BUSINESS SECRETS WEEKLY

LionBerry’s Weekly Delusion & Re-Illusion Update

Lion’s Mane Mushroom Powder in Your Coffee Isn’t Lifting Your Brain Fog.

Welcome to Health Food Washing 101: Where Marketing Is the Science and the Label Is the Proof. If It’s on the Label, It Must Be True???

THE BOTTOM LINE — FOR THOSE WHO DON’T READ THE WHOLE THING:

Lion’s mane mushroom contains two bioactive compounds — hericenones and erinacines — that tell your brain to repair itself, grow new neurons, and cut through brain fog. Erinacine A is currently the most highly researched compound in the world for Alzheimer’s disease, Parkinson’s disease, and traumatic brain injury. These compounds are alcohol-soluble. They cannot be released by hot water. Coffee is hot water. This means every lion’s mane mushroom powder coffee on the market — regardless of what the bag promises — is delivering zero of these brain compounds to your brain. Zero. The powder passes through you untouched.

The only way to get hericenones and erinacines out of the mushroom and into your body is a dual extraction: alcohol AND water, from the fruiting body of the mushroom. That’s what LionBerry uses. That’s the difference between a product that performs and a product that just looks like it should.

Dual extract = the actual brain compounds, bioavailable, crossing the blood-brain barrier, reaching your brain.

And here’s the part nobody mentions: adding a liquid extract to your coffee is not harder than stirring in a powder. It is not a chore. It is not a complicated ritual. It is a dropper in a cup. There is no reason to choose powder over extract. None. The extract does what the powder only pretends to do, and it takes exactly the same amount of effort to use.

Buy whatever coffee you love. Put LionBerry in it instead.

There is a product sitting in your grocery store, your local market, and your favorite wellness shop. It comes in a beautiful bag. It says “clean label.” It says “no added sugars.” It says “gluten friendly.” It might say “adaptogenic.” It almost certainly says “lion’s mane mushroom” in large letters, because lion’s mane is having a moment, and moments sell product.

Ryze. Four Sigmatic. Every white-label mushroom powder coffee that appeared overnight when the trend hit.

What none of them say — anywhere on that bag, in that Instagram post, or in that influencer’s sixty-second testimonial — is this:

The lion’s mane in here is dried mushroom powder. It cannot reach your brain. It will not lift your brain fog. The focus you feel is caffeine. It was always just the caffeine.

That part didn’t make the label.

This is health food washing. The wellness industry’s version of greenwashing, where the language of real clinical function gets borrowed by products that cannot perform that function. Slap enough clean-sounding words on a package and the product inherits the credibility of the real thing without doing the work of the real thing. “Focus.” “Clarity.” “Neurogenesis.” “Lift the brain fog.” All words that live in the same neighborhood as lion’s mane research. None of them accurate when the lion’s mane in question is dried powder dissolved in hot water.

It’s not lying, exactly. It’s just letting you believe something that isn’t true and charging you a premium for the privilege.

The lion’s mane conversation got hijacked by powder.

And lion’s mane is not the first casualty of this. Elderberry has the same problem. People process it into a syrup so aggressively overcooked that the anthocyanins — the actual anti-inflammatory compounds that make elderberry worth anything — get burned off entirely in the heat. Then people try it, feel nothing, and elderberry gets a reputation problem it didn’t earn. The plant isn’t the failure. The processing is the failure. The label never mentions the processing. The category takes the hit.

Lion’s mane is heading down the same road.

Here’s what the bag won’t tell you, but the science will.

1. WHAT IS ACTUALLY IN LION’S MANE MUSHROOM?

Lion’s mane (Hericium erinaceus) contains two classes of bioactive terpenes: HERICENONES and ERINACINES. Both trigger production of NGF (Nerve Growth Factor) and BDNF (Brain-Derived Neurotrophic Factor) — the chemical signals that tell your brain to repair, regrow, and rebuild.

These are the compounds behind focus, clarity, neurogenesis, and actually cutting through brain fog. Not vibes. Not marketing. Chemistry.

Hericenones are aromatic terpenes extracted from the fruiting body of the mushroom. They stimulate NGF biosynthesis directly in brain cells — sending the signal for neurons to repair, regenerate, and reconnect. They are low molecular weight compounds, which means they cross the blood-brain barrier. They reach your brain. Not just your bloodstream. Your actual brain.

Hericenones are the brain repair signal. Most supplements never make it past your gut. Hericenones do.

Erinacines are diterpenoids from the mycelium. They also stimulate NGF synthesis. Erinacine A is the single most researched compound in the world right now for Alzheimer’s disease, Parkinson’s disease, and traumatic brain injury. Also low molecular weight. Also crosses the blood-brain barrier.

Both are in this bottle. Both are doing work.

Neither one does anything for your brain unless they have been properly extracted. That is the entire problem. That is the only problem. And that is exactly where every lion’s mane mushroom powder coffee on the market is failing you.

2. THE BRAIN FOG IS STILL THERE. IT’S JUST MORE EXPENSIVE NOW.

Here’s what actually matters, and what the label will never tell you:

Hericenones and erinacines are alcohol-soluble terpenes.

Not water-soluble.

Alcohol-soluble.

Every popular lion’s mane mushroom powder coffee on the market mixes dried powdered lion’s mane into coffee — which is hot water. Hot water cannot extract alcohol-soluble compounds. This is not an opinion. This is basic chemistry.

Hericenones and erinacines are alcohol-soluble terpenes. Coffee is hot water. Hot water cannot touch them.

Those terpenes stay locked inside the chitin cell wall of the dried mushroom powder. Chitin is the same material as crab shells. Your gut does not have the enzymes to break it down. It was not built for it.

The lion’s mane mushroom powder passes through you completely intact. Completely inert. Your brain never saw it.

So the powder dissolves into your cup, looks like something is happening, and exits your body exactly the same way it came in. Untouched. Unabsorbed. Unbothered.

Expensive and unbothered.

What you DO feel from lion’s mane mushroom powder coffee? That’s caffeine. Caffeine genuinely works — caffeine feels like focus, your brain interprets it as clarity, and for a few weeks, maybe a few months, you think the lion’s mane is doing something. The brain associates the ritual with the result. The placebo is real enough to feel like progress.

It’s not the lion’s mane. It was never the lion’s mane. That’s just Tuesday morning with coffee.

Then the caffeine stops being novel. The placebo wears off. You’re right back to losing your keys and walking into rooms and forgetting why you went in there.

And now lion’s mane has a reputation problem it didn’t earn. The powder failed you. The extract never got a chance. The whole category takes the hit — and every product with “lion’s mane” on the label, including the ones that are actually extracted properly and actually work, gets written off as hype.

That’s the damage. Not just to LionBerry. To the entire conversation about what lion’s mane can actually do.

⚠️ LION’S MANE MUSHROOM POWDER IN YOUR COFFEE = YOU ARE PAYING FOR PLACEBO ⚠️

3. WHAT LION’S MANE MUSHROOM POWDER GIVES YOU — AND WHAT IT ABSOLUTELY DOES NOT

What you get ZERO of from dried lion’s mane mushroom powder:

✗ Hericenones — locked in chitin, not bioavailable, not reaching your brain

✗ Erinacines — same problem, same chitin wall, same result

✗ NGF induction — not happening

✗ BDNF induction — not happening

✗ Neurogenesis — no

✗ Dendritic regrowth — no

✗ Myelin sheath support — no

✗ Focus — not from the lion’s mane

✗ Clarity — not from the lion’s mane

✗ Cutting through brain fog — absolutely not

If you bought lion’s mane mushroom powder coffee for focus, clarity, and lifting brain fog — you got the immune product with brain health branding. That is not science. That is health food washing. Great product. Wrong label. Wrong promises.

Powder does contain beta-glucans, which support immune function, gut health, blood sugar, and cholesterol. Those are real benefits. But nobody is buying mushroom coffee for their cholesterol. And there is no reason — not one — to choose a powder that cannot deliver the brain benefits over a liquid extract that can. A dropper in your coffee takes exactly the same effort as stirring in a powder. The extract does what the powder cannot. This is not a hard choice.

4. BUY WHATEVER COFFEE YOU LOVE. PUT THIS IN IT INSTEAD.

For the actual brain benefits — neurogenesis, dendritic regrowth, myelin sheath protection, NGF and BDNF induction, real focus, real clarity, actual brain fog obliteration — you need a dual extract: alcohol AND water, from the fruiting body of the mushroom.

The alcohol pulls the hericenones and erinacines out of the chitin cell wall and into a bioavailable form. The water captures the beta-glucans. Your brain gets what it was promised. Your immune system gets the bonus.

The alcohol pulls the brain compounds out. The water gets the immune compounds. You need both. That’s what a dual extract is.

Both hericenones and erinacines are low molecular weight compounds. They cross the blood-brain barrier. They actually reach your brain — not just your bloodstream. Your brain.

Most supplements never get past your gut. These do.

LionBerry uses a dual extract — alcohol and water — from the fruiting body of the mushroom, because that is the only way to get hericenones and erinacines out of the chitin wall and into a form your body can absorb and your brain can use. It costs more to do it this way. It takes longer. It cannot be scaled by cutting corners.

We don’t cut corners. Not because it’s easy. Because the lion’s mane in this bottle is supposed to do what lion’s mane is supposed to do.

LION’S MANE MUSHROOM POWDER COFFEE ≠ NGF/BDNF induction

LION’S MANE MUSHROOM POWDER COFFEE ≠ neurogenesis

LION’S MANE MUSHROOM POWDER COFFEE ≠ myelin sheath protection

LION’S MANE MUSHROOM POWDER COFFEE ≠ dendritic regrowth

LION’S MANE MUSHROOM POWDER COFFEE ≠ lifting the brain fog

It does taste good though. We’ll give it that.

5. WHAT A DUAL EXTRACT ACTUALLY DELIVERS

✓ Hericenones → NGF/BDNF stimulation → brain repair and rebuild signal activated

✓ Erinacines → NGF synthesis → neuroregeneration and neuroprotection

✓ Blood-brain barrier penetration — low molecular weight, actually reaches your brain

✓ Neurogenesis — growth of new neurons

✓ Dendritic regrowth — rebuilding the connections between neurons

✓ Myelin sheath support → nerve conduction, reaction time, sustained focus

✓ Actual brain fog relief — the real kind, not the caffeine kind

✓ Beta-glucans → immune and gut benefits included

✓ Bioavailability guaranteed — extraction breaks the chitin wall so your body can actually absorb it

Real extraction.

Real bioavailability.

Real compounds reaching your actual brain.

Zero powdered fantasy.

Brain repair. Nerve growth. Immune support. Gut health. One bottle. Properly extracted so your body can actually use it. Revolutionary concept, we know.

Buy whatever coffee you love.

Put this in it instead.

RESEARCH CITATIONS

Because we didn’t make this up.

[1] Ma et al. (2010). Hericenones and erinacines: NGF biosynthesis stimulators. Mycology — DOI: 10.1080/21501201003735556

[2] Kawagishi et al. (1991). Hericenones C, D and E, NGF synthesis stimulators. Tetrahedron Letters

[3] Friedman M. (2015). Chemistry, Nutrition, and Health-Promoting Properties of Hericium erinaceus. Journal of Agricultural and Food Chemistry — DOI: 10.1021/acs.jafc.5b02914

[4] Ratto et al. (2022). Hericerin derivatives and pan-neurotrophic pathway activation in hippocampal neurons. Journal of Neurochemistry — DOI: 10.1111/jnc.15767

[5] PMC Narrative Review (2024). Lion’s Mane: A Neuroprotective Fungus. PMC — pmc.ncbi.nlm.nih.gov/articles/PMC12030463

[6] Phan et al. (2014). Hericenones and NGF-mediated neurite outgrowth via MEK/ERK and PI3K-Akt signaling. Food & Function — DOI: 10.1039/c4fo00031e

[7] Restorative Medicine Monograph — Lion’s Mane comprehensive review. Restorative Medicine — restorativemedicine.org/library/monographs/lions-mane

LionBerry Regenerative

Facebook & Instagram: @lionberry

Business Secrets Weekly drops every Sunday at www.lionberry.us

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Elderberry’s Reputation Problem Doing It Right So It Actually Works

Lionberry 's Weekly Delusion and Re-illusion Update.

Elderberry has a reputation problem. People try it and they say it kind of works. Sometimes. Maybe a little. That is not the berry’s fault. That is what got done to the berry long before it ever reached the bottle.

So let me start with what this berry can actually do when it is done right. We use the native American elderberry, Sambucus canadensis, fresh-pressed, and it carries roughly ten times the antioxidant punch of a blueberry. It is antiviral, and the anthocyanins are a big part of why, because they can grab onto the proteins a virus uses to get into your cells and gum up the works [11]. It works on your immune system the smart way, nudging the inflammatory signals up or down depending on what your body actually needs instead of just flooring the gas [11]. The anthocyanins feed the good bacteria in your gut like a prebiotic [4]. And when those bacteria break the anthocyanins apart, one of the main things they make is protocatechuic acid, which is the major thing your body turns cyanidin-3-glucoside into [12]. That little molecule slips across the blood-brain barrier and calms inflammation once it gets up there [12]. It works all the way from your gut up to your brain. It is past being a superfruit.

The problem is almost nobody ever gets that berry, because of what happens to it before it reaches them.

We make two products with elderberry. LIONBERRY REGENERATIVE™ HYDRATION and ELDERBERRY SIPS. Neither one is a syrup.

Syrup is fine for pancakes. Thicker is not better. When you cook elderberry down into a syrup you are not concentrating the medicine. You are boiling it off. What you have left is sugar and a sad story about what used to be in there.

Heat is the enemy. Long slow steeping, simmering the berry for hours with spices, that is not doing what people think it is doing. Dehydrating and powdering food changes the cell structure, takes too much heat, and burns off the delicate plant properties. So we do not use dehydrated powder.

Most powdered elderberry comes from overseas. Roughly 95% of the drugstore elderberry on the shelf is powdered European elderberry, Sambucus nigra, dried with heat [7]. The anthocyanins, those deep purple compounds that do the actual work, are fragile. Long heat destroys them [7]. By the time that powder is packed into a capsule the color is faded and the chemistry is gutted. And here is the thing people miss. The color is the medicine. When the purple is gone, the value went with it. A faded capsule is a receipt for something you no longer have.

Spray drying is worse. It shoots the material through hot air, so you get even more heat stress and even more loss [7]. And most of that overseas powder is the whole berry, seeds and all, which means you are grinding in the seed material and a heavier, muddier phytochemical profile than you ever get from clean juice. Juice leaves the seeds behind.

Here is where people get nervous, and where the American berry quietly wins. All elderberry, every species, carries some cyanogenic glycosides in the seeds and the unripe parts. Sambunigrin is the main one [9]. And yes, heat does knock those down. Cooking and heavy processing have been shown to cut cyanogenic glycoside levels way back [10]. That is the real reason so much elderberry, especially the European berry, gets cooked so hard. The higher cyanide load and old tradition push you straight toward heavy heat. But heavy heat is the exact thing that destroys the anthocyanins. So with the European berry you are boxed in. Cook it enough to feel safe and you cook the medicine right out of it.

American elderberry does not put you in that corner. It runs much lower in those compounds to begin with, and when researchers actually measured commercial American elderberry juice, they found no quantifiable trace of them [9]. That is exactly why we can press American elderberry, keep it as a juice, and never have to cook it into oblivion to make it safe. Low cyanide going in means we get to keep the heat low and the anthocyanins high. The European berry forces a choice between safe and potent. The American berry lets us have both.

But it is not just more. It is different. American elderberry carries acylated anthocyanins that European elderberry barely has, if it has them at all [1]. One of the big ones is a real mouthful. Cyanidin-3-O-[6-O-(E)-p-coumaroyl]sambubioside-5-O-glucoside. Forget the name. Remember the one word that matters. Acylated. That little acyl group is armor. It makes the molecule tougher against pH swings, against heat, against oxygen, against time sitting on a shelf [1]. And that armor is not a fun fact for a label. It is the whole reason the berry can do anything once it is inside you.

Most of these anthocyanins do not get absorbed up top in the stomach and the small intestine. That is not a problem. That is the plan. They are supposed to ride all the way down to the colon, because the colon is where the real work happens. The trouble is the colon is alkaline. The minute elderberry leaves the acid of the stomach and hits that alkaline stretch, a bare unprotected anthocyanin starts coming apart. The acyl armor is what holds it together long enough to arrive in one piece [1].

When it arrives, your own gut bugs go to work. Bifidobacterium especially. They take those anthocyanins apart and turn them into short-chain fatty acids and small phenolic compounds [4]. Those short-chain fatty acids are what talk to the L-cells in your gut lining, the same cells that run your body’s own GLP-1 signaling [4]. Elderberry does not contain GLP-1. It feeds the system that makes your own. That is the whole point. And it is worth saying that when the Washington State University team studied elderberry and saw the gut microbiome shift, fat oxidation climb, and glucose handling improve, they used elderberry juice [2]. Juice is the form the good data is sitting on.

So how you deliver it is not a small detail. A concentrated dry capsule and an acidified juice do not act the same once they hit your gut. So far, every time somebody lines up whole food against an isolated extract, the whole food comes out ahead [3]. There are not a lot of head-to-head studies yet, so I am not going to oversell it, but that is the way it keeps landing. A juice that is already acidified shows up in friendly shape. Low pH is exactly where anthocyanins are happiest, so more of them survive the trip and reach the colon intact, armor and all. A dry capsule has to dissolve, rehydrate, and tough out that alkaline run on its own, with no acid and no food around it to carry it through. Same berry on the label. Two completely different rides through your body.

This is why you never want to isolate one thing out and call it the answer. Plants work as a team. You would not send your eleven-man football squad onto the field, hand the ball to the tight end, and tell the other ten to sit down. He is not getting to the end zone by himself. He needs the line blocking and the backs running and everybody doing their job at the same time. Elderberry is the same way.

We evolved eating food. And the plants we eat evolved to defend themselves. So when we eat the plant, we are eating the very compounds it built to protect itself. Those compounds are sister molecules. Some of them mirror each other. Some of them work together. Some land on the same receptors, some land on different ones, and some of them flat out need each other just to become usable in your body at all. Pull one out of that lineup and you have got a tight end standing alone on the field wondering where his team went. Keep them together and they cover for each other. That is what a whole-food preparation does that a powdered isolate cannot.

LIONBERRY REGENERATIVE™ HYDRATION is more than a hydration drink. It is more than a sports recovery drink. It is metabolic recovery. It is GLP-1 friendly, built and optimized for GLP-1. It is for after you got your butt kicked, or after whatever it was that the day took out of you.

Think about what we hand athletes and kids. Sports drinks and energy drinks loaded with artificial color, sweeteners, powdered isolates, and caffeine. LIONBERRY is the other direction entirely. Not an energy drink. No isolates. No dehydrated powders. Real fruit, pressed, grown out of the ground by farmers.

For LIONBERRY REGENERATIVE™ HYDRATION we start with a clear light base of elderflower tea, easy to drink, and we bring our elderberry to it. The anthocyanins are delicate. Long heat kills them. Dehydrating and spray drying kill them. So we engineer the pH first. We do not reduce it, we do not boil it, we do not cook it down into a syrup.

People brag about strange things. I have heard competitors boast that they never add a drop of water to their elderberry syrup. Good. I would hope not. Cooking elderberry down with honey and spices into a syrup is about as medicinal as making pancake syrup. The plant properties are gone. We do not make syrup.

Our second product is ELDERBERRY SIPS.

ELDERBERRY SIPS starts with fresh-pressed American elderberry juice. We additively bring in Concord grape for heart support and tart cherry for its melatonin and magnesium. Those are not afterthoughts. They earn their place. They also do something useful on the chemistry side. Together they pull the pH down to 3.7. That low pH protects the elderberry anthocyanins, and it does something else for us too. It shortens the pasteurization way down. About a minute at around 165°F. That is the whole window. And the acid is the reason. At 3.7 that short fast hold is exactly what our process authority signed off on. Quick heat, locked color, anthocyanins intact.

And yes, we use glass.

We hate hauling it. We are beasts of burden. It is heavy, it breaks, it is fragile, it costs a fortune to ship. Less-than-truckload freight is brutal. There are glass tariffs. But plastic leaches and aluminum cans are lined with plastic too, and healthy bodies deserve better than that.

Now here is the one way you can dry a berry without cooking the life out of it. Freeze drying. Freeze drying pulls the water out under vacuum at low temperature. No hot air. No reduction. No simmering it down. Done right it keeps the color, keeps the anthocyanins, keeps the heat-sensitive compounds that dehydration and spray drying murder [5][6]. For anything this rich in anthocyanins, freeze drying is the gold standard.

But done right is doing a lot of work in that sentence. You cannot just freeze dry juice and walk away. Two things have to be true.

First, you protect the anthocyanins with acid. They are most stable at low pH, so you bring the pH down and hold those purple compounds together through the whole process [8]. And not every acid is your friend here. Citric acid is. Ascorbic acid is not. Drop ascorbic acid into the water of the juice and it turns into hydrogen peroxide. Some people just call it bleaching, because that is what it looks like. It strips the color right out. And the color, again, is the medicine. So you use citric. You acidify first, then you dry.

Second, you carry it with acacia gum. Acacia gum, gum arabic, is a protective carrier. It shields the anthocyanins from oxygen, holds down moisture, and keeps the color and the chemistry steady in storage [5]. The powder ends up protected instead of sitting there naked and falling apart.

Citric acid to protect. Acacia gum to carry. Freeze dry, not spray dry, not dehydrate. That is the only way a powder ever earns its place near elderberry.

And that is where the work is headed next. Start with American elderberry juice. Bring in elderberry extract to push the anthocyanin content even higher while keeping that juice-derived profile. Protect it with citric acid. Carry it with acacia gum. Freeze dry the whole thing together. Juice plus extract, both freeze dried, the most good packed into the smallest honest package. Not whole seeded berry powder. Not a cooked-down reduction. The juice work, kept intact, in a form you can carry in your pocket.

When elderberry does not work, it is almost never the plant’s fault. It got overheated in dehydration. It got cooked down into a syrup. It got powdered and shipped in from overseas. It got handled until there was nothing left to handle. The reputation that elderberry only kind of works is a processing problem, not a plant problem.

Quality matters. Results matter. Temperature, water activity, and pH matter. And the color matters most of all, because the color is the proof that the medicine is still in there.

We want elderberry’s reputation higher than it is. We want better results. We want people honestly impressed, because it actually worked.

Do elderberry right.

References

[1] Lee J, Finn CE. Anthocyanins and Other Polyphenolics in American Elderberry (Sambucus canadensis) and European Elderberry (Sambucus nigra). USDA Agricultural Research Service. https://www.ars.usda.gov/ARSUserFiles/1718/pdf/2007/anthocyaninsandotherpolyphenolicsinamericanelder.pdf

[2] Solverson et al. Nutrients. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11510622/

[3] Kumkum R, Aston-Mourney K, McNeill BA, Hernández D, Rivera LR. Bioavailability of Anthocyanins: Whole Foods versus Extracts. Nutrients. 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123854/

[4] A Review of Factors Affecting Anthocyanin Bioavailability: Possible Implications for the Inter-Individual Variability. Nutrients. https://pmc.ncbi.nlm.nih.gov/articles/PMC7023094/

[5] Baeza et al. Food Science and Technology International. 2021. https://pubmed.ncbi.nlm.nih.gov/32659122/

[6] Brønnum-Hansen & Flink. International Journal of Food Science and Technology. 1985.

[7] Anthocyanin Content and Storage Stability Studies. https://repositorio.uca.edu.ar/bitstream/123456789/13862/1/anthocyanin-content-storage-stability.pdf

[8] Kaack K. Processing of Anthocyanin Colourant from Elderberry Using Citric Acid. https://dcapub.au.dk/pub/planteavl_94_423.pdf

[9] Cyanogenic Glycoside Analysis in American Elderberry. Molecules. 2021. (No quantifiable cyanogenic glycosides found in commercial American elderberry juice.) https://pmc.ncbi.nlm.nih.gov/articles/PMC7961730/

[10] Senica M, et al. Processed elderberry (Sambucus nigra L.) products: A beneficial or harmful food alternative? (Heat processing reduced cyanogenic glycosides up to 96%.) https://www.sciencedirect.com/science/article/abs/pii/S002364381630247X

[11] Elderberry for Prevention and Treatment of Viral Respiratory Illnesses: A Systematic Review. (Antiviral action via anthocyanins binding viral glycoproteins; modulation of inflammatory cytokines.) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026097/

[12] Protocatechuic acid, the major metabolite of cyanidin-3-glucoside: blood-brain barrier permeability and anti-inflammatory, neuroprotective activity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504963/ and https://pmc.ncbi.nlm.nih.gov/articles/PMC11478363/