Facts About Elderberry & Cytokines

Lately, I have received questions regarding Elderberry and Cytokines as it relates to COVID-19. I thought that it would be helpful to post detailed information on the subject. Thankfully this information was gathered, summarized, and originally published to aspire.com, during an interview between Gabrielle True at aspire.care and Naturopathic physician, Dr. Lindsey Wells.

Dr. Lindsey Wells is a naturopathic physician. Dr. Wells has focused her practice on pediatric primary care and consultative care for Autism Spectrum Disorder (ASD), PANS/PANDAS, other neurodevelopmental disorders, and various chronic illnesses. She uses therapies, including homeopathy, botanical medicine, nutraceuticals, nutrition, counseling, and water therapy…For her complete bio and more information, please see her website: https://lindseywellsnd.com.

You can read majority of the interview below. For more information about this or to read the entire post and see sources for the studies mentioned below, click here

Gabriella: All right, let’s delve into cytokine. Will you please explain what a cytokine is? Is there only one kind of cytokine?

Lindsey: Cytokines are small, secreted proteins released by cells. They have a specific effect on the interactions and communications between cells that mediate and regulate the immune system and inflammation. In essence, they are chemical messengers that are released to help regulate the immune system response. With that immune system response comes inflammation. The immune system is supposed to recognize something that should not be there, and it calls all of its armies to that site to help fight inflammation. Part of its army is cytokines.

We need pro-inflammatory cytokines when we are sick. The body commonly releases pro-inflammatory proteins in response to a viral infection. This results in the recruitment of immune system cells to the site of infection. So the body releases these pro-inflammatory cytokines in response to a viral infection which recruits the immune cells to that site of infection to help fight the illness.

Gabriella: What is elderberry? Is elderberry an immunomodulator?

Lindsey: The botanical name for Elderberry is Sambucus nigra, and it is known for its anti-viral properties against the flu and common cold. It is a commonly used botanical. Yes, elderberry is an immunomodulator.

  • Elderberry inhibits the haemagglutination of the influenza virus to prevent adhesion of the virus to the cell receptors, meaning it doesn’t allow the flu virus to adhere to the cell-receptors, which is how it helps to prevent viral replication.
  • It also has anthocyanins, which are anti-inflammatory in their properties, which is why it can help with aches, pain, and fever seen in acute illness.
  • It is an immunomodulator. If your immune system is too overstimulated, it can help to decrease that stimulation in the body. If it is understimulated, it can help to increase it. This is an important part of the conversation about elderberry as it modulates the immune response; it does not necessarily cause everyone to enhance their immune system and enhance those cytokines.

Gabriella: There has been discussion that elderberry can cause a cytokine storm. Please address the facts.

Lindsey:  There are many studies done on elderberry; I am going to go over a few of them so that you can reference them.

Study 1Sambucus nigra extracts inhibit infectious bronchitis virus at an early point during replication

Background: This study looked at the Infectious Bronchitis Virus (IBV), a pathogenic chicken coronavirus that infects the respiratory tract of chickens and causes the production of eggs with deformed and weakened shells. There is an IBV vaccine, but it is not wholly effective in protecting against new infections due to the recombinant nature of the virus i.e., the virus can replicate and mutate.

The study looked at 3 extracts of botanicals that have anti-viral properties due to polyphenol properties. The 3 plant extracts were Rhodiola, Nigella sativa seeds, and Sambucus nigra (elderberry.


  • Treatment with elderberry reduced viral titers by 4-6 orders of magnitude – significant
  • Virions (an infective form of a virus outside a host cell) treated with elderberry shows compromised envelopes and presence of membrane vesicles, i.e. it disrupted the envelope and membrane of the virus so that it was deemed ineffective and could not replicate.


  • Vaccination against IBV in conjunction with administering elderberry due to active polyphenols could have a synergistic effect
  • As stated in this study, the results of this study could potentially translate to other coronaviruses, including those that affect humans

Study 2: Randomized Study of the Efficacy and Safety of Oral Elderberry Extract in the Treatment of Influenza A and B Virus Infections

Background: The study took sixty patients (aged 18-54 years) who were suffering from influenza-like symptoms for 48 hours or less. The subjects were treated with elderberry for four times a day for five days. The first dose was given within 48 hours of the onset of symptoms. It was a randomized, double-blind, placebo-controlled study during the influenza season of 1999-2000. The subjects scored their improvements daily on a scale of 0-10 (0 = no improvement; 10 = pronounced improvement).


  • In the treatment group, a pronounced improvement was reached after 3-4 days compared to 7-8 days in the control group who were not treated with elderberry. The elderberry did shorten the duration of the illness.
  • The treatment group used rescue medications (nasal spray and painkillers included) significantly less compared to the placebo group.

Study 3: Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama

Background: This trial was a placebo, double-blind study conducted on a group of individuals living in a kibbutz during the outbreak of influenza B in 1993. They used elderberry as a means of treatment in the treatment group and fever, improvement in symptoms, and complete cure found in 6 days.


  • Fever was resolved in 93% of the cases in 2 days compared to 6 days in the control group
  • Complete resolution of symptoms seen in 2-3 days in 90% of the treatment group compared to 6 days in the placebo group
  • There were higher hemagglutination (the clumping together of red blood cells ) inhibition titers to influenza B in the group treated with the elderberry compared to the control.

Study 4: Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travelers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial

Background: A larger-scale double-blind controlled trial with 312 air travelers. The study was designed so that participants took either the elderberry or placebo for 10 days before travel and 5 days after travel. They recorded symptoms at baseline (10 days before travel), before travel at 2 days, and after travel for 4-5 days. As well as recording cold symptoms in a daily diary.


  • Elderberry group had a significantly lower number of cold episode days as a collective group (57 days) compared to the placebo group (117 days)
  • Elderberry group had lower symptom score (247) compared to the placebo group (583)
  • Elderberry group experienced 2-day shorter duration of cold

Gabriella: Do any of those studies talk about cytokine storms?

Lindsey: No, they don’t. There are ZERO studies on PubMed about Elderberry and Cytokine Storms. Concerns about elderberry and cytokines seem to be from a study done in 2001 on healthy individuals.

Study 5: The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines

Background: This study looked at using elderberry and production of cytokines in healthy individuals, so people who did not have any symptoms. They then used the elderberry to monitor and measure specific inflammatory cytokines.

Remember, you always have to look at the study design. This study was very specific about only measuring those inflammatory cytokines we talked about in the beginning.


  • In this study, researchers concluded, “Sambucol might, therefore, be beneficial to the immune system activation and in the inflammatory process in healthy individuals.”
  • The key takeaway from this study is that Elderberry supported cytokine production during a healthy inflammatory process related to the optimal immune function that was beneficial in this situation. It said it did produce an inflammatory or cytokine response, but it was beneficial and optimal for that certain situation.
  • The research DID NOT suggest it would stimulate a cytokine storm in patients that have an underlying condition that may tax the immune system.
  • So what you are seeing about elderberry and cytokine stimulation is based on this study from 2001. They did not measure the pro-inflammatory cytokines.

Gabriella: So, with the knowledge, you have right now on the use of elderberry for other viruses and what you know about COVID-19, what are your thoughts on taking elderberry now?


  • Elderberry is not likely to cause a cytokine storm.
  • It should be used as immune support and prevention. Plenty of human and animal trials show how elderberry works. The properties in elderberry help with flu and cold symptoms.
  • Although elderberry is safe, to err on the side of caution, if you have symptoms of COVID-19, then DISCONTINUE the use of elderberry. 

As always, I hope that this information was helpful and informative to you.  You can shop our freshly made and potent Elderberry Syrup here.

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