Elderberry: benefits, dosage, contraindications
Scientific name(s)
Sambucus nigra
Family or group:
Plants
Active ingredients:
Anthocyanins
Vitamin A
Vitamin C
Quercetin
Rutin
Vitamin B1
Indications
Scoring methodology
EFSA approval.
Respiratory infections ✪✪✪✪✪
The flowers, when used internally (infusion), have traditionally been used as diaphoretics. Astringent, expectorant, and decongestant, they clear the respiratory passages (throat, nose, ears) with a beneficial effect on bronchitis and sinusitis. They soothe minor inflammations and irritations of the eyes. They are particularly known to stimulate immune defenses, prevent viral infections, fight fever, as well as treat cold symptoms, and relieve cough and asthma. nnA tea of elderflowers used as a gargle can also soothe sore throats. They can also treat catarrh (acute or chronic inflammation of the mucous membranes with hypersecretion).nnThe berries, in syrup form, rich in vitamins, are useful in the treatment of bronchial inflammation and pulmonary conditions. nnAccording to the EMA, elderflower is a traditional herbal medicinal product used for the relief of the early symptoms of the common cold.nn
Posologie
Orally: 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.
Influenza ✪✪✪✪✪
Clinical research shows that certain elderberry extracts may reduce flu symptoms. Significant symptom relief appears to occur within 2 to 4 days after treatment for most patients. On average, this elderberry extract appears to reduce symptom duration by about 56%. The infusion of the flowers or the berry extract may therefore reduce the severity and duration of the infection when taken 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 influenza-related respiratory complications, similar to oseltamivir 75 mg twice daily for 5 days in adults and children. It should be noted that there was no placebo group. Other double-blind, placebo-controlled trials conducted during influenza A and B epidemics have shown that taking elderberry extract provides rapid relief of flu symptoms. Indeed, a significant improvement in symptoms was achieved in 2 days in 93.3% of subjects treated with the elderberry extract, whereas it took 6 days for 91.7% of the people in the placebo group to show a similar improvement. The progression of symptoms such as pain, fever, cough, mucus discharge and nasal congestion was evaluated by patients on a scale from 0 to 10 (10 indicating the greatest improvement). Participants in the group that received the elderberry extract gave an average score of 9 compared with 1 for individuals in the placebo group.
Posologie
Orally: 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, used externally on the skin, elderflowers have a soothing effect. They are anti-inflammatory and treat dermatological conditions (chilblains, irritations, eczema, hives).
Posologie
For topical use: 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 concentrated bud macerate of elder is recommended in cases of constipation, providing a mild laxative action. Elder has been traditionally used in medicine as a purifying plant that promotes bowel transit and stimulates gastric emptying. Indeed, elder may provide a significant source of fiber, thereby contributing to optimal intestinal function. The laxative property of elder is attributed to a substance called anthraquinone, a derivative of anthracene (a family of polycyclic aromatic hydrocarbons). It is generally accepted that the effects of elder are mild and safe for the treatment of uncomplicated occasional constipation. The efficacy of a combination containing elder flowers, anise, fennel, and senna was evaluated in 20 subjects suffering from chronic constipation. This randomized, placebo-controlled study revealed that the active herbal treatment produced a laxative effect and constituted a safe therapeutic option for the treatment of constipation. The herbal tea contained: 2.0 g of fruit of Pimpinella anisum (green anise), 2.0 g of fruit of Foeniculum vulgare (fennel), 5.0 g of flower of Sambucus nigra (elder), and 6.0 g of flower of Cassia augustifolia (senna) per 15 g of mixture.
Posologie
Oral use: buds, flowers
5 g
Adults
Glycerinated macerate
Synergies
Properties
Antiviral
Elderflowers, when used internally, play a positive role in preventing various viral infections (HIV, hepatitis, influenza, etc.). In vitro, an elderberry extract inhibits the H1N1 virus in a dose-dependent manner. It is thought that elderberry flavonoids bind to H1N1 virions and prevent the virus from entering host cells. Similarly, an elderberry extract exposed to different strains of the herpes virus (HSV-) was able to completely inhibit viral replication.
Usages associés
Diuretic
Rich in water (79%), the elderberry is an excellent diuretic, capable of increasing the frequency of urination. Elderflower extract also increases sodium excretion. However, it is important to note that elderberry does not alter urine pH, which means it does not influence the dissolution of ions that could contribute to the formation of kidney stones. The elder bud may facilitate drainage for the renal elimination of water and toxins, hence its detoxifying action.
Usages associés
Anti-inflammatory
Studies have validated the anti-inflammatory effects of ethanolic extracts of elderberry berries, focused on phenolic compounds such as quercetin. These studies demonstrate quercetin's ability to effectively inhibit reactive oxygen species and to reduce nitric oxide production in LPS-activated murine microglial cells, key mechanisms in the brain's inflammatory response. Specific animal model research has also shown that elderberry 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 such as diabetes.
Usages associés
Immune stimulant
Overall, elderberry has been found to exert an immunostimulant action. It increases the immune system's defenses when attacked by an influenza virus. Indeed, elderflowers, when taken internally, have a beneficial effect in preventing 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 rats with induced diabetes, administration of an elderberry extract reduces atherogenic risk by decreasing lipid peroxidation, neutralizing free radicals and inhibiting LDL cholesterol oxidation, notably by maintaining the pool of antioxidant enzymes such as glutathione peroxidase and superoxide dismutase. The elderberry extract also protects hemoglobin against glycation.nn
Usages associés
Immunomodulatory
In rats with induced diabetes, administration of an elderberry extract, in combination with aronia, decreases the expression of pro-inflammatory cytokines (TNF-α and IFN-γ).nn
Antibacterial
In vitro, it has been shown that extracts of elderberry berries or flowers exhibit inhibitory (bacteriostatic) effects on at least 13 pathogenic bacterial strains responsible for nosocomial infections (i.e., Staphylococcus sp., Bacillus cereus, Salmonella poona, Staphylococcus aureus, Pseudomonas aeruginosa).nn
Usages associés
Depurative
In traditional medicine, the flowers stimulate elimination and thin secretions, supporting kidney function, promoting the elimination of toxins by sweating, and preventing kidney stones.nn
Usages associés
Safe dosage
Adults aged 12 years and older: 2 g - 5 g (herbal tea)
- Infusion: 2 to 5 g of crushed flower in 150 ml of boiling water, prepared as an infusion and taken three times daily. Infusion: 3–6 g of crushed herb substance in 200 ml of water as a decoction, divided into 2 single doses per day. - Liquid extract (DER 1:1), 25% ethanol extraction: 2–5 ml three times a day - Tincture (1:5): 25% ethanol: 10–25 ml three times a day
Adult from 18 years: 500 mg - 1500 mg (powder)
Berries are taken as a syrup (15 ml, 3 to 4 times per 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 immunostimulatory activity. Elderberry stimulates the production of cytokines, including interleukin and tumor necrosis factor. Immunosuppressive drugs include azathioprine, basiliximab, daclizumab, muromonab-CD3, mycophenolate, tacrolimus, sirolimus, prednisone, and other corticosteroids.
Precautions
Pregnant women: avoid
Avoid due to lack of information.
Breastfeeding: avoid
Avoid due to lack of information.
Autoimmune diseases: avoid
Elder may have immunostimulant effects. Elder appears to stimulate the production of cytokines, including interleukin and tumor necrosis factor. Theoretically, elder could exacerbate autoimmune diseases by stimulating disease activity. Autoimmune diseases include multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis.
Contraindications
Children up to 12 years: prohibited
The cooked elder 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 prohibited from eating raw berries. Cooking above 65°C destroys the toxin.
