Uncooked Berries and Plant Parts Pose a Universal Risk
It is critical to understand that raw, unripe elderberries and other parts of the elder plant—including the stems, leaves, roots, and bark—contain cyanogenic glycosides. When ingested, these compounds can release cyanide, leading to symptoms like severe nausea, vomiting, and diarrhea. Cooking the berries thoroughly destroys these toxic compounds, making them safe for consumption in forms like syrup or jam. Unripe, raw elderberries should never be consumed under any circumstances.
High-Risk Groups and Specific Dangers
Individuals with Autoimmune Diseases
Elderberry is known for its immune-stimulating properties, which is why it is often promoted as a supplement for colds and flu. However, this is precisely what makes it dangerous for people with autoimmune diseases such as lupus, rheumatoid arthritis, multiple sclerosis (MS), or inflammatory bowel disease. By stimulating the immune system, elderberry could potentially trigger a flare-up of symptoms, exacerbating the condition. The immune system's overstimulation can cause increased inflammation and damage, making it a high-risk supplement for this population. Anyone with an autoimmune condition should avoid elderberry unless specifically advised by their doctor.
Pregnant and Breastfeeding Women
Medical experts and health organizations advise against elderberry for pregnant and breastfeeding women. This is not because of proven harm, but due to a lack of sufficient research on its effects on this specific population. Since ethical considerations limit research on pregnant and breastfeeding individuals, the safety data is simply not available. Given the potential toxicity of raw plant parts and the unknown effects of concentrated supplements, it is considered safest to avoid elderberry entirely during pregnancy and lactation.
People on Immunosuppressant Medications
Patients who have undergone organ transplants or have severe autoimmune diseases often rely on immunosuppressant drugs to prevent their body from attacking itself or the new organ. Since elderberry works to boost the immune system, taking it could counteract the effects of these vital medications. This can have severe health consequences, including organ rejection or a worsening of the underlying condition. For this reason, individuals on immunosuppressants should not take elderberry supplements.
Individuals with Diabetes
Elderberry has been observed to have a potential effect on blood sugar levels. For individuals with diabetes, especially those on medications like insulin or metformin, this can increase the risk of hypoglycemia, or dangerously low blood sugar. This can lead to dizziness, weakness, and other serious complications. Any diabetic considering elderberry must consult their doctor first to assess the risk and monitor their blood sugar closely.
People Taking Diuretics
Elderberry can have a natural diuretic effect, which increases urination. For people already taking prescription diuretic medications, combining them with elderberry can lead to an amplified effect. This can cause excessive fluid loss and lead to dehydration or an electrolyte imbalance. It is important to consult a healthcare provider before using elderberry if you are on diuretic medication.
How Elderberry Interacts with Certain Medications
Interactions Beyond Immunosuppressants and Diuretics
- Chemotherapy Drugs: Elderberry may interact with certain chemotherapy drugs, potentially increasing side effects or reducing the effectiveness of the treatment. Cancer patients should never take elderberry without first consulting their oncologist. One case study involved a patient taking the chemotherapy drug pazopanib, where concurrent elderberry use was associated with liver injury.
- Other Medications: Interactions with other drugs are less well-researched, but caution is always warranted. The fact that dietary supplements are not strictly regulated by the FDA means that product contents can vary, increasing the risk of unknown interactions.
Elderberry Products: Proper Preparation vs. Danger
| Aspect | Properly Prepared Elderberry | Raw Elderberry / Plant Parts |
|---|---|---|
| Toxicity | Toxin-free, as heat destroys cyanogenic glycosides. | Contains toxic cyanogenic glycosides that can release cyanide. |
| Consumption Method | Cooked, typically in syrups, jams, or gummies from ripe berries. | Should never be ingested, as it can cause serious illness. |
| Side Effects | Generally well-tolerated, with rare and mild GI upset. | Immediate and severe gastrointestinal distress (nausea, vomiting, diarrhea). |
| Preparation | Requires cooking berries, removing stems and leaves, and using reputable, tested products. | Involves direct ingestion of unprocessed, wild, or unripe parts of the plant. |
Conclusion
While elderberry is a popular supplement for seasonal immune support, certain individuals and situations carry significant risk. Groups such as those with autoimmune disorders, pregnant and breastfeeding women, and people on immunosuppressant or diabetes medication must exercise extreme caution or avoid it entirely. Furthermore, the universal danger posed by consuming raw elderberries or other plant parts cannot be overstated due to cyanide-producing toxins. Always source elderberry products from reputable, certified manufacturers and consult a healthcare professional before beginning supplementation, especially if you have pre-existing health conditions or take prescription medication. For further information on herbal supplement safety, consult reliable resources such as the National Center for Complementary and Integrative Health (NCCIH) at the NIH.
