A high salt intake has been associated with increased blood pressure and poor heart health.
It’s thought that our ancestors evolved in an environment with a low salt intake. Because of this, humans have developed efficient biological processes to retain salt in our body. But in today’s world, we have an abundance of salt in our food, particularly processed foods.
Generally speaking, the term salt refers to table salt. Table salt is refined and processed to remove other minerals and impurities. Table salt usually contains anti-caking agents such as sodium ferrocyanide (E535) and on average contains 97-99% sodium chloride. Therefore, the term “salt” generally means sodium chloride.
Salt is associated with high blood pressure because sodium attracts water. A high-salt diet draws water into the bloodstream, increasing blood volume and the pressure in your blood vessels. Long term high blood pressure puts pressure on organs including the heart, kidneys, brain, and eyes. Over time if blood pressure is not managed, it can cause negative affects to blood vessels and organs.
However, not everyone responds to salt in the same way. Some people can consume a high salt diet and they will not develop high blood pressure.
Put simply, salt sensitivity describes an increase in blood pressure in response to sodium intake. Salt resistance describes someone who has a high salt diet and does not develop high blood pressure.
Of course, salt is not the only factor that causes high blood pressure.
Ongoing high blood pressure and salt sensitivity are caused by an interaction between our genes and lifestyle habits including a high salt diet and sedentary behaviour. Almost half of the US population has chronic high blood pressure, salt sensitivity, or both.1
Multiple gene variants have been associated with salt sensitivity and high blood pressure. In particular, common variations within the genes that code for AGT (angiotensinogen), and ACE (angiotensin converting enzyme) have been identified. These genes play a significant role in the renin-angiotensin system, this is what regulates your blood pressure. This system includes your kidneys, heart, blood vessels, liver, lungs and central nervous system that includes the brain, as shown in Figure 1.
A common gene variation within AGT (classified as rs699 or M235T) has been strongly associated with increased risk for high blood pressure, and two studies have reported a link with salt sensitivity.2,3 A trial showed that people who inherit the rs699 variant have a greater reduction in blood pressure following a low-sodium diet, compared to those who do not have the AGT gene variant.3
Interestingly, the rs699 variation is inherited in linkage with AGT rs5051, -6 G > A. Linkage means the variations are usually inherited together. The rs5051 A variant is also associated with a greater reduction in blood pressure after decreasing sodium. These results suggest that people who inherit these genetic variations within AGT are more likely to experience salt sensitivity and may benefit from reducing salt in their diet to better manage blood pressure.4
The most common variation within the ACE gene is not a single DNA base change, which is the most common variation and often called a SNP (single nucleotide polymorphism). In this case the ACE gene has an insertion or a deletion, meaning an extra chunk of DNA is added (insertion) into the gene or it is missing (deletion). Regarding DNA testing, the ACE insertion or deletion is identified by a number of SNPs including rs4340.5
The ACE deletion has been associated with increased ACE levels and high blood pressure, especially in those with a high sodium diet.6 Despite there being convincing evidence linking high blood pressure with the ACE deletion, studies on salt sensitivity have been inconsistent. Large intervention trials are needed before any strong conclusions can be made.
If you have done genetic testing, you can check your results to determine if you have inherited genes that can increase your susceptibility to high blood pressure and possibly salt sensitivity. Furthermore, if you have a blood pressure monitor you can do an assessment at home by consuming a low sodium diet for about a week, then increase your salt intake for 4 days. If your blood pressure increases by more than 5% after eating the higher salt diet, you are considered salt sensitive.
If you have inherited variations within AGT or ACE, or you find that salt does increase your blood pressure, reducing sodium along with increasing other minerals such as potassium, magnesium and calcium can help keep blood pressure levels within a healthy range. Also, by focusing on intaking enough fruits and vegetables instead of packaged foods can support healthy immune function and help to maintain a healthy weight. In turn these can improve long term cardiovascular health.7
Dr Denise Furness, PhD, BSc (Hons), RNutr +
Geneticist & Nutritionist
CSO and Founder, Your Genes & Nutrition
Sunshine Coast, Australia
Dr Denise Furness, PhD is a molecular geneticist and registered nutritionist. She is a pioneer in the field of nutrigenomics and epigenetics with 20 years’ experience in the area. She began her career as a research scientist focusing on folate nutrigenomics, methylation, and DNA damage. She has published her work in peer reviewed journals and has won numerous awards for her research and conference presentations. In 2012 she founded Your Genes and Nutrition and began applying her knowledge in private practice.
+Our Medical Consultants are retained advisors to Pure Encapsulations.
Felder et al.. Curr Opin Nephrol Hypertens. 2013
Johnson et al. Blood pressure is linked to salt intake and modulated by the angiotensinogen gene in normotensive and hypertensive elderly subjects. J Hypertens. 2001
Hunt et al. Enhanced blood pressure response to mild sodium reduction in subjects with the 235T variant of the angiotensinogen gene. Am J Hypertens. 1999
Hunt et al.. Hypertension. 1998
Lupoli et al. Dietary Salt Intake, Blood Pressure, and Genes. Curr Nutr. 2013
van der Kleij et al. Enhanced responses of blood pressure, renal function, and aldosterone to angiotensin I in the DD genotype are blunted by low sodium intake. J Am Soc Nephrol. 2002.
Pem D, Jeewon R. Fruit and Vegetable Intake: Benefits and Progress of Nutrition Education Interventions- Narrative Review Article. Iran J Public Health. 2015 Oct;44(10):1309-21. PMID: 26576343; PMCID: PMC4644575.
Hypertension affects more than 30% of the adult population worldwide, more than one billion people around the world. Furthermore, the CDC has reported that only 1 in 4 adults with high blood pressure are thought to have it under control.1
The genes you inherit from your parents along with lifestyle factors are known to effect blood pressure. A gene is a segment of DNA that contains the instructions for building a protein. Proteins, such as enzymes are complex molecules that trigger various biological actions needed to sustain life.
One key gene, called MTHFR (methylenetetrahydrofolate reductase) codes for an enzyme that processes folate and regulates homocysteine levels. Homocysteine is a natural product, and considered an intermediate amino acid because it supports the production of other amino acids. However, high levels can damage the cells that line our blood vessels increasing the risk for blockages causing high blood pressure and cardiovascular complications.
Research indicates that common, inherited MTHFR gene variations increase the risk for high homocysteine levels and high blood pressure.2,3 The most widely studied gene variation is referred to as MTHFR 677. It is called “677” because there is a “C” to “T” DNA base code change at position 677 within the MTHFR gene. Over 40% of the American population are likely to have at least one MTHFR 677 variant, it is less frequent in Asians and Africans.4
Ultimately, the MTHFR 677 variation causes a structural change in the protein and slower enzyme activity. This can lead to low folate and higher homocysteine levels in our blood. Folate (vitamin B9), along with other supporting B vitamins are needed to metabolize homocysteine and keep levels within a healthy range. Low folate, B vitamins or sluggish enzyme activity can directly impact homocysteine, blood pressure and cardiovascular health.
Aside from the MTHFR 677 variation, vitamin B2 (riboflavin) also directly influences how well the MTHFR enzyme can metabolize folate and homocysteine. Vitamin B2 is required to produce FAD (flavin adenine dinucleotide). FAD is a cofactor required for many enzymes to function, including MTHFR. Without FAD the MTHFR enzyme works at a slower rate or may be totally inactive. Furthermore, the MTHFR 677 variation changes the structure of the enzyme, reducing the ability of the FAD cofactor to bind.3 This is one of the reasons why the variation causes the enzyme to not work so well.
Research indicates that vitamin B2 may be key to reducing high blood pressure in people with the MTHFR 677 TT variation. Studies have shown a reduction in systolic blood pressure by 6 - 13 mmHg and up to 9 mmHg in diastolic blood pressure, with increased vitamin B2 in those with the TT variation.3,5,6 It has been suggested that people with the MTHFR 677 TT variant may be able to increase and restore enzyme activity with vitamin B2 (riboflavin) supplementation. Higher vitamin B2 levels are associated with increased MTHFR enzyme activity, lower homocysteine and improved blood pressure.2,6,7
Moreover, studies suggest that those with the inherited MTHFR TT gene are less likely to be able to control their blood pressure with prescribed antihypertensive therapies.8 Intervention trials show vitamin B2 supplementation may help to achieve healthy blood pressure along with routine antihypertensive treatment in these people.8
Vitamin B2 supplementation offers a personalised approach which may help to prevent the onset of high blood pressure, along with lifestyle interventions in people with the MTHFR TT gene. In addition, people with the MTHFR 677 TT variation who have high blood pressure and cannot manage their blood pressure with antihypertensives, may benefit from vitamin B2. In summary, vitamin B2 may be the key in those with the MTHFR genetic risk for high blood pressure.
How do I know if I have the MTHFR 677 variant?
Dr Furness: We inherit two copies of our genes, one set from Mom and one set from Dad. If someone inherits a variation from one parent this is a single variation (known as heterozygote), this is shown as MTHFR 677 CT. If someone inherits a double variation, therefore from both Mom and Dad (known as homozygote) the result is shown as MTHFR 677 TT. If you have done genetic testing, you can check if you have inherited the MTHFR 677 CC, CT or TT result.
Dr Denise Furness, PhD, BSc (Hons), RNutr +
Geneticist & Nutritionist
CSO and Founder, Your Genes & Nutrition
Sunshine Coast, Australia
Dr Denise Furness, PhD is a molecular geneticist and registered nutritionist. She is a pioneer in the field of nutrigenomics and epigenetics with 20 years’ experience in the area. She began her career as a research scientist focusing on folate nutrigenomics, methylation, and DNA damage. She has published her work in peer reviewed journals and has won numerous awards for her research and conference presentations. In 2012 she founded Your Genes and Nutrition and began applying her knowledge in private practice.
+Our Medical Consultants are retained advisors to Pure Encapsulations.
Ward, et al. Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project, BMC Medicine. 2020
McNulty, et al. Riboflavin, MTHFR genotype and blood pressure: A personalized approach to prevention and treatment of hypertension, Mol Asp Med. 2017
Horigan et al. Riboflavin lowers blood pressure in cardiovascular disease patients homozygous for the 677C→T polymorphism in MTHFR. J Hypertens. 2010
Wilson et al. Riboflavin offers a targeted strategy for managing hypertension in patients with the MTHFR 677TT genotype: a 4-y follow-up. Am J Clin Nutr. 2012
McNulty et al. Riboflavin lowers homocysteine in individuals homozygous for the MTHFR 677C->T polymorphism. Circulation. 2006
Wilson CP et al. Blood pressure in treated hypertensive individuals with the MTHFR 677TT genotype is responsive to intervention with riboflavin: findings of a targeted randomized trial. Hypertension. 2013
Veganism used to be a niche topic, but with the public's interest in plant-based foods, it's becoming more mainstream. A vegan diet avoids all animal products or by-products, including eggs, dairy, and honey.
With planning, vegan diets can be healthy and provide many health benefits, but emphasizing specific vitamins and minerals can ensure that vegans get the adequate nutrients they need. In the same way a non-vegan lifestyle can be healthy or unhealthy depending on what foods are included in the diet, vegan diets come with unique vitamins and mineral guidelines that should be prioritized for optimal health.
Vitamin B12 is usually the primary nutrient people consider when looking for essential vitamins in a vegan diet. Vitamin B12 is found naturally only in animal products, so supplements are necessary to meet needs. Still, there are other nutrients to consider, either because they are harder to get from plant-based foods or because they help improve the absorption of other nutrients. 1
People follow vegan diets for many reasons, including ethical, health, or religious practices. 2 Plant-based diets may benefit health in many ways, including improving diet quality, increasing fruit and vegetable intake, and lowering saturated fat intake. 3
Several studies suggest that vegan diets can support positive health outcomes such as: 2,4
Of course, specific food choices matter; simply being vegan isn't enough to get these benefits. A vegan diet high in highly processed vegan food products may not be healthier than a diet containing animal products. A vegan pattern emphasizing plants and plant proteins is essential; otherwise, you could miss out on vital nutrients. 2 Eating or supplementing the diet with key nutrients can support a well-balanced vegan lifestyle. 1
1. EPA and DHA
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are omega-3 fatty acids that support normal function of the heart. The primary food source for these nutrients is seafood, although seeds and nuts such as flaxseed, chia seeds, and walnuts also contain EPA and DHA.
Plant-based sources of DHA and EPA contain another omega-3 fatty acid called alpha-linolenic acid (ALA). ALA can be converted to EPA and DHA in the body, but the process is inefficient compared to direct consumption from seafood, so even if you eat foods with ALA, you aren't getting as much of the active forms per serving. 5
Some studies suggest that people who follow a vegan diet have lower levels of DHA and EPA in their blood than those who eat meat, so supplements are a consideration.5 Many supplements use fish oil to provide EPA and DHA, which wouldn't be suitable for people on a vegan diet, but algae-based supplements are vegan and can be an option to support healthy levels in the body. 6
2. Iron
Iron is an essential nutrient for cell growth, oxygen transport, healthy blood cell formation, energy production, and immune health. It's found in animal products like meat, poultry, and fish, but it's also found in many plants. 2
The amount of iron consumed by people following vegan diets is high, as leafy greens, grains, and beans all contain iron. The type of iron found in these foods is called non-heme iron (versus heme iron found in animal sources). Non-heme iron is less bioavailable than heme iron because it has to go through an extra step before it can be absorbed by the body. Even if someone following a vegan diet eats the same amount of total iron as someone who eats meat, the amount of absorbable iron might be lower. Compounds like phytates or tannins in plant foods can also interfere with absorption. 7
As a result, iron recommendations for people on a vegan diet are higher to make up for lower absorption rates.viii Supplementation is often used in addition to diet to meet those needs, but iron supplements should always be discussed with your healthcare practitioner before taking them because too much iron can be toxic. 9
3. Vitamin C
Vitamin C is an essential nutrient for the normal function of the immune system. It's also important for skin health and acts as an antioxidant. You can find vitamin C in many fruits and vegetables, especially citrus fruits, bell pepper, broccoli, and potatoes. People who follow vegan diets that include these foods often have adequate amounts, but those who rely on processed and packaged foods may be lacking. 10
Aside from its primary jobs in your body listed above, vitamin C optimizes iron absorption, making it especially important for people who get iron from non-heme iron sources. Vitamin C helps with iron absorption by (reducing iron) to a form that's easier for your body to absorb. Pairing iron-rich meals with foods that contain vitamin C (or supplemental vitamin C) could help support healthy iron levels. 10
4. Folate
Folate is a B vitamin that supports normal psychological function, homocysteine metabolism and immune system function. It also supports energy levels by contributing to the reduction of tiredness and fatigue, normal blood formation, plays a role in cell division and amino acid synthesis.11 It's especially critical to get enough in the reproductive years to support a healthy pregnancy.12
Folate works closely with vitamin B12 for red blood cells and nerve cell production. The two nutrients also help maintain healthy homocysteine levels, an amino acid in the blood associated with cardiovascular health.
Like vitamin C, folate is found in a wide variety of plant foods like vegetables, legumes, and whole grains, so eating a balanced diet rich in plant foods is the best way to get enough of it unless the diet is high in processed foods.1
Some foods are also fortified with folic acid, but supplements are an option to meet needs. Folate supplementation (in the form of folic acid) is recommended for women who could become pregnant even if they eat enough of these folate-containing foods because it's such a critical nutrient for healthy fetal development. 13
5. Calcium
Calcium, a mineral essential for bone health and muscle and nerve function, is found in high amounts in dairy products like milk, yogurt, and cheese, so people who follow a vegan lifestyle may have a low intake. Even though plant-based foods like leafy greens and broccoli contain calcium, studies suggest that vegans may have lower bone mineral density and increased fracture risk, possibly due to inadequate calcium intake (among other bone-building nutrients). 2
Similar to iron, the calcium found in some plants is less bioavailable due to oxalates, phytates, and fiber. These foods interrupt calcium absorption from plant-based sources, with bioavailability rates ranging from 20 to 40%.14
To meet the recommended daily intake for calcium, vegans can focus on calcium-rich foods like fortified plant-based milk, tofu, sesame seeds, almonds, navy beans, and leafy greens and possibly use calcium supplements to fill in the gaps.
6. Vitamin D3
The sunshine nutrient, vitamin D, works alongside calcium to support bone health. xv It's also essential for muscle function and immune health. Sun is the primary source of vitamin D, but many people don't get enough since so many factors affect our exposure. Time of day, use of sun protection like sunscreen or UV-blocking shirts, skin color, geophagy, age, and genetics are just some factors that influence how much vitamin D we gain from the sun.16
Vitamin D isn't found in very many foods. Fatty fish and fortified foods could, but people following vegan diets (and even those who don't) may consider supplements to fill in the gaps, especially in low-sun climates or during winter. Vegan vitamin D supplements are available, but it's important to read nutrition labels carefully since some vitamin D is sourced from animal sources. 2
7. Selenium
Selenium is a trace element needed for antioxidant activity. It's also an essential nutrient for thyroid health as it's required for thyroid hormone production. xvii Selenium is found in plant foods like Brazil nuts, sunflower seeds, and mushrooms. 2
The amount of selenium in the soil influences how much is found in foods, so the amount in a particular food can vary. A study comparing vegetarians, vegans, and omnivores found low selenium for all groups, so it may be a nutrient to consider supplementing for all diet patterns. 16
8. Zinc
Zinc is needed for immune health, enzyme and cofactor production, iron metabolism, and skin health. It's found in meat, dairy, eggs, seeds, nuts, and whole grains. Bioavailability is an issue for plant-based sources of zinc as phytates can interfere with absorption. 18 Zinc absorption ranges from 5% to more than 50%, depending on the amount contained in plant-based foods in the diet. 19
Studies suggest people following a vegan diet may have lower zinc levels. xx Strategies to improve bioavailability from foods or supplement with a zinc supplement could help ensure adequate zinc intake.19
Each of the above nutrients can make the difference between a diet pattern that is adequate and one that meets all the requirements for optimal health. A balanced vegan diet can provide the nutrients needed to thrive, but it's essential to pay attention to food choices and supplement if necessary.
If you're considering a vegan eating pattern, make sure you understand what nutrient sources are available and take additional steps to ensure optimal intake. Working with a healthcare practitioner who can look closely at your diet to assess for gaps and recommend supplements as needed can help create a plan individualized to your body.
Caitlin Beale, MS, RDN is a registered dietitian and freelance health writer. She has a master's degree in nutrition and over ten years of experience as a registered dietitian.
+The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.
1 Neufingerl N, Eilander A. Nutrient Intake and Status in Adults Consuming Plant-Based Diets Compared to Meat-Eaters: A Systematic Review. Nutrients. 2021;14(1):29. Published 2021 Dec 23. doi:10.3390/nu14010029
2 Sakkas H, Bozidis P, Touzios C, et al. Nutritional Status and the Influence of the Vegan Diet on the Gut Microbiota and Human Health. Medicina (Kaunas). 2020;56(2):88. Published 2020 Feb 22. doi:10.3390/medicina56020088
3 Miles FL, Lloren JIC, Haddad E, et al. Plasma, Urine, and Adipose Tissue Biomarkers of Dietary Intake Differ Between Vegetarian and Non-Vegetarian Diet Groups in the Adventist Health Study-2. J Nutr. 2019;149(4):667-675. doi:10.1093/jn/nxy292
4 Key TJ, Papier K, Tong TYN. Plant-based diets and long-term health: findings from the EPIC-Oxford study. Proc Nutr Soc. 2022;81(2):190-198. doi:10.1017/S0029665121003748
5 Saunders AV, Davis BC, Garg ML. Omega-3 polyunsaturated fatty acids and vegetarian diets. Med J Aust. 2013;199(S4):S22-S26. doi:10.5694/mja11.11507
6 Sarter B, Kelsey KS, Schwartz TA, Harris WS. Blood docosahexaenoic acid and eicosapentaenoic acid in vegans: Associations with age and gender and effects of an algal-derived omega-3 fatty acid supplement. Clin Nutr. 2015;34(2):212-218. doi:10.1016/j.clnu.2014.03.003
7 Haider LM, Schwingshackl L, Hoffmann G, Ekmekcioglu C. The effect of vegetarian diets on iron status in adults: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2018;58(8):1359-1374. doi:10.1080/10408398.2016.1259210
8 Pawlak R, Berger J, Hines I. Iron Status of Vegetarian Adults: A Review of Literature. Am J Lifestyle Med. 2016;12(6):486-498. Published 2016 Dec 16. doi:10.1177/1559827616682933
9 Gallego-Narbón A, Zapatera B, Vaquero MP. Physiological and Dietary Determinants of Iron Status in Spanish Vegetarians. Nutrients. 2019;11(8):1734. Published 2019 Jul 26. doi:10.3390/nu11081734
10 Piskin E, Cianciosi D, Gulec S, Tomas M, Capanoglu E. Iron Absorption: Factors, Limitations, and Improvement Methods. ACS Omega. 2022;7(24):20441-20456. Published 2022 Jun 10. doi:10.1021/acsomega.2c01833
11 EFSA Journal 2009; 7(9):1213. https://efsa.onlinelibrary.wiley.com/doi/pdf/10.2903/j.efsa.2009.1213
12 Caffrey A, McNulty H, Rollins M, et al. Effects of maternal folic acid supplementation during the second and third trimesters of pregnancy on neurocognitive development in the child: an 11-year follow-up from a randomised controlled trial. BMC Med. 2021;19(1):73. Published 2021 Mar 10. doi:10.1186/s12916-021-01914-9
13 Bakaloudi DR, Halloran A, Rippin HL, et al. Intake and adequacy of the vegan diet. A systematic review of the evidence. Clin Nutr. 2021;40(5):3503-3521. doi:10.1016/j.clnu.2020.11.035
14 Melse-Boonstra A. Bioavailability of Micronutrients From Nutrient-Dense Whole Foods: Zooming in on Dairy, Vegetables, and Fruits. Front Nutr. 2020;7:101. Published 2020 Jul 24. doi:10.3389/fnut.2020.00101
15 Mangels AR. Bone nutrients for vegetarians. Am J Clin Nutr. 2014;100 Suppl 1:469S-75S. doi:10.3945/ajcn.113.071423
16 Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol. 2013;5(1):51-108. doi:10.4161/derm.24494
17 Fallon N, Dillon SA. Low Intakes of Iodine and Selenium Amongst Vegan and Vegetarian Women Highlight a Potential Nutritional Vulnerability. Front Nutr. 2020;7:72. Published 2020 May 20. doi:10.3389/fnut.2020.00072
18 Lemale J, Mas E, Jung C, Bellaiche M, Tounian P; French-speaking Pediatric Hepatology, Gastroenterology and Nutrition Group (GFHGNP). Vegan diet in children and adolescents. Recommendations from the French-speaking Pediatric Hepatology, Gastroenterology and Nutrition Group (GFHGNP). Arch Pediatr. 2019;26(7):442-450. doi:10.1016/j.arcped.2019.09.001
19 Office of dietary supplements - zinc. NIH Office of Dietary Supplements. Accessed June 2, 2023. https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/.
20 Foster M, Chu A, Petocz P, Samman S. Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. J Sci Food Agric. 2013;93(10):2362-2371. doi:10.1002/jsfa.6179
Zinc is an essential mineral that plays a part in more than 300 different enzymatic reactions in the body. From protein structure to DNA synthesis, zinc is necessary for many processes in the body to function normally.1 It's involved in nutrient metabolism, cognitive function, fertility and reproduction, and bone health. 2 3 4 However, the role most people associate with zinc is its contribution to healthy immune system function.5 4
Zinc is found in foods like shellfish, pumpkin seeds, meat, and seafood. Still, some studies suggest that certain groups of people may not get enough from their diet.6 As a result, many turn to supplements to fill in the gaps, but choosing the right supplement can be overwhelming.
How do you choose, and what form do you need when faced with so many options? This guide will take a closer look at the different forms of zinc so you can find the best choice for your needs.
From pills to lozenges to nasal sprays, one of the first things to consider when choosing a zinc supplement is that certain forms may be better absorbed. You want to ensure that your body can absorb and use the zinc effectively with minimal side effects (some forms of zinc can cause GI upset). 7
When you take a zinc supplement, you aren't taking zinc alone. Supplemental zinc isn't well absorbed on its own, so it's usually chelated (bonded) to another substance. This process
increases the bioavailability of zinc in the supplement, making it more readily available for absorption. Think of it like a helping hand to get the zinc where it needs to go in your body.
Zinc is often bound to inorganic or organic acids to create different forms, each with varying levels of absorbability and bioavailability. Organic acids tend to be better absorbed than other forms. 8
Zinc absorption also depends on how much zinc you get in your diet and your zinc status (meaning the body takes what it needs). People with lower intakes may have better absorption rates than those who get more from their diet.
As mentioned above, zinc bound to organic acid tends to be better absorbed, so these forms are generally recommended over others. Examples of inorganic acids include sulfate and oxide. Examples of organic acids are gluconate, picolinate, acetate, and citrate.
Let's dive into some of these forms in more detail.
Zinc gluconate:
Zinc gluconate, a compound formed by chelating zinc with gluconic acid (an oxidized form of glucose), is a widely used form of zinc. You'll find it incorporated into a variety of
supplements, such as pills, capsules, lozenges, and sprays. Studies suggest that zinc gluconate can support healthy immune function. 9 10
Zinc citrate:
Zinc chelated with citric acid is known as zinc citrate, another popular form of zinc found in dietary supplements. Research supports using supplemental zinc citrate to help maintain healthy zinc levels in the body. It's absorbed at similar rates as zinc gluconate and may be even more bioavailable than some forms of zinc. 7
Zinc picolinate:
A type of zinc chelated with an organic acid called picolinic acid (a derivative of the amino acid tryptophan), zinc picolinate is commonly used in supplements for its high absorption rate. Studies suggest that zinc picolinate is bioavailable and can improve zinc absorption in the body. A study comparing zinc gluconate and zinc picolinate found that both forms were well-absorbed, but zinc picolinate had a slight edge over gluconate. 11
Zinc acetate:
Zinc acetate is made by adding acetic acid with zinc (acetic acid is the main component of vinegar). Zinc acetate has been extensively studied for its role in supporting healthy immune function in scientific research. 3 10 Comparative studies examining zinc acetate and zinc gluconate in supporting normal immune function have revealed similar efficacy between the two forms. 10
Zinc sulfate:
You may have seen zinc sulfate in topical forms to support skin health, like in diaper rash creams, but it's also used in dietary supplements. Zinc sulfate is made by adding sulfuric acid with zinc and may have slightly lower bioavailability than other forms. Aside from being poorly absorbed, zinc sulfate may be more likely to cause stomach upset. 3
Zinc oxide:
That white nose and face paint used by lifeguards isn't only for show. Zinc oxide is used in sunscreen as a physical barrier to block UV radiation and protect the skin from harmful sun damage. It's often used as a coloring agent in products like cosmetics, so some consider it more of an additive than a nutritional form of zinc. Since it's also less bioavailable than other forms of zinc when used as a dietary supplement, it's not typically recommended as a primary form of zinc supplementation. 7
Aside from choosing the right form of zinc, brand quality is an essential consideration when you purchase a supplement. Independent, ceritfied testing and quality ingredients are crucial when selecting zinc supplements to ensure your supplement is safe, free from harmful contaminants, and accurately labeled.
Independent verification guarantees that the product contains the ingredients listed on the label, in the declared potency and amounts, without potentially harmful substances such as heavy metals, microbial contaminants, or other adulterants.
The recommended daily adult intake of zinc is 15 mg and because there are many sources of zinc throughout the environment, exposure and toxicity are not uncommon.12 You should always consult your physician prior to starting any supplement regime as increased levels of certain trace minerals can become toxic.
The quality of all the other ingredients in your supplement also matters. Fewer additives and fillers are less likely to cause adverse reactions or become a problem for people with allergies and sensitivities.
Zinc supplements can support immune function and many other systems in the body, but not all zinc supplements are created equal. The form of zinc you choose can affect its bioavailability and absorption, so chelates like gluconate, acetate, picolinate, and citrate are optimal choices.
Additionally, selecting a high-quality brand is crucial to ensure that the supplement contains the appropriate ingredients in the right amounts without harmful contaminants.
Working with a healthcare provider to help you examine your diet and health history can help you determine if zinc supplementation is necessary and which form of zinc may be most beneficial for your needs.
Caitlin Beale, MS, RDN is a registered dietitian and freelance health writer. She has a master's degree in nutrition and over ten years of experience as a registered dietitian.
+The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.
1 Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press (US); 2001.
2 Olechnowicz J, Tinkov A, Skalny A, Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci. 2018;68(1):19-31. doi:10.1007/s12576-017-0571-7
3 Gupta M, Mahajan VK, Mehta KS, Chauhan PS. Zinc therapy in dermatology: a review. Dermatol Res Pract. 2014;2014:709152. doi:10.1155/2014/709152
4 Prasad AS. Clinical, immunological, anti-inflammatory and antioxidant roles of zinc. Exp Gerontol. 2008;43(5):370-377. doi:10.1016/j.exger.2007.10.013
5 Sanna A, Firinu D, Zavattari P, Valera P. Zinc Status and Autoimmunity: A Systematic Review and Meta-Analysis. Nutrients. 2018;10(1):68. Published 2018 Jan 11. doi:10.3390/nu10010068
6 Reider CA, Chung RY, Devarshi PP, Grant RW, Hazels Mitmesser S. Inadequacy of Immune Health Nutrients: Intakes in US Adults, the 2005-2016 NHANES. Nutrients. 2020;12(6):1735. Published 2020 Jun 10. doi:10.3390/nu12061735
7 Wegmüller R, Tay F, Zeder C, Brnic M, Hurrell RF. Zinc absorption by young adults from supplemental zinc citrate is comparable with that from zinc gluconate and higher than from zinc oxide. J Nutr. 2014;144(2):132-136. doi:10.3945/jn.113.181487
8 Sangeetha VJ, Dutta S, Moses JA, Anandharamakrishnan C. Zinc nutrition and human health: Overview and implications. eFood. 2022 Oct;3(5):e17.
9 Maywald M, Rink L. Zinc in Human Health and Infectious Diseases. Biomolecules. 2022;12(12):1748. Published 2022 Nov 24. doi:10.3390/biom12121748
10 Hemilä H. Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. JRSM Open. 2017;8(5):2054270417694291. Published 2017 May 2. doi:10.1177/2054270417694291
11 Barrie SA, Wright JV, Pizzorno JE, Kutter E, Barron PC. Comparative absorption of zinc picolinate, zinc citrate and zinc gluconate in humans. Agents Actions. 1987;21(1-2):223-228. doi:10.1007/BF01974946
12 Agnew UM, Slesinger TL. Zinc Toxicity. [Updated 2022 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
Whether it's coffee or tea, many people reach for that cup of caffeine first thing in the morning. It's a ritual that jumpstarts the day and provides the energy needed to power through. Still, if you find yourself struggling to make it through the afternoon, you might want to consider mushrooms as your new best friend.
Caffeine too late in the day can disrupt sleep patterns, keeping you up late with insomnia, so the low energy cycle continues. Mushrooms, on the other hand, may be able to support the sustained energy you need to feel good all day long. Unlike the quick fix of caffeine, mushrooms can provide a more balanced and long-lasting form of energy by supporting the entire adrenal system.
Mushrooms have been used for centuries in traditional medicines all over the world. They are packed with nutrients that can help support your energy levels and overall health, so you don't have to rely on caffeine to make it through your day.
Before diving into all the ways mushrooms support even energy, it's helpful to consider why mushrooms are so good for you.
The compounds found in these small plants impact many systems in the body, from your muscles to the cardiovascular, hormone, and immune systems, which can translate to balanced energy and health.i In other words, mushrooms support energy by keeping your body balanced so you can function at your best.
Mushrooms contain compounds that support healthy energy, mental clarity, and other health benefits, such as:1
For example, one way mushrooms could help support healthy energy levels is because of their antioxidant activity. By keeping free radicals in check that could otherwise add to oxidative stress in the cell, medicinal mushrooms can support healthy mitochondrial function to generate energy production.1 Mitochondria are the organelles responsible for transforming nutrients from the food we eat into energy.
Here are a few specific ways research suggests mushrooms can support energy:
Adaptogens are a class of botanicals that help the body adapt to stress.ii When our bodies are under stress, it can impact everything from how we sleep to our ability to concentrate and focus.
Adaptogens may work partly by supporting the hypothalamic-pituitary-adrenal (HPA axis). 2 Your HPA axis is the control center for your body's stress response, and adaptogens may help keep it functioning properly to protect against the negative impacts of stress on the body.
Stress and energy go hand-in-hand because when we're stressed, our bodies are in "fight-or-flight" mode. Being constantly in this mode can lead to burnout and make you much more tempted to reach for a sugary or caffeine-filled beverage. Certain mushrooms could help maintain stress resilience to prevent feelings of burnout and overwhelm.
Some types of mushrooms may help when you are feeling completely drained, while others could help with increased energy and concentration during times of stress. Reishi, for example, is a type of mushroom used in traditional Chinese medicine for centuries. It is supportive of immune health and nourishing the adrenals.iii Mushroom adaptogens like reishi could help moderate mild fatigue and overall well-being.iv
Brain fatigue can make you want to reach for an afternoon cup of coffee or energy drink. But these beverages may give you a quick boost followed by an inevitable crash. Some mushrooms could help improve focus and concentration without the crash.
Lion's mane is a type of mushroom that has been shown to support cognitive function.v It may help with the growth and repair of nerve cells by supporting the brain's production of nerve growth factor (NGF) levels. NGF is a protein that helps to protect and repair nerve cells, and it has been shown to decline with age.vi
We all know how important it is to get regular exercise. But starting a new workout routine can be daunting if you're not used to being active. And if you're not properly fueled, it can be tough to get through a workout without feeling fatigued.
Mushrooms could help support energy production during exercise. Cordyceps mushrooms, for example, have been shown to improve physical performance and help the body better use oxygen in studies on healthy, older adults. viiviii
In one study, subjects were given cordyceps or a placebo every day for six weeks. At the end of the study, those who took the mushrooms saw significant improvements in their aerobic capacity compared to those who received the placebo, suggesting that cordyceps supported could help you feel less fatigued during a workout and improve your endurance. 7
Mitochondria are organelles in your cells that produce energy from the food you eat. One of the normal by-products of mitochondrial energy production is the generation of free radicals. These unstable molecules can damage cellular structures. This production also goes up after intense exercise.
Your body works hard to keep free radicals in check with antioxidants. Antioxidants help by scavenging the free radicals and neutralizing them. One theory of why we feel fatigued is that free radicals (also called reactive oxygen species or ROS) build up and overwhelm the body's natural repair system, affecting normal energy metabolism.ix Some research suggests that mushrooms have antioxidant activity that can help remove the excess free radicals and help mitochondrial energy production to reduce fatigue.x
If you're looking for an energy boost that doesn't come from caffeine, mushrooms may be a good solution. Mushrooms that act as adaptogens may help your body better respond to stress, support better sleep, and improve mental clarity. And certain mushrooms could also help support energy production during exercise.
Add mushrooms to your diet by including them in meals or taking them as a supplement. In combination with a healthy diet and lifestyle, mushrooms could help you maintain all-day energy.
Caitlin Beale, MS, RDN is a registered dietitian and freelance health writer. She has a master's degree in nutrition and over ten years of experience as a registered dietitian.
+The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.
References
1 Geng, Ping, Ka-Chai Siu, Zhaomei Wang, and Jian-Yong Wu. “Antifatigue Functions and Mechanisms of Edible and Medicinal Mushrooms.” BioMed Research International 2017 (2017): 9648496. https://doi.org/10.1155/2017/9648496.
2 Panossian, Alexander, and Georg Wikman. “Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress—Protective Activity.” Pharmaceuticals 3, no. 1 (January 19, 2010): 188–224. https://doi.org/10.3390/ph3010188.
3 Wachtel-Galor, Sissi, John Yuen, John A. Buswell, and Iris F. F. Benzie. “Ganoderma Lucidum (Lingzhi or Reishi): A Medicinal Mushroom.” In Herbal Medicine: Biomolecular and Clinical Aspects, edited by Iris F. F. Benzie and Sissi Wachtel-Galor, 2nd ed. Boca Raton (FL): CRC Press/Taylor & Francis, 2011. http://www.ncbi.nlm.nih.gov/books/NBK92757/.
4 Tang, Wenbo, Yihuai Gao, Guoliang Chen, He Gao, Xihu Dai, Jinxian Ye, Eli Chan, Min Huang, and Shufeng Zhou. “A Randomized, Double-Blind and Placebo-Controlled Study of a Ganoderma Lucidum Polysaccharide Extract in Neurasthenia.” Journal of Medicinal Food 8, no. 1 (2005): 53–58. https://doi.org/10.1089/jmf.2005.8.53.
5 Mori, Koichiro, Satoshi Inatomi, Kenzi Ouchi, Yoshihito Azumi, and Takashi Tuchida. “Improving Effects of the Mushroom Yamabushitake (Hericium Erinaceus) on Mild Cognitive Impairment: A Double-Blind Placebo-Controlled Clinical Trial.” Phytotherapy Research: PTR 23, no. 3 (March 2009): 367–72. https://doi.org/10.1002/ptr.2634.
6 Ma, Bing-Ji, Jin-Wen Shen, Hai-You Yu, Yuan Ruan, Ting-Ting Wu, and Xu Zhao. “Hericenones and Erinacines: Stimulators of Nerve Growth Factor (NGF) Biosynthesis in Hericium Erinaceus.” Mycology 1, no. 2 (June 23, 2010): 92–98. https://doi.org/10.1080/21501201003735556.
7 Yi, Xiao, Huang Xi-zhen, and Zhu Jia-shi. "Randomized double-blind placebo-controlled clinical trial and assessment of fermentation product of Cordyceps sinensis (Cs-4) in enhancing aerobic capacity and respiratory function of the healthy elderly volunteers." Chinese Journal of Integrative Medicine 10.3 (2004): 187-192. https://doi.org/10.1007/BF02836405
8 Chen, Steve, Zhaoping Li, Robert Krochmal, Marlon Abrazado, Woosong Kim, and Christopher B. Cooper. “Effect of Cs-4® (Cordyceps Sinensis) on Exercise Performance in Healthy Older Subjects: A Double-Blind, Placebo-Controlled Trial.” Journal of Alternative and Complementary Medicine 16, no. 5 (May 2010): 585–90. https://doi.org/10.1089/acm.2009.0226.
9 Zoll J, Sanchez H, N'Guessan B, et al. Physical activity changes the regulation of mitochondrial respiration in human skeletal muscle. J Physiol. 2002;543(Pt 1):191-200. doi:10.1113/jphysiol.2002.019661
10 Geng P, Siu KC, Wang Z, Wu JY. Antifatigue Functions and Mechanisms of Edible and Medicinal Mushrooms. Biomed Res Int. 2017;2017:9648496. doi: 10.1155/2017/9648496. Epub 2017 Aug 14. PMID: 28890898; PMCID: PMC5584359.
From collagen formation to its function as an antioxidant and for the immune system – vitamin C (also: ascorbic acid) fulfills important tasks in our body. Here you will learn everything about individual vitamin C requirements, which functions the vitamin fulfills in the body and which foods provide you particularly well with the antioxidant.
The water-soluble vitamin C, also called ascorbic acid, is probably the best known of all vitamins. While humans have to ingest vitamin C with food every day, animals, with the exception of guinea pigs, bony fish and primates, manage to produce vitamin C themselves. The precursor is glucose (glucose), which is converted into vitamin C. The importance of vitamin C for the human body was already experienced by sailors during the Age of Exploration: tooth loss, immunodeficiency and fatigue were the consequences of the months-long, one-sided diet with cured meat and ship's rusks. There were no fresh fruits and vegetables on board. However, it was only through investigations at the beginning of the 20th century that the evidence intensified that it was precisely in these foods that an essential factor against the sailor disease, scurvy, was found. In the 1920s, Albert von Szent-Györgyi Nagyrápolt and Sylvester Zilva succeeded in identifying and isolating ascorbic acid (= vitamin C).
Did you know that ...
Smokers have a 40% higher need for vitamin C.1
Absorption of vitamin C through certain foods can be reduced.
Vitamin C content in food is highly dependent on storage and processing.
Vitamin C is a true all-rounder and fulfills a variety of functions and tasks in the body.
Radical Scavenger Vitamin C
As a valuable antioxidant, vitamin C is able to intercept free radicals before they can damage our cells. Vitamin C works closely with other antioxidants, such as vitamin E, and can help the body save it.
Vitamin C & Immune System
The antioxidant properties of vitamin C are particularly important with seasonal changes: Vitamin C actively supports our innate immune system and helps to ward off invaders and pathogens. When our immune system runs at full speed and renders pathogens harmless, many free radicals are formed.4 This "oxidative stress" in turn can have a negative effect on immune function. Vitamin C is of central importance for a functioning immune system.
Vitamin C & Iron Metabolism
The special properties of vitamin C are also important in iron metabolism, because it supports the absorption of iron. Thus, iron absorption can increase by a factor of 4 in the presence of vitamin C.2 The reason for this is that vitamin C can reduce so-called trivalent iron, as it is mainly found in plant foods, to divalent iron. The body then finds it much easier to absorb.
Collagen Formation & Vitamin C
Vitamin C is also involved in collagen formation in organs and tissues. This is important so that bones, skin and teeth are sufficiently supplied and functional. Vitamin C is a co-factor of the enzymes that spin collagen from the individual building blocks into long threads.
Precisely because our body needs vitamin C (ascorbic acid) on a daily basis, but cannot produce it itself, it is all the more important to consume enough of it. This is especially true in the colder season, when our immune system has a lot to do. In Austria, Germany and Switzerland, dietary societies recommend a daily vitamin C intake of an average of 100 mg for adults (105 mg men, 95 mg women).3 In the case of children and adolescents, only about half of that is recommended. Pregnant, breastfeeding women, and those over 60 years old, on the other hand, have a higher need. You are advised to take 150 – 200 mg daily. In addition, it is assumed that the vitamin C turnover in smokers is about 40% higher. The reason for this is the higher metabolic losses resulting from the increased exposure to free radicals. In fact, lower vitamin C concentrations are measured in the blood of smokers than in non-smokers. Smokers should therefore consume at least 150-200 mg of vitamin C daily from various sources, including dietary supplements, in order to be adequately supplied.
The good news: Even if more vitamin C is taken than recommended, there is hardly too much vitamin C. Any natural excess is not absorbed by the organism or simply excreted by the body.
Vitamin C in food
Vitamin C cannot be produced by the human organism itself and cannot be stored. This makes the daily intake through food all the more important. Where is there a lot of vitamin C in it? Foods with a high vitamin C content include above all fresh, if possible, unpeeled fruits and vegetables. The following foods are particularly good sources of vitamin C:
Paprika
Currants
Citrus fruits
Spinach
Various types of cabbage such as broccoli or Brussels sprouts
Rosehips
Acerola cherry
Vitamin C Content
Unfortunately, vitamin C is one of the most sensitive micronutrients. Even with foods that are particularly rich in vitamin C, storage and processing are decisive for the vitamin C content. Leafy greens are thought to lose about 10% of vitamin C daily during storage. Tuber vegetables, such as potatoes, are slightly more robust, but still lose about half of their original vitamin C content per month of storage. But the good news is: Blanching and then freezing vegetables (ex: broccoli) can counteract the reduction of vitamin C content, which is why frozen vegetables are also preferable to canned vegetables.
Vitamin C is a sensitive micronutrient. But with these tips, it is possible to make better use of the potential of vitamin C content in food.
Consume with peel: In plant foods, a large part of the vitamin C is in the shell or directly underneath
Only wash briefly and avoid storage in water: Vitamin C is water-soluble and is washed out quickly.
Cooking with the shell: Vitamin C is very sensitive to light, heat, oxygen and other oxidants. Even with the use of 80°C hot water, for example, up to 60% of the vitamin C of potatoes and Co. can escape into the cooking water.
Consume fresh: Light, oxygen and other oxidants have a negative effect on the content of vitamin C in food. Therefore: Do not store for too long!
Vitamin C offers a wide range of support for the human body acting as one of the most potent dietary antioxidants and providing nutritional support.5 Vitamin C may provide protection from reactive oxygen species released as part of a normal immune response. It maintains healthy mast cell function and supports lymphocyte formation.6-8 It also supports the body's defense system by enhancing white blood cell function and activity, and promoting interferon levels, antibody responses and secretion of thymic hormones.9-11
Dr. Rebecca Göngrich is a molecular biologist with a creative streak. Rebecca lives out her interests every day by writing texts, creating lectures and advising customers.
+The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.
Schectman G, Byrd JC, Gruchow HW. The influence of smoking on vitamin C status in adults. Am J Public Health. 1989 Feb;79(2):158-62. doi: 10.2105/ajph.79.2.158. PMID: 2913833; PMCID: PMC1349925.
Ems T, St Lucia K, Huecker MR. Biochemistry, Iron Absorption. [Updated 2022 Apr 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. https://www.ncbi.nlm.nih.gov/books/NBK448204/
German Society for Nutrition; D-A-CH reference values for nutrient intake; German Society for Nutrition e. V. 2021https://www.dge.de/wissenschaft/referenzwerte/vitamin-c/? L=0 (accessed on 12.11.2021)
Carr A, Frei B. Am J Clin Nutr .1999;69:1086?07.
Romero SA, et al. Exp Physiol. 2015 Apr 1;100(4):435-49.
Johnston CS, Solomon RE, Corte C. J Am Coll Nutr. 1996 Dec;15(6):586-91.
Lenton KJ, et al. Am J Clin Nutr. 2003 Jan;77(1):189-95.
Sasazuki S, et al. Eur J Clin Nutr. 2006 Jan;60(1):9-17.
Wintergerst ES, Maggini S, Hornig DH. Ann Nutr Metab. 2006;50(2):85-94.
Wintergerst ES, Maggini S, Hornig DH. Ann Nutr Metab. 2006;50(2):85-94.Johnston CS, Barkyoumb GM, Schumacher SS. Nutrients. 2014 Jul 9;6(7):2572-83
Immune health is a hot topic, but what exactly does it mean to have a healthy immune system? It doesn't mean that we never feel a bit under the weather because that's just a part of life. Instead, immune health means our body keeps us well most of the time and helps us bounce back quickly if we feel less than our best.
Many things can deplete our immune systems, including stress, poor diet, or lack of sleep. So to counter these daily immune system stressors, people often turn to natural ways to optimize immune health. One way to accomplish this is by using botanicals, or plant-based supplements.
Botanicals and herbs have been used for centuries in traditional medicine to promote vitality and well-being, passed down by knowledgeable healers from generation to generation. For a long time, Western medicine largely dismissed these treatments, but in recent years, there has been a renewed interest in the science of botanicals as a way to support health
Some botanical supplements work by directly supporting the cells of the immune system while others help by helping the body better regulate stress or improving sleep quality, which also indirectly benefits immunity. Today, there is a growing body of scientific evidence to support the use of certain botanicals for immune health. They are powerful allies that can be part of a daily wellness routine. Here are 5 botanical supplements that could help support your immune health.
Black elderberry is more popular than ever, but it's been used medicinally for centuries.1 The berries and flowers of elderberry contain antioxidants, which help protect the body against oxidative damage from free radicals that could otherwise negatively impact your immune cells.2
Some research suggests it may help when you're feeling a little under the weather by supporting a healthy immune response. Your immune system uses a complex array of signaling molecules to control how your body responds to potential pathogens, and elderberry may help to regulate these signals.3
A meta analysis featuring 180 participants looked at the effect of elderberry syrup on upper respiratory health and found that it shortened how long people felt under the weather, so it could be something to use when you start to notice you don't feel well.4
The powdered roots of Panax ginseng have been used historically in Traditional Chinese Medicine for many aspects of health.5 The word Panax is derived from Greek, meaning all-healing.6
People given Ginseng saw positive changes in many immune cells, including:7,8
T cells, which are vital players in our adaptive immune system.
B cells, which are essential for producing antibodies.
Dendritic cells, which are key players in alerting the immune system to potential threats.
A lot of the research on ginseng points to its ability to support the equilibrium of the immune system, so it's primed and ready to keep you well. The benefit of ginseng may be related to compounds found in the plant like saponins, ginsenosides, and other phenolic compounds that support immune health in your body.9
Although it shares ginseng in the common name, Eleutherococcus (or eleuthero) is different and affects your health in different ways. Traditionally it's used to support energy, Siberian ginseng is an adaptogen, meaning it helps the body better deal with stress.10
Adaptogens are plants that help the body to resist physical, chemical, or biological stressors by helping it to maintain homeostasis. This may be beneficial for immune health because stress is known to have a negative impact on our bodies, including immune cells.
Eleutherosides are the compound in Siberian ginseng that are thought to underlie its effects and support healthy immune activity. In particular, Siberian ginseng could support T-cell production and Natural Killer cell activity.11,12 Remember, these immune cells are essential for keeping you healthy and protected against potential threats.
When used in combination with Andrographis, a plant with a long history of use in Ayurvedic medicine, Siberian ginseng may provide additional positive health benefits.13
Also used in Traditional Chinese Medicine, Reishi (or Lingzhi) is a woody mushroom used for centuries for overall health and well-being. Reishi is one of the more studied mushrooms and has been called the 10,000-year mushroom or the Mushroom of Immortality.14
Like the other plants listed above, Reishi helps modulate the immune response.15,16 In fact, its action is so potent that it's not always recommended for people with autoimmunity because it can be so effective at activating immune cells.
Interestingly, one study on athletes found that Reishi could support the immune response of healthy athletes exposed to stress (this is important because strenuous exercise can temporarily deplete the immune system).17
Reishi also is considered a calming botanical that may support your immune system. Inflammatory cytokines are chemical messengers that signal for inflammation as a normal part of the immune response, but sometimes they can get out of balance. Reishi appears to help reduce the production of some of these inflammatory cytokines, keeping your immune response in check.18
Acerola, also known as Barbados cherry or West Indian cherry, is a small, red fruit found in the tropics. It's often used as a food or beverage ingredient because it's known to be one of the best natural sources of ascorbic acid (vitamin C). 100 grams of Acerola contains about 1,600 mg of vitamin C - that's 50 to 100 times the amount found in the same serving size of oranges or lemons.19
Most people are familiar with vitamin C to support the immune system, and it does this by supporting the activity of several important immune cells.xx Vitamin C is essential for the function of neutrophils, macrophages, and Natural Killer cells - all of which are important for a healthy immune system.20
Vitamin C is helpful for both the adaptive and innate immune systems.21 The adaptive immune system is the part of the immune system that "remembers" threats and helps to protect you from them in the future. The innate immune system is the first line of defense against potential threats.
Supplements usually contain the synthetic form of vitamin C, but Acerola provides a natural form of vitamin C.22
These five all have different mechanisms by which they support immune health. Some, like Siberian ginseng and Reishi, help to modulate the immune response, while others, like Acerola, provide essential nutrients that are necessary for healthy cells.
While a holistic approach is necessary to keep your immune system healthy, all these plants could be a beneficial way to stay healthy and feel well.
Caitlin Beale, MS, RDN is a registered dietitian and freelance health writer. She has a master's degree in nutrition and over ten years of experience as a registered dietitian.
+The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.
References
1 Tiralongo, Evelin, Shirley S. Wee, and Rodney A. Lea. Nutrients 8, no. 4 (March 24, 2016): 182. https://doi.org/10.3390/nu8040182.
2 Sidor, Andrzej, and Anna Gramza-Michałowska. “Advanced Research on the Antioxidant and Health Benefit of Elderberry (Sambucus Nigra) in Food – a Review.” Journal of Functional Foods, Natural Antioxidants, 18 (October 1, 2015): 941–58. https://doi.org/10.1016/j.jff.2014.07.012.
3 Ulbricht, Catherine, Ethan Basch, Lisa Cheung, Harley Goldberg, Paul Hammerness, Richard Isaac, Karta Purkh Singh Khalsa, et al. “An Evidence-Based Systematic Review of Elderberry and Elderflower (Sambucus Nigra) by the Natural Standard Research Collaboration.” Journal of Dietary Supplements 11, no. 1 (March 1, 2014): 80–120. https://doi.org/10.3109/19390211.2013.859852.
4 Hawkins, Jessie, Colby Baker, Lindsey Cherry, and Elizabeth Dunne. “Black Elderberry (Sambucus Nigra) Supplementation Effectively Treats Upper Respiratory Symptoms: A Meta-Analysis of Randomized, Controlled Clinical Trials.” Complementary Therapies in Medicine 42 (February 1, 2019): 361–65. https://doi.org/10.1016/j.ctim.2018.12.004.
5 Nag, Subhasree Ashok, Jiang-Jiang Qin, Wei Wang, Ming-Hai Wang, Hui Wang, and Ruiwen Zhang. Frontiers in Pharmacology 3 (2012): 25. https://doi.org/10.3389/fphar.2012.00025.
6 Yun, T. K. “Brief Introduction of Panax Ginseng C.A. Meyer.” Journal of Korean Medical Science 16 Suppl (December 2001): S3-5. https://doi.org/10.3346/jkms.2001.16.S.S3.
7 Hyun, Sun Hee, Ha-Young Ahn, Hyeong-Jun Kim, Sung Won Kim, Seung-Ho So, Gyo In, Chae-Kyu Park, and Chang-Kyun Han. “Immuno-Enhancement Effects of Korean Red Ginseng in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Trial.” Journal of Ginseng Research 45, no. 1 (January 1, 2021): 191–98. https://doi.org/10.1016/j.jgr.2020.08.003.
8 Kang, Soowon, and Hyeyoung Min. “Ginseng, the ‘Immunity Boost’: The Effects of Panax Ginseng on Immune System.” Journal of Ginseng Research 36, no. 4 (October 2012): 354–68. https://doi.org/10.5142/jgr.2012.36.4.354.
9 Riaz, Muhammad, Najm Ur Rahman, Muhammad Zia-Ul-Haq, Hawa Z. E. Jaffar, and Rosana Manea. “Ginseng: A Dietary Supplement as Immune-Modulator in Various Diseases.” Trends in Food Science & Technology 83 (January 1, 2019): 12–30. https://doi.org/10.1016/j.tifs.2018.11.008.
10 Davydov, M., and A. D. Krikorian. “Eleutherococcus Senticosus (Rupr. & Maxim.) Maxim. (Araliaceae) as an Adaptogen: A Closer Look.” Journal of Ethnopharmacology 72, no. 3 (October 2000): 345–93. https://doi.org/10.1016/s0378-8741(00)00181-1.
11 Szołomicki, J., L. Samochowiec, J. Wójcicki, M. Droździk, and S. Szołomicki. “The Influence of Active Components of Eleutherococcus Senticosus on Cellular Defence and Physical Fitness in Man.” Phytotherapy Research: PTR 14, no. 1 (February 2000): 30–35. https://doi.org/10.1002/(sici)1099-1573(200002)14:1<30::aid-ptr543>3.3.co;2-m.
12 Bohn, B., C. T. Nebe, and C. Birr. “Flow-Cytometric Studies with Eleutherococcus Senticosus Extract as an Immunomodulatory Agent.” Arzneimittel-Forschung 37, no. 10 (October 1987): 1193–96.
13 Gabrielian, E. S., A. K. Shukarian, G. I. Goukasova, G. L. Chandanian, A. G. Panossian, G. Wikman, and H. Wagner. Phytomedicine: International Journal of Phytotherapy and Phytopharmacology 9, no. 7 (October 2002): 589–97. https://doi.org/10.1078/094471102321616391.
14 Wachtel-Galor, Sissi, John Yuen, John A. Buswell, and Iris F. F. Benzie. “Ganoderma Lucidum (Lingzhi or Reishi): A Medicinal Mushroom.” In Herbal Medicine: Biomolecular and Clinical Aspects, edited by Iris F. F. Benzie and Sissi Wachtel-Galor, 2nd ed. Boca Raton (FL): CRC Press/Taylor & Francis, 2011. http://www.ncbi.nlm.nih.gov/books/NBK92757/.
15 Lin, Yu-Li, Yu-Chih Liang, Shiuh-Sheng Lee, and Bor-Luen Chiang. “Polysaccharide Purified from Ganoderma Lucidum Induced Activation and Maturation of Human Monocyte-Derived Dendritic Cells by the NF-KappaB and P38 Mitogen-Activated Protein Kinase Pathways.” Journal of Leukocyte Biology 78, no. 2 (August 2005): 533–43. https://doi.org/10.1189/jlb.0804481.
16 Hsu, Hsien-Yeh, Kuo-Feng Hua, Chun-Cheng Lin, Chun-Hung Lin, Jason Hsu, and Chi-Huey Wong. “Extract of Reishi Polysaccharides Induces Cytokine Expression via TLR4-Modulated Protein Kinase Signaling Pathways.” Journal of Immunology (Baltimore, Md.: 1950) 173, no. 10 (November 15, 2004): 5989–99. https://doi.org/10.4049/jimmunol.173.10.5989.
17 Zhang, Y., Z. Lin, Y. Hu, and F. Wang. “Effect of Ganoderma Lucidum Capsules on T Lymphocyte Subsets in Football Players on ‘Living High-Training Low.’” British Journal of Sports Medicine 42, no. 10 (October 2008): 819–22. https://doi.org/10.1136/bjsm.2007.038620.
18 Ahmad, Md Faruque. “Ganoderma Lucidum: Persuasive Biologically Active Constituents and Their Health Endorsement.” Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie 107 (November 2018): 507–19. https://doi.org/10.1016/j.biopha.2018.08.036.
19 Prakash, Anand, and Revathy Baskaran. “Acerola, an Untapped Functional Superfruit: A Review on Latest Frontiers.” Journal of Food Science and Technology 55, no. 9 (September 2018): 3373–84. https://doi.org/10.1007/s13197-018-3309-5.
20 Delva, Lemâne, and Renée Goodrich Schneider. “Acerola (Malpighia Emarginata DC): Production, Postharvest Handling, Nutrition, and Biological Activity.” Food Reviews International 29, no. 2 (March 13, 2013): 107–26. https://doi.org/10.1080/87559129.2012.714433.
21 Carr, Anitra C., and Silvia Maggini. “Vitamin C and Immune Function.” Nutrients 9, no. 11 (November 3, 2017): 1211. https://doi.org/10.3390/nu9111211.
22 Uchida, Eriko, Yoshitaka Kondo, Akiko Amano, Shingo Aizawa, Takayuki Hanamura, Hitoshi Aoki, Kenichi Nagamine, Takeshi Koizumi, Naoki Maruyama, and Akihito Ishigami. “Absorption and Excretion of Ascorbic Acid Alone and in Acerola (Malpighia Emarginata) Juice: Comparison in Healthy Japanese Subjects.” Biological & Pharmaceutical Bulletin 34, no. 11 (2011): 1744–47. https://doi.org/10.1248/bpb.34.1744.
Purchasing a supplement on your own can feel overwhelming. Whether at a store or online, you're faced with what feels like hundreds of options with different ingredients, price points, and dosages.
Food supplements can be powerful tools for your health, but it is mostly up to the individual supplement manufacturer to ensure quality and efficacy. Since quality is not always guaranteed, it's critical for you as the consumer to understand how and why to choose a trusted, well-respected brand.
To help you feel more confident about your supplements, here are the key things to look at when choosing a quality supplement:
Products sold as dietary supplements have to come with a supplement or nutritional facts label that lists the active ingredients or nutrients, the amount per serving, daily values, as well as other inactive ingredients that may be included, such as fillers, binders, and artificial colorings. The manufacturer suggests the serving size, but your healthcare provider might decide a different amount is more appropriate for you.
NRV is an abbreviation for ‘Nutrient Reference Value’. As a consumer, one may be more familiar with the old system of noting RDA's (Recommended Daily Allowance) within the nutritional facts, but the values for RDA and NRV are exactly the same. Food supplement labels list the ingredients included in the product and give the proportion of the NRV value (% NRV) that is contained within the supplement (e.g., vitamin C, 80mg, 100% NRV). NRV’s are set for 13 vitamins and 14 minerals for the purposes of food labelling and are guidance levels on the daily amount of vitamin or mineral that the average healthy person needs to prevent deficiency. A supplement may promote itself as having an abundance of nutrients included, but upon review of the nutritional information, it is seen that the % NRV levels are quite low- just because it is included, does not always mean it is at an affective amount. If you are choosing products from a trusted brand, higher %NRV, sometimes even those over 100%, are significant because that is the level that is scientifically proven to provide a product’s claimed therapeutic effect.i
Like any food label, a product is required to list all comprised ingredients. In the case of food supplements, this is broken down into active and inactive or other ingredients. Ingredients are listed in the nutritional facts in decreasing order by weight or amount per serving where the active ingredients are generally those listed first as they are the nutrients that provide the effects in order to achieve therapeutic goals and health benefits.
Inactive ingredients are preservatives, fillers, artificial colors, or flavors. These are usually added to extend shelf life, change the appearance or taste, or reduce the cost of manufacturing. A common example of this is the widely used additive, magnesium stearate. Magnesium stearate is an inactive ingredient used by many supplement companies as an anticaking, lubricant agent that reduces the cost of manufacturing since its lubricating characteristics prevents ingredients from sticking to production equipment thus increasing the final yield of product. Although generally recognized as food safe, magnesium stearate is an unnecessary ingredient with no health benefits. However, the impact of long-term intake of this ingredient is still unclear. ii
High quality nutritional supplements are free from these unnecessary additives. While not a problem for everyone, inactive ingredients can include substances associated with adverse reactions for sensitive people.iii These additives could lead to reactions for people with food sensitivities, intolerances, or allergies.iv Some even have questionable long-term health implications.v
A high-quality supplement minimizes the use of unnecessary additives and fillers to the end product, so you only get the specific ingredients you want.
Premium nutritional supplement companies will produce products using the bioidentical forms of nutrients as those are the most bioavailable. When we consume a vitamin or mineral, its bioavailability refers to the amount of the nutrient that has an active effect within our bodies. Put simply, the higher a nutrient’s bioavailability is, the more of it that will get sent to the parts of the body that need it.vi
Equally as important as the ingredients themselves are the bioavailability of those ingredients. Bioavailability basically refers to each nutrient’s ability to provide the desired effect in the body. When a nutrient has high bioavailability, it usually means the nutrient is in a form that is well absorbed and/or easily unitized by our cells.
A common example of bioavailability can be demonstrated when discussing the nutrient folate. Folate is an essential vitamin and therefore we must obtain it through diet or supplements. The most common form of folate used in supplements or fortified foods is folic acid. Folic acid is a distinctly man-made form of folate and is often used due to its stability and long shelf-life.
In order for folic acid to be used by our body, our cells must first convert folic acid into the active form of folate (i.e. methylated folate). However, many people contain a very common and often undetected genetic alteration (mutation, polymorphism) that prevents their cells from efficiently converting folic acid into the active form. Therefore, for many individuals, using a supplement containing folic acid to raise folate levels might not be effective. However, using a supplement that already contains the active form of folate (methylated folate) would have much higher bioavailability because it would already be easily utilized by our cells.
Put simply, the higher a nutrient’s bioavailability, the more effective it may be.vii Therefore, when finding a high-quality nutritional supplement, it’s important to assess each nutrient in the formulation to ensure it is a well-researched and highly bioavailable form. While it can be it can be difficult for the everyday consumer to easily identify if a supplement is leveraging high-quality, bioavailable nutrients, most companies that do use these types of ingredients will often mention this on their bottles or brand marketing materials. You can always consult your local pharmacist too to determine the quality of ingredients used in supplements.
To the everyday consumer, it can be difficult to easily identify if a supplement is leveraging high-quality, bioavailable nutrients, but companies that do use these types of highly effective ingredients will often illustrate this attention to detail on their bottles or brand marketing materials. You can always consult your local pharmacist too to determine the quality of ingredients used in supplements.
Well-respected supplement manufacturers will seek out additional third-party testing if applicable to the local market and local regulations to help consumers feel more confident about the product. These reputable organizations will certify that what’s listed on the bottle is actually in the product, formulas are appropriate, all active and inactive ingredients are listed regardless of amount or do extensive testing to determine if products are actually free from common allergens or common intolerances and sensitivities (e.g., Certified Gluten-Free).
Nutritional supplements will generally note on the bottle if a product is third-party verified, but you can always consult your local pharmacist if it is unclear to you as the consumer.
With the rise in food allergies and food sensitivities, keeping your supplements free from offending ingredients is vital for optimizing your health. If you have an allergy, intolerance, or sensitivity, even if a product doesn't necessarily have an allergen in the supplement, you want to make sure it's also free from cross-contamination
While there isn't a single certification for hypoallergenic supplements, a high-quality company will have comprehensive standard operating procedures to prevent cross-contamination of allergens. They will also clearly label a product containing the top allergens such as soy, dairy, fish, or shellfish.
Further, if there is a chance an ingredient could have come into contact with an allergen, these products should be tested for exposure, and the company should be transparent about its practices.
If you have any reactions to foods or ingredients, it makes sense to look for a product that emphasizes the importance of creating hypoallergenic supplements.
Nutritional supplements made with only premium ingredients sourced from trusted suppliers and guided by nutritional experts can be highly effective, powerful tools to support your health. A high-quality supplement will provide the nutrients your body needs and should be FREE FROM unnecessary additives and many common allergens.
If you still find yourself needing some additional support in choosing a high-quality supplement that is right for you, it is always important to have a relationship with a healthcare practitioner who knows you and nutrition needs and can recommend what’s best for your health.