immune that comes and goes

Overview

The immune system is your body's natural defense against infections and illness. Sometimes it may feel like your immunity 'comes and goes' – you have periods of feeling well, then develop frequent infections or symptoms like tiredness, swollen glands, and fever that fade and return. This is not a single disease but a pattern that can have many causes, from everyday factors like stress and poor sleep to more long-term conditions that affect the immune system.

It is very common to have occasional dips in immunity, such as after a viral illness or during a stressful life period. However, a consistent pattern of 'coming and going' immune problems over months is less common and may need medical review.

It can affect people of all ages. Children, adults, and older people may all experience fluctuating immune-related symptoms, but the likely causes differ depending on age and other health conditions.

Symptoms

Common symptoms

• Frequent infections such as colds, sinusitis, bronchitis, or ear infections
• Tiredness that comes and goes without a clear reason
• Feeling generally unwell, with body aches or chills
• Swollen or tender lymph nodes (glands) that enlarge and shrink
• Fevers that appear and then fade
• Mouth ulcers, cold sores, or skin rashes that keep coming back

Symptoms in children

• Recurrent ear infections or chest infections
• Persistent thrush (white patches in the mouth)
• Slow growth or difficulty gaining weight
• Needing repeated courses of antibiotics without full recovery

Symptoms in older adults

• More frequent or more severe infections than usual
• Slow recovery from illnesses
• Unexplained weight loss or loss of appetite
• Increased confusion during infections

Causes

Main causes

• High stress or poor sleep, which can temporarily lower immune defenses
• Nutritional deficiencies, such as low levels of certain vitamins or minerals
• Autoimmune conditions where the immune system attacks the body in flare-ups and remissions
• Primary immunodeficiencies – inborn conditions that make the immune system weaker
• Chronic infections that tax the immune system (for example, viral infections)
• Certain medicines that change how the immune system works
• Natural ageing, which makes the immune system less efficient

Risk factors

• Chronic stress or burnout
• Underlying chronic illnesses such as diabetes or asthma
• Poor hygiene or crowded living conditions
• A diet lacking in key nutrients
• Smoking or heavy alcohol use
• A family history of immune disorders

When to see a doctor

See a doctor urgently if:

• You keep getting infections that need antibiotics more than two or three times a year
• Infections are unusually severe or slow to clear
• You have an ongoing fever for no obvious reason
• You are losing weight without trying

Book a routine appointment if:

• You notice a clear pattern of symptoms that come and go over several months
• Your energy levels are affecting your daily life or work
• You have concerns about your child's frequent infections or growth

Diagnosis

A doctor will ask about your medical history, your symptoms and how long they last, and any patterns you have noticed. They may refer you to a specialist in immune medicine (an immunologist) if they suspect an underlying problem. A diagnosis may take time because many conditions affect the immune system differently.

Tests that may be done

• Blood tests to look at white blood cell counts and immune markers
• Tests for levels of immunoglobulins (proteins that fight infection)
• Tests for inflammatory markers or specific antibodies
• X-rays or scans to check for chest infections or other problems
• Swabs or cultures from infected areas to find the cause of repeated infections

What to expect at your appointment

You may need more than one appointment. Blood tests will be repeated over time to see if patterns emerge. The doctor will explain any results in plain language and tell you whether more tests are needed. Referral to a specialist can take a few weeks.

Treatment

Treatment depends entirely on the underlying cause. For many people, improving sleep, managing stress, and eating well can strengthen the immune system. If an immune condition is found, treatment will focus on supporting the immune system or calming it down, depending on the problem.

Self-care at home

• Get seven to nine hours of sleep most nights
• Find ways to manage stress, such as breathing exercises, walking, or talking to someone you trust
• Wash your hands regularly to avoid infections
• Stay up to date with a healthy, balanced routine
• Avoid smoking and limit alcohol

Medical treatments

If an underlying infection is present, doctors may prescribe appropriate medicines. For conditions where the immune system is underactive, treatment may include infusions of immune proteins (immunoglobulins) or growth factors to help the body make immune cells. If the immune system is overactive, as in some autoimmune conditions, treatment may involve medicines that reduce or control inflammation. Your healthcare team will explain the options and form a plan with you.

When is surgery considered?

Surgery is not usually needed for fluctuating immune function itself. Occasionally, a biopsy of a swollen lymph node or other tissue may be done to help diagnose a condition, but this is rare.

Living with this condition

Pace yourself. Listen to your body and rest when you feel unwell, but try to keep up gentle routines when you are well. Keeping a symptom diary can help you see patterns and gives your doctor useful information.

Lifestyle tips

• Build a regular sleep routine
• Stay physically active most days, even with short walks
• Use stress-reduction techniques like mindfulness or hobbies you enjoy
• Avoid close contact with people who are sick
• Keep your living spaces clean and ventilated

Diet and exercise

Eat a varied diet with fruits, vegetables, whole grains, and lean proteins. Drink enough water and limit sugary or processed foods. Regular exercise – such as walking, swimming, or cycling – can boost your energy and support immune health, but avoid overtraining when you feel tired.

Mental health and emotional wellbeing

Living with recurring symptoms can be frustrating and worrying. It is normal to feel anxious or low at times. If you notice these feelings lasting more than a couple of weeks, talk to your doctor. Taking care of your emotional health is just as important as your physical health.

Prevention

You cannot always prevent an underlying immune condition, but you can reduce your risk of infections and support your immune system by maintaining good sleep, nutrition, exercise, and stress management. Practising good hygiene is also key.

Vaccines

Keep up to date with recommended vaccines, such as flu and COVID-19 vaccines. If you have an immune condition, check with your doctor which vaccines are safe and advisable for you.

Screening programmes

Routine screening is not normally needed if you are generally healthy. If you have a known immune disorder, your doctor may suggest regular blood tests to monitor your immune function.

Complications

If left untreated

• More frequent or more severe infections that may need hospital care
• Lung damage from repeated chest infections
• Poor growth or development in children
• Higher risk of complications from common illnesses
• A reduced quality of life due to ongoing symptoms

Long-term outlook

For most people, symptoms can be managed or improve with the right approach. Even when an underlying condition is present, many treatments can help keep infections under control and restore a good quality of life. Working closely with your healthcare team gives you the best chance of feeling well.

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