Introduction:

Elderberry, or elder, has been used for centuries to treat wounds (when applied to the skin) and for respiratory illnesses (when taken internally). In many countries (including Germany), elder flower is used to treat colds and flu. Some evidence suggests that chemicals in elder flower and berries may help reduce swelling in mucous membranes (such as the sinuses) and decrease nasal congestion. Elder may have anti-inflammatory, antiviral and anticancer properties.

Elderberry also contains flavonoids, which have antioxidant properties and may help prevent damage to the body’s cells. However, very few studies have been done in humans, so the effectiveness of elder is not known.

There are several species of elder, but Sambucus nigra, or European elder (also called black elder), is the used most often for medicinal purposes. Avoid dwarf elder (Sambucus ebulus), which can be toxic. It is important to use a trusted preparation of elder because raw or unripe fruit -- as well as the leaves, seeds, and bark -- of the plant contain a chemical related to cyanide, which is poisonous.

Alternative Names:

Elder

Plant Description:

European elder is a large shrub or small tree that grows up to 30 feet tall in wet or dry soil in a sunny location. It is native to Europe, Africa, and parts of Asia, but has become naturalized in the United States. Deciduous leaves grow in opposite pairs and have five to seven leaflets. Flowers are white and flat-topped with five primary rays. Berries are green, turning red and then black when ripe.

Parts Used:

The berries and flowers are used medicinally. Berries must be cooked before they are consumed. Raw berries contain a chemical similar to cyanide.

Medicinal Uses and Indications:

Colds and Flu

By lessening congestion and possibly increasing perspiration, elder may help reduce the symptoms of colds and flu. One study suggested that using a standardized elderberry extract, Sambucol, could shorten the duration of flu by about 3 days. Sambucol also contains other herbs plus vitamin C, so it isn’t known whether elder by itself would have the same effect.

Bacterial Sinusitis (Sinus Infection)

One study examined the use of a proprietary product, Sinupret, to treat bacterial sinusitis along with an antibiotic (doxycycline or Vibramycin) and a decongestant. People who received the combination had significant improvement compared to those who did not take Sinupret. However, Sinupret contains other herbs in addition to elder, so it’s not possible to say whether taking elder alone would have the same effect.

Available Forms:

Elder is available as a liquid, syrup, tincture, capsules, and lozenges. Dried elder flower is usually standardized to at least 0.8% flavonoids. Sambucol is standardized to 38% elderberry extract for adults and 19% for children. Sinupret contains 18 mg of elder flower.

How to Take It:

Pediatric

Do not give elder or any product containing elder to a child without first talking to your pediatrician.

Adult

• Sinupret: 2 tablets taken three times a day for bacterial sinusitis
• Sambucol: 4 tbsp. a day for three days for colds and flu
• Tea: Steep 3 - 5 g dried elder flower in 1 cup boiling water for 10 - 15 minutes. Strain and drink three times per day.

Precautions:

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider.

Do not use unripe or uncooked elderberries. They may be poisonous.

Elder appears to have few side effects when used properly for short periods of time (up to 5 days).

Pregnant and breast-feeding women should not take elder.

Possible Interactions:

If you are being treated with any of the following medications, you should not use elder without first talking to your health care provider:

Diuretics (Water Pills) -- Diuretics help rid the body of excess fluid and increase the amount of urine the body produces. Elder may have diuretic properties, so taking elder at the same time as a diuretic could increase the effect of the drug and raise your risk of dehydration. Diuretics include:

• Hydrochlorothiazide
• Bumetanide (Burinex)
• Furosemide (Lasix)
• Amiloride (Midamor)
• Metolazone (Zaroxolyn)

Diabetes Medications -- Elder may lower blood sugar levels. If you are also taking drugs for diabetes, taking elder may increase your risk of developing hypoglycemia (low blood sugar).

Chemotherapy -- Elder may interact with some chemotherapy drugs. Do not take elder or any herb or supplement while undergoing chemotherapy without first talking to your oncologist.

Laxatives -- Elder may have laxative properties and should not be taken at the same time as other laxatives.

Theophylline (TheoDur) -- Elder may reduce levels of theophylline, a drug taken for asthma and other respiratory conditions.