Infection and Disease, E Coli. – Immune Vitamins.

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The relationships between infection and disease have been studied extensively over the past few years, and new light is being shed on how organisms alone or in combination damage the body. We are exposed to hundreds of creatures over time and these things may contribute to illness without our knowledge. As in my previous newsletter about Heart Disease (plaque formation) and infection, silent disease can exist without symptoms. It makes sense that we look to our immune response to try to kill offending agents and to try to prevent the negative outcomes, but we also need to test to see if organisms exist. Early screening for these hidden creatures can save us a great deal of aggravation and anguish later on. It is also imperative that we help strengthen our defenses as much as possible. Based on the recent press on illness from food borne bacteria, here's a little information. 

There are a variety of infectious agents that can be commonly and easily spread through food. One of these is the ever popular E. Coli family. This creature gets a decent amount of press every once in a while when people seem to get sick from eating contaminated vegetables, fruit or meat. It was discovered by a German physician, Theodore Escherich, and has near one hundred different strains. These organisms live in the intestinal tract of mammals and are actually useful in helping digestion. There are mild and somewhat insignificant strains of this family and of course more dangerous types that can actually lead to severe infection and death.

The mild strains can lead to simple urinary tract infection, cystitis and diarrhea, and are treated easily with antibiotics. The dangerous strain, E. Coli 0157:H7 produces a toxin that can affect a variety of tissues and can be fatal to children, the elderly, and those with weakened immune systems. This type is the one linked to the recent outbreak associated with consumption of spinach.

Remember that with gastrointestinal inflammation and loose bowel movement we might be losing out on important vitamins and minerals that would have otherwise been absorbed. This can negatively affect the immune response. Our immune system has requirements for all of the vitamins and minerals, especially Vitamin C, B6, E,Glutathione, and Zinc. It can be stimulated as well by adaptogens such as Astragalus, and plant extracts as Echinacea and Garlic. It is important to test for vitamin levels in patients that have intestinal problems.   

Click on the list of Immune beneficial supplements below. 





                                              C Time Plus  


Dr. Chris Calapai

Hemorrhagic colitis associated with a rare Escherichia coli serotype. 

We investigated two outbreaks of an unusual gastrointestinal illness that affected at least 47 people in Oregon and Michigan in February through March and May through June 1982. The illness was characterized by severe crampy abdominal pain, initially watery diarrhea followed by grossly bloody diarrhea, and little or no fever. It was associated with eating at restaurants belonging to the same fast-food restaurant chain in Oregon (P less than 0.005) and Michigan (P = 0.0005) and with eating any of three sandwiches containing three ingredients in common (beef patty, rehydrated onions, and pickles). Stool cultures did not yield previously recognized pathogens.

However, a rare Escherichia coli serotype, 0157:H7, that was not invasive or toxigenic by standard tests was isolated from 9 of 12 stools collected within four days of onset of illness in both outbreaks combined, and from a beef patty from a suspected lot of meat in Michigan. The only known previous isolation of this serotype was from a sporadic case of hemorrhagic colitis in 1975. This report describes a clinically distinctive gastrointestinal illness associated with E. coli 0157:H7, apparently transmitted by undercooked meat.  

Vitamin E supplementation and in vivo immune response in healthy elderly subjects. A randomized controlled trial.

OBJECTIVE: To determine whether long-term supplementation with vitamin E enhances in vivo, clinically relevant measures of cell-mediated immunity in healthy elderly subjects. DESIGN: Randomized, double-blind, placebo-controlled intervention study.

SETTING AND PARTICIPANTS: A total of 88 free-living, healthy subjects at least 65 years of age.

INTERVENTION: Subjects were randomly assigned to a placebo group or to groups consuming 60, 200, or 800 mg/d of vitamin E for 235 days.

MAIN OUTCOME MEASURES: Delayed-type hypersensitivity skin response (DTH); antibody response to hepatitis B, tetanus and diphtheria, and pneumococcal vaccines; and autoantibodies to DNA and thyroglobulin were assessed before and after supplementation.

RESULTS: Supplementation with vitamin E for 4 months improved certain clinically relevant indexes of cell-mediated immunity in healthy elderly. Subjects consuming 200 mg/d of vitamin E had a 65% increase in DTH and a 6-fold increase in antibody titer to hepatitis B compared with placebo (17% and 3-fold, respectively), 60-mg/d (41% and 3-fold, respectively), and 800-mg/d (49% and 2.5-fold, respectively) groups. The 200-mg/d group also had a significant increase in antibody titer to tetanus vaccine. Subjects in the upper tertile of serum alpha-tocopherol (vitamin E) concentration (>48.4 micromol/L [2.08 mg/dL]) after supplementation had higher antibody response to hepatitis B and DTH. Vitamin E supplementation had no effect on antibody titer to diphtheria and did not affect immunoglobulin levels or levels of T and B cells. No significant effect of vitamin E supplementation on autoantibody levels was observed.

CONCLUSIONS: Our results indicate that a level of vitamin E greater than currently recommended enhances certain clinically relevant in vivo indexes of T-cell-mediated function in healthy elderly persons. No adverse effects were observed with vitamin E supplementation.    

The Effect of Dietary Supplementation with Vitamins A, C and E on Cell-mediated Immune Function in Elderly Long-stay Patients: A Randomized Controlled Trial.

Thirty elderly long-stay patients were randomly allocated to receive either placebo or dietary supplementation with vitamins A, C and E for 28 days. Nutritional status and cell-mediated immune function were assessed before and after the period of supplementation. Following vitamin supplementation, cell-mediated immune function improved as indicated by a significant increase in the absolute number of T cells (p<0.05), T4 subsets (p<0.05), T4 to T8 ratio (p<0.01) and the proliferation of lymphocytes in response to phytohaemagglutinin (p<0.01). In contrast, no significant changes were noted in the immune function of the placebo group.

We conclude that supplementation with the dietary antioxidants vitamins A, C and E can improve aspects of cell-mediated immune function in elderly long-stay patients. 

The Effect of a Vitamin and Mineral Supplement on Infection and Self-Reported Health

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians-American Society of Internal Medicine. 


Impact of Trace Elements and Vitamin Supplementation on Immunity and Infections in Institutionalized Elderly Patients. Background  Antioxidant supplementation is thought to improve immunity and thereby reduce infectious morbidity. However, few large trials in elderly people have been conducted that include end points for clinical variables.

Objective  To determine the effects of long-term daily supplementation with trace elements (zinc sulfate and selenium sulfide) or vitamins (beta carotene, ascorbic acid, and vitamin E) on immunity and the incidence of infections in institutionalized elderly people.

Methods  This randomized, double-blind, placebo-controlled intervention study included 725 institutionalized elderly patients (>65 years) from 25 geriatric centers in France. Patients received an oral daily supplement of nutritional doses of trace elements (zinc and selenium sulfide) or vitamins (beta carotene, ascorbic acid, and vitamin E) or a placebo within a 2×2 factorial design for 2 years.

Main Outcome Measures  Delayed-type hypersensitivity skin response, humoral response to influenza vaccine, and infectious morbidity and mortality.

Results  Correction of specific nutrient deficiencies was observed after 6 months of supplementation and was maintained for the first year, during which there was no effect of any treatment on delayed-type hypersensitivity skin response. Antibody titers after influenza vaccine were higher in groups that received trace elements alone or associated with vitamins, whereas the vitamin group had significantly lower antibody titers (P<.05). The number of patients without respiratory tract infections during the study was higher in groups that received trace elements (P=.06). Supplementation with neither trace elements nor vitamins significantly reduced the incidence of urogenital infections. Survival analysis for the 2 years did not show any differences between the 4 groups.

Conclusions  Low-dose supplementation of zinc and selenium provides significant improvement in elderly patients by increasing the humoral response after vaccination and could have considerable public health importance by reducing morbidity from respiratory tract infections.


Micronutrients in women’s health and immune function.

Lawrence J. Machlin’s contributions to elucidating the roles of nutrients in optimizing human health included the support of research in the areas of women’s health and immune function. Several essential nutrients have been shown to affect women’s health throughout the different life stages. Symptoms of premenstrual syndrome affect the vast majority of menstruating women, and calcium supplementation significantly reduces physical and emotional symptoms. Premenstrual syndrome in fact might be a predictor of osteoporosis induced by low calcium intake.

Periconceptional multivitamin supplementation has reduced the risk of serious birth defects, premature delivery, and low birth weight by 50% and improved maternal health during pregnancy. Micronutrients of particular importance for prevention of adverse pregnancy outcomes are folic acid, zinc, and iron. However, if the preterm delivery is caused by preeclampsia, then data suggest that calcium supplementation and high doses of vitamins C and E significantly reduce that risk. Well-controlled studies consistently have shown that calcium supplementation, with or without vitamin D, significantly reduces the risk of hip fracture. Antioxidants such as vitamins C and E have been shown to reduce the risk of fracture in women smokers.

As in the rapidly growing embryo, the immune system includes rapidly multiplying cells whose functions are dramatically affected by an individual’s micronutrient status. Multivitamins have been shown to enhance many aspects of immune response, and antioxidant micronutrients consistently have been found to enhance lymphocyte-proliferative responses and skin-test responses, especially in the elderly.