Got Elderberry?

I decided to kick off my misinformation post with an easier topic – I wasn’t about to take on vaccines right away, any of them. So I was thinking I should talk about essential oils. However, I’ve seen SO much online recently regarding elderberry and with COVID-19 and flu season going on, I figured this apparent immune booster was a good topic to cover. I have seen it mentioned on every social media platform I use – often in mom groups (probably because moms are often most concerned about their littles – fair enough!), but also just everywhere in general.

What is it?

Other than being the berry made infamous by Monty Python, elderberry is, per the Oxford Dictionary, “the bluish-black or red berry of the elder, used especially for making jelly or wine”. In the health world, the black elderberry (also known as Sambucus nigra) is the “cure-all” for colds and flus, and an apparent immune system “booster”. It has actually been used for a REALLY long time – potentially since the first people, long time. There are several types of elderberry, but the European elderberry seems to be the most relevant in regards to use in medicine historically, and also the most researched if you search them on a database like PubMed.

What does it do?

It depends who you ask and where you look! That’s the fun thing about finding health information of any type on the internet. I’ve mostly seen it, as I mentioned, recommended for cold and flu symptoms (kind of like Echinacea syrup, if I’m not mistaken?).

There is no doubt that elderberry has many good components to it. There is a lot of research on the composition of elderberry, and a systematic review (a summary of many studies on the same subject) by Vlachojannis, Cameron, and Chrubasik (2010) showed that anthocyanins are present, which do have anti-viral properties – meaning they have the potential to work against viruses. This tidbit of information + folklore is likely what supports its use today for symptoms of cold or flu, however there is very minimal research on the effects of elderberry for these indications.

I did find one meta-analysis (which is a study that looks at other independent studies in this case, on elderberry as a treatment for cold/flu symptoms) by Hawkins, Baker, Cherry, and Dunne (2019) (very recent – 1 point!) that examines elderberry’s use for the treatment of symptoms of upper respiratory infections. It found that using elderberry when symptoms arise has a substantial effect in decreasing total duration of symptoms (Hawkins et al., 2019).

Keep in mind however that this meta-analysis had a small sample size of only 180 patients over all the studies it looked at – this means the results are not very trustworthy (-1 point for them). I would therefore take this with a grain of salt for now, and hope that more research is done on the subject.

CONCLUSION: It certainly contains anthocyanins which have anti-viral properties, but whether it actually reduces symptoms of cold or flu is up in the air.

Is it safe?

Alongside the vitamins and anthocyanins that elderberries possess, they actually also have a component in them which becomes hydrogen cyanide when you digest it (–> see CDC link for more info). Per the CDC, you likely do not want to be eating uncooked elderberry products (particularly the root) as a result, because they can result in poisoning. The CDC mentions that no other poisoning events have been recorded recently in he literature on their site, however other recent sources do mention poisoning as a risk per the meta-analysis by Hawkin et al., (2019). The berries themselves seem to be lower risk than the root, but cooking them just in case seems to be a safe move unless you enjoy having an upset stomach (again, this is per CDC recommendation and supported by studies including the meta-analysis I’ve cited). Realistically, if you’re reading this I would guess that you buy your elderberry products not pick the berries yourself (but honestly, you never know on the internet!).

I googled “elderberry recipe” just to see what came up, because I bet some people DO make their own products – the first link from “Wellness Mama” does recommend, if you’re making juice, to bring the berries to a boil first, but this recipes was “medically reviewed” by an MD apparently. I can’t guarantee that this is the case with all websites with recipes – it probably isn’t. I’d say to be safe just buy it if you want to use it – but there is not the same regulations/testing/etc. on over the counter (OTC) herbal products and supplements in the USA as there are for prescriptions drugs… so exercise cautions in all situations!

If you feel sick, it may be better to do what your healthcare provider usually recommends:

  1. Stay home (if you’re able – I know that based on recent discussions on Twitter & current Canadian political discussions this is a pipe dream for many, sadly)
  2. Rest (if you can – again, I know this is not always an option but try your best)
  3. Drink lots of fluids – this most people should be able to conquer.
  4. If you’re ~into~ cold medicine (if you think cold medicine is the DEVIL, please skip this part or maybe skip this blog because I am 100% for the use of cold medicine when you are suffering), that can be helpful but make sure that you discuss with your doctor or pharmacist what is best to take, especially if you are pregnant, breastfeeding, have any comorbidity or are taking any other medication (OR UNREGULATED HERBAL SUPPLEMENT/HERB – please always mention these to your provider and/or pharmacist!). Actually – just ask them if you have any doubts anyway too! Pharmacists are EXPERTS in drugs – if you are worried or have questions, ask them! I feel like sometimes they are underused for this purpose but they shouldn’t be!
  5. AS ALWAYS – contact your HCP if you are concerned about your symptoms or have ANY questions about when you may need to take a next step!

Conclusion: ????

  • Elderberry information you see floating around is likely based on folklore and *some* research, which seems to be mostly focused on the composition of the berry and the components potential benefits
  • I wouldn’t trust anyone telling you to pick and eat raw elderberries, and based on what I’ve read I wouldn’t really recommend making your own products unless you are taking the necessary precautions to avoid any GI symptoms/poisoning
  • The jury is OUT right now on whether it actually decreases cold and flu symptoms – too few patients to make a generalizable statement across multiple studies, and I didn’t look into all the studies the meta-analysis examined to see how independently trustworthy they were – but people likely have heard it from a friend of a friend of theirs or it’s a recommendation passed down from their mother’s great-aunt’s second cousin twice removed, or whatever, and that’s why you’re hearing it!
  • IF YOU’RE TAKING OTC OR HERBAL PRODUCTS, INCLUDING ELDERBERRY, check with your provider or pharmacist to make sure the product is SAFE for you/your baby if you are pregnant or breastfeeding and that it doesn’t interact with anything else you’re taking – people often forget or don’t know that these products (vitamins, minerals, herbs and supplements) should be included whenever any HCP asks you about any medication you’re taking!

That’s about it on Elderberry – as always, your health decisions are YOURS to make. I am just here to provide you with some information. Notice how I am not biased against using it? I am just providing you with facts. As always, if I have made any errors or am missing any important information please DM me on twitter and let me know!

FYI about the citations – I am not adhering strictly to APA format because I want to be able to provide a direct link where possible for my readers. Also I know not everyone has access to journal articles and search databases, but I will include them at the end of every post if I am using them, for reference.

References

Hawkins, J., Baker, C., Cherry, L., & Dunne, E. (2019). Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complementary Therapies in Medicine, 42, 361-365.

Vlachojannis, J. E., Cameron, M., & Chrubasik, S. (2010). A systematic review on the sambuci fructus effect and efficacy profiles. Phytotherapy Research, 24(1), 1-8.

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