Elderberry Plus Syrup: Elderberries and Mushroom Mycelium

Elderberry Plus Syrup: Elderberries and Mushroom Mycelium

Host Defense® Talks with the Expert – How Elderberry Plus supports an engaged and balanced immune system.*

Jerry Angelini is Head of Science Education at Fungi Perfecti® and Host Defense®. He has a Masters of Science and Rehabilitation Medicine degree from Boston University, and has been trained in Western Herbalism, Traditional Chinese Medicine and Ayurvedic medicine. With more than 30 years of experience, Jerry is an invaluable source of knowledge and an important part of our team. We sat down with Jerry to discuss how beneficial mushroom mycelium and the fermented substrate used to grow it play a vital role in the Host Defense® product line.

Elderberry has been under the microscope lately. Some people have shared concerns about the potential for activating the immune response in an abnormally aggressive manner currently being referred to as a cytokine storm (1). When we dive deeply into both the ethnobotanical use of elderberry as well as the research into how it functions, we will find that elderberry is a safe, modulatory immune support for otherwise healthy individuals (2 - 5, 7). Elderberry is also an excellent source of specialized compounds called polyphenols which give elderberries their deep purple color. The polyphenols as well as other compounds in elderberry juice may support other aspects of health and wellness such as cardiovascular function, blood sugar already within the normal range, and antioxidant activity (4, 5).

The big concern most people have when considering immune support is making sure it doesn’t make things worse. The immune system is designed to go into action when tissue has been injured or when it recognizes other types of threats. The mechanics of the immune response include a set of stages:

  1. Immune cells identify a problem.
  2. Immune cells send signals to increase other immune cell activity, called “recruitment”.
  3. Immune cells destroy a threat and clean up damaged tissue.
  4. Immune cells signal that the problem has been contained and the immune system can stand down to a watchful waiting phase. 

The cytokine storm is when recruitment signals (known as pro-inflammatory cytokines and chemokines) cascade into an avalanche.  They allow our white blood cells to move around more easily, hone in on problematic locations, and impact things like swelling and temperature regulation. In unusual circumstances referred to as a cytokine storm, the feedback mechanism hard wired in the immune response can become faulty. This can be due to a situation where infection coupled with tissue destruction is so significant that the cytokines and chemokines try to increase repair mechanisms, however, they make things worse. The uncontrolled swelling, fever and secondary tissue damage can be life threatening and even fatal (1).

Some of the most trusted nutritional supplements support immune functioning by modulating immune activity instead of stimulating immune activity. Immune modulation is a complex process that requires a number of different compounds found in one or more substances.  These multiple compounds allow our immune cells to be recruited to mount an effective response. Modulatory compounds simultaneously support the final stages of the immune response. The immune system is able to then clear up tissue damage. It can also reduce cytokine and chemokine signaling thereby allowing the immune system to return to watchful waiting. Elderberry juice has a number of different compounds that both support immune engagement and modulate the immune response to balance immune activity (2-5).  

When reading research on the impact that a particular substance may have, there are a number of factors that we will want to take into consideration. One factor is the substance itself: is the tested substance the same substance we may be considering? When looking at the research on elderberry, there are a number of different preparations that have been studied. One is the elderberry juice concentrate. A second is the elderberry extract. A third is the elderberry flower. It is important to recognize that elderberry extract is different than elderberry juice concentrate. Elderberry flower functions very differently than the berry juice or the extract and cannot be considered the same as the berry. When we review the research on the juice concentrate and the extract we can see that there is some overlap with some distinct differences in activity (3 - 5). In the research that looks at mechanism of action, not human clinical outcomes, elderberry extract appears to engage the immune response (3). In a very small sample of people, there was an increase of the cytokines that signal the immune system to recruit other immune cells and work harder.  These recruitment cytokines are inflammatory and help the immune system work harder. These cytokines also initiate the self-regulating processes of the immune response, because the immune system is wired to maintain homeostasis. The presence of these engaging cytokines automatically initiates the clean up process.  

The research on elderberry juice shows a wider set of mechanisms associated with its activity. The juice concentrate, similar to the extract, appears to increase immune activity (6). At the same time, elderberry juice concentrate has an expanded action when custom-dried, concentrated, rehydrated, and then subjected to a laboratory process similar to the human digestive and intestinal absorptive process. The elderberry juice concentrate had a very powerful modulatory impact on immune cells (4). The elderberry juice concentrate appeared to trigger the immune cells to decrease engagement signaling and return to a state of watchful waiting. This potential overall support of engagement and then return to watchful waiting is most notably observed in how people feel. In a randomized, double-blind study that tracked how people feel, elderberry juice reduced the discomforts associated with a strongly engaged immune response by an average of four days earlier than those who received the placebo. The participants also reported needing significantly less symptoms-supportive, over the counter products to manage the discomforts. When our immune systems are strongly engaged by the cytokines that make it work hard, they create strong feelings of discomfort. When the immune system modulates those cytokines and moves into a state of watchful waiting, the body returns to a more balanced state of physical sensations. 

When we complete a thorough review of the literature and take into consideration the extended historical use of particular substances, we can form a more complete and hopefully accurate perspective. The traditional use and research on elderberry indicate that it may be supportive of a balanced immune response. The extract and the juice concentrate both appear to increase the immune system’s ability to function strongly. Furthermore, the research on the juice concentrate expands upon the engagement activity by also supporting modulation, the ability of the immune system to decrease its excitatory state and return to a state of watchful waiting. These findings along with centuries of continuous use in Northern Europe indicate that elderberry is a safe immune supportive and immune balancing substance.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

**If you or a loved one has a compromised immune response or autoimmune condition please work with a qualified integrative health care practitioner before using any substance that impacts the immune response.


  1. Microbiol Mol Biol Rev. 2012 Mar; 76(1): 16–32.
Into the Eye of the Cytokine Storm

Jennifer R. Tisoncik, Marcus J. Korth, Cameron P. Simmons, Jeremy Farrar, Thomas R. Martin, and Michael G. Katze


  1. J Int Med Res. 2004 Mar-Apr;32(2):132-40.

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

Z Zakay-Rones, E Thom, T Wollan, J Wadstein


  1. Eur Cytokine Netw. 2001 Apr-Jun;12(2):290-6.

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

Barak V, Halperin T, Kalickman I.


  1. Journal of Functional Foods; Volume 19, Part A, December 2015, Pages 649-660

Anti-inflammatory effects of gastrointestinal digested Sambucus nigraL. fruit extract analysed in co-cultured intestinal epithelial cells and lipopolysaccharide-stimulated macrophages

Anna Olejnik, Katarzyna Kowalska, Mariola Olkowicz, Joanna Rychlik, Wojciech Juzwa, Kamila Myszka, Radosław Dembczyński, Wojciech Białas


  1. Journal of Functional Foods; Volume 18, Part B, October 2015, Pages 941-958

Advanced research on the antioxidant and health benefit of elderberry (Sambucus nigra) in food – a review

Andrzej Sidor, Anna Gramza-Michałowska


  1. Biosci. Biotechnol. Biochem., 76 (9), 1633–1638, 2012

Anti-Influenza Virus Effects of Elderberry Juice and Its Fractions

Emiko KINOSHITA, Kyoko HAYASHI, Hiroshi KATAYAMA, Toshimitsu HAYASHI, and Akio OBATA


  1. Experimental Pathology and Health Sciences 2016;8 (2): 59-66

Sambucus nigra – a promising natural source for human health

Sara Cunha, Diana Meireles, Jorge Machado

Back to blog