The threat of COVID-19 has prompted a lot of questions regarding over the counter antiviral remedies. I thought I would discuss a few herbs that are thought to possess activity against viruses in general. We do not have specific information regarding COVID-19 because it is too new.

Presently, the only known weapons we have against the spread of COVID-19 are handwashing, social distancing, and wearing masks.

Until a vaccine is available, our options are limited. I take dietary supplements for several reasons. Some of these may help decrease my risk of contracting this virus.

I believe benefit far outweighs the risk in this situation.

I have written about many of these herbs in the past. For more information, click the highlighted link to visit the corresponding blog post.

Green Tea

Green tea (Camelia sinensis) consumption can have significant positive effects on human health.¹

Green tea contains catechins, which are polyphenolic compounds. These substances, especially epigallocatechin-3-gallate (EGCG), have shown broad antiviral effects.²

Green tea extract has the potential to cause liver toxicity. Products that contain the United States Pharmacopeia (USP) verification stamp must be labeled with the following:

Due to the potential risk for hepatotoxicity with green tea extracts, products that carry the United States Pharmacopeia (USP) verification stamp must include the following text on the label: “Do not take on an empty stomach. Take with food. Do not use if you have a liver problem and discontinue use and consult a healthcare practitioner if you develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice (yellowing of the skin or eyes)”³

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Ascorbic Acid ( Vitamin C)

Studies have shown that patients with acute infections have low circulating ascorbic acid levels.⁴

⁵

We also know that vitamin C modulates interferons and cytokines in patients with viral infections.⁶

Ascorbic acid has also been shown to reduce neuralgia pain associated with the herpes virus.⁷

There have also been instances where influenza A patients with life-threatening respiratory failure have rapidly improved after receiving ascorbic acid and thiamine.⁸

Elderberry

Elderberry is a dark purple berry that grows on the European elder tree. There is evidence that elderberry fruit extract taken four times daily can reduce the symptoms and duration of influenza infection if started within 48 hours of symptoms. This extract can reduce the duration of symptoms by 56% on average.⁹

Another study found that lozenges containing elderberries taken four times daily within 24 hours of influenza onset improved flu-like symptoms compared with placebo ¹⁰

Zinc

Zinc is the second most abundant trace element in the human body. This element is essential for growth, development, DNA synthesis, and RNA transcription.¹¹

A review article published in 2019 concluded that zinc can stimulate the body’s viral response.¹²

In vitro studies have also shown zinc may possess antiviral effects. This paper also stated that zinc treatment at therapeutic doses can drastically improve the clearance of acute and chronic viral infections.¹³

We know that Zinc lozenges can decrease the duration of the common cold by up to 40%.¹⁴

Quercetin

Quercetin is a common flavonoid found in many Chinese herbs and fruits, vegetables, and red wine.

Quercetin has been shown to possess anti-influenza activity. This is likely due to its ability to inhibit the entry of the virus into the cell.¹⁵

This substance has also exhibited the ability to inhibit virus replication in the initial stages of influenza infections.¹⁶

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Echinacea

Echinacea is the name given to some flowering plants in the daisy family. This plant has been used for centuries by Native Americans to treat many illnesses.

Currently, Echinacea is used primarily as an herbal remedy in the treatment of the common cold and flu.

Echinacea extracts have shown antiviral activity against several different viruses.¹⁷

¹⁸

¹⁹

There are also studies claiming Echinacea is an efficacious immunomodulator. There is still insufficient evidence available to make therapeutic recommendations for specific disease states.²⁰

We all want to protect ourselves from infection.

It is much easier to prevent an illness than to treat it. There are some simple steps we can take to stay healthy.

Eat whole foods.
Exercise regularly.
Drink plenty of water.
Avoid bad habits.
Get enough sleep.

I also believe herbal products can help us stay healthy. One of the biggest causes of sickness is oxidative stress. Our cells are bombarded with free radicals daily.

Just breathing the air can introduce toxins into the body.

In addition to my products, I take ProtandimTM Tri-Synergizer daily. This not only helps protect my cells from free radical damage but also makes me feel better and improves my energy level. I strongly recommend giving this supplement a try.

With COVID-19 comes uncertainty and fear. Besides staying as healthy as possible, we should also wash our hands often, wear masks when near others, and practice social distancing. Although the products mentioned in this post are not proven to treat, prevent, or cure COVID-19, some have good evidence against other viruses. I think the benefits of taking them far outweigh the risks.

Nutraceuticals have been used in Ayurvedic and Chinese medicine for thousands of years. Large, randomized-controlled studies are not always available to support these agents due to prohibitive costs. This does not mean they are ineffective. It usually means there is not enough profit to be made from them to justify the high costs of the studies.

If you have any questions regarding this post or about medications or nutraceuticals, please send me a message. I would also like to invite you to join our email list to receive our monthly newsletter. Our newsletter will keep you up to date on new products, our influencers, and sales.

Until next week, stay happy, healthy, and safe!

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Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

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I am excited to be able to introduce an elderberry supplement into the Sunshine Nutraceutical product line. Elderberry is a purple berry produced by the European elder tree, a shrub which grows up to ten meters tall. Elder flowers and berries have been used as medicines and flavorings for centuries and are especially popular as potent cold and flu remedies. These common ailments have few treatments and can be annoying and even deadly in certain individuals. Elderberries have been utilized to treat various health conditions including diabetes, gingivitis, inflammation, acne, and more. This post will concentrate on the evidence available for the use of elderberries as a nutraceutical agent.

Elderberry for Colds, Flu and Bacterial Infections

Probably the most common use for elderberry is as a treatment for upper respiratory infections. Colds and influenza are prevalent especially during the winter months and are often treated with over-the-counter medications to combat symptoms and at times antibiotics are prescribed. Both colds and the flu are caused by viruses. Antibiotics are ineffective in the treatment of viral infections. Taking antibiotics unnecessarily can lead to resistant bacteria so it is important to use antibiotics only when they are indicated. No antibiotic is 100% effective and, if a resistant bacterial strain begins to multiply, it can be difficult to treat the infection.

The real question is whether elderberry will help with upper respiratory symptoms. I know plenty of individuals who swear it works. Before adding the elderberry product to my line, I did some research. I located a meta-analysis published in February of 2019. I have mentioned in previous posts that I like meta-analyses because they have a larger sample size and are generally more accurate than single studies.

This meta-analysis showed that elderberry supplements, when taken at the onset of respiratory symptoms, substantially reduced symptom duration compared to a control group. The investigators concluded that elderberry supplementation reduced influenza virus symptoms substantially more effectively than the upper respiratory symptoms caused by the common cold. It should be noted that this meta-analysis included only one study on elderberry supplementation for the common cold.¹

Elderberries neutralize hemagglutinin spikes found on the surfaces of some viruses. This prevents the viruses from piercing cell walls or entering the cell to replicate. If the viruses are unable to replicate, they cannot spread.²

Elderberries can also increase the antibodies produced by our bodies against the influenza virus. This indicates elderberries may actually be able to prevent the flu from occurring.³

A study published in the BMC Complementary & Alternative Medicine Journal in 2011 concluded that elderberry liquid extract was effective against human pathogenic bacteria and influenza viruses. Many patients develop bacterial infections when ill with the influenza virus. Elderberry may prove to be helpful in fighting both the influenza virus as well as bacterial infections during outbreaks.⁴

Elderberry for Treatment and Prevention of Cancer

A study published in 2007 found extracts of the fruits of both the European elderberry (Sambucus nigra) and American elderberry (Sambucus Canadensis), demonstrated anti-initiation and anti-promotion properties. This may prove to be useful in fighting cancer in the future. However, more studies need to be conducted on this subject ⁵

Elderberry as an Antioxidant

Elderberry may act to protect the body against oxidative stress. Elderberry has been proven to be an antioxidant and free radical scavenger in vitro (outside the body). It has antioxidant activity comparable to other highly antioxidant fruits such as blueberry and chokeberry.⁶

Elderberry Effect on Obesity, Diabetes and Inflammation

Obesity is the result of excessive adipose tissue growth. This can happen through two different mechanisms; Hypertrophy, which is the expansion of existing fat cells, and hyperplasia, which is the addition of new fat cells.

The oxidative stress caused by an increase in fat tissue leads to obesity-related comorbidities including insulin resistance, diabetes, cancer and heart disease.⁷

The accumulation of fat in hypertropic adipose tissue associated with obesity leads to oxidative stress and chronic inflammation.⁸

A recent study found an extract of the elderberry fruit (EDB) was able to decrease reactive oxygen species (ROS) in hypertrophic adipocytes suggesting an antioxidant action. This may be a potential protective mechanism against obesity risk factors such as insulin resistance and chronic inflammation.

This study also suggested that the anti-obesity and anti-diabetic effect of EDB may be due to inhibition of dietary sugar and fat absorption from the GI tract.⁹

Some evidence suggests polyphenols from several berry fruits can inhibit digestive enzymes which are responsible for the hydrolysis necessary for absorption of dietary lipids and carbohydrates.¹⁰

Zielinska-Wasielica et al. cited the following in their study published in August of 2019:

Results of the study indicate that Sambucus nigra fruit extract may offer substantial preventive and therapeutic potential for the treatment of obesity and obesity-related disorders, accompanied by oxidative stress, inflammation and insulin resistance. Moreover, the extract can inhibit digestive enzyme activity, and consequently, significantly reduce the intestinal absorption of dietary lipids and carbohydrates, which is an effective strategy for the prevention and treatment of obesity and metabolic comorbidities.¹¹

Contraindications

No contraindications to elderberry have been identified.

Side Effects

Consuming uncooked leaves, stems, or berries can lead to cyanide toxicity, which may cause vomiting and diarrhea. Commercial preparations generally do not cause adverse effects at prescribed dosages.

Pregnancy and Lactation

I do not recommend taking an elderberry supplement if you are pregnant or breast feeding as there are not enough studies confirming safety in infants and small children. For this reason, I recommend reserving the use of elderberry supplements to those over the age of eighteen.

Elderberry Drug Interactions

Although drug interactions with elderberry are not well-documented, exercise caution when taking the following:

Insulin
Blood pressure lowering medications Chemotherapeutic agents
Laxatives
Theophylline
Caffeine (Elderberry may inhibit the enzyme that metabolizes theophylline and caffeine). ¹²

Our Elderberry Product

Sunshine Nutraceuticals has a brand-new elderberry product that contains 600 mg of elderberry extract per capsule. This supplement is designed to be taken twice daily 20-30 minutes prior to a meal with eight ounces of water. I DO NOT recommend taking this product if you are pregnant, breast feeding or under eighteen years of age. If you have a known medical condition, consult your physician or pharmacist prior to taking supplements containing elderberry.

I expected to find a lot of information on elderberry for the treatment of colds and flu. After all, this is why many utilize this supplement and praise its effectiveness. What I didn’t expect was that elderberry has positive effects on diabetes, insulin resistance, and inflammation. We all know about the positive effects of blueberries as an antioxidant. It appears elderberries are not just good as a flavoring agent

and food source, but also possess medicinal properties beyond treatment of upper respiratory tract infections. As with all nutraceuticals, more studies are needed to determine the exact mechanism of action of the benefits of the elderberry. In the future, we may be able to isolate the active compounds from this plant, and use it not only to treat colds and the flu, but to prevent cancer, help fight insulin resistance, and more.

I firmly believe that, as a society, we under-utilize the natural substances provided to us in favor of chemicals which may help treat diseases but not without serious side effects. If we eat right, exercise, and spend time concentrating on our health, we may be able to avoid ingesting harmful chemicals. I know this sounds odd coming from a pharmacist, but this is the conclusion I have come to. Prescription drugs are absolutely necessary in some circumstances, but with the right lifestyle, we can limit our exposure to them.

Pharmacist Michael

Nutritional Supplements for a Healthy Life

Tag: elderberry

Some Remarkable Over The Counter Antivirals