Immunodeficiency: Therapy

General measures

  • Observance of the general rules of hygiene! One of the easiest ways to keep yourself and others healthy is to wash your hands regularly. Hands should be washed under clean running water for at least 20 seconds.
  • Nicotine restriction (refrain from tobacco use).
  • Alcohol restriction (abstaining from alcohol)
  • Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition using electrical impedance analysis.
    • Overweight: Participation in a medically supervised weight loss program.
    • Underweight: participation in a medically supervised program for patients with underweight.
  • Competitive sports or a high physical workload at work compromise the immune system.
  • Review of permanent medication due topossible effect on the existing disease.
  • Antibiotics can destroy the natural intestinal flora. The intestine is important for the immune defense.
  • Avoidance of psycho-social conflict situations:
  • Avoidance of the following environmental stresses:
    • Exposure to ionizing radiation
    • Noise
    • Radiation syndrome – complex of symptoms that may occur after therapy/exposure to ionizing radiation.
  • Notes on general lifestyle:
    • Fulfilled intimate life – Studies show that people who have a regular sex life are in better health than those who rarely have sex.
    • Kissing is not only good for the mood, but also promotes the body’s defenses.
    • Maintain friendships (“social network”) – friends are the best insurance against stress and loneliness.
    • Laugh heartily every day, because laughter is healthy. An old saying goes, “Laugh and the world laughs with you, cry and you cry alone.”
    • Ensure regular and adequate sleep. Restful night sleep is very important for the optimal functioning of the immune system. Lack of sleep reduces the activity of natural killer (NK) cells. These recognize and kill abnormal cells such as tumor or virus-infected cells. Ideal is a sleep duration between 6.5 and 7.5 hours.
    • Alternating warm showers, brush massages, Kneipp’s castings, treading water, swimming and sauna bathing strengthen the immune system.
  • Travel recommendations:
    • Before starting a trip and after returning from the trip participation in a travel medical consultation or examination, if necessary!Note: The risk of travel-associated infections depends on the degree of immunosuppression.
    • In sufficient time interval to the planned travel date implementation of the vaccinations listed belowNote: Influenza occurs year-round in the tropics and subtropics.
    • In severe immunosuppression, live vaccinations are contraindicated!

Conventional non-surgical therapy methods

Vaccinations

The following vaccinations are advised, as infection can often lead to worsening of susceptibility to infection:

  • Pneumococcal vaccinationNote: In patients with immunosuppression, the STIKO advises sequential vaccination, with PCV13 (conjugate vaccine) given first and PSV23 (23-valent polysaccharide vaccine) given 6-12 months later. This strategy has significantly higher protective efficacy than when vaccinated with PSV23 alone.
  • Influenza vaccination (flu shot).
  • Herpes zoster vaccination

During therapy with immunosuppressants should not be vaccinated with live vaccines. Administration of a live vaccine before the start of therapy is possible with a time interval of usually at least 4 weeks, in the case of low-grade immunosuppressive effect 2 weeks. Before alemtuzumab or octrelizumab therapy, the interval should be at least 6 weeks.In patients with primary immunodeficiencies (PID), standard and indicated vaccinations with inactivated vaccines are generally possible without additional risk; live vaccinations, on the other hand, are contraindicated in many patients with primary immunodeficiency. For vaccinations of persons with a primary immunodeficiency, see Vaccinations in Immunodeficiency – Application below for information on vaccinations recommended by the Standing Committee on Vaccination. Travel vaccinations in immunosuppression.

  • Vaccinations with inactivated vaccines (hepatitis A, tick-borne encephalitis (TBE), polio (inactivated polio vaccine), typhoid, rabies, Japanese B encephalitis, and meningitis) are possible; however, the immune response is reduced
  • Live vaccinations (relevant to travel medicine are oral polio and typhoid vaccination, as well as yellow fever and intranasal influenza vaccination) are contraindicated.
  • Accompanying persons should always have optimal vaccination protection!
  • Check seroconversion (develop specific antibodies against antigens of a foreign body in the context of a one vaccination) about 4 weeks before travel!

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
  • Observance of the following special nutritional recommendations:
    • Patients with immunodeficiency / susceptibility to infection, for example, chemotherapy, must be extremely vigilant and careful in everyday life. For example, foods that are not sterilized and thus contain many pathogens (e.g., N. Listeria) should be avoided.The following rules should be observed in food selection and preparation:
      • Avoid: Raw or only soft-boiled eggs, as well as fried eggs and dishes containing raw eggs (tiramisu, dishes with beaten egg whites); raw milk or raw milk products (raw milk cheese).
      • All dishes should be cooked at least 60 ° C for at least 10 minutes.
      • Opened food should be used up or the rest thrown away.
      • Ice cream only from the freezer; soft ice cream should not be eaten, as it often contains pathogens.
    • Diet rich in:
  • Other specific dietary recommendations depending on the cause of immunodeficiency / susceptibility to infection.
  • See also under “Therapy with micronutrients (vital substances)” – Taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
    • Any kind of exercise (in moderation) is helpful to reduce stress and strengthen the immune system.
    • Endurance training of moderate intensity and moderate volume strengthens the immune system; it is important to adapt the training individually to your own training condition. Training beginners, for example, benefit from two to three times a week of endurance training at about 30-minute training sessions.Suitable training measures are: Jogging and (Nordic) walking in the fresh air or alternatively indoor training on the cycle ergometer, the treadmill, on the cross trainer or with a rowing machine.
  • Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check) depending on the cause of immunodeficiency / susceptibility to infection.
  • For detailed information on sports medicine, please contact us.

Physical therapy (including physiotherapy)

  • Hydro- and balneotherapy (e.g., alternating showers).
  • Inhalation therapy
  • Magnetic field therapy

Psychotherapy

Complementary treatment methods

  • Antihomotoxic therapy
  • Biological buildup cure
  • Autologous blood therapy
  • Fever therapy
  • Hematogenous oxidation therapy (HOT)
  • Mesotherapy
  • Ozone therapy
  • Phytotherapy
  • Low-level laser therapy
  • Regeneration cure
  • Multistep oxygen therapy (SMT)
  • Thymus therapy (THX)