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Elderberry Herb - Dosage and Useful Properties

Taxonomic Class

Caprifoliaceae

Common Trade Names

Elderberry Power, Elder Flowers

Common Forms

Available as ointments and aqueous solutions of the bark and leaves as well as oils, ointments, and wine; all are derived from the berries.

Source

Several species of Sambucus produce elderberries. Most of the literature refers to S. nigra and S. canadensis, although other species with similar chemical components exist. The flowers and berries are used most often; the inner bark and leaves contain most of the potentially toxic compounds.

Chemical Components

The flowers of S. nigra contain flavonoid glycosides, a cyanogenic glycoside (sambunigrine), essential oils, mucilage, tannins, and organic acids. Fruit from the elder (S. nigra) contains organic pigments (anthocyanins), amino acids, sugar, rutin, and a substantial amount of vitamin C (36 mg per 100 g of fruit). The elder leaves contain 3.5% rutin. The inner bark of the elder also consists of baldrianic acid. Other species contain additional compounds.

Actions

Elder has traditionally been used to treat diabetes, although studies in mice indicate that the agent exerts no effects on glucose control . This plant has shown activity against Salmonella typhi and Shigella dysenteriae and limited activity against Shigella flexneri. A branch tip extract of the red elder (Sambucus racemosa) was found to have strong in vitro antiviral activity against respiratory syncytial virus. No studies in humans or animals have been reported.

A recent study indicated that Nigeria was somewhat active against the production of inflammatory cytokines in vitro, giving some merit to folklore suggesting that the plant is effective in the treatment of fever, infections, and rheumatism. Elderberries have been reported to have antispasmodic, diaphoretic, diuretic, laxative, and sedative activity. The cyanogenic glycosides contained in the elder plants release cyanide when hydrolyzed, as when they are chewed; this effect might eventually explain some of the purported actions of this plant. Antihistamines have been detected in human plasma after oral administration of an elderberry extract .

Reported Uses

Elder has been used as an insect repellent, with sprays of the flowers placed in horses' bridles. The powder of dried elder flowers has been added to water and dabbed on the skin as a mosquito repellent. The herb has been used as a weight-loss agent and to treat colds, "dropsy;' insomnia, migraine headaches, renal disorders, and rheumatism. Clinical support for these uses in humans is lacking.

Mixed with sage, lemon juice, vinegar, and honey, elder has also traditionally been used as a gargle. With peppermint and honey in a hot drink, elder is said to be able to treat a cold, inducing diaphoresis to "sweat out" an illness. Elderberry juice has been used in hair dye and scented ointments. Other reported uses include treatment of asthma, burns, cancer, chafing, edema, epilepsy, gout, headache, hepatic disease, measles, neuralgia, psoriasis, syphilis, and toothache and for wound healing, although no scientific data support such uses.

Dosage

No consensus exists.

Adverse Reactions

GI: diarrhea (from berries of the S. ebulus and leaves of any species), vomiting (with ingestion of excessive amounts of S. racemosa berries).

Interactions

None reported.

Contraindications And Precautions

Berries of the dwarf elder species (S. ebulus) are contraindicated. Because all green parts of the elder plant are poisonous, avoid consumption of the leaves and stems. Avoid using elderberry in pregnant and breast-feeding patients. Use elderberry products cautiously because of the risk of cyanide toxicity.

Special Considerations

Monitor fluid intake and output of patients who experience adverse GI reactions from elderberry The dwarf elder (S. ebulus) is regarded as particularly poisonous. Large doses can cause diarrhea, vertigo, and vomiting (signs of cyanide toxicity).

Alert: Cyanide poisoning can result from ingesting the bark, roots, leaves, and unripe berries of the elder plant. Children making pipes or peashooters from the hollowed shafts of the elder can suffer cyanide poisoning. Ingestion of 60 mg of cyanide has caused death in humans. Emesis and gastric lavage are recommended for known elder plant ingestion. Amyl nitrate, sodium nitrate, and sodium thiosulfate can also be used when cyanide toxicity is suspected.

Instruct the patient to keep this plant out of the reach of children and pets and to have the telephone number for the nearest poison control center readily available.

Advise the female patient to avoid using elderberry during pregnancy or when breast-feeding.

Commentary

The use of elderberry products as cathartics is not recommended because of the risk of cyanide toxicity. Numerous other laxatives and cathartics exist whose safety and efficacy are well established. Because safe and effective anti-inflammatory drugs are also available for treating rheumatism and other conditions for which elderberries have been used, elderberry use for these conditions is not recommended. There is insufficient evidence to support use of this herbal product for medicinal applications.

   

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