ELDERBERRY

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Parts used and where grown: Numerous species of elder or elderberry grow in Europe and North America. Only those with blue/black berries are medicinal. The flowers and berries are both used. Species with red berries are not medicinal.

Elderberry has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Influenza
	Cold sores Common cold/sore throat Infection Inflammation
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies): Elderberries have long been used as food, particularly in the dried form. Elderberry wine, pie, and lemonade are some of the popular ways to prepare this plant as food. The leaves were touted by European herbalists to be pain relieving and to promote healing of injuries when applied as a poultice.¹ Native American herbalists used the plant for infections, coughs, and skin conditions.

Active constituents: Flavonoids, including quercetin, are believed to account for the therapeutic actions of the elderberry flowers and berries. These flavonoids include anthocyanins that are powerful antioxidants and protect cells against damage according to test tube studies.² According to laboratory research, an extract from the leaves, combined with St. John’s wort and soapwort, inhibits the influenza virus and herpes simplex virus.³ The effect on influenza of a syrup made from the berries of the black elderberry has been studied in a small double-blind trial.⁴ People receiving an elderberry extract (2 tablespoons [30 ml] per day for children, 4 tablespoons [60 ml] per day for adults) appeared to recover faster than did those receiving a placebo. Animal studies have shown the flowers to have anti-inflammatory properties.⁵ These actions have not been verified in human clinical trials.

How much is usually taken? A syrup of black elderberry extract (1 teaspoon–1 tablespoon [5–15 ml] for children, 2 teaspoons–2 tablespoons [10–30 ml] for adults) can be taken twice daily. A tea made from 1/2–1 teaspoon (3–5 grams) of the dried flowers steeped in 1 cup (250 ml) boiling water for ten to fifteen minutes may be drunk three times per day.⁶

Are there any side effects or interactions? The safe internal use of elderberry is limited to the use of the dried flowers or syrups made from the ripe berries.⁷ The roots, stems, leaves, and unripe berries may contain poisonous constituents that can cause nausea, vomiting, and diarrhea.⁸ Preparations containing any of these parts of the elder plant should be avoided.

At the time of writing, there were no well-known drug interactions with elderberry.

1. Duke JA. CRC Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press, 1985, 423.

2. Youdim KA, Martin A, Joseph JA. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radical Biol Med 2000;29:51–60.

3. Serkedjieva J, Manolova N, Zgórniak-Nowosielska I, et al. Antiviral activity of the infusion (SHS-174) from flowers of Sambucus nigra L., aerial parts of Hypericum perforatum L., and roots of Saponaria officinalis L. against influenza and herpes simplex viruses. Phytother Res 1990;4:97–100.

4. Zakay-Rones Z, Varsano N, Zlotnik M, 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. J Alt Compl Med 1995;1:361–9.

5. Mascolo N, Autore G, Capasso G, et al. Biological screening of Italian medicinal plants for anti-inflammatory activity. Phytother Res 1987;1:28–31.

6. Gruenwald J, Brendler T, Jaenicke C, et al. (eds). PDR for Herbal Medicines. Montvale, NJ: Medical Economics, 1998, 1116–7.

7. Foster S. 101 Medicinal Plants. Loveland, CO: Interweave Press, 1998, 72–3.

8. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press, 1996, 104–5.

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