Will Elderberry Prevent Illness?

Background

Elderberry (Sambucas nigra) contains flavonoids, including quercetin and anthocyanidins. It is most often used for influenza, the common cold, and general immune stimulation. It is noted for its cardiovascular, anti-inflammatory, and immune-stimulatory properties.

Buyer Beware

Elderberry tablets, capsules, syrups, and gummies are considered an herbal supplement and are therefore not FDA-approved. The potency and purity of all herbal supplements are unknown.

Four Small Studies with Some Positive Results

In a trial of 64 participants between the ages of 16 and 60 with flu symptoms (fever, headache, muscle aches, cough, mucus discharge, and nasal congestion) given an elderberry extract (ViraBloc®) of 175 mg in the form of a slow-dissolving lozenge given four times each day for two days or a placebo, there were significant differences for four out of six scores at 24 hours and all six at 48 hours.

In a study of 60 participants more than 18 years old with flu symptoms given Sambucol® 15 mL four times daily for five days or a placebo, there was no difference between symptom scores in the treatment and control groups at the onset of treatment. Symptom relief occurred significantly faster in the treatment group, achieved by day 3 or 4 of illness, vs. the control group that didn’t report symptom relief until day 7 or 8. Significantly less rescue-medication was needed in the treatment group.

In another study including 27 participants utilizing Sambucol® at 15 mL twice daily for three days in children or 15 mL four times daily for three days for adults or a placebo, persistence of fever was significantly shorter in the treatment group, and improvement and complete cure took substantially longer in the placebo group.

Keep in mind that in the three studies discussed above, a total of 77 participants received the treatment, which means that no firm conclusions can be made about the effectiveness of treatment. These studies also relied on subjective reports of symptom severity.

In a company-funded trial, 312 adults who took 600 mg of black elderberry each day for nine days before traveling by airplane and then took 900 mg a day for six to seven days during and after travel were no less likely to catch a cold than participants given a placebo. However, among those who got the cold, the placebo group participants have a significantly longer duration of cold episode days and a considerably higher average symptom score.

Warnings

Never consume the leaves, stems, unripe fruit, or uncooked fruit of the elderberry. No one on immunosuppressants should take elderberry products.

In Summary

No large randomized, controlled trials have evaluated the effectiveness of elderberry for the prevention or treatment of influenza or the common cold. In vitro and in small studies, elderberry appears to have some positive effects on various virus strains.

Elderberry for influenzaMed Lett Drugs Ther. 2019;61(1566):32.

Holst L, Havnen GC, Nordeng H. Echinacea and elderberry-should they be used against upper respiratory tract infections during pregnancy? Front Pharmacol. 2014;5:31. Published 2014 Mar 4. doi:10.3389/fphar.2014.00031

Krawitz C, Mraheil MA, Stein M, et al. Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B virusesBMC Complement Altern Med. 2011;11:16. Published 2011 Feb 25. doi:10.1186/1472-6882-11-16

Młynarczyk K, Walkowiak-Tomczak D, Łysiak GP. Bioactive properties of Sambucus nigra L. as a functional ingredient for food and pharmaceutical industryJ Funct Foods. 2018;40:377-390. doi:10.1016/j.jff.2017.11.025

Simonyi A, Chen Z, Jiang J, et al. Inhibition of microglial activation by elderberry extracts and its phenolic componentsLife Sci. 2015;128:30-38. doi:10.1016/j.lfs.2015.01.037

Tiralongo E, Wee SS, Lea RA. Elderberry supplementation reduces cold duration and symptoms in air-travellers: A randomized, double-blind placebo-controlled clinical trialNutrients. 2016;8(4):182. Published 2016 Mar 24. doi:10.3390/nu8040182

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