Elderberry and The Immune System 

With cold and flu season fast approaching, there are many natural remedies to  select from to foster a healthy immune response. 

One of these natural  remedies, that also happens  to taste great, is Elderberry  (Sambucus sp.). The plant  has dark purple berries with  white flowers and is native  to Europe but has been  naturalized to North  America.   

It is important to note that  while the berries are rich in  antioxidants, the roots and  leaves of the plant are  potentially toxic.   

The berries and flowers of the plant are rich in anthocyanins, iron, vitamin Avitamin C,  and pectin. As a result of their diverse nutrient content, elderberry fruit can attack  influenza viruses from multiple different pathways.   

Anthocyanins belong to the flavonoid group of phytochemicals; commonly found in  teas, wine, fruits, vegetables, nuts, olive oil, and cocoa. They add vibrant colors of  red, blue, and purple to these foods as well as a potent antioxidant capacity.    

A high consumption of anthocyanins from food (eg. currants, raspberries,  blueberries, red grapes, red cabbage, plums) may help to lower oxidative stress in  people who have a high risk of cardiovascular disease. Intakes of 19-100mg daily of  anthocyanins from food have been reported to reduce the levels of biomarkers  associated with cardiovascular disease risk (CHD, hyperlipidemia) (5,6).    

Recent research into the human effects of anthocyanins has revealed their ability to  strengthen blood vessels, balance the immune system, and combat inflammation  (2,3).   

The flowers and berries of the plant also have a diaphoretic action; helping the  immune system to mount an optimal fever response to efficiently kill pathogens that  are susceptible to the heat. At a microscopic level, elderberry promotes a healthy  immune response against viruses by increasing the number of inflammatory  molecules called cytokines (7).   

Cytokines can cause local and systemic inflammation; encouraging immune cells to  the area to help clear infection.   

A recent study used elderberry to prevent the onset of influenza during air travel.  The study looked at 600-900 mg of elderberry extract containing 90-135mg of  anthocyanins. Study participants took 2 capsules per day for 10 days before air  travel.   

Two to four days before departure, the dosage was increased to 3 capsules per day,  until 4 days after arrival at their destination (1).    

Of the 312 participants taking the elderberry extract, 29 developed a cold. The  group taking the placebo treatment had greater symptom severity and over twice  the duration of illness compared to the elderberry group.

Furthermore, the combination of elderberry and antibiotics/decongestants may be  an effective synergy to treat bacterial sinusitis (4). 

To top off all the various functions of the fruit, it seems that the strongest effect of  elderberry extract is in the post-infection period. This means that elderberry helps to  recover immune function once an infection from the flu has been cleared (8).   

Elderberry use may have favourable effects on glucose metabolism, insulin  secretion, cholesterol, blood lipids, and blood pressure (4).   

There are known interactions between elderberry and medications (eg.  chemotherapeutics) so it is always a good idea to speak with a medical professional  before using the flowers or berries.     

References:   
1. Tiralongo E, Wee SS, Lea RA. Elderberry supplementation reduces cold duration and symptoms in  air-travelers: a randomized, double-blind placebo-controlled clinical trial. Nutrients. 2016;8(4):182.

2. Lila, Mary Ann. “Anthocyanins and Human Health: An In Vitro Investigative Approach.” Journal of  Biomedicine and Biotechnology 2004.5 (2004): 306–313. PMC. Web. 2 Nov. 2017. 

3. Youdim K, Martin A, Joseph J. Incorporation of the elderberry anthocyanins by endothelial cells increases  protection against oxidative stress. Free Radic Biol Med. 2000;29(1):51–60. 

4. Ulbricht, Catherine & Basch, Ethan & Cheung, Lisa & Goldberg, Harley & Hammerness, Paul & Isaac,  Richard & Purkh Singh Khalsa, Karta & Romm, Aviva & Mills, Edward & Rychlik, Idalia & Varghese,  Minney & Weissner, Wendy & C Windsor, Regina & Wortley, Jayme. (2014). An Evidence-Based  Systematic Review of Elderberry and Elderflower ( Sambucus nigra ) by the Natural Standard Research  Collaboration. Journal of dietary supplements. 11. 10.3109/19390211.2013.859852. 

5. Peter J. Curtis, Paul A. Kroon, Wendy J. Hollands, Rebecca Walls, Gail Jenkins, Colin D. Kay, Aedín  Cassidy, Cardiovascular Disease Risk Biomarkers and Liver and Kidney Function Are Not Altered in  Postmenopausal Women after Ingesting an Elderberry Extract Rich in Anthocyanins for 12 Weeks, The  Journal of Nutrition, Volume 139, Issue 12, December 2009, Pages 2266–2271,  https://doi.org/10.3945/jn.109.113126 

6. Kelley DS, Rasooly R, Jacob RA, Kader AA, Mackey BE Consumption of Bing sweet cherries lowers  circulating concentrations of inflammation markers in healthy men and women. J Nutr.  2006;136:981–6. 

7. Barak V., et al. The effect of Sambucol, a black elderberry-based, natural product, on the production of  human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw. 2001;12(2):290-6.

8. Torabian G., et al. Anti-influenza activity of elderberry (sambucus nigra). Journal of functional foods  2019; 54: 353-360.