Elderberry syrups are used to fight colds and flu
Elderberry syrups are used to fight colds and flu

By Sarah Crawford, PhD

INTRODUCTION

Winter is coming soon, and, with it, another flu season.  You want to start taking elderberry, but which product should you choose?  I have outlined seven things to consider when purchasing a product containing elderberry.  You want a product with a high concentration of the fruit, prepared and processed in a way that does not destroy its flu-fighting properties, and a cost-effective choice.  Let’s take a closer look to see what’s out there……

Table: Selected Commercially Available Elderberry Products

Product Name/Volume or Weight Form of Elderberry Key elderberry flu-fighting ingredients/dose Retail price of key ingredients/mg Quality Ranking*
Sambucol

(original)/(120ml)

Elderberry extract (38%) syrup (120ml) 3.8g of elderberry juice in each 10ml dose. 45.6g total elderberry 3800 mg=(38%) $1.08/10ml dose;
$0.28/g key elderberry
1
Mrs Miller’s

elderberry jelly/9 oz.

Liquid berry concentrate 25% 20g/serving (about ½ elderberry)  $2.10/ serving key elderberry; approx. $0.21 /g 2
Rubini

BioFlavonoides

Elderberry Extract

Elderberry concentrate (18:1) syrup 25% elderberry NA 3
Sambucol

Extra Defense/(120ml)

Elderberry extract (38%) plus additional supplements syrup 3.8g=38%Same amount of elderberry as ‘original’ formula $1.12/10ml dose;

$0.30/g key elderberry/

dose

4
OptiBerry

IH141/10g

Proprietary combined 6 mixed berry + vitamin C 10%

capsule

Approx 7mg/ capsule = 15% $3.18/capsule

$0.45 /mg key elderberry

5
Frontier Dried Whole Elderberries/16 oz. Dried fruit, 16 ounces (453 grams) 100% berry $1.25/ounce;

$0.044/g key elderberry

6
Sinupret

(Quanterra

Sinus Defense)/3.9g

Combined phytochemical tablet 36 mg =23% per tablet; 23% of the active ingredients in the tablet are elderberry (36mg per tablet) $0.60 per tablet;

$0.20/g key elderberry

7

Source: Sambucol (original) 120ml – Amazon, $12.96; Mrs. Miller’s elderberry jelly, 9 0z., 7.99 Amazon;  Rubini pricing not available; Sambucol Extra Defense 120ml, $13.45 Amazon; Optiberry, 10g $27.99 Optimum Health Vitamins; Frontier Whole Elder European Berries, 16 ounces, $19.96 Amazon; Sinupret 3.9g, $14.95 Amazon.

*Quality rankings- the best 1 and six lowest based on the method of preparation effects on bioactive components and elderberry concentration in the final product. These products were chosen based on several criteria:1Porter, Randall S., and Robert F. Bode. "A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products." Phytotherapy Research (2017). Representative types of products containing elderberry;2 Lohachoompol, Virachnee, George Srzednicki, and John Craske. "The change of total anthocyanins in blueberries and their antioxidant effect after drying and freezing." BioMed Research International 2004.5 (2004): 248-252. Popular consumer choices for anti-flu products;3Amakura, Yoshiaki, et al. "Influence of jam processing on the radical scavenging activity and phenolic content in berries." Journal of Agricultural and Food Chemistry 48.12 (2000): 6292-6297. Proportion of the product that contains elderberry. The products are listed based on the order of “quality rankings.” The data were obtained from product supplement /nutrition labels.

NA=data not available

  1. Specific elderberry components with flu-fighting properties.

Elderberries are rich in flu-fighting bioactive compounds. Among these are flavonoids that include anthocyanins (plant pigments) and quercetin, both of which destroy free radicals.  They also contain Vitamin C in large quantities.1Porter, Randall S., and Robert F. Bode. "A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products." Phytotherapy Research (2017). These ingredients have been studied individually, but may also have a combined effect when extracts prepared from whole berries are consumed.

  1. Effect of processing/preparation method on flu-fighting properties of the elderberry.

Research studies have shown that products prepared from berries typically show varying degrees of loss of free radical fighting phenolics, which vary depending upon the extraction method used.2 Lohachoompol, Virachnee, George Srzednicki, and John Craske. "The change of total anthocyanins in blueberries and their antioxidant effect after drying and freezing." BioMed Research International 2004.5 (2004): 248-252.

Typical berry processing methods involve heating the berries with sugar to make jams and jellies.  This method of preparation may cause a minimal reduction in the activity of key flu-fighting molecules.3Amakura, Yoshiaki, et al. "Influence of jam processing on the radical scavenging activity and phenolic content in berries." Journal of Agricultural and Food Chemistry 48.12 (2000): 6292-6297.   Steam extraction to produce juices can destroy much of the anti-oxidant quercetin.4Sablani, Shyam S., et al. "Effect of thermal treatments on phytochemicals in conventionally and organically grown berries." Journal of the Science of Food and Agriculture 90.5 (2010): 769-778.   Cold-press preparation methods appear to be less destructive to these important compounds.5Häkkinen, Sari H., et al. "Influence of domestic processing and storage on flavonol contents in berries." Journal of agricultural and food chemistry 48.7 (2000): 2960-2965.

Berry dehydration by freeze-drying, vacuum microwave drying, and air-drying processing methods results in reduced levels of total phenolics and anthocyanins as well as decreased anti-oxidant activity.6Kwok, B. H. L., et al. "Dehydration techniques affect phytochemical contents and free radical scavenging activities of Saskatoon berries (Amelanchier alnifolia Nutt.)." Journal of food science 69.3 (2004). That said, the best anti-oxidant activity among the dehydration methods was retained in freeze-dried berries, followed by air-dried and microwave dehydrated samples, in that order.6Kwok, B. H. L., et al. "Dehydration techniques affect phytochemical contents and free radical scavenging activities of Saskatoon berries (Amelanchier alnifolia Nutt.)." Journal of food science 69.3 (2004).

Overall, freezing fresh berries appears to be the best way to preserve the bioactivity of the fruit.2 Lohachoompol, Virachnee, George Srzednicki, and John Craske. "The change of total anthocyanins in blueberries and their antioxidant effect after drying and freezing." BioMed Research International 2004.5 (2004): 248-252. Measurements of anthocyanin levels after freezing do not show significant differences from the fresh fruit.

  1. What forms of elderberry are commercially available and what are the properties of each? (Please see Table foradetailed list.)

Optiberry (capsules)

Optiberry contains a vegetable encapsulated mixture of six berries: blueberry, strawberry, cranberry bilberry, raspberry and elderberry.7Zafra‐Stone, Shirley, et al. "Berry anthocyanins as novel antioxidants in human health and disease prevention." Molecular nutrition & food research 51.6 (2007): 675-683. The formulation is proprietary; however, the formulation is prepared in a way that preserves the anthocyanin activity of the components. The formulation also contains Vitamin C at 10%.  Assuming that elderberry comprises ⅙ of the berry component, one can estimate that 15% of the Optiberry capsule contains anthocyanins from the elderberry.

Sinupret (tablets)

Sinupret is a tablet formulation that contains a variety of plant compounds including the elderberry (36 mg) or about 23% per dose.8Ismail, C. "Pharmacology of Sinupret. Recent results on the rationale for the Sinupret compound." Hno 53 (2005): S38-42.  Elderberry components comprise approximately 23% of each tablet.

Sambucol (original extract formulation)

Sambucol is a liquid elderberry extract (38%) containing three flavonoids at a high concentration of  3800 mg/dose.9Barak, Vivian, Tal Halperin, and Inna Kalickman. "The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines." Eur Cytokine Netw 12.2 (2001):   The children’s formulation contains 19% elderberry extract.9Barak, Vivian, Tal Halperin, and Inna Kalickman. "The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines." Eur Cytokine Netw 12.2 (2001):  Sambucol, in its original syrup formulation, contains the fewest additional ingredients of the more popular elderberry products used for medicinal purposes.

Sambucol  Extra Defense (liquid)

Sambucol Extra Defense is a newer, more complex formulation that contains the same concentration of elderberry extract (38%) as Sambucol original, but is supplemented with additional vitamins and minerals at fairly high concentrations.  Unlike the original product, it is a multivitamin supplemented with elderberry extract.

Rubini (concentrated liquid)

Rubini is a highly concentrated elderberry extract prepared by evaporation of the water component of the fruit using a proprietary method designed to concentrate the active components of the berry.10Veberic, R., J. Jakopic, and F. Stampar. "Flavonols and anthocyanins of elderberry fruits (Sambucus nigra L.)." II International Symposium on Human Health Effects of Fruits and Vegetables: FAVHEALTH 2007 841. The elderberry-to-extract ratio of the product is 18:1, with a minimum anthocyanin concentration of 3.2%. The product, developed in 2011 by researchers in Germany, is not currently available in the U.S.

Jellies, juice

Jelly and juice are prepared by boiling extraction most commonly. Three pounds of fresh elderberries maximally yields up to three pints of juice, which is about 25% more concentrated than fresh berries.  However, each serving of jelly/juice is about 50% sugar, reducing the elderberry concentration to about 62%.

  1. Additives, preservatives and fillers’ side effects.

Encapsulations Optiberry contains no additives, fillers, preservatives, or artificial colors.11Ulbricht, Catherine, et al. "An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration." Journal of dietary supplements11.1 (2014): 80-120. At the other extreme, Sinuset contains glucose syrup, indigo carmine, aluminum hydroxide; lactose monohydrate; light magnesium oxide, shellac, silicon dioxide, titanium dioxide, and more.12Stoltenberg, Ines, et al. "PHARMACY." (2011). The side effects of some of these ingredients are questionable at best. Sambucol contains: glucose syrup, purified water, citric acid, potassium sorbate.13Mumcuoglu, Madeleine. "Use of Elderberry Extract." U.S. Patent Application No. 12/159,691.

  1. Should elderberry besole ingredient or combined with other flu-fighting agents?

Unfortunately, not enough information is currently available to answer this question properly.  The concept that “more is better” does not necessarily apply here. What is needed are more clinical trials that examine the effects of natural phytochemical extracts like the elderberry and other flu-fighting drugs and vitamins.  There is some evidence, however, that the elderberry extract by itself may be as effective as other commercially available products, such as Tama-flu.14Elrod, Susan Marie, Phillip Greenspan, and S. Mark Tompkins. "EFFECT OF MUSCADINE CONCENTRATE AND COMMERCIAL ELDERBERRY PREPARATION ON WILD-TYPE H1N1 AND H3N2 INFLUENZA VIRUSES IN VITRO." DEVELOPMENT OF NUTRACEUTICALS AND

  1. Cost-effectiveness of combined formulations/pure elderberry.vis-a-visconcentration of flu-fighting ingredients.

The Table shows the comparative costs of some of the popular elderberry products. Sambucol products and Mrs. Miller’s jelly were among the most cost-effective ($0.20-$0.30 per gram serving) The most expensive was Optiberry which cost $0.47 for the elderberry per dose, which comprised only $15% of the product. The dried elderberry tea was the most economical, priced at only $0.05 per gram.

  1. Importance of dose level standardization.

Currently, there are no standard dosing guidelines established for elderberry products used in medicinal formulations. The concentrations of elderberry in the tablet, capsule and syrup formulations of the popular products ranged from 15-40%. More research is needed to determine the optimal concentrations of elderberry supplementation.

CONCLUSION

The Table shows “Quality Rankings” assigned based on the effects of processing on the active elderberry components. As tablets and capsules require a powdered, dehydrated form of the material, these are ranked lower because this process has the greatest negative impact on the activity of the bioactive phenolics.

Sambucol ranks #1 because the product is a liquid formulation with a significantly high elderberry content. However, it consists of just three flavonoids rather than the whole juice (as in jams, for example). We still don’t know how each of the ingredients of the elderberry contributes to its overall effectiveness; the entire berry may very well have greater flu-fighting capacity than selected components.   The method of processing and concentrating the product Rubini is promising, but more information is needed.   The jelly/juice product has the highest content of elderberry, but also contains about 50% sugar. Despite the higher sugar content, jams and jellies are ranked high (#2)  because they consist of the whole berry components; the temperature used in preparation, however, may affect product contents.

The teas rank low (#6) due to the inactivating effects of the drying process.

There are many ways to consume your elderberries- I hope this review helps you to pick the product that’s best for you!

Related article: Seven Things to Consider When Choosing a Form of Elderberry

1 Porter, Randall S., and Robert F. Bode. "A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products." Phytotherapy Research (2017).
2 Lohachoompol, Virachnee, George Srzednicki, and John Craske. "The change of total anthocyanins in blueberries and their antioxidant effect after drying and freezing." BioMed Research International 2004.5 (2004): 248-252.
3 Amakura, Yoshiaki, et al. "Influence of jam processing on the radical scavenging activity and phenolic content in berries." Journal of Agricultural and Food Chemistry 48.12 (2000): 6292-6297.
4 Sablani, Shyam S., et al. "Effect of thermal treatments on phytochemicals in conventionally and organically grown berries." Journal of the Science of Food and Agriculture 90.5 (2010): 769-778.
5 Häkkinen, Sari H., et al. "Influence of domestic processing and storage on flavonol contents in berries." Journal of agricultural and food chemistry 48.7 (2000): 2960-2965.
6 Kwok, B. H. L., et al. "Dehydration techniques affect phytochemical contents and free radical scavenging activities of Saskatoon berries (Amelanchier alnifolia Nutt.)." Journal of food science 69.3 (2004).
7 Zafra‐Stone, Shirley, et al. "Berry anthocyanins as novel antioxidants in human health and disease prevention." Molecular nutrition & food research 51.6 (2007): 675-683.
8 Ismail, C. "Pharmacology of Sinupret. Recent results on the rationale for the Sinupret compound." Hno 53 (2005): S38-42.
9 Barak, Vivian, Tal Halperin, and Inna Kalickman. "The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines." Eur Cytokine Netw 12.2 (2001): 290-296.
10 Veberic, R., J. Jakopic, and F. Stampar. "Flavonols and anthocyanins of elderberry fruits (Sambucus nigra L.)." II International Symposium on Human Health Effects of Fruits and Vegetables: FAVHEALTH 2007 841. 2007.
11 Ulbricht, Catherine, et al. "An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration." Journal of dietary supplements11.1 (2014): 80-120.
12 Stoltenberg, Ines, et al. "PHARMACY." (2011).
13 Mumcuoglu, Madeleine. "Use of Elderberry Extract." U.S. Patent Application No. 12/159,691.
14 Elrod, Susan Marie, Phillip Greenspan, and S. Mark Tompkins. "EFFECT OF MUSCADINE CONCENTRATE AND COMMERCIAL ELDERBERRY PREPARATION ON WILD-TYPE H1N1 AND H3N2 INFLUENZA VIRUSES IN VITRO." DEVELOPMENT OF NUTRACEUTICALS AND FUNCTIONAL FOODS: ELDERBERRY (SAMBUCUS NIGRA), MUSCADINE (VITUS ROTUNDIFOLIA), AND CRAFT BEER: 100.