Elderberry: Benefits, Dosage, Contraindications
Other name(s)
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Scientific name(s)
Sambucus nigra
Family or group:
Plants
Active ingredients:
Anthocyanins
Vitamin A
Vitamin C
Quercetin
Rutin
Vitamin B1
Indications
Rating methodology
EFSA approval.
Respiratory Infections ✪✪✪✪✪
Internally used flowers (infusion) are traditionally used as diaphoretics. Astringent, expectorant, and decongestant, they clear the respiratory tract (throat, nose, ears) with a favorable action on bronchitis and sinusitis. They relieve minor eye inflammations and irritations. They are notably known for boosting immune defenses, preventing viral infections, fighting off fever, and treating cold symptoms, relieving cough and asthma. Elderflower tea used as a gargle can also soothe sore throats. They can also treat catarrh (acute or chronic inflammation of the mucous membranes with hypersecretion). The berries, in syrup form, rich in vitamins, are useful for treating bronchial inflammation and lung conditions. According to the EMA, elderflower is a traditional herbal medicinal product used for the relief of early cold symptoms.
Posologie
Oral route: fruit, flower
60 mL
5 - days
Adults
syrup, Sambucol, dry extract
Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials
Interfering With Lipid Raft Association: A Mechanism to Control Influenza Virus Infection By Sambucus Nigra
Sambucus nigra extracts inhibit infectious bronchitis virus at an early point during replication
Clinical Effectiveness of a Combination of Black Elder Berries, Violet Herb, and Calendula Flowers in Chronic Obstructive Pulmonary Disease: The Results of a Double-Blinded Placebo-Controlled Study
A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products
The effects of Sambucus nigra berry on acute respiratory viral infections: a rapid review of clinical studies
Primary care experience on Stimunex® gocce in children with recurrent respiratory infections: a real-world study during the COVID-19 pandemic era
Structure-activity relationship of immunomodulating pectins from elderberries
Pilot Clinical Study on a Proprietary Elderberry Extract: Efficacy in Addressing Influenza Symptoms
Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections
Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses.
Antibacterial activity of elder (Sambucus nigra L.) flower or berry against hospital pathogens.
Flu ✪✪✪✪✪
Clinical research shows that some elderberry extracts could reduce flu symptoms. Significant symptom relief seems to occur within 2 to 4 days following treatment for most patients. On average, this elderberry extract appears to reduce the duration of symptoms by about 56%. The infusion of the flowers or the extract of the berries would therefore reduce the severity and duration of the infection when consumed at the onset of symptoms. Elderberry has also been evaluated in combination with echinacea to treat flu symptoms. A preliminary clinical study shows that taking a specific combined product (Echinaforce Hot Drink, A. Vogel) containing concentrated elderberry juice and echinacea extracts for 10 days improves recovery rates and reduces the rate of respiratory complications related to the flu, similar to oseltamivir 75 mg twice a day for 5 days in adults and children. Note the absence of a placebo group. Other double-blind, placebo-controlled trials conducted during an epidemic of influenza A and B have shown that taking elderberry extract quickly relieves flu symptoms. Indeed, significant symptom improvement was achieved in 2 days in 93.3% of subjects treated with the elderberry extract, while it took 6 days for 91.7% of the placebo group to show similar improvement. The evolution of symptoms such as pain, fever, cough, mucus excretion, and nasal congestion was assessed by patients on a scale from 0 to 10 (10 being the most pronounced improvement). Participants in the elderberry extract group gave an average score of 9 compared to 1 for individuals in the placebo group.
Posologie
Oral route: fruit, flower
175 mg
Adults
syrup, Sambucol, dry extract, juice
Synergies
Effect of an Echinacea-Based Hot Drink Versus Oseltamivir in Influenza Treatment: A Randomized, Double-Blind, Double-Dummy, Multicenter, Noninferiority Clinical Trial
Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections
Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled Trial
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
Dermatoses, Eczema ✪✪✪✪✪
In traditional medicine, when applied externally to the skin, elderberry flowers have a soothing effect. They are anti-inflammatory and treat dermatological conditions (chilblains, irritations, eczema, hives).
Posologie
Cutaneous route: flower
Adults
poultice, mother tincture
Sambucus nigra L. ameliorates UVB-induced photoaging and inflammatory response in human skin keratinocytes
Medicinal plants used for dermatological affections in Navarra and their pharmacological validation
New nanomaterials for the improvement of psoriatic lesions
Constipation ✪✪✪✪✪
A treatment in the form of a concentrated elderberry bud macerate is recommended for constipation, providing a gentle laxative action. Traditionally, elderberry has been used in medicine as a depurative plant that promotes intestinal transit and stimulates gastric emptying. Indeed, elderberry would provide a significant fiber intake, thus contributing to optimal intestinal function. The laxative property of elderberry is attributed to a substance called anthraquinone, a derivative of anthracene (family of polycyclic aromatic hydrocarbons). It is generally accepted that the effects of elderberry are mild and safe for the treatment of occasional uncomplicated constipation. The efficacy of a combination containing elderberry flowers, anise, fennel, and senna was evaluated in 20 subjects suffering from chronic constipation. This randomized, placebo-controlled study revealed that the herbal active treatment produced a laxative effect and was a safe therapeutic option for the treatment of constipation. The tea contained: 2.0 g of Pimpinella anisum fruit (aniseed), 2.0 g of Foeniculum vulgare fruit (fennel), 5.0 g of Sambucus nigra flower (elderberry), and 6.0 g of Cassia augustifolia flower (senna) per 15 g of mixture.
Posologie
Oral route: buds, flower
5 g
Adults
glycerinated macerate
Synergies
Properties
Antiviral
Internally used elderflowers positively influence the prevention of various viral infections (HIV, hepatitis, influenza, etc.). In vitro, an elderberry extract dose-dependently inhibits the H1N1 virus. It is thought that elder flavonoids bind to H1N1 virions and prevent the virus from entering host cells. Similarly, an elderberry extract brought in contact with different herpes virus (HSV) strains fully inhibited viral replication.
Usages associés
Diuretic
Rich in water (79%), the elderberry is an excellent diuretic, capable of stimulating urination frequency. Elderflower extract also increases sodium excretion. However, it is important to note that elder does not alter the pH of urine, meaning it does not influence the dissolution of ions that could contribute to kidney stone formation. The elderbud could facilitate drainage for renal elimination of water and toxins, hence its detoxifying action.
Usages associés
Anti-inflammatory
Studies have validated the anti-inflammatory effects of ethanolic elderberry extracts, focusing on phenolic compounds like quercetin. These studies demonstrate quercetin's ability to effectively inhibit reactive oxygen species and reduce nitric oxide production in LPS-activated murine microglial cells, key mechanisms in cerebral inflammatory response. Specific animal research has also highlighted that elder polyphenolic extracts can modulate the inflammatory response by inhibiting the production of pro-inflammatory cytokines, such as TNF-α and IFN γ, in an experimental diabetes model. This suggests an interesting therapeutic potential in modulating inflammatory processes, notably in pathological contexts like diabetes.
Usages associés
Immunostimulant
Overall, it has been noted that elder exerts an immunostimulant action. It boosts the immune system's defenses when challenged by the flu virus. In fact, internally used elderflowers positively influence the prevention of various viral infections (HIV, hepatitis, influenza, etc.). Elderberries appear to stimulate the immune system by increasing cytokine production by monocytes (IL-1β, TNF-α, IL-6, IL-8, IL-10).
Usages associés
Antioxidant
In diabetes-induced rats, taking an elderberry extract reduces atherogenic risk by decreasing lipid peroxidation, neutralizing free radicals, and inhibiting LDL cholesterol oxidation, notably due to the maintenance of antioxidant enzyme pools like glutathione peroxidase and superoxide dismutase. Elderberry extract also protects hemoglobin against glycation.
Usages associés
Immunomodulator
In diabetes-induced rats, taking an elderberry extract, alongside aronia, decreases the expression of pro-inflammatory cytokines (TNF-α and IFN-γ).
Antibacterial
In vitro, it has been shown that elderberry or elderflower extracts exhibit inhibitory (bacteriostatic) effects on at least 13 pathogenic bacterial strains responsible for nosocomial diseases (i.e., Staphylococcus sp., Bacillus cereus, Salmonella poona, Staphylococcus aureus, Pseudomonas aeruginosa).
Usages associés
Depurative
In traditional medicine, the flowers stimulate elimination and fluidify secretions, promoting kidney function, eliminating toxins through sweating, and preventing kidney stones.
Usages associés
Safety dosage
Adult from 12 years: 2 g - 5 g (tea)
- Tea: 2 to 5 g of crushed flower in 150 ml boil water as an infusion three times daily. Tea: 3-6 g of crushed herb substance in 200 ml of water in decoction divided into 2 single doses per day. - Liquid extract (DER 1:1), ethanol 25% extraction: 2-5 ml three times a day - Tincture (1:5): ethanol 25%: 10-25 ml three times per day
Adult from 18 years: 500 mg - 1500 mg (powder)
Berries are taken as syrup (15 ml, 3 to 4 times a day) or as a powder up to 1.5 g.
Child from 12 years: 5 mL - 20 mL (juice)
Berries in syrup form can be administered to children.
Interactions
Médicaments
Immunosuppressant: moderate interaction
Theoretically, elderberry could interfere with immunosuppressive therapy due to its immunostimulant activity. Elderberry stimulates the production of cytokines, including interleukin and tumor necrosis factor. Immunosuppressant drugs include azathioprine, basiliximab, daclizumab, muromonab-CD3, mycophenolate, tacrolimus, sirolimus, prednisone, and other corticosteroids.
Precautions
Pregnant woman: avoid
Avoid due to a lack of information.
Breastfeeding woman: avoid
Avoid due to a lack of information.
Autoimmune diseases: avoid
Elderberry could have immunostimulant effects. Elderberry appears to stimulate the production of cytokines, including interleukin and tumor necrosis factor. Theoretically, elderberry could exacerbate autoimmune diseases by stimulating disease activity. Autoimmune diseases include multiple sclerosis, systemic lupus erythematosus, rheumatoid arthritis.
Contraindications
Child up to 12 years: forbidden
Cooked elderberry flowers and berries are edible (juice, jelly, jam), but all other parts of the plant contain calcium oxalate and are therefore toxic. The unripe fruit also contains a toxic alkaloid (sambucine). Children should be forbidden from eating raw berries. Cooking above 65°C destroys the toxin.
