Treating Immunodeficiency with IVIG Therapy

If you suffer from primary immunodeficiency disease or continue to experience symptoms of infection after receiving conventional treatment, intravenous immunoglobulin (IVIG) therapy may be the right treatment for restoring a healthy immune response.

And here at Restoration Healthcare, our medical director — Dr. Sunny Raleigh — is highly proficient in diagnosing primary immunodeficiency and prescribing and managing the delivery of IVIG.

According to the U.S. Centers for Disease Control and Prevention (CDC), “People with weakened immune systems are at higher risk of getting severely sick from SARS-CoV-2, the virus that causes COVID-19. They may also remain infectious for a longer period of time than others with COVID-19…”

While certainly timely, the CDC’s statement is true of any infectious illness. If you have a compromised immune system or an immunodeficiency (an inadequate immune response due to an absence or reduction of antibodies, immune cells, or both), you will likely suffer more frequent, more severe, and longer-lasting infections.

The list of conditions and treatments that can weaken a person’s immune system, according to the CDC, include the following:

• Cancer
• Bone marrow transplant
• Solid organ transplant
• Stem cells for cancer treatment
• Genetic immune deficiencies
• Human immunodeficiency virus (HIV)
• Use of oral or intravenous corticosteroids or other medicines called immunosuppressants that lower the body’s ability to fight some infections. Examples include mycophenolate, sirolimus, cyclosporine, tacrolimus, etanercept, rituximab.

Admittedly, that’s a very short list of conditions and treatments that can contribute to a weakened immune system. To that list, we here at Restoration Healthcare would add at least the following:

• Primary immunodeficiency disease (PIDD) — a group of genetic disorders in which essential functions of an individual’s immune system are intrinsically impaired
• Exposure to environmental toxins and unhealthy substances in food products
• Dysbiosis (an imbalance of gut microbes) — the gut is responsible for about 70 percent of immune function
• Nutritional deficiencies — deficiencies in zinc, selenium, iron, copper, folic acid, and vitamins A, B6, D, and E can negatively impact immune response
• Emotional stress, which increases cortisol levels
• Poor sleep (quantity or quality)
• Hidden infections — viruses and bacteria can remain “dormant” in the body long after symptoms of infection are gone. For example, the virus that causes chicken pox may remain hidden for decades and then reactivate to cause shingles.

In this post, we introduce you to intravenous immunoglobulin (IVIG) therapy and share why it may be useful for restoring a healthy immune response.

What Is Intravenous Immunoglobulin (IVIG)?

IVIG (intravenous immunoglobulin) contains a variety of antibodies (proteins that fight infection) delivered intravenously (through a vein). Every time you get a bacterial, viral, fungal, or parasitic infection, your body’s immune system creates a unique antibody to fight it. Over the course of your life, your body manufactures thousands of different antibodies, each uniquely designed to attack a specific pathogen (a disease-causing organism).

IVIG is a diverse and highly concentrated collection of antibodies extracted from the blood of thousands of healthy individuals. If your own body is not producing the antibodies you need to fight infection — or is not producing these antibodies in sufficient quantities — IVIG may help address the deficit.

An infusion typically takes an hour or longer, depending on the dose recommended for your weight and the reason you’re receiving treatment. The dose is lower if you’re supplementing for the antibodies your body isn’t producing. The dose is higher if it’s being used to treat an autoimmune condition (the immune system attacking healthy cells of the body).

With a prescription from your Restoration Healthcare physician, we perform IVIG treatments in our functional medicine clinic in Irvine.

Do You Need IVIG?

Whether you need IVIG depends on several factors. If your body’s immune system is capable of producing the antibodies it needs but isn’t doing so for some reason, we would rather find other ways than using IVIG to restore its health and function. In our medical practices, it’s important know why your immune system isn’t functioning as it should and then address the underlying causes. Sometimes, IVIG can be useful in these situations to provide the immune system with a temporary boost, while we implement longer-term solutions, such as detoxing the body, reducing stress, making dietary changes, and so on. These longer-term solutions often take more time to deliver results. In the meantime, IVIG can make you feel better faster.

That said, IVIG may be necessary in two specific situations:

1. You have humoral immunodeficiency, meaning your body isn’t equipped to produce enough antibodies. IVIG makes up for the deficiency. The antibodies remain in your system for several weeks, after which you should receive another dose.
2. You have an autoimmune condition in which the immune system attacks your own blood cells, blood platelets, nerve cells, or other healthy cells of your body. We don’t know yet how IVIG helps with autoimmune conditions, but it seems to be effective in down-regulating the immune system to a point at which it no longer attacks healthy cells.

Possible Side Effects

Any medical treatment carries possible side effects, and IVIG is no different in that respect. Common side effects, which tend to be mild, include the following:

• Headache
• Chills
• Fever
• Flushing
• Flu-like muscle or joint pain
• Tiredness
• Nausea/vomiting
• Allergic-like reactions

More serious but less common side effects to IVIG therapy include allergic reactions, blood clots, rashes, kidney problems, and low blood counts. Nearly all side effects can be mitigated in the following ways:

• Performing specific blood tests before starting treatment
• Changing the brand of IVIG used
• Lowering the dosage or dividing it into several doses spread out over several days
• Delivering the infusion more gradually
• Delivering the antibodies subcutaneously (under the skin) or intramuscularly (into muscle tissue)
• Staying well hydrated
• Taking an over-the-counter pain medication that we recommend
• Taking aspirin (if you’re allowed) and/or avoiding sitting for long periods of time to prevent blood clots

Risk of Infection

While we’re advocates of testing for primary immunodeficiency and autoimmune response — and then using intravenous immunoglobulin if and when called for — some people are concerned that because the antibodies are extracted from the blood of numerous people, the IVIG product might contain a bacteria or virus, such as the hepatitis or AIDS virus. Due to the way IVIG is manufactured, this possibility is extremely low, especially given the fact that we use products from reputable labs here in the U.S. The process used to purify IVIG destroys bacteria, viruses, fungi, and other infectious organisms. In addition, IVIG lot numbers are identified and tracked closely, so if an issue does arise, the affected products can be quickly removed from circulation.

Alternatives for Treating Autoimmunity

Although IVIG is often used to help in the treatment of autoimmunity and primary immunodeficiency, other treatments are available and may offer better outcomes alone or in combination with IVIG.

Relatively recent research suggests that intestinal permeability plays a major role in autoimmune disorders. Imbalances in the gut, such as dysbiosis, can interfere with tight junctions of cells that line the gut, allowing food particles, toxic agents, microorganisms, and bacterial byproducts to “leak” out through the lining and trigger an immune response that can culminate in autoimmunity. Restoring equilibrium in gut microbiota and repairing the mucosal barrier in the gut are key to stopping the progression of autoimmune conditions and possibly reversing the course of autoimmunity.

Also important is down-regulating the immune system, so it’s not so reactive. While conventional medicine relies mostly on glucocorticoids such as prednisone and dexamethasone to suppress the immune response, certain supplements can be used to down-regulate the immune system more gently, so it functions properly instead of not at all. Treating the inflammation that results from an over-active immune system is also important in restoring health and alleviating symptoms.

Remember that effective treatment for any illness begins with an accurate and thorough diagnosis, not merely to identify the illness but more importantly to identify the cause(s). Don’t settle for quick fixes, even IVIG. The objective isn’t merely to alleviate symptoms or even to supplement for what your body should be producing and isn’t — it’s to restore proper health and function, so your body functions the way it is supposed to.

If you are experiencing frequent, severe, or prolonged infections, it’s important to find out why and address any underlying issues. Here at Restoration Healthcare, we encourage you to schedule an appointment with one of our integrative and function medicine practitioners who will conduct a thorough physical exam, medical history, and testing to identify any and all factors that may be negatively impacting your immune response. Then we develop a personalized treatment plan that targets all contributing factors and places you on the road to optimal health and fitness.

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Disclaimer: The information in this blog post about intravenous immunoglobulin (IVIG), is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at Restoration Healthcare, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.