Snuffing Out the Storm – Elder Berry/Flower
She has a place of honor among my jars of herbs. In fact, I’m unwilling to live where she’s absent. One of my first questions about moving to Earth Offering was, “Does elder grow there?”.
Though illness was rare in the wilderness, visitors could bring it and at the first signs of flu I would always count on elder, echinacea and garlic to quickly terminate the ridiculous invasion. So imagine my shock at being handed part of an article saying that elderberry is to be avoided in this new H1N1 flu…that it stimulates cytokines and could precipitate a cytokine storm (an overproduction of the immune system’s cytokines causing lethal inflammation of the lungs).
In the comments section to Kiva Rose’s article, Avoiding the The Cytokine Storm and Swine Flu Panic, a reader referenced this same “don’t-use-elderberry” article…so it seems to be circulating some distrust of using elder for H1N1.
Needless to say, I’ve spent the last couple of days digging around for an explanation. I knew that elderberry was an immunomodulator. I also knew that there’s confusion between immune modulation and immune stimulation. So I figured that the author mistook its helpful increase of cytokines (necessary to fight infection) for recklessly churning them out (as could happen with an immune stimulator).
While I did find some references to it stimulating cytokines, the Physician’s Desk Reference For Herbal Medicines tells us about an animal study where Sambucus nigra and S. ebula resulted in reduced inflammation and pain, as well as inhibited cytokine secretion.(Yesilada,1997;Ahmahdiani,1998).
There are pro-inflammatory cytokines and anti-inflammatory cytokines. So the phrase “it stimulates cytokines” doesn’t tell us much besides the fact that this part of the immune system gets a boost.
Herbalist, Paul Bergner, writes in Influenza 1918:
Sambucus nigra, elder berry berries or flowers, are used in traditional herbalism to treat respiratory infections, including influenza. Clinical trials over the last decade have demonstrated a powerful effect of an elder berry extract syrup on the course of influenza (Zakay-Rones et al. 1995, 2004). The extract has also been shown to inhibit influenza virus replication in ten strains of the virus in vitro (Zakay-Rones 1995). Notably, elder berry extracts have been shown to enhance both inflammatory and anti-inflammatory cytokines in human cells in lab experiments (Barak et al). In one lab study, an extract of the flowers inhibited all pro-inflammatory cytokines measured (Harokopakis) and in an other showed at least partial inhibition of inflammatory cytokines (Yesilada et al).
Most of the clinical trials have been on Sambucol, made from the berry of Sambucus nigra. Those trials demonstrate that it kills H1N1 and those taking it recover from the flu in 2-3 days as opposed to 6 days in the control group. We find reports of it both increasing and decreasing cytokines (just what we could expect from an immunomodulator). – Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry. 2009. July
One reason may be attributed to the fact that it directly reduces the viral load by killing off the virus, thus reducing the demand on the immune system itself. There is a relationship between the viral load (quantity of virus spreading through the body) and the severity of the illness, including immune response.
Overproduction of cytokines leading to a cytokine storm seems to be more related to an individual’s overall nutritional status, especially in regards to vitamin D. Its vitamin D that sits in the control box making sure that the immune system behaves itself. This is sited as one reason flu flares up in the winter when most of us aren’t getting enough sunlight on our skin to produce the necessary vitamin D.
Much has been written about the nutrients we need to have a functional immune system (including one that doesn’t jump into over-drive). Vitamins E, C, A and D, omega 3 oils (fish oil), zinc, selenium, B12, iodine, adequate protein, magnesium are at the top of the list.
Another reason may be that it (particularly the flower) has anti-inflammatory properties. The flower contains the important flavonoids quercitin and rutin, recommended for reducing inflammation. We don’t hear much about using the flower for influenza, however, Peter Holmes speaks highly of it in that capacity. In fact, he claims it not only promotes expectoration and resolves infection in the lungs but goes so far as to restore the lungs.
This year my elder flu prep was made from the flower. I’m curious to know how it compares to using the berry. Have any of you compared them? Do you have anything to add to the apparent controversy on using elder for H1N1?