The Go-To Supplements When people aren't feeling their best, there’s a list of supplements they turn to—vitamins C and D, zinc, and elderberry come to mind, although the list of options that people can discuss with their healthcare provider is longer, depending on how much an individual knows about supporting immune health.
For a starter, James DiNicolantonio, Pharm.D., Director of Scientific Affairs at AIDP Inc., took a deep dive into the studied usage of vitamin C and zinc. “There’s a dose-dependent response,” he explained. “1 gram of vitamin C causes a 6.9% decrease in common cold symptoms, but 4 grams shows a 20% reduction. It only takes 10mg to prevent scurvy, but it takes more to see actual benefits.” Ideally, he continued, adults would take 10g vitamin C and children would take 4g in order to see a potential 50% reduction in the severity of the common cold—but the human body has a tolerable upper limit of 2g/day and children have an upper limit of 1.2g/day, which is approximately when diarrhea begins. And, he says, that amount should not be taken all at once—it should be taken in doses. “Taking just one dose of vitamin C or zinc daily will not help,” he exlplained. “We don’t drink all our water in one sip, we don’t breathe all our air in one inhale—and in order to maintain the proper levels of zinc and vitamin C, we have to dose it right and take it regularly.”
What’s the proper dose of zinc? Dr. DiNicolantonio continued: “You want to get about 18mg or more of ionic zinc every two hours, and a daily total of at least 75mg. Doing less than that will likely have no effect on colds.” There are more than 40 brands of zinc lozenges on the U.S. market, but, he said, due to inadequate lozenge release of ionic zinc, very few of those brands are expected to have any effect on colds. And another tip: “Zinc can cause copper deficiency. The AREDS study added copper to their zinc supplement for this reason.” The AREDS study was useful for another reason, too—Dr. DiNicolantonio noted that it went on for seven years, and that around the four-year mark there was a 27% reduction in mortality, thanks in part to the use of zinc. The long-term nature of the study means that we can draw conclusions regarding the usefulness of zinc to the elderly.
Dr. DiNicolantonio also discussed elderberry. His tip: Make sure that the extract you sell or use is standardized, with a high proportion of anthocyanins. “A non-standardized elderberry extract that is not high in anthocyanins will give little, if any, benefit; anthocyanins have antiviral effects. With standardized elderberry, there is a 2-4 day reduction in duration of influenza and the common cold—verystatistically significant.”
And then, of course, there’s vitamin D. Dr. DiNicolantonio’s recommendation here was to go for vitamin D3 above D2, which increases free and total vitamin D levels better than D2. It converts to active vitamin D better, as well, and has less risk of toxicity.
…And Beyond Dr. DiNicolantonio didn’t stop with the basics. He noted several other promising supplements. One of those was selenium, which at 297 mcg/day enhanced the adaptive immune system—B and T cells—and, incidentally, researchers have linked selenium status to COVID-19 outcome (Plus—read theJuly edition of Vitamin Connection, which takes an in-depth look at that connection, as well as at selenium’s effects on immune health).Dr. DiNicolantonio also suggested glutathione, which improved dyspnea in COVID-19 patients at 2g/day; alpha lipoic acid, which cut mortality in half in COVID-19 patients at 1,200mg/day via IV.
Looking back at the common cold and influenza, Dr. DiNicolantonio noted that a six-month study conducted prior to cold/flu season found that giving older adults 600mg N-acetylcysteine twice daily significantly attenuated influenza symptoms, as well as improving immune health.
There were a couple supplements Dr. DiNicolantonio noted that can support those with upper respiratory tract infections (URTI). First, quercetin, which significantly reduced URTI incidence in cyclists at 1,000mg/day; and second, beta-glucan, which is taken up by the immune system and has been shown in “at least a dozen” clinical trials to reduce the incidence of URTIs at 250-500mg/day for adults and 100mg/day for children.
And there are ways to increase the bioavailability of supplements. For one: Martie Whittekin, CCN, author and radio host who presented on Aloe vera and the science behind Lily of the Desert’s Aloe, noted that aloe can help the body digest and absorb nutrients. “Retailers should recommend that customers take supplements with 2-4oz of Lily of the Desert aloe to help absorb nutrients that improve immune function, and aloe should be kept in the immune section.”
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Related: Can Selenium Signifcantly Increase the Cure Rate in COVID-19? FTC Sends 35 More Letters to Companies With Unsubstantiated COVID-19 Claims Duke University Medical Center to Assess Probiotics in COVID-19 ExposureGut Health We know gut health makes a difference in immunity—upwards of 80% of the immune system is located in the gut, not to mention that healthy digestion means the body can make the most of the immune-supporting nutrients in food and supplements. Moreover, the immune system has a sweet spot, and it’s best to hit that: “We want to achieve a balance between defense and moderation,” said Luis Gosalbez, Ph.D., Business Director at Clasado Biosciences. “We want to have an immune system that fights invaders, without going overboard. And we know that the microbiome plays a vital part in this.”
Several presenters had some quick tips for choosing products to stock in this important category. For instance— Anthony Thomas, Ph.D., Director of Scientific Affairs at Jarrow Formulas, offered this tip: “Look for the science. Most strains have been shown effective at between 1 and 10 billion CFUs, not 25 billion. And most studies are done on one strain, maybe a combination of a couple, not a laundry list like you see on many of the products out there.” As we at WholeFoods regularly report, it’s not enough for a company to head to market on the strength of someone else’s science—or even on the strength of reputation: Not every elderberry extract is the same, so stock the one that’s been studied; not every probiotic does the same thing or works at the same pace or in the same way, so stock the product that has been studied.
Another suggestion: Stock synbiotics, probiotics that already contain prebiotics. Ewa Hudson, Director of Insights at Lumina Intelligence, told attendees that customers are buying synbiotics: Probiotics containing prebiotics receive 3 million reviews, out of 4.1 million, and are rated higher across e-commerce in 12 countries, including the U.S., she explained. In the U.S., probiotics without prebiotics received an average rating of 4.40 stars; probiotics with prebiotics received 4.49 stars. “It may not seem like a lot, but customers generally choose which product to buy based on customer reviews, so it makes a difference.”
For those who prefer to have their pre- and probiotics separately, however—either because they’re looking for a different dosage or because they’re sensitive to certain prebiotics—Clasado Biosciences sells Bimuno, a GOS blend that Dr. Gosalbez said stimulates the growth of good bacteria in the gut, and has been shown in scientific studies to act in just 7 days. For those with sensitive stomachs, Clasado offers Bimuno IBAID—which is gluten-free, for those avoiding gluten.
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*Note: Information in this interview is intended for educational and scientific purposes only. It is not intended as medical or nutritional advice for the treatment or prevention of disease. For medical advice, consult your personal health care practitioner.