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Coronavirus & Elderberry!

There is so much going on about Elderberry! I wanted to share some thoughts below and also reiterate, we are still learning. We are understanding each new day a little bit more. This is a perfect example of doing our research and being educated and then sitting with our own belief system! In these times when there is so much unknown, it is so important! As Rosemary Gladstar always teaches us when doing our Materia Medica research and working with the plants, we would find three or more sources which we consider to be excellent for our Materia Medica work, do the same for this Elderberry discussion. I would also encourage you to review and read the articles and thoughts which are not in favor. Understand and know all sides.

I spent weeks listening and following and then I, personally, went to my plants. I sat with them and myself. I was afraid! Was I recommending something which would be NOT helpful? I tuned in to the sweet Elderberry and my inner-self and experience!

I also read and read and read numerous articles and posts from herbalists all over the world. It is so important that we work with the plants and feel good about them and their gifts. It is also important to understand and deeply know that we are each different individuals and herbalism and working with the plants is not a "one size fits all". It is not this plant does that! If there is doubt, my personal belief is the medicine is not as potent. We have spoken about this with an old tincture someone finds and asks "Is this still good?" The Fire Cider recipe where someone added the honey first, "will this still be good?", the herb which looks a bit "off".

These are great moments to do just as Rosemary has taught us, sit with the plants and our senses! What do we know! What have the plants taught us? What are our experiences and others whom we trust, admire and learn from?

Larken Bunce is one of the directors at Vermont Center for Integrative Herbalism here in Vermont. I respect her highly. Below you will find her views on Elderberry, as well as one of Rosalee'.

My belief is if you are concerned at all, there are other ways to boost immune in this time. For those of you whom have experienced Elderberry and the effects which they have experienced, you may make your own decision for yourself.

With love, Helen

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Thank you Larken Bunce for this great explanation. I have been reading, reviewing posts, and also learning as much as possible about this new virus! Aren't we all? I share your same sentiments and truly appreciate your thoughts below.

In good health, Helen

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What’s the deal with elderberry and cytokine storm? We’re all seeing this question and concern making the rounds. Many others have addressed it, so I haven’t felt my voice was necessary. But, a number of my students have asked what this was about, so I responded on our VCIH FB group page, not intending it for wide distribution. However, folks have found my words useful and have been sharing it, so I figured I might as well make it easier to find and attribute. If you share via cutting and pasting, please share everything after this, not just the highlights.

If this situation has demonstrated anything it's that context is seriously important. I’ll preface my thoughts by highlighting that the author of the original blog post that started this concern (who I’m not tagging because she doesn’t need any more flak over this) was simply suggesting we should use critical thinking and specificity and not just throw elderberry at everything/everyone--which has become the pop-herbalism tendency. The response to this reasonable gesture towards nuance has been a volatile mix of anger (from other herbalists) and fear and confusion (from the wider herb-using online population). It doesn’t help that we’re in an overall fearful and uncertain time. I’m sad for the divisiveness this has caused and the impact on the author. I also see how much work we still have to do to educate the general herb enthusiast about differential selection of plants. So, here’s the summary of my opinion, which is just that--an opinion--since no one has yet worked directly with our current situation.

It’s based on my clinical experience, understanding of the available scientific literature, and other herbalists’ thoughts on the matter. It’s not meant to discredit other’s opinions or be used as a weapon of Truth in anyone else’s arguments. Kindness, please, friends. Kindness.

I believe there is likely to be benefit and unlikely to be harm when elderberry is used in the context of a larger protocol, appropriate to the person and their specific needs in the moment. This may indeed mean NOT using it in *some* folks with auto-immune conditions and/or when there is already plenty of pro-inflammatory cytokine activity, as in active, feverish infection. Using this kind of practical, differential thinking is all that the original concern was getting at. Hopefully this is the kind of specificity we all employ as herbalists can convey to worried friends or clients.

Here’s the long form answer for those that want more details: To my knowledge and that of other herbalists responding to this same concern, there's no evidence clinically or via research that elderberry has ever caused a cytokine storm, which is an uncontrolled inflammatory response which damages tissue--here we mean lung tissue. This is more common in those with strong immunity, e.g. “young, healthy” folks, but not restricted to that population. There is evidence that elderberry extract can increase certain pro-inflammatory cytokines, the same ones involved in cytokine storms. Cytokine storms were a feature of H1N1 influenza and elevated levels of two of these same cytokines (IL-6 and IL-8) were identified in some folks with severe cases. So, if we’re extrapolating theoretically (as the original author of the post that started this concern was doing), we might be concerned, as cytokine storm features in severe cases of COVID-19, too. It’s good to be critical and have nuance in our use of herbs, which I believe is all she was advocating for. But, let’s take another look: while cytokine storm *was* a feature of H1N1, at least here in Vermont it was also an instance where a huge amount of elderberry was consumed indiscriminately by a self-treating population. In fact, it gained a lot of popularity around that time because of some well-timed research re: direct antiviral activity. But, to my knowledge none of us practicing identified a relationship between elder and worsening flu symptoms. Could we have missed hearing about it? Of course. But, what we did hear was how much folks felt like elderberry helped them stay well or get better faster than other family members or co-workers, etc. As I mentioned and the article pointed out, research suggests elderberry can indeed upregulate some of these pro-inflammatory messengers and this is part of its value in improving early immune response. But, there's also research suggesting it reduces those same cytokines, acting as an anti-inflammatory. So, it’s likely most accurate to say it’s a *modulator* of cytokine expression or activity, making it generally safe and helpful *for many*, though not all, folks.

The bottom line is that herbs and humans and our interactions are complex. While using research to ask better questions and be more specific in our use, we also want to look at clinical experience. Again, to my knowledge, no one has seen or suspected this cause and effect relationship (elderberry use = cytokine storm in viral infection) clinically. I personally am using elderberry and thoughtfully recommending it to my family and friends to stay well right now, **along with other herbs and approaches**. However, if I were to get sick and began to run a fever (sign of more pro-inflammatory cytokines), I would stop elderberry and move towards more appropriate herbs to address fever management--not suppression--like yarrow, elder flower, and peppermint and perhaps work on keeping mucus thin with aromatic herbs like garlic, ginger, horseradish and elecampane. Licorice and Baikal skullcap can be strong anti-inflammatories, along with the other herbs I mentioned.

This is NOT meant to be taken as “how to treat COVID-19”, I’m just giving you my personal approach for ME, right now. (I’d also call my doc and see if I need to get tested and stay the heck home, which I’m very privileged to be able to do.)

The point is that I would use elderberry when it’s appropriate and most effective and then shift to other herbs when they are more indicated. Not because I’m worried that elderberry will cause harm, but because other herbs will likely work better at different stages of illness.

Back to the original article raising alarm, the author’s original concern was directed at using caution with folks who have auto-immune conditions, which also involve excess inflammation driven by these and other pro-inflammatory cytokines. Many herbalists have not seen worsening of autoimmunity-related inflammation/symptoms with elderberry, but a number of individuals do say they’ve had this experience and some clinicians have also seen it, including that author. When COVID-19 came on the scene and everyone was going wild for elderberry all over the interwebs, the author shared her old article to make sure folks know that maybe elderberry isn’t for everyone in every situation, esp. not some folks with auto-immune conditions, or when it’s time to choose other more specific plants. Then things went, shall we say, viral.

Thanks for reading and I hope this has been useful. Remember that this is the time for collaboration and integration. If there is any suspicion of COVID-19, be sure folks minimize interaction with others as best they can, seek testing, and avail themselves of all appropriate/available medical care! Please don’t suggest folks choose herbs over any recommended medical treatment or that taking herbs means folks can be less careful with exposure of themselves or others. While we supsect herbs may have a valuable supportive role to play, *no one* here in the US knows enough to say anything definitive and we need to stay humble here.

Other info:

This live facebook so helpful from Rosalee.

Is elderberry safe? I'm here to address the elderberry controversy! Posted by Rosalee de la Forêt on Wednesday, March 18, 2020

This is a great list of resources from American Herbalist Guild.

PREVIOUS BLOG POST

My thoughts on the Coronavirus …………………………..

There is so much information about the Coronavirus I wanted to share a bit. I have also incorporated Rosemary’s thoughts about how to care for ourselves when we have a viral infection, cold or flu.

Helen harvesting Elderberries at Three Springs Farm

Who am I? I am Helen Ward, a local herbalist @ Three Springs Farm of Vermont, Waitsfield and the Educational Director of Rosemary Gladstar’s The Science & Art of Herbalism Herbal Online and Herbal Home Study Course for over 10 years.

One of my plant allies is Elderberry! We grow Elderberry on our family run farm, Three Springs Farm, here in the Mad River Valley in Vermont. I started making Elderberry syrup and tinctures shortly after we moved here and continue to share this love and passion with my community.

What is the Coronavirus?

A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat.

The 2019 Novel Coronavirus (2019-nCoV) is a virus which was first detected in Wuhan, China with an outbreak of respiratory illness. At first they linked to a large seafood and animal market, suggesting human to animal exposure, but over time it is clear to be human to human exposure.

Symptoms are similar to the flu ~ fever, cough and shortness of breath to start.

So what can we do to protect ourselves?

  • Stay well hydrated and rested

  • Elderberry - great, effective and gentle immune booster

  • Increase Vitamin C, incorporate Elderberry daily to boost immune system and other great herbs like Medicinal Mushrooms and Astragalus.

  • Decrease stress - uses extra energy and depletes our immune system!

  • Wash our hands often or wear a face mask if the immune system is compromised.

  • Keep our hands away from the face (eyes, nose, mouth)

If you do start to experience some flu-like symptoms here are a few recommendations!

  • Elderberry Syrup at the onset as a powerful antiviral and immune booster.

  • Echinacea Tincture - antiviral, antimicrobial, and antibacterial properties and can help fight infection and boost immunity!

  • Fire Cider - Apple Cider Vinegar infused with Garlic, Onion, Horseradish, Ginger and Cayenne peppers. There are many different versions, I love adding Elderberry to mine. The ACV alkalizes our system to help ward off viruses faster.

  • Eat plenty of foods to help fight the infection - clear broths, soups, simple grains, veggies, and light meals!

  • Avoid foods which will “feed” the virus such as sugar, ice cream, oranges and milk

  • Get plenty of rest!

  • Stay well hydrated!

Elderberry (Sambucus nigra)

  • Boosts our immune system

  • Reduces the intensity and duration of the cold and flu by ½ to ⅓

  • Contains a large amount of Vitamin C

  • Chemical constituents in Elderberry inhibit the early stages of infection by blocking key viral proteins responsible for attaching and penetrating our cells. They also reduce the replication, therefore, reducing the intensity and duration!

The US National Library of Medicine did a study of Elderberry & chickens who had been infected with this strain of the coronavirus showing Elderberry was able to inhibit the coronavirus in chickens.

How does this translate to humans? The US National Library of Medicine felt that S.nigra (Elderberry) has proven to inhibit the virus and this warranted that future studies should be done.

Elderberry is safe for everyone in the family!

Where to find Elderberry Syrup ~ The Village Grocery, Kenyons and the Mad Taste Place in the Mad River Valley, your local health food store or you can easily learn to make your own Elderberry Syrup!

Contraindications - cook the seeds of all Sambucus species as they contain a resin which is a nauseant and diuretic; this resin is destroyed by cooking.

Latin Name: Sambucus nigra

Common Names: Elderberry, Black Elderberry, North American Elderberry

Properties: antioxidant, diaphoretic, diuretic, laxative, immune-boosting, anti-inflammatory

Uses: Immune system boost, coughs, colds, flu, bacterial infections, viral infections, tonsillitis, lower cholesterol, improved vision and heart health.

Indicated for: Cancer, HIV, asthma and bronchitis, reduce inflammation of the urinary tract and bladder.

Infusions of the fruit are said to be beneficial for nerve disorders, back pain, and have been used to reduce inflammation of the urinary tract and bladder.

Elderberries contain organic pigments, tannin, amino acids, carotenoids, flavonoids, sugar, rutin, viburnic acid, vitamin A and B and a large amount of vitamin C. They are also mildly laxative, diuretic, and diaphoretic. Flavonoids, including quercetin, are believed to account for the therapeutic actions of the elderberry flowers and berries. According to test tube studies these flavonoids include anthocyanins that are powerful antioxidants and protect cells against damage.

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Content source:

~ Rosemary Gladstar’s Cold & Flu Document, https://scienceandartofherbalism.com

~ US National Library of Medicine Study: https://www.ncbi.nlm.nih.gov/pubmed/24433341

~ CDC Center for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/about/index.html

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