Black Elder

Photo © Steven Foster

Sambucus spp. Text by Armando González Stuart, Ph.D., 2005

Other common names: Elderberry, Sambucus Common names in Spanish: Saúco, Saúco negro, Flor de Saúco Botanical family: Caprifoliaceae. Medicinal parts: Mainly the flowers, but also the bark, leaves and berries.

History Black elder is a medium sized shrub or small tree that has been used for centuries in Europe and North America for a variety of ailments, especially those related to respiratory problems (Libster, 2002; Adame and Adame, 2000; Mills and Bone, 2000; Dimayuga, 1996; Martinez, 1989).

Various species of elders are found throughout temperate and cool regions of the world, including North America, and usually flower from May through July (Forster-Waldl et al., 2003; Harris, 2003).

The leaf, flower, and berries have curative properties, although the flowers and the berries do not have the same medicinal applications (Fintelmann and Weiss, 2000).

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2000). 2005. 2001). while the berries do not have this effect (Libster. but may cause nausea and vomiting in larger doses (McCann.Active Principles • Flavonoids including quercetin and rutin are believed to account for the therapeutic (antioxidant) actions of the elderberry flowers and berries (McCann. but not the leaves or berries (Blumenthal. Nakajima et al. • Elderberry has been used in traditional herbal folk medicine for many centuries for the treatment of influenza. colds and sinusitis. Applications in herbal therapy • Germany’s Commission E has approved the use of elder flowers for respiratory ailments such as bronchitis. colds and fever. 2 . • Elder flowers have a diaphoretic effect and therefore help in lowering fever. coughs. bark and unripe berries can be potentially toxic (Skidmore-Roth. 2004). • Elderberry juice possesses significant antioxidant properties which may be useful in the scavenging and quenching of free radicals (Lichtenthaler and Marx. Weiss and Fintelmann. and reportedly possesses antiviral activity against influenza and herpes simplex (Zakay-Rones. The leaves. 2005. • The berries also have a laxative effect in small doses (Starek. 2000). et al. Weiss and Fintelmann. 2004. 2002. 2004). as well as nonspecific stimulation of the nervous system.. 2000).. please see safety and precautions section below). 2004).

S. and skin conditions. which is used as a “cure-all” or panacea (Carmona et al. • The tea made from the flowers may also be beneficial in treating the flu (Jaber. 1990). combined with St. John’s wort and soapwort. 2002). Animal studies have shown the flowers to have anti-inflammatory properties (Mascolo et al. among others. 3 . anxiety and other nervous disorders (Martínez. including black elder. 2002). 1989). 1984). • According to laboratory research.. 2004). coughs. as well as increasing the susceptibility of this bacterium to the antibiotic clarithromycin (Chatterjee et al. 2002. • Some constituents in Elder flowers have antimicrobial activity and are employed against infections of the respiratory tract (Holetz et al. • Native Americans used the plant for infections. are applied directly to the joints as a compress to relieve pain and swelling in arthritic patients and a tea made from the berries is used as a purgative (Adame and Adame. • In Syria. • In Mexican Traditional Medicine (MTM). 2000. 1990).. mexicana. an extract from the leaves.• Elderberry extracts. A decoction of the root is used internally against dropsy (congestive heart failure) and an infusion (tea) made from the flowers is said to be useful against insomnia.. 2000). an herbal tea known as “Zahraa” contains a complex mixture of herbs. under the Unani system of medicine.. anti inflammatory and laxative properties (Barnes et al. Cabrera. • Elder is also used for its diuretic. inhibits the influenza virus and herpes simplex virus (Serkedjieva et al. 2002). significantly inhibited growth of H. Adame and Adame. pylori. The leaves were touted to be pain relieving and to promote healing of injuries when applied as a poultice (Libster.. 2005). the fresh leaves of a related species.

2002. Sam n 1.• Elder flowers are a significant source of Vitamin C (Meletis. specifically in human colon cells (Pool-Zobel et al. • Even though anthocyanins from elder. Lugasi and Hovari. This particular compound may also have an application in immunotherapy (Forster-Waldl et al. thereby conferring significant protective effects against oxidative damage (Youdim et al.. this may not be the case in vivo.. 2002). 1999). 2000). 2003). as well as other antioxidants. for example (Mulleder et al. This compound is a 33. Clinical trials with Elder flowers 4 . Samuelsson. such as anthocyanins.2 kDa ribosomal inactivating protein (RIP). 2002. • Elderberry extracts that contain anthocyanins may have potential benefits against various oxidative stressors. although the absorption of these compounds in the human body is variable (Wu et al.. and seems to be responsible for the principal allergenic properties of the plant. have antioxidant capability in vitro.. Some studies have shown that administration of antioxidants improves endothelial function.. has been identified. tocopherols. Cao and Prior.. • Anthocyanins possess beneficial effects on health and contribute antioxidant effects beyond those provided by some essential micronutrients such as ascorbate. 1999). 2002. • An elderberry allergen. • Vascular endothelial cells can incorporate anthocyanins into the membrane and cytosol. 2002). and selenium.. 2003). Endothelial dysfunction has been proposed to play an important role in the initiation and development of vascular disease (Milbury et al. • The free radical scavenging properties of anthocyanins in Elder may prove beneficial in the treatment of vascular ailments (Roy et al. 1999). like other flavonoids.

. Higher doses may significantly reduce postprandial serum lipids.. equivalent to 5 ml elderberry juice for 2 weeks. 2004 Elderberry syruo (15 ml) To assess the efficacy and 60 5 .. 2005 Elderberry juice (150 ml) Purpose of Number of study subjects 7 To study the urinary pharmacokinetics of monomeric anthocyanins contained in elderberry juice in healthy male subjects Results The low urinary excretion of dietary anthocyanidin glycosides had a low urinary excretion rate.. To evaluate the effects of elderberry juice on cholesterol and triglyceride concentrations as well as antioxidant status 34 Zakay-Rones et al. 2004 Capsules with 400 mg spraydried powder containing 10% anthocyanins three times per day. 1995). 1990). Selected Clinical Trials Employing Elder Author/Reference Plant/Plant product Frank et al. The elderberry extract at low doses exerts a minor effect on serum lipids and antioxidant capacity. Sambucol® is a standardized herbal product (syrup) made from elder flowers.. In vitro studies have shown that the active constituents on Elder may interfere with the infectivity of influenza virus (Baum and Paulson. Symptoms of influenza were Murkovic et al. 2001).A double-blind study conducted with human subjects determined that an extract of elderberries may be an effective treatment for influenza (Zakay-Rones et al. Table 1. indicating that a proportion of these plant pigments underwent metabolism before entering the circulation. which was shown to be effective in vitro against 10 strains of influenza virus (Barak et al.

Safety/Precautions • • • Elder flower is included in the Generally Regarded As Safe (GRAS) List (Mills and Bone. Zakay-Rones et al.. 2002). 6 . Blumenthal. and may be an option for the safe treatment for influenza A and B. no studies have validated their use during pregnancy and lactation (McCann. without any side-effects. 2001. Even though herbal products made from Elder flowers have not shown any toxicity (Brinker. 2005)..or placebo syrup four times a day for 5 days safety of oral elderberry syrup for treating influenza A and B infections. 2000). 2001 A standardized elderberry extract. Not available The elderberry extract was very effective in vitro against on all strains of influenza virus tested. Barnes et al. 2004. Products such as cough syrups and teas made from elder flower are usually safe taken in moderation. Sambucol® (SAM) To evaluate the efficacy and safety of an elderberry extract to inhibit replication of human influenza viruses ameliorated four days earlier and the use of medication was significantly decreased in subjects receiving elderberry compared to placebo.

Barak V.. 2002). Plantas Curativas del Noreste Mexicano Monterrey.• • Slight gastrointestinal discomfort is one of the possible side effects (Tsui et al. leaves. • • The bark is a strong purgative and is not recommended in modern herbal therapy (phytotherapy) (Meletis. Literature cited Adame J.. Halperin T. Brinker 2000). 2002. Parts of Black Elder (especially the roots. 2000). Heating or cooking destroys the toxin (Brinker. resulting in cellular hypoxia (oxygen insufficiency). Herb/Drug Interactions • • Very little is known. 7 . 2002. México: Editorial Castillo. Isr Med Assoc J. The possible interactions between elder flower products and OTC cold remedies have not been evaluated. 2003). • Ingestion of the unripe berries as well as the teas made from the root.. such as sambunigrin. unripe berries and far less the flowers) contains cyanogenic glycosides. Kalickman I. 2003. 2004. with a further warning not to be used in small children or the elderly (McCann. but elder preparations made from the berries should not be taken concurrently with laxatives. which can be potentially toxic (Dellagreca et al. Brinker. Ingestion of the unripe berries causes cyanide poisoning. • Allergies to elder pollen and products containing elder have been recorded (Forster-Waldl et al. Adame H. Skidmore–Roth. 2001). 2004. It is best to avoid taking concurrently (Libster. 2000. Barnes et al. 2002. 2005). The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. bark or leaves are likewise contraindicated. McCann. Birkenfeld S. Starek 2001. 4(11 Suppl):919-922. 2000)..

Paulson JC. 40:35-8. "Zahraa". 1988. Acta Histochem Suppl. Baja California: University of Baja California. 2005. J Ethnopharmacol. M. Sonntag S. Kalickman I. Halperin T. Bagchi D. Obon C. Carmona MD. 25(2):47-56 Harris M. Herb Contraindications and Drug Interactions 3 rd ed. Anthocyanins are detected in human plasma after oral administration of an elderberry extract. Prior RL. 8 .507-508. Rivera D. Medicina Tradicional y Popular de Baja California Sur. F. Clin Exp Allergy. Clin Chem. a black elderberry-based. Nat Prod Res. 45(4):574-576. Sandy.Barak V. Botanica North America. 2003. La Paz. et al. 2004.2 kDa allergen with significant homology to ribosomal inactivating proteins. 2005. Type I allergy to elderberry (Sambucus nigra) is elicited by a 33. Marchetti M. 2000. Llorach R. 2000. Eur Cytokine Netw. 1996 Forster-Waldl E. Sialyloligosaccharides of the respiratory epithelium in the selection of human influenza virus receptor specificity. Monaco P. Urinary pharmacokinetics of cyanidin glycosides in healthy young men following consumption of elderberry juice. New York: Harper Collins. Yasmin T. Int J Clin Pharmacol Res. 1999. Brinker. Inflammatory cytokines. Toxicology of Botanical Medicines 3 rd ed. [Epub ahead of print] Cao G. Cabrera R. 1990. 2003 pp. 2003. Sandy. Brinker. Dimayuga R. on the production of human cytokines: I. New York: Integrative Medicine Publications. Oregon: Eclectic Medical Publications. 12(2):290-296. Baum LG. 33(12):1703-10. The Expanded Commission E Monographs. with enhanced susceptibility to clarithromycin. Stohs SJ Inhibition of Helicobacter pylori in vitro by various berry extracts. Scholl I et al. 265(1-2):19-26. 2001. F. Blumenthal. natural product. Strass G et al. The effect of Sambucol. Frank T. Synthesis of degraded cyanogenic glycosides from Sambucus nigra. Fiorentino A. a Unani multicomponent herbal tea widely consumed in Syria: Components of drug mixtures and alleged medicinal properties. Yerbario mexicano. Chatterjee A. 2001. Dellagreca M. 17(3):177-181. Mol Cell Biochem. Oregon: Eclectic Medical Publications. Mexico City: Gomez-Gomez Hermanos.

M. Mexico City: Editorial Botas. Complete Guide to Safe Herbs. London: Churchill-Livingstone. Screening of some plants used in the Brazilian folk medicine for the treatment of infectious diseases. Bone K. 2004. Nakajima JI. Bergmann AR et al. Schroder N. LC/PDA/ESI-MS Profiling and Radical Scavenging Activity of Anthocyanins in Various Berries. London: Elsevier-Churchill-Livingstone. 53(1):103-10. 2002. 376-377. Blumberg J. New York: Delmar.2004(5):241247. 38(5):227-234. 1999. pp. 58(2):244-9. J Biochem Biophys Methods. J Agric Food Chem. Eur J Nutr. Urinary excretion of cyanidin glycosides. 2002. Hovari J. 2002. Cao G. Pfannhauser W. 1989. Bioavailablility of elderberry anthocyanins. 2002. Marx F. et al. Principles and Practice of Phytotherapy. placebo-controlled study. 2003. 2002. J Biomed Biotechnol. Bub A. London: Dorling Kindersley. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized. Mills S. M. Meletis C. Milbury PE. Mech Ageing Dev. 29(2):231-261. Martínez. 2004. Libster. Nahrung. 2005.Holetz FB. Rechkemmer G. 53(1-3):61-66. 47(2):79-86. Sanches NR. Abuja PM. et al. Murkovic M. Prior RL. 2005. 2002. Pool-Zobel BL. Mills S. Jaber R. Respiratory and allergic diseases: from upper respiratory tract infections to asthma. Bone K. Prim Care. 2000. Lugasi A. double-blind. Integrative Herb Guide for Nurses. Total oxidant scavenging capacities of common European fruit and vegetable juices. Eur J Clin Nutr. Murkovic M. Anthocyanins are potent antioxidants in model systems but do not reduce endogenous oxidative DNA damage in human colon cells. Mulleder U. Lichtenthaler R. 123(8):997-1006. Las Plantas Medicinales de México.274-283. Tanaka I. 9 . The Essential Guide to Herbal Safety. Seo S. pp. Pessini GL. 97(7):1027-1031. Antioxidant properties of commercial alcoholic and nonalcoholic beverages. Mem Inst Oswaldo Cruz.

132(7):1865-1871. Plantas Medicinales. against influenza and herpes simplex viruses. J Nutr. Aromáticas y Culinarias. 2005.. B.Roy S. et al. Drugs of Natural Origin 4th ed. Serkedjieva J. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Parietaria diffusa M. A survey of dietary supplement use during pregnancy at an academic medical center.. Wollan T. 32(2):132-40. Zlotnik M. aerial parts of Hypericum perforatum L. Weiss R. Tomei PE. pp. Barcelona: Servilibro Editores. 2002. Khanna S. 10 . Antiviral activity in vitro of Urtica dioica L.. 185(2):433-437. Zakay-Rones Z. J Int Med Res. Louis: Mosby.98(3):3237. Zaccaro L. 2001. Varsano N. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L. Antiviral activity of the infusion (SHS-174) from flowers of Sambucus nigra L. New York: Thieme. Starek. Samuelsson. Handbook of Herbs and Natural Supplements 3 rd ed. 1:361–369. Cao G. Youdim KA. Wadstein J.) during an outbreak of influenza B Panama. 2000. London: Taylor and Francis. Absorption and metabolism of anthocyanins in elderly women after consumption of elderberry or blueberry. Fintelmann J. 36(9):1023-1031. Uncini Manganelli RE. et K. et al. J Alt Compl Med 1995. 29(1):51-60. Zakay-Rones Z. Zgórniak-Nowosielska I.1999. Martin A. G. Thom E. Free Radic Biol Med. Skidmore-Roth L. Joseph JA. Am J Obstet Gynecol. Wu X. 2000. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.365-369. Phytother Res 1990. and roots of Saponaria officinalis L. 2002. Free Radic Res. J Ethnopharmacol. Prior RL. 2005. 4:97–100. and Sambucus nigra L. Alessio HM et al. St. Tsui B. Tsourounis C. Dennehy CE. Manolova N. Herbal Medicine 2nd ed. 2004. Anti-angiogenic property of edible berries. 2001.