Elder flowers and berries have been used in traditional medicine and as flavorings for centuries. In folk medicine, the flowers have been used for their diuretic and laxative properties and as an astringent.
Various parts of the elder have been used to treat cancer and a host of other unrelated disorders. Elderberry is available as an aqueous solution, berries, extract, flowers, oil, and wine.Reported usesElderberry extracts are used to treat asthma, bronchitis, cough, epilepsy, fever, fungal infections, gout, headache, hepatic dysfunction, neuralgia, rheumatic diseases, and toothache. They are also used as diuretics, insect repellents, and laxatives.Native Americans used tea made from elderberry flowers to treat respiratory infections. They also used the leaves and flowers in poultices applied to wounds, and the bark, suitably aged, as a laxative. The berries are frequently made into beverages, pies, and preserves, but they have also been used to treat arthritis.AdministrationInfusion (add 3 to 4 g of elderberry flowers to 5 oz of simmering water): 1 to 2 cups by mouth several times dailyElderberry juice-containing syrup: Adults, 4 tablespoons daily for three days; children, 2 tablespoons daily for three days.HazardsAdverse reactions associated with elderberry include diarrhea, nausea, and vomiting. There are no known interactions with elderberry.Pregnant and breast-feeding patients should avoid use.Safety Risk Elderberry has been associated with cyanide-like poisoning. Patients should avoid consumption of berries from the dwarf elder (S.ebulus) because it can contain an especially high content of cyanide-like compounds.Clinical considerationsDon't confuse elderberry with American elder (Sambucus canadensis).Leaves and stems shouldn't be crushed when making elderberry juice because of potential for cyanide toxicity.Elderberry may interfere with the intended therapeutic effect of conventional drugs.Elderberry (especially S. ebulus) can cause cyanide-like poisoning characterized by diarrhea, vomiting, vertigo, numbness, and stupor-particularly if uncooked portions are consumed. It can also cause toxic reaction in children if they use elderberry stems for peashooters.Uncooked elderberries are more likely to cause nausea.Monitor patients for nausea and vomiting.Warn patient not to treat symptoms of asthma, infection, or hepatic disease with elderberry before seeking appropriate medical evaluation because doing so may delay diagnosis of a potentially serious medical condition.Inform patient of the toxic potential of certain varieties of elderberry.Advise patient to keep this and other herbal products out of children's reach.Tell patient to remind pharmacist of any herbal or dietary supplement that he's taking when obtaining a new prescription.Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.Research summaryThe concepts behind the use of elderberry and the claims made regarding its effects haven't yet been validated scientifically.
