Boost your immune system.

Stay strong in the face of adversity.

Invictimune is our ultimate immune support formula, designed for your resilience during challenging times. Invictimune's advanced formula is like nothing you will find in any Health Food store. It combines all of the best immune enhancing vitamins, minerals and Western herbal extracts, with Eastern extracts that have been widely used throughout China, Japan and Korea these past few months. 

Our team collaborated on the formula with both Chinese and Japanese medical researchers. We worked with independent scientists to review our research, including an esteemed professor of immunology who studied at Harvard and has authored over 60 papers in peer-reviewed medical journals. We did this to ensure the efficacy and safety of the Invictimune formula, in light of the current global situation. Below is a summary of our research into each ingredient.

This is no basic immune support formula.

If you would like to feel confident that you are doing everything in your power to support your immune system, this is the formula for you. 

"I am the master of my fate,
      I am the captain of my soul."

- Invictus, by William Ernest Henley

Andrographolide 穿心莲

Andrographolide is a major bioactive constituent of Andrographis paniculate, a traditional plant commonly used to for immune support against various ailments ranging from respiratory infections to snakebite. Andrographolide sulfonate is the main ingredient in the modern Chinese medicine Xiyanping (an injection approved by the China Food and Drug Administration for the treatment of respiratory infection). In China, that medicine is used in combination with conventional antibiotics to treat pneumonia (Ma et al., 2019). Clinical evidence has shown that the combination of Xiyanping with piperacillin and sulbactam provided significant support for elderly patients suffering with pulmonary infection (Huang et al., 2019).

Several peer-reviewed reviews have summarised evidence regarding andrographolide’s potential in boosting immune function (Jayakumar et al., 2013, Varma et al, 2011).

Antimicrobial Support

Humanity has been in a constant tug-of-war with infectious pathogens. Whenever a new antimicrobial drug becomes available, drug-resistant microorganisms quickly arise. When an unsuitable drug is used to treat drug-resistant microorganisms, the therapy not only fails but also leads to a worse prognosis due to adverse side effects. However, natural antimicrobials like andrographolide have been shown to be effective at supporting the immune system against various microbial organisms.

In vitro antibacterial function activity support has been reported for Salmonella, Shigella, E.coli, gram A streptococci, Staphylococcus aureus, S. aureus, methicillin-resistant S. aureus, and gram-negative Pseudomonas aeruginosa (Mishra et al., 2009; Zaidan et al., 2005; Thomson et al., 2006).

Apart from supporting the immune system battle against bacteria, andrographolide has also shown to potential to help maintain anti-viral and anti-parasitic responses against herpes simplex virus 1 (HSV-1), malaria, HIV, and Epstein-Barr virus (EBV) (Wiart et al., 2005, Mishra et al., 2009, Reddy et al., 2005, Tang et al., 2012).

For upper respiratory tract infections, a systematic review of randomized-control clinical trials concluded that Andrographis paniculate extract alone provides more effective immune maintenance as compared to placebo (Poolsup et al., 2004).

Antioxidative and Anti-Inflammatory Support

Andrographolide significantly reduced the accumulation of reactive oxygen species and neutrophils adhesion in a rat model, indicating its potential benefit for support against inflammation (Shen et al., 2000). In another study, andrographolide showed free radical-scavenging ability (Lin et al., 2009). These effects could be mediated by inhibiting several proinflammatory processes. For example, andrographolide inhibited Lipopolysaccharide (LPS) induced nitric oxide production from macrophages, acting as an anti-inflammatory supportive agent against bacterial endotoxin (Chiou et al., 2000).

In an animal model of joint health, it has been shown that andrographolide extract helps the body naturally protect itself against the injury-induced inflammation by reducing the levels of chemokines and inflammatory factors and thereby preventing neutrophil accumulation and infiltration. It has also been shown to inhibit lipid peroxidation and to enhance antioxidant enzyme activity (Luo et al. 2020).

Astragalus Root Extract 黄芪

Astragalus has been used in TCM and as a dietary supplement since ancient times. Its Chinese name “Huang Qi” was record in “Shen Nong Ben Cao Jing”, the first ever book of Chinese herbal medicine. The active part of the plant is its 4-7 years old dried root. The major active components of Astragalus are polysaccharides, flavonoids and saponins.

In Chinese medicine terms, Astragalus is used for “qi”-deficiency, which is claimed to manifest as a lack of strength, poor appetite, spontaneous sweating, swelling, abscesses, frequent cold and spontaneous sweating, shortness of breath, muscular atropy, night sweats, ulcers and sores (reviewed by Auyeung and Ko., 2016). In modern terms, we would say that Astragalus has immune-boosting effects, mainly due to its polysaccharide component (Zheng et al. 2020). The polysaccharides in Astragalus was found to regulate the immune function in multifaceted actions. Specifically, the polysaccharides stimulated cytokines and antibodies production via the conduction of signalling of immune cell activation, as well as promoting, regulating the proliferation and the balance of immune cells and therefore immune organ index. The regulatory pattern of Astragalus polysaccharides depends on status of the immune cells; healthy unchallenged vs challenged or disturbed. In healthy unchallenged immune cells, Astragalus polysaccharides support the immune system (Yin et al. 2012), whereas in challenged situations, Astragalus polysaccharides have a regulatory function. A very recent clinical study has found that injecting intravenously Astragalus polysaccharides improves reduces the expression of major proinflammatory cytokines (Huang et al., 2019).

Astragalus extract with its all components; polysaccharides, flavonoids, and saponins, is used in many TCM formulations for a wide spectrum of purposes. Myriad evidence has highlighted its immunomodulatory, anti-oxidative and anti-inflammatory support effects. Inflammation is at the root of many issues, ranging from joint issues to gastrointestinal issues. Various in vitro and in vivo studies have shown that astragalus has non organ-specific anti-inflammatory supporting effects by targeting a variety of signalling pathways and immune cells. For example, astragalus could help suppress the progression of moderate airway inflammation in a mouse model of asthma (Du et al., 2008). It also inhibited inflammatory cytokine productions and down-regulated inflammatory signalling pathways in rats (Qin et al., 2012). Therefore, astragalus root extract is commonly used to boost immunity in the initial phases of inflammation and viral infection, as well as regulate the immune function in other instances, including immunosuppression. Studies have shown that astragalus can ameliorate the toxicity induced by man-made, toxic substances (Huang et al., 2019).

Chinese Skullcap 黄芩

The dried roots of Chinese skullcap, Scutellaria baicalensis, have been used in traditional Chinese medicine for over 2000 years for support against viral infection and inflammation. According to the TCM theory, Chinese skullcap has the functions of clearing heat, eliminating dampness, purging fire, detoxification and haemostasis (Wang et al., 2018). It is almost always part of a multi-herb formulations and is the key component of some famous patented formulations.

Chinese Skullcap has multiple functions due to its polysaccharide, flavonoids and flavonoids glycosides content. These constituents control the balance of immune system functions. In addition, skullcap has shown promising supportive effects of the nervous system, immune system and the liver.

Anti-Viral Support

Chinese skullcap is best known for broad spectrum support of bodily anti-viral processes against numerous viruses. A study using human peripheral blood leukocytes infected with vesicular stomatitis virus (VSV) revealed that baicalin and wogonin-containing skullcap extracts could assist in the natural modulation of cytokine production and promote natural resistance of leukocytes to VSV (Black-Olzewska et al., 2008).

Baicalin, the major component from Chinese skullcap, has proven beneficial in supporting in vivo antiviral activity against influenza viruses (Ding et al., 2014; Zhu et al, 2015), dengue virus (Zandi et a., 2012; Moghaddam et al., 2014), enterovirus-71 (Li et al., 2015), Japanese encephalitis virus (Johari et a., 2012) and the respiratory syncytial virus (RSV) (Shi et al., 2016). The compound helps the immune system target cell attachment and intracellular replication of H1N1 and H3N2 (Ding et al., 2014; Zhu et al, 2015; Nayak et al., 2014). Due to potent anti-viral response maintenance properties of Baicalin, it has been utilized for liver support (Wang et al., 2018).

Anti-Bacterial Support

Apart from the well-known anti-viral response support effects, Chinese skullcap has also been shown to help the body inhibit a range of bacteria, including Candida albicans (Wong and Tsang, 2009), Streptococcus sanguis II, S. salivarius, Actinomyces viscosus, A. naeslundii, A. odontolyticus, two strains of Capnocytophaga, Bacteroides melaninogenicus ss intermedius, B. gingivalis, Fusobacterium nucleatum, and Actinobacillus actinomycetemcomitans (Tsao et al., 1982).

The major component Baicalin could assist mice immune systems to reduce mortality from staphylococcal pneumonia caused by Staphylococcus aureus from 80% to 28% (Qiu et al., 2012).

Another component of Chinese skullcap, viscidulin, has been shown to support the immune response of mice, maintaining protection against a lethal dose of E.coli by neutralizing the endotoxin lipopolysaccharide (LPS) and reducing pro-inflammatory cytokines (Fu et al., 2008).

Antioxidant

The extract of Chinese skullcap can help protect cardiomyocytes from moderate hypoxia, ischemia and decrease cell death by scavenging reactive oxygen species (Shao et al., 1999). Similarly, antioxidative effects were shown to support the skin against the ill-effects of solar radiation (Gabrielska et al., 1997) and hydrogen peroxide-induced craniocerebral injury (Gao et al., 1999).

Chan et al., (2010) compared the antioxidant capacity of Chinese skullcap to roots with Polygonaceae, Ginseng and Araliaceae and found that water extracts of Chinese skullcap had the highest antioxidative capacity.

Since many microscopic and vascular damages are caused by oxidative stress and a reduced intrinsic antioxidant defence, Chinese skullcap is often used for support in such instances. In addition, there is evidence that baicalin has a significant in vitro supportive effect in insulin secretion and could have potential for maintaining healthy regulation of blood sugar levels (Li et al., 2012).

Anti-Inflammatory Support

Chinese skullcap also has various anti-inflammatory support activities, including inhibiting nitric oxide, cytokines, chemokines and growth factors (Kim et al., 2009; Hong et al., 2013; Kim et al., 2018). In several inflammation models, Chinese skullcap was effective for supporting joints, as well as for liver support against inflammation and vascular inflammation (Yang et al., 2013; Wang et al., 2017; Cheng et al., 2017).

Neuroprotective Support

Chinese skullcap was reported to help protect neuronal cells protect themselves from oxidative stress (Kim et al., 2001, Gong et al., 1999). Supplementing with Chinese skullcap supported attenuation in neuroinflammatory responses and maintained healthy memory in animal models (Yang et al., 2014; Cao et al. 2016; Li et al. 2016).

In addition, water extracts of Chinese skullcap were shown to support memory in rats and promote the recovery of neurons (Heo et al., 2009). The major components baicalin and wogonin were effective in maintaining resilience against hippocampal cell injury and neuronal loss. As such, they appear to be promising neuroprotective agents for supporting memory and a healthy nervous system, which both tend to decline with age (Cho and Lee 2004; Li et al., 2005; Cheng et al., 2008; Tarragó et al., 2008; Mu et al., 2009; Choi et al., 2010).

Liver Support

Chinese skullcap is also used for liver support. It is a key component in the Chinese preparation “Xiao chai hu tang”, which is widely used for liver support (Shimizu et al., 2010). It is reported that Chinese skullcap maintains antibacterial effects in the liver, which may assist in inhibiting the growth of hepatocellular carcinoma cells (Nan et al., 2002; Llovet et al., 2003; Lv et al., 2006).

Baicalin appears to be the constituent responsible for liver protection as it has been shown to support the liver in inhibiting injury and fibrosis, oxidative stress, inflammatory response and reduce LPS-induced hepatotoxity (Nan et al., 2002; Thanh et al., 2015; Hwang et al., 2005; Wang et al., 2016).

Forsythia Fruit Extract 连翘

Forsythia is known as a “heat-clearing” Chinese herb used to promote the skin’s resistance to carbuncle (bacterial infections under your skin at a hair follicle), as well as aid in the dispersion of lumps and stagnation (Franzblau and Cross, 1986). Forsythia is commonly used for support against cough and sore throat caused by viral infection. The rationale is that the “heat-clearing” property of Forsythia can help foster resilience against high fever induced by viral infections.

Forsythia is an ingredient in the modern Chinese patented formulation Lianhua qingwen capsules. Lianhua qingwen is approved by the China Food and Drug Administration for the treatment of flu and was used during the recent COVID-19 outbreak (Wang et al., 2012). Forsythia is also an ingredient in the TCM herbal product “Shuang huang lian”, which purportedly inhibited COVID-19. This combination has been shown to aid the inhibition of production of pro-inflammatory molecules and provide support against inflammation (Yang et al., 2020).

Anti-Inflammatory Support

Anti-inflammatory response support is the most common use of forsythia fruit. In Taiwan’s nationwide health database, it is among the top 10 most commonly used single herbs for helping maintain a healthy response against atopic dermatitis, urticaria and acne (Chen et al., 2015; Lin et al., 2013; Chen et al., 2016).

A number of in vitro and in vivo studies suggest that Forsythia can help the body to alleviate itself of inflammation and allergy by reducing anaphylactic antibodies, mast cell degranulation, and histamine release (Kim et al., 2003; Lee et al., 2010). It also supports the inhibition of inflammatory mediators such as nitric oxide, pro-inflammatory cytokines and decrease leukocyte recruitment into inflamed tissues (Kang et al., 2008; Lee et al., 2011; Kim et al., 2006; Lee et al., 2010).

Forsythia may also promote the immune system’s natural inhibition of accumulated inflammatory cells in infective sites, which would otherwise contribute to chronic inflammation and multiple sclerosis after viral infection (Ko et al., 2006; Kang et al., 2008).

Anti-Bacterial Support

Forsythia has demonstrated potent maintenance of the immune system’s antibacterial function activity against S. pneumoniae, E. coli, Sta. aureus, Haemophilus influenza, a beta-group Streptococcus, Yersinia enterocolitica, Klebsiella pneumonia, F’s dysentery bacillus, Salmonella typhi and Pseudomonas aeruginosa, Bacillus subtilis, Str. mutans, and Po. gingivalis and antifungal activity against Aspergillus flavus, Rhizopus stolonifer, Penicillium citrinum, Aspergillus niger, and Saccharomyces carlsbergensis (Guo et al., 2016; Wong et al., 2010; Liu et al., 2005). The mode of action by which the immune system achieves this includes disrupting the cell membrane and degrading bacterial proteins (Guo et al., 2016).

Anti-Viral Support

Ethanol extracts of Forsythia were shown to be useful supplements for supporting the immune system as it struggles to inhibit influenza A (H1N1) virus, respiratory syncytial virus (RSV) and infectious bronchitis virus (IBV) (Su et al., 2010; Deng et al., 2016; Li et al., 2014; Zhang et al., 2002; Ko et al., 2005; Qu et al., 2016; Duan et al., 2012; Yang et al., 2015; Li et al., 2011; Zhang et al., 2017).

Antioxidative Support

Forsythia extract contains numerous potent antioxidant components, including forsythoside A, isoforsythoside A, phillygenin, phillyrin, forsythialan A and polysaccharides. These constituents showed inhibitory effects against lipid peroxidation and decreased oxidative stress markers (Xia et al., 2015; Qu et al., 2012; Kuang et al., 2011; Lu et al., 2010; Piao et al., 2009).

Japanese Honeysuckle Flower Extract 金银花

Japanese honeysuckle, Lonicera japonica, is a plant native to eastern Asia. It has been used in traditional Chinese medicine since ancient times. In China, honeysuckle is frequently used in modern TCM formulations to help maintain the immune system whilst combatting upper respiratory infection, viral pneumonia, influenza, viral enteritis, “hand, foot and mouth disease”, COPD, and cerebrovascular disease. The main clinical efficacies are to promote a healthy response to cough, fever, inflammation and viral or bacterial infections (reviewed by Ma et al., 2019). A formulation involving honeysuckle was used as an immune supplement by sufferers of H7N9 avian influenza.

The polysaccharides present in the Lonicera japonica extract was found to promote immunostimulatory effects by reversing the function of macrophages and natural killer cell activities and helping the body restore the production of proinflammatory cytokines in immunosuppressed mice (Zhou et al 2018). In a similar model, Lonicera japonica extract helped support the restoration of sepsis-induced immunosuppression (Kim et al. 2015). In a different model that resembles uncontrolled systemic inflammation, Lonicera japonica extract helped the immune system regulate levels of inflammatory mediators as well as inflammatory cytokine production (Kwon et al. 2015). These studies raise the importance of Japanese honeysuckle in modulation the immune system, which is important whilst under a challenge such as a viral infection.

Modern pharmacological studies also supported its functional benefits, especially its anti-bacterial response support, anti-viral response support, and antioxidative properties.

Anti-Bacterial Support

A key difference of natural plants like honeysuckle from antibiotics is the broad antimicrobial spectrum of immune response is supported instead of specific targets from an antibiotic. Various extracts have shown to support the body’s antibacterial activity against a range of infectious bacteria, including Streptococcus pneumoniae, Mycobacterium tuberculosis and Escherichia coli (Li et al., 2015; Minami, 2018).

Today, misuse of antibiotics has led to the spread of multidrug resistance. Studies suggest that honeysuckle extracts may help the immune system suppress such antibiotic-resistant bacteria (Li et al., 2015).

Anti-Viral Support

Various in vitro and in vivo studies suggest that honeysuckle extracts may help the immune system naturally inhibit herpes simplex keratitis (Liu et al., 2011) influenza virus pneumonia (Liu et al., 2011), influenza A virus (Pan et al., 2007; Shi and Guo, 2010) porcine reproductive and respiratory syndrome virus (Cheng et al., 2012) Newcastle disease virus (Zhang et al., 2010) respiratory syncytial virus (Hu et al., 2010; Li et al., 2010; Yu et al., 2008), influenza virus (Kashiwada et al., 2013) and the human cytomegalovirus. (Chen et al., 2009).

Antioxidative Support

Honeysuckle contains numerous antioxidant components that have been shown to reduce oxidative damages caused by scavenge free radicals and hydrogen peroxide (Li et al., 2015). In addition, honeysuckle extract can enhance the intrinsic antioxidant enzyme system and inhibit lipid peroxidation, thereby reducing oxidative damage in the body (Gong et al., 2009; Li et al., 2015).

Quercetin

Quercetin is a polyphenol derived from fruits and vegetables. It has unique properties that may support both physical and mental performance, as well as maintain a reduced infection risk (Davis et al., 2009).

Quercetin has been shown to increase cytokine secretion, have antioxidant activity, support inflammation reduction and help to protect against brain edema in animal models (Jung et al., 2012, Liu et al., 2012, Dong et al., 2014). Notably, in a western diet-induced obese mouse model, quercetin could help to support the natural suppression of oxidative stress and the natural prevention of accumulated immune cells which result in inflammation (Kobori et al., 2016). Due to these potent anti-inflammatory promotion properties, quercetin has been suggested as a potential supplement for helping with mild bronchial asthma responses, mild allergic rhinitis and minor anaphylactic reactions (Mlcek et al., 2016).

In human clinical studies, the effect of supplementing quercetin is less clear. Some studies showed a significantly reduced inflammation and upper respiratory tract infections (Nieman et al., 2007, Nieman et al., 2010) whereas other studies report no change in immune function (Nieman et al., 2009). However, in the latter study there was no challenge to the immune system, suggesting that quercetin’s beneficial role in supporting the body’s natural anti-inflammatory effect will be noticed more following an insult or challenge. Notably, in a randomized controlled trial, quercetin supplementation had no significant influence on the rate of upper respiratory tract infections. However, in a subgroup of participants aged over 40, 1000 mg/day quercetin supplementation resulted in a significant reduction in the number of sick days and symptom severity related to upper respiratory tract infection (Heinz et al., 2010). Therefore, the effect of quercetin in humans may vary depending on age and health status.

Selenium

Selenium is an essential micronutrient as well as a potent antioxidant that plays important roles in inflammation and immunity. Adequate levels of selenium are important for various stages of immune response and regulating inflammation (Hoffmann and Berry, 2013; Avery and Hoffman, 2018; Huang et al., 2012). Selenium deficiency has long been recognized to affect immune cell functions and increased oxidative stress. However, very high levels of selenium intake are also toxic (Beck et al., 2001). Selenium deficiency is related to severe lung pathology post influenza infection in mice. This severe pathology is accompanied with higher infiltrated mononuclear cells and higher production of inflammatory cytokine levels after the 6th day of infection. In selenium-adequate mice, the infection started to be resolved at day 6 and it cleared by day 10 (Beck et al., 2001).

Inside the body, selenium is incorporated into selenoproteins, which are involved in the activation, proliferation and differentiation of numerous immune cells: (reviewed by Huang et al., 2012)

• T helper cell differentiation
• B cell function and antibody production
• Adherence and migration of leukocytes
• Eicosinoid (immune mediators) synthesis in macrophages
• Phagocytosis (engulfing of pathogens)
• Regulating inflammation

Within immune cells, selenoproteins perform antioxidant, protein folding, cell signalling and other functions. Notably, the levels of selenium can influence the production of reactive oxygen species in the destruction of engulfed pathogens. 

Selenium levels can also affect viral infections by an indirect action, through supporting the immune function at early stage of the disease or challenge, then the immune system is regulated thereafter when selenium levels are adequate (Beck et al., 2001). Selenium supplementation has been shown to boost anti-viral immunity (through immunomodulatory rather than a direct effect) against influenza viruses, HIV-1 (), and Poliovirus (Broome et al., 2004).

Immune Support

In addition, selenium supplementation has been proposed as a supplement for a wholistic approach to maintaining health, even for those suffering with numerous immune-related disorders, including: (reviewed by Huang et al., 2012)

• stress-induced immune suppression
• systemic inflammatory response syndrome
• intestinal inflammation and food-borne illnesses
• allergies and asthma
• cystic fibrosis
• autoimmune diseases
• lymphedema
• diabetes
• aging

Elderberry Extract

Elderberry has long been used as supportive agent for the immune system, frequently used by sufferers of common colds or influenza (Roxas and Jurenka, 2007). It has an immunomodulatory effect by regulating or reducing inflammatory cytokines and adhesion molecules which triggers cytokine-induced inflammatory patterns (Badescu et al., 2015). Research has also reported its antioxidant (Netzel et al., 2005), anti-inflammatory support and blood sugar regulation maintenance properties. In addition, elderberries contain a variety of vitamins, minerals and phytochemicals such as carotenoids. These nutritional constituents make elderberries a versatile supplementation for not only the immune system but also overall wellbeing.

A meta-analysis on elderberries found it can help maintain protective effects against influenza types A, B, and herpes simplex-1 virus (HSV-1). The mechanism by which this is thought to occur is by rendering viruses nonfunctional by coating them (Ulbricht et al., 2014). Flavonoids from elderberry extract could bind to H1N1 virions and potentially help the immune system block the ability of the viruses to infect host cells (Roschek et al., 2009). Other constituents including anthocyanins and procyanidins have strong inhibitory activity on nitric oxide production, thereby helping to maintain lower levels of inflammation (Ho et al., 2017).

Notably, several clinical trials have shown the supportive effects of elderberry extracts in humans. Two clinical trials using liquid extract showed a test group experienced a reduction in the duration and severity of influenza infection (Vlachojannis et al., 2010). A pilot trial demonstrated similar results for those with cold and flu like symptoms (Kong, 2009). Another clinical trial revealed that echinacea hot drink supplemented with elderberry is effective in supporting the immune system as it fights influenza, with maintaining a lower risk of related complications. In fact, the participants who supplemented their immune system with the natural drink fared as well as those treated with the medication oseltamivir, the gold standard treatment for influenza (Rauš et al., 2015). Lastly, a randomized controlled trial showed a significant reduction of cold duration and severity in air travellers who were supplementing with Elderberry extract (Tiralongo et al., 2016).

In summary, numerous studies suggest the efficacy of elderberry extract as a regulatory supplement for supporting the immune system in coping with viral infection-induced inflammatory reactions such as seasonal influenza.

Vitamin C

Vitamin C is an essential micronutrient which cannot be synthesized or stored by the human body. Therefore, daily intake of Vitamin C is critical.

As a cofactor for a battery of gene regulatory enzymes, Vitamin C has multifaceted functions ranging from epithelial barrier protection against pathogens to overcoming oxidative stress (Carr et al., 2017). Vitamin C deficiency is known to result in higher susceptibility to infections. In turn, infections further exhaust vitamin C due to enhanced inflammation and metabolic requirements.  

Vitamin C is well documented to be an effective micronutrient for supporting the immune system against respiratory and systematic infections. In a systematic review of Vitamin C and Immune Function, the authors concluded that: “Prophylactic prevention of infection requires dietary vitamin C intakes that provide at least adequate, if not saturating plasma levels (i.e., 100–200 mg/day), which optimize cell and tissue levels.” If someone already has an infection, significantly higher doses of Vitamin C will be required to compensate for the increased metabolic demand imposed by inflammatory response. This is typically seen in sepsis for example. Adequate ascorbic acid was found to help maintain lowered levels of proinflammatory cytokine production as well as the inducible nitric oxide synthetase (iNOS) and cycloogegenase-2 (COX2).

Vitamin D 

Vitamin D is a fat-soluble micronutrient which is critical for survival. Vitamin D is typically obtained from sunlight, but it is also found in foods such as fish, eggs and dairy. Our bodies synthesise vitamin D from cholesterol, given exposure to adequate UV rays. There is only sufficient UV rays from the sun when the UV index is at least 3.

The benefits of Vitamin D include immune health (Aranow, 2011, Llie et al., 2020, Ebadi and Montano-Loza, 2020, Lanham-New et al., 2020, McArthy and Byrne, 2020, Grant et al., 2020, Daneshkhah et al., 2020), cognitive support (Soni et al., 2012, Lee et al., 2020), bone health (Bischoff-Ferrari et al., 2009) and emotional wellbeing (Anglin et al., 2013, Eyles et al., 2005, Schaffer et al., 2014, Spedding, 2014). Adequate vitamin D may also help maintain healthy blood sugar levels (Zhiwei et al., 2019).

Recent research has indicated that vitamin D may have immune supporting properties through modulation of both the adaptive and innate immune system through cytokines and regulation of cell signalling pathways (Laird et al., 2020). Surprisingly, the researchers found that lower latitude and typically ‘sunny’ countries such as Spain and Italy (particularly Northern Italy), had low mean concentrations of 25(OH)D and high rates of vitamin D deficiency. These countries have also been experiencing the highest infection and death rates in Europe this year. The northern latitude countries (Norway, Finland, Sweden) which receive less UVB sunlight than Southern Europe, actually had much higher mean vitamin D concentrations, low levels of deficiency and for Norway and Finland, lower infection and death rates. The correlation between vitamin D concentration and mortality rate reached conventional significance (P=0.046) by Spearman's Rank Correlation. The implication may well be that getting vitamin D orally through diet, rather than sunlight alone, is critically important. This may be an interesting topic for further much-needed research.

Vitamin E

Vitamin E functions as a potent antioxidant obtained exclusively from the diet. It can protect cells from oxidation, a detrimental process linked to poor joint health and ageing (Rizvi et al., 2014). It supports the first line defence against lipid peroxidation, which protects cell membranes from free radical attack. However, growing evidence suggests that the current dietary guideline for vitamin E is inadequate (Wu et al., 2019).

Notably, immune cells usually contain higher levels of vitamin E due to higher demand. Immunomodulatory effects of vitamin E has been shown in animal and human studies under various test conditions (Lee & Han, 2018).

In addition, vitamin E has been shown to support a number of cell-mediated and humoral immune responses. These include increased proliferation of white blood cells, antibody levels, immunoglobulin levels, interleukin (IL)-2 production and natural killer cell activity (Lee & Han, 2018). As a result, vitamin E supported immunostimulatory effects could enhance resistance against infectious pathogens such as the influenza virus (Han et al., 2000).

In addition, there is evidence that vitamin E could help maintain heart health. Several populational studies have found an association between higher vitamin E intake and lower risk of heart diseases (Stampfer et al., 1993, Knekt et al., 1994). Due to vitamin E’s property in inhibiting platelet aggregation, it may also help maintain protection against the formation of blood clots that can lead to a heart attack. One of the mechanisms to help support protection against such inflammatory patterns is related to reducing oxidative stress induced by several exogenous and endogenous factors. Also, since inflammation is directed by the immune cells, vitamin E regulation of the immune cells helps in maintaining lower inflammation in the arteries (Shen et al. 2018, Min et al., 2018).

Zinc

Zinc is an essential mineral involved in regulating intracellular signalling pathways in innate and adaptive immune functions (Wessels et al., 2017). During an inflammation, adequate zinc is essential, as during acute immune response, zinc needs to be transiently transferred from serum into the organs, possibly acting as a danger signal for immune cells (Wessels et al., 2015). In addition, intracellular killing of pathogens, cytokine production and immune cell maturation are dependent on adequate zinc. Therefore, a low zinc status can increase susceptibility to infectious diseases, such as viral infections, diarrheal diseases and impaired lymphocyte functions (Wessels et al., 2017). Therefore, having adequate zinc levels in the blood/body helps to support the immune function and reduce the pathology induced following infections via regulating the immune function.

Zinc deficiency affects roughly 30% of the elderly population, which contributes to their weakened immune system and related chronic disorders (Haase et al., 2009). For example, zinc deficiency has been associated with diabetes, neurodegenerative diseases and inflammation (Chabosseau & Rutter, 2016, Kozlowski et al., 2012, Bonaventura et al., 2015). Nevertheless, zinc supplementation is not only beneficial for the elderly, but also patients suffering from: (Overbeck et al., 2008)

• Viral infections, eg. Common cold, diarrhea, chronic hepatitis C, HIV
• Bacterial infections, eg. Helicobacter pylori
• Parasitic infections, Eg. Malaria
• Autoimmune diseases, eg. Type 1 diabetes and Rheumatoid arthritis
• Transplant rejections