When it comes to immune health, it is essential for brand owners to determine what type of immune support they’re trying to provide through a formulation.
a. A person thinks they may be coming down with a cold or flu—they need something to stimulate immune response.
b. A person has a chronic immune weakness such as allergies, colds, flu, etc. —they need something for long-term support of immune functionality.
c. A person has an autoimmune or overactive immune response—they need something to modulate or even downregulate immune function.
d. A person has chronic inflammation such as joint pain, cardiovascular problems, etc.—they need something to support the body’s response to inflammation (inflammation is an initial response by the immune system to potential harm from things such as physical trauma, bacteria, virus, etc.).
Of these, supplement manufacturers should keep in mind that the first two are what most consumers think about when a product is touted as an immune health product. They are either sick and need acute help to stimulate the immune system, or they’re looking for long-term benefits to support the immune system and its functionality. The following examples of both short- and long-term nutraceutical ingredients for immune health are but a few of the numerous immune support ingredients with scientific substantiation.
- Vitamin C acts by increasing lymphocyte activity, phagocyte function, leukocyte mobility, antibody and interferon production.1,2,3 In general, high doses of vitamin C need to be consumed daily in order to activate the immune system. Products containing small amounts of vitamin C provide little to no benefit to a person seeking an immediate immune response.
- Echinacea acts by activating many critical cells involved with a healthy immune response to infection, such as neutrophils, macrophages, leukocytes, natural killer (NK) cells and other chemical messengers.4
- Elderberry has several effects, including antiviral and immunomodulating effects, and it inhibits the replication of several strains of influenza viruses A and B,5 as well as H1N1 "swine" flu.6 It also increases the production of inflammatory cytokines, such as interleukins (ILs) and tumor necrosis factor (TNF).7 One of the unique properties of elderberry is it is a botanical extract offering both acute and long-term use benefits for immune health.
- Zinc is essential for neutrophil, NK cell and T-lymphocyte function.8 For acute use, zinc appears to be beneficial when used orally as a lozenge and taken frequently throughout the day—not in one large dose, swallowed whole.9
- Medicinal mushrooms such as chaga, reishi, maitake, shitake and cordyceps impact lymphocytes, macrophages, T cells and NK cells.10
- 1,3/1,6 beta-glucan increases macrophage phagocytosis of tumor cells, increases the cytotoxicity of NK cells and stimulates the release of IL-1 and TNF.11
- Probiotics offer beneficial impacts by different mechanisms, including their capacity to increase the intestinal barrier function, prevent pathogenic bacterial movement and modulate inflammation.12 Since an estimated 70% of the immune system originates in the gut,13 supporting the microbiome can play a positive role in immune health.
- In numerous published clinical studies, low blood levels of vitamin D have been correlated with an increased risk of infections.14 A secondary analysis of the Third National Health and Nutrition Examination Survey (NHANES) examined serum D levels of nearly 19,000 participants. The results suggested lower vitamin D levels were associated with higher episodes of self-reported upper respiratory tract infections (URTIs).15 For vitamin D to be beneficial, it is advisable to get vitamin D testing done to ensure the proper amounts are consumed.
David Foreman is a registered pharmacist, author and media personality known to consumers internationally as “The Herbal Pharmacist.” A background in pharmacy and natural medicine puts him in an elite class of health experts who can teach integrative medicine practices. Foreman helps consumers achieve health and vitality through his four pillars of health: diet, exercise, spirituality and supplements. A graduate of the University of South Carolina College of Pharmacy, Foreman currently serves on the Organic & Natural Health Association’s (O&N) scientific advisory board and is the author of “4 Pillars of Health: Heart Disease.”
1 Leibovitz B, Siegel BV. “Ascorbic acid and the immune response.” Adv Exp Med Biol. 1981;135:1-25.
2 Vilter RW. “Nutritional aspects of ascorbic acid: uses and abuses.” West J Med. 1980;133:485-492.
3 Smogorzewska EM, Layward L, Soothill JF. “T lymphocyte mobility: defects and effects of ascorbic acid, histamine, and complexed IgG.” Clin.Exp.Immunol. 1981;43(1):174-179.
4 Manayi A, Vazirian M, Saeidnia S. “Echinacea purpurea: Pharmacology, phytochemistry, and analysis methods.” Pharmacogn Rev. 2015;9(17):63-72.
5 Zakay-Rones Z et al. “Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama.” J Altern Complement Med. 1995;1:361-369.
6 Roschek B et al. “Elderberry flavonoids bind to and prevent H1N1 infection in vitro.” Phytochemistry. 2009;70:1255-1261.
7 Barak V, Halperin T, Kalickman I. “The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines.” Eur Cytokine Netw. 2001;12:290-296.
8 Shankar AH, Prasad AS. “Zinc and immune function: the biological basis of altered resistance to infection.” Am J Clin Nutr. 1998;68:447S-463S.
9 Mossad SB et al. “Zinc gluconate lozenges for treating the common cold. A randomized, double-blind, placebo-controlled study.” Ann Intern Med. 1996;125:81-88.
10 Guggenheim AG, Wright KM, Zwickey HL. “Immune Modulation From Five Major Mushrooms: Application to Integrative Oncology.” Integr Med (Encinitas). 2014;13(1):32-44.
11 Stier H, Ebbeskotte V, Gruenwald J. “Immune-modulatory effects of dietary Yeast Beta-1,3/1,6-D-glucan.” Nutr J. 2014;13:38 (2014).
12 Plaza-Díaz J et al. “Immune-Mediated Mechanisms of Action of Probiotics and Synbiotics in Treating Pediatric Intestinal Diseases.” Nutrients. 2018;10(1):42.
13 Vighi G et al. “Allergy and the gastrointestinal system.” Clin Exp Immunol. 2008;153(Suppl 1):3-6.
14 Cannell JJ et al. “Epidemic influenza and vitamin D.” Epidemiol Infect. 2006;134(6):1129-1140.
15 Ginde AA, Mansbach JM, Camargo Jr. CA. “Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey.” Arch Intern Med. 2009;169(4):384-390.