Pregnancy SmartShop formulas

Is it safe? · Pregnancy Smart

How much elderberry is safe during pregnancy?

Assigned clinical reviewerMatt Stahl· PharmDDraft · pending clinical reviewUpdated

What does the evidence say about elderberry during pregnancy?

  1. A rapid review of five clinical studies in 936 adults states there is currently no reliable or sufficient scientific evidence to support the use of Sambucus nigra in pregnant or lactating women, and reports adverse events were rare with no serious events. 1
  2. Little is known about whether elderberry is safe to use for health purposes during pregnancy or while breastfeeding, and only preliminary research suggests it may ease symptoms of flu, colds, or other upper respiratory infections. 2
  3. Raw or unripe elderberries and other parts of the elder tree, including the leaves and stem, contain poisonous cyanide-producing substances that can cause nausea, vomiting, and severe diarrhea, and cooking eliminates this toxin. 2
  4. Sambunigrin, the cyanogenic glycoside behind that warning, is most concentrated in elder leaves at 27.68 to 209.61 µg/g fresh weight, lower in flowers at 1.23 to 18.88 µg/g, and lowest in the berries at 0.08 to 0.77 µg/g, occurring primarily in unripe berries and degrading when heated. 3
  5. For anyone nursing, LactMed states that no recommendations can be made on the use of medicinal doses of elderberry products during breastfeeding, because relevant published information was not found. 4

Is elderberry safe in each trimester?

  • First trimester. This is when most people reach for it, and it is also when the evidence gap is hardest to justify. NCCIH is direct: little is known about whether elderberry is safe to use for health purposes during pregnancy.
  • Second trimester. If you are already taking a product, the useful thing to check is the form. Syrups, capsules, lozenges, and hot-drink granules all carry different amounts, and the trial schedules ranged from 2 days of lozenges to 15 or 16 days of capsules.
  • Third trimester. Flu season planning is the honest version of this question. Since elderberry has no pregnancy dosing evidence, the conversation with your provider is better spent on the options that do, including the seasonal flu vaccine.

Doses used in clinical studies, all in non-pregnant adults

FormAmount and schedule used in trialsDuration
Syrup15 ml, four times a dayPer the individual study protocol
Lozenges175 mg, four times a day2 days
Capsules3 capsules a dayBetween 15 and 16 days
Hot drink granules5 mL in 150 mL hot water, five times a day, then twice a dayLoading then maintenance, per the study protocol

Frequently asked questions

How many days can you take elderberry?

The published schedules vary by form and none were set in pregnancy. Lozenges ran 2 days in one study, capsules 15 to 16 days in another, and syrup four times a day for the course of the illness. Since there is no pregnancy dosing evidence at all, duration is a question for your provider rather than a label.

Is elderberry safe in the first trimester?

Nobody can tell you honestly. NCCIH says little is known about elderberry during pregnancy, and the clinical review is explicit that there is no reliable or sufficient evidence in pregnant or lactating people. That is an absence of data, which is different from a clean record.

Are raw elderberries toxic?

Yes, and so are the leaves and stems. They contain cyanide-producing substances that can cause nausea, vomiting, and severe diarrhea. The compound is most concentrated in leaves and least in the berries, occurs primarily in unripe berries, and breaks down with heat, which is why commercial products are cooked.

Can you take elderberry daily?

Daily dosing is what the trials did, in non-pregnant adults, over courses of a few days to a couple of weeks. Extending that into an ongoing pregnancy habit goes beyond anything that has been studied. If you want a daily immune-support routine while pregnant, build it from things with pregnancy data.

Does elderberry syrup actually shorten a cold?

The evidence is suggestive and thin. In the reviewed studies, adults who started elderberry within a couple of days reported symptoms easing by about half within 2 to 4 days, with one study showing 2.7 days of illness versus 4 days. NCCIH calls the research preliminary. None of it involved pregnant participants.

Related in the library

References

  2. Elderberry: Usefulness and Safety (NCCIH)

    NIH NCCIH · https://www.nccih.nih.gov/health/elderberry

  4. Elderberry, Drugs and Lactation Database (LactMed)

    NIH LactMed · https://www.ncbi.nlm.nih.gov/books/NBK501835/

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.