Which products and lifestyle changes may best support a healthy immune system?
It starts as a tickle in the throat. Then a few sneezes. Before long, a full-blown cold, flu or another virus has incapacitated an otherwise healthy individual. What gives? Immune health is key to overall health and affects many other systems in the body. Even the healthiest person gets ill from time to time. Which practices and products might help boost the immune system so this happens less often?
While individuals look at what methods they can implement to support immune health, natural health practitioners are looking at this information, too. How can they best support their patients in this area and which products might be most beneficial? Manufacturers of natural health products want to stay on top of current market trends. Many are asking what new ingredients may help strengthen one’s immune health. And everyone wonders: what effect has the pandemic had on the immune health market?
The Current Market for Immune Health
At ADM Protexin, Bio-Kult, a manufacturer based in Florida, Kim Plaza serves as a technical advisor. She cited statistics from the Council for Responsible Nutrition (CRN) 2022 annual survey of Americans.1 Supplement use, according to the survey, is back to pre-pandemic levels, where about 75 percent of people use nutritional supplements. Immune support product use is remaining steady from the previous year, said Plaza.
“The market size of immune-supporting supplements was valued at $55.3 billion in 2020,” said Plaza, citing the Immune Health Supplements Market Report, 2021-2028. “[This] is expected to grow at a compound annual growth rate (CAGR) of 11.3 percent from 2021 to 2028,” she noted. Plaza explained that there is a constant trend in this area of supplementation. “Consumers are possibly becoming ever more knowledgeable about specific supplements for specific uses,” Plaza said.
Curt Sculliuffo is a sales and marketing representative at EuroMedica, a manufacturer based in Wisconsin. He stated that in the post-pandemic world, the interest in immune function has waned slightly. “The market has slowed quite a bit since COVID has died down, but we expect things to pick up as usual for the winter months,” said Sculliuffo. “Although taking care of your immune system should be a year-round issue, we see lulls on these products during the warmer months.”
Stacey Smith, DC, is the marketing and communications manager, of NORAM at Gnosis by Lesaffre. The France-based manufacturer has a U.S. office in New Jersey. She stated that biotics, in particular probiotics, are being recognized in the marketplace for their impact on immune health. “Probiotics occupy an important place in the competitive market of immunity ingredients and are now perceived as a clear solution for consumers,” said Smith. “According to a 2020 survey from the CRN, probiotics are in the top five ingredients dedicated to immunity. In 2022, U.S. consumers showed a higher interest in probiotics, ranking even higher than zinc.”2
At Natural Path Silver Wings, a manufacturer based in Tennessee, Vice President of Sales & Marketing, Audra Dunleavy, MBA, shared her thoughts. “The demand has significantly increased for colloidal silver immune support products at unprecedented levels,” she stated. “Because of this, immune supplements have also reached a wider and larger general population like never before. Though immune supplement sales historically spike during the fall and winter months, during the past three years, the demand has not tapered off during the spring and summer seasons compared to the same time pre-pandemic,” she stated. People are still taking proactive steps to protect their immune systems throughout the entire year, rather than seasonally, Dunleavy said.
Has COVID-19 Affected the Immune Health Market?
Dr. Shirin Peters works with Bethany Medical Clinic located in New York. She shared an interesting view of how the pandemic has affected the immune health of the population at large. “Because of COVID restrictions for almost three years, our immune systems were collectively protected from exposure to common bacteria, viruses and fungi, which strengthen our general immunity and the ability to fight off future infection,” she noted.
Plaza, at ADM Protexin, Bio-Kult, pointed out that consumer focus has changed somewhat due to the pandemic. “A focus on ‘preventative medicine’ seems to have become more prominent, as consumers are no longer focused purely on symptomatic relief to treat acute infections but are instead looking to naturally support their immune system, on an on-going basis, to try and prevent ill-health from manifesting in the first place,” she said. Sales-wise, this has resulted in a sharp increase in the market. Where a previous market growth of one percent was observed, Plaza stated, the projected post-pandemic market growth is expected to be between 11.3 percent and 12 percent growth over the next five years.3
Omni-Biotic is a manufacturer located in New York. Pam Conboy, Healthcare Practitioner Support & Education, at the company, agreed that immune health is an area of increasing interest and growth. “Since the pandemic, almost everyone has started taking immune health seriously, which we expect will continue in the future.” Understanding the important role nutrition plays in immune health helps individuals be more prepared for whatever illnesses may arise, she said. Similarly, “Immune boosters, when taken regularly, can help reduce the symptoms of an illness and help reduce the period of sickness, making them a hit among consumers,” she noted.
Dr. Serena Goldstein, a naturopathic doctor based in Florida, stated that more deeply understanding all the different aspects that can affect immune health is important. COVID-19 caused more individuals to look for connections between illness and their lifestyle choices. Depression, stress, poor sleep and a diet high in sugar, alcohol and soda, as well as lack of exercise, can all contribute to a lower immune function. Likewise, Dr. Goldstein noted, inflammatory-related conditions, such as obesity, heart disease and metabolic syndrome, as well as others, can lower the immune system’s function.
“As functional medicine and naturopathic medicine have regularly preached ways we can look at the body and each organ system as interconnected to another system, I would also stress—no pun intended—to address our emotional health, and adopt more of a growth, free-thinking mindset to utilize information to improve our health and change our scripts,” she said. Personal growth and healing are just as important as, and can contribute to, physical healing, and in turn a healthier immune system.
Hank Cheatham is the vice president at Daiwa Health Development, a manufacturer in California. Cheatham stated that the challenge to the immune system is greater following the pandemic. “As a result of the COVID-19 pandemic, auto-immune disorders, flu and other diseases which challenge the immune system, have become more prevalent. It is essential for doctors and other health care professionals to become knowledgeable about natural products that can provide prevention by supporting one’s immunity.”
Cheatham pointed to the company’s product, BRM4, which may help to boost one’s immune system function. RBAC is the active ingredient in BRM4 and has been tested in more than 70 clinical trials and research studies, Cheatham noted. “RBAC is derived from rice bran, modified by shiitake mushroom enzyme; shown in research studies to be a true immune modulator and is proven safe.”
Following the pandemic, Ken Misher, product marketing manager at Standard Process, a manufacturer based in Wisconsin, stated that he continues to see a focus on immune health. This focus is influencing consumer purchasing, he said. “New product development has actually increased as manufacturers have hustled to deliver immune-fortifying products, particularly supplements, to new and existing customers. Customers want the latest science, flavors, delivery mechanisms, branding and marketing.”
And while traditional delivery formats like capsules and tablets continue to be popular, newer formats like gummies and beverages are growing rapidly, he stated. “People love the experience of eating gummies. Formats will continue to evolve as consumers look for unique ways to boost their immune health.”
Key Ingredients for Best Immune Health Support
In addition to BRM4, Cheatham said that Daiwa Health is excited about ImmunoLin, the active ingredient in Daiwa GastroImmune. This ingredient is a protein-based (>90 percent) dietary supplement containing more than 50 percent (w/w) immunoglobulins that help support digestive function and a healthy mucosal immune system, Cheatham explained. “The protein mixture found in ImmunoLin is serum-derived bovine immunoglobulin/protein isolate (SBI) and is manufactured using a tightly controlled and highly reproducible process at an FDA (U.S. Food and Drug Administration)-inspected facility,” he said.
Biotics are another key ingredient, said Smith. Because of ongoing stress and fatigue caused by modern life, most individuals’ natural defenses are bombarded regularly. “It is critical that we arm our bodies with the tools they need to fight these adversaries, and consumers are now aware that optimizing their immune system is key to staying healthy and performing well every day,” he said. “Enter biotics!”
The gut microbiome significantly impacts one’s health, and scientists are continuing to dive deeper into understanding more about all its complexities, added Smith. “Decades of research have shown that the microbiome and the gut’s microbial diversity can be modulated with many distinct pro- and prebiotics,” Smith noted. Gnosis by Lesaffre offers a powerful pro- and prebiotic combination that works synergistically to deliver proven immune support, he said.
Conboy stated that certain key ingredients are must-haves to support immune health. “Supplement brand owners must ensure their portfolio includes immune support supplements such as vitamin C, vitamin D and quercetin, which are sure to be in massive demand in the coming year,” she said. Likewise, products that include elderberry and zinc have also been shown to support the immune system, Conboy noted.
Dr. Goldstein stated that while vitamin C and zinc are important, there are other key ingredients to support the adrenal system, like holy basil and oats, both of which can be great tonics. “I also like mushroom blends such as cordyceps and reishi,” she said. Dr. Goldstein recommends that people see a naturopathic doctor who can help them choose the best supplements and therapies for their unique needs.
“I am personally thrilled to witness the heightened awareness about the power of quality nutritional supplements,” said Conboy. “Knowledge is power and people are becoming more educated.” She is also excited about the increased commitment by raw material and product manufacturers to provide solid evidence of efficacy utilizing preclinical and human clinical trials. “When conducted with the final, commercially available formulation (article of commerce), this data can provide consumers with a high level of confidence in the efficacy of the product and its relative value,” stated Conboy.
At EuroMedica, Sculliuffo stated, “Some of the most popular ingredients trending for immune support include quercetin, andrographis and elderberry. Then of course you have the tried and trusted favorites such as zinc, vitamin C and vitamin D,” he said. “When combined, many of these products work very well synergistically.”
At Life Extension, a manufacturer based in Florida, Vanessa Pavey, ND, is an education scientist. Dr. Pavey stated that while “tried-and-true” immune-supporting ingredients like zinc and vitamins C and D continue to be popular, something is changing in the marketplace. “Enhanced deliveries can set some of these ingredients apart in the competitive market for consumers,” she noted. “For example, combining liposomal vitamin C with a hydrogel made from fenugreek seed galactomannan fiber can help enhance bioavailability. Probiotics and postbiotics for specific health claims outside of the digestive realm are also catching the interest of consumers. And functional mushrooms are another ingredient area that has been expanding over the past couple of years and does not seem to be slowing down. Popular mushroom varieties include shiitake, maitake and chaga.”
While many individuals reach for vitamin C automatically when they feel run down, it’s important to know that there are limitations to this vitamin’s absorption in the body. “Vitamin C taken by mouth is absorbed through sodium-dependent vitamin C transporters (SVCT) in the digestive tract,” Dr. Pavey explained. In doses greater than 200 mg taken at once, this absorption may begin to slow down, she said. “Vitamin C in a liposomal form is not dependent on SVCT but is vulnerable to degradation by stomach acid and digestive enzyme activity. To overcome this, combining liposomal vitamin C in a hydrogel made from fenugreek seeds can help protect the liposome from the digestive process. This allows for up to seven times greater vitamin C plasma levels over a 24-hour period compared to unformulated vitamin C.” 4
At Natural Path Silver Wings, Dunleavy said that in addition to a healthy diet and lifestyle habits and good rest, there are three main supplement categories when it comes to immune health: traditional herbal ingredients—such as echinacea and oregano—along with vitamins such as vitamin C, D and E, and minerals. Minerals include things like zinc and colloidal silvers, she said. “Atomic colloidal silver in particular has been gaining ongoing popularity as an immune support supplement.”
What is colloidal silver? “Colloidal silver contains a mixture of pharmaceutical grade ultra-fine elemental silver mineral particles suspended in pharmaceutical grade ultra-pure water,” Dunleavy explained. “Practitioners typically recommend colloidal silver liquid supplements in either oral spray or dropper bottles,” she noted. Doses range depending on several factors, but typically a practitioner might recommend closer to 50 ppm daily, year-round for supporting immune health. That number might increase to as high as 500 ppm when one’s immune system is challenged, said Dunleavy.
Naturopathic Laison at Natural Processes, Daina Parent, ND, stated that individuals looking to support the immune systems of children may want to look closely at prebiotics—particularly the human milk oligosaccharide 2’-FL. It resists digestion and moves to the lower GI (gastrointestinal) tract where it becomes effective in feeding selective bacteria.5 “This is important for supporting the immune system and overall immune health as we know the gut is intimately connected to the immune response,” said Dr. Parent.
Most Exciting in the Immune Health Space Now
New advances in alternative health products, studies and research are exciting. Some of the most intriguing ingredients or products in the immune health space now are mushrooms and beta-glucans, said Kristin Chapman, MSc, category manager, also at Life Extension. “Whole dried mushrooms provide a variety of immune-modulating compounds including beta-glucans, the naturally occurring polysaccharides that help prime certain immune cells like natural killer (NK) cells,” 6 she said. “Combining whole dried mushrooms with highly purified beta-glucans from baker’s yeast can help supply the body with a variety of beta-glucans to help mount a healthy and effective immune response.”
Likewise, the entire plant echinacea—the roots, leaves, flowers and stems—contain a variety of bioactive substances, like echinacosides, alkamides and phenolic compounds that help provide a better chance of staying healthy all season long, Chapman explained. “For example, alkamides help support NK cell activity by suppressing inhibitors of the NK cells.”7
Lifestyle Practices That May Strengthen the Immune System
In addition to natural health products, there are basic things individuals can do regularly that may increase their immunity to disease. Dr. Peters stated that dirt plays an important role. “Spend time in nature and get hands and feet dirty,” she said. “Make sure to get adequate vitamin D in your diet and daily sunlight exposure.” This is because vitamin D plays an important role in the immune system. Additionally, Dr. Peters recommended that individuals, “Get a balanced diet comprised mostly of whole foods and fresh locally sourced produce for adequate vitamins and minerals to boost immunity.”
While hand sanitizer may play an important role in protecting individuals from infection, Dr. Peters said it’s important to avoid overusing it. “When hiking or spending time outdoors in non-urban areas, try to avoid using sanitizer which would kill the good bacteria you are exposed to,” she said. Already sick? Reaching for one key supplement is likely to be beneficial. “Zinc tablets do shorten the duration of common cold symptoms,” said Dr. Peters.
Dr. Goldstein noted that laughter is great medicine and recommends that her patients find a way to add that into their lives, whether through visiting a comedy club or socializing with friends who make them laugh. Limiting sugar and alcohol and adding whole, organic foods is another lifestyle change she recommends. Also, limiting time with people who drain one’s energy or leave an individual feeling frustrated. This can often cause more stress as well as negative thoughts.
“Sleep is incredibly important, especially going to bed before 11 p.m. before you get that second wind,” said Dr. Goldstein. “A solid seven to nine hours of sleep will help, and if you’re feeling extra stressed, your body may need to sleep more.” This is where a mid-afternoon coffee or even a morning cup of joe can be a detriment, Dr. Goldstein noted, as it likely keeps an individual from drinking more water and getting the foods needed to provide the vitamins and minerals the body needs. “I do recommend that if you do enjoy coffee and are wary about going cold turkey, switch to organic dark roast, as this tends to be a cleaner bean and dark roast has the least amount of caffeine, versus medium or light,” said Dr. Goldstein.
She also recommends exercise—from walking to weightlifting—and having days designated for each or add in regular walks throughout the day. “Yoga and pilates are also great, as many times I often tend to advise against cardio, as it is a stressor on the body and doesn’t necessarily have the same metabolic effect as lifting weights,” said Dr. Goldstein, “especially higher weight, lower reps.”
Jacob Teitelbaum, MD, is the author of From Fatigued to Fantastic and resides in Hawaii. He noted that while the pandemic increased awareness of the importance of immune health, it doesn’t mean that people know better how to make their immune systems healthier. “Unfortunately, much of what has been supplied in the media is misinformation focusing on only that which is very profitable, rather than science or common sense,” he said.
When working with patients, Dr. Teitelbaum recommends focusing on the following:
1. A good multivitamin with zinc, retinol, and vitamins C and D. “Many other nutrients are also important. I prefer the Essentials multivitamin by Euromedica, two tablets a day.”
2. Getting seven to nine hours of sleep nightly. “One of the most potent ways to immune suppress an animal is to sleep deprive it,” Dr. Teitelbaum noted.
3. Exercise in the sunshine builds stores of vitamin D that are crucial for healthy immunity.
4. Stay hydrated. “Our first line of immune system defense is our IgA antibody system. Like the Navy, it requires a moist environment and does not do well in dry dock,” Dr. Teitelbaum explained. “Mucosal surfaces must be kept moist for our first line of defense to work.”
1 CRN Reveals Survey Data from 2022 Consumer Survey on Dietary Supplements, Council for Responsible Nutrition. www.crnusa.org/newsroom/crn-reveals-survey-data-2022-consumer-survey-dietary-supplements.
2 Unlocking Insights into the Supplement Consumer: 2022 Trends and Opportunities – Market Place. www.naturalproductsinsider.com/media-assets/unlocking-insights-supplement-consumer-2022-trends-and-opportunities-white-paper.
3 Immune Health Supplements Market Report, 2021-2028. www.grandviewresearch.com/industry-analysis/immune-health-supplements-market-report.
4 Akay Internal Study. Liposomal hydrogel vitamin C pharmacokinetics. Data on file. 2021.
5 Gibson, G.R., et al. Nat Rev Gastroenterol Hepatol, 2017. 14(8) p. 491-502.
6 Castro EDM, et al. Mol Nutr Food Res. 2021; 65(1):1901071.
7 Sullivan AM, et al. Immunopharmacol Immunotoxicol. 2008; 30(3):553-74.
Healthy Take Aways
• About 75 percent of people in the U.S. use nutritional supplements.
• The market size of immune-supporting supplements was valued at $55.3 billion in 2020.
• Immune supplements now reach a wider and larger general population than ever before.
• According to a 2020 survey from the Council for Responsible Nutrition (CRN), probiotics are in the top five ingredients dedicated to immunity.
• Due to COVID-19 and its restrictions for nearly three years, individuals’ immune systems may be weaker now than pre-pandemic levels.
For More Information:
ADM Protexin, Bio-Kult, www.bio-kult.com
Daiwa Health, www.dhdmed.com
Gnosis by Lesaffre, www.gnosisbylesaffre.com
Life Extension, www.lifeextension.com
Natural Path Silver Wings, www.npswsilver.com
Standard Process, www.standardprocess.com