(Alternative Medicine Review, March 2005)

Drug-Botanical Interactions

There are no confirmed drug interactions with elderberry extract. However, due to the ability of Sambucus flower extracts to potentiate insulin release in vitro, (26) patients with diabetes should be advised to monitor blood sugar closely when using flower extracts.

Side Effects and Toxicity

Elderberry extracts are generally without side effects when taken in the suggested dosages. (12) Berries should be cooked, as the consumption of uncooked berries or juice can result in vomiting and diarrhea. (1)

Certain constituents of the leaves, stems, flowers, and roots contain poisonous alkaloids. (27) It has also been reported that small percentages of the general population have a type-1 allergy to Sambucus nigra as evidenced by positive-skin prick or RAST test. (28)

Dosage

Maintaince:   Elderberry fruit syrups are often standardized to 30-38 percent elderberry. Powdered extracts are dosed at 500 mg (capsule) 2-3 times daily for 3-4 days, or if in liquid form, dosed at one tablespoonful (15 mL) three times daily. In the case of acute viral infections, course of treatment is generally at least three days. (29)

(Flu attack:  Understand that Sambucol is most effective only when the virus is outside the cell.  It prevevents the virus from getting into the cell and reproducing.  This means that Sambucol is most effective in the early stages before the virus penetrates the cells.  This means that we take Sambucol at the very first hint of getting the flu!  If in doubt, we take 4 oz spread through the day.  Usually that is sufficient.  If in doubt, we take more the second day.

   The point is that a few dollars preventative (even if we were wrong and it was only a bad taco) is worth it.  It is much better than a week or more of being sick.  When we, including many friends and family, do this religiously, we have zero flu incidents during the year.  The preventative Sambucol action actually only happens a few times a year.  It is worth it.

Late flu attack:  Think bombing fleas.  When a person has to fleas in their house, it is a repeated event.  The first bomb kills the actives fleas.  It doesn’t kill the eggs that haven’t hatched.  Therefore, you bomb again a few days apart when the eggs hatch, eventually killing them all.  When you have missed getting rid of the virus in the early stages, the flu virus has embedded itself more into the cells.  They can’t be inactivated by Sambucol until they come out to spread into other cells.  However, this happens faster than flea eggs hatching (hours vs days) so taking 8 oz of Sambucol a day for 2-3 days has worked very well to shorten the flu life to half of normal.  Having this happen once helps remind a person to catch it earlier!)

Warnings and Contraindications

Currently there are no reported adverse effects in regard to fetal development, pregnancy, or lactation. However, as elderberry is not a well-researched botanical, health care practitioners should use caution in recommending it to women who are pregnant or nursing.

Cytokines are produced by the immune system when it is under attack from viruses and pathogens. Cytokines signal immune cells to travel to the site of attack or infection. This is a normal body process that is kept under control by a feedback loop.

Sometimes this process can become uncontrolled and too many immune cells are stimulated in a single place. This is often referred to as a cytokine storm.  Cytokine storms can cause significant tissue and organ damage.  There is no evidence in the literature to indicate that elderberry extract causes cytokine storms.

Bird and Swine Flu

   (For most influenza and viral conditions, Sambucol appears to be a natural health benefit.  However, there is one condition in which some caution is warranted.  When the virus is a type that particularly attacks the respiratory system, such as bird and swine flu, the inflammatory result of cytokines are NOT welcome.  In other parts of the body, they serve very welcomed healing purposes.  In the lungs, they cause congestion – a very unwelcome condition!

   While the jury is still out as to how much Sambucol influences cytokines, we do feel that adding anti-inflammatory nutrients would be a wise move.  It would allow use of the very effective Sambucol while keeping inflammation down.  We are not, currently, in the situation of a pandemic situation.  If you are preparing for the possibility, you would want to see Special Concerns with Bird Flu.)