NTA NTP 12: Immune System

Phagocytes: Macrophages

-"Big eater," live under skin, in lungs, and in connective tissue around intestines -"Goats" of the immune system, collecting garbage, waiting for invaders; highly effective guards -Vicious killers that also secrete cytokines (or, chemical "help" signals) to alert other immune cells of the breech -Don't like to travel out into the Lymphatic System -Hold up "flags" that indicate the type of invaders spotted -Wait for activated T cells to show up as reinforcements

Immune System (Parts & Function): Lymph Nodes

-"Dating bars" where B and T cells meet antigens and antigen presenting cells -Antigens and antigen presenting cells enter through incoming arteriole or (afferent) lymphatic vessel (a way to catch invaders) -B cells, T cells and antigen presenting cells circulate through lymphatic system until they make a "match" -Provide "factory space" for B and T cells to proliferate in response to a specific pathogen or antigen -Scattered throughout body, both superficial and deep

3 Lines of Defense (Mechanisms & Interactions): Physical Barriers

-"Non-specific" physical barriers that block pathogens from entering the body and blood stream -Healthy, intact skin, sweat, mucus and mucosal surfaces, saliva, sufficiently acidic gastric juice, enzymes, and healthy gut flora -Body actions such as coughing, sneezing, sweating, urinating, defecating, vomiting, crying, and spitting all help to remove pathogens and harmful foreign substances from the body

3 Lines of Defense (Mechanisms & Interactions): Innate Immunity

-24-7 security and management system that is always ready to amount rapid, but non-specific immune response -Responsible for evaluating for danger and pushing the adaptive immune system into action (decides between friend and foe) -Integrates all incoming immune information and comes up with a game plan that it delivers to the adaptive immune system -Not capable of adapting to specific invaders Key players: -Complement proteins -Phagocytes (specific leukocytes--white blood cells) -Granulocytes -Natural killer cells

IgG antibodies

-75% of antibodies in the blood and are the longest living of the immunoglobulins. -Latches onto macrophages, neutrophils, and NK cells to help them bind with whatever kind of specific antigen that antibody is "labeled" with -Very good at neutralizing viruses outside of cells.

Lymphocytes

-A type of white blood cell that make antibodies to fight off infections -Born in the bone marrow, but migrate to parts of the lymphatic system such as the lymph nodes, spleen, and thymus

Memory Cells

-Activated B and T cells that stay in the system after an attack and can thereby "remember" specific intruders. --The second time an intruder tries to invade the body, B and T ______________ cells help the immune system activate much faster

Immune System (Parts & Function): Thymus

-Adaptive immune response "school" where T cells are taught how to respond to specific pathogens and how to differentiate between self-cells and invaders -Immature T cells migrate from b_______ m____________ to t_______________ to continue development -Once mature, T cells migrate to other lymphatic tissue and organs where they become active when needed

Allergies

-Adverse reactions to non-pathogens, associated with the generation of IgE by activated B cells and Th2 type cytokines produced by Helper T cells. -They generally also involve mast cells and eosinophils, and sometimes other cells of the innate immune system. -Memory cells are also important in _________________ reactions. -After an initial exposure, the body's "memory" of the pathogen may trigger a rapid and extreme immune response, sometimes leading to anaphylactic shock.

Food Hypersenstivity

-An adverse reaction to a food that is immunologically mediated. -Includes both the allergenic and non-allergenic reactions

Antibody

-Blood protein produced in response to and counteracting a specific antigen -Combines chemically with substances which the body recognizes as alien, such as bacteria, viruses, and foreign substances in the blood

Histamine Effects

-Blood vessels to dilation (vasodilation) -Promotes wakefulness -Increases permeability of capillaries facilitating the movement of plasma/lymph and white blood cells t injured or infected tissues, causing swelling. -Regulates appetite and promotes HCL secretion -Causes smooth muscle to contract -Sneezing due to increased nerve sensation -Increases pain sensing, especially in the abdominal organs (viscera) -Increased secretions from glandular tissue -Causes runny nose and watery eyes -Causes itching, redness, and hives -Stimulates norepinephrine release, which increases heart rate

Immune System (Parts & Function): Lymphatic System- Primary Organs & Tissues

-Bone Marrow -Thymus

Food Intolerance

-Can be used interchangeably with the term sensitivity. -This is a reproducible adverse reaction to a specific food or food ingredient.

Parasites

-Category of pathogens includes a number of different organisms that live on or in a host and cause that host some degree of harm, including fungi

Granulocytes: Eosinophils

-Circulate in bloodstream and exit into tissue when called by T helper cell cytokines in response to parasites or allergens -Destroy invaders by releasing special protein granules -Can create collateral tissue damage associated with allergic symptoms such as asthma.

Complement Proteins

-Complex system of more than 20 proteins that act together to help eliminate infectious microorganisms -Notify phagocytes and other innate immune cells of threat -Causes the lysis (bursting) of foreign and infected cells -Causes inflammation of surrounding tissue 3 Activation Pathways: -Classical Pathway: activated by antibodies -Alternative Pathway: pathogen-specific pattern recognition -Lectin Activation Pathway: activated by both internally produced lectins and some from foods

Type II Food Hypersensitivity

-Cytotoxic -Triggered by the body having formed antibodies to a particular invading microbe, which then cross-reacts with normal, but similar-appearing proteins on the membrane of one of the body's own cells. -These reactions generally occur within minutes to hours of exposure. -This type of hypersensitivity is characterized by self-reactions, or autoimmunity. -Associated diseases include hemolytic anemia, rheumatic heart disease, Grave's disease, and Myasthenia gravis. -These reactions are mediated by IgG, IgM, and complement proteins. -Because complement proteins are involved, dietary lectins may exacerbate symptoms and could be a good target for dietary support of any associated conditions.

Free Radicals

-Electrically charged ions or molecules that have an unpaired electron in their outer shell. -The unpaired electron makes free radicals unstable and destructive to nearby molecules. -Source of oxidative stress.

Immune System (Parts & Function): Lymphatic Vessel

-Entry point for antigens and antigen presenting cells -Closed at one end and start as small lymphatic capillaries in tissues -Carry lymph that forms in tissues to larger l_______________ v________________ -Along with blood stream, this acts as highways to transport cells and substances to the scene of the "crime"

Food Allergy

-Food hypersensitivity, mediated by the production of IgE antibodies- capable of producing anaphylactic shock

Non-Emotional Neurolimbic Food Reaction

-Food reactions driven by a survival instinct-driven limbic system imprintation created by the histamine response to any of the previously mentioned biochemical sensitivities. -Histamine acts as a neurotransmitter to save us from future harm, but sometimes we don't need the reminder!

Emotional Neurolimbic Food Reaction

-Food reactions driven by an association between a given food with a fearful or painful experience. -Example: if eating lime jello during a traumatic parental fight, lime jello may trigger a digestive or inflammatory response years later.

Granulocytes: Neutrophils

-Foot soldiers that circulate throughout bloodstream with a license to kill -Once a battle erupts, they can be at the front line within 30 minutes -Like other phagocytes, capable of "eating" invaders -Practice chemical warfare, combating invaders with a toxic soup of destructive enzymes and reactive oxygen species (a potent free radical that destroys microbes, but can also damage connective tissues through acidification) -Produce cytokines that stimulate a larger inflammatory response.

Viruses

-Fragments of DNA or RNA that are much smaller than a bacterial cell -Replicate by attaching to the wall of a host cell, injecting DNA into the cell, then using machinery inside of the cell to produce new __________ particles -When the hijacked cell dies. it bursts and releases a population of ____________ particles into the environment -The generic expression and function of the infected host cell will be different than a healthy host cell.

IgE antibodies

-Great at defending against parasites -Known for "allergic response" -Ig___s are very good at binding with granulocytes, such as mast cells, basophils, and eosinophils, stimulating these cells to degranulate once they've met with their encoded antigen. -"Degranulation" means that a toxic soup of chemicals and enzymes (including histamine in the case of mast cells and basophils) is released into the surrounding tissue, creating swelling, runny nose, watery eyes. If the histamine amount is high and spreads throughout the system, the result can be a dangerous situation known as anaphylaxis. -Because of this, the substance that an Ig___ antibody binds with has a special name- allergen, as opposed to antigen.

Type I Food Hypersensitivity

-Immediate; true allergies. -The food or environmental factor that triggers a reaction is called an "allergen", rather than an "antigen" (as most other immune responses). -The symptoms of an allergic response are generally felt within 15 to 30 minutes of exposure. -This type of hypersensitivity can manifest as atopic conditions such as asthma, hay fever, and eczema. -The type ___ hypersensitivity— or allergy's— classic Th2, histamine-driven response is mediated by IgE, basophils, and eosinophils. -In a worst case scenario, this type of reaction can result in anaphylactic shock.

Phagocytes: Monocytes

-Large class of phagocytes that stay in the blood on constant watch -"Sentinel cells", standing guard in the blood stream -After 3 days in the blood, they travel to capillaries and enter into tissues where they mature into macrophages

Immune System (Parts & Function): Spleen

-Largest single mass of lymphatic tissue in body -Filters blood for pathogens and antigens -Provides a site for macrophages, B cells and T cells to meet invaders -Every heartbeat sends 5% of blood here! -Screens all body's blood about every 30 minutes -Stores platelets (up to 1/3 of body)

Granulocytes: Basophils

-Least numerous type of granulocyte -Like eosinophils, circulate in the bloodstream and exit into tissues when called by T helper cytokines -Respond to an inflammatory call along with eosinophils and Th2 lymphocytes, creating an allergic-type response -Release small amounts of histamine and other toxic chemicals after binding with immunoglobulin E (IgE) -Trigger the release of inflammatory prostaglandins from damaged cells -Contain less histamine than mast cells, they are largely responsible for sustaining allergic responses (great)

Phagocytes: Dendritic Cells

-Live just below surface of epithelial linings, such as the skin, gut, and brain, as well as in organs like the liver, heart, kidney, and lungs. - "Wine tasters" of our tissues, sampling local fluids and spitting them back out to make sure nothing is amiss -Peaceful phagocytic cells, which don't engulf entire organisms like macrophages -When they encounter potential antigens, they take a "picture" of the materials floating around in local tissue and take it to Lymphatic System. -Important messenger between the innate and adaptive immune systems -"Special friendship" with T cells, who go to work once presented with the "photographic evidence"

Immune System (Parts & Function): Lymphatic System- Secondary Organs & Tissues

-Lymph nodes -Lymphatic vessels -Lymphatic fluid -MALT (Mucosal-Associated Lymphoid Tissue) -Spleen Main transportation systems and "meet-up spots" for pathogens, antigens, phagocytes, B cells, and T cells

Killer T Cells

-Lymphocytes that use enzymes to destroy the cell membranes of bacteria and other foreign invaders -Potent weapons that can destroy virus-infected cells by looking "into" a cell via MHC I proteins on another cell's surface

B Cells

-Lymphocytes with special proteins on the external surface of their membranes called ___ cell receptors, or BCRs -Each mature ___ cell produces a single unique type of BCR that functions as the "eyes" of the cell -A BCR has 2 parts- a "recognition" part and a "signaling" part -Because each ___ cell and its receptors are unique, we end up with a diverse collection of them that can probably recognize any organic molecule in the universe! -A ___ cell's role in adaptive immunity is to produce antibodies after activation, either through stimulation by a ___ helper cell or direct contact with the specific kind of substance it was made to recognize. -These specific substances are called an antigens and made of carbohydrates, proteins, and/or fatty acids. -After a ___ cell's receptor has bound with an antigen- or after it has been activated by a ___ helper cell- it is stimulated to begin producing antibodies

Non-allergic Hypersensitivities

-May involve IgG and IgM antibodies, or no antibodies at all. -They do NOT elicit an IgE response and are not capable of producing anaphylactic shock. -____________________ hypersensitivities tend to have more chronic symptoms and may or may not elicit a histamine response

Antioxidants

-Molecules that neutralize free radicals by donating an electron -Stabilizes previously unstable molecules, reducing their capacity to damage cells and tissues

IgA antibodies

-Most abundant immunoglobulin in body tissues (as opposed to the bloodstream) because it guards the mucosal surfaces of the body. -About 80% of the B cells that live just under mucosal surfaces produce Ig___. -Unique structure that allows it to pass through the intestinal wall, out into the intestine. -Resistant to the acids and enzymes of the digestive tract. -Ig___'s only interaction with bacteria is to bind with it and prevent it from binding with and infecting you -Also binds with digested food particles and is important in creating immune system tolerance to those foods

Natural Killer Cells (NK Cells)

-Non-phagocytic, non-antigen presenting lymphocytes that have many similarities to T cells but are unable to adapt to a specific invader (non-specific) -Mature in bone marrow and migrate mostly to the spleen or liver to await cries for help -Always "on call," ready to transit to the scene of the crime -Produce special cytokines that activate macrophages, turning them into vicious killers -Considered "innate" (as opposed to "adaptive") because they don't express T cell receptors on their surface which recognize specific presented antigens -Decide to destroy other cells based on recognition of certain carbohydrate or proteins patterns found on cellular membranes -Can destroy some tumor cells, virus-infected cells, bacteria, parasites, and fungi by forcing them to commit apoptosis (or cellular suicide)

Granulocytes

-Non-specific warriors that combat pathogens using inflammatory substances and enzymes capable of "meltng" an invader -Important in allergic reactions 4 main types: ‣ neutrophils ‣ eosinophils ‣ basophils ‣ mast cells

Immune Support for Foundations: Fatty Acids

-Proper Omega 3 to Omega 6 ratio to support prostaglandin synthesis -Sufficient healthy fatty acids in diet to support proper digestion and bile flow -Assists with absorption of immune boosting fat soluble vitamins: A, D, E and K

Type IV Food Hypersensitivity

-Represent classic delayed food hypersensitivity and can also be seen in organ-specific autoimmune conditions. -Immune responses generally occur within 48 to 72 hours of exposure to exogenous substances like foods, heavy metals, or to bacterial, fungal, or viral pathogens. -Because they involve the recognition of MHC complexes, they are mediated by T cells (generally Th1 or Th17) and macrophages. -The specific symptoms that a person may manifest are strongly influenced by their genetics. -Some associated conditions are contact dermatitis (including poison ivy), Celiac Disease, Hashimoto's Thyroiditis, Crohn's Disease, Multiple Sclerosis, and many non-Celiac gluten sensitivities.

Granulocytes: Mast Cells

-Reside mostly in mucosal linings and connective tissues, rather than in the bloodstream -Release large amounts of histamine and other toxic chemicals after binding with IgE -Trigger the release of inflammatory prostaglandins from damaged cells -Because of the large amount of histamine that these cells contain, they are considered to be directly responsible for anaphylaxis (allergy-induced shock)

Bacteria

-Single-celled microorganisms with no nucleus that are able to function independently of the human body, but may take up residence inside of it. -Spend most of their lives eating and reproducing. They multiply very quickly-- one can double every 15 minutes! -Assert their virulence by colonizing the host, forming biofilms, infecting cells, and using tricks to evade the immune system. -Many pathogenic ___________ contain lipopolysaccharides (LPS)- orendotoxins- in their cell membranes, which is a significant immune system stimulant

3 Lines of Defense (Mechanisms & Interactions): Adaptive Immunity

-Skilled specialists (special forces) -Capable of targeting their attacks to specific invaders that may have bypassed physical barriers and innate immunity -Can adapt to protect against almost any invader Key Players: Lymphocytes -B Cells -T Cells

Peyer's Patches

-Small masses of lymphatic tissue found throughout the ileum region of the small intestine. -A.K.A. aggregated lymphoid nodules -Form an important part of the immune system by monitoring intestinal bacteria populations and preventing the growth of pathogenic bacteria in the intestines

Phagocytes

-Special cells that engulf and destroy pathogens, bacteria, old cells, and other particles or debris in the body using phagocytosis and special enzymes -Identify pathogens using special receptors on surface that recognize fats and carbohydrates found on outer membranes of common bacteria 3 main types: ‣ monocytes ‣ macrophages ‣ dendritric cells

Immune System (Parts & Function): Bone Marrow

-Spongy tissue inside bones where all new blood cells and immune cells are created -Housed mainly in central skeletal system--pelvis, sternum, cranium, ribs, vertebrae, scapulae, femur

Immune System (Parts & Function): MALT Subcategories

-Stand watch over body's barriers by communicating directly with mucosal surfaces -Provide sites for macrophages, B cells and T cells to meet up with pathogens and antigens (microbes, viruses, parasites, allergens) -Outgoing lymphatics connect these vessels with lymphatic system ‣ SALT (skin-associated lymphoid tissue), is found in the mucosal lining of the skin. ‣ GALT (or gut-associated lymphoid tissue), is found in the mucosal lining of the digestive tract. An important component of GALT is Peyer's Patches. ‣ NALT (or nasal-associated lymphoid tissue), is found in the mucosal lining of the nasal pathway. ‣ BALT (or bronchial-associated lymphoid tissue), is found in the mucosal lining of the air pathway. ‣ CALT (or conjunctiva-associated lymphoid tissue), is found in the mucosal lining of the eyes. ‣ LALT (or larynx-associated lymphoid tissue), is found in the mucosal lining of the throat. ‣ VALT (vulvo-vaginal associated lymphoid tissue), is found in the mucosal lining of the reproductive and urinary tracts.

Th2 (Helper T Cell Subset)

-Stimulates B cells to produce more IgE and IgA antibodies and is appropriate for when bacteria or parasites have invaded the digestive tract

Th1 (Helper T Cell Subset)

-Stimulates macrophages and natural killer cells, and triggers B cells to produce IgG antibodies -This makes it ideally suited for defending against a viral or bacterial attack outside of a cell

Th17 (Helper T Cell Subset)

-Stimulates neutrophil attacks and is specifically involved with fungal infections

Regulatory T Cells

-Subset of Helper ____ cells -Promote immune tolerance and prevent the system from overreacting

Immune Support for Foundations: Blood Sugar Regulation

-Support the immune system to reduce blood sugar surges and opportunities for glycation. -Work with a client to balance macronutrient ratios and increase consumption of foods that slow the absorption of glucose into the bloodstream (protein, fat, and fiber). -Even clients with macronutrient ratios that appear more "balanced" may still experience symptoms of hypoglycemia with chronic and/or active immune challenges. -Increased activation of the innate immune system through stimulation of certain receptors (known as Toll-Like Receptors) decreases insulin sensitivity in adipose, liver, and muscle cells. -Shifts the body away from ketosis (fat-burning) and towards glycolysis (glucose-burning). -Helps the body to meet a higher metabolic need for carbohydrates as immune cells proliferate. -Support clients in finding nutrient dense, non-glycating carbohydrate sources.

Type III Food Hypersensitivity

-Usually occurs within 3 to 8 hours of exposure to bacterial, fungal, or viral pathogens. -The immune system forms complexes of antibodies bound with the invading antigen. -These complexes should be cleared from the body by macrophages in the liver and spleen— but when they're not, the body often stores them in places rich in connective tissue like joints, kidneys, and the walls of blood vessels. -There, they can create an ongoing inflammatory response that may be manifested as conditions like Lupus or Rheumatoid Arthritis. -These immune responses are mediated by IgG, IgM, complement proteins and neutrophils and, like Type II hypersensitivities, can be worsened by dietary lectins.

Immune Support for Foundations: Hydration

-Water is needed by all mucous membranes to stay moist and keep barrier immunity strong. -The lymphatic system, which is the staging ground for the adaptive immune response, relies on proper hydration to transport immune components. -Dehydration can exaggerate histamine activity- and therefore histamine symptoms- for purposes of water regulation. This can be a significant contributor to asthma and allergy symptoms. -Ensure that a client is drinking an adequate amount of water per day, supplemented with bio-individually appropriate electrolyte nutrients.

Helper T Cells

-___ cells that help the immune system by increasing the activity of killer cells and stimulating the suppressor _____ cells -Messenger of the immune system team. They act as cytokine factories, producing many different cytokines that have powerful effects on other immune system cells -Alert other cells based on information from MHC II proteins presented by cells of the innate immune system (most often, dendritic cells).

Autoimmunity 3 Legged Stool (Perfect Storm)

1. Genetic Setup 2. Epigenetic/Environmental Exposures 3. Cross-reactivity/Molecular Mimicry

Nutritional Therapy Approach to Dietary Intolerances

1. Recommend that a client use pulse testing for foods that seem to be provoking some type of hypersensitivity symptoms. Start with: -Sanchez-Cuenca (to detect general allergic tension) -Diet/Pulse Record with FMJ (if needed) 2. If 6 beats or more on either, follow up with Coca's Pulse Testing for individual foods or other substances. 3. Think back to the "bucket analogy". A body may experience them with greater severity when the total load of toxins and/or other burdens is high. Food reactions are also significant contributors to a body's load, or "bucket". 4. 3 basic questions an NTP must address for clients with food reaction symptoms: ‣ Are the symptoms caused by something the client would benefit from avoiding? (e.g. wheat or milk sensitivity) ‣ Are the symptoms caused by something that needs to be Foundationally detoxified? (e.g. mercury toxicity) ‣ Are the symptoms caused by a deficiency in something? (e.g. micronutrient or essential fatty acid deficiencies) 5. Consider an Elimination Diet as support for inflammatory and/or allergic symptoms (gold standard). 6. Reintroduce foods in 4-12 weeks: challenge phase with Coca's Pulse Testing and noting of symptoms/ reactions. 7. On any type of elimination diet, attempted food reintroductions are important and should be done very slowly- one every 3 days or after symptoms from previous reintroductions are gone, whichever comes last.

Antigen

A toxin or other foreign substance which induces an immune response in the body, especially the production of antibodies.

Food Reaction

An adverse response to a substance. This encompasses all types of food __________________, including intolerances, hypersensitivities, and allergies.

Immunoglobulins

Any of a class of proteins present in the serum and cells of the immune system, which function as antibodies.

T Cells

Cells created in the thymus that produce substances that attack infected cells in the body.

Types of Antibodies

IgG, IgM, IgA, IgD, IgE

Immune System Big Idea #1: (North to South)

In nutritional therapy we always address the Foundations first: Healthy DIGESTION is key to healthy immunity.

Immune System (Parts & Function): MALT

Mucosal Associated Lymphoid Tissue -Specialized lymphatic tissue situated along all mucosal surfaces of the body -Found in skin, eyes, nose, mouth, tonsils, GI tract, respiratory tract, urinary tract, reproductive tract, -Provide sites for macrophages, B cells and T cells to meet up with pathogens and antigens (microbes, viruses, parasites, allergens) -Stand watch over body's barriers by communicating directly with mucosal surfaces -Outgoing lymphatics connect these vessels with lymphatic system

Immune System (Parts & Function): Integumentary System

Provides physical barriers and non-specific innate immunity: 1. Cutaneous membranes: cover and protect exterior surfaces of body 2. Mucous membranes: line and protect body cavities and organs 3. Serous membranes: surround and protect organs 4. Synovial membranes: line and protect joints 5. Adipose tissue: communicates metabolic state of body to immune system via hormones called adipokines, which in turn control immune cell activity

Immune System (Parts & Function): Digestive System

Provides physical barriers, innate and adaptive immunity: 1. HCl and pepsin: neutralizes pathogens before entering intestine 2. GALT: houses 70-80% of immune system cells 3. Epithelial cells: secrete protective mucous as barrier against colonization and invasion by pathogens (1 layer thick in small intestine; 2 layers thick in large intestine), rich in antimicrobial proteins like lysozyme (enzyme that catalyzes destruction of cell walls of certain bacteria), facilitate nutrient digestion and assimilations, provide immunological surveillance signals at gut-mucosa-lumen interaface 4. Gut Flora in Large Intestine: stimulates immunity, feeds epithelial cells (produce SFAs for fuel), crowds out pathogenic bacteria

Immune Support for Foundations: Mineral Balance

Sufficient macro and micro minerals needed to support immune response: -Magnesium -Zinc -Selenium

Immune Support for Foundations: Liver/Gall Bladder

Support healthy ______ and ______________ function for optimal complement protein production, energy production, and elimination of immune products (such as antigen-antibody complexes) and waste materials: ‣ Micronutrients, such as zinc, magnesium, iron, vitamin C, B vitamins ‣ Phosphatidylcholine ‣ Fatty acids ‣ Amino acids such as taurine and glycine ‣ Liver-supportive plants such as digestive bitters, milk thistle, dandelion root, and yellow dock

Immune Support for Foundations: Small Intestine + Microbiome Support

Support healthy _________ ______________ function, particularly when signs of mid-gut ecosystem imbalances are present, and to support a healthy mucosal lining with tight cellular junctions. This provides a health terrain on which beneficial bacteria can reside: ‣ Micronutrients such as zinc and B vitamins ‣ Glutamine ‣ Digestive bitters ‣ Gut-supportive plants, such as chlorophyll, marshmallow root, slippery elm, dill, thyme, oregano, ginger, garlic

Immune Support for Foundations: Digestion/Upper GI

Support healthy hydrochloric acid production for optimal food disinfection and breakdown: ‣ Micronutrients, such as zinc, B1, folate, B5, B6, B12 ‣ Nutrient dense water (with electrolytes) ‣ Chlorophyll ‣ Digestive bitters ‣ Supplemental HCL as a last resort (with an awareness of contraindications covered in the digestion module)

Immune Support for Foundations: Large Intestine + Microbiome Support

Support healthy large intestine function, particularly when symptoms of low gut ecosystem imbalances are present, and to support bowel regularity: ‣ Micronutrients such as magnesium and B vitamins ‣ Nutrient dense water (with appropriate electrolytes) ‣ Digestive bitters ‣ Prebiotic fibers ‣ Therapeutic probiotic strains ‣ Gut-supportive plants, such as chlorophyll, marshmallow root, slippery elm, thyme, oregano, caraway oil, peppermint oil, psyllium, mullein, goldenseal, lemon balm, chamomile

Immune System Big Idea #3: (Root Cause)

The immune system vigilantly works to address the UNDERLYING CAUSES of INFLAMMATION to achieve homeostasis.

Immune System Big Idea #2: (S & R)

To improve immune function, STRENGTHEN the defenses and REMOVE the stressors.

MHC II

‣ After a macrophage, a dendritic cell, or an activated B cell devour an invading bacteria, it will load digested protein fragments of that bacteria onto a class ____ MHC molecule and display it on its surface ‣ Because this cell is displaying this special "notification warning" on its surface, it can be called an antigen presenting cell.

Endogenous Antioxidants

‣ Alpha-lipoic acid ‣ Bilirubin ‣ Catalase ‣ Coenzyme Q ‣ Ferritin ‣ Glutathione ‣ Glutathione peroxidase ‣ Melatonin ‣ Superoxide dismutase ‣ Uric acid

Nutrient-Dense Antioxidant Food Sources

‣ Berries ‣ Citrus ‣ Cloves ‣ Dark chocolate ‣ Green and black teas ‣ Prunes ‣ Potatoes

Exogenous Antioxidants

‣ Beta-carotene ‣ Vitamin C ‣ Vitamin E ‣ Plant polyphenols ‣ Selenium ‣ Zinc

Exogenous Free Radicals

‣ Chemicals ‣ Cigarette smoke ‣ Environmental pollutants ‣ Ozone ‣ Radiation ‣ Pesticides

Endogenous Free Radicals

‣ Cytochrome P-450 enzymes ‣ Energy production ‣ Glycation ‣ Necrosis (or tissue death) ‣ Overexercising ‣ Phagocytosis and other immune activity ‣ Prostaglandin synthesis

MHC 1

‣ Expressed on the membrane of every cell in the body with a nucleus ‣ Contain fragments of proteins produced within the cell, including ordinary things like enzymes and structural proteins but also proteins encoded by viruses and other parasites that may have infected cell. ‣ Function like billboards for everything that is going on in the cell — good or bad.

Potential Food Allergens (note in FMJ if related to symptoms)

‣ Gluten ‣ Corn ‣ Soy ‣ Dairy ‣ Eggs ‣ Peanuts ‣ Tree nuts ‣ Fish/Shellfish ‣ Sesame

Potential Food Intolerances (note in FMJ if related to symptoms)

‣ Nightshades ‣ FODMAPs ‣ Oxalates ‣ Salicylates ‣ Histamine triggers ‣ Fructose ‣ Sulfur ‣ Fats ‣ Lectin-containing foods ‣ Anything else that seems to be a pattern