herb · for slow recovery
Elderberry
Steers the immune response so an infection resolves sooner.
Say that in clinical terms
Modulates pro-inflammatory cytokines and accelerates immune response resolution, reducing infection duration.
How strong is the research?
Mixed evidence
In 87 patients with confirmed flu, elderberry did not shorten the illness.
Industry funded
3 papers read, 2 supporting, 1 against.
Who was studied: Adults aged 18 to 54 with laboratory-confirmed flu, in Norway, in one season.
How much to take
daily
600–900 mg
Higher doses for active infection. May reduce duration by up to 4 days.
Before you take it
- Raw and unripe elderberries (Sambucus nigra) contain sambunigrin, a cyanogenic glycoside that can cause nausea, vomiting, and diarrhea; commercial standardized extracts are processed (heated or membrane-filtered) to eliminate this compound.
- Immunostimulant activity is documented; theoretical risk of exacerbating autoimmune conditions and antagonizing immunosuppressant drugs (cyclosporine, tacrolimus, corticosteroids); at least one case report of autoimmune hepatitis temporally associated with elderberry use.
- In vitro studies show weak inhibition of CYP1A2, CYP2D6, and CYP3A4; a second in vitro study found no inhibitory effect on these enzymes; no clinically significant pharmacokinetic drug interaction in humans has been confirmed, but precaution is appropriate with narrow-therapeutic-index CYP3A4 and CYP2D6 substrates.
- No NIH/IOM Tolerable Upper Intake Level (UL) has been established for elderberry extract; it is an herbal botanical without a defined supplemental intake ceiling analogous to micronutrient ULs.
- Insufficient safety data exist for use during pregnancy or lactation; the European Medicines Agency recommends against use in these populations due to absence of adequate evidence.
What we make of it
The dose we list does not match what the trial actually gave.
The detail
The study gave 15 ml of elderberry syrup four times a day. The 600 to 900 mg range we list is a different formulation on a different schedule, so it does not follow from this trial.