germ theory vs terrain theory

Are You Wearing Your INNER Mask? Understanding Germ Theory vs Terrain Theory

by Dr. Jamie Chan-Ortega, Ph.D. 12/20/20

Throughout this topsy-turvy year of the coronavirus pandemic, we’ve heard again and again to wear our masks, wash our hands, and social distance. These external measures of hygiene and safety are important and have their roots in germ theory, which undergirds public health. When it comes to germ theory vs terrain theory, there are supporters on both sides, and reasons for and against each, as detailed below.

But what we have not been hearing much of, nor been given much advice on, is our inner shield, or our inner “mask,” if you will. I’m talking about our immune systems and optimizing our internal human body defenses. Germs seek to damage. In order to remain in good health, one must have strong internal defenses. This is the “terrain” theory of health and undergirds personal health and wellness.

With the conventional germ theory, we have a focus on the germ, the virus, and the threatening microscopic bugs that exist in the environment and other people. These microbes – and their presence on other people – are external and more difficult, if not impossible, to control.

With the terrain theory, the focus is on the host, ourselves, our biology, our inner environment of cellular health, and our inside “mask” or “shield” of immune defenses and immune intelligence. These are internal and more directly under our control.

Is one approach better than the other? Should we care more about external measures of protection like social distancing and masks to please germ theory issues? Or should we be more concerned about terrain theory and optimizing our internal terrain of personal health and immune resiliency?

I am, in many cases, a centrist. I take a balanced approach to most issues. I often ask the question: Must it be either/or? Must the answer be mutually exclusive? In the case of external masks and “internal masks,” why not do both?

As a functional medicine practitioner and a doctor of natural health sciences, my concern – and honestly, my gripe – is that there has been an exorbitant amount of talk about external measures of protection against the coronavirus (such as with germ theory), but very little guidance on internal measures of protection and prevention. One of the most compelling reasons to optimize the host’s terrain, aka your own bodily health, is the mechanism by which the coronavirus damages the host’s tissues so quickly and severely. When infected, the virus triggers a sudden and intense systemic inflammatory response within the host’s body. This is called a cytokine storm. Cytokines are immune cells that modulate inflammation. The cytokine storm signature of the coronavirus is marked by a sudden increase in circulating pro-inflammatory cytokines. This acute, body-wide inflammatory response is what makes the coronavirus so deadly.

But here’s the catch: this cytokine storm is most likely to occur in people whose immune systems have already been primed with inflammation. This is most evident when we examine the terrain theory and look at populations who suffer most from the coronavirus: people with pre-existing inflammatory conditions like obesity, diabetes, heart disease, cancer, autoimmune diseases, and asthma. And my goodness, that covers – unfortunately – most Americans, because most Americans have proinflammatory lifestyles and eat proinflammatory foods. If you do not have any inflammatory conditions and if your general level of internal inflammation is low, your immune system will not have been primed or activated, and will therefore not have an augmented inflammatory reaction if infected by the coronavirus.

Another way to look at it is you don’t necessarily want a “strong” immune system that will fire off all its inflammatory guns the moment a virus enters our terrain, and you certainly don’t want a “weak” immune system that doesn’t respond effectively to a threat. Terrain theory believes you actually want an intelligent and balanced immune response, where the right amount of inflammation occurs to fight and defend against the microbe, but not so much that it sends you into a bodywide storm of unchecked inflammation that severely damages your own tissues.

So of course we want to never even come in contact with the virus in the first place. External measures of social distancing, handwashing, and masks do help with that, which germ theory supports. But if for some reason we are exposed to the virus and become infected, we can greatly increase our chances of a quick and complete recovery if our internal terrain is not already inflamed.


  • Avoid sugars and refined carbs (which are inflammatory). This is major. This is basic. Get a handle on this one because avoiding processed carbs and sugars is FUNDAMENTAL to reducing co-morbidities like obesity, diabetes, and heart disease that make you exponentially more susceptible to the coronavirus. Insufficient diets with toxic chemicals can wreak your internal defenses.
  • Secure 7 hours of quality sleep every night
  • Eat an abundance of whole, nutrient-rich, deeply-pigmented vegetables and fruits (shoot for 6-9 cups a day)
  • Consume ample good fats like avocado, coconut oil, olive oil, salmon, seeds, and nuts, including high-potency omega-3 fish oils.
  • When eating animal proteins, eat small amounts of only clean, grass-fed in their natural habitat, pastured meats rather than industrial meats (the latter of which are higher in pro-inflammatory omega-6 essential fatty acids)
  • Optimize digestion by eating mindfully and supporting with digestive enzymes and hydrochloric acid so that your immune system doesn’t react to partially digested proteins (poorly digested proteins can become antigenic and rev up your immune system in a bad way)
  • Lose that excess weight (because fat releases pro-inflammatory chemicals)
  • Engage in positive outlets for stress (because chronic stress is, you guessed it, inflammatory. 
  • Take Vitamin D. This is one of the best, most affordable immune-supportive supplements you can take. Vitamin D has long been known to regulate immune cells and the production of inflammatory cytokines.
  • Reduce your toxic load. Eat organic, stop drinking out of BPA-loaded water bottles, and switch to non-toxic bath and beauty products so you’re not constantly absorbing toxins through your skin. For detoxification support that doubles as immune support, take NAC (n-acetyl-cysteine) and liposomal glutathione (available for in-office purchase only, as it requires refrigeration). NAC is my personal favorite because it has an affinity for lung tissue and is a powerhouse of an antioxidant.
  • Take anti-inflammatory botanicals like CBD. My line of CBD oils and cream is organic, produced in an FDA-approved lab, and 3rd-party tested for purity and integrity. Most of all, they are effective.



GI-MAP Gut Microbial Test

The GI-MAP contains human body biomarkers for digestion and absorption, inflammation, immune function, parasites, bacteria, viruses, and autoimmune triggers. Whether or not you have GI symptoms, this test is essential for determining the root causes of illnesses, because the GI tract and all its many functions (digestion of foods, absorption of nutrients, gut lining barrier against toxins, gut-derived immune responses) are so fundamental to health.

DUTCH Complete Hormone Test

The DUTCH tests check your levels and patterns of stress hormones, along with the levels of your sex hormones and how they’re being metabolized in your body. It’s a must-do test if you have chronic stress, fatigue, or any symptoms of hormone imbalance like irregular periods, PMS, hot flashes, low libido, or hair loss. The status of your stress response and hormone balance directly relates to your immune health and level of inflammation.

 IgG Food Sensitivity Test

The Great Plains Lab recently expanded this test to cover a whopping 190 food allergens plus candida and yeasts. Food sensitivities are pervasive and chip away at our gut immune function. Chronic food sensitivities also create a chronic, low level of inflammation and adrenal stress. This test makes it plain and clear which foods are triggering our immune system, so we can take decisive action in decreasing or eliminating these foods from our diet and focus on healing the gut.

SIBO – Small Intestine Bacterial Overgrowth Test

If you experience “baby belly” and significant bloating or discomfort after meals, you may have SIBO. This test definitely reveals if you have an overgrowth of bacteria in your small intestine, and differentiates which type of bacteria is overgrown. SIBO often leads to inflammation, leaky gut, impaired digestion and absorption of nutrients, and weakened intestinal motility which leads to constipation and increased toxic buildup produced by the bad bacterial overgrowth. (Available for purchase in-office or over the phone)

Organix Comprehensive Metabolic Test

This test provides a “metabolic snapshot of a patient’s overall health.” The Organix test gives insight into how well your body is metabolizing fats, proteins, and carbohydrates. It also tests for cellular energy production, B vitamins, detoxification pathways, oxidative stress (the “rusting” or wear-and-tear of your cells), neurotransmitter health, and gut health like yeasts and bacteria.  For an overall picture of what’s going on in your internal terrain, the Organix test gives you the most bang for your buck. 

Wellness is everything; it’s about physical health, strength, and energy. It’s about resiliency and the ability to bounce back quickly – whether it’s from a viral infection, a loss, or a sudden and unexpected change of events. It’s about having a sound and lucid mind. And it’s about having a spirit of power, not fear.

My mission is to empower people with the knowledge and tools they need to be truly well. This is why I believe understanding the differences between germ theory vs terrain theory is so important. Would you like me to partner with you in your personal plan journey to greater wellness? I’d be honored and happy to help you. Call 562-789-1588 or schedule online for your Functional Medicine consultation with me in person or through video chat. I can’t wait to hear your story and help you get truly well.