Elderberry

Greetings, listeners!  Welcome to another episode of the integrated pharmacist podcast.  Today I'd like to share with you one of my favorite herbal medications - the elderberry.  With the current COVID-19 pandemic causing socioeconomic upheaval, people are scrambling for some miracle product that will prevent themselves from getting the dreaded disease.  From disinfectants and face-masks to unproven medications, very little seems to be off the table at his point.
Elderberry has taken some spotlight in all of this, because of its history of use in other viral infections.  Research suggests one of it's effects is similar to the human hormone interferon.  Interferon is a chemical that virus-infected cells release that helps prevent neighboring cells from getting infected.  The in-vitro trial I refer to demonstrates mostly late-stage activity against influenza virus infection as well as immune response activation to up-regulate specific cytokines during active infections.

Elderberry is a shrub that grows well in moist, sunny places, though it can tolerate drier soil as well.  It can be found growing wild in much of the United States east of the Rocky Mountains (although we also have a species here in Nevada) and it's found abundantly in parts of Mexico and Central America.  Some farmers use elderberry as hedges, because they typically take well to most soil and can be molded to a desired shape.  According to some superstitions, witches congregate under elder trees especially when they bare fruit - which makes sense due to their long history of use in natural remedies.  The elder also gained some notoriety as the wood of a special wand in a famous book about the wizarding world.  Most parts of the plant are poisonous, and the berries should not be eaten raw.  Cooking the berries destroys the toxic glycosides found in the flesh, but even more concentrated in the seeds.  If you're making your own, I found a recipe on www.mountainroseherbs.com that calls for fresh or dried elderberries.  The cooking process includes simmering for 1 hour.  The final product can be sweetened and flavored as desired.  This particular recipe is meant to be stored in the fridge and enjoyed 1 teaspoon a day and will last through the "cold season."
I'd like to emphasis that with current evidence, there is no recommendation that elderberry will work for the coronavirus.  With that being said, I'd like to discuss an interesting trial I found that demonstrates what the elderberry can do.  This trial was published in 2016 and conducted in

Australia.  The BerryPharma company produces an elderberry extract that contains 300 mg per capsule that they wanted to test for efficacy and safety in treating or preventing cold and flu-like symptoms that develop while traveling.  They randomized and blinded 312 participants to take their extract or a matching placebo.  Participants took 2 capsules a day for 10 days prior to international travel and then 3 capsules for up to 5 days after departure.  Compared to the placebo arm, those who did contract an illness and were treated with elderberry experienced an average of 2 days shorter illness and less severe symptoms.  I would highlight that the extract did not seem to prevent participants from getting ill, but did alleviate symptoms and duration.  This seems to correlate with the in-vitro evidence that the extract works more in late-stage infection compared to early-stage.
I must say I had difficulty finding this specific brand of elderberry extract.  I would have thought, having put so much effort into clinical trials that this product would be more widely available.  I did learn that BerryPharma is produced by an Italian company called Iprona.  They make elderberry products under the ElderCraft label.  I did manage to find a handful of products that contained ElderCraft elderberries in them, but I did not find a specific 300 mg capsule.  That being said, what I did find is that currently available products range in price from about 5 cents per dose up to about $1 a dose.  Most bottles hold a 30 day supply at the range of $6 up to about $30.  For the green-thumbs, it may be a fun experiment to start growing and making your own extract - just be sure no one is consuming any part of the bush except the cooked fruit.

I recommend elderberry juice or syrup to my friends who are looking for ways to reduce cold and flu-like symptoms during the "cold months."  However, looking for quality products, as usually, can be a challenge.  It seems the safest bet, for now, is to make your own.  They grow pretty easily and it requires minimal effort and extra ingredients.  This seems like an easy starter herb for people just getting their feet wet.
Thank you so much for listening.  It really helps grow my podcast if you leave a kind rating or review on Apple Podcast or wherever you listen to this podcast.  Please help others find me by telling your friends!  And please join me next time on the Integrated Pharmacist Podcast.

References:
Torabian G, Valtchev P, Adil Q, Dehghani F. Anti-influenza activity of elderberry (Sambucus nigra). Journal of Functional Foods. 2019;54:353-360. doi:10.1016/j.jff.2019.01.031
Krawitz C, Mraheil MA, Stein M, et al. Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. BMC Complement Altern Med. 2011;11:16. Published 2011 Feb 25. doi:10.1186/1472-6882-11-16
https://blog.mountainroseherbs.com/elderberry-syrup-recipe
Tiralongo E, Wee SS, Lea RA. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients. 2016;8(4):182. Published 2016 Mar 24. doi:10.3390/nu8040182