Elder

Sambucas nigra, Sambucus canadensis

Efficacy

• Indications with possible efficacy:
  None
• Indications with possible, but poorly documented efficacy:
  Influenza (berry)
  Sinusitis (flower)
• Other indications with no proof of efficacy:
  Bronchitis
  Constipation
  Diuretic
  Rheumatismal pain

Safety

• Risk of Drug Interaction: Low
• Adverse effects: Rare

Description

Part of the plant used: berry and flower

This shrub, commonly found in Europe (common elder) and North America (American elder), produces berries that are typically used to make wine and pies. It has been used on both continents as a remedy against colds and excess mucous for a very long time.

Elderberry extract is used in syrups and juices while elder flowers are used as infusions, extracts or tinctures.

Direction of use

According to the different references, there is a great variability in the dosage. It makes it difficult to do recommendations and propose usual doses.

Precautions

• Side effects
  Elder causes very few adverse events. It is generally safe and rarely results in gastrointestinal disorders (nausea, vomiting), dizziness, weakness.
• Contraindications
  Patients suffering from autoimmune diseases such as multiple sclerosis, lupus erythematosus and rheumatoid arthritis should avoid elder.
• Interactions
  Theoretically, elder may increase the effects of diuretic, decongestant, anti-inflammatory and hypoglycemic drugs and counters the effects of immunosuppressive drugs.
• Pregnancy and breastfeeding
  Elder is not recommended for women who are pregnant or nursing since its safety has not been established.

Clinical Notes

• The bark, leaves, seeds and raw/unripe fruit contain sambunigrin, a potentially toxic derivative of cyanide.

Warning

In 2004, Canada adopted new regulations that control the manufacturing, packaging, labeling and importing of natural health products. The new regulations also include an adverse reaction reporting system. Products that conform to the regulation's criteria are identified with a natural product number (NPN) and can be legally sold in Canada. This number indicates that the product meets specific criteria for safety and purity, not that it is effective for any indication.

Medicinal plant contents vary naturally from plant to plant - just as fruits from the same package may vary in taste and texture. There is no standard to measure the active content of each plant. Thus, efficacy of natural products should be expected to vary from brand to brand as well as from bottle to bottle of the same brand.

For more information about the Natural Health Products Regulations, or to check if a product has been assessed, visit the Health Canada website at www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php.

References

1. Barnes J. et Al. Herbal Medicines, 2e édition, Pharmaceutical Press, 2002
2. Natural Medicines Comprehensive Database, Therapeutic Research Faculty, 2010
3. Passeportsanté.net. Sureau noir. www.passeportsante.net
4. Medline Plus, Elder, medlineplus.gov, January 2007
5. Rotblatt M. et Ziment I. Evidence-Based Herbal Medicine, Hanley & Belfus, 2002
6. Natural Therapeutics Pocket Guide, 2000-2001
7. The Review of Natural Products, 6th Edition, 2010