Ah-choo! That’s the usual clarion call for a person to say to himself or herself, “Is it a cold or allergies? And I need to boost my immune system right now!”

People don’t call doctors when something signals their immune systems may be off, listing a bit, feeling dull or sluggish; people now turn to the supplement aisle. Other signals that make Americans question how well their immune systems are functioning include overall sluggishness, fatigue and symptoms of stress (mild anxiety, sleeplessness). The great news is that now, more than ever, Americans actually understand that they have such a checks-and-balances system in place and that when it functions optimally, they can pretty much sustain decent health and overall well-being.

And also, more than ever, Americans tend to be more proactive about prevention and conditioning, as well as more trusting that dietary supplements and healthy “free from” foods and beverages will increase the quality of their immune functioning.

That said, there are still a few “myth-conceptions” many consumers have about immune health. And many will continue to likely bring these into your store when seeking the most suitable immune-support supplements.

For example, offers Cheryl Myers, chief of education and scientific affairs for EuroPharma, Inc., Green Bay, WI, one misconception is the belief that they only need to think about immune health during one time of the year. “Also, and for understandable reasons, I think that immune health is often confused with symptom relief and symptom relief only,” she adds. “Symptom relief is definitely a major factor — a person wants to stop sneezing, coughing, and feel better. But in the quest for relief, we often forget the health of our entire system.”

Neil E. Levin, CCN, DANLA, senior nutrition education manager, NOW, Bloomingdale, IL elaborates that Americans consider their immune status only when they feel something, and they immediately tend to consider remedies and other reactive strategies, rather than shifting the focus on how good nutrition and lifestyle habits may help them avoid such situations. Although he believes that turning to natural remedies to address symptoms is appropriate, the nature of immunity is that it is suppose to provide continual protection. Research has established that a lack of essential nutrients exacerbates susceptibility to illnesses and also makes normally mild immune challenges more severe.

Michael Schwartz, president, Michael’s Naturopathic Programs, San Antonio, TX, believes that the most prevalent misconception is that consumers don’t have to do anything special to have a healthy immune system, and that taking a multivitamin takes care of their immunity. “That is so far from true,” he states. “They need to know that the immune system has nutritional requirements, like every other system in the body.”

Lisa Lent, founder and CEO of Vitalah, Santa Cruz County, CA, echoes Dr. Schwartz’ findings, noting that the myth that a healthy diet by itself will create an optimally functioning immune system. While nutrient-dense diets do indeed contribute to qualitative functioning of the immune system, she says, the average American diet, even if it’s healthier today than it was five or 10 years ago, still “lacks many of the foundational vitamins and minerals necessary to adequately support the immune system.”

According to Levin, lack of certain vitamins and minerals can impact the in vivo environment for disease incubation and expression. “The lack of essential nutrient factors, especially vitamin D, and antioxidants like selenium, both mark us as susceptible hosts for infections and actually stimulate gene expression in the invaders to make them more aggressive — even promoting their mutation into more virulent forms,” he says.

For example, says Levin, the link between vitamin A deficiency and increased mortality from measles has been known for about a century; and more recent research suggests a link between selenium deficiency and flu severity, along with a greater risk of pneumonia even from mild cases of the flu. And, he opines, although Vitamin D has received sustained recommendations by physicians and the health media for a wide variety of health conditions, its role in supporting healthy immune function has been neglected in consumer media. Research has shown that vitamin D has a powerful effect on innate immunity; the immediate, effective action of patrolling immune cells to neutralize suspected invasive organisms.

However, this benefit has been shown to occur from higher dosage levels than what is recommended for bone and dental health. In fact, Levin points out, lower serum vitamin D levels have been shown to be related to increased lower respiratory tract infections, which is yet another example of its relationship to healthy immunity.

Aging, says Lent, also affects the functioning of the immune system, and many consumers don’t believe that this system ages in a similar manner to bones, joints, etc. “As we grow older, the body’s ability to effectively fight off sickness and infection diminishes,” she says. “As such, it is essential that we support our immune systems through a healthy diet, exercise and quality supplementation.”

Further, Lent adds, most people don’t make the connection between adequate hydration and immunity. Drinking adequate amounts of water helps flush out toxins and enhances oxygen flow through the blood to the cells to ensure efficient function.

Family care naturopathic physician Chris D. Meletis, ND, who is also director of science and research for Trace Minerals Research, based in Ogden, UT,  has observed that one of the biggest challenges in immune system education is the mindset that “there is an instant fix” for a weakened immune system.

He looks at what he calls the three categories of “immune system competence.” First is a healthy immune system (well-nourished, low-stress and adequate sleep) that may cause one cold a year and some allergies; a semi-healthy immune system (fairly well nourished, moderate stress and semi-adequate sleep) with about two colds per year and other immune challenges, and third, a sub-optimal immune system (poor diet, high stress and poor sleep), that can typically cause three colds and other immune challenges per year.
The lack of essential nutrient factors, especially vitamin D, and antioxidants like selenium, both mark us as susceptible hosts for infections and actually stimulate gene expression in the invaders to make them more aggressive. — Neil E. Levin, NOW
“The more worn out and weakened the immune system the longer it may take to help revitalize and support renewed immune function,” Meletis points out. “The fast-food eating, stressed-out individual that has been running too hard and fast will generally take more of a nutritional or supplement nudge to get back on track.”

Cheryl Myers agrees, opining that the connection to the incredible damage of overall oxidative stress on the immune system is “vastly underrated by the public.”

On the other side of the spectrum, points out Steven Myers, vice president, Bio Nutrition, Inc., Oceanside, NY, many people are unaware that an overactive immune system is just as bad and can even be worse than an under-active immune system. Autoimmune conditions are on the rise and the key is to modulate and balance immune functioning.

Stocking ShelvesIn essence, the aforementioned commentary and observations show that just about every consumable in your store can be supportive of healthy immune function (organic produce, waters, etc.).  But your immune-specific supplement section can be enhanced with several vitamin and mineral products specific to healthy immune support.

Michael’s Daily Immune System, for example, says Dr., Schwartz, “addresses the complex operation of keeping the body free of toxins and invasion of microbes, the immune system requires a constant source of nutrients. Nutrients are essential for the proper growth of T-cells and B-cells, as well as the proper manufacturing of plasma and antibodies.”

The supplement contains a variety of vitamins and minerals that address immune function in specific ways. Vitamin A in the form of beta carotene is integral in the formation of mucous membranes, part of the body’s outer protection against foreign toxins by releasing mucus, which contains leukocytes that function as the catalyst for the B-cells and T-cells in the immune response process. Vitamin C is essential for the immune system, as it helps absorb iron. Vitamin B2 aids in the formation of red blood cells and antibodies. Pantothenic acid (vitamin B5) and vitamin B6 both assist in the production of antibodies. Folic acid (vitamin B9) is necessary for growth of all types of cells in the body, including white blood cells.  Vitamin E protects fat soluble vitamins and red blood cells. And zinc is necessary for cell growth and the proper functioning of the immune system.

Antioxidant vitamins are integral to healthy immunity, emphasizes Trisha Sugarek MacDonald, BS, MS, senior director of research & development/ national educator for Bluebonnet Nutrition Corporation, Sugar Land, TX. “While carrying out their immune functions, white blood cells generate free radicals, which can damage the very white blood cells that produce them,” she explains. “Vitamin C, a free-radical scavenger, is concentrated in certain white blood cells, providing them with a built-in defense mechanism. Antioxidant compounds present in the body counteract free-radical toxicity (also called ‘oxidative stress’), by providing components to stabilize free radicals and ultimately supporting the immune system by maintaining the integrity of immune cells.”

Bluebonnet’s Targeted Choice Wellness Support Formula Caplets, for example, includes free radical-quenching vitamins A, C and the mineral zinc. Studies show that ensuring regular adequate levels of these essential nutrients may impede the oxidative stress pathway by reducing free-radical damage.  It contains vitamin A as beta-carotene, vitamin C from ascorbic acid and zinc, which all increase free radical blocking activity. Insufficient zinc amounts, she adds, affects the function of T-cells and other immune cells. “Studies have observed that even a mild zinc deficiency can elicit changes in immune status, such as defective natural killer (NK) cell function, decreased interleukin-2 production and anergy (i.e., the absence of a normal immune response to a particular antigen or allergen),” says Sugarek MacDonald. “[The formula] contains ample amounts of zinc to not only provide antioxidant protection but to also shield mucosal cells and stimulate immune function.”

She adds that the formula also contains vitamin D3, of which clinical studies have shown to be crucial for supporting immune function. This vitamin has been shown to signal an anti-microbial response by producing a peptide that is important for cell-mediated immunity and an antiviral defense.

Vitalah’s effervescent beverage mix (Immune Oxylent) is a blend of vitamins, minerals and other nutrients to support overall immunity and well-being, according to Lent. “Vitamins D and C pack an antioxidant punch, defending against invaders and restoring the immune system to its peak performance, while selenium and zinc reinforce the foundation of a healthy immune system by helping to keep it balanced,” she describes. “Waste-clearing potassium keeps the immune system performing at an optimal level, and raw coconut water and pink Himalayan salt combine to support the body’s ability to stay hydrated.”

Austin, TX-based Natural Vitality’s Natural Calm magnesium supplement is also highly suitable for immune support, says Ashley Koff, RD, brand ambassador for the firm. She explains, “Magnesium operates inside the cell to turn on the body’s stress response which means that when stress happens, calcium crosses into the cell and the magnesium present will push it back outside of the cell to end the stress response. This is critical for better immune function because the body can do its digestive and repair work better when not in a stressed state. Magnesium also helps to support the immune system with its role in maintaining bone health as bone marrow stores the white blood cells that are a key tool of the immune system. The healthier the bone, the more protected and healthier its marrow.”

Koff adds that this mineral helps promote a healthy inflammatory response which is critical for better immune health.

Trace Minerals Research not only offers zinc for this category but also selenium. As aging leads to progressively deteriorating function of numerous organs and systems in the human body, researchers believe that selenium can help slow age-related decline in immune function, and it has also been studied for its impact on allergies and asthma (immune imbalances), according to Dr. Meletis. “Immunosenescence is a very real concern that health care providers and natural products store educators need to be aware of,” he says. “Different approaches for different seasons of human life.”

Levin describes a vitamin and mineral formulation that incorporates herbs (NOW Elderberry & Zinc Lozenges), specifically elderberry extract powder that is synergistically formulated with Zinc and Vitamin C as well as echinacea, propolis and slippery elm. He elaborates that zinc is involved in wound healing and immune function,  associated with macrophage and neutrophil functions, natural killer (NK) cell response, and the activation of T-lymphocytes. Vitamin C plays a vital role in immune system function because it is essential for wound healing due to its critical importance as a component of connective tissue. Vitamin C also supports healthy B- and T-cell function and histamine release.

EuroPharma’s ViraPro, another herb-infused immune supplement, blend of elderberry with vitamins and minerals. The company uses vitamin A in the retinyl form, says Cheryl Myers, because it is a more concentrated form to use specifically “as an anti-viral.” Also, she explains, one study found that patients treated with vitamin A following surgery exhibited an increase in lymphocytes. It also includes vitamin C, which has been shown to reduce cold incidence by as much as 50 percent when consumed as a preventative, notes Myers. Vitamin C is said to also alleviate allergy and other respiratory symptoms, because it has a natural anti-histamine effect. ViraPro contains vitamin D, deficiencies of which tend to increase susceptibility to allergies and upper respiratory issues, Myers points out. “One long-term study showed that for each increase of vitamin D, there was a corresponding 7% lowered risk of infection, and a medical survey found that low vitamin D correlated with a prevalence of rashes, sneezing, and sinus infection,” she states.

The immune formula also contains vitamin E in the form of mixed tocopherols and zinc, plus magnesium, calcium lactate, and selenium which “are also great partner minerals — and each one bolsters the other for immune defense, strengthening cellular integrity and keeping things running smoothly,” explains Myers .“Its ingredients strengthen resistance during healthy times, help prevent the ups and downs of colds and flus, and shorten the duration of colds or viruses if any slip through defenses.”
Studies have observed that even a mild zinc deficiency can elicit changes in immune status, such as defective natural killer cell function, decreased interleukin-2 production and anergy (i.e., the absence of a normal immune response to a particular antigen or allergen). —Trisha Sugarek MacDonald, Bluebonnet Nutrition Corp.
Another unique immune health formulation, according to Steve Myers, VP of marketing for the Island Park, NY-based Bio Nutrition, the firm’s Olive Leaf & Oregano Immune Wellness Formula blends a base of essential immune-balancing vitamins and minerals for immune system support with botanicals researched to help general immune boost and function. Vitamin D3, vitamin C, selenium and zinc are well received and well documented for their ability to sustain healthy immune function. Magnesium in the formula comes from chlorella, which is known to cleanse the blood and supports elimination of toxins. This formula is enhanced by olive leaf with 20% oleuropeins, which research has shown ability to prohibit pathogenic bacteria ability, antioxidant oregano extract, elderberry extract and maitake mushroom.

Boosting Immune-Supplement SalesUnlike other condition-specific or targeted supplements, those for immune support are relevant, timely and suitable for every customer and his/her family, all the time. Creating signage to this effect may be impactful, as curious customers will inevitably ask why that’s so.

“In an ideal world,” opines Dr. Meletis, “a health savvy consumer will invest daily in sustaining immune competence and will then utilize acute/short term ‘immune nudging’ formulas to support the body during times of heightened need for defense. I share with my patients that a well-nourished person who sustains a higher level of daily health is more capable to deal with immune challenges, and should not wait until they have symptoms to tend to their well-being.”

He adds that there are two sub-categories that retailers should have — supplements for acute/short-term immune boosts, and supplements for chronic/long-term immune support. Koff, who is also a practitioner, says she frequently advises retailers to use qualified professionals such as herself to promote and educate about the supplements in this category, and how to achieve overall strong immunity. “I also advise to avoid language that can be an over-promise and think it’s best to remind customers to visit their practitioners if they are dealing with certain issues,” she adds.

Seasons will drive more customers to ask about immune support, thanks in large part to consumer media coverage exhorting them to boost their immune systems before the winter and for spring. And although immune-support is a full-time consideration and practice, Myers believes that there are times throughout the year that retailers can more heavily promote a natural approach to immune health — such as the beginning of the school year, the middle of winter and in early spring and fall when pollen counts are high.  “Bringing in guest speakers to discuss the many ways the immune system is under attack, and the interplay of natural ingredients in helping overcome deficiencies and keep people healthy can go a long way to getting that message out there,” she notes.

Review and renovate your immune health department to make it interactive, informative and attractive, says Sugarek MacDonald. Cross-merchandise immune supplements with foods that are also good for immune protection.

Supplement recommendations can vary but Levin suggests that retailers always recommend a multivitamin-mineral formula as a foundation, plus, if the customer feels he or she needs extra support, vitamin C and zinc as found in lozenges and effervescent packs are suitable, and consumers tend to recognize these today. “Enhance this nutritional program with a variety of botanicals that reduce stress and support healthy immunity,” he adds.

Sugarek MacDonald advises to select wide-ranging and appropriate targeted supplements for immune health and divide the immune health product section into sub-categories, such as: • Allergies (e.g., quercetin, bromelain, and stinging nettle) • Winter season (e.g., zinc, vitamins E & C, andrographis, and NAC.) • Sleep deprivation (e.g., melatonin, 5-HTP, and L-tryptophan) • Maintaining a healthy weight (e.g., yoga mats, Fit Bits, whey protein isolate powder, protein bars, garcinia cambogia, Clarinol CLA, chromium etc.)

“Avoid too much product redundancy. Focus on one immune health sub-category or pick three popular items across the immune health categories for an overall immune health approach and then rotate on a monthly basis,” says Sugarek MacDonald. “Also provide literature that states the benefits of sleep, meditation, moderate exercise and healthy habits on a special ‘immune health’ stand or table.”

Dr. Schwartz recommends for staff to try the various products and see which ones they feel are effective after a certain amount of time. “Examine each formula, forget marketing, go to what is important and meaningful,” he says. “Promote your best.”

Vitamins and minerals that work to promote and sustain immune-health do more than that duty, making them very attractive to promote in this category. Additionally, vitamins and minerals are typically the first “natural products” consumers tend to think about when considering improving their health, so they are a natural fit.WF