symptoms of colds and influenza.
- Output forms: Capsules, tablets, liquid extract, tea.
- Features of the reception: Echinacea is recommended to be taken at the first signs of colds. The course of treatment should not exceed 8 weeks. With autoimmune diseases, echinacea can only be taken after consulting a doctor. Echinacea can interact with some drugs, so before its use it is necessary to consult a doctor.
Probiotics:
- The mechanism of action: Probiotics are living microorganisms that benefit health, improving the intestinal microflora. The intestines plays an important role in the immune system, since there is most of the immune cells. Probiotics strengthen the intestinal barrier, prevent the penetration of pathogens into the blood, stimulate the production of antibodies, and modulate the immune response.
- Indications for use: Intestinal dysbiosis (after taking antibiotics, with improper nutrition, with stress), diarrhea, constipation, bloating, irritable intestine (SPK), strengthening the immune system, allergy prevention.
- Contraindications: Individual intolerance, acute pancreatitis, severe immunodeficiency conditions (HIV, organs transplantation).
- Side effects: In rare cases: bloating, flatulence, constipation, diarrhea (usually pass for several days).
- Examples of brands and dosages:
  - Culturelle Digestive Daily Probiotic: 1 capsule per day. Contains Lactobacillus Rhamnosus GG, one of the most studied and effective probiotics strains.
  - Align Probiotic: 1 capsule per day. Contains Bifidobacterium infantis 35624.
  - Garden of Life Dr. Formulated Probiotics Once Daily: 1 capsule per day. Contains a mixture of various probiotics strains.
  - Probiotic Pearls: 1 capsule per day. They have a shell resistant to the acidic environment of the stomach.
- Output forms: Capsules, tablets, powder, chewing tablets, liquids.
- Features of the reception: Probiotics are recommended to take on an empty stomach, 30 minutes before meals, or before bedtime. When taking antibiotics, probiotics should not be taken simultaneously with antibiotics, but with an interval of several hours. It is necessary to store probiotics in the refrigerator in order to maintain the viability of bacteria. When choosing a probiotic, attention should be paid to the number of viable bacteria (some kind of colony -forming units) and to strains of bacteria, which are part of the probiotic.

Section 4: Scientific research and evidence base

Review of vitamin C studies:
- Colds: Met-analyzes show that regular intake of vitamin C can slightly reduce the duration and severity of colds, especially in people subject to intensive physical exertion or living in cold conditions. However, vitamin C does not prevent a cold in most people.
  - Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000980.
- Immune function: Vitamin C plays an important role in maintaining the function of immune cells, such as neutrophils and lymphocytes. He also participates in the production of antibodies and interferon.
  - Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017 Nov 3;9(11).
- Antioxidant Protection: Vitamin C is a powerful antioxidant that protects the cells from damage by free radicals formed in the process of metabolism and under the influence of the environment.
  - Padayaty SJ, katz a, wang y, eck p, kwon o, lee jh, CHEN s, Corpe CP, Dutta SK, FALLER J, GUO J, Holeczke ba, Jenkins J, Klevay LM, Levine M. Vitamin M. Vitamin Prevention of its Role in J AM COLL NUTR. 2003 Feb;22(1):18-3
Vitamin D Review Review:
- Immunomodulation: Numerous studies have shown that vitamin D plays an important role in the regulation of the immune system. It affects the function of T-lymphocytes, B-lymphocytes, and macrophages. Vitamin D deficiency is associated with an increased risk of autoimmune diseases and infections.
  - Aranow C. Vitamin D and the Immune System. J Investig Med. 2011 Aug;59(6):881-6.
- Respiratory infections: Some studies have shown that vitamin D may reduce the risk of respiratory infections, especially in people with vitamin D.
  - Martineau Ar, Jolliffe Da, Greenberg L, Aloia JF, BERGMMAN P, DUBAL N, Ferr P, Grant CC, Harries AD, HOLENEN E, LARANEN E, Langaum A, Modlin Rl, Modlin Rl, Mary Fitzprick BM, Pand Mr. S, White JH, Rootman TA, Gamba-Cororn M. Vitamin D Supplements protect against Rodesiri infections: systemic review and meta-analysis from individual patients. BMJ 2017 Feb 15; 356: I 6583.
- Autoimmune diseases: Some studies suggest that vitamin D may reduce the risk of developing autoimmune diseases, such as multiple sclerosis and rheumatoid arthritis.
  - Mora JR, Iwata M, von Andrian UH. Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol. 2008 Sep;8(9):685-98.
Overview of zinc research:
- Immune function: Zinc is necessary for the development and functioning of immune cells. Zinc deficiency weakens the immune system and increases the risk of infections.
  - Prasad AS. Zinc in human health: effect of zinc on immune cells. Mol Immunol. 2008 Aug;45(13):353-7.
- Colds: Some studies have shown that zinc intake can reduce the duration and severity of colds, especially if you start taking it in the first 24 hours after the onset of symptoms.
  - Hemilä H. Zinc lozenges may shorten the duration of colds: a systematic review. Open Respir Med J. 2011;5:51-8.
- Diarrhea: Zinc supplements can reduce the duration and severity of diarrhea in children, especially in developing countries.
  - Bhutta ZA, Bird SM, Black RE, Brown KH, Gardner JM, Hidayat A, Khatun F, Martines J, Molla AM, Nahar S, Rice AL. Therapeutic effects of oral zinc in acute and persistent diarrhea in children in developing countries: pooled analysis of randomised controlled trials. Am J Clin Nutr. 2000 May;71(5 Suppl):1356-61.
Review of Echinacea research:
- Colds: Some studies have shown that echinacea can reduce the duration and severity of colds, but the results are contradictory. The effectiveness of Echinacea can depend on the type of echinacea, dosage, and the time of the beginning of the reception.
  - Karsch-Völk M, Barrett B, Linde K. Echinacea for preventing and treating the common cold: a systematic review. Cochrane Database Syst Rev. 2014 Feb 20;(2):CD000530.
- Immunomodulation: Echinacea has immunomodulating properties, stimulating the activity of macrophages and increasing the production of interferon.
  - Manayi A, Vazirian M, Saeidnia S. Echinacea purpurea: Pharmacology, phytochemistry and analysis methods. Pharmacogn Rev. 2015 Jul-Dec;9(18):63-72.
Probiotic research review:
- Immune function: Probiotics can modulate the immune system, strengthening the intestinal barrier, preventing the penetration of pathogens into the blood, stimulating the production of antibodies, and modulating the immune response.
  - Gill HS, Guarner F. Probiotics and human health: a clinical perspective. Postgrad Med J. 2004 Aug;80(947):516-26.
- Colds: Some studies have shown that the intake of probiotics can reduce the risk of respiratory infections and reduce their duration.
  - Hao Q, Dong BR, Wu T. Probiotics for preventing acute upper respiratory tract infections. Cochrane Database Syst Rev. 2015 Feb 12;(2):CD006895.
- Diarrhea: Probiotics are effective in the treatment of diarrhea caused by antibiotics or rotavirus infection.
  - Allen SJ, Martinez EG, Gregorio GV, Dans LF. Probiotics for treating infectious diarrhoea. Cochrane Database Syst Rev. 2010 Nov 10;(11):CD003048.

Section 5: Safety and Cautions when receiving dietary supplies

Side effects and interactions:
- Possible side effects: It is important to remember that even natural additives can cause side effects, especially when the recommended dosages are exceeded. It is necessary to carefully study the instructions for use and observe the recommended dosages. If any side effects occur, it is necessary to stop taking the additive and consult a doctor.
- Interactions with drugs: Bades can interact with drugs, enhancing or weakening their effect, or causing undesirable side effects. It is especially important to consider possible interactions when taking anticoagulants (warfarin, aspirin), immunosuppressants, antibiotics, and diabetes. Before taking any dietary supplements, you need to consult a doctor, especially if you take any drugs.
- Special population groups: Pregnant and nursing women, children, older people, and people with chronic diseases need to consult a doctor before taking any dietary supplements. Some dietary supplements can be contraindicated in certain diseases.
Quality and reliability of dietary supplements:
- Quality check: Bades are regulated less strictly than drugs, so it is important to choose dietary supplements from well -known and reliable manufacturers who conduct quality control of their products. You should pay attention to the availability of quality certificates (for example, GMP – Good Manufacturing Practice).
- Checking the composition: Before buying dietary supplements, you must carefully study the composition of the product. Make sure that all the ingredients and their exact dosages are indicated. Avoid dietary supplements with unknown or dubious ingredients.
- Reliability of information: Do not trust advertising promising wonderful results. Critically evaluate the information about dietary supplements received from the Internet and other sources. Contact scientific research and the opinion of qualified specialists.
Individual approach and consultation with a doctor:
- Individual need: The immune system of each person is unique, so there is no universal dietary supplement that suits everyone. The choice of dietary supplements should be based on individual needs, health status, and test results.
- Consultation with a doctor: Before taking any dietary supplements, it is necessary to consult a doctor. The doctor can evaluate your health status, identify possible contraindications, and choose the optimal dietary supplement and its dosage. Self -medication can be dangerous for your health.

Section 6: Alternative approaches to strengthening immunity (in addition to dietary supplements)

Healthy lifestyle:
- Balanced nutrition: The diet should be rich in fruits, vegetables, whole cereals, low -fat protein, and healthy fats. Limit the consumption of sugar, processed products, and fast food.
- Regular physical activity: Moderate physical activity strengthens the immune system, but excessive training can suppress it.

Immunomodulators: review of the best dietary supplements

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