Holistic Health for Coronavirus and the Elderberry Controversy

Elderberries at Lillie House

As a promoter of home and community herbalism as a holistic way of enhancing health, I wanted to weigh in on a general home herbalism program for dealing with coronavirus, as well as a few controversies going around, especially the elderberry controversy (some folks on social media are issuing dire warnings against taking it at this time.)

So I would like to share and summarize a few resources that I have found helpful, which others more qualified and really know their stuff have already put together.

So to start with, it is a good idea to know and follow the CDC recommendations: 

-be careful of hygiene.

-wash our hands regularly with soap for 20 seconds. 

-Cough or sneeze into your elbow. 

-minimize unnecessary social contact. 

Beyond that, the general consensus seems to be, as my friend and trained CMT herbalist Ashley Yun told me, the best holistic medicine is a healthy lifestyle and diet. -Get your your sleep, water, daily exercise, some sun for vitamin D, time in nature

-avoid stress where possible, 

-eat less processed fats and sugars, 

-eat more whole foods, more greens, and colorful fruits and veggies. 

Going further, both physician/herbalists I cite below recommend herbs to strengthen immune system, including zinc and elderberry preparations, as well as other immune stimulating foods and herbs, like chickpeas, almonds, cashews, lentils, chia seeds, pumpkin seeds, oatmeal for zinc; and vitamin D and vitamin C. 

My herbalist friends and colleagues Ashley Yun and Hannah Hawthorn added that those with autoimmune problems or other immune disease, those who suspect they have the virus, may want to consult with a professional before taking these stimulating herbs (read below to get a overview of the risks.) 

The line of a Permaculture approach to home herbalism is that there are sound holistic things we can all do that safely enhance our health and make us less of a burden on the medical industry, but when things get serious it is time to consult a practicing professional who can give you specific advice for your situation. 

And when it comes to elderberry preparations without a lot of processed sugar are probably preferable, though these do have a proven effect (on flu), so I would say if that is what you have access to I wouldn’t want to put you off from something that is proven effective if that is what you have access to. 

A great brief list of holistic steps you can take, written by a physician, Dr. RupaMarya MD, can be found here: https://healthykidshappykids.com/2020/02/27/coronavirus-covid-19/?fbclid=IwAR0rRBWCWWN8e0H8fkqYe0qcv4wqbmmOyZipTVRqPhF-iMwlW4O6kK1vq8k

Next a lot of this is similar to the best (much longer) piece I found, which is from Dr. Eliza Song, which I linked to below. 

https://healthykidshappykids.com/2020/02/27/coronavirus-covid-19/?fbclid=IwAR0rRBWCWWN8e0H8fkqYe0qcv4wqbmmOyZipTVRqPhF-iMwlW4O6kK1vq8k

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Journalistic pieces: 

https://www.cleveland.com/news/2020/03/should-i-take-elderberry-supplements-to-ward-off-flu-coronavirus.html

https://vancouversun.com/news/staff-blogs/high-dose-vitamin-d-and-elderberry-syrup-for-flu-treatment/

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Now, since both physicians above recommend elderberry and zinc products that modulate cytokine levels, that brings us to the controversy. What is the risk from immune boosting herbs like elderberry, echinacea, astragalus, reishi, zinc? 

The short story is that I could not find any doctors, scientists, or noted herbalists specifically warning that elderberry or these other medicines could cause a risk (cytokine storm) in otherwise healthy adults or children. There is a study which found no known side effects of elderberry, a couple of physicians saying they believed there was no risk. 

Until there is some research based source advising us against immune stimulating herbs, I will continue to use them with some reasonable caution.

Elderberry is one of my favorite herbs because it has a great body of solid research as an antiviral, being shown to reduce the flu by 3-4 days and reduce its symptoms and also lesson the symptoms and duration of colds better than any prescription can. And there is some research indicating some effectiveness on related viruses to Covid, but no direct evidence of its effectiveness in Covid 19:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899428/?fbclid=IwAR18w2SZgz5fkUk3zkFlVd7jWgosniaXVf53KmblJEcS9Y4arU6Mdt6_8F4

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For herbalism geeks and practitioners who want to go deeper: 

Some have warned that an article in the Lancet confirmed that an overactive immune response known as a cytokine storm (associated with dramatically elevated cytokine levels) has been a major cause of death from Covid 19. 

Some herbalists citing a lot of reasonable caution warned that elderberry changes some  cytokine levels (raising some, lowering others), and believed that raising cytokine levels could be risky if cytokine storm is a possibility. 

Since we don’t understand a lot about cytokine storm, that seems reasonable, especially for practitioners looking to do no harm. 

But most of our Immune boosters, including the zinc recommended in the Lancet article, also raise some of the same cytokine levels, sometimes more than elderberry. That list includes: astragulus, echinacea, reishi mushroom, goldenseal, caffeine, green tea, lycopene, chocolate, kimchi, honey, etc. it also includes regular exercise, sleep, and sex. These all cause acute increases in some cytokines similar to elderberry.

And age. And immune deficiency. Cytokine baselines go up with age, stress, exhaustion, and immune dysfunction, which is perhaps why these folks are at risk for cytokine storm. 

So if we are being cautious and 5ere is a risk, how much risk? 80% of deaths have been in people 60 or older (cytokine levels increase with age) and in those with already compromised immune systems or overactive immune systems. Given the relative levels of cytokines, the risk that taking elderberry could cause or exacerbate cytokine storm in a healthy person is really very low. As pointed out by Dr. Song, there are no cases of this. 

But the probable reduction of symptoms and duration in most people could actually help reduce the spread of the illness, if people are coughing less and for a shorter time. 

So, the general healthy public taking elderberry with some precautions and context would almost certainly slow the spread of the virus and ultimately save lives with very minimal risk. So we may have alternatives that we like better, and there may be some risks, but until there is scientific counter indications a judgement also needs to be considered about scaring the public away from an effective medicine they may have ready access to.

Going even deeper, Dr. Song’s understanding on cytokine storm seems more in tune with a little current reading on the topic, which goes beyond Cytokines=bad. 

Basically, cytokine storm is associated with patients with poor immune systems, so herbs like elderberry that improve immune system health may actually be good. 

As she said, any hyper response of cytokines is associated with a deficient immune response, as is often the case with biological functions. In those with healthy immune response, resting daily cytokine levels are lower. But they have a bigger boom when needed. In older people and those with compromised immune systems, resting rates of cytokines are much higher. But response to stress is poor as Dr Song implied, so it’s this poor response that appears leads to a rebound into cytokine storm. Again, healthy exercise causes an acute raise in cytokines, but then over time, to a lower resting level. So does sex. So do elderberry, chocolate tea, coffee, and coneflower. These things improve immune health and so lower risk of cytokine storm. 

Over exercise or fatigue lower acute cytokine levels, but raise baseline levels and poor immune response. So does diabetes. So especially does eating a diet high in saturated fats and sugar. These apparently put us in a risk category for severe response to covid 19.

Best holistic advice on a program for coronavirus from an herbalist mom and pediatrician:

Coronavirus (COVID-19): What a Pediatrician Wants You to Know

Herbalist opinions:

https://wellnessalternatives-stl.com/2018/05/cytokine-storm/

https://thrivalnutrition.com/cytokine-storm-and-elderberry-usage-episode-218/ 

https://www.organicconsumers.org/news/elderberry-trumps-tamiflu-flu-remedy

http://www.naturalmedicinemamas.com/nmm-blog/cytokine-storm-and-herbs-life-or-death-information

MD opinions: (to summarize, all agree elderberry is safe at this time.) 

https://healthykidshappykids.com/2020/02/27/coronavirus-covid-19/?fbclid=IwAR0rRBWCWWN8e0H8fkqYe0qcv4wqbmmOyZipTVRqPhF-iMwlW4O6kK1vq8k

https://www.facebook.com/DrElisaSongMD/posts/do-you-need-to-worry-about-taking-elderberry-and-creating-a-cytokine-storm-what-/866774387001688/

Coronavirus (COVID-19): What a Pediatrician Wants You to Know

https://health.clevelandclinic.org/elderberry-a-natural-way-to-boost-immunity-during-cold-and-flu-season/

Research on elderberry, exercise, herbs and cytokines:

https://www.ncbi.nlm.nih.gov/pubmed/11399518

https://www.ncbi.nlm.nih.gov/pubmed/12455180

https://www.ncbi.nlm.nih.gov/pubmed/12690937

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