In our quest to combat disease, modern medicine has developed an array of tools: from antibiotics and other antimicrobials, pharmaceuticals can provide a strong push-back against infection when necessary. Conversely, in cases where the immune system turns its fire against our own bodies (conditions collectively known as “autoimmunity”, for example rheumatoid arthritis, lupus, or certain inflammatory bowel diseases), we see the use of steroids, anti-inflammatories, and immunosuppressants. And while in either case these modern interventions can be life-saving, both circumvent our immune systems: antimicrobials purport to take over the job of fighting pathogens, while steroids and immunosuppressive drugs just turn the immune system off.
But our immunity is a sophisticated, subtle learning system that works best when it is fully engaged. In fact, we’re starting to discover that some of the dysregulation in immune function (hypersensitivities, asthma and allergies, for example) might be linked to an overly sheltered, microbe-free environment:
To herbalists, the use of drugs that fight infection or suppress the immune response as a first-line intervention seems akin to a parenting philosophy that either does a child’s work for her, or tells the child to be quiet and go to her room. Neither, in the long run, produces healthy, well-adjusted adults.
We strive instead to support our immune system’s own functional processes, much like we would support the innate curiosity and exploring mind of a child. There is a long tradition in herbal medicine of using herbs and mushrooms around times of seasonal change, or during travel, to support optimal immunity and thereby keep the physiology strong and resilient. The strategy focuses on three main areas: first, herbalists value the health and integrity of the mucosa (our barrier from the outside world, and first line of defense). Second, we work to both support and balance host immunity (the activity of our white blood cells, complement proteins, and inflammatory molecules that interact with the world both inside and outside our bodies). Third, we try to remain mindful of the stress in our lives, cognizant that
There are two pieces to mucosal immunity: the integrity of the barriers that line our respiratory and digestive passages, and the lymph tissue, rich in white blood cells, found all throughout the gut (and, to a certain extent, the respiratory system). To support good mucosal integrity, herbalists turn to plants that support normal, healthy inflammatory tone in the membranes, and also ones that are soothing and moisturizing to our tissues when applied topically. Ginger is a great example of a warming herb that supports a healthy inflammatory response, even during stressful times.3 Roots like licorice or marshmallow are some of our most soothing, protective agents to support healthy mucosal tone.4 Taken together, they are both energetically balanced – a great combination of warming and cooling, dry and moist – and fully supportive to the integrity of our protective barriers. And speaking of balance, one of our favorite herbs for optimal mucosal tone is Schisandra – a five-flavored berry that is sweet and sour, soothing and toning, and while it possesses many virtues, can also be used for a balanced immune response in the mucosa.5
When taking herbs by mouth as teas or tinctures, one might wonder if their active chemistry is able to join in the conversation with our immune system. After all, compounds such as high-molecular-weight polysaccharides (glucans, for example) or saponins have low oral bio-availability, meaning it’s challenging to get them into the bloodstream.6 But getting into the blood may not be necessary: part of the beauty of our digestive mucosa is that it is studded with patches of lymph tissue rich in immune cells. This makes sense: our immune system is attempting to sample and understand the contents of our bellies, and making decisions about function and support in response to what it discovers. Botanical and fungal compounds can interface with white blood cells right inside our GI tract, without the need to be absorbed into the bloodstream.7
We can add roots like Astragalus or Codonopsis,8
rich in saponins and polysaccharides, or mushrooms like reishi, shiitake, maitake, turkey tail, and more into our daily regimes confident that, when taken by mouth, their chemistry interfaces directly with our mucosal immunity, talking to it in its own language. In fact, there is a good body of evidence showing that constituents such as botanical saponins are so good at supporting an optimal immune response that they are called “immune-stimulating complexes (ISCOMs)” and added to vaccines.9
This leads directly to the role herbs and mushrooms play in modulating host immunity. If these botanical and fungal constituents can exploit mucosal immunity to speak to the white blood cells found there, we should expect an ability to interact with overall host immunity. “Host” immunity is defined as the coordinated response, executed by cellular, hormonal, and peptide players, that each one of us (the host”) can call upon to maintain a stable internal cellular environment. We are, of course, hosts to our own cells and to a lot of other cells, too: the microbes in our GI tracts, on our skin, in our respiratory systems, and more. Truly, as first penned by Whitman (and most recently paraphrased by Ed Yong),10 we contain multitudes. The trick is balancing the host’s cells, friendly bacteria, and potential pathogens: this is where the subtle complexity and wisdom of our immune system becomes apparent. How does host immunity distinguish between self and other, friend and foe?
Our host defenses are usually subdivided into two categories: the innate response, which is quick, ready, and dominated by proteins and cells capable of killing or engulfing harmful microbes; and the acquired response, which is slower, helps us remember, train, and modulate the overall immune response, and is dominated by antibodies and lymphocytes such as T and B cells. Many medicinal polysaccharides, as we’ve seen, have an effect on innate immunity and support the optimal activity of those cells and proteins.11 But perhaps more importantly,
by interfacing with the cells at work here, immune-active herbs and mushrooms can extend their influence across the whole host response. The acquired response is what helps the immune system discriminate and navigate the multitudes inside and outside of us – so a well-balanced response is essential.
When realizing that herbs have the ability to affect the function of the host immune system, many ask whether this might mean that autoimmune diseases (where immunity attacks our own tissues) could be worsened by taking these herbs. These concerns tend to be based on an incomplete understanding of how the acquired immune system functions: it’s not quite like a gas pedal with a certain degree of intensity in one particular direction, but much more like a network or ecosystem, with the ability to engage with different pieces of the local ecology with different levels of intensity. For example, when we get a cold we don’t usually see life-threatening inflammation in our kidneys, or eruptions on our legs and feet: inflammation stays contained to the affected site, with some systemic symptoms like fever or aches tied to the overall response. The immune processes active in the gut, which help to balance the populations of gut flora, aren’t the same as those in the lungs: the same flora there would cause a strong reaction. Repair and regeneration processes at work in the liver, coordinated by immune cells, differ from those in bones and joints – but all the same players are active. The immune system’s response is diverse, subtle, and highly variable.
That said, it is often the case for those who suffer from autoimmune disease that a cold will indeed trigger a flare-up of symptoms elsewhere in their bodies. Additionally, viral infections may be part of the underlying cause of certain autoimmune diseases (though these links still remain quite mysterious).15 So it’s not unreasonable to wonder how constituents such as polysaccharides and saponins from plants and mushrooms might affect this complex dance. The short answer seems to be that the medicinals we’ve looked at, like Astragalus,16 reishi,17 or other mushrooms,18
act to balance and support optimal immune function19
even in cases where there is autoimmunity – and, at the very least, seem quite safe to take in these situations. As with so many herbal interventions, from bitters to support digestion through the bioflavonoids for cardiovascular function, we see these agents linked to optimal, balanced function. This is different from how modern pharmaceuticals work, and this difference is worth bearing in mind when thinking about host immunity as well.
The final consideration in herbalists’ minds as we approach the colder months is the level of stress in our lives, and how this might affect our immune response.
Given the connections between stress and decreased immune function, one might expect that adaptogens could have an impact on immunity, too. This does seem to be the case: herbs like ginseng have a long history of use to support immunity,21 and others like eleuthero are showing themselves to be valuable adjuncts as well.22 Of course we’ve already seen that mushrooms like reishi can play important immune-supportive roles. This brings up a couple of interesting points: first off, the chemistry of adaptogens like ginseng and eleuthero, rich in saponins and in some cases immune-active polysaccharides, closely approximates that of our immune-active tonics – so it stands to reason there would be some functional crossover as well. But second, there may be more of a connection between our moods, stress, and immunity than we realize: the dance between our host defense and the multitudes we contain may impact our personality, consciousness, and stress response.23 So herbalists often think of adaptogens as overall stress-, immune-, and mood-balancing herbs. We include them in almost every preparation designed to make human beings more resilient – and immune resilience is no exception.
In sum, with a little attention paid to our mucous membranes, a little support for stress in the form of herbal adaptogens, and an immunomodulating “conversation” between our host immunity and medicinal herbs and mushrooms, we can go a long way towards ensuring a healthy, balanced response. The botanicals and fungi used most often taste great – or at least, fairly neutral in flavor – making them easy, safe additions to broths, sauces, soups, teas and tincture blends. Just remember that a little more heat might be required for the tougher roots and fruiting bodies: often ten minutes of simmering does the trick, but in some recipes, mushrooms are put into a crock pot for eight or even 24 hours. This can make pre-extracted products like tinctures a convenient choice. But any way you choose it, think about the herbalist’s approach to optimal immunity any time the seasons change, you’re traveling, expect to come into a high-exposure situation, or want to ensure full immunity after an illness has passed. Long-term use of these remedies works best: remember that you’re interacting with a sophisticated, learning system, for which change takes time. But after a few weeks of connection, you will see the results: challenged, engaged, and enlivened by its newfound dance with botanical biodiversity, your immune system will be at peak performance.
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