Today I saw a patient who had been concerned about having recurrent infections. I spend all year with infections and they have told me several times that I have low defenses - tells me the patient.
But, what we mean when we say that we have low defenses?
There are several contexts in which I see that this term is used. Examples include patients with infections continuously, as the patient I attended today, requiring constant use of antibiotics. Women with candidiasis repeat, without reaching to solve the problem. Patients with recurrent herpes, one after another, even using antivirals. People with constant colds. Patients with persistent diarrhea. So, we can say that the constant infections are a sign of low defenses.
Often, patients with chronic fatigue report that also have low defenses. Also patients having inflammatory processes, joint pain, skin blemishes or oral ulcers (among other symptoms) believe they have low defenses.
Many people believe that stress defenses down. Called low weight also one suspects that the defenses down. It is also common to think that some medications such as antibiotics lower the defenses.
This popular wisdom continues to be on track in many cases. However, in most patients I evaluate, no real quantization defenses available beyond a CBC (basic blood count).
Quantification and treatments for low defenses
So what defenses can be measured? You are right. The defense system or immune system has many measurable components. And very important: some components of the immune system can be replaced. It is therefore very important to properly quantify defenses specialized blood tests, because if there is a replaceable component under this may mean the introduction of therapies that can change the lives of people. For example, immunoglobulins can be administered intravenously and subcutaneously.
Some vitamins, without being properly defenses, are important in the regulation of immune functions. It is therefore also important measurement of some vitamins that can replace if they are low, such as vitamin D.
On the contrary, when the immunologists detect low defenses that can not be replaced then we can use prophylactic vaccines. For example, people with deficiency of some complement factors and have recurrent infections may improve if anti-pneumococcus, haemophilus and anti-anti-meningitis vaccines are administered.
People with deficiencies of neutrophils can benefit from the use of colony stimulating factors; patients with deficit of some cytokines can do with some cytokines available for clinical use.
In other cases, even if quantization is normal, we can attempt to potentiate immunity, for example, vaccines using bacterial or fungi that can be delivered mucosally.
Many patients find benefit with some of these interventions.