Is Elderberry Safe Right Now?
If you are one of the many people that have sworn by elderberry as a helpful tool to get through the colds and flu season, you might be scratching your head at this question. Many people say that a spoonful taken at the first tickle in the throat, helps to nip a cold in the bud, and there is research to support it's use in the fight against cold and flu viruses, and certain bacteria.
But even if you are a elderberry devotee, please read this.
We are in some uncharted waters right now with the new novel Corona Virus (COVID-19). Every day - moment really - there is new information being discovered and disseminated. So it is important to stay informed. According to experts, this COVID-19 virus is not only novel (new), so we don't know really know what we are up against; it is also mutating - so it is basically a moving target. Experts are basically re-writing the "Rule Book" on the fly when it comes to this virus.
I wanted to alert you to some new information that has arisen about COVID-19, how it can potentially progress to more severe illness, and why we might want to perhaps be cautious about supplements that could be stimulating to the immune system. As Dr. Afrouz Demeri, ND - Director of Functional Medicine at the University of California Irvine's Integrative Health Institute says, "Things that may have been safe 3 weeks ago, may not be safe right now."
One severe complication of COVID-19 appears to be something called a "Cytokine Storm" - read this article to learn more.
What is a Cytokine Storm?
“Cytokines are inflammatory immunologic proteins that are there to fight off infections and ward off cancers,” explains Randy Cron, M.D., Ph.D., professor of pediatrics and medicine, and author of the textbook Cytokine Storm Syndrome (Springer, 2019). “But when they’re out of control they can make you very ill.”
Simply put, a Cytokine Storm is when the immune system goes into "severe overdrive" in response to an insult or infection (like a virus). So the inflammatory response - which is normally part of a healing process - switches into something that can be harmful, even lethal. According to Dr. Cron, up to 10% of the population could carry genes that make them more prone to this type of immune system issue.
While a Cytokine Storm is generally very rare with garden variety flu and colds, it appears to be one potential severe complication of COVID-19. Because of this, while experts don't believe elderberry "causes this," there is a concern that certain foods and supplements designed to activate and boost the immune system could potentially exacerbate this mechanism.
So Should We Avoid Elderberry Right Now?
According to this study, one of the ways that elderberry works to ward off colds and flu is that it stimulates cytokine production, which activates the immune response. "In addition to its antiviral properties, Sambucol Elderberry Extract and its formulations activate the healthy immune system by increasing inflammatory cytokine production. Sambucol might therefore be beneficial to the immune system activation and in the inflammatory process in healthy individuals or in patients with various diseases."
But because cytokine storms is one of the concerns for severe cases of COVID, I asked the question about it's safety to a network of doctors and natural health practitioners in March, and not everyone agreed at that time. The general consensus was that since we do not have the data yet, the best approach may be to proceed with caution. The safest, most conservative route would be to avoid elderberry during the COVID-19 outbreak, and other supplements, and interventions that could have the potential to overstimulate the immune system. Some doctors felt that it may be safe (for those without automimmune issues or other conditions) to take for prevention only, or at the first signs of a sore throat; but to stop taking if there is a fever, or lung involvement (this advice may also be a sensible approach during a regular flu and cold season as well).
What About Anti-inflammatories?
So if we are to avoid foods and substances that could promote inflammation, it would make sense that anti-inflammatories such as Advil are safe to take, right? Again - not so fast. According to this article, experts in France warned that anti-inflammatories like NSAIDs may not be helpful or safe with COVID-19. Then according to this article, experts were questioning that notion, saying that the hard data is not there to suggest that Ibuprofen is not safe or effective for treating COVID-19 symptoms. But then, the BMJ (a respected medical journal) published this report stating that NSAIDs should be avoided with COVID-19. The alternative recommendation is to use acetaminophen, but it is important to not exceed recommended doses, as high doses can be toxic to the liver. There are studies underway to look at the use of anti-inflammatories and anti-virals together, but the results are not in yet. We have to remember that one of the reasons our body gets a fever, is because a fever is part of the healing process and helps to make you a less hospitable host to a virus or bacteria. It is when fevers get really high, or we are extremely uncomfortable, that a fever reducer is important. As with all interventions, one must consider the risk/benefit ratio - please talk to your doctor to get his/her recommendations for your situation.
What to Do if You or a Loved One Ends up in the Hospital?
According to Dr. Cron, "a cheap, simple test, widely available at most hospitals in the United States and worldwide, can help diagnose cytokine storm syndrome. A protein called serum ferritin tends to get very high in this disorder,” he said. “If you are sick enough to be in a hospital and you have a fever, you should get a serum ferritin. It typically comes back in less than 24 hours and almost every hospital can do it, and if it’s high you can work them up for cytokine storm syndrome.” He says the key to successfully treating Cytokine Storms is to identify (with a serum ferritin) and treat it as early as possible.
According to this article, at this time, there are currently no treatments for COVID-19, the current approach is to provide provide therapies to manage symptoms. One potential therapy being considered and tested in China is IV vitamin C. According to this study, "the rationale for vitamin C in sepsis is strong." Higher cortisol was linked to "poorer outcomes" with regards to sepsis. Cortisol is considered a "stress hormone," and vitamin C is found to lower cortisol. Thiamine was also found to be deficient in sepsis patients in this study as well.
The race to find treatments and remedies is on. As information becomes available, I will update this article.
For More Information, Please Read:
Key Lifestyle Prevention Strategies:
Controlling Stress - in addition to all the normal stress of daily life, this pandemic has increased our stress levels significantly. One of the best pieces of advice that I have seen - is to use this time of social distancing to do some self care. Meditation, yoga, epsom salt baths, taking breaks from the news and social media, laughing (watch funny movies, read jokes), and other ways to lower stress levels. Lowering our stress levels are beneficial for our nervous system and immunity.
Sunshine & fresh air - during the 1918 Flu Pandemic, patients who received sunlight and fresh air had significantly better outcomes. According to this article, "Put simply, medics found that severely ill flu patients nursed outdoors recovered better than those treated indoors. A combination of fresh air and sunlight seems to have prevented deaths among patients; and infections among medical staff. There is scientific support for this. Research shows that outdoor air is a natural disinfectant. Fresh air can kill the flu virus and other harmful germs. Equally, sunlight is germicidal and there is now evidence it can kill the flu virus." Sunshine is our best source of vitamin D, which is important for our immune system to respond in a healthy way. If you get a glimmer of sunshine - sit out in the sun for 20 mins to soak up some healthy vitamin D rays.
Heat - if you have access to a sauna or an infrared sauna, it may be prudent to sit in it for 20 minutes daily, as heat could potentially be the Achilles heel of this and other viruses.
Limiting sugar and inflammatory foods - According to this study, "sugar has direct and severe effects on immune system i.e. on white blood cells." Additionally, sugar promotes inflammation, which we obviously do not want to promote, especially with this virus. So we are focusing on nutrient dense foods in our house, and limiting our intake of refined sugars during this time in order to help our bodies be as healthy as possible right now. So if you have been wanting to give up your soda habit, this could be a very powerful motivator to do so. Read this article for over 20 reasons to give up sugar (including cancer prevention).
Social Distancing. There is lots of evidence that avoiding social gatherings and crowds, especially at the early stages of this pandemic, is not alarmist or extreme. Social distancing has proven to be a key strategy in controlling the spread of this virus. Again, remembering that social distancing is a temporary measure to slow down the spread of the virus. If you must gather, keeping a 6 foot distance from people is what is currently being recommended (but I would not be surprised if this changes, keep informed).
Self-Quarantine. The United States government is now urging persons returning from Europe to self-quarantine for 2 weeks upon returning, whether or not they have any symptoms.
Hand washing. Regularly washing your hands - making sure to use plenty of regular soap and washing for 20 seconds. Also, avoiding touching your face to prevent introducing any potential virus into the mucous membranes - these are essential practices to also prevent catching and spreading the virus.
Watch this informative video from Dr. Afrouz Demeri, ND - Director of Functional Medicine at the University of California Irvine's Integrative Health Institute. She discusses the fact that some of the common things that she is typically recommended for viruses, should be avoided at this time. As she says, "Things that may have been safe 3 weeks ago, may not be safe right now." Dr. Demeri says that if you develop lung symptoms to contact your healthcare provider.
Please note - I am continuing to do research on this subject. I am regularly reaching out to and discussing the situation with doctors and experts, reading articles and studies, etc. As new information becomes available, I will be updating this article, and posting updated information in my Facebook page as it becomes available.
Please note: All of this advice could be especially important for persons with autoimmune disease, on immunsuppressive medication, pregnant women, or those with other underlying inflammatory health conditions like lung issues, heart disease, and diabetes. In fact, persons with these conditions may not be a good candidate for elderberry or other immune stimulating compounds even during a normal cold or flu season. Persons with underlying conditions may wish to self-quarantine.
*Sara Vance is not a doctor and is not providing medical services. Sara does not diagnose, prescribe, or treat symptoms, or disease. Clients - especially those with a medical condition or taking prescription medications- should discuss any & all nutritional and supplement recommendations with their doctor before proceeding.