Elderberries are native to Europe, Asia, and North America, and are widely distributed in temperate and semitropical regions because they tolerate a wide range of growing conditions. Only those with blue and black berries are medicinal, not the red berries. The flowers and berries are both used. The elderberry plant berry have long been used as food, particularly in the dried form. Elderberry wine, pie, juice, and elderberry jelly are some of the popular ways to prepare the elderberry plant as food.

Elderberry Extract 500 mg
Source Naturals

 Elderberry is the berry of the black elder tree (Sambucus nigra). Elderberry is an excellent source of vitamins A, B and C. Its constituents may also strengthen the body's immune system. Elderberries contain bioflavonoids and anthocyanins, which positively influence cell function.

Elderberry Supplement Facts
Serving Size: 3 Tablets
Servings Per Container: 20
Amount Per Serving:
Proprietary Blend: 1,500mg
    Elderberry Extract, Elderberry, Elder Flower Extract, and Elder Flower.

* Elderberry daily value not established.

Click Elderberry to purchase or to see a complete list of products at Physician Formulas
Subscribe to a FREE Supplement Research Update newsletter by Ray Sahelian, M.D. Twice a month you will receive a review of several studies on supplements and natural medicine topics, including elderberry.

What's in elderberry ehrb?
A number of important compounds are found in elderberry, the most important being anthocyanins. Anthocyanins are powerful antioxidants and have immune stimulating properties.

Elderberry extract
Elderberry is sold by raw material suppliers in various extract potenciess, including extract 5% anthocyanidins and 6 percent anthocyanosides.

Additional Herbs and Supplements that influence the immune system
AHCC -- Active Hexose-correlated Compound - AHCC - is a mushroom extract that has been tested as an immune enhancing, liver protective and anti-cancer agent. For more AHCC research information
Andrographis -- Andrographis has become popular in Scandinavia for use during winter upper respiratory infections.
See Immune for a full list
Curcumin or Turmeric supplement

Elderberry Research Update
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 Mar-Apr;32(2):132-40.
Elderberry herb has been used in folk medicine for centuries to treat influenza, colds and sinusitis, and has been reported to have antiviral activity against influenza and herpes simplex. We investigated the efficacy and safety of oral elderberry syrup for treating influenza A and B infections. Sixty patients (aged 18-54 years) suffering from influenza-like symptoms for 48 h or less were enrolled in this randomized, double-blind, placebo-controlled study during the influenza season of 1999-2000 in Norway. Patients received 15 ml of elderberry or placebo syrup four times a day for 5 days, and recorded their symptoms using a visual analogue scale. Symptoms were relieved on average 4 days earlier and use of rescue medication was significantly less in those receiving elderberry extract compared with placebo. Elderberry extract seems to offer an efficient, safe and cost-effective treatment for influenza. These findings need to be confirmed in a larger study.

Bioavailability of anthocyanidin-3-glycosides following consumption of elderberry extract and blackcurrant juice.
Int J Clin Pharmacol Ther. 2004 May;42(5):293-300.
Pharmacokinetic parameters and the bioavailability of several dietary anthocyanins following consumption of blackcurrant juice and elderberry extract were compared exploratorily in 6 healthy volunteers. They were given a single oral dose of either 137 ml of blackcurrant juice (144.8 mg total anthocyanins) or 30 ml of elderberry extract (147.3 mg total anthocyanins). Within 7 hours, the urinary excretion of total anthocyanins (i.e. the sum of all assayed anthocyanidin glycosides) was 0.04% and 0.37% of the administered dose following blackcurrant juice and elderberry extract ingestion, respectively. Pharmacokinetic parameters based on non-compartmental methods for plasma and urine concentrations exhibited higher variability in urinary excretion after ingestion of elderberry extract. Anthocyanin absorption was significantly greater following the intake of elderberry extract than after the intake of blackcurrant juice. The geometric means of t(1/2) were not significantly different following elderberry extract and blackcurrant juice ingestion. The urinary excretion rate of intact anthocyanins was fast, appeared to be monoexponential for both blackcurrant juice and elderberry extract. However, in order to evaluate the contribution of anthocyanins to the health-protecting effects of blackcurrant juice and elderberry extract it will be necessary to perform further studies on the unchanged glycosides and their in vivo metabolites in human plasma and urine.

Anti-angiogenic, antioxidant, and anti-carcinogenic properties of a novel anthocyanin-rich berry extract formula.
Biochemistry (Mosc). 2004 Jan;69(1):75-80, 1 p preceding 75.
Edible berry anthocyanins possess a broad spectrum of therapeutic and anti-carcinogenic properties. Berries are rich in anthocyanins, compounds that provide pigmentation to fruits and serve as natural antioxidants. Anthocyanins repair and protect genomic DNA integrity. Earlier studies have shown that berry anthocyanins are beneficial in reducing age-associated oxidative stress, as well as in improving neuronal and cognitive brain function. Six berry extracts (wild blueberry, bilberry, cranberry, elderberry, raspberry seeds, and strawberry) were studied for antioxidant efficacy, cytotoxic potential, cellular uptake, and anti-angiogenic (the ability to reduce unwanted growth of blood vessels, which can lead to varicose veins and tumor formation) properties. We evaluated various combinations of edible berry extracts and developed a synergistic formula, OptiBerry IH141, which exhibited high ORAC (Oxygen-Radical Absorbing Capacity) value, low cytotoxicity, and superior anti-angiogenic properties compared to the other combinations tested. Anti-angiogenic approaches to treat cancer represent a priority area in vascular tumor biology. OptiBerry significantly inhibited both H2O2- and TNF-alpha-induced VEGF (Vascular Endothelial Growth Factor) expression by human keratinocytes. VEGF is a key regulator of tumor angiogenesis. Matrigel assay using human microvascular endothelial cells showed that OptiBerry impaired angiogenesis. In an in vivo model of angiogenesis, OptiBerry significantly inhibited basal MCP-1 and inducible NF-kappaB transcriptions. Endothelioma cells pretreated with OptiBerry showed a diminished ability to form hemangioma and markedly decreased tumor growth by more than 50%. In essence, these studies highlight the novel anti-angiogenic, antioxidant, and anti-carcinogenic potential of a novel anthocyanin-rich berry extract formula, OptiBerry.

Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study.
Eur J Clin Nutr. 2004 Feb;58(2):244-9.
In a recent pilot study, the intake of elderberry juice resulted in a significant decrease in serum cholesterol concentrations and an increase in low-density lipoprotein (LDL) stability. This study was designed to verify the preliminary results. We investigated the impact of elderberry juice on cholesterol and triglyceride concentrations as well as antioxidant status in a cohort of young volunteers. Study A: The randomized, placebo-controlled trial for studying the effect of anthocyanes on lipid and antioxidant status, 34 subjects took capsules with 400 mg spray-dried powder containing 10% anthocyanes t.i.d. equivalent to 5 ml elderberry juice for 2 weeks. A subgroup of 14 subjects continued for an additional week to test for resistance to oxidation of LDL. Study B: To investigate the short-term effects on serum lipid concentrations, six subjects took a single dose of 50 ml of elderberry juice (equivalent to 10 capsules) along with a high-fat breakfast. In the placebo-controlled study, there was only a small, statistically not significant change in cholesterol concentrations in the elderberry group (from 199 to 190 mg/dl) compared to the placebo group (from 192 to 196 mg/dl). The resistance to copper-induced oxidation of LDL did not change within 3 weeks. In the single-dose experiment increases in postprandial triglyceride concentrations were not significantly different when the six subjects were investigated with and without elderberry juice. Elderberry spray-dried extract at a low dose exerts a minor effect on serum lipids and antioxidative capacity. Higher, but nutritionally relevant doses might significantly reduce postprandial serum lipids.

 Effects of dietary anthocyanins on tocopherols and lipids in rats.
J Agric Food Chem. 2002 Dec 4;50(25):7226-30.
The effects of dietary cyanidin-3-O-glucoside (C3G) and concentrates from blackcurrant [Ribes nigrum] (BC) and elderberry [Sambucus nigra] (EC) on plasma and tissue concentrations of alpha- (alpha-T) and gamma-tocopherol (gamma-T) and cholesterol, as well as the fatty acid composition of the liver lipids were investigated in growing, male rats of the Sprague-Dawley strain. Animals were fed semisynthetic diets supplemented with 2 g/kg C3G, BC, or EC for 4 weeks. Dietary anthocyanins did not affect feed intake, body weight, and organ weights. C3G elevated the concentrations of tocopherols in the liver and lungs (P < 0.05). Cholesterol levels in plasma and liver were not affected by any of the regimens. C3G and BC reduced the relative amount of saturated fatty acids in the liver. BC also lowered the percentage of 22:6 + 24:0 and EC the ratio of 20:3/20:4 n-6. In conclusion, dietary C3G, BC, and EC appear to have little effect on cholesterol levels and the fatty acid pattern in the liver but seem to be capable of sparing vitamin E in healthy, growing rats.

Absorption and metabolism of anthocyanins in elderly women after consumption of elderberry or blueberry.
J Nutr. 2002 Jul;132(7):1865-71.
The absorption and metabolism of anthocyanins (ACN) in humans was studied in four elderly women given 12 g elderberry extract (EBX) (720 mg total ACN), and six elderly women given 189 g lowbush blueberry (BB) (690 mg total ACN). The two major ACN in EBX, cyanidin-3-glucoside and cyanidin-3-sambubioside, as well as four metabolites: 1) peonidin 3-glucoside, 2) peonidin 3-sambubioside, 3) peonidin monoglucuronide, and 4) cyanidin-3-glucoside monoglucuronide were identified in urine within 4 h of consumption using HPLC-MS/MS with diode-array detector detection and retention time. Total EBX ACN excretion was 554 +/- 90 microg (mean +/- SD, n = 4) (0.077% of intake/4 h, wt/wt). In 5 of 6 women fed BB, urine samples contained ACN, which were identified as the original forms based upon comparisons to the BB food sample, which contained 24 ACN, 22 of which were identified by HPLC-MS/MS. Reasonable correlations between BB and urine proportions of the different ACN were obtained except for ACN arabinosides. Total urinary excretion during the first 6 h was 23.2 +/- 10.9 microg. Plasma ACN levels were below detection limits using 2 mL plasma in women that consumed BB. This study demonstrates for the first time that in vivo methylation of cyanidin to peonidin and glucuronide conjugate formation occurs after people consume ACN and demonstrates the low absorption and excretion of ACN compared with other flavonoids.

Bioavailablility of elderberry anthocyanins.
Mech Ageing Dev. 2002 Apr 30;123(8):997-1006.
Considerable epidemiological evidence suggests a link between the consumption of diets rich in fruits and vegetables and a decreased risk of cardiovascular disease and cancers. Anthocyanins have received attention as important dietary constituents that may provide health benefits and contribute antioxidant capacity beyond that provided by essential micronutrients such as ascorbate, tocopherols, and selenium. The emergence of renewed interest by industrial countries in traditional herbal medicines and the development of 'functional foods' are stimulating the need for more information regarding the bioavailability and efficacy of plant polyphenols. Flavonoids represent a numerous group of secondary plant metabolites based on the structure of a pyran ring flanked by two or more phenyl rings and varying subtly in the degree of unsaturation and the pattern of hydroxylation or methylation. Flavonoids also vary in the type of sugar attached or the degree of polymerization. Anthocyanins, potent flavonoid antioxidants widely distributed in fruits, vegetables and red wines, normally occur in nature as glycosides, a form not usually considered as bioavailable. We have examined the bioavailability and pharmacokinetics of anthocyanins in humans. Anthocyanins were detected as glycosides in both plasma and urine samples. The elimination of plasma anthocyanins appeared to follow first-order kinetics and most anthocyanin compounds were excreted in urine within 4 h after feeding. The current findings appear to refute assumptions that anthocyanins are not absorbed in their unchanged glycosylated forms in humans.

The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines.
Eur Cytokine Netw. 2001 Apr-Jun;12(2):290-6.
Sambucus nigra L. products - Sambucol - are based on a standardized black elderberry extract. They are natural remedies with antiviral properties, especially against different strains of influenza virus. Sambucol was shown to be effective in vitro against 10 strains of influenza virus. In a double-blind, placebo-controlled, randomized study, Sambucol reduced the duration of flu symptoms to 3-4 days. Convalescent phase serum showed a higher antibody level to influenza virus in the Sambucol group, than in the control group. The present study aimed to assess the effect of Sambucol products on the healthy immune system - namely, its effect on cytokine production. The production of inflammatory cytokines was tested using blood - derived monocytes from 12 healthy human donors. Adherent monocytes were separated from PBL and incubated with different Sambucol preparations i.e., Sambucol Elderberry Extract, Sambucol Black Elderberry Syrup, Sambucol Immune System and Sambucol for Kids. Production of inflammatory cytokines (IL-1 beta, TNF-alpha, IL-6, IL-8) was significantly increased, mostly by the Sambucol Black Elderberry Extract (2-45 fold), as compared to LPS, a known monocyte activator (3.6-10.7 fold). The most striking increase was noted in TNF-alpha production (44.9 fold). We conclude from this study that, in addition to its antiviral properties, Sambucol Elderberry Extract and its formulations activate the healthy immune system by increasing inflammatory cytokine production. Sambucol might therefore be beneficial to the immune system activation and in the inflammatory process in healthy individuals or in patients with various diseases. Sambucol could also have an immunoprotective or immunostimulatory effect when administered to cancer or AIDS patients, in conjunction with chemotherapeutic or other treatments. In view of the increasing popularity of botanical supplements, such studies and investigations in vitro, in vivo and in clinical trials need to be developed.

Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress.
Free Radic Biol Med. 2000 Jul 1;29(1):51-60.
The objective of this study was to investigate the ability of endothelial cells (EC) to incorporate anthocyanins and to examine their potential benefits against various oxidative stressors. Endothelial dysfunction has been proposed to play an important role in the initiation and development of vascular disease, with studies having shown that administration of antioxidants improves endothelial function. Elderberry extract contains 4 anthocyanins, which where incorporated into the plasma membrane and cytosol of EC following 4 h incubation at 1 mg.ml(-1). However, incorporation within the cytosol was considerably less than that in the membrane. Uptake within both regions appeared to be structure dependent, with monoglycoside concentrations higher than that of the diglucosides in both compartments. The enrichment of EC with elderberry anthocyanins conferred significant protective effects in EC against the following oxidative stressors: hydrogen peroxide (H(2)O(2)); 2, 2'-azobis(2-amidinopropane) dihydrochloride (AAPH); and FeSO(4)/ascorbic acid (AA). These results show for the first time that vascular EC can incorporate anthocyanins into the membrane and cytosol, conferring significant protective effects against oxidative insult. These findings may have important implications on preserving EC function and preventing the initiation of EC changes associated with vascular diseases.

Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama.
J Altern Complement Med. 1995 Winter;1(4):361-9.
A standardized elderberry extract, Sambucol, reduced hemagglutination and inhibited replication of human influenza viruses type A/Shangdong 9/93 (H3N2), A/Beijing 32/92 (H3N2), A/Texas 36/91 (H1N1), A/Singapore 6/86 (H1N1), type B/Panama 45/90, B/Yamagata 16/88, B/Ann Arbor 1/86, and of animal strains from Northern European swine and turkeys, A/Sw/Ger 2/81, A/Tur/Ger 3/91, and A/Sw/Ger 8533/91 in Madin-Darby canine kidney cells. A placebo-controlled, double blind study was carried out on a group of individuals living in an agricultural community (kibbutz) during an outbreak of influenza B/Panama in 1993. Fever, feeling of improvement, and complete cure were recorded during 6 days. Sera obtained in the acute and convalescent phases were tested for the presence of antibodies to influenza A, B, respiratory syncytial, and adenoviruses. Convalescent phase serologies showed higher mean and mean geometric hemagglutination inhibition (HI) titers to influenza B in the group treated with Sambucol than in the control group. A significant improvement of the symptoms, including fever, was seen in 93.3% of the cases in the SAM-treated group within 2 days, whereas in the control group 91.7% of the patients showed an improvement within 6 days. A complete cure was achieved within 2 to 3 days in nearly 90% of the SAM-treated group and within at least 6 days in the placebo group. No satisfactory medication to cure influenza type A and B is available. Considering the efficacy of the extract in vitro on all strains of influenza virus tested, the clinical results, its low cost, and absence of side-effects, this preparation could offer a possibility for safe treatment for influenza A and B. Research elderberry.

Elderberry questions
Q. I’ve just been reading about the health benefits of elderberry on your website and wondered if you knew of any more recent research?
   A. As of April 2008, I have not seen any more human clinical studies with elderberry supplement.