Resilience Rising

by Lisa Schofield | September 1, 2022

Immune support products remain in demand. Here’s how to fulfill it.

Another winter season is getting ready for its closeup, and its predecessor autumn is warming up the stage by cooling down the temps, making room for germs to cavort among us.

According to a report by FMCG Gurus, “What’s Next for Immune Health in 2021?” (Feb. 2021), 71 percent of global consumers are interested in products with immune-support benefits, and 67 percent are willing to purchase immune-boosting products, even when they don’t have symptoms.

A survey of 1,000 participants by SPRIM, “Immune Support Supplement Category Market Insights 2021,” found that 61 percent of consumers began or increased their purchasing of dietary supplements for immune support in the wake of COVID-19, and that feeling “tired and rundown” was the primary buying trigger for reaching for immune-support supplements. Further, 83 percent of global consumers who take immune supplements do so every day and will purchase consistently to replenish.

Another key trigger is the influx of media reports teaching consumers that immune-compromised individuals are at risk for hospitalization, even death, creating urgency to improve immune status and overall health; 57 percent of participants in SPRIM’s survey said they were concerned about their immune health because of COVID-19. This concern is expected to drive the category to reach $31.5 billion in sales by 2028, up from $20 billion in 2020.

While spikes of immune-support supplement purchases may be seen in the winter, category leaders have begun to promote immune health all year long—GSK, for example, has begun to promote its Emergen-C year-round versus only the cold/flu season. “The demand for immune support products has shifted from more conventional, seasonal immune support to everyday regimens,” confirmed Reshma Rathi, vice president of operations, Specialty Enzymes & Probiotics, California.

When consumers are pondering what immune-support products to purchase, according to SPRIM, scientific and clinical trial evidence to prove product efficacy was the top motivator. Of those who have not purchased a supplement in the prior 12 months, 73 percent said they would buy an immune-support supplement if there was a scientific claim associated with it.

The top five ingredients most consumers seek out for immune support are vitamins C, D and B complex, zinc and probiotics. Of the latter, a DuPont survey found that probiotic consumption increased by 66 percent in the U.S. since the beginning of the pandemic.

Based on customer inquiries during the past 12 to 18 months, several suppliers confidently asserted that this category is steadily growing.

Since 2019, California-based Ingredients by Nature has doubled its immune-ingredient sales each year, reported Rob Brewster, president. “This is because more people are understanding the connection to gut health and its overall impact it has on our bodies. Citrus flavonoids are also a popular ingredient due to their ability to aid in strong antioxidant support, in turn, strengthening the immune system and supporting a healthy inflammatory response,” he attributed.

Leslie Gallo, president, Artemis International, Indiana, reflected that during the past six months the company has experienced “very positive movement,” with increased demand for its ElderCraft extracts, acerola (vitamin C). “Over the past year, we’ve experienced an uptick in customers requesting we develop custom blends. This makes sense in the context of an increasingly crowded market, which is driving more intense hunger for differentiation,” she commented.

Elderberry is the tenth most sought-after supplement for immunity, and the second top herb after turmeric for this purpose, according to SPRIM’s survey. Elderberry syrup has been a staple for natural health consumers for more than two decades, and it has come a long way, still relevant for today’s immune-support consumer, according to Melanie Bush, vice president of science and research, Artemis International. She pointed to a meta-analysis conducted just before the pandemic that evaluated the clinical efficacy of elderberry extracts on respiratory symptoms. The authors concluded that “supplementation with a standardized elderberry extract is significantly effective at reducing the total duration and severity of upper respiratory symptoms, as compared to a placebo group.” Bush noted that this compelling statistical evaluation of existing clinical data helped to solidify elderberry’s place as a respected immune support supplement throughout the pandemic.

Immune Ingredients

OptiMSM, Washington-based Bergstrom Nutrition’s branded form of distilled methylsulfonylmethane (MSM), can help reverse the immunological decline by addressing chronic inflammation, according to Tim Hammond, Bergstrom Nutrition’s vice president of sales and marketing. MSM helps reduce the levels of inflammatory cytokines, managing the overall inflammatory response. OptiMSM is also known to support glutathione production, an antioxidant essential in healthy immune function, and MSM will also help to reduce immunosuppression caused by strenuous and exhaustive activities.

He explained, “sulfur-containing compounds, such as OptiMSM, play a critical role in supporting the immune response. OptiMSM modulates the immune response through the crosstalk between oxidative stress and inflammation. Oral supplementation of OptiMSM supports not only healthy sulfur intake, but also the body’s robust response to an immune challenge.”

OptiMSM has evidence that it can support immunomodulation. When the immune system is suppressed, OptiMSM conserves its ability to respond to threats, helping improve resistance to viruses and toxic substances. Conversely, when the immune system overreacts and produces too much inﬂammation, OptiMSM can mitigate the excessive response. “This is especially important for the lungs, where excessive inﬂammation causes symptoms like coughing, sneezing and difﬁculty breathing, and can lead to secondary complications,” he said. “Multiple studies have shown MSM can inhibit lung-speciﬁc inﬂammatory paths and relieve upper and lower respiratory symptoms.”

ParActin, from HP Ingredients, Florida, has also been shown to support healthy immunity and in tandem, reduce excess inflammation. ParActin is a unique extract of Andrographis paniculata that is intended for use in dietary supplements for helping to manage healthy inflammatory response. ParActin is a patented extract from the plant called Andrographis paniculata, standardized to andrographolide, 14 deoxyadngrographolide and neo-andrographolide.

ParActin’s andrographolide has shown to be a potent agent for helping to manage the body’s inflammatory cascade. Andrographolide inhibits NF-kB—the key regulator of the immune and inflammatory response system. When you can turn off NFkB you can reduce inflammatory cytokines and proteins that cause pain and inflammation, such as COX2, prostaglandins, IL-6, IL-12 and TNF-a, among others.

At first blush, it appears that enzymes and probiotics are more suited for digestion, but these powerful ingredients are highly useful for supporting the gut-based immunity, keeping people feeling well.

Specialty Enzymes offers two immune-support ingredients, ImmunoSEB + ProbioSEB CSC3, which, according to Rathi, have shown promising results in promoting immune response in clinical studies and case series.

ImmunoSEB is an enzyme blend with powerful proteolytic action. ProbioSEB CSC3 is a probiotic blend of three spore-forming Bacilli species: SEBiotic (B. coagulans), SEBclausii (B. clausii), and SEBtilis (B. subtilis).

In 2021 alone, Rathi reported, three studies on ImmunoSEB and ProbioSEB CSC3 (an enzyme and probiotic combo) were published in peer-reviewed journals with promising results. The most recent clinical trial, published in Medicines, assessed the safety and efficacy of a combined treatment of ProbioSEB CSC3 (probiotic blend) and ImmunoSEB (systemic enzyme complex) in individuals experiencing a primary symptom of post-viral fatigue. This is an issue for up to 40 percent of people who have had COVID-19.

Results show that 91 percent of participants supplementing with ImmunoSEB and ProbioSEB CSC3 experienced resolution of fatigue, versus only 15 percent in the control group. Those in the supplement group also had a greater improvement in physical and mental fatigue scores at all time points. “These products can be positioned as promoting overall immune health, the resolution of post-viral fatigue, and promoting energy levels,” noted Rathi.

“Researchers have found that certain bacteria in the gut influence the development of aspects of the immune system,” said Kristen Wilhoyte, director of global product marketing, Deerland Probiotics & Enzymes, Georgia. “Researchers have estimated that about 70 percent of the immune system is housed in the gut.”

Deerland’s Bacillus subtilis DE111 has been shown to prevent colonization of bacterial pathogens, maintaining healthy gut bacterial balance, support normal immune reaction fi intestinal cells, produce short-chain fatty acids that support gut barrier function, and to re-sporulate in the small intestine, extending its benefits.

In a study involving 44 participants aged 20-62, researchers observed after four weeks of daily consumption of the probiotic DE111 at 1 billion CFU, a significant reduction in the basal levels of several immune cell populations, including CD3+ T cells, cytotoxic T cells and NKT cells. Additionally, the probiotic group showed an increased capacity for immune response in cells stimulated by an induced inflammation. The results suggest that DE111 may modulate the immune system through action on both innate (rapid response) and adaptive (slow response) immune cell types.

New from Deerland is MuniSpore Bacillus clausii CSI08, which like DE111, has been shown to crowd out unwanted bacteria to maintain healthy gut flora balance, to resporulate, and to support the normal immune reaction of intestinal cells. Its immune-support benefits stem from its total antioxidant capacity (TAAC), which is significantly higher than that of another lactobacillus strain touted for antioxidant activity.

Berries have a positive reputation as being very healthy. And in the immune category, elderberry still rules. Artemis International’s ElderCraft European Black Elderberry Extract is made from Austrian-grown Haschberg elderberries and is standardized to anthocyanins and polyphenols. “A human clinical trial was conducted on over 300 subjects who were prone to upper respiratory infections after long-haul flights. The ElderCraft supplementation resulted in a significant reduction in symptom severity and duration,” Bush noted.

She added that a new published study revealed that the polysaccharide bioactives in ElderCraft help to exert an immune-boosting response via dendritic cells of the immune system. Other studies pending publication have suggested that ElderCraft may inhibit viral replication as well as serve as exert prebiotic activity and modulate gut microflora in humans. A second phase, large-scale clinical trial is currently underway, Bush said.

A berry blend from Minnesota-based Futureceuticals is Phyto-C a proprietary compound of 11 broad-spectrum superfoods for immune protection formulas. A low dose of 150 mg per serving, Phyto-C provides active compounds from blueberry, strawberry, maqui berry, acai, tart cherry, as well as acerola extract, kale, broccoli, green tea extract, green coffee bean extract and turmeric extract.

While immune health significantly grew over the last several years (72 percent), COVID-adjacent categories, including brain health, eye health, sleep, mood and diabetes, are also rising, according to Brewster. And because people with unhealthy blood sugar levels are more susceptible to immune health issues, he noted there is a greater audience for ingredients with a multi-functional mechanism.

Eriomin, from Ingredients by Nature, is primarily composed of eriocitrin, a lemon flavonoid extract, according to Brewster, who explained that like other citrus bioflavonoids, Eriomin has antioxidant benefits and inflammation benefits that can help support immune health. “In addition to Eriomin, our full range of citrus bioflavonoids has seen a significant uptick in sales,” he commented. “With its ability to aid in vitamin C absorption, aid in strong antioxidant support, and support a healthy inflammatory response, as well as to support healthy blood sugar levels, citrus bioflavonoids are critical to building a potent immune health formula.”

Ingredients by Nature’s branded Brewster Bioflavonoids are drawn from multiple citrus sources—orange, lemon, lime, tangerine and grapefruit—with each source contributing to and supporting aspects of immune health.

AlvioLife, from New Jersey-based PLT Health Solutions, is a patented composition of Boswellia serrata resin standardized to 30 percent 3-O-acetyl-11-keto-ß-boswellic acid (AKBA) and Bengal quince fruit (Aegle marmelos) extracts. This combination of botanical extracts is a synergistic blend shown to possess stronger 5-lipoxygenase (5-LOX)-inhibition activity than either extract alone, according to Steve Fink, vice president of marketing for the company. Strong evidence suggests that 5–LOX exerts influence on the onset and progression of tracheal inflammation, at a low, 200 mg/day dose.

AlvioLife is backed by two human clinical trials focusing on its effects on respiratory function. In a double-blind study 36 subjects with bronchial asthma took AlvioLife (200 mg/d) or a matching placebo for 56 days. AlvioLife exerted significant improvements in asthma symptoms scores, which were improved even at 14 days, compared with the placebo. Further, AlvioLife resulted in significant increase in serum IFN-γ and reduction in IL-4, compared with placebo.

In a second double-blind trial, healthy subjects with self-reported sensitivity to pollution took either 200 mg/d of AlvioLife or a matching placebo for six weeks. AlvioLife was found to improve lung function by up to 16 percent; lung capacity by up to 30 percent; aerobic exercise capacity by up to 7 percent, and to reduce upper respiratory tract symptoms by up to 40 percent, and improved the percentage of CD4+ T helper cells.

ImmunoLin, from Iowa-based Entera Health, part of The Lauridsen Group, is a novel functional protein containing what the company stated is the highest level of IgG available per gram as a dietary supplement ingredient. ImmunoLin, a serum-derived bovine immunoglobulin/protein isolate (SBI), contains more than 60 percent immunoglobulins and other important serum-proteins shown to support digestive function. It is distinguished by being a non-dairy protein ingredient with concentrated IgG levels for immune support.

Immunoglobulins work by binding potentially toxic antigens within the digestive tract and prohibiting them from crossing the gut barrier. These antigens are naturally present in the intestinal tract and cause inflammation when exposed to the immune system.

Immunity in 2023

The new year is a scant few months away, so with the increased desire for overall immune sustenance, will the shelves be too crowded? Unlikely.

“With COVID numbers going up right now, and with consumer awareness heightened overall to their immune health, I envision it will continue to grow,” affirmed Rathi. “It may not grow at the rate that it did early in the pandemic, but there will be growth.”

She added that according to market research firm Fortune Business Insight, the global immune health supplements market is projected to grow from $20.18 billion in 2021 to $31.50 billion in 2028 at a CAGR of 6.6 percent from 2021 to 2028.

Brewster agreed that the once-in-lifetime sales of all-things-immune-supporting in 2020 and 2021 are unsustainable. However, given the rising COVID-19 cases (notably the BA.5 variant), as well as the monkeypox fear, along with increased travel, consumers remain vigilant about their immune health. “We anticipate the immune support market will continue to be top of mind for consumers regardless of the time of year,” he stated. NIE