BLACK ELDERBERRY (Sambucus Nigra)

 

 

The Elder plant is a weed native to most areas of Europe. The berries and flowers of the plant are still commonly harvested to compound natural medicines.

 

We make no therapeutic claims for any product not listed with the TGA.  This information is to provide history for educational purposes only.  Only use on the advice of a registered health professional.  

 

Black Elderberry was primarily used throughout history as an old fashioned and well established cure for the common cold.  Elder leaves are still occasionally used in an ointment for bruises, sprains, chillblains, or as an emollient for tumors, swellings, and wounds. (Ref 1)

 

Clinical Trials of Elderberry in Influenza have shown that symptom relief may be experienced within 24-48 hours and that the duration of illness may be reduced by up to 3 days.  (Ref 3)

 

Chemical components: 

Flowers:  Flavonoids, primarily quercertin, isoquercertin, rutin and astragaline (Dawidowicz et al 2006, wach et al 2007), alphalinolenic acid, linolenic acid, naringenin (christensen et al 2010).  (Ref 3)

Berries:  Anthocyanins are abundant.  Cyanidin 3-sambubioside is the most abundant and accounts for 50% of all anthocyanins found in the berries (Verberic et al 2009, murkovic et al 2000).  Also present are flavonoids, including quercertin and derivatives.  The unripe berries contain cyanogenic glycosides and therefore should not be consumed (Dellagreca et al 2003).  (Ref 3).

 

Antiviral/Antimicrobial:  Sambucol whose chief ingredient is elderberry extract (1.9g per 5ml) is effective against 10 strains of influenza virus (Zakay-Rones et al 1995).  Recent research suggests that the in vitro anti-influenza activity of concentrated elderberry juice is very weak, while the in vivo activity is relatively strong (Kinoshita et al 2012).  Research has demonstrated an ability of components to bind to H1N1 virions, thus blocking the ability of viruses to infect host cells (Roschek et al 2009). (Ref 3)

 

Immune stimulation:  Sambucol has been shown to increase the production of certain inflammatory cytokines in human monocytes (Barak et al 2001).  In vivo evidence confirms that concentrated elderberry juice suppresses viral replication, and stimulates the immune response (Kinoshita et al 2012).  (Ref 3)

 

Influenza:  Three clinical trials investigating elderberry oral mixture or oral lozenges demonstrate that it reduces symptom severity more rapidly than placebo and may shorten the duration of infection. 

Trial 1:  Sixty patients aged 18 to 54 years with three or more symptoms of influenza were given 15ml of Sambucol syrup four times a day for four days.  The first dose was given within 48 hours of onset of symptoms.  Significant improvement occurred after 3.1 days in the group receiving Sambucol as opposed to 7.1 days in the group given a placebo. 

Trial 2:  Twenty seven subjects including children were investigated in a placebo controlled study during an outbreak of Influenza B Panama (Zakay-Rones et al 1995). Treatment was given for three days, then patient symptoms monitored for six days.  A significant improvement was seen in 93.3% of patients receiving elderberry within two days, whereas it was not until after six days that 91.7% of the placebo group reported feeling better.  

Trial 3:  A randomised double blind clinical trial involving 64 participants aged 16-60 evaluated the efficacy of a standardised, proprietary elderberry extract in reducing influenza symptoms compared to placebo.  The extract was administered via lozenges given four times a day for two days.  After 24 hours, the group receiving the active treatment showed significant improvement in most symptoms, whereas the placebo group showed no such improvement.   By 48 hours, 28% of patients in the active group were void of all symptoms and 60% showed some form of improvement.  No patient in the placebo group achieved complete recovery by this point and only 16% showed improvement in one or two symptoms.  (Ref 3)

 

There is more research evaluating the actions of elderberries than elderflowers; however, most research has been conducted in vitro or with animal models with relatively few human clinical trials available.  (Ref 3)

   

Standardized extracts, tinctures, and solid formulations prepared by a health professional may provide more reliable dosage, however there is no guarantee of strength, purity, or safety of herbal medications, so effects can vary.  As with any medicinal preparation, to ensure the correct dose, patients have been encouraged to measure all liquid medications with an appropriate device such as a dropper, measuring spoon, or cup.  Using different formulations of Elderberry together greatly increases risk of adverse effects. 

 

The appropriate dosage of Elderberry depends on several factors such as the patient's age, health, and other medical conditions. Keep in mind that natural products are not always necessarily safe. Be sure to follow relevant directions on product labels and consult your pharmacist or physician before consuming.

 

Several herbal reference books list the following as common dosages:
 
 
Infusion:  2-3 teaspoons of dried elder flower in 250ml hot water, steep for 10-15 minutes.  Administer 3-4 times daily.  (Ref 1)
 
Tincture:  20-60 drops of 1:2 Elder flower tincture mixed in water or juice 3 or 4 times daily (Ref 1)
 
Syrup:  Containing 30-38% Elderberry.  15ml three times per day.  (Ref 3)
 
Capsules:  Most commercially prepared capsules such as market leader Sambucol juice the berries, dehydrate the juice, then encapsulate the end product. Suggested dose is 500mg (one capsule) three times per day. (Ref 3)
 
 
For Influenza, according to clinical studies: 
Syrup:  15ml of Sambucol syrup four times per day.
Lozenges:  Containing 175mg elderberry extract, one four times per day for at least 2 days. 
 
 
 
Never consume unripe or uncooked Black Elderberries.  They contain cyanogenic glycosides that can be dangerous.  (Ref 3)
 
 
 
Qualified natural health practitioners may prescribe outside this dosage range.  Please do not increase dosage without professional advice.
 

 

As with many natural medicines, consuming regularly in smaller amounts has resulted in longer lasting benefits, while high doses are said to have a short lived but more intense effects. After a period of regular consumption of any herb, a pause of a few weeks is always recommended.

 
 

 

Elder Flower Tincture

 The most highly regarded method of administration for Herbalists and Naturopaths is via cold percolated 25% ethanol solvent tinctures.  This extracts the highest percentage of water and alcohol soluble active ingredients resulting in a strong tincture which allows a patient to take a small amount of tincture for a very significant effect.  The most popular ratio of menstrum (solvent) to raw herb for Elder flower is 2 parts menstrum to 1 part Elder Flower.  This is referred to as a 1:2 tincture. (Ref 2)

 

Elderberry is LIKELY TO BE SAFE for most people when used in medicinal quantities for  short durations. The safety of long-term use is unknown.

 

Side effects -

Elderberries have been generally well tollerated in clinical trials (Zakay-Rones et al 1995,2004).  In large doses Elder may produce Nausea, Diarrhoea, and polyuria (mills and Bone 2005).  (Ref 3)

  

 

Other medical conditions -

Pregnancy and Breastfeeding -  Elder is likely to be safe when consumed in regular dietary ammounts, however data is lacking on the safety of Elder when taken in large amounts during pregnancy and breastfeeding.  Avoid over use.

 

Drug interactions -

Shown in vitro to be a relatively weak inhibitor of CYP3A4 (Schroder-Aasen et al 2012).  Whether this is clinically relevant remains to be tested.  (Ref 3)

 

Diuretics:  Elderflower has a diuretic activity.  Increased diuresis is possible with concomitant use - observe (Beaux et al 1999).  (Ref 3)

 

Diabetic drugs: Elderflower has demonstrated Hypoglycaemic effects in vitro; the clinical significance of this observation remains unknown, and further research is required (Gray et al 2000, Gallagher et al 2003).  (Ref 3)

 

 

 

WARNING - 

Ask your Pharmacist before thinking about taking Elder products with any other medication.

 

     

    Although rare, allergic reactions may occur. Stop taking Elder and seek emergency medical attention if you experience symptoms of a serious allergic reaction including difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives.

     

     

    References:

    1)  Practical Herbalism, ordinary plants with extraordinary powers.  Phillip Fritchey, MH, ND, CNHP. p153-158

     

    2)  Herbal Manufacture, Sharn Nulty, BHSc. DipHM. DipRM.  Byron Bay 2015  

     

    3)  Herbs and Natural supplements, an evidence based guide, volume 2, 4th edition.  Braun and Cohen 2015. p298-302.