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6 Benefits and Side Effects of Elderberry (Sambucus) (5 Contraindications To Be Noted) [Updated Feb/2023]

Sambucus (Elderberry) is a deciduous shrub belonging to the honeysuckle family, and the fruit is rich in a variety of anthocyanins, flavonoids (such as quercetin, rutin) and polyphenols

There are many varieties of elderberry, with Sambucus nigra L. being the most common, including leaves, bark, flowers and berries that can be used for medicinal purposes, among which elderberry fruit is most commonly used as a research target. Note 9

In 400 BC, the famous Greek physician and father of medicine: Hippocrates gave elderberry the name of a natural medicine box, which means the greatest healing plant in nature.

Before the invention of antibiotics, elderberry was one of the mainstream ingredients in the prescription of medical personnel at that time, and today it is made into health food (juice and lozenge), which is considered to have potential effects on colds, flu and viral infections, but there is still not much evidence in humans.

What are the proven benefits of elderberry (sambucus)?

  1. Elderberry is beneficial for upper respiratory symptoms (cold and flu)

Upper respiratory tract infections can be defined as self-limited irritation and swelling of the upper respiratory tract (nose, sinuses, pharynx, larynx, and airways), with the common cold and flu being the most common.

The main symptoms are cough, sore throat, runny nose, malaise, nasal congestion, headache, fever, and viral infections with the most common causative agents, such as rhinovirus, influenza virus, adenovirus, enterovirus, and respiratory syncytial virus.

In addition to influenza, there are relatively few complications of upper respiratory tract infection, and complications of influenza infection include primary influenza viral pneumonia, secondary bacterial pneumonia, sinusitis, otitis media, myocarditis, etc

A meta-analysis (4 randomized controlled trials of 180 patients with upper respiratory tract infection) suggested that supplementation with elderberry extract significantly reduced the duration of upper respiratory tract symptoms. Note 1

In addition, moderator analysis found that influenza vaccination status did not change the effect of elderberry supplementation, and that the magnitude of improvement (duration and severity of symptoms) was most pronounced with influenza (compared to the common cold).

*Conclusion: Supplementation with standardized elderberry extract in the presence of upper respiratory tract symptoms can help reduce symptom duration and severity, but limited by small sample sizes, more studies are needed to support this

  1. Elderberry benefits knee osteoarthritis

Osteoarthritis, also known as degenerative joint disease, primary osteoarthritis, abrasive arthritis or age-related arthritis, is the leading cause of disability worldwide.

A variety of factors, including family history, age, obesity, diabetes, synovitis, systemic inflammatory mediators, innate immunity, lower extremity alignment (knee valgus or varus), joint dysplasia, trauma, metabolic syndrome, and inflammation are all associated with the formation of knee osteoarthritis.

A randomized, double-blind, active-controlled trial (4-week, 79 patients with knee osteoarthritis) noted that topical elderberry gel (Sambucus ebulus L., extracted from leaves) had better symptom improvement (WOMAC pain score, total WOMAC score, and VAS score for) than diclofenac (diclofenac). Pain measured). Note 1

*Conclusion: Topical elderberry extract gel may be helpful for knee osteoarthritis, but limited by the small sample size, more studies are needed for further verification

  1. Elderberry is beneficial for paederus dermatitis

Paederus dermatitis is an acute irritant contact dermatitis caused by cryptopterin released when the cryptoptera is crushed on the skin.

Patients usually present with sudden burning sensation and skin pain accompanied by erythema, pustules, and vesicles, and pigmentation is a common sequelae that may last up to a month, and extensive ulceration may occur.

This vesicular dermatitis can be confused with viral and bacterial skin conditions such as bullous pustules, herpes simplex, and herpes zoster.

A randomized, double-blind, prospective, placebo-controlled trial (62 patients with cryptopteroperis dermatitis) used topical palemolin (5% elderberry alcohol soak) and hydrocortisone ointment in group A, and 70% ethanol topical solution and hydrocortisone ointment in group B. Note 1

The results showed that group A was more effective in controlling burning, pain, inflammation, dry wounds, infection and accelerated healing, and 93.9% of group A patients completely eliminated lesion-related problems within 48 hours after treatment (65.4% in group B).

*Conclusion: Elderberry extract soak solution may be of positive help in the treatment of Cryptopterus dermatitis, but limited by the small sample size, more studies are still needed for further verification

  1. Elderberry is good for cardiovascular disease

Cardiovascular diseases are currently the biggest threat to human health, but fortunately, there are 9 potentially modifiable risk factors, including lipids, smoking, diabetes, high blood pressure, abdominal obesity, psychological factors, fruit/vegetable intake, exercise and alcohol consumption. Note 4

By 2020, cardiovascular disease will overtake infectious diseases as the leading cause of the global burden of disease, accounting for about 56% of overall morbidity and 73% of total mortality.

A double-blind controlled study (12 weeks, 52 postmenopausal women) found that although elderberry fruit extract was safe, its cardiovascular protection effect was limited, and there were no significant changes in associated risk markers such as inflammation index, vasoreactivity, and lipids. Note 3

  1. Elderberry is good for osteoporosis (caused by diabetes)

Osteoporosis is the most common metabolic disease of the bone, characterized by decreased bone density and increased porosity, leading to fractures, usually caused by postmenopausal estrogen deficiency and age-related bone loss. In addition, diabetes is a common predisposing factor.

Clinically, about 1/2 to 2/3 of diabetic patients have decreased bone strength, and 1/3 are diagnosed with osteoporosis. Note 6

An animal study pointed out that (in mice injected with streptozomycin/streptozotocin-induced diabetes), elderberry extract may have the effect of slowing bone loss and improving osteoporosis, but it needs to be further confirmed due to the lack of relevant human studies. Note 5

  1. Elderberry is good for cholesterol management

Cholesterol is a waxy steroid molecule that has the effect of maintaining cell membrane fluidity and insulation, and is indispensable for maintaining normal cell function.

In addition, cholesterol is also a precursor to hormones, which can produce sex hormones, mineral corticosteroids (to maintain water and electrolyte balance), glucocorticoids (to control protein and carbohydrate metabolism, immunosuppression and inflammation), and are indispensable for maintaining normal metabolic function. Note 8

A double-blind controlled study (2-week study of 34 healthy subjects) showed that low-dose elderberry extract had a slight lipid-lowering (cholesterol) effect after meals compared with placebo. Note 7


Are there any side effects of elderberry?

Commercially qualified elderberry extract is safe for short-term use at the recommended dosage and no significant side effects have been noted.

Unripe, uncooked fruits or other parts (flowers, rhizomes and leaves) contain lectins (cyanide) or cyanogenic glycosides, and excessive ingestion may cause adverse reactions such as nausea, stomach pain, numbness, impaired consciousness, weakness, vomiting or severe diarrhea.

Safety precautions

  1. Do not use for pregnant women, breastfeeding mothers, and children (because the relevant safety is unknown)
  1. Do not use if the liver and kidney function is poor (because the relevant safety is unknown)
  1. Some people are allergic to elderberry. If you experience allergies (such as runny nose, itchy or red eyes, difficulty breathing) after eating, please stop using it immediately and seek medical attention
  1. Patients with autoimmune diseases (rheumatoid arthritis, lupus erythematosus, multiple sclerosis) or patients who have received organ transplantation should not take it (because it may stimulate the immune system)
  2. Do not use in combination with diuretics, diabetes drugs, chemotherapy drugs, laxatives and immunosuppressive drugs, which may interfere with the action of drugs and cause unknown risks
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