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Elder Berry Extract

Also known as: Elderberry, black elderberry, European elderberry, Sambucus nigra ssp. nigra, Sambucus nigra ssp. canadensis, American elderberry, Sambucus nigra ssp. cerulea, blue elderberry, Sambucus nigra

Overview

Elderberry extract is primarily derived from the fruit of the Sambucus nigra species, a botanical supplement rich in phenolic compounds, flavonoids (especially anthocyanins), and micronutrients. Traditionally, it has been used to treat upper respiratory tract infections (URTIs), including common cold and influenza symptoms. Its growing popularity stems from its potential antiviral and immunomodulatory effects. Research on elderberry is moderately mature, with an increasing number of randomized controlled trials (RCTs) and systematic reviews/meta-analyses supporting its efficacy. While evidence quality varies, several well-conducted studies indicate its effectiveness in reducing URTI symptoms. It is available in various forms, including syrups, capsules, and lozenges, and is generally recognized for its safety profile when consumed appropriately.

Benefits

Elderberry supplementation significantly reduces the severity and duration of upper respiratory symptoms, making it a clinically relevant option for common cold and influenza symptom relief. A meta-analysis of RCTs involving 180 participants demonstrated a large effect size in symptom reduction compared to placebo, suggesting strong efficacy. Beyond symptom relief, elderberry extract exhibits antiviral activity by inhibiting viral replication and entry, as shown in in vitro studies against influenza and other viruses. It also modulates the immune response by reducing pro-inflammatory cytokines like TNF-α and IFN-γ, shifting towards a Th2-helper cell response, which can mitigate inflammation during viral infections. The extract's phenolic compounds also contribute antioxidant activity, further supporting immune function. Benefits have been primarily observed in adults with viral URTIs, with symptom improvement typically occurring within days of supplementation during acute illness episodes. While data for children or immunocompromised populations are limited, the existing evidence supports its use for acute viral respiratory symptoms.

How it works

Elderberry's primary mechanism of action involves its bioactive flavonoids, particularly anthocyanins, which exert antiviral effects by inhibiting viral replication and preventing viral entry into host cells. This has been demonstrated in vitro against various viruses, including influenza. Additionally, elderberry possesses immunomodulatory properties. It helps to downregulate the production of pro-inflammatory cytokines, such as TNF-α and IFN-γ, thereby promoting a more balanced immune response and potentially reducing excessive inflammation associated with viral infections. The phenolic compounds present in elderberry also contribute antioxidant activity, which further supports overall immune function and cellular health. While the bioavailability of anthocyanins is moderate, their absorption can be influenced by the specific formulation and co-ingested nutrients.

Side effects

Elderberry extract is generally considered safe, with no serious adverse events reported in clinical trials. Common side effects are rare and typically mild, primarily involving gastrointestinal discomfort. There is no evidence to suggest that elderberry overstimulates the immune system or can cause a 'cytokine storm.' However, due to its immunomodulatory effects, caution is advised for individuals with autoimmune conditions, although specific drug interactions and contraindications are not well documented. It is important to note that safety data regarding elderberry use during pregnancy, lactation, and in pediatric populations are limited, and therefore, its use in these groups should be approached with caution and under medical supervision. As with any supplement, it is recommended to consult a healthcare professional before starting elderberry, especially if you have pre-existing health conditions or are taking other medications.

Dosage

Effective doses of standardized elderberry extract in clinical trials typically range from 300 mg to 600 mg per day, often divided into multiple doses during acute illness episodes. The optimal dosage can vary depending on the extract's standardization, particularly its anthocyanin content, as formulations differ significantly. For maximal benefit, it is recommended to initiate supplementation at the onset of symptoms. While there is no established maximum safe dose, doses used in randomized controlled trials have been well tolerated. It is crucial to follow the specific dosing instructions provided on the product label, as concentrations of active compounds can vary between different brands and forms of elderberry extract. Always ensure the product is derived from the fruit and not other parts of the plant, as raw or unripe elderberries can be toxic.

FAQs

Is elderberry effective for COVID-19?

Current evidence is insufficient to recommend elderberry for COVID-19 treatment. While its antiviral and immunomodulatory properties are promising, more specific research is needed to determine its efficacy against SARS-CoV-2.

Can elderberry prevent colds?

Some evidence suggests potential preventive effects of flavonoid-rich supplements, but elderberry's preventive efficacy for colds is less well established compared to its therapeutic use in reducing symptom duration and severity once symptoms have begun.

Does elderberry interact with medications?

No major drug interactions have been widely reported. However, due to its immunomodulatory effects, caution is advised if you are taking immunosuppressant medications. Always consult your doctor.

How quickly does it work?

Symptom improvement is typically observed within 2 to 4 days of starting elderberry supplementation, especially when initiated at the very first signs of acute illness.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/30670267/ – This meta-analysis of randomized controlled trials (RCTs) found that elderberry significantly reduced the severity and duration of upper respiratory symptoms. It suggests elderberry as a viable alternative to antibiotics for viral URTIs, despite a small total sample size and some heterogeneity among studies, indicating a high-quality analysis with significant clinical findings.
https://www.semanticscholar.org/paper/Elderberry-for-prevention-and-treatment-of-viral-a-Wieland-Piechotta/a168d4ee6fecde12f2ad538bc6b15f6520a3acd4 – This systematic review and meta-analysis, encompassing 30 RCTs on flavonoids including elderberry, concluded that these compounds are efficacious and safe for viral respiratory infections. It confirmed the immunomodulatory effects of elderberry, though it noted limitations due to mixed flavonoid sources and limited elderberry-specific data, highlighting a comprehensive and rigorous methodological approach.
https://pubmed.ncbi.nlm.nih.gov/33827515/ – This systematic review of multiple RCTs and in vitro studies concluded that elderberry is safe and reduces pro-inflammatory cytokines without causing immune overstimulation, suggesting potential antiviral effects. It emphasized the need for larger RCTs and noted limited data regarding COVID-19, representing a high-quality review with balanced conclusions.