GUEST ARTICLE

User-friendly supplements offer an immune system boost this winter

By Dr Martin Koeberle and Dr Verena Garsuch

- Last updated on GMT

©Getty Images
©Getty Images

Related tags: Hermes Pharma, Immunity, COVID-19

A strong immune system is one of the best defenses we have for protection against common infectious diseases. This has never been more important than now, as we tackle another winter dealing with the COVID-19 pandemic.

Extended periods of lockdown and social isolation have reduced our exposure to germs and viruses in general, so having had little to do, our natural immunity is low and struggles to deal with the “normal” winter viruses, such as colds and flu.

This combined with rising COVID-19 cases and the emergence of new variants means people are seeking ways to stay healthy with a strong immune system. There are many different ways to boost the immune system; together with healthy eating, regular exercise and getting enough sleep, supplements are a popular option.

Building a strong immune system

Martin Hermes Pharma
Dr Martin Koeberle, Head of Analytical Development & Stability Testing at Hermes Pharma. ©Martin Koeberle/Hermes Pharma

Since the pandemic began, there has been a heightened awareness of the need for a strong immune system to protect from diseases. Nutrition is one of the major contributors to developing and maintaining a healthy immune response.

Depending on individual diets, eating habits, lifestyle and underlying health conditions, taking vitamin and mineral supplements can be a valuable support for the natural immune system. Studies show that supplements – especially the micronutrients vitamin D and zinc – can act as a defense against pathogenic diseases.

Consumers are not only aware of the benefits of supplements – sales figures​ prove they act on this in order to boost their immune systems. In the early stages of the pandemic, there was a:

  • 44% increase in supplement sales in the US
  • 40-60% increase in over-the-counter health product sales in France during March 2020 compared with previous years
  • 63% increase in vitamin sales alone in the UK

With such heightened demand for immune-building supplements, there is a golden opportunity for the healthcare industry to build on this market need and further develop their product ranges.

The evidence says supplements do their job

Verena Hermes Pharma
Dr Verena Garsuch, Manager Analytical and Clinical Development & Stability Testing at Hermes Pharma. ©Verena Garsuch/Hermes Pharma

Research proves that supplements contribute to the function of the immune system. Some studies show that vitamin C supplementation can reduce the frequency​ of the common cold. Importantly for the current pandemic, vitamin D supplementation was found to significantly reduce intensive care unit admission and mortality in a select group​ of COVID-19 patients, and in population studies​.

EU Guidelines (such as EU regulation 432/2012​) have established lists of permitted health claims of dietary supplements based on evidence, and states that vitamins A, B6, B9 (folate), B12, C and D as well as copper, iron, selenium and zinc can all contribute to the normal function of the immune system.

Supplement providers have therefore focused on marketing these vitamins and minerals (particularly zinc and vitamins C and D) for building a healthy immune system. Often these come in multivitamin and multimineral products, and combinations like vitamin C + zinc.

Alternatively, products such as herbal teas and powders with plant extracts, including echinacea, sage, thyme, and citrus fruits are also sold as immune-boosting supplements.

Who needs supplements the most?

Mother wiping nose

Taking supplements can be particularly important for people who have trouble obtaining sufficient levels of nutrients from their diet, or who want added reassurance due to health conditions.

Poor diet, diseases, and lack of exercise and sleep can all contribute to vitamin and mineral deficiencies that may lower the natural immune system. Supplements may help to counteract these.

Certain chronic conditions can impact on the ability of the body to absorb nutrients from the diet, resulting in a need for higher nutrient intake. Such conditions include those that affect the digestive system, such as Crohn’s disease, gastrointestinal cancers, or eating disorders, such as bulimia.

A need for higher nutrient intake can also affect certain populations with increased health demands, including pregnant women and older people.

Additionally, many people have hectic, stressful jobs and lives and struggle to get the balance needed to support their immune system. This can be especially true if eating a lot of vitamin-poor processed foods.

Whatever their reason for wanting to increase nutrient intake – whether it be the current pandemic or a nutrient imbalance – a growing number of people are taking supplements to ensure that their immune system can function optimally.

The importance of user-friendly dosage forms

People have different preferences and needs when taking supplements, for example taste and convenience when integrating them into an already busy lifestyle. For the healthcare industry, this means putting the patients in the center of product development and delivering supplements in a form that suits the end consumer.

A survey​ found that certain dosage forms can be off-putting to consumers, with 60% of people polled in Germany describing having difficulties swallowing traditional tablets and capsules - this was particularly apparent in people aged 16-34, where 70% experienced difficulties. Flavour is also a factor, with 41% of people polled confirming that a pleasant flavor was important for regular intake.

Yet, many healthcare companies automatically turn to traditional tablets and capsules for their products. Instead, by offering a variety of user-friendly dosage forms and different flavors they can better meet the needs and preferences of modern consumers - and turn them into loyal and long-term customers.

User-friendly dosage forms include orally disintegrating granules, instant drinks (effervescent or non-effervescent granules and powders), chewable tablets, lozenges, effervescent tablets, as well as novel delivery approaches that, for example, leverage Nespresso hard-pod coffee machines to prepare supplements as pleasant hot drinks.

These various forms help to overcome the issues consumers face with swallowing tablets, and offer more options and enjoyable ways to take supplements.

These options also support the daily use of supplements, which is important for some health conditions or for particular nutrients. Further, user-friendly dosage forms can accommodate larger doses (such as 3 grams (g) of ingredient in effervescent tablets or 7g in instant drinks) whereas a conventional tablet or capsule would become far too large to swallow.

The challenges of developing and manufacturing immune supplements

Surgical mask

There are compelling reasons for supplement providers to adopt user-friendly dosage forms for their products. However, there are some development and manufacturing challenges that need to be considered – working with a specialist partner may be an advantage here, utilising their experience and expertise.

One factor to consider is the formulation to be used. For example, how to make compounds with prolonged release profiles, which is important to aid absorption for certain supplements, such as vitamin C.

Creating the right powder flow properties is another challenge, as well as ensuring the stability of the dosage forms.

Additionally, some minerals and plant extracts have limitations in how they can be formulated into supplements. Some plant extracts, like echinacea, have foaming effects in high doses and so are unsuitable to some dosage forms like effervescent tablets, which require soluble or well dispersible particles.

Others, like nettle, need high doses to be effective, but have unpleasant flavors that need to be masked.

Fortunately, there are various technologies that can help to solve these problems, enabling the healthcare industry to deliver an optimum product in a user-friendly dosage form. For example, coating technologies can greatly influence the outcomes of the desired dosage form.

Hot melt coating (HMC), for instance, is a technology that allows ODGs to be released over extended periods of time. HMC covers vitamin particles with a layer of lipid excipient, and when combined with different emulsifiers, this can alter the rate of dissolution to meet the product’s needs.

Special granulation technologies are needed to create effervescent tablets that are moisture resistant but yet also dissolve quickly upon contact with water, leaving no residues or foam. Granulation is also important to reduce the amount of dust in powder products, and to increase the flowability of powders, ensuring that the ingredients are distributed evenly in the blend.

When granulation is not an option, premixes can improve blend uniformity as fine particles are mixed with an oily substrate with good blending characteristics and then can be brought homogenously into the powder mixture.

Further, certain compounds have strong, unpleasant flavors that need to be masked to ensure a good taste of the final product, and it can be challenging to choose a flavoring that is strong enough to mask the ‘chemical’ taste without it being overpowering.

Common flavors offered are citrus and berry, giving a natural touch to the final product. Knowledgeable formulation experts and access to a large range of optimal flavors are important for ensuring effective taste masking.

Choosing the right manufacturer to supplement your development strategy

With the application of such technologies, it is possible to overcome the challenges that arise when developing supplements in user-friendly dosage forms. The benefits of doing so are significant, making supplements more attractive to the consumer, easier to integrate into daily routines, and more likely to be adopted into long-term use.

Additional support may be needed to overcome such challenges though, and it may be beneficial to partner with an experienced formulation development and manufacturing team that can offer specialised expertise in user-friendly dosage forms. In this way, they can support with the launch of new immune health brands with rejuvenated product lines and dosage forms.

The development of immune-boosting supplement ranges, designed to suit the differing requirements of consumers, is particularly important right now. More than ever, consumers understand the importance of a strengthened immune system as one of the best defenses we have for protection against COVID-19 and other common infectious diseases – and they are turning to supplements for that additional boost.

This provides an opportunity for the healthcare industry to answer this market need with broadened and optimised product ranges that ultimately help people more conveniently and reliably integrate supplements into their daily routines and boost their immune system.

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