Five stars

Imagine how stressful surgery is on the body. First there’s the obvious emotional and physical stress, compounded by the stress caused by the actual disease or trauma. Inevitably, pain killers, drugs, and sleep deprivation all add to the stress load.

Enter immunonutrients. A recent report in the British Medical Journal (BMJ) examines surveys of five specific nutrients that have been shown to improve immune system function after surgery. The overall result: fewer infections and shorter hospital stays.

The alpha and the omega

Of course, you don’t have to be in need of surgery to reap the benefits of immunonutrients, which also provide natural defenses against common viral and bacterial infections. So with some helpful insights from HSI Panelist Allan Spreen, M.D., we’ll take a look at the five immunonutrients featured in the BMJ report, along with notes on the best sources of each.

I’ll begin with the nutrient that needs no introduction to HSI members: omega-3 fatty acids. We’ve written about this essential nutrient so often in both the Members Alert and the e-Alert that I’m not going to delve into this very familiar information again here. (For a quick overview of the benefits of omega-3s, check the e-Alert archives on the HSI web site for “Fish in Fashion” 4/10/02.)

The other four immunonutrients are arginine, L-glutamine, branched chain amino acids, and nucleotides. After looking over this list, Dr. Spreen told me he was “really impressed they used the term ‘immunonutrients’ in a staid journal.” And although he said he was amazed that the BMJ spoke so highly of these nutrients to help in the recovery from surgery, he noted that, “the Europeans are far less biased than our American Medical Association.”

The multi-tasker

First up is arginine (also known as L-arginine), which I told you about earlier this year in “Free Flow” (1/28/03). This remarkable amino acid is known to play a role in a number of very beneficial functions, including: blood vessel dilation, reduction of inflammation, repair of skin and connective tissue, and thymus gland regulation.

And Dr. Spreen tells me that arginine is one of the best-known stimulants of the formation of growth hormone by the human body. As he pointed out in the e-Alert “Let it Grow” two weeks ago, “The injectable hGH (human growth hormone) is risky, as it causes the body to make less of its own, while arginine is the antithesis of that – it causes the body to make more of its own. Growth hormone is a wonderful ‘youth agent,’ and we make less as we age. The effects of rejuvenating the body (it’s skin, muscles, energy, what-have-you) apparently have been shown to extend to the immune system also.”

L-arginine’s dietary sources include dairy products, meat, poultry and fish, as well as nuts, rice, whole-wheat, soy and raisins. It can also be taken in supplement form, available in most health food stores and through Internet sources.

The antioxidant’s friend

The BMJ report highlighted the successes of using post-surgical L-glutamine (or simply “glutamine”) intravenously to combat toxins and reduce the incidence of pneumonia. Dr. Spreen said, “I’m STUNNED at the comments (and progress) made with intravenous glutamine. I had no idea they’d gone so far at trying such things. It’s pretty detailed when you’re putting it in an IV and fixing up intestinal mucosae and stimulating the immune system.”

Dr. Spreen also explained this additional benefit of L-glutamine: “It seems the brain uses glutamic acid almost as well as glucose for energy, and with less stress in doing so. The problem is, it doesn’t cross the blood-brain barrier into the brain directly. However, glutamine DOES cross, and then the brain can convert it to the utilizable form and burn it. It makes sense that easy-energy fuel for the body’s processes would make everything work better.”

L-glutamine is one of the precursors of the highly effective antioxidant glutathione, which I’ve written about many times. Fortunately there are a number of good food sources of L-glutamine, including meats, fresh fruits, and vegetables. L-glutamine supplements are also widely available.

The repairman

Dr. Spreen tells me that branched chain amino acids (BCAAs) are apparently the easiest form of protein for the body to use for repair, and that’s why this nutrient is popular with many body builders. “BCAAs are readily available for incorporating into new proteins, both stuctural and enzymatic (and the enzymatic side may be even more important than the structural repair, if you can rank such things).”

The three BCAAs (leucine, valine, and isoleucine) are essential amino acids, which are also precursors of glutamine. Without BCCAs in our diets, we literally couldn’t live.

About BCCAs, Dr. Spreen says, “I’ve always felt that anything that makes it easier for the body to ‘do its thing’ is immunologically beneficial. If it has easy access to energy, readily available components for fixing whatever’s damaged, and ways to move the body’s biochemical processes around without having to worry about ‘rationing’ what’s available, that HAS to make it easier to go out and eat invading organisms and fix whatever’s broken.”

BCAAs are available in supplement form, but are easily obtained from meat, whey protein, egg protein and other dairy products.

Down in the DNA

As for our last of the big five immunonutrients – nucleotides – Dr. Spreen says they’ve been mentioned in articles for years as immune system enhancers, but he’s never had the occasion to use them.

Nucleotides (the basic unit of nucleic acids) are the building blocks of DNA, and they help make cell division possible. When the immune system is under stress, new cells are needed to help fight infection. White blood cells, bone marrow cells, and the mucous cells of the intestine all require sources of nucleotides.

Breast milk is perhaps the richest source of nucleotides. Formula-fed infants are generally more prone to infection than breast-fed children, and researchers believe that nucleotides are primarily responsible for this difference. Organ meats such as liver and kidney are rich in nucleotides, as are legumes and seafood. Nucleotides and nucleic acids supplements are also available.

Food for thought

You’ve probably noticed that most of the dietary sources for the five immunonutrients are protein-rich meats and dairy products. So you might think that in addition to supplements, a high-protein diet might be ideal for supplying the body with the immune boosting characteristics of these nutrients. But it turns out the opposite is true.

Dr. Spreen added this very important tip: “If amino acid supplements (which can be expensive) are taken with protein foods, the protein receptor sites are flooded with competition from the protein in foods. So if you’re trying to get a predominance of one amino acid for some reason (L-glutamine for energy, arginine for growth hormone production, etc.) you’d be wasting money to take them with other proteins.”

If you’re considering having surgery, or if you have other health problems that might call for improved immune system support, talk to your doctor about immunonutrients. It could make all the difference between a difficult recovery and a successful one.

To Your Good Health,

Jenny Thompson
Health Sciences Institute


“Immunonutrition May have Beneficial Effects in Surgical Patients” British Medical Journal, 2003;327:117-118 (19 July),

“Commonly Used Immunonutrients and Their Key Functions” British Medical Journal, online extra, 7/19/03,

“Immune-Boosting Nutrients Beneficial After Surgery” Dr. Joseph Mercola, 8/9/03,