The Monographs: Elderberry

Overview and Author’s Commentary

Elderberry (Sambucus spp.) grows all over the American Northwest where I live and has long been  used  in  traditional  Western  medicine. Elder   flower   and   elder   leaf   are   in   classic diaphoretic teas, and together with elder berries are ingredients in my Flew Away formulation, a classic formula for colds and flu. Elderberry is also  in  Vital  Adapt,  my  general  adaptogenic tonic formula.

Elderberry is used as a general nutritive tonic, providing a high concentration of flavonoids. It is also used as an immune tonic to prevent and alleviate many cold and flu symptoms, including runny nose, cough, sore throat, fever, and muscle pain. Elderberry is especially great for children in the fall and winter as an overall immune tonic.

Therapeutic dosing range

• Fluid  extract  1:1:  2  to  5  ml,  once  or twice daily
• Standardized   extract   (5 percent total flavonoids): 500 to 2000 mg daily
• Tea (may be mixed with elder leaf and elder flower): 2 to 6 cups daily

Safety Profile

There are no known adverse reactions to ripe elderberries and elder flowers. The leaves, bark, and unripe berries contain a toxic cyanide- producing glycoside and ingestion should be avoided. However, there are certain instances where they may be used, generally under the supervision of a qualified healthcare provider, such as the leaves in tea form or in certain topical applications.

Habitat and Cultivations

Elderberry grows widely throughout the U.S., generally in large, dense stands in moist habitats. The black or common elder (S. Canadensis, S. mexicana) is a small tree or shrub bearing large clusters of lacy white or creamy flowers, followed by tiny dark purple berries. It blooms in June and July, and the berries mature in September and October. The flowers, berries, and inner bark are used as medicine. S. nigra is indigenous to Europe, growing in conditions similar to those in which the American variety. The plants possess similar medicinal properties.

Key Constituents

The berries are rich in vitamin C and a wide range of important flavonoids, including quercetin and anthocyanins, which are believed to account for the therapeutic effects. The leaf and flowers contain flavonoids, anthocyanins, carotenoids, essential oil, mucilage, and tannins. The main active compounds include anthocyanins cyanidin 3-glucoside and cyanidin 3-sambubioside as well as, quercetin and kaempferol .1 (K. Brønnum-Hansen, S.H. Hansen: Highperformance liquid chromatographic separation of anthocyanins of Sambucus nigra L. J Chromatogr 1983; 262: 385 – 392).

Traditional Use

Elderberries have long been used as food, particularly in dried form. Elderberry wine, pie, and lemonade are some of the popular ways to prepare this plant. The leaves are touted as being pain-relieving and they promote healing of injuries when applied as a poultice. Native Americans have traditionally used the plant for infections, coughs, and skin conditions. In a warm infusion elder flowers are diaphoretic and gently stimulating. In a cold infusion they are diuretic, alterative, and cooling. The flowers and expressed juice of the berries have been beneficially employed in scrofula, cutaneous diseases, syphilis, and rheumatism. The inner bark of Sambucus nigra is an emetic and cathartic and has been successfully used to treat epilepsy.

Modern Research

• Elderberry extract possesses significant antioxidant activity and has been shown to impair angiogenesis.3
• Sambucus nigra provides nonspecific immune enhancement and boosts cytokine production.4 A unique protein found in elderberry acts as a messenger, regulating immune response.5
• Elderberry is a potent viral inhibitor. Its anti- influenza ability has been much researched in both Israel and Switzerland. As well, elderberry extract has demonstrated an ability to inhibit herpes virus and HIV in cell culture.6 The H1N1 inhibition activities of the elderberry flavonoids compare favorably to the known anti-influenza activities  of  oseltamivir (Tamiflu®) and amantadine.7
• The   anthocyanins   present   in   elderberries protect vascular epithelial cells against oxidative insult, preventing vascular disease. Elderberry has been shown to reduce LDL cholesterol and atherosclerosis.8
• Elderberry could improve bone properties by inhibiting  the  process  of  bone  resorption  and stimulating the process of bone formation.9

References

1. V. Schmitzer, R. Veberic, A. Slatnar, and F. Stampar, “Elderberry (Sambucus nigra L.) wine: A product  rich  in  health-promoting  compounds,” Journal of Agricultural and Food Chemistry 58(18) (2010):  10143–46.  [FC]
2. Harvey Wickes Felter, MD, and John Uri Lloyd, Phr, M, PhD, King’s American Dispensatory, 18th ed. Third revision, (1898), 583, Reissued by Eclectic Medical Publications, Sandy OR. 1993.
3. K. A. Youdim, A. Martin, and J. A. Joseph, “Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress,” Free Radical Biology and Medicine 29(1) (2000): 51–60; and S. Roy, S. Khanna, H. M. Alessio, et al., “Anti-angiogenic property of edible berries,” Free Radical Research 36(9) (2002): 1023–31.
4. V. Barak, S. Birkenfeld, T. Halperin, and I. Kalickman, “The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines,” Israel Medical Association Journal 4 (11 suppl.) (2002): 919–22.
5. V. Barak, T. Halperin, and I. Kalickman, “The effect of Sambucol, a black elderberry- based, natural product, on the production of human cytokines,” European Cytokine Network 12(2) (2001): 290–96. [FC]
6. Z. Zakay-Rones, N. Varsarno, M. Zlotnik, et al., “Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama,” Journal of Alternative and Complementary Medicine 1 (1995): 361–69 [FC]; Barak, et al., “The effect of Sambucol”; M. Konlee, “A new triple combination therapy,” Positive Health News 17 (1998): 12–14; Barak, et al., “The effect of herbal remedies”;  and R. C. Fink, B. Roschek Jr., and R. S. Alberte, “HIV type-1 entry inhibitors with a new mode of action,” Antiviral Chemistry and Chemotherapy 19(6) (2009): 243–55.
7. B. Roschek Jr., R. C. Fink, M. D. McMichael, D. Li, and R. S. Alberte, “Elderberry flavonoids bind to and prevent H1N1 infection in vitro,” Phytochemistry 70(10) (2009): 1255–61. [FC]
8. Youdim, et al., “Incorporation of the elderberry anthocyanins.”
9. Y. Zhang, Q. Li, H. Y. Wan, et al., “Study of the mechanisms by which Sambucus williamsii HANCE extract exert protective effects against ovariectomy-induced osteoporosis in vivo,” Osteoporosis International 22(2) (2011): 703–09. [FC]