In 1918, during the global influenza pandemic, nurses—often the first female health professionals on the front lines—cared for patients with herbal extracts, teas, and tinctures when modern medicines were scarce. At the same time, the botanist and physician Hildegard of Bingen had recorded observations about medicinal plants centuries earlier that continue to shape Europe today. This tradition now intersects with modern immunology: we are increasingly understanding how certain plants provide extracts that activate immune cells, dampen inflammation, and shorten the duration of viral infections. For high performers, this means that nature and science can be strategically utilized—for more resilience, energy, and longevity.

The immune system is your interconnected defense network: innate and adaptive components that recognize, mark, and eliminate intruders. Plants provide bioactive molecules—such as Ginsenosidesactive saponins from ginseng, Polysaccharidescomplex carbohydrates that stimulate immune receptors like TLRs, and Flavonoidsantioxidant plant pigments that act on cytokine-mediated signaling pathwaysmessenger substance network that controls immune cells. The context is crucial: plants modulate—they dampen overreactions or push weak responses. Standardized extracts, dosage, and timing are essential. During the cold season, early intervention in the nasopharynx, where viruses first replicate, is most important. For sustained performance, it’s about balancing activation (e.g., increased NK cell function) and regulation (e.g., more IL-10 as an anti-inflammatory).

Elderberry shows a significant reduction in upper respiratory symptoms in a meta-analysis—an indication that antiviral and inflammation-modulating effects become clinically noticeable ^[1]. Echinacea combined with sage rapidly alleviates acute sore throats in clinical applications and reduces viral load in the throat—the earlier it is used, the greater the benefit in the critical early phase ^[2]. Ginseng supports cognitive alertness, acts immunostimulatory, and has anti-inflammatory effects—an ideal combination for high-stress individuals who want to strengthen their immune defense without performance loss ^[3]. The adaptogenic properties of ginseng also help normalize training- or stress-induced inflammatory responses, improving recovery and immune competence ^[4]. Astragalus mainly provides polysaccharides that modulate innate and adaptive immunity—from increased phagocytosis to antibody formation—and can strengthen defenses against viral infections ^{[5] [6]}.

A quantitative meta-analysis on elderberry summarized clinical studies with a total of 180 participants and found a clear, large effect size for the reduction of symptoms in upper respiratory infections. Relevance: Elderberry can reduce the disease burden in cases of cold or flu and offers an option to avoid unnecessary antibiotic use in viral infections ^[1]. In a prospective clinical application, patients with acute tonsillopharyngitis received lozenges containing Echinacea purpurea and Salvia officinalis. Result: Rapid relief of sore throat and—particularly noteworthy—a strong decrease in viral load already after the first administration and over four days. Significance: Early topical application addresses the infection site and can favorably influence the disease course and risk of contagion ^[2]. Reviews and preclinical-clinical evidence on Panax ginseng show immunostimulatory and antiviral activities mediated by ginsenosides, which inhibit pro-inflammatory signaling pathways and enhance immune cell functions; animal studies also demonstrate normalization of cytokine profiles and activation of innate defenses after extreme stress. For high performers, this translates to more robust immune responses under stress without pro-inflammatory costs ^{[3] [4]}. Additionally, reviews on Astragalus support the immunomodulatory effect of its polysaccharides—from promoting mucosal immunity to maturing adaptive immune cells—with potential application as an adjunctive strategy during infection-prone phases ^{[5] [6]}.

- Timing Echinacea correctly: Use Echinacea purpurea at the first sign of a scratchy throat, ideally in lozenge form combined with sage for local effect in the throat area. Apply consistently for 3-4 days, especially during cold season ^[2].
- Use Astragalus cyclically: Take a standardized Astragalus preparation (containing APS) daily for 6-8 weeks, then pause for 2 weeks. This is sensible during high-stress phases, travel, and winter. Combine with protein-rich meals for better routine integration ^{[5] [6]}.
- Elderberry for the acute phase: From the onset of symptoms, use elderberry extract or syrup according to manufacturer instructions for 5-7 days. Goal: shorten symptoms and reduce disease burden—ideal as a “travel pharmacy” ^[1].
- Ginseng for resilience: Integrate Panax ginseng (standardized extract) into your morning routine, especially consistently on training days. It acts immunomodulatory and supports performance; evaluate benefits after 8-12 weeks ^{[3] [4]}.
- Smart stacking: In the flu season, a base stack of ginseng (in the morning) + astragalus (at noon) for basic resilience; for the first throat symptoms, apply Echinacea/sage locally, and for the onset of cold, use elderberry for the acute phase. Check for interactions; consider medications.
- Prioritize quality: Choose standardized extracts with declared contents (e.g., ginsenosides, APS). Consult a doctor for autoimmune diseases, pregnancy, breastfeeding, or long-term medication.

The coming years will produce more precise, standardized plant extracts targeting defined immune goals—from mucosal immunity to NK cell activation. Adaptive protocols are also expected, utilizing biomarkers such as cytokine profiles and viral load in real time to individually dose Echinacea, Astragalus, elderberry, and ginseng—for maximum efficacy with minimal risk.