Many of you are looking for immune-boosting substances right now and rightfully so. Elderberry extract has become very popular during the cold and flu season and many people swear by its effect, but is it a “placebo” effect or the real deal?
What Makes COVID-19 So Dangerous?
I think most of us have heard by now that this virus attacks the lungs and that is what eventually can lead to death. But what is attacking the lungs? Something called a “cytokine storm“. So what are cytokines?
are a large group of proteins, peptides or glycoproteins that are secreted by specific cells of the immune system. Cytokines are a category of signaling molecules that mediate and regulate immunity, inflammation, and hematopoiesis (the production of all of the cellular components of blood and blood plasma.) Cytokines are produced by a broad range of immune cells, some you may have heard of such as B Lymphocytes, T Lymphocytes, and macrophages. This is how your immune system works, with inflammation!
Cytokine Release Syndrome (CRS) and its extreme form, cytokine storm, can occur in advanced infection states like Acute Respiratory Distress Syndrome (ARDS), sepsis, or COVID-19. This is what is happening with severe cases of COVID-19. This is a serious condition and requires ICU intervention and should not be addressed with an herbal supplement. For this discussion, I’m talking about a healthy population using it for immune support.
Will Elderberry Cause a Cytokine Storm?
There actually has been quite a bit of discussion about this. The study that has been cited over and over again to back up a claim that elderberry could trigger a cytokine storm, is a study published in European Cytokine Networks in 2001 by Barak, et al. The study was done on monocytes and concluded that elderberry extract could “activate the healthy immune system by increasing inflammatory cytokine production.” Let’s put this into perspective, running in a marathon has been shown to increase IL-6 (a cytokine) about 100-fold! You cannot extract data from monocytes alone and apply it to the whole human, or to the local cellular environment in the lungs. There is just not enough data to support this.
There is no evidence to suggest that the small elevation in cytokine release by monocytes after high-dose elderberry exposure is enough to trigger a cytokine storm in a human. Elderberry is one of the most used, and most trusted immune support botanicals in the integrative medicine repertoire. It has also been studied in humans with influenza, an infection with a known risk of cytokine storm and ARDS, and there are no studies reporting an increased risk of respiratory distress, cytokine storm, or ARDS.
Is There Evidence?
Here are a few examples:
1) A 2004 study in Norway followed 60 patients (aged 18-54) suffering from influenza-like symptoms for 48 hours or less. They were given 15 mL of elderberry extract 5 times daily or placebo for 5 days. Among reported outcomes, the patient use of respiratory rescue medication was reduced, suggesting fewer respiratory complications in the elderberry group.
2) A 2019 meta-analysis of Sambucus (Elderberry) supplementation for upper respiratory symptoms (including influenza) reported no increase in respiratory risk or side effects and determined elderberry to be safe in this population.
3) This Study compared Sambucus to products containing propolis and Echinacea. The results showed Elderberry “Sambucol could, therefore, have immunostimulatory properties when administered to patients suffering from influenza (as shown before), or immunodepressed cancer or AIDS patients who are receiving chemotherapy or other treatments.”
I know this is a deep-dive on understanding cytokines and how your immune system responds during respiratory distress but it’s important to know that herbal extracts can be very helpful as long as you are not waiting too long before seeking medical advice. Take your Elderberry extract at the first sign of any viral attack (along with all your other immune support) but don’t expect it to be a miracle drug. If you feel yourself going downhill fast, unable to breathe and running a fever, take yourself to a medical professional!