Immune Depletion & Post Viral Fatigue
ALWAYS GETTING SICK AND NEVER FEELING WELL ?
Your immune system is designed to protect, defend and fight against harmful pathogens such as viruses and bacteria. However, recurrent and persistent infections are caused by (and lead to) a weakened immune system. When we are run down, stressed and eating poorly, the body is unable to fend off repeated bouts of illness and fails to eliminate invading pathogens effectively. Some viruses can linger and deplete the immune system over the course of several weeks or months, increasing the risk of chronic fatigue even after the initial infection is resolved. Diet, rest (convalescence) and gentle activity are key pillars to supporting your post-viral infection recovery and may mitigate the risk of recurrent infection or develop.
Why do the effects of a virus linger?
It is not clear exactly why. One theory suggests that some viruses overload the immune system. When the body is unable to substantially diminish the viral army, the battle becomes prolonged. This progressive assault makes it difficult for our immune cells (T cells) to regroup, attack and effectively kill off the virus. We become unable to make a full recovery and are then more susceptible to chronic and recurrent infections. Mitochondrial dysfunction is also strongly implicated in the disease process of post-viral fatigue. Not only are mitochondria the powerhouses of the cell required for cellular energy production, they also help regulate immune responses. Dysregulation of these functions, combined with the role mitochondria plays in oxidative metabolism, can help explain the weakness, muscle pain, postexertional fatigue, and cognitive impairment (‘brain fog’) experienced in chronic fatigue disorders. In essence, the batteries of our cells run low on reserves and become unable to meet our energy demands, while their ability to create more energy is also compromised. Furthermore, poor diet and lifestyle choices increase your susceptibility to contracting bacterial and viral infections. These factors also increase the likelihood of infections persisting for longer than they should. Delayed recovery and ongoing fatigue are higher among those who have pre-existing inflammatory health conditions such as type 2 diabetes. Post-viral fatigue is also strongly linked to depression, therefore treatment should encompass strategies that improve your physical, mental and emotional health.
INITIAL or ACUTE TREATMENT
From a naturopathic perspective the aim whilst ill is to support the immune system to battle the invading pathogen. Not to fight through, and not to suppress the symptoms. Those symptoms is your response to the illness - for example your fever helps to kill off the pathogen (a fever should always be managed carefully), fatigue enforces rest so that your vitaly energy is not further depleted and the energy can be used to rally the immune system to do its job, and the cough or runny nose is a response to clear out the mucous that builds up to rid the pathogen.
Herbal medicine, sleep, rest, easily digested wholefoods full of nutrients to resupply the immune system are key factors for an easy recovery.
POST-VIRAL FATIGUE SYNDROME
Usually, fatigue goes away fairly quickly once the body has dealt with an infection, but post-viral fatigue syndrome occurs when the exhaustion that started with a viral infection continues for a longer period of time after the infection has passed. A wide range of viruses can establish chronic fatigue including EpsteinBarr virus (EBV), cytomegalovirus (CMV), human herpesvirus, Ross River virus, enteroviruses. The initial infection is thought to trigger chronic inflammation that damages the central nervous system (CNS), dysregulates the immune system and impairs cellular energy production.
What is inflammation?
Inflammation is the body’s response to infections, injury or toxins. When something damages your cells, your body releases chemicals that trigger a response from your immune system. While designed to defend and heal from acute threats, chronic inflammation lingers and can have a negative impact on cellular processes that affect energy levels, mood and cognitive function; damage various body tissues (e.g. joints) leading to chronic pain; or contribute to diseases including type 2 diabetes, cardiovascular disease, autoimmune conditions, and neurodegenerative disorders (e.g. Alzheimer’s disease).
Similarly, many patients who recover from the acute phase of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) complain of persistent symptoms. The average duration of long-coronavirus disease (COVID-19) is thought to be three to four months, but like other viruses that cause chronic fatigue, there is no clear timeline. Long-COVID affects everyone differently. Just how long symptoms last and how long recovery will take varies from person to person.
Common symptoms of post-viral fatigue syndrome and long-COVID include:
Ongoing tiredness and exhaustion, made worse by exercise
Extreme persisting and relapsing fatigue
Depressive symptoms
Sleep disturbances
Headaches
Difficulty concentrating
Muscle and joint aches and pains
Taking steps to modify your everyday diet and lifestyle habits can help to resolve these symptoms in due course. Increasing your intake of specific nutrients that can be obtained from dietary sources or supplements may be required to help boost your immune response and strengthen your defences against chronic fatigue.
WHEN YOU ARE UNWELL AND RECOVERING
Sleep and Rest, rest and sleep. Ensure that sleep is solid, and this is where adrenal and stress support is both useful and important. If you are not getting quality sleep due to stress, work or otherwise, adrenal support is often the first important step to recovery.
Movement and Exercise that is appropriate to your state of health. Excessive and rigorous exercise may deplete you and your immune system further. But walks in nature and movement maintaining mobility and stimulating circulation and oxygenation can be beneficial.
Toxins and chemicals in your environment. Reduce your exposure to household chemicals, and eliminate alcohol, smoking and caffeine. These habits and exposures have all been demonstrated to reduce immune capacity.
NUTRIENTS & FOODS to SUPPORT BETTER IMMUNE RECOVERY
Avoid all refined sugary refined and heavily processed foods - take-away meals, soft drinks, sweets and pastries, dairy products (mucous building)
Protein required to produce immune cells : Red Meat Chicken Bone broth Salmon Eggs Beans/Legumes e.g. lentils, chickpeas Nuts and seeds e.g. peanuts/hemp/pumpkin seeds
Polyphenols are plant chemicals giving our vegetables their vibrant colours and are antioxidants that help support mitochondrial function, reduce oxidative stress and may reduce fatigue and enhance recovery after exertion - Blueberries Blackcurrants Blackberries Raspberries Pomegranate Red cabbage Cherries Black grapes
Probiotics are the beneficial live bacteria and yeasts that help to restore the composition of gut flora. Importantly, 70 to 80% of immune cells reside in the gut, impacting both local and systemic immunity - Yoghurt Kefir Kombucha Sauerkraut Kimchi Miso
Prebiotics are the fibres that feed beneficial bacteria and yeasts housed within the gut - ẞ-glucans: Oats Barley Rye Shiitake mushrooms Reishi mushrooms
Omega 3 Fatty Acids reduces inflammation, and supports activation of the innate and adaptive immune systems - Salmon Sardines Chia seeds Hemp seeds Flaxseeds/linseeds Walnuts
I would like to be able to say there is one specific nutrient (vitamin or mineral) essential for immune function, however all nutrients have a role to play and are especially supportive for a weakened immune system that may result in chronic fatigue. Consider these following nutrients specifically during this time:
Coenzyme Q10 for mitochondrial energy - Organ meats Beef Chicken Salmon Cold pressed extra virgin olive oil Peanuts Pistachios
Vitamin A enhances epithelial and mucosal barrier function, regulates innate and adaptive immune activity and enhances defences against infections - Cod liver oil Beef liver Sweet potatoes Winter squash Kale Red bell peppers Mango
Vitamin B6 deficiency impairs immunity by suppressing T cell differentiation and altering cytokine levels, is a co-factor for enzymes in the body, including those involved in energy metabolism - Salmon Beef Sesame seeds Chickpeas Bananas Sweet potatoes
Vitamin C is an antioxidant required for immune function, deficiency increases susceptibility to infections, and is associated with fatigue and depression., and supports plant-based (non-haem) iron absorption - Blueberries Strawberries Oranges Kiwifruit Mango Acai Guava Camu camu Rose hips Broccoli Spinach
Vitamin D regulates innate and adaptive immune activity, deficiency increases susceptibility to infections and is common in fatigue - Cod liver oil Salmon Sardines Mushrooms (sunned), plus skin sun exposure.
Vitamin E is a powerful antioxidant, enhances immunity by modulating T cell function - Salmon Sunflower seeds Almonds Hazelnuts Avocados
Selenium helps regulate immune responses and modulate inflammation, is incorporated into selenoproteins, required for antioxidant activity (e.g. glutathione peroxidase), and helps prevent viral infections and control oxidative stress induced by them - Brazil nuts Salmon Beef Pork Turkey Chicken Eggs Brown rice Sunflower seeds
Zinc is super important for the immune system - Gatekeeper of immune function by regulating cell signalling pathways in innate and adaptive immune cells. Possesses anti-inflammatory and antioxidant properties. Deficiency increases susceptibility to infections, and is related to poor T cell activation and perceived severity of chronic fatigue syndrome. Red meat Chicken Dark chocolate Pumpkin seeds/pepitas Cashews Chickpeas Lentils
There is a way out of the fog of chronic fatigue, and support can also be provided to prevent the continual recurrence of immune infections. The dragging fatigue, the mouth ulcers, the picking up of every bug the kids bring home, or what is going around the workplace are all signs that your immune system needs some extra support.
There are more tips on supporting winter immunity on a previous journal article Winter Immunity.
Reach out if you have any questions, or make a naturopathic appointment if think you could do well with some immune support to regain your health and vitality.
References: please reach out if you are interested in viewing the sources.
This article follows naturopathic principles for treatment of the chronic and depleted immune system, adapted from Eagle Clinical Support.
