Science Vs - Immune Boosting: Is It a Bust?

Episode Date: March 5, 2021

Internet influencers have been pushing “immune boosters” during the pandemic — claiming they’ve got just the pill, berry or brew to rev up our body’s defenses. But is there really a way to boost our immune system? We’re finding out whether these vitamins and supplements truly work as a shield against colds and viruses. We speak to public health Prof. Tim Caulfield, nutrition Prof. Carol Johnston, immunologist Shiv Pillai, and immune aging researcher Niharika Duggal.  UPDATE 3/12/21: An earlier version of this episode overstated the evidence that starting to exercise leads to fewer colds and flus. While we do have lots of evidence that suggests exercise is good for our immune system, the research around starting an exercise program is more mixed. We've updated the episode. Check out the transcript right here: http://bit.ly/3cjIe6f And find more rhymes from Shiv on TikTok: profpillaipoet Credits:  This episode was produced by Rose Rimler with help from Wendy Zukerman, as well as Taylor White, Nick DelRose, Meryl Horn, and Michelle Dang. We’re edited by Blythe Terrell. Fact checking by Diane Kelly. Mix and sound design by Bumi Hidaka. Music written by Peter Leonard, Marcus Bagala, Emma Munger, and Bobby Lord. A huge thanks to all the researchers we got in touch with for this episode, including Dr. Brian Crucian, Dr. Harri Hemila, Dr. Wendy Weber, Dr Shai Shen Orr, Dr. Ravindra PV, Prof. Philip Calder, Dr. Oveta Fuller, Dr. Kate Edwards, Dr. Hawley Kunz, Prof. Graham Rook, Prof. Emily Ho, Dr. Dayong Wu, Prof. David Nieman, Dr. Byron Quinn, Dr. Allison Kelliher, and Prof. Adrian Martineau. And special thanks to Willa Rubin, the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman and you're listening to Science Versus from Gimlet. And we're back with a brand new season. So to kick us off on today's show, we are asking, can you boost your immune system? Yeah, we're pitting facts against fighting off infections. And this idea that we can pop a pill to boost our immune system, it started exploding during the early days of the pandemic. Tim Caulfield, a professor of public health at the University of Alberta in Canada,

was watching as it all took off. It was in the air, you know, this idea of immune boosting. It was just part of the gestalt, you know, and it remains so. And as the pandemic got worse and worse, this idea grew and grew. And it felt like products to boost our immune system were suddenly everywhere, especially, as we've seen, all over social media. And Tim wanted to know, what exactly was this stuff that was getting touted all over the internet? So he did what any self-respecting academic would do, and he started scrolling Instagram.

And I really did. I went through hundreds and hundreds of posts. A hard day for work at the lab for you is getting a coffee and scrolling Instagram. And, you know, I wish I could say it was fancier, but that's what I did. Tim and his team systematically trawled Instagram, looking for the top trending posts labelled with the hashtag immune booster.

And there was a lot of the stuff that you'd expect, so-called superfoods, a lot of vitamins and herbs were in the mix too. I saw supplements for me, you know, vitamin D to zinc and obviously vitamin C, ginger, elderberry. Echinacea I saw, a lot of smoothies, a lot of smoothies out there. And of course, all this came with a healthy dose of that influencer holier-than-thou vibe. Tim talked about it with our producer Rose Rimler. I love to see like the Instagram post, the mother of all immune boost Instagram posts.

What would it look like? It would definitely be someone sitting on the beach or in the forest. They would be in a yoga pose for sure. They would have a smoothie by their side. They have supplements in one hand and magical berries in the other. And people have been gobbling these supplements up. At the start of this pandemic, sales of zinc more than doubled and elderberry quadrupled. One manufacturer said that demand for the buzziest immune boosting ingredients surged so fast that it would, quote, make your head swim. But at the heart of all this hullabaloo is one big question. Does any of this stuff

actually work? Do you want to know? Oh, I do want to know. And I totally get why. I totally get why you'd want to boost your immune system in this crazy world that we're living in right now. If we could find something to take that could help protect us from a cold or flu or COVID-19, that'd be a game changer. We could all just pop a pill and be less likely to get sick. And this is not just on the minds of Instagram influencers and companies selling this stuff. A lot of brainiacs have been looking into it. Like one Nobel Prize winning scientist spent decades on this.

And even NASA is looking for a way to boost the immune system of astronauts to make sure that they stay healthy in space. So today we're asking, could there be anything to this stuff? Is there anything we can do to give our immune system a boost and maybe even help us fight off COVID? Because when it comes to immune boosting, there's a lot of supplements in one hand and magical berries in the other. But then there's science. Science versus boosting the immune system is coming up just after the break. Bumble knows it's hard to start conversations. Hey.

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wherever you tune in. Welcome back. Today, we're asking if there's any way to boost our immune system. And one thing we've got to tell you before we dive in too deep is that if you want to annoy a scientist who studies this stuff, just say the phrase immune boosting. Because if you really did turn up the dial on your whole immune system, you'd probably have a lot of problems, like autoimmune diseases and allergies. So it's not a good thing. But don't worry, we get it. When you say you want to boost your immune system,

what you mean is that you don't want to get colds or flus or the coronavirus. That's why we're buying this stuff. So in that spirit, we're asking, what can we do to keep ourselves healthy? And we're going to start by looking at one of these so-called immune boosters. It's popular right now, but it's been in the cupboard for decades. It's the granddaddy of immune boosting, vitamin C. Hi, is that Carol? It's Carol. Hi. Hi. Carol Johnston, that is. She's a professor of nutrition at Arizona State University. She has a great laugh and has spent much of her career studying vitamin C. And it all started when she was just getting her footing in science. Carol was in school trying to figure out what to study. And her advisor said, you've got three options.

One was vitamin A, one was vitamin B6, and the third was vitamin C. And vitamin C immediately caught my interest. You know, I was young. I was in my, you know, I was 21 and the B6 and the vitamin A sounded boring, whereas vitamin C had this excitement behind it. The excitement behind vitamin C was largely drummed up by a guy called Linus Pauling. If that name sounds familiar, he was a famous scientist, actually won the Nobel Prize in chemistry. But later in life, he got interested in nutrition. And what really grabbed his attention was vitamin C. He took it from this boring everyday nutrient to a cold busting superhero. In 1970, Linus published this book

arguing that people should take vitamin C supplements every day and then take extra if they're feeling sick. And it was quite popular. It was a popular book. And I remember that there was always this, oh, I have a cold, I should take vitamin C because of this book. And Linus had some good reasons to think that vitamin C might help our immune system,

because it does a lot of stuff in our body. Like, it helps to turn baby white blood cells, one of the immune system's star players, into mature killing machines. And we know that white blood cells love vitamin C because they're absolutely packed with it. White blood cells have more than 50 times as much vitamin C crammed inside them compared with other blood cells.

And Carol reckons that this helps them fight invaders. So your white blood cells, they're moving about and their killing capacity is enhanced by vitamin C. So vitamin C helps with all of this, and it's such a special nutrient. And that's why it makes sense that popping vitamin C might do some good for your immune system. But scientists like Carol have to actually see if this makes a difference in the real world. And so several years ago, she recruited around 30 college students and divided them into

two groups. One group got vitamin C capsules. Another group got fake ones. And to figure out who got sick, Carol and her team gave each of them a journal. And each night they had to check off any cold and flu symptoms that they had. Did you have a runny nose? Did you have sneezing? Did you cough? Did you have any throat irritation? They did this for eight weeks during cold and flu season, and then turned in their journals. When we got all the data, we plotted it every day, 56 days, and it was very clear that there was less cold and flu symptoms in the group that had the vitamin C. It was awesome.

Now, this is a small study, just 30 college students. And science being science, we need to see if other researchers have gotten the same results. Luckily, with vitamin C, there's heaps of studies on this. A few review papers have rounded them up for us. And all in all, they include thousands of people. And here's what they find. Taking vitamin C probably won't stop the average person from getting sick in the first place. But when people do catch a cold, they tend to not feel so crap,

so the symptoms aren't so severe, and they tend to feel better a little faster when they take vitamin C. So they get over their colds about half a day to maybe a day and a half earlier. That means if you've got the sniffles and you're taking vitamin C, perhaps you won't get through all the diehards while you're sick. And so that's important. Even though it doesn't stop a cold from happening, perhaps, the fact that it can reduce the severity of the cold symptoms

and reduce the duration of the cold symptoms is a very important finding. That's for your everyday sniffles. What about COVID? Well, the one study we found that looked at popping a vitamin C pill when you have COVID showed that it didn't do anything. But it's not like there's mountains of research on this. So that's vitamin C.

It might not be yippee-ki-yay good, but still, Carol takes it every day. Because she said, for most of us, there's no real downsides here. Can you overdose on vitamin C? There's really no concerns except you might get diarrhea. And that really is the only adverse effect. So that's vitamin C. What about zinc? It's like vitamin C's best bud.

They seem to hang out side by side in the vitamin aisle. Well, Carol says you really don't want to be popping a ton of zinc every day. It's not as safe as vitamin C. But what about just taking it when you're sick, like when a cold is starting to kick in? This is what Rose used to do. There was a period in my life where I was a zinc evangelist, and I was like, if I feel like I'm getting a little bit sick,

I will pop a zinc tablet, the one kind that you dissolve in your mouth. Was I a sucker? So there are, okay, so if you look at that research, it's like 50-50. Okay, 50% of the studies show a benefit, 50% don't. When we looked through the research, we figured that downing a little zinc when you're sick might shorten a cold. When it comes to COVID, again, early days here, but we're not seeing anything to make our heads swim.

And there's one final vitamin that we want to talk about. You might not think of it as an immune booster but it's been getting a lot of headlines during this pandemic. It's basically donning a cape and an N95 mask these days. It's vitamin D. There is some evidence that vitamin D can help with respiratory infections but people seem to be suggesting that it's got COVID-19 fighting superpowers. Some intriguing research about a possible link between COVID-19 outcomes and vitamin D.

Vitamin D, sometimes called the sunshine vitamin, can be instrumental in fighting COVID. There's growing evidence that supports a connection between the two. So, if you take this D, will you really not get sick tonight? Sick tonight? Okay, so it's not ludicrous to think that vitamin D could help us here. Some research suggests that vitamin D can tamp down inflammation, which is one of the big problems for people with serious COVID. And there are some studies suggesting that people who are vitamin D deficient

might be more prone to getting a nasty case of COVID. But when we went deeper into the research here, we found that there are a bunch of studies that are not finding this link. And they don't tend to get these big, nice headlines. All in all, it's just too soon to know if vitamin D is going to go the way of hydroxychloroquine, or it'll be something that actually helps us. For what it's worth, though, Dr. Anthony Fauci says he's taking vitamin D, and he said he would not mind recommending it. So there you go. All right, so that's the picture with vitamins. If you're feeling a tickle in the back of your

throat, it's probably not a bad idea to pop some vitamin C or zinc. And if you want to be super careful, downing vitamin D each day won't hurt you. But it's not like the evidence is so mind-boggling that we at Science Versus have lined our cupboards with this stuff. When we come back, we're going to look for immune boosters in nature. And we're going to find out something that really can help here. It worked. So what I can say, it definitely worked. Coming up. Welcome back.

Today on the show, what we can do to keep our immune system happy and ourselves healthy. We've talked about how vitamins aren't totally bunk, but if a virus is heading up your nose, they're unlikely to save you from being flooded with phlegm. Our next stop is something totally different. We're moving away from vitamins and belly flopping into the world of plants, specifically elderberry and echinacea. As coronavirus cases were soaring, more and more and more people started talking about this stuff. And it sounds lovely, but supplements from the earth with brand names like Garden of Life and Gaia Herbs could help us. So could they?

To find out, Rose and I called up Shiv Pillai. He's an immunologist at Harvard. We found out that you seem to be somewhat of a famous poet. Would you think about doing like a little piece of that for us? Yeah, why not? I'll do it for you. Yes. Yes. Yes. Pathogens lurking everywhere. Go get them first. They never fight fair. Give me a D, give me a J. Shiv is a massive immune system nerd,

so much so that he made this little ditty about super important white blood cells called lymphocytes. ...to tap. Everybody do the lymphocyte wrap. We had to cut it down a little. I like my rhymes to be 15 minutes long, typically, they're better ones. We asked Shiv to take a break from poetry and talk to us about some of the plants and herbs that people say can boost our immune system.

And Shiv says that looking to nature to find really good medicines, it actually makes a lot of sense. Plants have been used in traditional medicine for centuries. And a lot of the drugs that we use today actually started out as plants. Things like aspirin, morphine, heart medications, and even drugs used in chemotherapy. I would say a lot of the drugs we take today come from plants. This is an extremely common approach. So I think everybody should be completely open to the idea that many of the

herbal treatments actually might help. But Shiv says that not every plant is made of medicine. To find out if it works, you have to test it. So let's take elderberry, for example. It's a plant that grows in Europe, Northern Africa, and parts of Asia. It looks shrubby with white flowers and glossy little black berries. And it's those berries that companies have been squishing into supplements. And one way that scientists can test to see if this stuff can help us fight disease is that they'll pop some elderberry extracts onto a petri dish, along with some nasty viruses. Exactly. This is taking something and putting it directly on a petri dish. And you're trying to see whether they do something. And scientists

have found that sometimes, yeah, they do something. Elderberry can kill viruses in petri dishes. And Echinacea, which is a pink daisy that's native to North America, it has some pretty cool powers in a petri dish too. Like when scientists mashed its roots into a dish with some mouse immune cells, it could stimulate those cells a little, which all sounds promising. But of course, this is all just in a Petri dish. Are there things that looked exciting in Petri dishes but didn't work in people? Millions. Millions of things that looked exciting in Petri dishes.

Millions of things that worked in, when I say millions, I'm exaggerating, I haven't counted. But many things that have worked in the mouse, which never worked in humans. You know, so there's lots of examples of that. So what happens when researchers move away from petri dishes and try out this stuff in people? You know, real dishes like you and me. Well, we scoured through the studies that have done just this, and some showed, hey, this stuff, it might work. Like, people take it when they're sick and they don't feel so yuck. But then other studies were like, nah, this stuff doesn't do anything.

And there could be a few reasons for this. One is that unlike with vitamin studies, where vitamin C is literally vitamin C, plants are more complicated. Everything you're dealing with is a mixture. Somebody might be referring to the bark. The other person might be referring to flowers, to leaves, for instance, or bush or whatever you're looking at. Plants might have different chemicals in their roots or bark or berries.

And so maybe we haven't cracked the right part of the plant that could help here. But that's not the only thing that's going on with this stuff. Because even when studies test basically the same brew, you still see conflicting results. And here we found one big difference between the yay and the nay studies. The bullish ones were often pumped out by the companies selling this stuff. So take elderberry. One industry-funded study found that elderberry syrup cut down people's flus by four days. Four days. Health blogs and magazines love to drop this paper. But when an independent group tried to repeat the study,

they found that taking elderberry did diddly squat. Yeah. And when Professor Tim Caulfield got off his Instagram for one moment, he could see some irony in all of this. He reckons that some people are turning to herbal supplements because they don't trust Big Pharma, but it's basically all part of the same machine. First of all, the supplement industry is a multi-billion dollar industry, right? So it has its own conflicts of interest, its own marketing problems. And the other thing, of course, is that Big Pharma is selling supplements, right? You know, they are very involved in this industry. So it is kind of

ironic that people are, you know, want to turn to supplements because they don't want to support Big Pharma. You know, that rationale fails in two ways. One, it's a multi-billion dollar industry on its own. And number two, big pharma is selling it. So they're getting your money anyway. And when you scroll down the fancy websites where they're selling these products, right past the pictures of pink flowers and healthy looking people and microscopes, you'll often see this statement. These claims have not been evaluated by the FDA, which means these companies haven't had to prove that this stuff works

before they sell it to you. Bottom line, Shiv says... So I don't think there's very good evidence that they protect you. OK, so you're not about to go for the elderberry or the echinacea when a sniffle is coming. No, no, no. I think probably it's a mistake to spend the money on that. Funnily enough, I actually do have elderberry in my cupboard.

Yeah, probably mix it with a little gin and it'll be better for you. Yeah, I like that. Doctor's orders. Could be a cocktail, you know. Yeah. So we don't have good evidence that taking elderberry or echinacea can boost your immune system. But if you've already got some in the cupboard, probably won't hurt you to take it. You might run into trouble if you eat raw

elderberry though, because it's got cyanide in it. But that cooks off, so it shouldn't be a problem with the stuff you get at the pharmacy. Still though, not all the so-called immune-boosting products out there are perfectly safe. Story time. Let's talk about colloidal silver. It's sold at the drugstore, and it can come as a liquid that's filled with tiny bits of silver and you swallow it. The box might say that it's great for immune support. And at the start of the pandemic, people went bananas for this stuff. But it doesn't work. It won't support your immune system. But what it might do, well, it can be bad for a bunch of stuff in your body, like your liver and kidneys.

And it can also turn your skin blue. Literally blue. Like a guy from Montana who took colloidal silver for a couple of years ended up turning a little blue and then he just happened to run for office. And no, he wasn't a Democrat. He was a libertarian. Okay, so while we've just told you all of this supposedly immune-boosting stuff

that is actually pretty meh, we wouldn't leave you looking so blue. It's time to tell you about one thing that actually can help your immune system. I would actually just say that there's no magic pill that can boost your immune system. You have to put in the hard work. This is Naharika Duggal. She studies aging at the University of Birmingham in the UK. So what's all this about hard work? Get up and get moving. Naharika says that one of the big things that we think can help our immune system is exercise. While not every study here shows an effect, the general picture is telling us that exercise is

good for our immune system. Active people tend to get sick less often. Getting regular exercise can bump up your immune response to a vaccine. And we even have a really cool understanding of how this all might work. Like, how might going for a run help us fight off a nasty germ? Well, a little background. To fight infections, a bunch of our immune cells have to be swimming around in our bloodstream, ready to find invaders and kill them. But weirdly, most of the time, a lot of our immune cells are kind of just hanging out in our organs.

But when you get moving, this changes. Your body starts churning out proteins that say, go, go, go, go, go, go, go. They're actually quite pushy. Yeah, actually, I would possibly say that these are like your traffic policemen or your teachers telling the immune cells where to go, what to do. These pushy little proteins yank the immune cells from their cosy spots in our organs and out into the bloodstream. So exactly what happens there is that it causes all your immune cells that are sitting in different organs to get up and come out and into circulation. Oh, and so going for a run makes there be more immune cells running around looking for trouble around your body?

Looking for trouble. So it's almost like a state of immune surveillance, but they're on high alert in case there's an infection. I love the mechanism here. Like, I love that getting off my butt gets my immune cells off their butts too. Yeah, it's really interesting, isn't it? Exercise mobilizes literally billions of immune cells that would otherwise just kind of be loafing about. So that's just one way that exercise is helping us here. And all of this

matters even more as we get older, because along with everything else, as we age, our immune system gets run down. This is what Naharika has been digging into. She wanted to see just how powerful exercise was here. Like, could it fight the seemingly inevitable decline of aging? So she rounded up a bunch of sporty boomers, oldies who had been cycling for years. Yeah, the oldest one was 80 and they were still cycling. And they're still cycling. Very impressive. It was really impressive. And the mean, if I remember correctly, the mean amount of cycling they did was 700 kilometers per month. That is putting us to shame. It definitely did.

For you Americans, that's more than 400 miles a month. Naharika and her colleagues took blood from these spandex warriors, and then they took blood from adults of all ages who weren't particularly active. She then compared them. And when she looked at the cyclists, she found that all this biking... It worked. So what I can say, it definitely worked. They had the immune system of a young person. In fact, even better. We were expecting some benefit, but not as good as that. They were as good as the young people. It was definitely an exciting, exciting day. When we were going

through this and we checked it, we checked it twice. It was brilliant. And perhaps you're thinking, well, these are real exercise nerds biking hundreds of miles every month. Do I have to do that? There are days where I just walk from the bed to the computer to the kitchen and that's it. I do feel your pain and trust I do. I wouldn't be a cyclist doing 700 kilometres a month. But luckily, researchers found that even going for a 30-minute walk wakes up your immune system a bit. So Naharika reckons that if you can... It's never too late to start.

And if you're not doing anything, at least start with something. It's going to have a beneficial effect. So if I've been sitting in a meeting for too long and I don't have time to do anything else, just a few flights of stairs and that will get your steps up. I'm sure my immune cells will be happy on that day. And she said what would make her immune cells even happier is if she got a good night's sleep as well. Because that is another thing that science says we can do to keep our immune system healthy. Yeah, in one study, scientists literally dripped a virus that causes

colds up people's noses. And it found that those who tended to get not much sleep were four times more likely to get sick compared to those who usually got at least seven hours of shut-eye. So, in this weird germy world where we all want to stay healthy, where does all of this leave us? The good news is that we're not totally in the dark about how to boost our immune system. The bad news is that it's not a pill we can buy at the drugstore. It's stuff like exercise and getting a good night's sleep. But at least this means that if you're not taking the stuff that's being peddled by Instagram influencers, it seems you're not missing out.

Here's Carol. Believe me, you're not going to find the magic pill on the internet. If there was a magic pill, it would be broadcasted by all scientists, like, you need to take this pill. It's not going to be a hidden gem that nobody else knows about. And so people need to realize there's not this fountain of youth out there. Well, there is one shortcut here, though. Something that can boost our immune system for COVID, at least. It's not a magic pill, though. More like a magic shot.

Sometimes two shots. You get it, right? It starts with V, but it's not a vitamin. It's the vaccine. That's science versus. Hello? Hey, Rose Rimmler. Hi, Wendy Zuckerman.

How many citations in this week's episode? 153. 153? That's right. That's a lot. That's a lot. And if people want to see these citations, where should they go? They can check out our transcript and they can find that by clicking on the link that's in our show notes.

Oh, and while people are looking at those show notes, they're going to find some cool stuff this week, right? Yeah, there's a link to more of the amazing rhymes of Dr. Shiv Pillai. He's quite prolific. Yes, he has a vast inventory of science raps, and they're all pretty good. Excellent. Thanks, Rose.

Thanks, Wendy. Next week, a massive, massive swarm of insects is heading straight for us and things are going to get real weird. You look out the window, you see them all flying around. You hear them. It's incredibly loud and it's just absolutely apocalyptic. This episode was produced by Rose Rimler with help from me, Wendy Zuckerman, as well as Taylor White, Nick Delrose, Meryl Horne and Michelle Dang.

We're edited by Blythe Terrell. Fact-checking by Diane Kelly. Mix and sound design by Bumi Hidaka. Music written by Peter Leonard, Marcus Begala, Emma Munger and Bobby Lord. A huge thanks to all of the researchers that we got in touch with for this episode, including Dr. Brian Crucian, Dr. Harry Hamilla,

Dr. Wendy Weber, Dr. Shai-Hsien Orr, Dr. Ravindra Peevee, Professor Philip Calder, Dr. Ovetta Fuller, Dr. Kate Edwards, Dr. Hawley Kunz, Professor Graham Rook, Professor Emily Ho, Dr. Dae Yong Woo, Professor David Neiman, Dr. Byron Quinn, Dr. Alison Keller, and Professor Adrian Martinau. A special thanks to Willa Rubin, the Zuckerman family, and Joseph Lavelle Wilson. I'm Wendy Zuckerman back to you next time