$55.29B
size of the global immune health supplement market in 2021, with a forecast CAGR of 11.4% through 2030
Get ready: Experts are cautioning that we may be in store for a rough sick season. “There’s a good chance that there will be an outbreak of the flu this year,” says Hank Cheatham, Vice President, Daiwa Health Development. “There are not as many strict public health interventions as there were last year, and we’ve seen a big surge in rhinovirus cases and common colds. There have also been surges in respiratory syncytial virus (RSV), so the next thing is to expect the flu, because that’s the way they normally follow each other in a regular respiratory season.”
Consumers are getting the message, and they are looking for immune support. “In light of recent public health advisories forecasting a particularly challenging flu season, marked by the prevalence of RSV, and evolving COVID-19 variants, consumer awareness and concern have seen a pronounced uptick,” reports Vishal Shah, Co-Founder & Executive Director, Nutriventia. “This heightened vigilance is driving individuals towards proactive health measures, including an increased focus on dietary supplements and functional beverages aimed at bolstering immune defenses. This heightened public consciousness serves as a fortuitous catalyst for manufacturers in the immune health supplement sector, offering a window of opportunity for market expansion and innovation. Thus, the present climate may be described as a double-edged sword; while the challenges are real, they indeed create a fertile landscape for growth in the immune health supplement market.”
In addition to increased consumer awareness of the importance of immune health and heightened interest in preventive healthcare in light of the COVID-19 pandemic, Buffy Gard, Global Business Development Leader, Fonterra, points to an aging population as a growth driver of the category.
"The present climate may be described as a double-edged sword. While the challenges are real, they create a fertile landscape for growth in the immune health supplement market."
—Vishal Shah, Nutriventia
Tracking the Post-COVID Market
Growth in this category will continue, experts predict. “According to a research report compiled by Polaris Market Research, the global immune health supplement market was valued at $55.29 billion in 2021 and is expected to grow at a CAGR of 11.4% through 2030, with North America and Europe leading the category in sales,” reports Maggie McNamara, Marketing Director, Gencor. “Immune health products are everywhere and are no longer sequestered to the fall and wintertime—immune health is thought about year-round.”
Also seeing that trend, Skye Chilton, CEO, Nammex, notes, “While the market for immune support was formerly more seasonal—growing in the fall, peaking in the winter, then declining somewhat in the spring—many consumers are now aware of the need to support their immune function year-round.”
Looking at consumer mindsets, Maria Stanieich, Marketing Manager, Kyowa Hakko USA, reports: “Post-pandemic, we have settled into a new normal; the kind of normal where concerns over our health are never far away. That plays a big factor in keeping the demand for immunity supplements very strong. A recent consumer survey by Kyowa Hakko of 503 U.S. supplement shoppers showed 40% of consumers have taken supplements to support immunity in the past 12 months. What’s more, out of those taking supplements, 79% do so as part of a daily regimen for long-term support. This shows that not only are there opportunities for as-needed immune health support, but everyday immunity, as well.”
The last few months have seen consumers taking a more proactive approach to healthier eating and exercising more—for maintaining health and immune resiliency, Cheatham adds. “They are now, more than ever, inclined towards wholesome and healthy food products and natural dietary supplements that deliver vitamins, minerals, and other healthy immunity-boosting ingredients, such as PeakImmune4.”
With another view of the immune health market, Stacey Smith, D.C., Communications and Marketing Manager, NORAM, Gnosis by Lesaffre, notes that though sales of supplements targeted for flu and cold dropped in 2022, the size of the immune supplement market is “enormous” compared to before the pandemic.
As for the shift in category focus, Dr. Smith maintains: “Trying to find a way to position immune-supporting formulations as a year-round supplement has turned out to be a hard nut to crack for brands in this space, as consumers view immune support as limited to an acute, seasonal need when they start feeling under the weather. During the pandemic, many argued that multivitamins would turn immune health supplements into ‘maintenance purchases,’ but this did not happen and likely never will, according to NBJ. Still, finding new ways to position products in this category can offer opportunities when looking beyond the typical flu and cold ‘sticker’ that is so attached to the notion of immune support. The importance of a robust immune system is essential for overall health. While lifestyle factors like regular exercise and sufficient sleep play vital roles in immune health, the role of nutrition, particularly micronutrients, should be considered. These tiny yet powerful components are unsung heroes of our immune-defense system.”
Noting another concern, Leslie Gallo, President, Artemis International, says, “The immune health supplement market is at an interesting crossroads. While all feedback and surveys indicate positive perception of immune supplements and consumer demand for ways to seek better health through food and drink, supplement manufacturers are still struggling with overly aggressive COVID-era amounts of inventory. When this situation will correct itself remains anyone’s guess. At some point, ingredients will need to be replaced, either due to demand or shelf life issues.”
An Evolving Market
“The market continues to grow in diversity, offering a wide range of immune health supplements, including vitamins such as vitamin C, vitamin D, and zinc, minerals, herbal supplements such as echinacea, elderberry, probiotics, and other specialty ingredients,” Gard says. “Consumers are increasingly looking for immune-boosting products with natural and clinically proven ingredients, especially during cold and flu seasons and to prevent COVID.”
Beyond that, consumers are searching for specific attributes, says Stanieich. “Our data suggests a high importance is placed on the ingredient’s particular benefits, ease of use, lack of artificial additives, and clinical studies to back up claims. Manufacturers of immune support applications who carefully and consistently communicate these features have a better opportunity to stand out in the market. Consumers prioritize safety and effectiveness, whether looking to supplements or beverages to support immune health. Over 86% said it’s important for immune health ingredients to be backed by science. With growing scrutiny by label-conscious consumers, brands must be more selective in choosing their product’s ingredients.”
Factoring this all in, Stanieich says, “Kyowa Hakko understands the need to provide clear and reliable information about its ingredients, and IMMUSE is backed by 10 years of scientific research and 30 published studies, including 15 human clinical trials. We are and will continue to remain dedicated to providing the clinically studied ingredients that consumers demand, and we’re excited to announce that IMMUSE is now available to a broader global audience with the recent launch of the immune health supplement IMMO Forte in Mexico.”
Also pointing to the significance of science: “There are numerous science-backed ingredients suitable for formulations targeting immune health,” says Karla Acevedo, Marketing Manager, Sirio. “At Sirio, we have our own dedicated ingredients division focused on developing high-quality ingredients. Among them is CitruSlender, a specialized ingredient well-suited for inclusion in respiratory support formulations.”
In addition to quality, consumers want more bang for their buck. “Some of the major trends shaping the immunity space today include the convergence of immunity claims with various additional health benefits,” Acevedo explains. “Multifunctional supplements have gained significant popularity among consumers who are seeking a more holistic approach to their well-being. This trend reflects a growing interest in products that not only support the immune system but also offer added advantages, such as antioxidant properties, stress reduction, or overall vitality. Manufacturers are responding by formulating immune health supplements that incorporate these multifaceted benefits, providing consumers with a more comprehensive approach to their health and wellness.”
Digging deeper into the data, Stanieich shares, “As consumers become savvier about health and nutrition, they’re looking for ways to boost both their immunity and digestive health. Our survey results showed 82% of consumers seek immune boosts through diet, activity, and supplements, while 81% are seeking digestive health via the same means. This shows that brands can cast a wide net by helping these consumers make the connection between immunity and the microbiome, particularly with ingredients such as IMMUSE, an award-winning immune health dietary and food postbiotic from Kyowa Hakko.”
Consumers are also looking for more personalized products, and brands are delivering. “For example, we have several that are targeted to specific segments of the population, such as Healthy Kid’s Compound which supports children’s healthy immune function,” says David Winston RH(AHG), Founder and President, Herbalist & Alchemist. “Alcohol-free, it contains immune potentiating echinacea root (E. angustifolia), elderberry fruit (Sambucus nigra var. canadensis), lemon balm herb (Melissa officinalis) and orange extract for flavor. It can be taken to help enhance immune competence during times of seasonal change.”
Spotlight on Trending Immune Support Ingredients
“Several probiotic formulas are in our top sellers,” says Amber Cerda, Director of Marketing, NOW. “We utilize specific live bacterial strains with evidence of supporting healthy immune system function. There is evidence that oxidative stress can negatively affect immunity. Accordingly, supplements that support free radical fighting and antioxidant support in the body also rank high in our sales. Glutathione, ubiquinol, Vitamin E-400 IU, C-1,000, and Alpha Lipoic Acid continue to sell well, as does Quercetin with Bromelain. It is interesting that Glutathione is now outselling its precursor, NAC, which was so incredibly popular during the pandemic. We also have a new item that is selling well: a combination of NAC, Quercetin & Zinc in one capsule supplying 1,000 mg NAC, 500 mg quercetin, and 15 mg zinc per two-capsule serving. And the important immune-supporting nutrient vitamin D continues to sell well, especially in higher strengths such as 5,000 IU.”
On the gut health front, Gard adds, “Probiotics are well-known for their beneficial effects on gut microbiota and our digestive health. What’s more interesting is the recent exploration of how probiotics may have direct and indirect effects on more than just our digestive health, but also our immune function and inflammation due to the interaction with the brain through the gut-brain axis. In a CARAVAN survey Nutiani fielded in May 2022 among U.S. adults 18+, 35% of respondents who are currently taking probiotics indicated they were taking probiotics for immunity. In addition, for people seeking immunity benefits, 39% of respondents indicated they aren’t currently but would take probiotics to meet their needs. Currently, very few brands market products against these benefits. The market will accelerate when the brands start aggressively marketing and as more science emerges.”
Consumers are looking for products that support their body’s response to stress as well as immune support, adds Winston. “We see a lot of demand for immune support products containing adaptogens. Some examples are Immune Balance Compound, a formula that helps to balance the immune system. A blend of immune amphoterics and immuno-regulatory herbs, it contains reishi mushroom and mycelium, turmeric rhizome, ashwagandha root, Huang Qin root, licorice root, and unprocessed rehmannia root. Another is Immune Adapt, which supports healthy immune function. Based on traditional Chinese Fu Zheng Pei Ben therapy, this formula restores vital energy and balance to the body so that it is better equipped to deal with stress and challenges to the immune system. It is a blend including schisandra, eleuthero, red and black reishi mushrooms, reishi mycelium, licorice, astragalus and the restorative tonic codonopsis. The tonic herb Bai-Zhu Atractylodes is added to support stomach and spleen qi, relieve dampness, and promote healthy immune system activity. Many of the immuno-regulatory herbs (turmeric, baikal skullcap, dan shen /red root sage, gotu kola, sarsaparilla, cinnamon, bupleurum, and unprocessed rehmannia), have been shown to down-regulate Th17 T lymphocytes, which are upregulated in autoimmune diseases, as well as other immune problems. The use of these herbs can inhibit inflammation, enhance immune competence and a tolerogenic state.”
In the past, Chilton notes, much of the immune category for dietary supplements was driven by natural alternatives to over the counter or prescription treatments for symptomatic relief. And now: “Herbalists and alternative practitioners have long known about the immune support of mushrooms such as reishi, chaga, maitake, and cordyceps, mainstreaming of that knowledge is helping to drive the rapid growth in this category. With the learning curve shortening on how to incorporate functional mushrooms and adaptogens into a daily wellness plan, we will continue to see growth in those products.”
Focusing in on mushrooms, Jerry Angelini, Head of Education, Fungi Perfecti, adds: “Looking at both internal and external data, immune support continues to be top of mind for consumers as a part of their everyday supplement regimen and mushrooms in particular continue to shape and evolve the overall immune support landscape into 2024. In addition, personalized and individualized health support continues to build its groundswell of interest for all age ranges. Alternate delivery formats beyond traditional capsules continue to be relevant, providing lifestyle flexibility for consumers. Fungi Perfecti, LLC (makers of Host Defense Mushrooms) continuously researches and participates in third-party research on ingredients and products in the Host Defense Mushroom line. We contract with independent immunology labs and collaborate with universities to further understand the potential benefits of mushrooms for a range of health and wellness goals. Research suggests that the mycelium and the fermented rice are both immunologically active. They both support immune engagement, modulatory activity, and the body’s natural day-to-day tissue generative activity; a significant range of immune functioning. This is great news as this data comes from a variety of testing models. There is also a significant amount of research demonstrating the supportive potential of lion’s mane for nerve generative activity. Fungi Perfecti’s research team is conducting their own research in this area. Fungi Perfecti has a dedication to research with a multidisciplinary team of 11 scientists, including Paul Stamets himself. We hope to keep everyone updated as research studies are completed and papers are published in peer-reviewed journals. The take home: the combination of mushroom mycelium and fermented rice in Host Defense products work!”
NOW is seeing the mushroom boom, too. Cerda explains, “Mushroom products with beta-glucans, as well as other immune-supporting components, are still selling well, and we have just added some new offerings. Our popular Mushroom Immune Renew product, consisting of an equal blend of eight certified organic mushrooms and mycelia and a standardized astragalus root extract, was available in capsule form but is now available as a powder that would be very nice to add to smoothies, soups, etc. The mushroom blend includes both organic mycelial biomass and mushroom fruiting bodies [blend of king trumpet (Pleurotus eryngii), turkey tail (Trametes versicolor), Cordyceps militaris, reishi (Ganoderma lucidum), Agaricus blazei, lion’s mane (Hericium erinaceus), maitake (Grifola frondosa) and Antrodia camphorata] cultured on organic oat substrate. There are naturally occurring polysaccharides in the mushroom blend plus the astragalus extract is unusual in being standardized (to polysaccharides). We also just added a turkey tail mushroom capsule, an increasingly popular fungal immune-supporting botanical. This product features organic turkey tail (Trametes versicolor) fruiting body and mycelial biomass. We are in the process of launching an enhanced bioavailability quercetin product for immune and respiratory support.”
On the herbal front, Winston adds, “While the market for immune herbs has fallen from the peak during COVID lockdown, it is still strong. And at the same time, our understanding of how various herbs support immune function continues to grow. There are several categories of herbs that influence the immune system, and many herbs affect more than one aspect of it. Herbs can work via multiple mechanisms.”
Winston notes that people often mistakenly assume that any immune support herb stimulates immune function. The truth: “Some herbs stimulate the surface immune system (what in TCM is called the Wei Qi), such as echinacea, elderberry or flower, hyssop, andrographis, isatis, and yarrow, among others. These herbs are primarily used to treat what is known in Traditional Chinese Medicine (TCM) as blood heat, wind heat or damp heat. The immune reservoir is a concept I created based on the TCM idea of the body’s ability to mount an appropriate response to immunological challenges. While there is not an actual 'immune reservoir,' the bone marrow, gut immune system and intestinal microbiome correlate most closely as an anatomical 'immune reservoir.' Nourishing immune herbs such as reishi, astragalus, maitake, cordyceps, turkey tail, codonopsis, chaga, and licorice are useful for strengthening overall immune response.”
Also looking at specific ingredients, Gallo spotlights the continued popularity of a familiar favorite. “Elderberry remains a top ingredient associated with immune support. But not all elderberry ingredients are equal in terms of quality, strength, and efficacy. New studies on ElderCraft European Black Elderberry Extract continue to set it apart as the most studied and validated elderberry ingredient on the market. Just in the last year or so, studies were published that demonstrate the ability of ElderCraft to activate dendritic cells of the immune system as well as inhibit viral replication of SARS-CoV-2 in vitro (patent pending), further solidifying the immune-support properties of ElderCraft. But exciting new studies in complementary areas outside of immune support alone are what make ElderCraft particularly unique. We know a healthy gut contributes to a healthier immune system and ElderCraft was shown in a human clinical study to have prebiotic benefits and caused a lasting increase of the healthy gut microbe Akkermansia. Another recent study showed that ElderCraft possessed the potential to activate Sirtuin 6, which is a protein that plays a crucial role in cellular health and longevity—think healthy aging and beauty from within. Therefore, as formulators are looking for ways to innovate within the immune category and beyond, ElderCraft serves as a versatile ingredient with multi-functional health benefits.”
Standing Out in a Crowded Immune Space
“For our customers, the question now is, ‘How can we be different?’ We are happily collaborating with customers on new formulations, using clinically validated dosages, adopting branded ingredients to add value, updating packaging to reflect the benefits of their product, and being more innovative with their ingredients to meet a broader customer base,” Gallo says. “Right now, gummies remain the top consumer delivery, but new innovative formats are on the horizon. Think multi-level, multi-functional gummies, personalized to address an individual’s specific needs or deficiencies.”
Consumers are comfortable using traditional immune health ingredients such as vitamins, minerals, herbs, and botanicals, McNamara adds. “However, they are open to trying other ingredients shown to support a healthy immune system while also combating unhealthy levels of inflammation. Consumers are becoming more educated on how inflammatory response can support overall immunity. The savvy consumer is especially open to trying ingredients with solid clinical research and even products that offer multiple benefits by combining multiple ingredients. It’s not the classic all-in-one multi-vitamin but rather a combination of branded ingredients for gut health + immunity or sleep + immunity. Consumers are now also more open to various formats, including powders, RTD shots, chewables, gummies, and traditional pill formats.”
Also focusing on applications, Stanieich says, “Capsules and gummies will remain popular for immune health but there is an exciting opportunity in functional beverages. Trends show that many supplement consumers have purchased bottled juices, teas, and smoothies both proactively and in response to getting sick. Around 63% of consumers said they are likely to purchase an immune-support beverage in the next three months, and nearly a third of consumers are unsatisfied with the current options that exist. Because beverage seekers place a higher value on taste, it’s important manufacturers choose their ingredients carefully. Using a highly soluble ingredient such as IMMUSE postbiotic, alongside immunity-forward flavors such as elderberry and citrus, is a winning combination.”
Clean-label is another draw, adds Gallo. “Fillers, non-natural colorants and flavors, and preservatives have fallen out of favor and smart manufacturers are looking to avoid them.”
The final word
All of this variety and innovation does have a drawback, as Gencor’s McNamara cautions: “The category has become inundated with thousands of products for a consumer to choose from, which may do more harm than good, especially if the product isn’t offering an efficacious dose of the main active.” Brands and retailers need to do their research to present the best offerings for consumers. WF
