Cytokine Storm and Elderberry: It’s Not That Simple!

Dear Families,

Many of you have heard about the role of how a cytokine storm can ultimately lead to the deadly complications of COVID-19. As you are aware, those poor people who have passed, have passed because of a poor immune response combined with an uncontrolled inflammatory response that ultimately caused airway compromise.

Some have suggested that elderberry can exacerbate the cytokine storm because it is “an immune boosting” plant. Elderberry does NOT act as an immune stimulant, as one would think. Herbs like black elderberry and Siberian eleuthero are immunomodulators, meaning they support when needed and balance at other times.

We don’t see anything in literature which would convince us not to use elderberry due to the risk of cytokine storm. The concept of immunomodulators is not well understood in a classical approach. It’s misunderstood that plant based “immune stimulants” can be harmful. Remember that old caution that “herbal immune stimulants” cannot be used in autoimmune disease? This has long since been disproven and it’s been shown that many whole herbs are immunomodulators rather than being blanket immune stimulants. Whole plants often contain protective phytochemicals which protect against the potentially adverse effects of isolated constituents.

It turns out that Elderberry (in its whole form) acts as an ANTI-INFLAMMAOTRY. This study goes as far to say, “In sum, these results bring new and supportive data to the inflammatory modulating properties of the phenolic compounds present in elderberries and elderflowers. Thus, intake of elderberry and elderflower might help to regulate inflammatory diseases.”  Elderberry may not only NOT cause a cytokine storm, it may actually help PREVENT the cytokine storm from happening.

Here is another review regarding the safety profile of Sambucus.


That is a good reminder that whole plants should be favored over standardized plants or isolated constituents. Here is another example to drive home the point. Take for instance eleuthero. Some would consider it an “immune stimulant,” and yet myself and herbalists around the world use this plant on a regular basis to treat autoimmune conditions. It turns out that eleuthero not only helps adapt the immune response, but actually helps optimize cortisol levels which can be enormously helpful in REDUCING autoimmunity. While elderberry does not have the same properties as eleuthero, the conversation has a lot of similarities.

There is actually literature which shows the some of the compounds found in Elderberry can helpful against prior Coronaviruses. These compounds do not function as simple immune boosters, but rather complex structures that may aid in reducing the replication of the virus (at least based on prior data with prior Coronaviruses).

Let us look at the data that we do have. We find the elderly being at the greatest risk. Why is this? It turns out that as we age, our enzymatic capacity to produce our master anti-oxidant (glutathione) is markedly decreased.

Studies have also demonstrated that many individuals with chronic health conditions, especially diabetes, high blood pressure, etc. have elevated markers of inflammation. Underneath this inflammation is oxidative stress, meaning there is too much fire and not enough fire extinguishing.

In a gross oversimplification, individuals who are at risk for a cytokine storm are those whose INTERNAL PHYSIOLOGY is lacking the ability to control the inflammatory response once it occurs. While this may be exacerbated by a high-glycemic (sugar) diet, it is not triggered by plants that can impact the immune response.

To manage an mitigate your risk of a cytokine storm, you need to do everything possible to reduce inflammation and boost your antioxidant levels. How do you do this?  Cut out sugar and simple carbs (cookies, cakes, white bread). Eat abundant amounts of vegetables, especially onions, garlic, brussels sprouts, etc. The sulfur that is contained in these foods will naturally increase glutathione levels.

Take modest amounts of vitamin C. Vitamin C helps recycle glutathione and will boost the glutathione levels. Take N-acetylcysteine (NAC), as NAC is the precursor to glutathione and will also boost glutathione levels.

We hope this is of help!



Dr. K