A combination supplement with elderberry and probiotics improves health in a number of ways, according to a new study from Italy.

The research was conducted specifically on airline crew members because they face a number of health challenges due to their work environment and irregular schedules.

According to the researchers, the two nutrients have a “synergistic effect” which further enhances the health benefits the two nutrients are known to provide.

In the published findings, the nutrient duo was shown to support improved bowel well-being, higher health-related quality of life, an improved immune system, and more.

The study was conducted at the University of Camerino in Camerino, Italy. The findings of the study were published in Microorganisms in April 2023.

Offsetting modern stress-filled lives

While airline travel of the 1960s and 1970s was seen as glamorous, most people today would agree that traveling by airline is stressful. The same could be said of the flight crews. While their jobs may still be seen as glamorous, the schedules of typical flight crews are chaotic and stressful.

This was the motivation for the new study. Flight crews were a perfect choice for assessing the benefit of certain nutrients in offsetting stress-induced health issues.

The researchers hoped to determine whether the combination of an elderberry extract and probiotic would mitigate or prevent some of the negative impacts of airline employment.

“Flight crew members can be subject to work-related health issues including lack of sleep, improper nutrition and cosmic radiation,” the researchers wrote in the study intro. “Compared to the general population, flight attendants have an increased prevalence of intestinal disorders and oxidative stress associated with low immune system function.”

Already popular nutrients

Elderberry, which has been used as a traditional medicine for centuries, is popular today as an immune supplement. Researchers attribute its effectiveness to its hypocholesterolemic and antioxidant activity. It also contains free radical scavengers, vitamins and minerals.

According to the American Botanical Council, elderberry is the most popular immune-building herbal in America. The American Botanical Council considers “herbals” as a product where the plant or fungi is the primary ingredient.

Probiotics are also one of America’s favorite immune-building nutrients; however, today they are widely-purchased for other aspects of health—everything from supporting brain function to aiding in weight loss.

The authors of the study pointed to a previous study where elderberry extract combined with a probiotic formulation revealed higher antioxidant activity than the single extract–suggesting that probiotics potentiate the antioxidant activity of elderberry.

According to the researchers, air crews face several distinct health risks that average people don’t need to worry about:

• Repeated exposure to cosmic radiation at high altitude increases cancer risk.

• Constant disruption of the circadian rhythm due to long flights increases risk of sleep disorders, depression and anxiety.

• Temporary hypoxia on gut flora, due to oxygen changes at high altitude on each flight, is destructive to the gut microbiome.

Study details

The study, a double-blind randomized study with placebo control, included 37 participants. The participants assigned to the supplement group were given the probiotic/elderberry blend daily for 30 days, while the control group received a placebo. The elderberry portion included both flower and leaf extract.

At the beginning and end of the trial, both the supplement and placebo participants provided fecal and saliva samples. Participants also completed bowel well-being questionnaires, which included two industry-standard measuring systems: the Psychological General Well- Being Index and the Gastrointestinal Symptom Rating Scale.

Benefits of elderberry and probiotic supplementation

According to the results, the supplemented group showed statistically significant differences after 30 days. Compared to the control group, they tested better for intestinal regularity, stool volume, constipation and other bowel well-being markers.

The health-related quality of life improved for the supplemented group as well. The benchmarks for this were management of anxiety, depression, general health quality, feelings of vitality and self-control. All showed statistically significant improvements, which is commisserate with other recent studies demonstrating the importance of a healthy gut microbiome relative to brain function. This important connection is known as the gut-brain axis.

For gastrointestinal symptoms, placebo participants had a max pain level of 7 (very severe discomfort) reported during the trial while supplemented participants reported only a 3 at most (moderate pain).

Healthy gut bacteria levels also increased for the supplemented group. Furthermore, the researchers confirmed intestinal transit survival of the active probiotic strains.

The researchers also measured slgA, an immunoglobulin that neutralizes mucosal pathogens, in all the study subjects. The supplemented group showed a statistically significant increase in slgA levels after 30 days.

“This increase was considered as a marker of enhancements to the body’s capacity to defend itself, which was likely due to the beneficial action induced by the high content of antioxidant polyphenols present in the elderberry extract and their potential combination with probiotics,” the researchers wrote in the published findings.

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Sources: Microorganisms/MDPI, University of Camerino, American Botanical Council.