If somebody was having issues with a weakened immune system, and also dealing with a chronically higher baseline level of inflammation, are there any known ways to strengthen the immune system while reducing or at least not increasing baseline inflammation? Is that even possible or is some level of inflammation unavoidable?
Would it depend on the specific inflammatory factors that are already causing the higher baseline response?
I know there’s some research about running reducing inflammation, but it also triggers some inflammation? Is the acute inflammation triggered by running tied to longer term reductions in inflammation?
In theory eating healthy foods that reduce inflammation should do that a little. Like fresh blueberries and some spices like cardamon (I think). Exercise should reduce inflammation and improve your available energy which should improve immune response. Same for sleep.
To add on to that, there is a low histamine diet that reduces inflammation. It’s a tough diet though because everyone has different triggers.
https://www.verywellhealth.com/what-is-a-low-histamine-diet-4694529
also dealing with a chronically higher baseline level of inflammation
Have you been tested for gluten intolerance and/or Celiac Disease? Chronic inflammation is one of the markers. It’s a very simple blood test, though it seems to be something doctors don’t always bother to check for. Talk to your doctor about the test.
If you aren’t sleeping well: sleep better
Talk to a good doctor, not to randos on the internet.
That’s about as helpful as being told I have “some inflammation” by every doctor I’ve seen so far. Thanks!
Don’t go to your regular GP, but ask to be transferred to a specialist. Tell your GP exactly for how long you have had the issue and what exactly you tried to emphasize that it’s nothing that goes away on its own.
That’s why I said “Talk to a good doctor”, not “Mention it to some overworked underpaid GP who gets paid for 5 minutes per patient”.
He does legit seem to be trying. I’ve already been sent to 2 specialists. Respiratory/pulmonology therapist gave me a long acting inhaler to use with my albuterol and told me I was probably just dealing with a lot of inflammation.Then referred me to an allergist because I asked.
Allergist found the positive ANA, but said she didn’t think it was anything actually related to my immune system. She gave me a sample of a different long acting inhaler and said to get a pneumonia vaccine and come back in 6 weeks to re-test my antibodies to different strains of staph. If they seemed like they don’t respond then she would consider something like a rheumatologist.
Again no real answers. Nobody can tell me why my chest x-ray and cat scan are clear, and my breathing tests don’t indicate I meet criteria for COPD or asthma, but for some reason, (aside from to he azithromycin) an albuterol inhaler has been one of the only other things that has been somewhat helpful with my energy levels and brain fog. They just gave me long acting inhalers to use instead because they assumed they should accomplish the same thing that Albuterol does, but make it so I don’t need the short acting inhaler.
I get that that’s what they should do, but they don’t seem to be doing anything, and they have their own set of risks and side effects (including increasing your risk for upper respiratory infections). Plus every time I see a new doctor, they never actually bother to try and listen to what I’m telling them. Or even what I’ve already tried and know doesn’t work. They think I’m just being a difficult patient.
Like I get my symptoms are vague and don’t really line up with an obvious diagnosis, but that’s also why I’m there to see them. At least with the GP it’s to the point where he no longer thinks I’m just being difficult/crazy because whatever is going on isn’t easy to just solve and be done with, and even my platelet count seems to indicate whatever this is, isn’t going away, it seems to be getting worse.
He actually listened to me about the azithromycin, even though he really fought me on prescribing it for the other 4 sinus infections I saw him for, and he referred me to a rheumatologist after the allergist wouldn’t. I’m supposed to see the rheumatologist next week, but I would be shocked if they didn’t just write me off like everybody else has when they first see me as a new patient.
The GP also gave me a referral to an ENT to see if I can at least figure out why I’m having constant sinus infections after every cold, but I can’t even get in to see them until April 2026.
Meanwhile when I get these symptoms flare ups, all I can do is try to treat the symptoms, and always try to avoid getting sick.
Inevitably I get a cold again, feel like shit, fall behind at work and every other aspect of life and responsibility that I have. Then I have to try to explain all this to my boss and other people, who don’t really seem to believe me when I tell them that I don’t understand why it keeps happening anymore than they do, and neither does any doctor I’ve been able to see so far.
What used to be something that would happen to me a few times a year (a normal cold) and then run it’s course after a few days, has turned into a never ending cycle. It’s very frustrating to try and do everything I know you’re supposed to do to get better, but then never get better.
If you’re sick, you think ok I’ll just take it easy for a few days, rest and take care of myself then I’ll be back to normal. But the back to normal never happens. Usually it just turns into a sinus infection. Then I get even worse until I finally get antibiotics.
Then, once the sinus infection is gone, I’ll finally be a little better for a week or two, try to have a normal life again and avoid getting sick, fail, and the cycle repeats itself.
I found out that all my life I’ve been intolerant to gluten, while completely unaware.
It manifested itself in severe gastroesophageal reflux disease, body wide inflammation, and it provokes my psoriasis (autoimmune).
I had no way of knowing because none of the symptoms presented in the way dietitians, doctors, gastroenterologists, immunologists could make a connection.
It’s just a personal anecdote, but something to reinforce with others are saying, where you could examine your diet a bit to start.
Edit: I stumbled ass backwards into figuring this out for myself, but it was because I started to cook fresh to lose weight. My rule was I could have anything I wanted to eat on the condition that I made it myself and I found after a while, it was just easier to boil potatoes or rice than to fuck around with dough.
As I carried on in my fitness and weight loss and cooking journey, so many of my conditions magically went away and I assigned it to the fresh eating and weight loss but it wasn’t that!
The day I decided to treat myself with beef and barley soup was the day I discovered. My body erupted and every condition came back in force! The pressure filled gurgling acid was immediately there, burning my throat like lava, which I had not suffered for months
It turns out I had inadvertently cut wheat and barley and gluten out of my life by accident, and gave my body a long enough time to recover, that by the time I reintroduced it to my diet I couldn’t ignore that it was the problem the whole time!
I’m not saying your problem is gluten, I’m saying it could be somewhere you never thought to look, and all the specialists told you you were crazy for thinking about.
Thanks! I don’t do gluten free, but I do try to avoid wheat/gluten and simple carbs in general, but can’t always resist the temptation even though I know I should avoid it.
One of my coworkers brings in these amazing baked goods a few times a year. Happened yesterday and I couldn’t resist. I did manage to limit myself to one, and took the others home for my family. Still seemed to have some increased redness/flushing afterwards. I don’t think it’s the only thing going on but that’s kinda what I meant when I said it seems like my baseline level of inflammation always seems to be higher than it ever was been in the past.
It’s not just with gluten, but it’s anything that spikes an inflammatory response, like pushing myself to do too much or stress. It’s like if I normally had a cup that was always half full before, things would fill it, but it never actually spilled. Now it’s like it’s always full to the brim, and the things that used to be no big deal now cause it to overfill, and set me back for days at a time.
Immunologist here: what you’re describing seems vague. Inflammation is honestly just an umbrella term that generally refers to any time when the immune system is doing something (hence the seemingly conflicting advice). As a result, it’s not entirely clear to me what specifically you’re referring to.
Remember that no pathogen will just sit there and let themselves be destroyed. Many will actively exploit the immune system to cause disease, and in those cases, having a stronger immune response is actually bad for you. As well, I’m not sure what you mean by having higher “baseline inflammation,” because again, inflammation isn’t a singular thing
Over the last year, I’ve been constantly sick with back to back colds that turn into sinus infections and require antibiotics. I literally just finished my 6th round. Never had this issue before the last year.
The best I can describe it is like constantly having the flu, but the symptoms seem to always be coming and going. It’s definitely worse and more persistent when I’m actually sick with a virus or sinus infection, but I also just haven’t had my normal level of energy/really felt like myself since COVID. It also seems like when I push myself, the symptoms tend to flare up. Like you know how when you feel like crap sometimes, but you push yourself to exercise and you feel better? I don’t have that anymore. If I exercise when I’m already feeling like shit, then I just feel even shittier for a few days.
I got COVID in March, and since then I’ve had an abnormally high platelet count that seems to be climbing, high ESR, low complement C4, normal complement C3, normal CRP. Everything else is 100% normal, except I had a positive ANA that was right at 1:80 and flagged as high. When it was retested again a few weeks later, all the other blood work was the same, but the ANA was negative.
I often get really weird temperature spikes (not actual fevers but enough to be noticeable and uncomfortable usually~99.9 °F) that are accompanied by brain fog, really bad fatigue, and very stiff and achy joints. Nobody has been able to tell me what’s going on other than I seem to be dealing with “some inflammation” probably related to COVID.
I’ve seen a PC multiple times, a respiratory therapist, and an allergist. I couldn’t get in to see an ENT until April 2026. I’m finally seeing a rheumatologist next week, but I’m not all that hopeful since I have very vague symptoms, my ANA was negative when retested, and all the other high values in my blood work don’t really seem to point to anything specific, other than “some inflammation.”
I’ve been told repeatedly to just treat the symptoms in the meantime. I have noticed when I take azithromycin (but not other antibiotics) for my sinus infections, I seem to feel more energetic, productive, and more like my old self than I have any other time since COVID. I know that it also has immunomodulatory and antiinflammatory effects, so I’m wondering if I might be able to find similar relief for my symptoms without an antibiotic.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4186419/
I’m not familiar with COVID, but it does sound to me like you’ve got long COVID. I’ve got no advice on that front - frankly, I don’t think anybody really knows what’s up with that. I get the impression that that’s why the advice that you’ve received so far are primarily focused on treating symptoms.
If your hypothesis is correct that your antibiotic is helping through its immunomodulatory effects, then it looks like it’s acting primarily through inhibiting cytokine production. Messing with cytokines will certainly affect your ability to fight off infections, since that’s how your body signals to immune cells that there’s something wrong. Of course, immunity is all about balance, and you don’t need to block cytokine signaling completely in order to decrease it to manageable levels… A brief search shows that there are inhibitors for TNFa, which based on your links seem to be what you’re leaning towards as the molecular mediator.
Have you considered bringing this up to your doctor? I’m not sure how feasible it would be to do a “trial run” with one of these inhibitors to see if it helps your symptoms. However, it may be simple enough to ask for a blood test to measure the amounts of different cytokines in your blood. My understanding (don’t trust me on this - I’m not a clinician) is that standard blood tests don’t typically measure cytokines, which is potentially why your blood tests so far haven’t been able to pick anything up out of the ordinary. That would at least help rule in/out any possible causes.
I will also point out an alternative hypothesis that might be worth considering - it could be that the antibiotic is depleting your microbiome, which would reduce the same cellular pathways that your antibiotic is said to inhibit due to your cells being in less contact with bacteria. Have you tried other antibiotics, and did they have a similar effect?
Thanks, this is seriously one of the most helpful answers I’ve gotten in the last year!
I will ask about the possibility of trying a modulator and getting blood work for my cytokine levels. I’ve also been trying to find other things that might target the same pathway. There seems to be some evidence that turmeric/curcumin also acts as an anti-inflammatory by inhibiting TNF-a/NF-kB. That has also been somewhat helpful, but not as much as azithromycin.
Have you tried other antibiotics, and did they have a similar effect?
Yes, I’ve been prescribed other antibiotics, but none have had the same effect. Most of the time I’m prescribed amoxicillin which does clear up the sinus infection, but doesn’t help with any of the other symptoms, and seems to actually increase my stiffness/achy joints
The second most recent sinus infection I had was probably the most severe, and I was given amoxicillin plus topical mupirocin. The Mupirocin actually seemed like it might have helped some with the brain fog, but not the other symptoms.
I think at one point I was prescribed clindamycin, and I kind of remember it being more helpful for my symptoms than amoxicillin, but not anywhere nearly as helpful as azithromycin.
Interestingly though it looks like clindamycin may be involved in the same pathway https://pubmed.ncbi.nlm.nih.gov/37429145/
That makes sense, but unfortunately in a frustratingly unhelpful way. NF-kB is the central mediator of cellular immunity. What that means is that everything that needs an immune response triggers NF-kB and everything immunity-related gets activated due to NF-kB. Likewise, TNFa is the prototypical pro-inflammatory cytokine. It’s remarkably good at triggering immune responses in a wide variety of cells, and every immune response that I know involves TNFa in some way.
In other words, having inflammatory symptoms be caused by NF-kB>TNFa is less of a “that’s an interesting pathway” and more of a “yeah, of course NF-kB and TNFa would be involved, what’s new?”
The concern is that we don’t really know what’s activating NF-kB in the first place, and so as a result you can’t really fix the core problem. And because NF-kB and TNFa are involved in basically every immune process, it’s hard to tell if these proteins are the ones actually responsible for causing your symptoms. You’d be operating on a hunch, essentially. Though I will say that your unusually nondescript and broad symptoms do seem roughly in line with what I would expect from TNFa signaling.
All that to say, I’m not a doctor and I have no experience with translating knowledge into practicable therapies, so definitely talk to a doctor about it. But TNFa is very easy to detect in your blood, and if TNFa is causing your symptoms, then it’s really easy to just check to see if you’ve got high TNFa in your blood when you’re taking the antibiotics vs. when you’re not. If you had the money, you could even buy a test kit yourself and get an answer in a single day, assuming you know how to use the kit
Yeah but not every anti-inflammatory is going to inhibit NF-kB equally, so having something to target with inhibition is more helpful than just advice to avoid inflammation.
https://pubmed.ncbi.nlm.nih.gov/15489888/
Overall these results indicate that aspirin and ibuprofen are least potent, while resveratrol, curcumin, celecoxib, and tamoxifen are the most potent anti-inflammatory and antiproliferative agents of those we studied.
You’d be operating on a hunch, essentially. Though I will say that your unusually nondescript and broad symptoms do seem roughly in line with what I would expect from TNFa signaling.
Unfortunately an educated hunch is about as much as I think I can expect as of now bc the only doctor who isn’t just dismissing me is kind of at that point, and since he can’t figure it out, he’s open to suggestions.
And also having TNF-a levels tested isn’t anything somebody has suggested previously. It took me going back and forth between March and April to even get in to see an allergist to measure my tryptase levels bc I assumed it was histamines. Turns out it wasn’t.
Cold hardening has immunomodulatory effects. But who knows whether it would be suitable for you - immunity is a whole world of its own, it’s fucking complicated!
Right… azithromycin’s immunomodulatory and anti-inflammatory effects appear to be due to inhibition of TNF-a/NF-kB so that’s why I’ve been focusing on alternative ways to potentially target the same pathway
A healthy non-inflammatory / anti-inflammatory diet should already do that I thought… At least that’s been my thinking. I’ve been practicing sticking to non-inflammatory foods most of the year and still eat all the normal immune system boosting veggies/fruits e.g. garlic/ginger/apples/oranges/blueberries/etc.
For me at least there aren’t specific inflammatory triggers so that’s more about a general diet. Unfortunately there are people that do get inflammation from specific sorts of foods & whatnot so some people end up on more restricted diets, but even then the usual veggies/fruits are usually okay.
I think I usually avoid foods that trigger inflammation in general (mainly seems like it’s generally just stuff you shouldn’t eat very often anyway like processed foods, sugar fried foods, trans fats, etc.) I eat seafood sometimes but no meat.
I’ve been trying to incorporate more things like ginger and turmeric and antioxidants.
I got really sick earlier this year with what seemed like long COVID, but since there was already not that much known about it, (and that’s not really a thing anymore apparently under this administration, 🙄) I haven’t ever really gotten a diagnosis or been given much advice other than try to avoid inflammation.
Still seem to have a lot of issues that come and go, but not really sure what triggers it other than it’s definitely worse when I’m sick, and I seem to get sick all the time now followed by sinus infections that persist until I get antibiotics. (Just finished my 6th round this year, which is probably roughly equivalent or more than the number of times I’ve been on antibiotics throughout my entire life before this year.)
I don’t meet the criteria for COPD or asthma or really have any obvious breathing issues, but got an Albuterol inhaler prescribed as kind of a guess by my PC, and it does definitely help some. I also noticed I feel amazing and almost back to normal on azithromycin. It’s not usually prescribed for sinus infections bc of antibiotic resistance, but my doctor was willing to give it a shot bc I asked specifically for that rather than another round of amoxicillin.
No idea why it works so well, but I don’t think it’s just a placebo. I found out in addition to antibiotic effects it may also reduce inflammation in general including airway inflammation. My lungs look clear on imaging and blood work seems to indicate some weird random markers of inflammation but nothing that seems to really line up with any specific diagnosis.
Turmeric seems to target some of the same inflammatory pathways as azithromycin, so that was why I started incorporating that as well. It seems to help some, but nowhere near the level that azithromycin does for whatever reason. That’s kind of the deal with most things. It’s like they seem to maybe help a little bit, but nothing is as helpful as azithromycin, and obviously can’t be on antibiotics nonstop for the rest of my life.
So I’ve been trying to just keep my inflammation down as much as I can while waiting forever to see more specialists who so far also can’t seem to figure anything out other than just treating the symptoms.
Yeah that’s a tricky road to navigate. Hopefully in time you’ll get to see a good Rheumatologist or similar to figure out or at least rule out some real deal inflammatory disease that might be affecting you. I have a Rheumatologist specialist now due to my primary doctor thinking I had something like that going on… the one thing I’ve learned from all this is that so much of this stuff is tons of blood tests and guesswork that just takes a while. In the end she ruled out most of those diseases (& realistically I didn’t present a lot of symptoms) but in my case there’s a some sort of early onset bone density issue and arthritis so it’s just something to monitor and keep tabs on.
If you’re luck(ier) maybe there’s just foods you need to avoid due to reactions (allergy, inflammation, whatever). I know someone who has a very restricted diet, she was just constantly getting sick with random symptoms most of her life until she finally saw a specialist and got tested for different foods and ingredients that affect her.
The long COVID effects could actually be a ton of other things. Before COVID was a thing there wasn’t really a name for that but those same symptoms are often experienced by people who were infected/recovered from other viral infections. Like for example the type that get carried around by mosquitoes. A family member of mine was infected and recovered from West Nile Virus - I only say “recovered” being that the hospital discharged him once he was well enough so statistically he “survived” WNV. But he has random symptoms that stuck around afterwards. A few went away after a year or two, some stuck around for longer… it’s all the same long COVID stuff that doctors just sort of shrug and say that the tests look normal.
Over time if you manage to get through all the different specialists and tests some of those things will become clearer. And don’t be afraid to try seeing new doctors / specialists if the ones you’re seeing aren’t really doing much to help you.
Thanks! Seeing a rheumatologist soon, so fingers crossed
Vitamin C/ascorbic acid overdose for a short period.
Most people simply don’t consume enough VitC in their daily lives, which affects the immune system, reducing its efficiency.
VitC is also pretty much the safest vitamin to overdose on - any surplus gets flushed out with your pee.
Whenever I start feeling sick, I start doing 4-5000mg a day doses, and keep doing 1000mg a day once I feel okay, for at least 2-3 weeks.
It doesn’t as much “kickstart” your immune system as bring it back to peak efficiency, but for most who don’t consume enough VitC, it can act like one.
I’ve read a study a while ago that compared vitamin intake effect on immunity. Additional VitC didn’t do a thing, while B-complex actually had a measurable effect.
Lactic acid signals fatigue, but also signals growth, boosts BDNF for learning, reduces oxidative stress and protects neurons vs burnout.
So get your sweat on and keep it at as high a shocking level as you can.
That might not be a great idea with a weakened immune system. They may have PEM, which will do more harm than good.
