Feature Article

Nutrition and Bioterrorism

Russell L. Blaylock, MD


It has been known for centuries that a certain number of people survive epidemics unscathed. This was true for the waves of Black Death that eventually killed forty million people in Europe in the fourteenth century and for the numerous smallpox plagues that have swept through the world since it was first recorded in history, which killed over 500 million people. It has been observed over a century ago that survivors appear to be those who were the healthiest before an epidemic struck.

Millions were killed by epidemics of typhus during World War I. Several observers noted that soldiers who carried garlic cloves with them for snacking were often spared the disease. Later it was learned that garlic contained factors that acted as a powerful antibiotic. Since this early observation, numerous phytochemicals have been found to have antibacterial and antiviral activity.(1)

Modern research has confirmed that enhanced nutrition reduces the risk of infections and improves recovery from infections of various types both in experimental animals and humans.(2) More recently, scientists and clinicians have discovered that non-specific immune enhancement can significantly increase one's resistance to numerous types of infectious agents - bacterial, viral, rickettsial and fungal.(3)

The connection between nutrition and immune function is quite strong. While protein-calorie malnutrition has been known for quite some time to result in immune incompetence, only recently has it been recognized that single nutrient deficiencies can result in profound immune dysfunction.(4) This would include deficiencies in vitamins, minerals and special metabolic substrates

We know that nutritional deficiency, especially of the carotenoids, plays a major role in age-related immune suppression and that immune recovery can occur with supplementation.(5) During a bioterrorism attack, it would be the very young, the very old and those with immunocompromising conditions that would be at most risk. This is why we have the flu vaccine programs every winter to protect the elderly.

It is also known that a large segment of our population is deficient in one or more nutrients. During stress, such as would occur during a bioterrorist attack, nutritional depletion would worsen. It is also known that stress enhances immune suppression and increases free radical generation in numerous tissues. Of particular concern is a depletion of magnesium, zinc, selenium and the water-soluble vitamins (the "B" vitamins and ascorbate). In addition, it is known that during infections, these same vitamins and minerals are rapidly depleted. All are utilized by the immune system for its function and for tissue protection.

Besides replacing lost minerals and vitamins, we now have at our disposal newer ways to enhance the immune system non-specifically. For example, beta 1,3/1,6 D-glucan has been shown to specifically enhance macrophage function by stimulating glucan receptors on the surface of the macrophage membrane.(6) In addition, special cytokines, such as TNF-a, IL-6 and IFN are all enhanced by the glucans.

This immune enhancing supplement has a wide margin of safety and has been shown to produce no chronic toxicities. In addition, it has been shown to produce no enhancement of anaphylaxis in animal models. Only the pure products should be used, since many cheaper brands either do not work or contain protein contaminants that can produce potentially serious side effects.

Not only is beta 1,3/1,6 D-glucan a powerful enhancer of cellular immunity, but it has also been shown to enhance wound healing and is a powerful radioprotectant.(7) The dose scheduling must be followed closely since massive doses will have an opposite effect. It is also important to supplement with ascorbate since macrophages are rapidly depleted of ascorbate during infectious challenges.

The importance of nutritional supplementation is especially critical in the face of a viral attack with smallpox, the Marburg virus or Ebola, since specific antiviral agents are either nonexistent or in short supply. We know that many individuals suffered only mild effects from smallpox infections during the epidemics occurring in the early nineteen hundreds, either as the varioloid type or discrete type. Immune enhancement would be expected to place most of those exposed in these more favorable groups.

It is also interesting to note that during the accidental Ebola infection of four workers at an Army research facility near Washington, D.C. none suffered from the infection.(8) No one knows why a virus that has a mortality rate of 95 percent in Africa did not kill these men. It may be that their immune functions were much better than the typical African having numerous parasitic infections and a poor nutritional status.

Depending on vaccines and antibiotics is quite hazardous as pointed out in Michael T. Osterholm's book Living Terrors.(9) Distribution logistics will be a nightmare, distribution personnel will be in short supply, and supplies will be dangerously low for vaccines and antibiotics. Nutritional immune enhancement will not only lessen the severity of infections, but it will buy valuable time until one can be provided with the appropriate antibiotic or vaccine.

It has been shown that beta 1,3/1,6 D-glucan and vitamin A can enhance the success rate of vaccination and significantly enhance the effectiveness of antibiotics as well. In addition, vitamin A has been shown to substantially reduce the complication rates following vaccination, something that must be considered during mass inoculations, especially with low stocks of vaccinia immune globulin.

Recently, I saw a patient, a military professional, for a complaint of generalized weakness. When I examined him, my first thought was that he had been in a bar fight. He had large purplish-red raised macular areas over his jaw, shoulders and back. He then told me the lesions arose within a week of getting his second anthrax vaccine several months before. He also suffered from severe weakness, muscle pains and cognitive difficulties for the past month and reported that he was getting worse each day.

I gave him a broad-spectrum vitamin/mineral supplement as well as additional vitamin A, ascorbate and vitamin E. Within several days he began to feel better and by one week he was completely symptom free. All of his lesions completely disappeared and his energy level was as high as it had ever been. Even though this represents a single case, I think it is instructive. Poor nutrition has been known to not only significantly reduce the success of inoculation but also to increase the complication rate as well.

Based on a careful study of nutrition, I recommend the nutrient supplements below to reduce your risk during a bioterrorism attack.


The aim of supplementation is to increase your immune resistance, especially the part of your immune system that combats viruses, bacteria and rickettseia called cellular immunity. In addition, most of these organisms damage the body by stimulating free radical production and inflammation.

Many of the nutrient supplements can significantly reduce the impact of both.

1. The most important is beta 1,3/1,6-D-glucan. I would recommend the type that is combined with IP-6 (inositol phosphate-6). This will maximize the immune enhancement and the IP-6 will deny the organisms the iron they need to grow. I recommend the product by ImmuDyne called MacroForce/IP-6 (7.5mg.) You should take four capsules a day. Do not exceed this dose, since it becomes less effective beyond this. Children between the ages 8 to 12 should take two capsules a day. Below age eight, the dose is 2.5 mg a day. This is to be used in children only in a state of emergency.

I do not recommend taking this until an event is either eminent or has occurred, since this is such a powerful immune stimulant. You can take one capsule of the 7.5 mg dose every other day or a maintenance dose of the MacroForce 2.5mg, once daily.

2. Magnesium oxide 500mg. Take one twice a day with meals. If you develop diarrhea or abdominal cramping, change to magnesium citramate, two capsules twice a day. Magnesium will reduce many of the symptoms of these infections and may counteract the LT and Edema toxin of anthrax.

3. Vitamin C (buffered) 500mg. Take three tablets three times a day. This boosts the immune system and has direct antiviral effects. Do not take with food and do not eat for one hour after taking it to prevent excess iron absorption.

4. Vitamin E succinate 400IU. This boosts immunity, reduces membrane injury and reduces inflammatory eicosanoid activation. Take one three times a day.

5. Probiotic with Lactobacillus and Bifidus organisms. Take three capsules at bedtime. This maintains the normal flora of your colon. Add the NT FactorTM to this to enhance their growth. Take two tablets with the probiotic.

6. Selenium 200ug (as selenomethionine). This stimulates immunity and reduces free radical injury. It is also a radioprotectant.

7. N-acetyl L-cysteine 500mg. Take one three times a day. Shown to significantly reduce the symptoms of viral illnesses. It markedly enhances cellular glutathione levels.

8. Curcumin 500mg. Take three times a day. Protects against free radical injury and reduces inflammation.

9. Garlic extract 600mg. Take one twice a day. Garlic is a very powerful antibacterial and antiviral supplement. The real advantage is that bacteria never develop resistance to garlic extract. In addition it increases NO production that is reduced by the LT toxin of anthrax.

10. Multivitamin/Mineral (without iron). Take one three times a day. Should be a powder in a capsule or a loose powder. It should contain at least 20mg of the "B" vitamins, 400ug of folate and 500ug of B12.

11. Vitamin A 7000 to 10,000IU. Take two a day. This enhances the effectiveness of vaccines and reduces the damaging effects of viral infections. For children under 8 years of age, take one a day. In small children use mixed carotenoids with 25,000IU beta-carotene (derived from the algae D, Salina). There is no toxicity with the carotenoids and an adequate amount will be converted to vitamin A. Combining vitamin A with the carotenoids has a synergestic effect.

12. DHA 100mg. Take one capsule three times a day. This oil stimulates the immune system and promotes cellular repair. Keep this oil refrigerated.

Other Things to Do

You should avoid immune suppressing omega-6 oils such as corn, safflower, sunflower, peanut, soybean and Canola oil. Use only extravirgin olive oil for cooking and for salad dressings.

Avoid red meat, especially beef, since it is high in iron. Iron powerfully promotes the growth and spread of viruses and bacteria. Do not take any iron supplements.

Avoid high sugar diets. Glucose promotes bacterial growth and suppresses the immune system.

Eat lots of fresh vegetables and some fruits.

Avoid processed foods containing MSG and aspartame.


1. Rohdewald P. Pycnogenol. In Rice-Evans CA and Packer L ( Eds), Flavonoids in Health and Disease. Marcel Dekker, Inc, New York, 1998, pp. 405-419.
2. Lesourd BM, Mazari L, Ferry M. The role of nutrition in immunity on the aged. Nutritional Reviews 1998;56:S113-S125.
3. Girodon F, Lobard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab 1997;41:98-107.
4. Gogu SR, Blumberg JB. Vitamin E enhances murine natural killer cell cytotoxicity against YAC-1 tumor cells. J Nutritional Immunology 1992;1: 31-38.
5. Santos MS, Gaziano JM, et al. ß-carotene-induced enhancement of natural killer cell activity in elderly men: an investigation of the role of cytokines. American Journal of Clinical Nutrition 1998;68:164-170.
6. Czop JK and Kay J. Isolation and characterization of beta-glucan receptors on human mononuclear phagocytes. J Exp Med 1992;173: 1511-1520.
7. Patchen ML, MacVittle TJ, Jackson WE. Postirradiation glucan administration enhances the radioprotective effects of WR-2721. Radiat Res 1989;117:59-69.
8. Preston R. The Hot Zone, Random House, New York, 1994, p 253.
9. Osterholm and Schwartz J. Living Terrors. What American Needs to Know to Survive the Coming Bioterrorist Catastrophe. Delecorte Press, New York, 2000.

Dr. Blaylock is a member of the Editorial Board of the Medical Sentinel, Clinical Assistant Professor, Department of Neurosurgery, University of Mississippi at Jackson, and President of Advanced Nutritional Concepts in Jackson, Mississippi. His e-mail is: [email protected].

Originally published in the Medical Sentinel 2001;6(4):134-136. Copyright ©2001Association of American Physicians and Surgeons (AAPS).