There are many herbal treatments available to patients, but few have been used longer than sambucas nigra, otherwise known as elder berry. Well known for its analgesic, antipyretic, anti-inflammatory, diuretic, laxative immune boosting qualities, elder berry has been used for multiple health alterations (Ulbricht, Basch, Cheung, Goldberg, Hammerness, Isaac, &...Wortley, 2014). In this paper the background, pharmacology, contraindications, current research and recommendations for use regarding elder berries will be discussed. Elder berries are a versatile fruit that has multiple applications in the healthcare field, warranting an increased role in patient care.
The sambucas genus contains many different plants, with the sambucas nigra shrub occurring in Europe and North America. Both the European variety (nigra) and the North American variety (canadensis) are often examined concurrently due to their similarities in use and pharmacology . Ulbricht et al. (2014) explain that the European variety grows up to 30 feet with the flowers and leaves used as flavouring, an analgesic, anti-inflammatory, antipyretic and diuretic and the bark is used as a laxative and emetic. They also state that traditionally, elder berries were used in England and Russia to ward off evil influences, witches, spirits and death. Fernandes, Marques, de Freitas, Mateus (2013) describe that dating as far back as ancient Egypt and the time of Hippocrates recipes for elder-berry based medications were found and extensively used to treat a multitude of ailments such as influenza, colds and sinusitis. Since it's early beginnings, elderberry has continued to be of use for the treatment of colds, flu, and fever in addition to burns, cuts and many other ailments (Ulbricht et al.; Fernandes et al.; Vlachojannis, Cameron, Chrubasik, 2010).
While the flowers and leaves of sambucas nigra specifically (other variations require cooking of the flowers and leaves) are safe, use of the bark and root requires careful monitoring by a healthcare provider. The bark and root pose a risk for cyanide poisoning (Ulbricht et al., 2014) . Ulbricht et al. find that the bark and root contains a glycoside that when metabolized by the body, increases cyanide levels which can result in a toxic build up and cyanide poisoning. The authors recommend if there is a toxic overdose, Ipecac should be used to stimulate emesis followed by gastric lavage. The study also warns if the berries, root and bark are not cooked properly, severe and uncontrollable GI distress (abdominal cramping, vomiting, diarrhea) occurs in addition to the risk of cyanide toxicity.
A popular medication with liquid elderberry extract, Sambucol (n.d.) contains 38% (11 grams in 120mL) elderberry extract in their adult version and 19% (1.91 grams in 120mL)in their pediatric version. They recommend 15mL 4 times daily for adults, for children 2-3 years 10mL two times daily, for children 4-8 years 10mL 3 times daily and for...