Elderberry and the Cytokine Storm Myth: What the Science Actually Says
By Herbal Healing ·
Does elderberry really cause cytokine storms? Separating pandemic panic from peer-reviewed evidence on Sambucus nigra's true antiviral mechanisms—plus a tested traditional syrup recipe.
Let me be direct with you: that last claim is pharmacological fear-mongering based on a fundamental misunderstanding of how this plant actually works in human physiology. As we head into late winter and early spring—prime respiratory virus season—let's separate the peer-reviewed evidence from the Facebook panic.
The Plant: Sambucus nigra L.
We're talking about the European black elderberry here—dark purple berries hanging in umbrella-shaped clusters (umbels, for the botanically curious). Native to Europe but naturalized across North America, this shrub has been in the human medicine cabinet since Hippocrates reportedly called it his "medicine chest."
But nostalgia isn't evidence. Let's look at what we actually know.
The Science: How Elderberry Actually Works
Elderberry's antiviral reputation isn't folk magic—it's biochemistry we can measure.
The active constituents we're tracking are:
- Anthocyanins (cyanidin-3-glucoside, cyanidin-3-sambubioside)—the pigments giving elderberries their deep purple color
- Hemagglutinin inhibitors—compounds that prevent viruses from entering host cells by blocking the spikes they use to attach
- Immunomodulatory polysaccharides—complex sugars that regulate immune response rather than simply "boosting" it
A 2021 systematic review in the Journal of Functional Foods confirmed elderberry extract demonstrates antiviral activity against multiple influenza strains and shows particular efficacy in reducing the duration of upper respiratory symptoms when taken within 48 hours of onset.
More recent research (2024) from the University of Sydney explored the mechanism more precisely: elderberry compounds appear to inhibit viral entry at multiple stages—binding, fusion, and replication. It's not just symptom relief; it's genuine interference with viral machinery.
The "cytokine storm" panic? It originated from a single in-vitro study showing elderberry increased cytokine production in cell cultures. Here's what the fear-mongers missed: cytokines are not inherently dangerous. They're signaling molecules. Your immune system uses them constantly. The problem in severe COVID-19 was an uncontrolled, dysregulated inflammatory cascade—not the presence of cytokines themselves.
Current consensus from clinical herbalists and pharmacologists: there's zero evidence in human studies that elderberry causes or exacerbates cytokine release syndrome. In fact, elderberry's immunomodulatory (not just immunostimulatory) effects suggest it helps regulate immune response rather than inflame it.
The Tradition: Before PubMed Existed
Indigenous European and North American healing traditions have used elderberry for centuries—not just for acute illness, but as a convalescent tonic. The berries were cooked into syrups, wines, and cordials; the flowers (flos sambuci) used as diaphoretics to encourage fever resolution.
The key word here is cooked. Raw elderberries contain cyanogenic glycosides—compounds that can release cyanide when metabolized. Traditional preparation methods (heat, alcohol extraction, drying) denature these compounds. Your ancestors weren't stupid—they figured this out through trial, error, and probably some memorable stomachaches.
Traditional dosage for acute symptoms: 1-2 tablespoons of syrup every 3-4 hours at onset, tapering as symptoms improve. For prevention during exposure season: 1 teaspoon daily.
⚠️ SAFETY & CONTRAINDICATIONS ⚠️
DO NOT consume raw elderberries. They contain cyanogenic glycosides that can cause severe nausea, vomiting, and weakness. Cooking, drying, or tincturing eliminates this risk.
Pregnancy & Lactation: Limited safety data. Traditional use exists, but I recommend consulting your midwife or obstetrician before regular use.
Autoimmune Conditions: Theoretical concern about immunomodulatory effects. If you have an active autoimmune condition (RA, lupus, MS), discuss with your rheumatologist or neurologist—especially if you're on immunosuppressive medications.
Blood Sugar: Elderberry may lower blood glucose. If you're on diabetes medications, monitor closely.
Drug Interactions: May have additive effects with diuretics and diabetes medications. No major interactions documented with common pharmaceuticals, but—as always—disclose all supplements to your prescribing physician.
I am not a doctor. This information is educational, not prescriptive. Elderberry supports immune function; it does not "cure" viral infections. If you have severe respiratory symptoms, seek medical care.
The Apothecary Recipe: Traditional Elderberry Syrup
This is the preparation I keep in my own cabinet from October through April. It's simple, effective, and significantly more affordable than boutique store versions.
Ingredients:
- 1 cup dried elderberries (Sambucus nigra)—or 2 cups fresh/frozen (fully ripe, never green)
- 4 cups filtered water
- 1 cinnamon stick (optional, for flavor and gentle warming properties)
- 3-4 slices fresh ginger (optional, for additional diaphoretic support)
- 1 cup raw honey (local if possible)—this acts as preservative and sweetener
Method:
- Combine berries, water, and optional spices in a saucepan. Bring to a boil, then reduce to a simmer.
- Simmer uncovered for 30-45 minutes until liquid reduces by roughly half. The berries will soften and the liquid will darken to a deep purple-red.
- Remove from heat. Strain through a fine mesh sieve, pressing berries gently to extract all liquid. Discard the spent berries—do not consume them.
- Allow the liquid to cool to lukewarm (below 110°F/43°C—hot liquid will destroy honey's enzymes and medicinal properties).
- Stir in raw honey until fully dissolved. The honey acts as a preservative; the final ratio should be roughly 1:1 honey to decoction by volume.
- Transfer to sterilized glass jars. Store in the refrigerator for up to 3 months.
Dosage:
For prevention: 1 teaspoon daily for adults, ½ teaspoon for children over 2.
For acute symptoms: 1 tablespoon every 3-4 hours for adults; 1 teaspoon every 3-4 hours for children over 2. Reduce frequency as symptoms improve.
Note: Honey is not safe for children under 12 months due to botulism risk.
The Verdict
Elderberry is not a miracle cure. It will not prevent COVID-19, influenza, or the common cold. What it can do—based on current evidence—is modestly reduce the severity and duration of viral upper respiratory infections when used appropriately and started early.
The "cytokine storm" fear was a product of pandemic panic and scientific illiteracy, not clinical reality. Used responsibly, with proper preparation and attention to contraindications, elderberry remains a valuable tool in the winter wellness arsenal—one your great-great-grandmother would recognize and respect.
As always: support your immune system with sleep, hydration, stress management, and—when appropriate—evidence-informed botanical allies. Your body is doing its best. Give it the tools to succeed.
Be well and be wise.
References:
Tiralongo E, et al. (2016). Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients.
Hawkins J, et al. (2019). Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complementary Therapies in Medicine.
Wieland LS, et al. (2021). Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complementary Medicine and Therapies.
Torabian G, et al. (2019). Anti-influenza activity of elderberry (Sambucus nigra). Journal of Functional Foods.