Elderberry Craze Reminiscent of Laetrile Cancer Sham

We're in the middle of a nasty flu season, not to mention other nasties floating around, such as colds, COVID-19, RSV, and norovirus. Needless to say, people are mobbing the supplement aisles, where they will encounter a bunch of stuff that is probably useless, harmful, or both. One of the latest crazes is an old one – elderberries, a "dietary supplement" that allegedly helps fight the flu.

Evidence, such as it is, for the supplement's efficacy against influenza is based on a deeply flawed clinical trial published in 2016 in the journal Nutrients. I'm not going to bother to debunk the study here. (It's not difficult. A dyslexic chicken could do it.)

Instead, I'm going to point out the elderberry similarity to one of history's most infamous quack products – laetrile (1), an old "drug" that was supposed to cure cancer and did anything but. Instead, it poisoned people with symptoms that mimicked cyanide. This should not be surprising because the pits of certain fruits, e.g., apricots and peaches, contain potentially lethal amounts of chemicals called cyanogenic glycosides. I have not bolded the word "cyanogenic" by accident. Cyanogenic glycosides break down to form hydrogen cyanide, which is supposed to attack cancer cells while leaving normal cells alone. It does one of these; it attacks cancer cells, and everything else. Here's how it "works."

Step 1: Synthetic conversion of amygdalin to laetrile

Step 2: Laetrile (non-toxic) is broken down in vivo by the enzyme beta-glucosidase to form benzaldehyde cyanonitrile, which is an unstable intermediate that decomposes under a variety of conditions, yielding benzaldehyde (almond oil) and deadly hydrogen cyanide. (A nice summary of the Laetrile story can be found here.)

What does this have to do with elderberry?
Plenty. While laetrile is infamous for its cyanide-releasing properties, elderberries share a strikingly similar mechanism due to the compound sambunigrin. Elderberry also contains a cyanoglycoside called sambunigrin. The similarity to laetrile is obvious. 

Laetrile and Sambunigrin contain identical cyano-containing fragments (blue ovals), differing only by the attached sugar. Both are cleaved by the enzyme beta-glucosidase to form benzaldehyde cyanohydrin, which further breaks down releasing hydrogen cyanide. The red hatch lines indicate the bond that breaks, releasing the sugar and benzaldehyde cyanohydrin

Will Elderberry kill you?

Basically, no. You're more likely to be struck by lightning – twice. I could not find a single documented case of fatal Elderberry poisoning. However, a non-fatal poisoning from Elderberry juice has been documented by the CDC. 

Elderberry poisoning is usually a non-problem because commercial products have been treated in a way that removes the cyanide (2). So, there's nothing to worry about right?

Not necessarily...

Unreal. Northwest Wild Foods sells raw, non-processed Elderberries. Just think of all the health benefits: Natural, raw, Kosher, and healthy! Provided that you boil the s### out of them before taking them for your case of the flu. 

Bottom line

Although the use of Laetrile and elderberry to treat (more like not treat) different maladies are different in some ways (3) it is quite similar chemically and conceptually: They are both plant-based therapies that don't do anything but do contain cyanide, especially when raw. You just gotta love the supplements industry! 

NOTES:

(1) Laetrile itself is not toxic. Instead, it forms a toxic chemical following an enzymatic reaction in the body. This is analogous to the conversation of acetaminophen by the liver to form a potent toxin called NAPQI – the reason that Tylenol can be deadly.

(2) The sambunigrin in elderberry is broken down in boiling water. First, the bond to the sugar is broken, and hydrogen cyanide is formed, but it is driven off in the boiling water or (when used) the drying process. Most Elderberries have been dried. When done properly the berries are safe.