We’ve been noticing lots of interest in our elderberry products over the past few months and wanted to respond to various concerns and misinformation being shared with respect to elderberry, the SARS-CoV-2 virus/COVID-19, and immune health.
This is a complex topic, but we wanted to share a few things to clarify. Elderberry has been shown in research to interfere with influenza viruses and support overall immune health. It has a long history of traditional use and enough clinical trials to merit a meta-analysis that showed it is effective at reducing upper respiratory symptoms due to cold and flu.1
Elderberry has diaphoretic, diuretic, laxative, antioxidant, and antiviral effects. Research has shown that it is effective against influenza A, B, and H1N1 variants. Elderberry contains a variety of compounds that support immune health. These include a variety of polyphenols, like anthocyanins, that bind with viruses to prevent them from attacking healthy cells, while also strengthening and protecting cell membranes to prevent viral penetration. This results in reduced symptom duration and severity.
Cytokines, Cytokine Storms, and the Immune Response
Part of our innate immune response is to release cytokines. Cytokines can be both inflammatory and anti-inflammatory and they are an early response to viruses to help prevent their spread in the body. When people have concerns about elderberry and COVID-19, they usually stem from two things. One is a 2001 French study2 showing that elderberry increases cytokine production. The other is that severe cases of viral infection can involve what are called ‘cytokine storms’. Cytokine storms are a massive over-reaction of an immune system gone berserk, provoked by a severe infection it can’t cope with. While they are rare, when they do occur, it’s often in the respiratory system and involves a lot of inflammation and accumulation of immune cells and damaged tissue. This has been noted for past epidemics like SARS-CoV-1 and for the more virulent influenza strains. So, some people may come away with the conclusion that elderberry is to be avoided because cytokines are dangerous.
A few things to note in response to this:
- There is no evidence anywhere that elderberry has been implicated in initiating a cytokine storm or pushing an otherwise mild infection towards something more severe.
- Cytokine release is a normal, desirable part of our initial immune response to a virus.
- The 2001 study showing that elderberry increased cytokine production was done in healthy people; the exact types and amounts of cytokines may differ for people already sick.
- Some of the cytokines upregulated by elderberry (like IL-6) can be both inflammatory or anti-inflammatory.
- Studies using elderberry in influenzacases did not find any adverse effects related to excess inflammation or cytokine storms. Remember, influenzais also capable of producing cytokine storms in severe cases.
- No research has been done yet specifically on elderberry and COVID-19, but one study has already shown that elderberry can down-regulate cytokines and reduce inflammation, if needed, in other conditions.3
- Because no one has had prior acquired immunity to COVID-19, our innate, initial immune response is important.
While everyone’s immune system, genetics, diet, lifestyle factors, and degree of viral exposure when falling ill can vary somewhat and influence their immune capabilities, elderberry has been shown through a long history of traditional use and modern clinical trials to be a safe and effective choice in supporting our immune health.
1. Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019 Feb;42:361-365.
2. Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I.Inflammatory cytokines. Eur Cytokine Netw. 2001 Apr-Jun;12(2):290-6.
3. Kirichenko TV, Sobenin IA, Nikolic D, Rizzo M, Orekhov AN. Anti-cytokine therapy for prevention of atherosclerosis. Phytomedicine. 2016 Oct 15;23(11):1198-210.
Robert Dadd is a Master Herbalist (Dominion Herbal College) with a BA in Communications from Simon Fraser University. His areas of research include adaptogens, probiotics, and essential fatty acids. He is currently the Product Information Supervisor for Flora Manufacturing and Distributing.