If you're taking immunosuppressantsmedications that reduce immune system activity, your doctor might have warned you about Elderberrya plant-based supplement traditionally used for immune support. But why? Let's break it down.
Why Elderberry Can Be Risky with Immunosuppressants
Elderberrya plant-based supplement traditionally used for immune support has long been a go-to for cold and flu season. Many people take it to boost immunity. But here's the problem: immunosuppressants work by reducinglowering immune activity. Elderberry does the opposite-it stimulates the immune system. This creates a dangerous conflict. For example, if you're on cyclosporinea drug used to prevent organ rejection after a transplant, elderberry could make your body attack the new organ.
According to a 2021 review by CSIRO PublishingAustralian research organization, elderberry increases cytokines like interleukin-6 and tumor necrosis factor. These are the very signals immunosuppressants try to suppress. The study found up to a 30% increase in these cytokines in immune cells exposed to elderberry compounds. This isn't just theoretical-it's happened in real patients. A kidney transplant recipient reported to Mayo Clinic Connect that their tacrolimus levels dropped 25% after taking elderberry. That's a serious risk for rejection.
How Elderberry Affects Your Immune System
Elderberrya plant-based supplement traditionally used for immune support contains active compounds called anthocyaninspigments that give berries their dark color. These make up about 1-2% of dried elderberries. Research shows anthocyanins boost immune activity. A 2016 study in Nutrients found elderberry increases cytokine production. cytokinessignaling proteins that regulate immune responses are signaling proteins that tell your immune system to fight infections. But if you're on immunosuppressants, this is exactly what you don't want.
Here's how it works: when you take elderberry, anthocyanins interact with immune cells. This triggers the release of cytokines. For most people, this is helpful-it helps fight colds. But for someone with a transplanted organ or autoimmune disease, it can cause harm. Imagine your immune system is a car. Immunosuppressants are the brakes. Elderberry is like pressing the gas pedal. The result? A potential crash.
Studies show elderberry can increase interleukin-6 by up to 30% in lab tests. Interleukin-6 is a key player in inflammation. For autoimmune conditions like rheumatoid arthritis, this could trigger flare-ups. The CSIRO PublishingAustralian research organization review warns that elderberry "may exacerbate symptoms in patients with autoimmune diseases."
Which Immunosuppressant Medications Are Affected?
Not all immunosuppressants react the same way to elderberry. But several high-risk drugs have been documented. Here's a breakdown:
| Medication | Used For | Risk Level | Notes |
|---|---|---|---|
| cyclosporine | organ transplants, autoimmune diseases | High | May reduce effectiveness; levels can drop significantly |
| tacrolimus | organ transplants | High | Reported drops in blood levels leading to rejection |
| mycophenolate | organ transplants, lupus | Moderate | Potential interference with immune suppression |
| prednisone | autoimmune diseases | Moderate | Elderberry may counteract anti-inflammatory effects |
| azathioprine | autoimmune diseases | Low | Less documented interaction, but still caution advised |
This table shows which drugs are most at risk. The cyclosporinea drug used to prevent organ rejection and tacrolimusa drug used for organ transplants have the highest risk. Patients on these medications should avoid elderberry completely. Even a small amount can cause problems. For example, a liver transplant patient on Reddit reported a rejection episode after starting elderberry syrup. This isn't rare-medical forums show consistent warnings from doctors.
Real Patient Experiences
Thousands of people share their stories online. On Mayo Clinic Connect, a kidney transplant recipient wrote: "My immunologist immediately told me to stop elderberry supplements after my annual checkup because my tacrolimus levels had dropped 25%." Another user in the r/Transplant community described a similar situation: "My rejection episode coincided with starting elderberry syrup for cold prevention."
But it's not all bad news. A lupus patient on the American Autoimmune Related Diseases Association forum said, "I've taken elderberry for three winters while on CellCept with no issues." However, this is rare. A 2022 sentiment analysis by Health Union found 87% of forum posts about this interaction advised avoiding elderberry. Most patients and doctors agree it's better to be safe than sorry.
For autoimmune conditions like ulcerative colitis, Medical News Today reported a patient who experienced "increased flare-ups after taking elderberry supplements while on Remicade (infliximab)." These real-world cases highlight why healthcare providers take this interaction seriously.
What Should You Do Instead?
If you're on immunosuppressants, you still need immune support. But elderberry isn't the answer. Here's what experts recommend:
- Vitamin Da nutrient that supports immune health without immune activation: A 2022 survey of 150 rheumatologists found 78% preferred suggesting vitamin D over elderberry for immune support in autoimmune patients. Vitamin D helps regulate the immune system without overstimulating it.
- Zinca mineral that supports immune function: In moderate doses, zinc can help fight colds without the risks of elderberry. But don't overdo it-too much zinc can cause side effects.
- Probioticsbeneficial bacteria that support gut health: Gut health is linked to immune function. Probiotics may help maintain a balanced immune response without the risks of herbal supplements.
The Arthritis Foundation's 2023 guidelines state: "If you're taking medication for rheumatoid arthritis, lupus, multiple sclerosis, or Hashimoto's thyroiditis, it's best to skip elderberry." Instead, work with your doctor to find safe alternatives. For organ transplant patients, Sweet's Elderberry's safety guide (2023) states: "Anyone who has received an organ transplant should avoid elderberry."
Can I take elderberry if I'm on a low dose of immunosuppressants?
No. Even low doses of immunosuppressants still require careful management. Elderberry's immune-activating effects can interfere regardless of dosage. Always consult your doctor before taking any supplement.
What about elderberry tea? Is it safer?
No. Elderberry tea contains the same active compounds as supplements. The risk depends on concentration, not form. If you're on immunosuppressants, avoid all elderberry products, including tea.
Should I stop elderberry before surgery?
Yes. Doctors typically recommend stopping herbal supplements like elderberry at least two weeks before surgery. This reduces the risk of immune complications during recovery.
Are there any safe alternatives to elderberry?
Yes. Vitamin D, zinc (in moderation), and probiotics are safer options for immune support. These don't overstimulate the immune system like elderberry does. Always discuss alternatives with your healthcare provider.
How do I know if elderberry is interacting with my medication?
Watch for signs like increased inflammation, unexplained fatigue, or changes in medication effectiveness. If you experience symptoms, contact your doctor immediately. Regular blood tests can also monitor drug levels for accuracy.
