While elderberry gummies may be a “new thing”, the use of the elderberry for food and for medicine and health reaches far back into human history! Seeds found in Neolithic dwellings indicate that the elderberry has been cultivated for over 4,000 years and likely has been used for food and medicine for a much longer time. In Anglo-Saxon and Scandinavian folklore, the elderberry tree (more like a really big bush) is known as Hyldemoer or “Elder Mother”. And, if you recall, an elder-wood wand (The Elder Wand) played a huge role in the Harry Potter world of wizarding stories. Hippocrates—the Father of Medicine—called the elder his “medicine chest”.
Elderberry is native to Europe but grows all over the world and is used in food and beverages. There are over 30 different varieties of the elder—most are really big bushes, but many also are trees. Elderberry has Generally Recognized as Safe (GRAS) status in the US. The green, immature berries contain cyanide, however, which can cause serious problems if the unripe berries are eaten.
Elderberries have been used in traditional Native American medicine to reduce fever, treat colds, make poultices for skin infections and skin conditions and to use as a healthy tonic. In European traditional medicine, elderberry was used to treat fevers, infections, sore throats, colds, the flu and to make elderberry wine. In traditional Chinese medicine, elderberry was known as Jie Gu Mu and was used to (surprise!) lower fevers, treat infections such as the cold and the flu, skin conditions, and the pain associated with arthritis.(1) Ayurvedic medicine from India also uses the elderberry to reduce fever, infections and to relieve pain.(2)
Elderberry—the Evidence
So, it is pretty clear that elderberry has been used for centuries to reduce fevers and treat mainly viral infections—what is the current state of evidence for any of these actions?
Elderberry (Sambucus nigra) contains flavonoids, phenolic acids, flavonols, vitamins, minerals, tannins, and fatty acids. Here are some of the amounts and types of nutrients found in elderberries:
- Vitamin A (in the form of beta-carotene)
- Vitamin C
- Calcium
- Iron
- Potassium
- Selenium
- Zinc
- B vitamins, including thiamin, niacin, Vitamin B6,and folic acid
- Polyunsaturated and Monounsaturated fatty acids (omega-3 and omega-6 fatty acids)
- Fiber (1 cup of elderberries contains about 36% of the recommended daily amount of fiber)
The flavonoids and flavonols in elderberries are thought to be responsible for the effects of elderberries. These effects include:
- Anti-inflammatory effects
- Elderberry increases the production of both pro-inflammatory and anti-inflammatory cytokines (small molecules that serve as cellular messengers), but the overall effect of the increased production of cytokines is anti-inflammatory.(3)
- Antioxidant effects
- The polyphenols (e.g. flavonoids and flavonols) are also high in antioxidant activity.(4) These include substances such as quercetin, myricetin, catechins, and kaempferol.
- Quercetin inhibits the release of histamine and has anti-allergy effects in addition to anti-inflammatory effects. It also has antioxidant and anti-viral actions.(5)
- Kaempferol, a flavonoid, is a potent anti-inflammatory substance and is being investigated for the treatment of inflammation-based cardiovascular disease and in hypertrophic scarring.(6)
- The polyphenols (e.g. flavonoids and flavonols) are also high in antioxidant activity.(4) These include substances such as quercetin, myricetin, catechins, and kaempferol.
Oxidative Stress—what is THAT all about?
We all hear a lot about antioxidants but a bit less about oxidative stress, which is the process that causes us to NEED antioxidants in our bodies.
Oxidative stress builds up normally in the mitochondria of the cells—you may remember those as the “powerhouses of the cell”. They are energy-producing organelles found in nearly every cell of the body. As the mitochondria produce energy, they also naturally produce damaging free radicals. These substances are highly reactive and can bind to proteins, other cell organelles, and to DNA. When this happens, the damaged proteins and organelles—and the altered DNA—can cause serious health problems. Natural antioxidants including Vitamins A, C, E, and substances such as glutathione can “soak up” these free radicals and prevent the damage. It is believed that the “modern” diet, the environmentally contaminated world we live in and some other conditions (e.g. obesity) or lifestyle choices we make (e.g. Tobacco use, alcohol use, too little exercise) increases the amounts of the free radicals produced. Antioxidants in foods—or in elderberry extracts—can help “soak up” these excess free radicals and help prevent further damage.
- Anti-viral effects
- These have been studied mainly for cold and flu viruses. Elderberry appears to shorten the length of the cold or flu (both influenza A and B)(7) and appears to block the entry of virus particles into cells.(8, 9)
- In the complete German Commission E monographs, elderberry is accepted as useful in fighting both a cold and both Influenza A and B.
- Immunomodulating effects
- Elderberry extracts can modulate the immune system, boosting its activity.(10) In lab studies, elderberry extracts increased cytokine production. Early in an infection, studies indicate that elderberry shifts cytokine production toward pro-inflammatory cytokines. This is beneficial in the early stages of infection because the inflammatory process can then destroy the virus. However, elderberry also increases the production of anti-inflammatory cytokines, potentially modulating the immune system by essentially re-balancing these two types of cytokines as it regulates their production, though this is not yet well-understood.(11)
- Systemic effects
- The use of elderberry appears to have systemic benefits beyond those mentioned.
- Elderberry extract can boost the immune system in diabetic rats, improving their blood glucose levels and reducing the risk of infections.(12) While one should always be cautious making judgments based on experimental models in rats, other studies indicate that the polyphenols—as found in elderberry extracts—can be effective in helping to control diabetes in humans.(13)
- A systematic review of phenolic compounds as found in elderberry extracts found that flavonoids and flavonols are effective in reducing cardiovascular risk factors, likely by their antioxidant and anti-inflammatory actions.(14)
- Other studies have shown that the components found in elderberry extract can also:(15)
- Improve and normalize blood pressure
- Enhance NO (nitric oxide) production, improving the dilation of blood vessels and improving blood flow
- Reduce oxidative stress
- The use of elderberry appears to have systemic benefits beyond those mentioned.
- Anti-viral effects
Elderberry extract may improve exercise performance by lowering oxidative stress, improve cardiovascular function, and improve muscle function.(16)
Takeaways
Elderberry extract—used to make Elderberry gummies—is rich in nutrients, including vitamins and minerals. It is also rich in plant substances that have a beneficial effect on individual cells, organs, and body systems, like the cardiovascular and immune systems.
Elderberry acts as an antioxidant, anti-inflammatory, and an anti-viral agent and can provide benefits for heart health, help regulate glucose levels, boost your immune system, and improve exercise performance and muscle function.
Are there any adverse effects? No, not in general—any adverse effects appear to be related to eating (many) handfuls of the un-ripened berry and include nausea and diarrhea. Because elderberry is an immune booster, talk to your healthcare professional first if you are on any kind of immune therapies. There is some evidence that people on immunosuppressant therapy may experience adverse effects while ingesting elderberry-containing foods, beverages, or supplements. Anyone with an autoimmune disease should also consult with their healthcare professional when using elderberry supplements because, in theory, elderberry—as an immune booster—may worsen autoimmune diseases.
Not so bad for a teeny berry! And in a gummy form, so easy on your flavor-sensitive taste buds!
Resources:
- https://www.whiterabbitinstituteofhealing.com/herbs/elderberry/ (Accessed 2/2022)
- https://www.indianmirror.com/ayurveda/elderberries.html (Accessed 2/2022)
- Barak V, Birkenfeld S, Halperin T, Kalickman I. The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. The Israel Medical Association journal: IMAJ. 2002 Nov 1;4(11 Suppl):919-22.
- Pandey KB, Rizvi SI. Plant polyphenols as dietary antioxidants in human health and disease. Oxid Med Cell Longev. 2009 Nov-Dec;2(5):270-8. doi: 10.4161/oxim.2.5.9498. PMID: 20716914; PMCID: PMC2835915.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835915/ - Sidor A, Gramza-Michałowska A. Advanced research on the antioxidant and health benefit of elderberry (Sambucus nigra) in food–a review. Journal of functional foods. 2015 Oct 1;18:941-58. https://www.sciencedirect.com/science/article/pii/S1756464614002400
- Ren, J., Lu, Y., Qian, Y., Chen, B., Wu, T., Ji, G.”Recent progress regarding kaempferol for the treatment of various diseases (Review)”. Experimental and Therapeutic Medicine 18.4 (2019): 2759-2776.
https://www.spandidos-publications.com/10.3892/etm.2019.7886 - Wieland, L.S., Piechotta, V., Feinberg, T. et al. Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complement Med Ther 21, 112 (2021). https://doi.org/10.1186/s12906-021-03283-5 https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-021-03283-5#citeas
- Roschek B, Fink RC, McMichael MD, et al. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry 2009;70:1255-61.
http://www.ncbi.nlm.nih.gov.proxy.heal-wa.org/pubmed/22779219?dopt=Abstract - Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M. 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. The Journal of Alternative and Complementary Medicine. 1995 Dec 1;1(4):361-9.
- Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res 2004;32:132-40.
http://www.ncbi.nlm.nih.gov.proxy.heal-wa.org/pubmed/15080016?dopt=Abstract - European Medicines Agency, Assessment Report on Sambucus nigra L. fructus. EMA/HMPC/44208/2012.
https://www.ema.europa.eu/en/documents/herbal-report/draft-assessment-report-sambucus-nigra-l-fructus_en.pdf - Badescu, M., Badulescu, O., Badescu, L., Ciocoiu, M. ( Effects of Sambucus nigra and Aronia melanocarpa extracts on immune system disorders within diabetes mellitus. Pharmaceutical Biology, 53, 533 539. https://doi.org/10.3109/13880209.2014.931441 https://www.tandfonline.com/doi/full/10.3109/13880209.2014.931441
- Guo H, Xia M. Anthocyanins and diabetes regulation. InPolyphenols: Mechanisms of Action in Human Health and Disease 2018 Jan 1 (pp. 135-145). Academic Press. https://www.sciencedirect.com/science/article/pii/B978012813006300012X
- Rangel-Huerta OD, Pastor-Villaescusa B, Aguilera CM, Gil A. A systematic review of the efficacy of bioactive compounds in cardiovascular disease: phenolic compounds. Nutrients. 2015 Jul;7(7):5177-216.
https://www.mdpi.com/2072-6643/7/7/5177 - Jennings, A.; Welch, A.A.; Fairweather-Tait, S.J.; Kay, C.; Minihane, A.M.; Chowienczyk, P.; Jiang, B.; Cecelja, M.; Spector, T.; Macgregor, A.; et al. Higher anthocyanin intake is associated with lower arterial stiffness and central blood pressure in women. Am. J. Clin. Nutr. 2012, 96, 781–788. https://www.ncbi.nlm.nih.gov/pubmed/22914551
- Kashi DS, Shabir A, Da Boit M, Bailey SJ, Higgins MF. The Efficacy of Administering Fruit-Derived Polyphenols to Improve Health Biomarkers, Exercise Performance and Related Physiological Responses. Nutrients. 2019; 11(10):2389. https://doi.org/10.3390/nu11102389 https://www.mdpi.com/2072-6643/11/10/2389/htm