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Is Sambucal Good or Bad for the cytokine storm of swine/avian flu? ****
This has been discussed here in depth; if you use the search function, keywords elderberry and cytokine storm, you should find a treasure trove of information from those with extensive knowledge of alternative and herbal medicines.
I'll also try taking a stab at it.
Unlike summerthyme, though, I am going to go from the "hard science" angle, though, so you can have a better understanding of what's going on.
DISCLAIMER: I'm advocating or suggesting nothing...just giving some facts and telling you what I'd do.
Here's how I understand it.
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How does sambucol (elderberry) work against flu?
Sambucol (black elderberry) has been found to both
1. stop flu viruses from entering cells and
2. increase the production of
both inflammatory and anti-inflammatory cytokines.
So far, sambucol has not shown to be resistant to ANY flu viruses.
ELDERBERRY IN ORDINARY FLU
ORDINARY flu viruses are actually found to be
susceptible to these increased inflammatory cytokines, so
elderberry extract has a dual mechanism of action for everyday, run-of-the-mill flus. It works really well in these, and documentation can be found all over the Net stating such.
ELDERBERRY IN BIRD FLU
As far as
bird flu (H5N1) and elderberry preparations are concerned, so far we mostly have in-vitro (petri dish) studies to consider. H5N1
is inhibited from entering the cell by elderberry.
But...
the bird flu virus itself causes massive production of those inflammatory cytokines in the victim, and unlike everyday flus, is
not susceptible to them at all.
This is problematic, because massive production of inflammatory cytokines
by the virus may lead to cytokine storm and something called ARDS (acute respiratory distress syndrome.)
In
theory, you can make a case that using elderberry extract for bird flu
could be problematic as it also can increase the number of circulating cytokines, and maybe have an additive effect with the inflammatory cytokines already being produced by the virus itself, possibly further increasing the risk of cytokine storm and ARDS.
There are many that prescribe to this school of thought...Dr. Henry Niman, the virologist, is one of them, and you can't really blame him. He's basing his call on theory...but note there, even he says "
may not be desirable." He says "may" because
we just don't know....which leads to the next school of thought:
This is important...1. elderberry extract in bird flu will also increase production of those
anti-inflammatory cytokines as well, although I am unsure to what extent compared to the increase of inflammatory cytokines. And, 2. started early enough, elderberry extract could actually prevent an avian flu virus from gaining a foothold, because elderberry wouldn't even let it get into cells to do its viral reproduction thing. And, that's major, because cytokine storm is probably associated with heavy viral loads in the body.
Therefore,
another school of thought (which is the one that most of the herbalists here believe) is that if you combine elderberry's antiviral properties with additional anti-inflammatory drugs to "help out" those anti-inflammatory cytokines: drugs like possibly aspirin, herbals such as
turmeric 95% curcumin and other antioxidants, or even some standard prescription drugs (such as ACE inhibitors, angiotensin II receptor blockers, the new TNF-alpha blockers, and possibly steroids like prednisone) you may beat the cytokine storm, particularly if you start taking both elderberry preps and turmeric 95% curcumin early,
before the bird flu virus has a chance to multiply in your body, and before cytokine storm has a chance to begin.
This can be accomplished by taking sambucol as a preventative, and increasing the dosage as soon as you begin feeling ill.
Add to that...medical science does not yet know the exact mechanism that triggers cytokine storm. In fact, it is unknown if increasing cytokine levels are what triggers the storm in the first place, or if something else acts as the trigger! It is unknown if elderberry products will actually increase a bird flu victim's risk of cytokine storm. This part is only theorized based on the knowledge of how sambucol works.
As an aside, there was some interesting research presented in a paper a few years ago that showed the antiviral drug Relenza, when combined with Celebrex and mesalazine (Rowasa, Pentasa) increased H5N1 survival in mice from 13% to 53%. (Zheng B.-J. et al. "Delayed antiviral plus immunomodulator treatment still reduces mortality in mice infected by high inoculum of influenza A/H5N1 virus" Proc. Natl. Acad. Sci. USA, Published online on June 3, 2008 DOI:10.1073/pnas.0711942105")
The reason this is interesting is that the anti-inflammatory drugs employed may well have controlled the cytokine storm seen with H5N1 bird flu! If that is true, then it would also make some sense that employing things like aspirin and turmeric 95% curcumin with sambucol could also be a quite effective combination.
So, in
bird flu, you have two choices...decide to go with theory and avoid elderberry preparations, or decide to roll with the fact that nobody really knows how elderberry preps will affect cytokine storm in bird flu, and take the elderberry. For H5N1 bird flu, most of the herbalists here have advised, in the past, to take elderberry as a preventative and increase the dose at the first presentation of symptoms, and take turmeric 95% curcumin concurrently.
ELDERBERRY IN THE CURRENT H1N1 SWINE, also now called MEXICAN FLU
As far as the current swine flu is concerned...it is an H1N1 variety, and part of it is a "bird" flu, but it is not exactly the same makeup as bird flu H5N1.
The H1N1 strain we're worried about right now is a combination of human, pig and avian flus.
Dr. Henry Niman suspects that some of the patients who died in Mexico died of cytokine storm. He thinks this based on their ages and the fact that cytokine storm is the probable cause of death in many folks in the 1918 pandemic, and IMO it's a good educated guess. However...again,
it's also entirely possible that those patients in Mexico died of other complicating factors, such as a concurrent bacterial pneumonia that set in on top of the flu, just as it is possible that many of the dead in 1918 died of concurrent bacterial pneumonias (particularly already weakened soldiers who died in the trenches from the flu in 1918. But I digress.) Research in mice using the "resurrected" 1918 virus does show that cytokine storm was probably a factor, but it's more than likely that concurrent infections were too. Probably it was a combination of several factors. Something tells me that Vitamin D deficiency may be a commonality between the dead in 1918 and in Mexico 2009, but again, I digress.
With this current swine flu, we haven't yet established definitively that cytokine storm is even a cause of death; Niman is simply guessing that it might be, or may be in the future. It wouldn't make a lot of sense in the case of the 23 month old who died in Texas. There is no clarification either way until we get more data on the Mexican patients who died. And, considering how Mexico has been handling this whole flu outbreak, it could be months before we have conclusive data. Add to that the fact that this flu is not
strictly a bird flu, and sambucol begins to look even more attractive as a treatment option.
Right now, the current swine flu strain is susceptible to the prescription drug Tamiflu, which is great if you can get a hold of some. However, that also may change, particularly by fall after this virus has a chance to adapt and mutate.
In my opinion,
elderberry preparations are an option for the current Mexican/swine flu, particularly if you concurrently take an anti-inflammatory herbal such as turmeric 95% curcumin to control any potential cytokine storm. Aspirin, for
adults not on blood thinners, might be good to add too, as it will fight fever. To be prudent, I'd do the same thing here as you would for bird flu; take sambucol as a preventative, and increase the dose to the treatment dosage at the first presentation of any flu symptoms.
Keep in mind though...turmeric 95% curcumin does have some drug/disease interactions to consider. People on Coumadin (warfarin), people with gallstones or bile duct disease, pregnant patients, patients on chemotherapy for breast cancer, and people with GERD or peptic ulcer disease should consult their doctor before taking turmeric 95% curcumin.
I really, really hope this helps.
Link for information on sambucol that I referenced in the above:
http://www.unigod.org/flu/sambucol.html