# Nutrition in Primary Immunodeficiencies
Malnutrition and Protein Synthesis
In severe primary immunodeficiencies, immune cells are continuously damaged or lost. This costs the body extra energy and building materials, especially proteins. Malnutrition develops easily, especially when chronic infections or intestinal disorders such as chronic diarrhea occur.
ProveniIncluded in official guidelines, or approved by EMA or FDA
An adequate intake of proteins contributes to the recovery and production of immune cells. In many patients it is difficult to take in sufficient proteins through normal diet, particularly after intestinal infections or when appetite is reduced by illness.
Some patients benefit from nutrition that is easier to absorb. A dietitian can investigate which foods are well tolerated and what additional support may be needed.
Nutritional Loss Through Diarrhea
Chronic diarrhea occurs in certain immunodeficiencies, especially when infections damage the intestinal mucosa. This leads to loss of nutrients, electrolytes and fluid.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Frequent, watery stools increase the risk of dehydration and deficiency in essential minerals such as sodium, potassium and magnesium.
The choice of food can be important here. Foods that are easily absorbed by the intestines can reduce symptoms. However, this varies greatly from person to person. A dietitian or gastroenterologist can help determine what is best tolerated.
Vitamin and mineral deficiencies
Through diarrhea, reduced absorption or increased needs, deficiencies can develop in vitamins and minerals.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Zinc, selenium, vitamin A, D and B12 all play a role in the proper functioning of the immune system. Deficiencies in these substances further impair immune function.
Whether and which supplements are needed varies per person and per type of immunodeficiency. This should always be discussed with your healthcare provider, as certain supplements can interfere with certain treatments or tests.
Interactions with Medicines and Treatments
Many patients with severe immunodeficiencies receive antibiotics for longer periods, antiviral agents or replacement therapies (such as immunoglobulins).
ProveniIncluded in official guidelines, or approved by EMA or FDA
Some antibiotics can disrupt the absorption of certain nutrients or damage gut bacteria, which affects digestion. This occurs especially with prolonged use.
Certain foods can affect how medicines work. This is something to discuss with your pharmacist or doctor, especially since immunodeficiencies often require complex medication regimens.
Nutrition and infection risk
Poorly nourished patients generally suffer more from infections and have slower recovery.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Good nutritional status helps the body defend itself better against infections, even if that immune system is already compromised.
This usually justifies attention to adequate calorie intake and good nutrition, but nutritional recommendations generally do not go much further without personal advice.
Food Aversions and Psychological Aspects
Patients with long-term illness sometimes develop aversions to certain foods (especially after hospital stays or intensive treatments). Fear of infection can also prevent normal eating.
This is real and understandable. Support from a dietitian, psychologist or social worker can help ensure adequate intake and restore enjoyment of food.
Probiotic Products and Gut Health
There is research into the benefits of probiotic products (food with 'good bacteria') in immunodeficiencies, especially after prolonged antibiotic use.
ResearchediPositive results in clinical studies, not yet standard treatment
It is plausible that recovery of healthy gut bacteria helps improve the intestinal barrier and possibly also immune function. However, this has not yet been definitively established and varies depending on the type of immunodeficiency.
Whether probiotic products are useful in your case should be discussed with your doctor or dietitian.
Safe Food and Food Safety
In severe immunodeficiencies, certain foods can contain harmful bacteria that are harmless for healthy people, but may pose risks for you.
ProveniIncluded in official guidelines, or approved by EMA or FDA
Risk foods (raw meat, unpasteurized milk, certain raw vegetable salads) can lead to serious infections.
Your doctor or nurse will inform you which foods you should better avoid based on your specific immunodeficiency and treatment.
Personal nutrition choices
Each case of primary immunodeficiency is different. What works well for one person may not be suitable for another.
That is why it is important to discuss food choices with your own team: your doctor, dietitian, nurse or gastroenterologist. They know your specific situation, medicines, symptoms and how your body responds.
---
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._