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Vitamins and Metals needed by the Immune System – Jan 2020

A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection

Nutrients 2020, 12(1), 236; https://doi.org/10.3390/nu12010236
by Adrian F. Gombart 1OrcID,Adeline Pierre 2 andSilvia Maggini 2,*
1 Linus Pauling Institute, Department of Biochemistry and Biophysics, Oregon State University, 307 Linus Pauling Science Center, Corvallis, OR 97331, USA
2 Bayer Consumer Care AG, 4002 Basel, Switzerland
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Immune support by micronutrients is historically based on vitamin C deficiency and supplementation in scurvy in early times. It has since been established that the complex, integrated immune system needs multiple specific micronutrients, including vitamins A, D, C, E, B6, and B12, folate, zinc, iron, copper, and selenium, which play vital, often synergistic roles at every stage of the immune response. Adequate amounts are essential to ensure the proper function of physical barriers and immune cells; however, daily micronutrient intakes necessary to support immune function may be higher than current recommended dietary allowances. Certain populations have inadequate dietary micronutrient intakes, and situations with increased requirements (e.g., infection, stress, and pollution) further decrease stores within the body. Several micronutrients may be deficient, and even marginal deficiency may impair immunity. Although contradictory data exist, available evidence indicates that supplementation with multiple micronutrients with immune-supporting roles may modulate immune function and reduce the risk of infection. Micronutrients with the strongest evidence for immune support are vitamins C and D and zinc. Better design of human clinical studies addressing dosage and combinations of micronutrients in different populations are required to substantiate the benefits of micronutrient supplementation against infection.

physical and biochemical barriers


immune cells


antimicrobial effects


antigen response


Impact of Vitamin D Deficiency


impact of Zinc Deficiency.


RDAs, actual mean Intake (Europe)


Summary (in PDF)

Every stage of the immune response depends on the presence of certain micronutrients, which have synergistic roles based on their complementary modes of action. First, selected micronutrients (e.g., vitamins A, D, C, E, and zinc) are required to ensure the structural and functional integrity of external and internal surfaces of the body (i.e., the skin and all mucus membranes), which form physical and chemical barriers that represent a first line of defense against invading pathogens.

Cell-mediated processes of innate immunity, such as cell proliferation, differentiation, function, movement, and the ability to mount an effective oxidative burst, rely on adequate amounts of vitamins A, D, C, E, B6, and B12, folate, iron, zinc, copper, selenium, and magnesium.

Similarly, chemical responses such as activation of the complement system and the release of proinflammatory cytokines requires certain vitamins and minerals (in particular, vitamins A, D, and C, zinc, iron, and selenium).
The inflammatory response bridges the gap between innate and adaptive immunity, and is regulated by vitamins A, C, E, and B6, as well as iron, zinc, and copper.
Adaptive immune responses encompassing cell-mediated and humoral immunity depend again on the presence of a variety of micronutrients at all stages (i.e., lymphocyte proliferation, differentiation, and function, and humoral- and cell-mediated immune processes).

At the same time, micronutrients are involved in self-protection of immune cells (via antioxidant mechanisms, e.g., vitamins C and E, zinc, iron, magnesium, copper, and selenium), inhibitory actions (vitamins D, B6, and E), and elimination of spent cells via apoptosis and clearance (limiting tissue damage, e.g., vitamin C).
Clearly, micronutrients are an integral part of the immune system, and the body needs optimal levels for effective immune function. It is well established that overt micronutrient deficiencies can adversely affect the immune system and predispose individuals to infections. It is likely that marginal deficiencies are also associated with increased risk of infections, although the effect may be less pronounced than those observed with overt deficiencies.
The dietary intake of various micronutrients is inadequate worldwide, including industrialized countries, which can increase the risk of infection. In addition, mounting evidence suggests that increased intake of some micronutrients above the RDA may help optimize or maximize immune function and thus improve resistance to infection. Thus, a gap exists between dietary intakes and levels for optimal immune function, providing a rationale to supplement the diet with micronutrients to help support the immune system and reduce the risk of infection.

Current studies suggest beneficial effects regarding risk reduction for

  • vitamin A (diarrhea and measles in children),
  • vitamin D (RTI in adults and children),
  • vitamin C (pneumonia in adults and children and common cold in active people),
  • zinc (otitis media, RTI, pneumonia, and diarrhea in children),
  • iron (RTI in children), and
  • MMN (multiple micronutrients) supplementation (helminth infection in children and infection/reinfection in older people).

In treating the symptoms of infection, benefits have been reported for

  • vitamin A (non-measles pneumonia, as well as measles-associated diarrhea and RTI in children),
  • vitamin D (tuberculosis, influenza and upper RTI in adults and children),
  • vitamin C (common cold in adults and children and pneumonia in adults and older adults), and
  • zinc (common cold in adults and children).

In particular, an MMN consisting of seven vitamins and four trace elements significantly decreased the length, severity, and number of symptoms of self-reported illness in older people, and significantly reduced the symptoms of SBS, ARTI, and diarrhea in employees exposed to the habitual levels of pollution experienced in a big city such as Jakarta. It is important that supplementation is used within recommended safety limits [143], particularly in potentially at-risk groups such as pregnant or postpartum women (for vitamin A [228,229]) or smokers (in whom high doses of vitamin E, for example, may have an adverse effect on the risk of lung cancer [230,231]).
Thus, although some contradictory data exist, the overall available body of evidence suggests that supplementing the diet with a combination of multiple, selected, immune-supportive micronutrients may help to optimize immune function and reduce the risk of infection. It is worth continuing to investigate the efficacy of MMN supplements that contain immune-supporting micronutrients at doses higher than the RDA—especially as they are relatively low cost and readily available, and have the potential to reduce the global burden of infection.


This excellent review only shows a subset of the benefits of Vitamin D and the immune system
Suspect that the study is also very conservative about the benefits of the other vitamins and metals


Autoimmune category starts with

See also web: consensus that ~50 diseases are autoimmune, ~50 more are suspected:


Immunity category starts with

262 items in Immunity category

    see also

Virus category listing has 1342 items along with related searches

Overview Influenza and vitamin D
Vitamin D helps both the innate and adaptive immune systems fight COVID-19 – Jan 2022
Vitamin D aids the clearing out of old cells (autophagy) – many studies
600,000 IU of Vitamin D (total) allowed previously weak immune systems to fight off a virus antigen - Nov 2020
Search for treg OR "t-cell" in VitaminDWiki 1440 items as of Jan 2020
141 VitaminDWiki pages contained "infection" in title (June 2021)
Search VitaminDWik for BACTERIA in title 25 items as of Aug 2019
Vitamin D and the Immune System – chapter Aug 2019
7X less risk of influenza if Vitamin D levels higher than 30 ng – Oct 2017
Common cold prevented and treated by Vitamin D, Vitamin C, Zinc, and Echinacea – review April 2018
Vitamin D improves T Cell immunity – RCT Feb 2016
Immune system - great 11-minute animated video - Aug 2021
   Only the brain is more complex, nothing about Vitamin D

18 titles in VitaminDWiki contained INNATE or ADAPTIVE as of Jan 2023
Increasing publications on vitamin D and Infection

47 studies are in both Immunity and Virus categories

Summaries of other Vitamins and Elements

Vitamin D Cofactors in a nutshell includes Vitamin K, Vitamin B12, Boron, Iodine, Omega-3, etc.
Bulk supplementation of Vitamin D, Magnesium, Zinc, B-12, K2, Boron etc. - lower cost and easier than pills
*COVID-19, flu, virus, Selenium, Vitamin D, Glutathione - Interview Sept 2020
Micronutrients (such as Vitamin D) needed during pregnancy – May 2016
Vitamin D is the 3rd most important contributor to health,
   and the lowest-cost way to improve health

Which supplements to take in morning and evening (Chronotherapy)
Supplement reviews by ConsumerLab – Vitamin D, Magnesium, Vitamin K, Calcium , Boron – Nov 2019
RDA is often not enough – 75 percent in US correctly believe – April 2019
Micronutrients (such as Vitamin D) for critically ill children – review Oct 2017

111 items in Supplements category

Importance to Health VDW10426  


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13398 .Micro RDA, Intake.jpg admin 24 Jan, 2020 242.04 Kb 1600
13396 .Impact of Zinc Deficiency.jpg admin 24 Jan, 2020 127.24 Kb 1598
13395 Impact of Vitamin D Deficiency.jpg admin 24 Jan, 2020 67.01 Kb 1675
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13393 Micro - antimicrobial effects.jpg admin 24 Jan, 2020 64.32 Kb 1561
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13391 Micro - physical and biochemical barriers.jpg admin 24 Jan, 2020 157.37 Kb 2042
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