Health Benefits Of Elderberry

Article by Stefan Burns - Updated September 2022. Join the Wild Free Organic email newsletter!

Elderberries are known for their many health effects, most notably for their ability to fight the cold and flu, and they have been used medicinally for thousands of years. Elderberries are harvested from Sambucus, a flowering plant found throughout the world in temperate and subtropical regions that can form large shrubs or small trees. Uncooked elderberries and all other parts of the plant are poisonous, but when the berries are cooked the cyanides are nullified. Elderberries contain notable amounts of vitamin C, vitamin B6 and iron.

Elderberries have many health effects because of their rich concentration of anthocyanins (1). Elderberry syrups, powders, and extracts have powerful effects on the gut, help reduce the length and severity of colds and the flu, and might have muscle building and fat burning effects by improving nutrient partitioning.

Elderberry for Cold, Flu, and Covid Viruses

The common cold is causes by the rhinovirus, the flu is caused by the influenza virus, and SARS-CoV-2 is caused by a coronavirus. Common symptoms of all these virus include fatigue, aches and pains, temperature increases, upper respiratory issues, and digestive issues such as diarrhea and vomiting. The common cold is the least severe of the three, with influenza and coronaviruses being worse, potentially life threatening.

Whereas pathogenic bacteria, fungi, and parasites will attack human tissues, viruses attack the immune system directly, which is what makes them so troubling. When the body is stressed, the immune system becomes stressed, and now weakened, the chance of getting a viral infection goes up dramatically.

“All disease begins in the gut”

— Hippocrates (460 - 377BC)

If you get infected, typically through the digestive system or the lungs, the immune system now ramps up production of antibodies and cells to protect itself from a fast replicating pathogen. Other pathogenic microorganisms which before were being held in check add to the stress by exploiting the hosts weakness. It can become a downward spiral if left unchecked.

One way to fight back against this unfortunate turn of events is by using elderberry! Elderberry reduces cold duration by 50% and the severity of symptoms by 50% or more (2), and elderberry was found to substantially reduce upper respiratory symptoms when sick (3). Elderberry flavonoids bind to and prevent H1N1 infection in vitro (4), and compare favorably to the known anti-influenza prescription medications like Tamiflu (5). Elderberry can also be taken as a preventative to support and strengthen the immune system due its unique natural pharmacology.

Viral infections are often treated with over the counter drugs, antibiotics, and antiviral medications which can have bad side effects and long term health consequences. Because of the covid-19 pandemic, mainstream scientific researchers are starting to better understand the relationship between diet and nutrition, inflammation and oxidative stress, and the immune system (6). What makes elderberry such a powerful natural medicine is because it’s rich in flavonoid phytochemicals, specifically anthocyanins, which exert potent anti-oxidants and anti-inflammatory effects throughout the body which strengthen the immune system via interactions with the gut. To understand more lets learn about anthocyanins and the digestive system.

Elderberry is Rich in Anthocyanins

Anthocyanins are favonoid polyphenol phytonutrients (plant pigments) that can range in color from red, blue, purple, or black.

Elderberry is very high in anthocyanins due to its dark purple to black color, and 66% of the phenolic components of elderberry juice are anthocyanins. Anthocyanins are biologically desirable because they have strong antioxidant effects. Foods rich in anthocyanins include elderberries, blueberries, raspberries, purple cauliflower, black “forbidden” rice, black beans, among many other foods that have red, purple, and black coloration.

Elderberry has an anthocyanin profile that differs from other berries, which includes cyanidin-3-glycoside, cyanidin-3,5-diglucoside, cyanidin-3-sambubioside, and cyanidin-3-sambubioside-5-glucoside. The high concentration of cyanidin-3-glycoside (C3G) is unique, as cyanidin-3-glycoside is a relatively rare anthocyanin, and C3G has unique and desirable physiological effects on the body.

Upon consumption, anthocyanins have a tough time reaching the blood stream because they are rapidly metabolized by the digestive system. Like turmeric and curcumin, the beneficially health effects of elderberry are primarily felt by the bodily tissues that metabolize them. Once ingested, some of the anthocyanins are metabolized by the epithelial cells of the digestive system, and for the anthocyanins that make it through to the bloodstream, elderberry anthocyanins are incorporated by endothelial cells, the cells which make up the inner lining of blood vessels. As anthocyanins are transported, more and more will be absorbed until some finally reach muscle or brain tissues.

Like curcuminoids, anthocyanins that are micro-emulsified into lipid-micellar structures are able to penetrate deeper in the body and can exert their effects on a wider range of bodily tissues.

In the graph below the bioavailability of elderberry anthocyanins cyanidin-3-glycoside (C3G) and cyanidin-3-sambubioside can be seen over 24 hours.

Plasma anthocyanin concentrations after consumption of 720 mg elderberry anthocyanins. Sample size of four elderly women. The point at 24 hr represents all three lines

For C3G, a peak plasma concentration (Cmax) of 42.5 +/- 4.5 nmol/L is reached at the 1 hour mark. The half life is ~100 minutes, and most anthocyanins from elderberry are excreted after 4 hours.

Overall, anthocyanins appear to be absorbed in their unchanged glycosylated forms in humans (7).

Elderberry Improves Digestive Function

Because elderberry contains a lot of flavonoids like cyanidin-3-glycoside and is rapidly absorbed by the the gut, elderberry has potent health effects for the gut. The gastrointestinal tract is the physical barrier that stops the diffusion of foreign materials from the lumen from entering into the circulatory system. The lumen is the soup of microorganisms and digestive fluids always slowly moving through your gut. With a properly functioning gut, only fully digested macronutrients like carbs, fats, and protein, along with small chemicals like micronutrients and phytonutrients, can pass through the intercellular tight junction shield and into the blood stream via guided mechanisms.

Cross-section view of epithelial cells of the digestive system. The tight junctions are where the membranes of the cells press up against one another. Notice the villi up top and how the lumen can filter through them.

Impairment of epithelial tight junctions is associated with various diseases caused by inflammation and immune system stress. This stress is created when partially digested foods and potentially pathogenic microbes enter into the blood stream, requiring cleanup by the immune system but now over a much larger area as compared to just the lining of the digestive system.

Dietary flavonoids, which is what elderberry is rich with, reduce oxidative stress and help to heal the epithelial tight junctions of the digestive system (8). Anthocyanins have been directly shown to improve intestinal barrier function and regulate the gut microbiome in mammals (9). When tight junctions are repaired, the barrier between microbiome, nutrients, and body tissues is reestablished, and normal function can resume. The immune system is still very active with the gut under healthy circumstances, but when the digestive system is compromised, the immune system needs to ramp up and better protect the circulatory system, a much larger and more diffuse area that covers the entire body. As a metaphor, no longer is the fighting solely at the trenches, but it is spread out through the countryside, and civilian casualties begin to occur.

Overtime, this increase in the duties of the immune system is chronically stressful and can lead to disease. To reduce the stress to the immune system and to all the other tissues of the body, the digestive system needs to be strong and intact, forming an impenetrable barrier between the microbiome and the rest of the body.

If you have gut problems like IBS, IBD, chron’s disease, celiac disease, or you just know your digestive system functions poorly, considering using fasting to reset your digestive system. Fasting has very powerful healing effects on the gut and throughout the body, though it is not to be done lightly. Short 24-hour fasts are easier and can also be used to understand and curb food cravings, an important distinction to understand which will improve your food choices and health. Overall elderberries are excellent overall for gut health.

Elderberry for Improved Nutrient Partitioning

Elderberry anthocyanins that make it into the bloodstream are then absorbed to some degree by endothelial cells, which like with the gut, increases protection against oxidative stress (10). In the bloodstream, anthocyanin-rich elderberry extracts enhance glucose and oleic acid uptake into human skeletal muscle cells (11), and anthocyanins, more specifically cyanidin-3-glycoside, increase fat burning and decrease fat storage through altering gene expression (12, 13, 14, 15, 16, 17, 18). Over time these effects of anthocyanins improve blood glucose markers, saturate muscle tissue better with glycogen, and can heal dysfunctional fat cells.

Overall, once anthocyanins are in the bloodstream they can be considered nutrient partitioners. They aren’t nutrients themselves, but they direct carbs and fats preferentially to muscle and skeletal tissue rather than adipose or visceral fat tissue.

The dosages required for anthocyanins to exert strong nutrient partitioning effects are quite high, and this is still an area that requires more human research.

Elderberry Sources

There are a ton of elderberry products out there, and below are my favorites which I have used and recommend.

Elderberry Juice

Elderberry Juice from Biotta is available in a lot of different grocery stores and has a great flavor. This product is pasteurized and the heat sensitive nutrients will have been destroyed.

Elderberry Lozenges

Therazinc Elderberry Lozenges by Quantum Health. These lozenges can be found nearly anywhere and at the first thought that I might be getting sick I reach for one of these. The combo of zinc and elderberry is great for fighting infections, and caught early can reduce the length and severity of the infection.

Elderberry Powder

Lost Empire Herbs has a 64:1 Full-Spectrum Extract Elderberry Powder, and their extract contains 13-18% anthocyanins. This is the most potent elderberry option of the list, and if you really want to experiment with how high-dosage elderberry makes you feel, this is the elderberry supplement I recommend.

Elderberry Tea

Dried Elderberries like those sold from Mountain Rose Herbs can be steeped in a tea using water anywhere from 170 - 212 F (75-100 C). Water temperature on the lower end of that range will degrade less anthocyanins and for better extraction more time is required. Steep dried elderberries for 10 minutes at 75 C for best effect.

Elderberries from Nature

Should you choose to prepare elderberry juice or syrup yourself, rather than to purchase a supplement, remember that the berries must be properly dried or cooked, since raw elderberries can cause nausea or in large amounts cyanide toxicity. Only ever use the berries — the rest of the plant is poisonous and should not be consumed in any form.

Elderberry Dosing

If using the Therazinc Elderberry Lozenges, the following dosing protocol can be used:

1 lozenge daily for general health and immune preventative effects. The lozenge can replace a daily zinc pill like from a zinc balance supplement.
3 lozenges daily while experiencing a viral infection, take one lozenge morning, afternoon, and night. This will provide throughout the course of the day 21 mg zinc and 108 mg elderberry powder. The bigger impact here will be from the zinc, not the elderberry.

If using the more potent Lost Empire Herbs 64:1 elderberry powder, the following dosing protocol can be used:

350 mg (1/8 tsp) powder daily for general health and immune preventative effects.
1 gram daily for viral infections. One serving (1/8 tsp, 350 mg) taken morning, afternoon, and night will keep the anthocyanin levels elevated throughout the body.
4 grams daily for glucose improving nutrient partitioning effects, spaced out as 1 gram every four hours (8 am, 12 pm, 4 pm, 8 pm).

If using elderberry tea using the following dosings:

General Wellness - 1 Tbsp steeped in 8 oz of 75 C water for 10 minutes
Viral Infection - 1 Tbsp steeped in 8 oz of 75 C water for 10 minutes morning, noon, and night.

For daily preventative strengthening to the immune system elderberry and dandelion is a powerful combination, combine them into a herbal tea and enjoy their many synergistic health benefits.

Reduce your Chance of Getting Sick with Elderberry

Elderberry can reduce your chance of getting sick, and if you do get sick, elderberry can also be used to shorten the duration and reduce the severity of the viral infection. As a natural remedy, elderberry won’t damage your liver like regular cold and flu medications.

Elderberry will always help but it’ll never completely heal you

Elderberry is just a supplement, it can never truly heal you. To heal at a deep level other considerations beyond a “magic” powder are required. Are you…?

Eating a healthy diet
Drinking plenty of water
Minimizing exposure to sick people
Sleeping every night

Mindful of stress
Exercising (weights, calisthenics, yoga, running)
Washing your hands when dirty
Aware and considerate of your emotions?

Keep some elderberry lozenges in the cabinet and drink elderberry tea as often or needed as desired. Elderberry is a great preventative herb, fantastic for health if used regurarly.

References:

Ulbricht C, Basch E, Cheung L, et al. An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration. J Diet Suppl. 2014;11(1):80-120.
Tiralongo E, Wee SS, Lea RA. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients. 2016;8(4):182.
Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019;42:361-365.
Roschek B, Fink RC, Mcmichael MD, Li D, Alberte RS. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry. 2009;70(10):1255-61.
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(2):132-40.
Iddir M, Brito A, Dingeo G, et al. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12(6)
Milbury PE, Cao G, Prior RL, Blumberg J. Bioavailablility of elderberry anthocyanins. Mech Ageing Dev. 2002;123(8):997-1006.
Suzuki T, Hara H. Role of flavonoids in intestinal tight junction regulation. J Nutr Biochem. 2011;22(5):401-8.
Li J, Wu T, Li N, Wang X, Chen G, Lyu X. Bilberry anthocyanin extract promotes intestinal barrier function and inhibits digestive enzyme activity by regulating the gut microbiota in aging rats. Food Funct. 2019;10(1):333-343.
Youdim KA, Martin A, Joseph JA. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med. 2000;29(1):51-60.
Ho GT, Kase ET, Wangensteen H, Barsett H. Phenolic Elderberry Extracts, Anthocyanins, Procyanidins, and Metabolites Influence Glucose and Fatty Acid Uptake in Human Skeletal Muscle Cells. J Agric Food Chem. 2017;65(13):2677-2685.
Sasaki R, Nishimura N, Hoshino H, et al. Cyanidin 3-glucoside ameliorates hyperglycemia and insulin sensitivity due to downregulation of retinol binding protein 4 expression in diabetic mice. Biochem Pharmacol. 2007;74(11):1619-27.
Guo H, Ling W, Wang Q, Liu C, Hu Y, Xia M. Cyanidin 3-glucoside protects 3T3-L1 adipocytes against H2O2- or TNF-alpha-induced insulin resistance by inhibiting c-Jun NH2-terminal kinase activation. Biochem Pharmacol. 2008;75(6):1393-401.
Tsuda T, Ueno Y, Aoki H, et al. Anthocyanin enhances adipocytokine secretion and adipocyte-specific gene expression in isolated rat adipocytes. Biochem Biophys Res Commun. 2004;316(1):149-57.
Tsuda T, Ueno Y, Kojo H, Yoshikawa T, Osawa T. Gene expression profile of isolated rat adipocytes treated with anthocyanins. Biochim Biophys Acta. 2005;1733(2-3):137-47.
Tsuda T, Ueno Y, Yoshikawa T, Kojo H, Osawa T. Microarray profiling of gene expression in human adipocytes in response to anthocyanins. Biochem Pharmacol. 2006;71(8):1184-97.
Tsuda T, Horio F, Uchida K, Aoki H, Osawa T. Dietary cyanidin 3-O-beta-D-glucoside-rich purple corn color prevents obesity and ameliorates hyperglycemia in mice. J Nutr. 2003;133(7):2125-30.
Grace MH, Ribnicky DM, Kuhn P, et al. Hypoglycemic activity of a novel anthocyanin-rich formulation from lowbush blueberry, Vaccinium angustifolium Aiton. Phytomedicine. 2009;16(5):406-15.

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