The Dangers of Raw and Improperly Prepared Elderberry
One of the most critical reasons for exercising caution with elderberry is the inherent toxicity of the raw plant. Unripe berries, leaves, bark, and seeds of the elderberry tree contain a poisonous, cyanide-producing compound known as cyanogenic glycoside. Ingesting these raw parts can lead to serious adverse effects, including nausea, vomiting, severe diarrhea, and stomach cramps. For this reason, only properly cooked and processed elderberry products, like those found in commercial syrups, gummies, and capsules, are considered safe for consumption. DIY recipes can be risky if not prepared with sufficient heat to neutralize all toxins.
Lack of Long-Term Safety Data
While short-term use of commercial elderberry supplements is generally well-tolerated, there is a significant lack of reliable information regarding the safety of using it for longer than 12 weeks. The long-term effects of daily or continuous elderberry supplementation are largely unknown. Most studies supporting its use have focused on short periods, often for the duration of a cold or flu. The absence of extensive long-term research means that potential side effects or interactions from prolonged daily consumption are not fully understood. Some isolated case reports have suggested a possible link between long-term use and liver injury or autoimmune hepatitis, although a direct causal link has not been established.
Risks for Individuals with Autoimmune Diseases
Elderberry has an immunomodulatory effect, meaning it can increase or stimulate immune activity. This property, while beneficial for fighting a cold, poses a significant risk for people with autoimmune diseases such as rheumatoid arthritis, lupus, multiple sclerosis, or dermatomyositis. For these individuals, an overactive immune system is already attacking the body's healthy tissues. By stimulating the immune response further, elderberry can potentially exacerbate symptoms and worsen the disease. In fact, studies have shown that for patients with certain autoimmune skin diseases, elderberry use was associated with the highest risk of disease exacerbation.
Potential Drug Interactions
Daily elderberry consumption can interfere with certain medications, making it unsafe for some individuals. It's crucial to consult a healthcare provider before starting a supplement regimen, especially if you are on regular medication.
- Immunosuppressants: As elderberry stimulates the immune system, it can counteract the effects of immunosuppressant drugs prescribed to manage autoimmune diseases or prevent organ rejection in transplant recipients.
- Diuretics: Elderberry has mild diuretic properties, which could increase the effect of medications that make you urinate more. This can lead to dehydration or electrolyte imbalance.
- Other Medications: Elderberry may also interact with other drugs, including those for diabetes (due to its effect on blood sugar) and potentially chemotherapy treatments.
Hidden Sugar Content and Other Considerations
Many commercially available elderberry products, particularly syrups and gummies, contain significant amounts of added sugar. This can be a concern for individuals managing their blood sugar levels, weight, or simply trying to limit sugar intake. The high sugar content can detract from the product's overall health benefits.
Furthermore, elderberry's effect on the gut microbiome is still being studied, and excessive intake could potentially cause gastrointestinal distress. It is always best to adhere strictly to the dosage instructions on reputable supplement labels and to cycle your intake rather than consuming it daily for extended periods.
Comparison Table: Short-Term vs. Long-Term Elderberry Use
| Feature | Short-Term Use (e.g., during illness) | Long-Term Daily Use |
|---|---|---|
| Safety Profile | Generally considered safe when using reputable, cooked extracts and following dosage instructions. | Long-term safety is unknown due to limited research. |
| Primary Purpose | Immune system support to help alleviate cold and flu symptoms. | General wellness and immune boosting, but with potential for unintended side effects. |
| Risk of Autoimmune Exacerbation | Low risk, as use is typically limited to a few days. | High risk, as continuous immune stimulation can trigger or worsen autoimmune diseases. |
| Potential Drug Interactions | Risk is lower due to short duration, but still possible with immunosuppressants. | Higher risk of interaction with immunosuppressants, diuretics, and other medications. |
| Common Side Effects | Mild gastrointestinal upset if dosage is exceeded. | Potential for severe side effects, including liver issues, based on rare case reports. |
Conclusion
While elderberry has garnered a reputation for its immune-supporting properties, it is not a supplement that should be taken daily and indefinitely by everyone. The potential for toxicity from raw plant parts and the unknown risks associated with long-term consumption warrant a conservative approach. Most importantly, individuals with autoimmune diseases and those taking immunosuppressant medications should avoid daily elderberry, as it can worsen their condition and interfere with treatment. Limiting elderberry use to short, targeted periods, like at the onset of cold or flu symptoms, and always consulting a healthcare provider is the safest and most prudent strategy.
Resources
- National Center for Complementary and Integrative Health (NCCIH): Elderberry: Usefulness and Safety
- WebMD: Elderberry: Health Benefits, Risks, Uses, Effectiveness
- National Institutes of Health (NIH): A Plausible Association Between the Use of Elderberry and Autoimmune Hepatitis
