Organic Elderflower by Ra Herbals

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acute bronchitis. Although there has been interest in using oral elderflower for acute bronchitis, there is insufficient reliable information about the clinical effects of elderflower for this purpose.
• Common cold. Although there has been interest in using oral elderflower for the common cold, there is insufficient reliable information about the clinical effects of elderflower for this purpose.
• Constipation. Oral elderflower has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical trial in patients with chronic constipation shows that drinking tea containing elderflower 500 mg, senna flower, fennel fruit, and anise fruit (Laboratorios Klein) 150 mL three times daily for 5 days decreases colonic transit time by approximately 27 hours and increases the likelihood of having a bowel movement when compared with placebo (49494). It is unclear if this effect is due to elderflower, other ingredients, or the combination.
• Diabetes. Although there has been interest in using oral elderflower for diabetes, there is insufficient reliable information about the clinical effects of elderflower for this purpose.
• Influenza. Although there has been interest in using oral elderflower for influenza, there is insufficient reliable information about the clinical effects of elderflower for this purpose.
• Laryngitis. Although there has been interest in using oral elderflower for laryngitis, there is insufficient reliable information about the clinical effects of elderflower for this purpose.
• Obesity. Oral elderflower has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small observational study in adults with overweight shows that replacing all meals for 8 days with a kit containing dried elderflower 3.9 grams, elderflower extract 600 mg, elderberry juice, dried elderberry, and dried asparagus, while also taking psyllium daily for 2 weeks, is associated with around a 3 kg decrease in body weight over 14 days when compared to baseline (94939). The validity of this finding is limited by the lack of a comparator group. Also, it is unclear if this effect is due to elderflower, other ingredients, the combination, or fasting from regular food.
• Rheumatoid arthritis (RA). Although there has been interest in using oral elderflower for RA, there is insufficient reliable information about the clinical effects of elderflower for this purpose.
• Rhinosinusitis. Oral elderflower has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: Some clinical research shows that taking a specific combination product that contains elderflower (18 mg per tablet) with gentian root, sorrel, verbena, and cowslip flower (SinuComp; Sinupret, Bionorica Arzneimittel GmbH), 2 tablets or 50 drops three times daily for up to 14 days, seems to help improve symptoms of acute or chronic rhinosinusitis, such as congestion and headache (374,64515). Taking this product orally three times daily in combination with mometasone furoate nasal spray (Nasonex) 200 mcg twice daily for 7 days improves symptoms, such as nasal obstruction, rhinorrhea, facial pain and pressure, impaired sense of smell, and mucopurulent secretions, when compared with mometasone nasal spray alone (95907). It is unclear if these effects are due to elderflower, other ingredients, or the combination. More evidence is needed to rate elderflower for these uses.

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LIKELY SAFE ...when used orally in food amounts. Elderflower has generally recognized as safe (GRAS) status in the US (4912).

POSSIBLY SAFE ...when used orally and appropriately, short-term. Dried elderflower 3.9 grams daily has been used with apparent safety for 8 days (94939). A specific combination product containing elderflower, gentian root, sorrel, verbena, and cowslip flower (SinuComp, Phytopharmica) has been used with apparent safety for up to 14 days (374,64515,95907).

POSSIBLY UNSAFE ...when excessive amounts of elderflower are consumed. The elder tree contains a cyanide-producing chemical in the leaves, stems, and unripe fruit, which can cause symptoms of nausea, vomiting, and diarrhea. Elderflower may also contain this toxin. Ingestion of large quantities may cause serious toxicity (17020,17021). Cooking eliminates the toxin. There is insufficient reliable information available about the safety of elderflower when used topically.

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

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ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, elderflower might increase the risk of hypoglycemia when taken with antidiabetes drugs.  Details In vitro research suggests that elderflower might lower blood glucose levels (13427). Monitor blood glucose levels closely.

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General ...Orally, elderflower is generally well tolerated when used in food amounts. No adverse effects have been reported when elderflower alone is used medicinally. However, a thorough evaluation of safety outcomes has not been conducted.

Gastrointestinal ...Diarrhea and colic have been reported after drinking a tea made from elderflower, anise fruit, fennel fruit, and senna flowers (49494). It is not clear if these effects were due to elderflower or the other ingredients.

Immunologic ...The pollen of the elder tree can cause an allergic reaction with rhinitis and dyspnea in some people who are allergic to grass pollen. These people might experience a similar allergic reaction to elderflower (11095).

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