Written by Sebastian Pole
Ayurveda presents some excellent philosophy and guidance on how we can maintain a healthy immune system. Here we will delve into how the immune system works and the role of our internal ‘digestive fire’.
In my clinical experience the majority of health imbalances come from some sort of deficiency and this invariably affects immunity. This depletion can manifest in dysfunction in the digestive system, endocrine system, neurological system and inflammatory processes in the body. From the Ayurvedic perspective this manifests as impaired digestive agni, tissue dhatu, constitutional dosha as well as our inherited reserve ojas and the life-force prana (see below for more about this). These directly and indirectly affect our deeper sense of health and well-being. One way of reversing this deficiency is to focus on nourishing the different aspects of immunity.
What is immunity?
Immunity is the organism’s natural response to protect us from infections and help maintain homeostasis. It maintains the ecological relationship between the mind-body-spirit and the world in which we live and interact. Our immunity is a holistic system interconnected with the psychological-neurological- endocrine systems, it is multi-dimensional and requires nourishment from diverse sources. Healthy communication between these different sources is the key to healthy immunity.
Our immune system is facing a unique historical challenge as we encounter increased environmental, industrial, social, pharmaceutical, dietary and spiritual stressors. This microcosmic challenge is a reflection of the larger environmental challenge that our macrocosmic world is also facing. The pressures of global population increase, industrial expansion and the destabilisation of many natural ecosystems are clearly stressing the earth’s natural immunity. We now know that these challenges also have a negative impact on our immune systems. How we care for ourselves and advise our patients can have a direct impact on the Earth’s immunity.
Let’s now look at some of the information that can help us to understand how we can weave our way through this quagmire of health challenges.
Symptoms of depressed immunity
- Regular or persistent bacterial, fungal, viral or parasitic infections
- Slow healing wounds
- Auto immune diseases
- Inflammatory disorders
- Chronic fatigue
- Chronic degenerative conditions; impaired immune system response is present in such diseases as cancer, candidiasis, ME, AIDS, TB
How the immune system works
In order to protect us from foreign invaders the immune system must be able to differentiate from ‘self’ or ‘non-self’ or what is ‘us’ and what is ‘not us’. In order to fulfil this objective the immune system galvinises the cooperation of numerous cells, organs and chemicals to work coherently to protect us against disease. There are two categories of immunity; a natural, innate, non-specific immunity and an acquired, adaptive, specific immunity.
Non-specific immunity is a natural, genetic type of immunity present at birth; for example, cows appear to have immunity to small pox, but it can be fatal in humans. Our innate immunity includes the skin, certain chemicals in the blood and special immune system cells that attack foreign substances in the body. It is responsible for 99.9% of all immune activity and is our first line of defence.
- Non-specific immunity is partly regulated by macrophages that literally hoover up foreign bodies in a process known as phagocytosis; Andrographis, Guduchi, Ashwagandha and Garlic all increase the action of phagocytosis.
- Natural Killer (NK) cells are a part of this non-specific system that act independently of other chemical messages and act as the first line of defence against many diseases. They are formed in the bone marrow and then travel to lymphoid tissue (tonsils, lymph nodes and spleen). From here they either attack cells infected with viruses or DNA damage (eg tumour cells). They also work as part of the acquired immune system (see below) and release cytokines that modulate T and B lymphocytes; Licorice and Garlic assist NK cell activity.
- Specific chemicals are used by this aspect of immunity to keep the body healthy; interferons, interleukins, Tumour Necrotic Factor; Ashwagandha, Turmeric and Green tea have all been shown to positively affect these immune system workers.
Specific immunity was a later development in our evolution and generates lymphocyte activity at a cellular level against invading foreign substances known as antigens. It is an induced response that is slower than our innate immune response, It has to be learned by the body and it also creates a memory. For example, the adaptive immune system creates a secondary response to a pathogenic infection by a disease to which the body can become immune after recovery (e.g. chickenpox) or via vaccination, or from receiving antibodies via your mother’s breast milk.
- T-lymphocytes are released by this specific immunity and they have ‘killer’ ‘helper’ and ‘suppressor’ activity; Kutki, Andrographis, Garlic and Licorice modulate T-cells.
- B-lymphocytes are produced by the bone marrow in adults and live in the spleen and digestive tract. They are transformed into plasma cells which create immunoglobulin anti-bodies on meeting a foreign invader and create memories of these invaders to recognise them when they next appear; Ashwagandha and Licorice modulate B-lymphocyte activity; Punarnava, Guduchi, Karela, Turmeric, Garlic and Licorice all help to modulate antibody response.
In recent medical history it is the specific immunity which has received most emphasis, even though it is responsible for only 0.1% of immune activity,. The excitement and therapeutic potential generated by the discovery of vaccinations and anti-biotics has led the way in medical research and investment. Tragically this one-dimensional ‘magic-bullet’ mentality has left the potential of our innate and non-specific immunity largely untapped as a resource for healing. As we shall see, Ayurveda offers enormous potential in nourishing non-specific immunity simply because, like us, it is multi-dimensional.
(Spelman et al 2006, Ferlazzo et al 2004, Clayton 2004, Bone 2003 &1996, Pole 2006)
Important components of the immune system
- Lymph system
- Bone marrow
- White blood cells
The integrated nature of the immune system
The endocrine and nervous systems are in continual feedback with the immune system and their state of balance regulate the immune response. So, the balance of our hormones and the functioning of our neurons are implicated in how our immune system responds to visiting foreign substances. The brain and immune system have a continual dialogue so that immune mediated chemicals inform the brain what to do and visa versa. It is clear how we can under perform when faced with an intolerable level of negative stress. As we know, emotional, hormonal and immune states all affect our digestion, sleep and mood. Certain studies have shown how different emotional states affect the immune system:
- Loneliness reduces NK cell activity. Lonely students have reduced NK cell activity and higher Epstein Barr virus levels (Kiecolt-Glaser et al 1984 & 1987).
- Excessive stress reduces immunity (as well as increasing the risk of strokes, increases atherosclerosis, high blood pressure, reducing neuronal regeneration and ageing). Caretakers of dementia patients suffer from reduced immunity. People under extreme academic stress show reduced levels of lymphocyte and interleukein production and higher cortisol levels (Kiecolt-Glaser et al 1984, Schultz R et al 1999, Stein 1985).
- Bereavement causes reduced immunity with reduced lymphocyte activity in men and post-bereavement depression can cause increased cancer and death. (Schleifer et al 1983 &1989, Kiecolt-Glaser et al 1986 & 2002).
- Marital conflict also affects immunity raising Blood Pressure, cortisol and NK cell activity (Miller et all 1999, Kiecolt-Glaser et al 1987).
Allopathic treatment of immune disorders and their side-effects
Whilst many pharmaceutical drugs are often life-saving their chronic use is having a debilitating effect on the health of many people. The cocktail of drugs that patients arrive with in the clinic is often astounding. We are in the middle of a human experiment that encourages end-stage emergency medicine instead of a more integrated approach that engenders health and nourishes the whole system. It is now clear that the poly-pharmacy approach of current allopathic practice is both not working in either the preventative or curative sense. Iatrogenic disease is now considered to be the third largest cause of death in the USA. As Ayurveda would recommend, health is all about time (kala) and space (desha) and who is using how much of what, and when. Practitioners of holistic medicne are helping to inspire change in the current medical paradigm and serve patients, society and environment in the most complete and healing manner (Lazarou 1998, Starfield 2000, Holford 2006, Clayton 2004 & 2007).
Some immunosuppressive medication:
Corticosteroids, such as prednisolone, dextamethasone: Often used to treat inflammatory digestive, skin or arthritic conditions.These work by blocking the action of inflammatory prostaglandins. They can depress the immune system, reduce T and B-lymphocytes, increase susceptibility to infection, osteoporosis, reduced efficacy of insulin, cause peptic ulcers, increase in blood pressure, fluid retention, acne, moon face, atrophy of body’s ability to produce corticosteroid hormones. They are cold, damp and aggravate kapha, and reduce ojas.
- Immunesuppressants and Antimetabolites, such as cyclosporine and methotrexate. Cyclosporine is used as an immunosuppressive drug after organ transplants or to treat certain auto-immune diseases. It can lead to increased susceptibility to infection, tremors, facial swelling, nausea and kidney damage. Methotrexate helps to block the metabolism of cells and is used to treat cancer, arthritis, psoriasis and cancer. The most frequent reactions include mouth sores, stomach upset, low white blood counts, headaches, itching, skin rash, dizziness, and hair loss. Methotrexate can also cause severe toxicity of the liver and bone marrow. They are hot, toxic and aggravate agni, rasa, rakta, majja and shukra dhatu.
- Anticancer drugs: Chemotherapy and Radiotherapy: As they are cytotoxic these drugs literally prevent cell formation and hence may halt the growth of tumours. This action also opposes the natural regenerative force of life, new cell formation and can lead to a range of side-effects including nausea, hair loss, red and white blood cell depletion, platelet reduction and bone marrow depletion. They are hot, toxic, depleting to agni, and every dhatu.
- Antihistamines: Antihistamines are used to suppress allergic symptoms.They act on H1 receptor sites by preventing histamine from attaching to these sites and theoretically preventing the body from responding to allergens. They are used to relieve mild to moderate symptoms and can cause drowsiness. An example is diphenhydramine. The different varieties have different energetics but are essentially stagnating to prana.
- Antibiotics: These are the mainstay of treatment in acute bacterial infections, including tetracyclines, macrolides (erythromycin), penicillins (amoxicillin or ampicillin). Antibiotics may be routinely dispensed without specific bacterial strain analysis. Common side effects are disturbed intestinal flora leading to outbreaks of Candida albicans, other yeast infections and diarrhoea. Rarer reactions are severe allergic reactions. Antibiotics are mainly cooling depleting agni, causing kapha and ama to accumulate.
- Antivirals: Antiretroviral drugs used for treating AIDS can cause hepatic injuries, renal and genitourinary diseases, allergies, fever, anaemia, nausea, diarrhoea, vomiting, skin problems, photosensitivity, elevation of cholesterol and triglyceride levels leading to coronary artery diseases. These appear to be heating and toxic. (British National Formulary 2006)
The Ayurvedic understanding of immunity
Ayurveda has a beautiful understanding of our immunity which it considers within a completely holistic context, including both a qualitative and quantitative understanding of immunity. The Ayurvedic view of immunity is based on the concept of inherited reserve and acquired reserve. It is literally known as ‘vyadhi-kshmatva’ or ‘self-avoidance of disease’.
”The immunity (vyadhi-kshamatva) is a strength within all of us that resists the causes of diseases and their aggressive tendencies.” – Chakrapannidatta
The Ayurvedic concept of immunity involves the health of the ojas, the heart(hridaya), the eyes (chakshushya), digestive strength (agnibala) and tissues (dhatu).
The quality of your inherited (sahaj) and acquired (yukti) organ reserve is generically known as ojas. Ojas holds a special place in Ayurveda as it nourishes and orders the functioning of the body. Just as ghee is the most refined essence of milk so ojas is considered to be the most superfine essence of all inherited organ reserve, digested nutrition and experiences.
“It is ojas which keeps all living beings refreshed. There can be no life without ojas…. It constitutes the essence of all the tissue elements.” – Charaka Samhita 1.30.9
If it is depleted, disease can set in:
“When ojas is low the person is fearful, weak, worried, has deranged senses, poor complexion, weak mind, is rough and thin’. – Charaka Samhita (CS) 1.17.73
When maintained at an appropriate level its beneficial qualities are seen in the lustre of the eyes, strength of the body, suppleness of the limbs, resistance to disease, efficient digestion, potent fertility, vital energy and lucidity of the mind. It is the seat of prana and agni helping to sustain their potential in the body. It is considered to sustain life (CS 1.30.10) and to provide strength (bala) (Ashtanga Hridaya 1.11.41). Bala is closely related to ojas. In fact, Sushruta views ojas and bala as being identical and uses the terms synonymously (Sushruta Samhita.1.15.20). Bala also possesses the quality of resisting diseases (CS 6.3.141), because it is able to inhibit their root cause, the doshas (CS 6.3.167).
Ojas has sweet (madhura), heavy (guru), cool (sheeta) and unctuous (snigdha) properties. Based on the principle of samanya-vishesha (CS 1.1.44 and 1.62) it is built by substances or experiences with similar attributes, such as ghee, milk, nuts, love, contentment, calm. It is also nurtured by non-violence, preservation of reproductive fluids, knowledge, self-control, understanding of the truth and sexual abstinence (CS 1.30.15). Conversely it is reduced by dry (ruksha), astringent (kashaya), light (laghu) and hot (ushna) qualities. Hence, ojas can be depleted by excessive: alcohol, fasting, consumption of un-unctuous food, eating food only tasting of one flavour, exposure to the wind and sun, over work, under nourishment, orgasm, exercise, depression, fever, infections, sadness, irritability, anger, anxiety and stress.
The heart (hridaya)
Ayurveda understands that the ‘seat’ of ojas is in the heart (CS 1.30.6) and that emotional balance and nourishment is an integral part of an efficiently functioning immunity. It is said that eight drops of ojas (para ojas) resides in the heart and that this is the regulator of all the ojas in the body. It can never increase and must be maintained for preserving health. The type of ojas flowing around the body is known as apara ojas. It is said to be half a handful (anjali). This type of ojas can increase and decrease.
From the heart the channels of prana, manas and rasa all extend revealing it as the source of breath, mental balance and nutrition. The heart, as well as being a governing organ of blood circulation, is also the seat of consciousness (CS 1.30.4). This emphasises the importance that Ayurveda places on using treatments that nourish both the physical and emotional heart for maintaining a health of the immune system. As we all know, oppressive stress negatively affects the immune system (Khansari et al 1990).
It is one of Ayurveda’s gifts to humanity that it reminds us to care for the emotional nourishment in our patients. To help generate a healing experience of self-worth and love is priceless prasad.
The eyes absorb external experiences and feed directly into the heart. Using positive visualisations and herbs that nourish the eyes plays a part in supporting ojas and the immune system.
A healthy digestion helps to feed the tissues (sapta dhatu), which feed the heart and nourishes immunity. If digestion is impaired then it cannot metabolise the appropriate nutrients required for nourishment of the tissues and hence results in the depletion of ojas. If the digestive fire becomes impaired in any way then toxic accumulations known as ama can clog the channels and obscure the clarity of nutritional absorption and emotional assimilation.
‘It is obvious that that the body tissues cannot be nourished and developed when food is not properly digested by agni’ – Charaka Samhita6.15.5
The importance of good diet on immunity cannot be over emphasised. Nutritive food protects health and prevents disease. It has been shown that 30% of all cancers are diet related and that 70% of these cancers are connected with typical diets that are high in animal fat, low in fruit, vegetables and fibre (WHO). Since 1950 there has been a global reduction of calorific intake by 38% in the consumption of complex carbohydrates and an increase of 36% for meat and 46% for vegetable oil. In the same period in the UK there has been a fall in fresh vegetable consumption by 24% and in the EU and US there has been a 35% increase in sugar and refined starch consumption. Our shift in nutritional habits is evidently having a negative impact on society’s health.
An increase in nutrition received from meat is a good example. Well-cooked meat, especially barbequed meat contains aromatic amines, including 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (2, 3) PhIP which is associated with bowel, breast and prostate cancer in human cell line studies. The more meat that is eaten is directly correlated with an increased incidence of death from cancer, as seen by statistics showing New Zealand as having the highest meat consumption and the highest levels of colon cancer. There has been a 36% calorific increase from meat consumption since 1950. Vegetarian diets are known to extend life and reduce degenerative diseases. (Clayton 2004 & 2007)
Other qualitative and quantitative nutritional factors are altering society’s health. Obesity has clear links with some forms of cancer (Cerhan 1997). Low selenium levels are specifically implicated in prostate cancer (Li et al 2004). Conversely, the increased use of protective oils containing Omega-3 and Omega 6 fatty acids is related with a reduced rate of cancers. Lycopene, carotenoids and onion flavonoids have proven to be protective against prostate cancer. Studies have shown that increasing essential nutrients can give essential protection against degenerative diseases such as Alzheimer’s, arthritis, coronary heart disease, macular degeneration, depression and cancer (Giovannuci et al 1995, Lewin et al 2006, Taylor 2004, Drewnowski 1997 & 2003).
Interestingly, but not surprisingly, organically grown food has been shown to have higher levels of nutrients and anti-oxidants than non-organic products. Studies comparing the nutritional value of organically grown and conventionally grown fruits, vegetables, and grains conclude there are significantly more nutrients in organic crops. These include: 27% more vitamin C, 21.1% more iron, 29.3% more magnesium, and 13.6% more phosphorus, 70% higher omega-3 content and certain vegetables have been shown to have 100% higher levels of flavonoids. In addition, organic products have 15.1% less nitrates than their conventional counterparts. It is also noted that the government recommended five daily servings of vegetables (lettuce, spinach, carrots, potatoes and cabbage) provided the recommended daily intake of vitamin C for men and women when they are organically grown but their conventional counterparts did not. Eating organic affects the amount of flavonoids, quercetin, and anti-oxidants that are protecting and nourishing you. You are also avoiding exposure to excessive levels of immune damaging pesticides and organophosphates (Worthington 2001, Heaton 2001, Grender-Pedersen et al 2003, Zheng et al 2001).
All this shows that the quantity and quality of food as well as the quantity and quality of agni affect immunity.
The health of the tissues leads to the final nourishment and support of the immune response. With good digestion of food the tissues are maintained in a healthy state, and if of exceptional quality, they can actually help to replenish any depletion of ojas caused by ageing and the ravages of time. This is clearly seen when a patient with manda agni leading to dhatu kashaya commonly suffers from degenerative disease. Looking after agni will look after the dhatu.
Any excessive, deficient, stagnation or overflow in the channel system throughout the body-mind impairs the nutritive and detoxifying function of the srotamsi. Whether there is constriction from vata tension (cold or dry), inflammation from pitta intensity (hot or oily) or congestion from kapha or ama mucus (wet or sticky) any imbalance in the flow of the channels (srotorodha) leads to imbalances in the movement of the dosha, dysregulation of the dhatu and this results in impaired immunity. Channel stagnating nervous, inflammatory and mucus proliferation all seem to be encouraged by modern diets and life-styles. Pharmaceutical drugs, amagenic diets, emotional indigestion and environmental pollutants are some of the current contributors to obstructing the healthy flow in the srotamsi.
The functional principles (dosha)
- Vata immune problems will manifest in people where there is a poor response to a disease and general depletion. This often involves lingering illness, chronic degeneration, wasting and weakness. This requires immune stimulants and immune tonics; Tulsi and Ashwagandha are good examples.
- Pitta immune problems will manifest with inappropriate and extended inflammation. This will require reducing the inflammatory cascade and reordering the immune response; Andrographis and Guduchi and good examples.
- Kapha immune problems will manifest with abnormal growths and mucus secretions. This will require clearing treatments that reduce congestion and remove stagnation; Pippali and Ginger are good examples.
To summarise, good immunity in an Ayurvedic context comes from:
- Avoiding the causes of poor immunity (nidana parivarjana)
- Balance of the dosha (tridosha hara chikitsa)
- Balanced digestion (sama agni)
- Reduced toxins (ama pachana)
- Keeping the channels of circulation open (srotas mukho vishodhana)
- A strong heart and balanced emotions (hridaya manas bala chikitsa)
- Nourishing the tissues (dhatu poshana)
- Avoidance of negative habits and behavioural patterns that can reduce your inherent reserve (asatmeya indriya samartha hara).
When considering a treatment plan I also like to think of the condition of the different ‘bodies’ we have (as propounded in the yogic texts); the food (annamaya kosha), breath (pranamaya kosha), mental (manomaya kosha), knowledge (vijanomaya kosha) and bliss (anandomaya kosha) bodies all need attention. The teachings of Ayurveda offer the wisdom to treat in a multi-dimensional manner.
Achieving abundant ojas means having access to:
- Pure air
- Pure water
- Pure food
- Emotional stability: love, peace of mind, balanced relationships.
- A regular lifestyle (dinacharya): Ayurveda lays much emphasis on prevention so as to prevent the degenerative cascade that can occur. This is an orderly routine that balances personal hygiene, nourishment, exercise, relaxation, creativity, wealth and love.
- Protection; your daily activities should be 100% healing with active avoidance of immune depressing chemicals and foods to keep your immune system intact.
- Detoxification; daily, seasonal and whenever required: Deep purification if there is strength (shodhana and panch karma), gentle purification in more depleted states (shamana), daily regulation of the elimination of toxins (amapacana).
- Tonify; daily, seasonally and as much as possible.
- Herbs and foods: Sweet in taste, sweet in post-digestive effect, cooling, heavy and unctuous all go to build ojas.
Special Ayurvedic treatment categories to nourish ojas and overall immunity
All of these dravya can taken with milk and or ghee to guide them to the deeper tissues.
Balya: Strengthening treatments giving power to the digestive fire (agni) and tissues (dhatus): sweet nourishing tonics such as bala, vidari kandha, gokshura, guduchi, kapikacchu, ashwagandha, shatavari.
Brimhana: Building treatments including snehana and oleation techniques to nourish the tissues using unctuous and oily substances such as figs, milk, honey, ghee, vidari kandha, gokshura, chywanaprash, hemp seeds, linseeds, almonds and walnuts (and their omega rich oils).
Jeevaniya: Life-enhancing herbs and treatments that include anti-oxidants and life-enhancing herbs; amalaki, tulsi, turmeric, guduchi, green tea, ashwagandha, chywanaprash.
Agnivardhaka: herbs and foods including all the six tastes that strengthen digestion to assist absorption of nutrients including chitrak, ginger, pippali, cinnamon, cumin, fennel.
Medhya: Nourishes the heart and brain to feed ojas with intellect promoting herbs such as gotu kola, amalaki, licorice, vacha, brahmi, shankapushpi, kapikacchu, guduchi.
Chakshusya: Nourish the eyes to feed your heart using lotus root, chrysanthemum flowers, bluberries, triphala and amalaki.
Hridaya: these herbs directly nourish the heart to feed ojas including arjuna, roses, amalaki, punarnava, cinnamon and chywanaprash.
Rasayana: These rejuvenative treatments nourish rasadhatu which is the first tissue responsible for creating a feeling of pleasure in life. In turn it nourishes the heart which feeds the production and protection of ojas. Such herbs as guduchi, amalaki, haritaki, bibhitaki, shatavari, ashwagandha, chywanaprash, vidari kandha and licorice are beneficial here.
Vrishya: Aphrodisiacs to rejuvenate the reproductive tissue including kapikacchu, ashwagandha, gokshura and shatavari
Shukrala: Fertility enhancing treatments directly feed shukradhatu which nourishes the heart and ojas: shatavari, vidari kanda, ashwagandha, safed musali
(Bhavaprakasha, Charaka Samhita, Ashtanga Hridaya Samhita)
An amazing feature of these herbs is their ability to help the body adapt to stress, hence many of them are known as adaptogens. There excellence manifests from their non-specific nature. They perform multiple actions on diverse organ and tissue systems.
- Sweet, heavy, wet, nourishing, building, tonifying
- Improve overall well-being; increase energy, optimise organ function, reduce stress response, increase inner strength, improve glucose levels, optimise protein synthesis, reduce cortisol levels, improve cholesterol ratios.
- As biological response modifiers (BRMs) they restore the body’s innate immune function and help the body adapt to different stressors. This gives them preventative, protective as well as curative activity against immune compromisation. By replenishing ojas, rasayana adaptogens replenish the wellspring of health and vitality.
- Initiate anti-oxidant enzymes to protect cellular DNA from damage and reverse the ageing and carcinogenic process.
- Systemic protection from drugs; adaptogens increase the tolerability of steroids, anti-biotics, chemotherapy and radiation treatments by protecting the immune system, bone marrow, blood counts and vital organs. They specifically prevent opportunistic infections and protect the vital organs and vital prana. Adaptogens actually potentiate steroids whilereducing both short and long-term side effects.
- Ideally an adaptogen will possess the ability to protect ojas, replenish deficiencies in the dhatu, increase prana, enkindle tejas as well as reduce oxidation, repair DNA damage, inhibit cellular proliferation, induce differentiation, induce apoptosis, inhibit angiogenesis, inhibit metastasis, enhance immunity (NK activity, antibody response, interferon levels, leucocyte function), reduce inflammation, regulate metabolism, balance the endocrine system, and check blood glucose levels. Ashwagandha is a good example of a herb that does many of these things.
(Rege et al 1999, Panossian et al 1999 and 2003, Yance 1999, Clayton 2004 & 2007, Sharma 1997, Dhuley et al 1997, Koul 1993).
Lifestyle routines that build vital immunity
- Exercise: Moderate exercise (up to an hour per day) is known to improve immunity (WHO, Nieman 1997).
- Yoga: The benefits of regular yoga practice are invaluable to a healthy immune system (Grossman et al 2004).
- Breathing: Regular exercises to bring prana into the system and regulate the flow of vitality around the entire system (Jayasinghe 2004).
- Meditation: Meditation has been shown to improve cellular immunity in geriatric patients. Relaxation and assertiveness training improves helper T-cells in HIV infected men. Melanoma patients who learnt stress management had improved NK cell function and greater survival rates. (Antoni et al 2002, Davidson et al 2003, Fawzy et al 1990, Wenger 1961, Kasamatsu 1964, Cohen 2004, Carlson et al 2004, Arias 2006).
- Expressing your emotions (verbally or through writing) improves immune function, results in less sick leave, improved liver function, reduced asthma, reduced arthritic pain. Spiegal’s ground-breaking work has shown how support groups have specifically helped to double the survival rates of women with metastatic breast cancer (Pennebaker et al 1988, Pietrikiet al 2004, Smyth et al 1999, Stanton et al 2002, Spiegal 1989 and 1993).
- Hopefulness improves the outcome of severe trauma (Irving et al 1997).
- Optimism improves the chance of preventing heart disease and recovery from heart surgery (Kubzansky et al 2001).
- Emotional support leads to improved recovery from illness and surgery (Berkman 1984).
- Regular massage: Along with helping you relax, feel energized and clearing stagnant lymph and toxins massage is good for immunity. Massage improves NK cell activity in HIV infected and cancer patients (as well as improving mood, reducing depression, and reducing anger). Massage increases weight gain in premature babies. Massage decreases cortisol and increases serotonin levels. Massage reduces pain and anxiety in cancer patients (Ironson 1996, Hernandez-Reif 2004, Corbin 2005).
- Surround yourself in a pleasant environment: Pleasant music and visual stimulation are good for you! They may help to reduce the release of high levels of cortisol stress hormones. Lavender oil has been shown to improve mood in the workplace as well as reduce aggressive behavior in patients (Knaska 1992, McKinney 1997).
- Seasonal detoxification is a wonderful way to keep your tissues bathed in healthy rasa.
- Getting the correct amount of sleep is essential to good immunity (Lange et al 2003).
- Making peace with everyone around you.
- Having fun. There is a great Hindi adage that goes ‘Sau rogon ka dwai, hason! Yeh hain mera bhai’, ‘There is medicine for 100 diseases, but laughter is my healing brother!’
Diet to boost immunity
As we have seen, the foundations of a healthy immune system are based on a whole food diet.
An important factor in immunity is the avoidance of poor quality foods that have been refined, heavily processed, denatured, are stale or rancid; examples are margarines with hydrogenated oils, low quality oils, refined sugars or processed and preserved foods.
Eat a diet rich in vitamin A, B, C, E, germanium, iodine, selenium, manganese, zinc, chlorophyll and including flavonoids, carotenes, anti-oxidants, omega-3/GLA oils, pre-biotic fructo-oligosaccharides (inulin).
In order to ensure that agni is primed to transform the food that is eaten it can be helpful to supplement the digestive enzymes by using hingvashtaka, trikatu or avipattikar churna.
Essential for any type of compromised immunity condition is a diet that removes toxins and regenerates any deficiencies. This is a dedicated effort to health and healing that can also be delicious.
- Follow a primarily vegetarian diet that is constitutionally appropriate. All food should be organic.
- Wholegrains; millet and roasted buckwheat are alkaline and can benefit the acidity associated with ageing along with brown and basmati rice, barley, quinoa and amaranth.
- Pulses: mung beans, aduki beans, chickpeas, fermented soy products.
- Super foods: sprouted beans (chickpeas, mung, fenugreek, sunflower, pumpkin), 5 soaked and peeled almonds/ day, micro-algae, seaweeds.
- Vegetables; carrots, asparagus, artichokes, mushrooms (shitake, oyster, maitake), ginger, cooked garlic, cooked onion, leeks, beetroots, celery, Brassica family; high in a range of cell protecting and immune boosting flavonoids.
- Inulin: Jerusalem artichokes, leeks, onions, garlic, chicory root.
- Beta-carotenes: yellow and orange vegetables; carrots, squash, pumpkin, paprika, chlorophyll rich micro-algae. Rich in cellular protecting anti-oxidants.
- Cruciferous vegetables: the Brassica family; cabbage, broccoli, brussel sprouts are high in indoles and isothiocyanates that are anti-cancer agents.
- Chlorophyll foods: dark, dreen leafy vegetables, micro-algae-spirulina.
- Sulphur: Allium family; garlic, onions, chives.
- Oils: omega-3 oils –hemp seed oil, linseed oil, micro-algae.
- Fruit: primarily berries with skins. Citrus peels.
- Dairy: some ghee.
- Avoid sugar and excess sweet foods, salt, low quality oils/fats.
Recipe: Immune nourishing soup
Simmer in 1.5 litres water- 1/2 hour
Strain and remove Guduchi, Ashwagandha and Amalaki
Add 1/2 cup organic pearl barley and ½ cup soaked and sprouted mung beans
Add root vegetables: Beetroots, carrots
Add fried leeks, onions, garlic, 10 Shitake Mushrooms
Add seasonal greens- kale, spinach, nettles, asparagus
Add ginger, rosemary, thyme, turmeric
Add 1-2 sticks kombu/ wakame
Simmer for 45 mins
Adjust quantities and water as desired
Add any particular favourite vegetables or herbs
Eat broth in convalescence
Eat 1-2 x/ week for general immune tonification
Benefits immune system, digestion, allergies, fatigue, inflammatory conditions
Creating a treatment plan to build ojas and immunity
Ayurveda offers us many so many effective insights into how to successfully help our patients. I thought I would discuss some of the things that I do in my clinic to try and achieve this. Depending on my patient’s personal requirements and their energetic pattern I prescribe a treatment that targets multiple aspects of someone’s health; body, mind, spirit, emotions, fitness and happiness. I will blend specific aspects of the above recommendations to help touch the heart of my patient and, in some way, to try and help them ignite their own inner healing. As health depends on many qualities so does the treatment to restore it.
This treatment may often include various dinacharya recommendations that will help the patient when they are living their daily life. I find that when internal remedies are given they often seem to ‘dredge’ unprocessed emotions from the tissues and bring them to the surface of consciousness. Some psychological work is beneficial to help digest these newly released old experiences. Writing a personal journal to facilitate free expression of undigested emotions can help. It may also include working with a psychotherapist or encouraging specific mediation practices. I will also use some body work techniques that may involve self-massage, more formal abhyanga, yoga, or referral for acupuncture or cranio-sacral work. Incorporating different healing modalities can help people truly heal.
The art I love most about my actual practice is the art of blending a unique formula for a patient. For me it epitomises what Ayurveda is all about; we are all unique and therefore need unique treatments. Blending a formula is a creative blend of ones practical, methodological and intuitive skills that are woven together to touch the essence of the patient’s heart. It is the subtle gift from the practitioner to their patient.
Agni is often boosted with hingvashtaka, trikatu or avipattikar churna. Inulin rich foods and pre-biotics are especially helpful when the intestinal flora has been disturbed by anti-biotics, NSAIDs and poor diet. As appropriate, fresh tea made with ushna quality spices, triphala and psyllium are a great help here.
Dhatus are nourished with a good diet (see above) and specific recommendations for the affected dhatu(s). I have started to recommend a food-state multi-vitamin and mineral supplement wherever dhatu depletion is apparent. I wonder whether these work like some bhasmas? Evidence showing the poor nutritive levels in commonly available foods, as well as the poor nutritional status of the population is overwhelming. I find hemp seed oil and ghee especially valuable for lubricating and building the dhatu. I frequently use aloe vera juice, ginger tea or honey as a vehicle for transporting other herbs to the dhatu.
Srotas are kept clear and regular by using a range of treatments including some of the guggul preparations which I find invaluable for channel integrity. Kanchanar guggul is especially effective for clearing growths and accumulations, triphala guggul for general clearing of the srotas, kaishore guggul wherever there is any inflammation. Our friend triphala is also invaluable here. For some obstructions castor oil (internally and externally) is invaluable. These all help to clear any ama.
Ojas is nourished using chywanaprash and a specific formula often including such wonderful rejuvenating herbs as ashwagandha, shatavari, amalaki, gokshura, vidari kandha, kapikacchu, turmeric, ginger, cinnamon. I also use some of the medicinal mushrooms (reishi, coriolus or maitake) for certain cases of extreme deficiency.
Manas and hridaya are a central part of most treatments. Whenever anyone is in pain and suffering their ‘heart’ needs nourishment. I will often use variations of rose, arjuna, brahmi, gotu kola, licorice, shankapushpi and vacha at about a 10-25% of the mixture.
Using plants as healing medicines helps people tap into the innate healing potential in Nature. I often like to give some herbal tea so that the actual colours, shapes and patterns of the plants can be seen, smelt and felt. A simple mix of licorice, gotu kola and cinnamon can work wonders for immunity, ojas and consciousness alike.
Recognising the signs of successful treatment and good health
- A healthy appetite and a balanced desire for food without cravings
- Appreciation of the flavour of food and feeling satisfied after eating
- Good digestion without any signs of discomfort, belching, flatulence or borborygmus
- Clear voice
- Relief from any pain or discomfort
- Proper functioning of the senses; hearing, feeling, seeing, tasting and smelling
- Clear complexion
- Appropriate length and quality of sleep
- Regular elimination of stool, urine and sweat
- Constant energy with good stamina & ability to exercise
- Enthusiasm for life
- Youthfulness and reduced ageing
- Balanced emotions; neither too happy with success nor too sad in times of difficulty
- Regularly compassionate, peaceful, loving, generous and calm
“While resting in the spirit, the mind, pure and stable, shines as a lamp shines with a bright flame from within the lantern.” – Charaka Samhita 5.5.15
- Antoni et al, Stress Management and Immune System Reconstitution in Symptomatic HIV-Infected Gay Men Over Time: Effects on Transitional Naive T Cells (CD4+CD45RA+CD29+), Am J Psychiatry 159:143-145, January 2002.
- Albert J. Arias, Karen Steinberg, Alok Banga, Robert L. Trestman, Systematic Review of the Efficacy of Meditation Techniques as Treatments for Medical Illness, The Journal of Alternative and Complementary Medicine. 2006, 12(8): 817-832.
- Berkman L, Assessing the Physical Health Effects of Social Networks and Social Support, Annual Review of Public Health, May 1984, Vol. 5, Pages 413-432.
- Bone K, Clinical applications of Ayurvedic and Chinese herbs, Phytotherapy Press, 1996, Australia.
- Bone K, A Clinical guide to blending liquid herbs, Churchill Livingstone, 2003, UK.
- British National Formulary, British Medical Association, 2006.
- Carlson, LE, et al, Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology 2004;29:448-74.
- Cerhan JR, Torer JC, Lynch CF, et al. Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States). Cancer Causes and Control 1997; 8(2):229–238.
- Clayton, P, A Pharmaco-Nutritional Approach to Cancer, lecture notes, 2007.
- Clayton, P, Health defence, Accelerated learning systems, 2004.
- Cohen L, et al. Psychological adjustment and sleep quality in a randomized trial of the effects of a tibetan yoga intervention in patients with lymphoma. Cancer 2004;100(10):2253-60.
- Corbin, L, Safety and Efficacy of Massage Therapy for Patients With Cancer, Cancer control July 2005, Vol 12, No 3.
- Dash, B and Sharma, R, Charaka Samhita, Chowkhamba Press, 1996, India.
- Davidson R et al, Alterations in Brain and Immune Function Produced by Mindfulness Meditation, Psychosomatic Medicine 65:564-570 (2003).
- Dhuley JN, ‘Effects of some Indian herbs (Ashwagandha, Shatavari, Guduchi) on macrophage functions.’ Journal of Ethnopharmacology, 1997.
- Drewnowski, A. Fat and Sugar: An Economic Analysis J. Nutr. 133:838S-840S, March 2003.
- Drewnowski, A. & Popkin, B. M. (1997) Dietary fats and the nutrition transition: new trends in the global diet. Nutr. Rev. 55:31-43.
- F. I. Fawzy, M. E. Kemeny, N. W. Fawzy, R. Elashoff, D. Morton, N. Cousins and J. L. Fahey, A structured psychiatric intervention for cancer patients. II. Changes over time in immunological measures, Archives of General Psychiatry, Vol.47, No.8, August 1990.
- Ferlazzo G, Munz C. NK cell compartments and their activation by dendritic cells.
- J Immunol. 2004 Feb 1;172(3):1333-9.
- Ferlazzo G, Thomas D, Lin SL, Goodman K, Morandi B, Muller WA, Moretta A, Munz C. The abundant NK cells in human secondary lymphoid tissues require activation to express killer cell Ig-like receptors and become cytolytic. J Immunol. 2004 Feb 1;172(3):1455-62.
- Giovanucci E., et al ‘95. “Intake of carotenoids and retinal in relation to risk of prostate cancer.” Journal of National Cancer Institute; 87:1767–76.
- Grinder-Pedersen, Salka E. Rasmussen, Susanne Bügel, Lars V. Jrgensen, Lars O. Dragsted, Vagn Gundersen, and Brittmarie Sandström, Effect of Diets Based on Foods from Conventional versus Organic Production on Intake and Excretion of Flavonoids and Markers of Antioxidative Defense in Humans, J. Agric. Food Chem., 51 (19), 5671 -5676, 2003.
- Grossmana P, Niemannb L, Schmidtc S, Walachc H, Mindfulness-based stress reduction and health benefits, A meta-analysis, Journal of Psychosomatic Research 57 (2004) 35–43.
- Hernandez-Reif M, Ironson G, Field T, Hurley J, Katz G, Diego M, Weiss S, Fletcher MA, Schanberg S, Kuhn C, Burman I, Breast cancer patients have improved immune and neuroendocrine functions following massage therapy, J Psychosom Res. 2004 Jul;57(1):45-52.
- Heaton , Organic Farming, Food Quality and Human Health: A review of the evidence, The Soil Association, United Kingdom, 2001.
- Holford P, Burne J, Food is better medicine than drugs, Piatkus publications, 2006.
- Ironson G, Field T, Scafidi F, Hashimoto M, Kumar M, Kumar A, Price A, Goncalves A, Burman I, Tetenman C, Patarca R, Fletcher MA, Massage therapy is associated with enhancement of the immune system’s cytotoxic capacity, Int J Neurosci. 1996 Feb;84(1-4):205-17.
- Irving L.M.; Telfer L.; Blake D.D, Hope, Coping, and Social Support in Combat-Related Posttraumatic Stress Disorder, Journal of Traumatic Stress, Volume 10, Number 3, July 1997 , pp. 465-479(15).
- Jayasinghe, Satyajit R., Yoga in cardiac health (A Review). European Journal of Cardiovascular Prevention & Rehabilitation. 11(5):369-375, October 2004.
- Kasamatsu, A., and T. Hirai, An EEG Study on the Zen Meditation (Zazen), Folia Psychiatrica et Neurologia Japonica 20, no. 4 (1966): 315-336.
- Kiecolt-Glaser, J., Malarkey, W., Chee, M., Newton, T., Cacioppo, J., Mao, H.-Y., & Glaser, R. (1993), Negative behavior during marital conflict is associated with immunological down-regulation. Psychosom Med. 55, 395–409.
- JK Kiecolt-Glaser, D Ricker, J George, G Messick, CE Speicher, W Garner and R Glaser, Urinary cortisol levels, cellular immunocompetency, and loneliness in psychiatric inpatients, Psychosomatic Medicine, Vol 46, Issue 1 15-23, 1984.
- JK Kiecolt-Glaser, JR Dura, CE Speicher, OJ Trask, and R Glaser, Spousal caregivers of dementia victims: longitudinal changes in immunity and health, Psychosom Med, July/August 1991; 53: 345 – 362.
- JK Kiecolt-Glaser, W Garner, C Speicher, GM Penn, J Holliday and R Glaser, Psychosocial modifiers of immunocompetence in medical students, Psychosomatic Medicine, Vol 46, Issue 1 7-14, 1984.
- JK Kiecolt-Glaser, Glaser R, Psychological influences on immunity, Psychosomatics.1986; 27: 621-624.
- JK Kiecolt-Glaser, LD Fisher, P Ogrocki, JC Stout, CE Speicher and R Glaser, Marital quality, marital disruption, and immune function, Psychosomatic Medicine, Vol 49, Issue 1 13-34, 1987.
- Janice K. Kiecolt-Glaser , Lynanne McGuire , Theodore F. Robles , Ronald Glaser, Emotions, Morbidity, and Mortality: New Perspectives from Psychoneuroimmunology, Annual Review of Psychology, 2002.
- Khansari, DN; Murgo AJ, Faith RE (1990). “Effects of stress on the immune system”. Immunology Today 11: 170–175.
- Knasko S, Ambient odor’s effect on creativity, mood, and perceived health, Chemical Senses 17: 27-35, 1992.
- Lange, T; Perras B, Fehm HL, Born J (2003). “Sleep Enhances the Human Antibody response to Hepatitis A Vaccination”. Psychosomatic Medicine 65: 831–835.
- Laura D. Kubzansky, PhD, David Sparrow, DSc, Pantel Vokonas, MD and Ichiro Kawachi, MD, Is the Glass Half Empty or Half Full? A Prospective Study of Optimism and Coronary Heart Disease in the Normative Aging Study, Psychosomatic Medicine 63:910-916 (2001).
- Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA . 1998 Apr 15;279(15):1200-5.
- Lewin MH, Bailey N, Bandaletova T, Bowman R, Cross AJ, Pollock J, Shuker DE, Bingham SA. Red meat enhances the colonic formation of the DNA adduct O6-carboxymethyl guanine: implications for colorectal cancer risk. Cancer Res. 2006 Feb 1;66(3):1859-65.
- Li, H, et al. A prospective study of plasma selenium levels and prostate cancer risk. Journal of the National Cancer Institute, Vol. 96, May 5, 2004, pp. 696-703.
- McKinney CH, Antoni MH, Kumar M, Tims FC, McCabe PM, Effects of guided imagery and music (GIM) therapy on mood and cortisol in healthy adults, Health Psychol. 1997 Jul;16(4):390-400.
- Miller, G., Dopp, J., Myers, H., Felten, S., & Fahey, J. (1999). Psychosocial predictors of natural killer cell mobilization during marital conflict. Health Psychol. 18, 262–271.
- Murthy, S, Bhavaprakasha of Bhavamisra, Krishnadas Academy, 2001, India.
- Nieman DC, Exercise immunology: practical applications, Int J Sports Med. 1997 Mar;18 Suppl 1:S91-100.
- Panossian A (2003) Adaptogens: a historical overview and perspective. Natural Pharmacy 7(4), 19-20.
- Panossian A, Wikman G, Wagner H (1999) Plant adaptogens III. Earlier and more recent aspects and concepts on their mode of action. Phytomedicine 6, 287-300.
- Petrie KJ, Fontanilla I, Thomas M, Boot R, Pennebaker J, Effect of Written Emotional Expression on Immune Function in Patients With Human Immunodeficiency Virus Infection: A Randomized Trial, Psychosomatic Medicine 66:272–275 (2004).
- Pennebaker JW, Kiecolt-Glaser JK, Glaser R. Disclosure of traumas and immune function: health implications for psychotherapy. J Consult Clin Psychol 1988;56:239–45.
- Pennebaker JW. Writing about emotional experiences as a therapeutic process. Psychol Sci 1997;8:162–6.
- Pole, S, Ayurvedic medicine, the principles of traditional practice, Elsevier, 2006.
- Raub JA, Psychophysiologic Effects of Hatha Yoga on Musculoskeletal and Cardiopulmonary Function: A Literature Review The Journal of Alternative and Complementary Medicine. 2002, 8(6): 797-812.
- Rege NN, Thatte UM, Dahanukar SA (1999) Adaptogenic Properties of Six Rasayana Herbs Used in Ayurvedic Medicine. Phytotherapy Research13, 275-291.
- Schleifer SJ, Keller SE, Camerino M et al. (1983), Suppression of lymphocyte stimulation following bereavement. JAMA 250(3):374-377.
- Schleifer SJ, Keller SE, Bond RN et al. (1989), Major depressive disorder and immunity. Role of age, sex, severity, and hospitalization. Arch Gen Psychiatry 46(1):81-87.
- Richard Schulz and Scott R. Beach, Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study, JAMA, Dec 1999; 282: 2215 – 2219.
- Sharma, P, Cakradatta: a treatise on the principles and practices of Ayurvedic medicine, Chaukhamba Publishers, 1998, India.
- Sharma KA, ‘Immunopotentiating compounds: (Guduchi) Tinospora cordifolia.’ Journal of Ethnopharmacology,1997.
- Simon D, The scientific basis of mind body medicine, lecture, 2005.
- Smyth JM, Stone AA, Hurewitz A, Kaell A. Effects of writing about stressful experiences on symptom reduction in patients with asthma ornrheumatoid arthritis: a randomized trial. JAMA 1999;281:1304–9.
- Spelman K, Burns J, Nichols D, Winters N, Ottersberg S, Tenborg M, Modulation of cytokine expression by traditional medicines: a review of herbal immunomodulators, Altern Med Rev. 2006 Jun;11(2):128-50.
- Spiegel, D., Bloom, J.R., & Gottheil, E. Effects of Psychosocial Treatment on Survival of Patients with Metastatic Breast Cancer, Lancet, 2(1989): 888-891.
- Spiegel, D. Social Support: How Friends, Family, and Groups Can Help. in Mind Body Medicine, Golrman, D. & Gurin, J. Consumer Report Books, 1993.
- Spiegel D, Classen C, Group Therapy for Cancer Patients: a Research-based Handbook of Psychosocial Care. New York: Basic Books, 1999.
- Stanton AL, Danoff-Burg S, Sworowski LA, Collins CA, Branstetter AD, Rodriguez-Hanley A, Kirk SB, Austenfeld JL. Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. J Clin Oncol 2002;20:4160–8.
- Starfield, B, Is US Health Really the Best in the World?, JAMA, Volume 284, No. 4, July, 2000.
- Stein et al, Stress and immunomodulation: the role of depression and neuroendocrine function, J Immunol.1985; 135: 827-833.
- Taylor, PR, et al. Science peels the onion of selenium effects on prostate carcinogenesis. Journal of the National Cancer Institute, Vol. 96, May 5, 2004, pp. 645-47 (editorial).
- Tillotson, A, The one earth herbal sourcebook, Twin Streams, 2001, USA.
- Wenger, M.A.,and B.K. Bagchi, Studies of Autonomic Functions in Practitioners of Yoga in India, Behavior Science 6 (1961): 312-323.
- WHO, Cancer: diet and physical activity’s impact http://www.who.int/dietphysicalactivity/publications/facts/cancer/en/
- Worthington V, Nutritional Quality of Organic Versus Conventional Fruits, Vegetables, and Grains, The Journal of Alternative and Complementary Medicine, Vol. 7, No. 2, 2001 (pp. 161-173).
- Yance D, Herbal medicine, healing and cancer, Keats publishing, 1999.
- Zheng T, Zahm SH, Cantor KP, Weisenburger DD, Zhang Y, Blair A. (2001) Agricultural exposure to carbamate pesticides and risk of non-Hodgkin lymphoma. J Occup Environ Med. 43(7):641-9.