From direct support to sleep/stress and digestive care, here’s a look at the many options your customers have for immune system maintenance.
November 21, 2019
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Now that it’s peak cold and flu season, your customers will be heading to your immune health section—but for the greatest benefits, you can also point them to, well, just about every other section of the store as well. Hank Cheatham, VP of Daiwa Health Development, says immune health is a body-wide endeavor.
The immune system itself, Cheatham explains, consists of millions of white blood cells (white cells known as lymphocytes include the T-cells, B-cells, and Natural Killer, or NK cells), the bone marrow, antibodies, and the thymus gland that identifies and then destroys the millions of microbes that can invade the body. NK Cells, he says, are part of the innate immune system: They require no special instructions to recognize a specific antigen before they attack and destroy a target cell. We’ll talk about that; the immune system itself certainly requires maintenance and attention. But it’s important to look at the bigger picture when addressing immune health. As Cheatham notes, “NK cell activity is reduced by physical trauma including surgery and various medical interventions, nutritional deficiencies, stress from natural disasters, depression, anxiety, fatigue, the flight or fight stress response, and aging.”
The holistic view is backed by many experts. For example, Chris Meletis, N.D., Director of Science and Research for Trace Minerals, says: “I generally recommend a broad mineral supplement with a focus on trace minerals, including chromium and vanadium, to help support healthy blood sugars, since higher blood sugars make a person more susceptible to infection.”
James LaValle, R.Ph., CCN, M.T., N.D., Clinical Pharmacist and Adviser for Probiotics.com (an informational site sponsored by Wakunaga of America, Co., LTD), notes that “several studies over the last decade have reported that adding a pre- or probiotic supplement to your daily routine for about 4 weeks prior to receiving a flu vaccine and for a few weeks after increased the effectiveness of the flu shot.”
We’ll start with the most well-known nutrients; Dr. Meletis suggests zinc and selenium, both generally found in a multivitamin or as part of a vitamin C formulation—with vitamin C, of course, being possibly the most well-known of all immune support supplements. For a dive into the benefits of vitamin C and the science backing it, go here, which will bring up all the Vitamin Connection columns by Richard Passwater, Ph.D., on this topic.
Those looking for an easy way to get their vitamin C—or to give it to picky kids—may want to consider ChildLife Nutrition’s Liquid Vitamin C, which has a natural orange flavor and comes with dosage suggestions for children.
Elderberry is another immune superstar. “Elderberry is a great acute immune herb,” says Kim Hapke, N.D., affiliated with Metabolic Maintenance. “It would be one of my top choices for boosting the immune system when a person has cold or flu symptoms or is likely to be exposed to viruses via something like air travel.”
Melanie Bush, Director of Berry Science at Artemis International, Inc., notes that elderberry has been achieving mainstream recognition. “This boost in respect for black elderberry is in large part due to scientific research affirming significant benefits,” according to Bush. “For example, a 2016 study by Tiralongo et al. concluded that an anthocyanin-standardized European black elderberry extract significantly reduced the duration and severity of cold symptoms in long-haul flight passengers. A recent 2019 meta-analysis by Hawkins et al. came to the conclusion was that ‘supplementation with a standardized elderberry extract is significantly effective at reducing the total duration and severity of upper respiratory symptoms.’ Black elderberry can make you feel better, faster—something that is very relevant to all types of consumers.”
When stocking elderberry supplements, Bush says, take care to seek out extracts that retain all compounds—“current research suggests it may be a combination of compounds working together.” Polysaccharides, she explains, have been shown to contribute to a suppression of viral replication while stimulating the immune system; flavonoid compounds have been found to bind to proteins on the surface of influenza viruses, preventing them from infecting cells. In terms of processed extracts, she says: “cold-pressed juices may not have had necessary heat steps to ensure the safety of the product.” An ingredient like ElderCraft, which concentrates all of these relevant compounds, would therefore be a good option, Bush says; branded ingredients are generally backed with strong science and appropriate standardization.
Elderberry enthusiasts have more options these days: INS Farms announced in July that fingerprint testing found no difference in the quality or potency of anthocyanins in European Elderberry over American Elderberry.
Understanding the phytochemical profile of the American-grown berry, said Devon Bennett, CEO of INS Farms, allows suppliers to create a standardized starting material for health impact studies—without which, it is impossible to repeat a study with any kind of accuracy (1). It also helps reduce adulteration, thanks to the fact that companies now know what the material should look like. INS Farms offers the Elder Pure line of elderberry raw materials. And at SupplySide West, Fruit d’Or announced that it has partnered with INS Farms to introduce ElderCran, a black elderberry extract syrup with cranberry extract powder for cold and cough. Norm’s Farms, which offers supplements with farm-fresh North American native elderberries, recently released ElderCran products, which the company says is “the perfect go-to daily supplement for anyone looking for a great immune system booster” (and it also promotes a healthy urinary tract).
For a superstar powerhouse, consider stocking RidgeCrest Herbals’ award-winning ClearLungs Immune: It contains vitamin C, Zinc, elderberry, and a whole host of other immune-boosting herbs, formulated specifically for those whose immune health struggles affect their lungs.
Another popular ingredient: Echinacea. HP Ingredients writes on their site that one randomized trial involving more than 700 people with cold symptoms found that those who took echinacea experienced “a reduction of their colds by seven to 10 hours, or 10% reduction in overall severity” (2). HP’s EchiMune is organic and standardized to 12% polyphenols.
Echinacea is on double-duty in Emerald Health Bioceuticals’ Endo Immune: Besides its immune-enhancing ability, it’s also part of the company’s PhytoCann Complex, which works to activate the Endocannabinoid System (ECS), making it a two-for-one deal that can help maintain both the ECS and the immune system year-round. As Holistic Nutritionist Dana Samu explains on the company’s website (www.emeraldhealthbio.com), “a healthy immune system is neither over-reactive nor under-reactive, but rather adaptive enough to accurately identify, and balanced enough to respond proportionately to, whatever risk it encounters. And there is a growing body of evidence that this resilience is precisely the role that the endocannabinoid system plays, by modulating the reactivity of our immune response” (3).
An up-and-coming supplement suggested by Dr. Cass Ingram: wild oregano. “In Herba Polonica, it was demonstrated that out of some 35 herbs only wild oregano boosted interferon levels from white blood cells. Garlic and onion are synergistic. All these herbs/spices have germ-killing properties. High-quality oil of oregano can be taken daily as a major preventative.” He mentions that any oregano taken daily should be 100% wild and certified for daily consumption: “Do not accept cheap imitations from farm-raised and cloned oregano plants. Truly wild oregano oil will keep people healthy during seasonal weather changes—be sure it is the edible kind emulsified in extra virgin olive oil.” He suggests OregaMax capsules and Oreganol P-73 drops and caps, both products sold by North American Herb and Spice.
Taking full advantage of the demand for green supplements, Sun Chlorella has a product made with what they call the greenest plant—chlorella. According to information provided by the Sun Chlorella Medical Advisory Board, chlorella contains nucleic acids, iron, vitamins D and B12, and chlorophyll—all “known for their immune-boosting powers.” Chlorella also contains Chlorella Growth Factor, a nucleotide-peptide complex of nucleic acids that allows chlorella to multiply rapidly. When ingested, it can help stimulate cellular repair and renewal. Another way it can help boost immunity: A 2007 study by researchers at Saiseikai Nara Hospital suggested that chlorella may help boost the concentration of immunoglobulin A (IgA), an antibody blood protein (4). (For more on this powerhouse, check out 7 Supplements for Liver Health.)
Continuing on the topic of immunoglobulins, Tina Anderson, Co-Founder and CEO of Just Thrive, recommends Ultimate IgG. She says that “Immunoglobulins are antibodies that function to detox, rebuild, and support. Antibodies are proteins made by the immune system to neutralize antigens through a cellular lock-and-key mechanism. They bind and neutralize toxins in the gut, including pathogens, fungi, viruses, mold, and more, allowing these toxins to be safely excreted from the body. Immunoglobulin G (IgG) is the most common type of antibody found in humans. It represents 75% of antibodies in blood circulation. It provides targeted immune support for allergies and infections.” Just Thrive’s Ultimate IgG contains IgG, IgM, IgA, and Bovine Serum Albumin. Anderson notes that the molecular structure of all antibodies produced by all animals is similar, allowing bovine immunoglobulins to perform the same role in human health as human immunoglobulins.
Fun fact: Immunoglobulins are a key reason why chicken soup is so good for the immune system. Naturade notes on their website that “Studies show that three classes of immunoglobulins, IgA, IgM, and IgG, are present in chicken serum. These components positively affect the body’s immune system” (5). Naturade’s Symbiotics line features colostrum, which contains the same immunoglobulins as chicken soup, as well as a variety of other nutritional components to support a healthy immune response.
Baker’s yeast is seeing growth in the immune health space, too. Take Embria Health’s baker’s yeast fermentate EpiCor, for instance: Justin Green, Director of Scientific Affairs, says that “published human clinical studies show EpiCor may support immune health. These include two randomized, double-blinded, placebo-controlled trials evaluating the effect of EpiCor on cold and flu symptoms in adults. In both studies, it was shown that EpiCor may help reduce nasal symptom occurrence, support the immune system, and help reduce the incidence of cold and flu symptoms.” It can help with seasonal allergies, too, he adds—and “emerging science suggests that consuming EpiCor may positively modulate gut microbiota.”
There’s also Wellmune, a beta 1,3/1,6 glucan derived from the cell wall of a proprietary strain of baker’s yeast. Donald J. Cox, Ph.D., wrote in a blog for Kerry, makers of Wellmune, that there are 10 published, peer-reviewed clinical studies showing that Wellmune can “enhance key immune functions, improve overall physical health, maintain healthy energy levels, help keep us healthy during times of stress, and provide immune support as we age” (6).
While on the topic of fermentates, Daiwa’s PeakImmune4 is thoroughly studied and has a range of benefits. “The active ingredient in PeakImmune4 is Rice Bran Arabinoxylan Compound (RBAC), which is made from a proprietary extract of rice bran modified with the enzyme from shiitake mushroom,” says Cheatham. Rice bran is simply a fiber with no immune enhancing properties, he says; shiitake mushroom has nowhere near the immune building strength of RBAC. How does RBAC get its immune-strengthening properties? “RBAC is produced using a patented biotechnological fermentation process. The rice bran is extracted, breaking down the hemicellulose, and then the extract is modified with an enzyme from shiitake mushroom. The result is a molecule proven to be a natural Biological Response Modifier and a true immune modulator.” RBAC, Cheatham says, has over 40 published studies confirming its immune health uses. “It is shown in scientific research to more than triple the activity of NK cells when it is needed because of a debilitated immune system. It also stimulates and regulates the activity of cytokines, which are chemical messengers used by the immune system to regulate inflammation. It has also shown anti-inflammatory properties in cases of irritable bowel syndrome and atopic dermatitis.”
Another anti-inflammatory: curcumin. Nena Dockery, Scientific & Regulatory Affairs Manager at Stratum Nutrition, notes that “curcumin exerts its effects mainly through its action in reducing the production of pro-inflammatory substances responsible for perpetuating inflammation. It is known that inflammation can promote the release of reactive oxygen compounds (ROS), causing oxidative stress. These ROS can in turn initiate a cell signaling cascade that enhances pro-inflammatory gene expression, thus perpetuating the inflammatory response. This dual action of curcumin makes it an ideal supplement ingredient for general immune system maintenance and support of healthy inflammation.” Stratum’s 95% curcumin ingredient is derived from natural turmeric.
For generalized support, customers may want to consider products containing ResistAid: According to Juliana Erickson, Senior Marketing Manager, Consumer Health & Nutrition at Lonza, it’s a “natural immune support ingredient that is produced from North American larch trees.” It’s a soluble polysaccharide known as arabinogalactan, and Erickson notes that it has multiple mechanisms of action: “Indirect action via gut microbiota-dependent pathways, direct action on the immune system via the gut-associated lymphoid tissue, and antioxidant action. These mechanisms support increased beneficial immune cell populations and also help to modulate and deliver the appropriate immune response based on the immune stressor.”
Related: Curcumin and Your Body
While internal immune support is important, your customers shouldn’t neglect care of their barrier defenses—if cared for properly, they can prevent pathogens from entering the body in the first place. Dr. Meletis suggests “ensuring there are optimal levels of magnesium to support over 300 enzyme pathways including ATP production, ‘the energy source’ for all of our body’s life-sustaining processes. This includes immune function and barrier defenses, such as fueling mucous membranes of the eyes, nose, throat, and lungs. If underpowered cells throughout the body are without adequate ATP, they will not be able to perform up to their full genetic potential.”
Another method of supporting barrier defenses would be nasal spray. Xlear is a xylitol-based nasal spray that, according to Nathan Jones, Founder of Xlear, “is designed to be used as a hygiene tool—it washes the airway.” It was created by a physician to prevent ear infections, Jones notes: “He read a few studies that showed that xylitol chewing gum reduced ear infections by 42% in children. Well, you can’t give chewing gum to a 6 month old baby, so he used the nasal spray instead. In his practice, he saw a 92% reduction in ear infections. It’s completely safe and all it does is wash out the upper airway, the xylitol binds up the bacteria so that they cannot adhere to the tissue, kind of like soap—it just washes the bacteria away.” While many nasal sprays are intended for use specifically when the airways are blocked, by allergies or due to illness, Jones says that Xlear can be used year-round: “You don’t wait until you are sick to wash your hands, you don’t wait until you have a cavity to brush your teeth. You shouldn’t wait until you are sick to wash your nose, either. Your nose filters about 12,000 liters of air a day, and all Xlear is doing is helping your nose stay clean and hydrated so it functions properly.”
Support for barrier defenses may also involve probiotics for oral health. Alexis Collins, Product Manager at Stratum Nutrition, suggests BLIS K12: “It’s a specific probiotic strain of Streptococcus salivarius, which is found naturally in the mouths and throats of healthy individuals. BLIS K12 activates and colonizes in the mouth, crowding out the ‘bad’ bacteria that could negatively impact your health. In addition to its ability to crowd out unwanted bacterial strains, BLIS K12 produces Bacteriocin-Like-Inhibitory-Substances (BLIS), which target and combat these undesirable bacteria. Research shows that BLIS K12 also supports certain cells in the mouth to help boost the immune system—when it’s activated in the mouth, a robust number of pediatric and adult clinical studies show that BLIS K12 benefits extend to supporting ear, nose, and throat health, as well.” And while everyone may have Streptococcus salivarius present in their oral cavity, Collins says, only a very few have the BLIS K12 strain specifically.
There’s also the importance of skincare—applying lotion when the skin is dry and cracking, and taking proper care of cuts and scrapes. Sovereign Silver makes a silver First Aid Gel intended to relieve stinging, redness, and itching, fight minor infections, and to help speed the healing of minor cuts and scrapes, blisters, and rashes—all places where pathogens can enter the body. The company notes on their website that silver has a 120-year history of safe use—with regard to argyria, or the gray-blue discoloration of the skin due to exposure to silver, Sovereign Silver notes that silver hydrosol, the product they sell, has never been reported to cause a single case of argyria.
“There are tens of thousands of scientific articles in the peer-reviewed literature on how stress affects immune health,” says Dr. Meletis. And not just negative stressors like injury or financial loss, either; he refers to the Holmes-Rahe Life Stress Inventory, used to predict the likelihood of a mental health breakdown. The Inventory scores major stressors, both positive and negative, and shows that marriage is more stressful than being fired; taking on a mortgage is more stressful than foreclosing on one; and an “outstanding personal achievement” is more stressful than “troubles with the boss” (7). This isn’t to say that negative stressors aren’t stressful—rather, it’s to say that if a customer turns down recommendations for stress support, it might be useful to point out that any change in the daily routine is stressful, not just negative changes.
“As I share with my patients,” Dr. Meletis continues, “when we are stressed, we enter a state of dis-STRESS, that leads us to lack a healthy state of EASE; thus we end up susceptible to dis-EASE. Likewise, I share that without 7-8 hours of sleep, we are not getting adequate rest. Rest is critical for REST-oration of our body.” The effect of adequate sleep on the brain, he says, is comparable to computer functionality: If we fail to “defrag our hard drive,” we’ll end up “carrying yesterday’s worries into today or tomorrow.” Here, he recommends magnesium and adequate B vitamins to help support healthy brain chemistry, sleep, and stress response.
Dr. Hapke recommends some “self-honesty in assessing lifestyle and stressors. If you do not eat enough fruits and vegetables, a multivitamin that includes important immune supportive nutrition like vitamins C, D, and A, as well as selenium and zinc, would be a good start. There is no substitute for a healthy amount of sleep, so if people are having difficulty achieving that, it is important to assist the process with options like melatonin, ashwagandha, passiflora, and valerian. And though everyone seems to feel stressed these days, it is important to admit if your lifestyle is unusually demanding or if you are under an unusual amount or stress, and support sleep and adrenal health by considering an herb such as ashwagandha, as well as taking practical steps to reduce stress.” Other stress reducers she suggests: ginsengs, Schisandra, astragalus, and reishi.
Robuvit, a French oak wood extract from Horphag Research, is another option: A study published in December 2018 found that Robuvit significantly reduced fatigue, insomnia, and oxidative stress—all vital for a strong immune system (8). Moreover, it helps build ribosomes, which allow for greater antibody assembly, helping the body fight illness more effectively (9).
Phytocannabinoids are an option here as well—Dr. Aimée Shunney, naturopathic physician and advisor to PlusCBD Oil by CV Sciences, told WholeFoods earlier this year that, “Adequate levels of endocannabinoids, the cannabis-like compounds that we make ourselves, limit the amount of stress hormones like cortisol that we make in response to stress and promote faster recovery. We call this stress resilience, and people who have it report less anxiety, better sleep, and better response to the stress in their lives.” CV Sciences also recently announced the results of a clinical study that demonstrated its product’s ability to improve sleep and enhance quality of life (10).
Related: SOS for Stressed and Tired
A large portion of the immune system is in the intestines—making digestive care particularly important to immune health. Dr. LaValle says that “When beneficial bacteria are thriving, they take up a lot of space in the lumen of the gut, and therefore harmful bacteria will have a harder time taking up residence and overpopulating. They actually direct the immune system in the intestines, telling it when bad bacteria are present and guiding the immune cells to kill the bad bacteria. In addition, the lactic acid bacteria produce a slightly acidic environment in the intestines, in which bad bacteria cannot survive.”
For immune support specifically, Anderson suggests spore-based probiotics. “Spore-based probiotics support immune health by a completely different mechanism than non-spore/conventional bacteria. Their spore shell allows them to arrive alive in the intestines where they go to work protecting the intestinal cell wall, which is exactly where the immune system lives.” Just Thrive spore-based Probiotic & Antioxidant, she says, has been shown in studies to arrive 100% alive in the small intestine, where “all four strains immediately begin killing toxin-producing pathogens. Because 70-80% of our immune receptor sites are embedded in our intestinal lining, reducing toxins in the intestinal environment immediately takes stress off of the majority of our immune system, thereby providing significant immune support.”
Anderson also notes that Just Thrive’s HU36 bacteria produces high levels of antioxidants in the intestines, “exactly where they need to be absorbed—making them the most bioavailable antioxidants available. These antioxidants that are produced right inside of the intestines help combat oxidative stress, a major culprit in immune health.”
Digestive-immune health doesn’t end with probiotics, either—don’t let your customers forget about supporting that good bacteria with prebiotics. Rich Troyer, CEO of Comet Bio, tells WholeFoods that “prebiotics are nondigestible ingredients that beneficially affect a consumer by selectively stimulating the growth of one or more strains of bacteria in the gut, which improves the health of the microbiome. In turn, a healthy microbiome supports and positively impacts the immune system. There are trillions of different strains of beneficial bacteria within the microbiome, and by supplementing them with prebiotics, they promote gut health and the immune system together.” There are a variety of prebiotics, with inulin being the most common, but Troyer notes that it’s not enough to only take inulin: “Not all prebiotics support all probiotics. There are trillions of different types of bacteria that exist in the microbiome, and it is not a one-size-fits-all formula. Certain prebiotics work better with specific strains of probiotics.” Arabinoxylan, he says, can positively impact the growth of the probiotic bifidobacteria—and it does so sustainably: “Our arabinoxylan is produced from farm leftovers such as leaves, stalks, and shells.”
Immune health is a year-round goal. Customers should support it holistically with a healthy diet, exercise, and vaccinations, and should talk to their healthcare provider about supplementation for an extra boost. WF