Elderberry and Cytokine Storms
In this environment of intensity, fear, and speculation, elderberry has emerged as an internet-fueled spectacle. It’s flying off the shelves and it’s also the center of a debate around cytokine storms. What started as a nuanced post by a fellow herbalist has turned into reductionist and extrapolative soundbites and memes.
Can elderberry provoke a cytokine storm? The short answer: it’s highly unlikely.
What are Cytokine Storms?
Cytokines are chemical messengers made by the immune system, aiding essential communication during the immune response and stimulating the movement of cells in the right direction towards inflammation and infection. There are many different types of cytokines, all acting in different ways to modulate our inflammation and immunity. For instance, one cytokine might be pro-inflammatory, while another might be anti-inflammatory.
A cytokine storm is often our body’s last-ditch effort to control an infection. It is an immune overreaction, a surge of pro-inflammatory cytokines that can add further damage, lung inflammation, and fluid buildup to an already overwhelmed system. This results in a deadly increase in respiratory distress.
Elderberry and Immune Support
The theoretical underpinnings of the current elderberry hysteria come from a 2001 study (Barak, Halperin, Kalickman) that suggests that elderberry supports cytokine production, including pro-inflammatory cytokines. The nuance here, that many miss when only reading the headlines, is that this was a study of healthy individuals. The conclusion was that in healthy populations, elderberry may be beneficial in immune system activation, which means it helps us keep our immune system primed and ready. In no way did the study suggest that elderberry would or could cause a cytokine storm in persons with an already overwhelmed and overactive immune system.
In fact, other studies point to a more modulatory action. A later study by the same team (Barak, et al., 2002) found that elderberry extracts were shown to enhance both inflammatory and anti-inflammatory cytokines in a lab setting. A recent 2016 study (Kirichenko, et al.) showed that an herbal formula based around elderberry actually inhibited cytokines in a population with atherosclerosis. This points again to probable modulatory action— are certain cytokines helpful in this situation? If yes, elderberry may stimulate the production of these cytokines. If no, then elderberry may inhibit cytokine production.
Unlike modern drugs, which act on us, plants interact with us in an ongoing conversation that is our heath. This often makes them modulatory instead of uni-directional. This is a little counter-intuitive for all of us who grew up with powerful and extremely targeted pharmaceuticals, so I completely understand how this reductionist view of elderberry as a risky herb came into being. But my hope from all of this is that more and more people will be introduced to the natural genius of ecological and evolutionary medicine. Herbs and fungi are part of our environment, have lived with viruses and bacteria for longer than we have, and are masters of chemistry. They can play an important role right now in supporting our physiology and making us strong, adaptable, and resilient.
Cytokine storms are a phenomenon of the ICU. If you are in the acute stages of infection or have a high fever, this is where hospitals excel—discontinue elderberry use and get medical care!
Elderberry has traditionally been used for strengthening our immune system, and modern studies are beginning to support this.
Still, Elderberry is intended as immune-support, not as a cure for anything. If you develop acute symptoms, discontinue use and seek medical care.
If you have a mild fever or an autoimmune condition, play it safe and use other herbs.
This article is not intended for the purpose of providing medical advice. All information, content, and material found in this article is for informational purposes only and is not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
Barak, V., Birkenfeld, S., Halperin, T., & Kalickman, I. (2002). The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. The Israel Medical Association journal: IMAJ, 4(11 Suppl), 919-922.
Barak, V., Halperin, T., & Kalickman, I. (2001). The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw, 12(2), 290-296.
Kirichenko, T. V., Sobenin, I. A., Nikolic, D., Rizzo, M., & Orekhov, A. N. (2016). Anti-cytokine therapy for prevention of atherosclerosis. Phytomedicine, 23(11), 1198-1210.
Tisoncik, J. R., Korth, M. J., Simmons, C. P., Farrar, J., Martin, T. R., & Katze, M. G. (2012). Into the eye of the cytokine storm. Microbiol. Mol. Biol. Rev., 76(1), 16-32.