Re: Elderberry Extract for Treating Influenza Symptoms
King HF. Pilot clinical study on a proprietary elderberry extract: efficacy in addressing influenza symptoms. Online Journal of Pharmacology and Pharmacokinetics. 2009;5: 32-43.
Elderberry
(Sambucus nigra) has a long history
of use for the treatment of colds and influenza. Clinical studies have found
that elderberry extracts can inhibit influenza a and b infections, and
pre-clinical studies have shown antiviral effects.1 A recent study
has shown that flavonoids from elderberry bind to the surface of the H1N1
influenza virus and interfere with host cell receptor recognition and/or
binding.2 This pilot clinical trial was designed to examine the
effect of a proprietary slow-dissolve elderberry extract lozenge in the
treatment of flu-like symptoms.
The
study was conducted at ShanghaiConstructionTechnicalCollege (Shanghai, China)
in March-April 2009. The patients were aged 16-60 years and presented with flu
symptoms for less than 24 hours. The patients had at least 3 of the following
symptoms: fever, headache, muscle aches, coughing, mucus discharge, and nasal
congestion. Using computer-generated randomization, the patients were assigned
either lozenges containing 175 mg elderberry extract (HerbalScience Singapore
Pte. Ltd.; Singapore;
n=32) or placebo lozenges (n=32) that were similar in appearance and taste. The
patients took 4 lozenges/day for 2 days at mealtimes and bedtime. The following
symptoms were monitored using a visual analogue scale (VAS): fever, headache,
muscle aches, cough, mucus discharge from the respiratory tract, and nasal
congestion. The patients were asked to score their symptom improvements 4 times
a day for 2 days on a scale of 0 (no problems) to 10 (pronounced problems).
At
baseline, 15 patients in the elderberry group and 9 in the placebo group had
fevers ranging from 37.3-38.8°C. After the first 24 hours, there was a
statistically significant decrease in fever compared to baseline in the
elderberry group (P<0.0001). After 48 hours, all of the patients with fevers
at baseline in the elderberry group had normal temperatures. In contrast, most
patients with fever in the placebo group did not show improvement after 48
hours and only 2 had normal temperatures. All patients reported headaches at
baseline. After 24 hours, there was a significant reduction in headache
compared to baseline in the elderberry group (P<0.0001). After 48 hours, 78%
of the elderberry group patients did not have headaches and 22% had mild
headaches (VAS=1). In the placebo group, headaches became more severe compared
to baseline after 48 hours (P<0.0001), and no improvements in headache were
reported.
At
baseline, all of the patients in the elderberry group and 87.5% of patients in
the placebo group had nasal congestion. After 24 hours, the elderberry group
showed a significant improvement in nasal congestion (P<0.0001). After 48
hours, 50% of patients in the elderberry group had no nasal congestion. In the
placebo group, nasal congestion was worse for most patients (P=0.049), and only
2 patients reported improvements after 48 hours. About half of the patients in
each group reported coughing at baseline. No significant improvement in
coughing was found after the first 24 hours in the elderberry group. However, after
48 hours, cough had improved in the elderberry group, but the difference was
not statistically significant (P=0.093). Nonetheless, the elderberry group showed
significant improvements in coughing when compared to the placebo group at 48
hours (P<0.0001). In the placebo group, the majority of patients reported a
worsening of cough and the VAS score increased compared to baseline after 48
hours (P=0.0041). No adverse effects were reported.
The
author concludes that the administration of this proprietary elderberry extract
"can rapidly relieve influenza-like symptoms." He comments that the
results suggest that the proprietary elderberry extract is similar or superior
to antiviral drugs in treating influenza-like symptoms and shortening the
duration of illness, but more research is needed to determine if the extract
can reduce viral shedding. The absence of adverse events leads the author to
suggest that the proprietary elderberry extract should be studied in children
and the elderly. He also suggests research on the proprietary elderberry
extract in treatment of pandemic H5N1 avian influenza infections based on unpublished
data by Dr. Roschek and coworkers showing that flavonoids from elderberry bind
to the viral strain in vitro. More research is needed to confirm these results,
including clinical trials which use objective measurements of symptoms and
laboratory-confirmed influenza cases.
—Marissa Oppel-Sutter, MS
References
1.Garner-Wizard M. Review of
pharmacology and clinical benefits of European elderberry. HerbClip. January
31, 2006 (No. 070752-297). Austin,
TX: American Botanical Council. Review
of Monograph. Sambucus nigra
(elderberry). Altern Med Rev. 2005;10(1):51-55.
2.Roschek B Jr, Fink RC, McMichael MD, Li D, Alberte
RS. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochem. Jul 2009;70(10):1255-1261.