What is Sambucol (Black Elderberry extract)?

From the Guidelines

Sambucol, a black elderberry extract, is a potential adjunctive treatment for viral infections, including COVID-19, due to its antiviral properties and ability to support immune function, as suggested by a 2020 study published in Autoimmunity Reviews 1. When considering the use of Sambucol, it is essential to weigh the potential benefits against the current lack of definitive evidence on its effectiveness for COVID-19 treatment. The study 1 highlights the potential of elderberry supplements in reducing the severity of viral infections, including influenza, by inhibiting viral replication and boosting the immune response. Key points to consider when using Sambucol include:

• The recommended dosage, typically 1-2 teaspoons of syrup or 1-2 lozenges, taken 2-4 times daily for adults during illness
• Potential interactions with other medications or health conditions, emphasizing the need for consultation with a healthcare provider before starting Sambucol, especially for pregnant, nursing, or individuals with existing health conditions
• The importance of not replacing standard medical care or prescribed treatments for serious illnesses with Sambucol or any other supplement The antiviral properties of Sambucol are thought to be related to its ability to inhibit viral replication and boost the immune response, potentially by interacting with viral receptors such as ACE2 and CD209L (L-SIGN) 1. However, more research is needed to fully understand the mechanisms and efficacy of Sambucol in the context of COVID-19 and other viral infections.

From the Research

Definition and Composition of Sambucol

• Sambucol is a black elderberry-based, natural product, which is a standardized extract of Sambucus nigra L. 2
• It is used as a natural remedy with antiviral properties, especially against different strains of influenza virus 2, 3

Mechanism of Action and Effects

• Sambucol has been shown to activate the healthy immune system by increasing inflammatory cytokine production, which may be beneficial for immune system activation and in the inflammatory process in healthy individuals or in patients with various diseases 2
• The production of inflammatory cytokines, such as IL-1 beta, TNF-alpha, IL-6, and IL-8, was significantly increased by Sambucol Black Elderberry Extract 2
• Sambucol may reduce the duration and severity of common cold and influenza symptoms in adults when taken within 48 hours of the onset of acute respiratory viral infection 4

Clinical Studies and Efficacy

• A meta-analysis of randomized, controlled clinical trials found that supplementation with elderberry substantially reduced upper respiratory symptoms, presenting an alternative to antibiotic misuse for upper respiratory symptoms due to viral infections 5
• A randomized, double-blind, placebo-controlled study found that oral elderberry extract relieved symptoms on average 4 days earlier and reduced the use of rescue medication compared to placebo 6
• A placebo-controlled, double-blind study during an outbreak of influenza B/Panama found that Sambucol reduced fever and improved symptoms within 2 days in 93.3% of the cases, whereas in the control group, 91.7% of the patients showed an improvement within 6 days 3

Safety and Side Effects

• Adverse events were rare and no serious events were reported in clinical studies 4, 6
• There is currently no reliable or sufficient scientific evidence to support the use of Sambucol in pregnant or lactating women 4