Maintaining a Healthy Immune System During the Ongoing Threat of COVID-19

With the recent and ongoing threat of COVID-19, we are reading more than ever about the immune system, its function, and its failures. And while it would be a hopeful prospect to improve upon a normal and/or healthy immune system, there is little to no evidence that we can take supplements or drink juices to make it work more efficiently. In short, “immune-boosting” is not a possibility.

The good news is that we can make changes in our daily lives to maintain a normal immune response. Here are a few ways that we can keep our system strong.


Unfortunately, many of us are deficient in vitamins and micronutrients, most notably Vitamin B6, Vitamin B12, Vitamin C, Vitamin D, Iron, Magnesium and Zinc. In fact, less than 14 percent of adults eat the recommended amount of vegetables per day. Micronutrient deficiency — even marginal amounts — can weaken the immune system, resulting in recurrent and chronic infections. This is where a multivitamin could be helpful, but the best way to achieve what we need is by eating healthy foods.

  • Vegetables and fruits (flavonoids) are a good source of vitamins and minerals. Aim for at least 5-7 servings per day (2-3 of these should be fruits) to reduce inflammation and oxidative stress.
  • Anti-inflammatory eating is recommended and includes foods rich in omega 3 fats, such as fish, plant foods, nuts, and seeds.
  • Fiber, such as flaxseed and psyllium husk, can improve your microbiome, and I suspect most of us are lacking the minimum daily requirement (which, I feel, is already too low).
  • Processed foods, sugar and excess alcohol should be avoided, as they foster inflammation and contribute to micronutrient depletion.

Some of my favorite pantry staples:

  • Artichokes have more antioxidants than any other fruit and vegetable in the supermarket, are high in fiber and low in calories. Look for artichoke hearts packed in water. (Check out Eating on the Wild Side by Jo Robinson.)
  • Olives contain healthy fats and phytonutrients.-Assorted nuts (my favorite are walnuts for nutritional value).
  • Canned tomatoes that are processed shortly after harvesting. Canned tomato paste has a very high concentration of lycopene.
  • Legumes and dried beans are very high in phytonutrients and have more antioxidants than all but a few fruits and vegetables. (Pressure cooking preserves nutrients, so these are a great option for an Instant Pot.)

Some of my favorite online resources:

As always, while some may not be eating enough, many have excessive caloric intake. And currently working at home presents even more of a challenge to keep calories in check (snacks, anyone?). Research shows that weight gain, especially around the middle of the body (visceral fat) is inflammatory and can negatively impact health and immune function. If you would like to reduce your calorie intake, intermittent fasting is a path I would recommend, but not for those over age 65. Whatever your strategy, it’s best to prioritize low calorie, nutrient-dense foods.


Research shows that 30 to 40 percent of us do not get sufficient sleep (7 or more hours per night), and a considerable proportion of us experience non-restorative sleep (sleep that has not been sufficiently refreshing), which is important because sleep is not merely a passive state of relaxation, but rather an active state of healing. If you are not sleeping well, the immune system begins behaving like that of a person 10 years older.

Insufficient sleep increases our susceptibility to viral infections, decreases our antibody response to vaccinations, and predisposes us to inflammation. It’s important to focus on sleep hygiene, such as creating a restful atmosphere, removing electronics from the bedroom, committing to a regular schedule of turning in and waking up, etc.

If you snore at night, wake up tired or with a headache, get drowsy during the day or behind the wheel, it is a good idea to consult your physician for a sleep evaluation. You might try Melatonin, as it not only has anti-inflammatory and antioxidant properties but reduces oxidative lung injury and inflammatory cell recruitment during viral infections. For those with insomnia or sleep difficulty that has exceeded a few months, an option is cognitive behavior therapy (CBT-I), which is aimed at changing sleep habits and scheduling factors and is one of the most effective treatments for insomnia. Online resources for CBT-I are:


Compared to a sedentary lifestyle, moderate physical activity lessens inflammation by decreasing stress hormones and inflammatory cytokine levels in the blood. It also reduces our percentage of body fat and macrophages in the fatty tissues, and activates the cholinergic anti-inflammatory pathway.

For those who would like to begin exercising, my recommendation is to walk 30 minutes to one hour per day (stride with the pace of “Staying Alive” by the Bee Gees!). Whenever possible, walk or exercise outdoors for a change of scenery and to soak in nature’s beauty. There are countless online options for virtual workouts and races, playlists and the like. Please share your favorites with me!


When we experience stress, our immune system’s ability to fight infections decreases, causing an exaggerated inflammatory response that disrupts immune regulation and is specifically associated with increased pro-inflammatory cytokines.

There is a multitude of accessible stress reduction strategies, including setting aside time for hobbies, interests, and passions. These don’t have to be time-consuming but should be an enjoyable part of your day, from reading and journaling to gardening (one of my favorite pastimes), cooking, meditation and more. There are also adaptogens, herbals, and botanicals that have been used for centuries to help promote resistance to occasional stress, creating calm and focused responses and support endurance for both mind and body (more to come on these soon).

Here are a few of my favorite meditations and breathing exercises.

Guided Imagery Journeys (This is a fantastic guided imagery resource and is one of the best tools that I used prior to my surgery last year. Belleruth Naparstek is gifted!)

Heart Math Inner Balance

Open Heart Project (This mindfulness meditation center lives in the cloud and is led by New York Times bestselling author and beloved Buddhist teacher Susan Piver.)

4-7-8 Breathing with Dr. Andrew Weil

Loving Kindness



Our connections with others have an impact on the immune system, as well. Loneliness, for example, is much more than a feeling of isolation, as it can up-regulate the genes that predispose to inflammation. And, it’s been shown that those with adversarial connections experience higher inflammation, which may alone negatively affect mood. Positive social connections, on the other hand, are associated with lower inflammation and better health.

In this time of social distancing, how do we maintain connections and positivity? Walking with family, making phone calls to those far and near and exchanging emails and text messages are simple ways to stay in touch. Other ways to connect are through community involvement, such as donating to local food pantries and shelters. We can also reevaluate the time we spend at home with family by playing games, sharing stories, watching movies, cooking meals — the list goes on and on. I, for one, know my dogs are excited to have the family home, as they are the happy recipients of extra walks and belly rubs!

We continue to await clinical, evidence-based integrative prevention or treatment strategies for the COVID-19 infection

So, while we’re unable to “boost” our immune system, there are ways to keep our existing system strong. We continue to await clinical, evidence-based integrative prevention or treatment strategies for the COVID-19 infection, but in the meantime, staying home, avoiding others and living optimally are our best strategies for staying healthy.