Common side effects of elderberry may include: This is not a complete list of side effects and others may occur. The major elderberry (Sambucus nigra) fruit protein is a lectin derived from a truncated type 2 ribosome-inactivating protein. Can Ms Affect Your Period. Elderberry should not be used in place of medication prescribed for you by your doctor. A review of the antiviral properties of black elder (Sambucus nigraL.) products. As far as what constitutes excessive flavonoid intake in humans, we cant say for sure since these findings have yet to be confirmed in human studies. Some information suggests that elderberry can increase inflammatory cytokine production, which is a part of a healthy immune system response. These little fruits may also help you combat the common cold. Dr. Todorov notes that for hundreds of years, herbalists have advocated using elderberry syrups and teas to combat upper respiratory infections. The elderberry bush or elderberry tree yields the berries that are commonly used in syrups, jams and wine, among other medicinal and culinary delights. If you choose to use elderberry, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. The 9 Best Vitamins and Supplements for Skin Health, 11 Popular Natural Remedies for the Common Cold, The 5 Best Supplements for IBS, According to a GI Dietitian, A review of the antiviral properties of black elder (, Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review, Elderberry extract outpatient influenza treatment for emergency room patients ages 5 and above: a randomized, double-blind, placebo-controlled trial, Elderberry supplementation reduces cold duration and symptoms in air-travellers: a randomized, double-blind placebo-controlled clinical trial. Researchers found that elderberry may reduce the duration and severity of symptoms related to colds and influenza, and there's no evidence that it overstimulates the immune system. Limited studies have found that elderberry eases flu symptoms like fever, headache, sore throat, fatigue, cough, and body aches. However, a single cup of elderberry tea has low amounts of these nutrients. It may help reduce the length of a cold or the flu. Each subject took elderberry supplements during their respective study. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use. Not all possible drug interactions are listed here. However, similar to elderberry syrup, tea often lacks the additional support that youd get from the inclusion of vitamin C and zinc. Elderberry may cause serious side effects. Version: 1.01. If youre on chemotherapy or take diabetes medications, diuretics, immunosuppressants, laxatives or other medications, talk to your doctor before starting supplementation. Both physical and mental stress can cause problems with the production of the gonadotrophin -releasing hormone (GnRH), a hormone that regulates ovulation and menstruation. Call your doctor if the condition you are treating with elderberry does not improve, or if you have a fever for more than 3 days or cold symptoms for more than 7 days. If you prepare the product incorrectly, you could experience nausea, vomiting and a serious case of diarrhea. While these results are promising, further large-scale human studies are. However, if youre healthy, its likely to only reduce it. However, research seems to support the use of dietary changes and supplements that reduce oxidative stress and inflammation as a natural treatment option for Hashimotos. Some medications, such as those used after a transplant, decrease the activity of the immune system. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Using elderberry supplements for kids is not recommended unless youve consulted with your pediatrician. Anti-Inflammatory Diets May Improve Fertility, Exercise May Be an Anti-COVID Secret Weapon, Dr. Whyte's Book: Take Control of Your Diabetes Risk, Street Medicine Reaches People Where They Live, Health News and Information, Delivered to Your Inbox, Chronic obstructive pulmonary disease (COPD), Flu (influenza). It contains very high amounts of anthocyanins, flavonoids, dietary fiber, and vitamins. With elderberrys anti-inflammatory and antioxidant properties, it makes sense that it can help treat sinus issues and diseases related to respiratory health. Elderberry is known for its digestive and immune system support, and can promote better skin health. Once standards are available, supplement companies can be held accountable for providing high-quality products. Further research is needed. This can cause nausea, vomiting, and diarrhea, or more serious side effects if consumed in large quantities. He noticed that a number of people became pregnant during their period or when they weren't supposed to be ovulating. Elderberry is often sold as an herbal supplement. If you're concerned about skin health, elderberries' substantial vitamin A content can help to improve the appearance of wrinkles and age spots. Additionally,the American elder extract showed inhibition of ornithine decarboxylase, which is an enzyme marker related to the promotion stage of cancer formation. Inflammatory cytokines. Elderberry is a berry from a European or Black elder tree. From all the categories of compounds tested, phenolic compounds (such as flavonoids) had a positive effect on the thyroid gland and may be useful against thyroid disorders. Elderberry extract appears to be safe when taken in small doses. U.S. Department of Agriculture: FoodData Central. Keep your supplements stored according to the instructions on the product label. Summary. Select a condition to view a list of vitamins. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Supplementation can assist your healing process, but severe cases of thyroid dysfunction may require extensive medication or surgery. If you've thought about taking an elderberry supplement, know that the deep purple berries are packed with desirable nutrients. If you already take diuretic medications, speak to your physician before consuming any elderberry supplement. Immunosuppressants are also used for other conditions, and common ones include: Keep elderberry in a cool, dry place. Common side effects may include: nausea, vomiting; stomach cramps; Does elderberry affect your thyroid? Its a deciduoustree growing up to 32 feet tall with cream-white flowers and blue-blackberries. Do not use different forms of elderberry (pills, liquids, and others) at the same time or you could have an overdose. However, the U.S. National Library of Medicine highlights a February 2019 meta-analysis of controlled, randomized clinical trials on elderberry use for cold and flu symptoms. This Dr. Axe content is medically reviewed or fact checked to ensure factually accurate information. Traditionally, elderberry has been used topically to treat wounds, as well as taken orally for cold and flu symptoms. Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have an autoimmune disease such as: Ask a doctor before using this product if you are pregnant or breastfeeding. Elderberry is a type of plant that is cultivated for its medicinal properties and used to treat a variety of conditions. Elderberry is not the same as American Elder, Elderflower, or Dwarf Elder, and these will not provide the same intended benefit as elderberry. This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Clin Chem 1999;45:574-6. Check with your physician for additional information about side effects. People using this herb from 10 days before travel until four to five days after arrival overseas experienced, on average, a two-day shorter duration of their colds as well as a noticeable reduction in cold symptoms. The syrups usually lack the additional vitamin C and zinc. J Gen Intern Med. Compared to other types of berries, elderberry is the clear winner. In some clinical trials, adults took 3 teaspoons (1 tablespoon) of elderberry extract in syrup form four times daily for five days. WebMD does not provide medical advice, diagnosis or treatment. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Fresh elderberries may last longer when refrigerated. Increased fiber consumption has been shown to improve your gastrointestinal system function. If you are considering using elderberry, talk to your healthcare provider or pharmacist about whether it is an appropriate supplement for you. Consuming it uncooked may cause nausea, vomiting and diarrhea. The berries are used to make medicine. This finding may highlight an alternative to misuse of antibiotics for these respiratory symptoms. Specifically, the flavonoids in the berries bind tothe H1N1 human influenza virus as well asthe H5N1 avian influenzavirus. doi:10.1016/j.ctim.2018.12.004, Tiralongo E, Wee SS, Lea RA. Elderberry may cause serious side effects. 2012;33:204-11. The benefits seem to be greatest when started within 24 to 48. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. A 2009 study randomized patients intotwo groups. American elderberry(Sambucus canadensis) has not been grown or promoted as a medicinal plant like its European relative. If we consider elderberry and autoimmune diseases outside the thyroid, elderberry has shown itself to be great for inflammation and immune support. No, that's not true all the time. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. View abstract. View abstract. It is a rich source of antioxidants known as anthocyanins and is often used to support the immune system. High in antioxidants, elderberries are a healthy addition to any diet and for anyone looking for delicious immune system support. 2016 Mar 24;8(4). This can cause nausea, vomiting, and diarrhea, or more serious side effects if consumed in large quantities. Since ancient times, elderberry has received mention for its health-enhancing properties, states the American Nutrition Association. If you have eaten an unknown berry and develop concerning symptoms, get immediate medical attention. Skip the missed dose and take the next regularly scheduled dose. Does elderberry interact with medications? Reportedly, the possibility of a cytokine storm due to COVID can worsen the inflammation and dysfunction of the thyroid. If you have a preexisting thyroid condition, its best to speak with a doctor before adding elderberry into your treatment regimen. View abstract. Compend.Contin.Educ.Dent. Barak V, Halperin T, Kalickman I. J Gen Intern Med. That's the case with elderberry, as these tiny purple berries are rich in nutrients your body needs, says the American Nutrition Association. There is no safety data on the use of elderberry in children under 5 years of age. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements. Inflammatory cytokines. Written by Divinity Nutra, Updated on February 20, 2023. Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Accordingto the United States Department of Agriculture, Americans consume around 0.7 pounds St. Johns wort, also known as hypericum perforatum,is a flowering plant of 10 Holy Basil Benefits: Tulsi Helps Anxiety, Acne & More, Daniel Fast: Benefits for Your Spiritual, Emotional and Physical Health, 15 Fermented Foods for a Healthy Gut and Overall Health, 9 Proven Black Seed Oil Benefits that Boost Your Health, L-Glutamine Benefits Leaky Gut & Metabolism, Chia Seeds Benefits: The Omega-3, Protein-Packed Superfood, Apple Cider Vinegar Benefits for Weight Loss, Skin Health, Cholesterol & More. Mynarczyk K, Walkowiak-Tomczak D, ysiak GP. A 2016 study on airline passengers suggested using elderberry extract for 10 days before and five days after a flight led to milder symptoms and 50% fewer sick days from cold illnesses. Raw unripe elderberries and other parts of the elder tree, such as the leaves and stem, contain toxic substances (e.g., sambunigrin) that can cause nausea, vomiting, and diarrhea; cooking eliminates this toxin. CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. It can be used for allergies on its own or in combination with other herbs and natural remedies. Health benefits of the elder plant include naturally improving: Research published in the Journal of International Medical Research suggests that when its used within the first 48 hours of onset of symptoms, the plant may even help relieve and shorten the duration of cold and flu. Research actually shows that elderberry is a safe, efficient and cost-effectivetreatment for the common cold and flu. View abstract. The researchers used Sinupret to treat bacterial sinusitis along with an antibiotic (doxycycline or vibramycin) and a decongestant. The elderberry plant contains a chemical that produces cyanide in the leaves or other plant parts and in the unripe green fruit. * Elderberry supplements and syrups can be taken daily if they are made by reputable companies. Other parts of the plant should be avoided as they contain a naturally occurring chemical compound called cyanogenic glycoside, which releases the poison hydrogen cyanide. This can cause nausea, vomiting, and diarrhea, or more serious side effects if consumed in large quantities. 2011;142:1168-75. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Elderberry juice syrup has been used for centuries as a home remedy for viral illnesses like the common cold and flu. Call your doctor for medical advice about side effects. Our team aims to be not only thorough with its research, but also objective and unbiased. Another popular way to consume elderberries is to purchase an elderberry syrup. Large quantities of the toxin may cause serious illness. Even the bark of the plant was used for its diuretic and slimming effects. Another study published in the Journal of International Medical Research referenced above suggests that when elderberry is used within the first 48 hours of the onset of signs of flu, it can shorten the duration of flu symptoms by anaverage of four days. Int J Clin Pharmacol Res. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. 2021;26(5):1384. doi:10.3390/molecules26051384, Sidor A, Gramza-Michalowska A. Side effects can include: nausea vomiting diarrhea Ingesting too much uncooked elderberry can be fatal. Effect of an herbal mouth rinse in preventing periodontal inflammation in an experimental gingivitis model: a pilot study. As with several other fruits, eating a lot of elderberry fruit can cause: Elderberries should always be cooked and processed before theyre consumed. If your symptoms continue to worsen, you should seek medical attention. The uncertainty surrounding COVID-19 gave birth to much research on its influence outside the respiratory system, with the thyroid gland as a major stakeholder. Is elderberry recommended to prevent COVID-19? Elderberry should not be confused with American Elder, Elderflower, or Dwarf Elder. Elderberry supplementation reduces cold duration and symptoms in air-travellers: a randomized, double-blind placebo-controlled clinical trial. Title 21. Touted for Several Uses, Including Treating and Preventing the Cold and Flu. Verywell Health's content is for informational and educational purposes only. Drug class: Herbal products. If your symptoms continue to worsen, you should seek medical attention. The elder plant may possess beneficial anti-inflammatory, antiviral, and anti-cancer effects, according to the University of Maryland Medical Center. 2010;10:17. Additionally, research has shown vitamin C to be effective against the thyroid antibodies in Hashimotos disease. A 2016 study published inNutrientsshowed that elderberry supplementation was able to reduce cold duration and symptoms in people using air travel. Some research suggests it reduces the severity and duration of symptoms associated with the flu or common cold. Dr. Irina Todorov, an integrative medicine physician with the Cleveland Clinic, is cautiously optimistic about elderberry's benefits. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you. Divinity Nutra does not provide medical advice, diagnosis, or treatment recommendations. Elderberry is very safe and well-tolerated among most individuals. This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. How much elderberry should I take for thyroid? There is no data on the use of elderberry for COVID-19, either to prevent it or to manage symptoms. Elderberry fruit containsquercetin, kaempferol,rutinand phenolic acids. In addition to black elderberry, there are several other varieties available as well. 2021;21(1):112. doi:10.1186/s12906-021-03283-5, Macknin M, Wolski K, Negrey J, Mace S. Elderberry extract outpatient influenza treatment for emergency room patients ages 5 and above: a randomized, double-blind, placebo-controlled trial. Try adding lemon, cinnamon or mint to give the flavor and health benefits a hearty boost. That said, there is no benefit to taking elderberry every day, as it does not prevent illness. Generic name: elderberry [EL-der-ber-ee] The findings were further supported by a 2019 study that was observing the anti-influenza properties of elderberries. Available at: https://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009). Inflammatory cytokines, An evidence-based systematic review of elderberry and elderflower (, Chemical profiling and UHPLC-QToF analysis for the simultaneous determination of anthocyanins and flavonoids in Sambucus berries and authentication and detection of adulteration in elderberry dietary supplements using UHPLC-PDA-MS, 2021 US open forum: elderberry standards development, A 2020 study did not find black elderberry to improve symptoms or reduce the amount of time of illness. This includes: There is no standard recommendation for dosing elderberry. 2016;8(4):182. doi:10.3390/nu8040182, Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. However, some groups of people should avoid elderberry. The thyroid is a hormone-producing gland responsible for controlling the metabolic rate. Still, there is some countervailing evidence to push back on the narrative that elderberry over-activates the immune system. Cao G, Prior RL. https://medlineplus.gov/autoimmunediseases.html, http://www.thyroid.org/hashimotos-thyroiditis/, https://pubmed.ncbi.nlm.nih.gov/11399518/, https://www.sciencedirect.com/science/article/abs/pii/S1756464619300313, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372600/, 6 Health Benefits and Uses for Elderberry Supplements. View abstract. Jennifer Lefton, MS, RD/N-AP, CNSC, FAND is a Registered Dietitian/Nutritionist and writer with over 20 years of experience in clinical nutrition. Elderberry is possibly unsafe when uncooked leaves, stems, or fruit are consumed. This can cause nausea, vomiting, and diarrhea, or more serious side effects if consumed in large quantities. Methods Find Exp Clin Pharmacol. There are no standard recommended amounts for elderberry in gummies, tablets, or teas. Researchers suggest that using polyphenolsto lower blood pressuremay also help reduce the side effects of blood pressure-lowering medications and improve overall quality of life. It was added to herbal mixtures to improve regularity. Elderberrys high antioxidant capacity is the secret to its healing tendencies. After you find (and harvest) those much-valued little berries, try canning several jars of elderberry jam, or stir them into a tasty homemade pie. Curr Ther Res Clin Exp. Unripe or unprocessed berries, as well as other parts of the plant, should not be consumed as they can be poisonous. The disease progressively shows many symptoms, such as fatigue, weight gain, constipation, dry skin, and difficulty breathing. However, the researchers noted that further research is still needed. The optimum dosage is 150-300 mg of elderberry extract per day. The berries contain chemical compounds called anthocyanidins, which have been foundto possessimmunostimulant properties. BMC Complement Med Ther. J Funct Foods. J Funct Foods. However, you should not consume raw berriesor other parts of the plant since they contain a cyanide-inducing chemical, which canresult in nausea, vomiting or diarrhea. Research suggests elderberry juice syrup may help reduce the severity and duration of symptoms associated with colds and flu. 2005;25(2):47-56. Bitsch I, Janssen M, Netzel M, et al. Eur J Clin Nutr 2004;58:244-9. View abstract. The triterpenes alpha- and beta-amyrin, ursolic acid, oleanolic acid, betulin, betulinic acid and a variety of other minor components have been identified. Other common names forSambucus nigraincludeblack elder, European elder, European elderberry and European black elderberry. One of the most well-studied elderberry supplement benefits is its powerful immune-boosting properties. Elderberries should always be cooked and processed before theyre consumed. Although commercial preparations are generally safe for consumption, eating raw elderberry may cause symptoms like nausea, diarrhea and vomiting. Third-party testing would double-check that the product's contents match what's on the label and indicate a more trustworthy product. Phytother Res 2012;26(11):1606-13. Side effects, in theory, can include cramping, bleeding, early. Edible berry extracts like elderberry extract are rich in anthocyanins and have been shown to have a broad spectrum of therapeutic, pharmacologic and anti-carcinogenic properties. If you seek a warm, healthy cup of tea after a long day of discomfort, elderberry tea can help. It's used to make jams, syrups, and wine. Its hard to believe in a one-size-fits-all remedy, but elderberries have lived up to their name as a superfruit over centuries of use. Be aware that elderberry has not been connected to any negative interactions with specific foods or medicines, stresses the Mayo Clinic. Phytother Res. Since there is no standard dosage, however, consult your healthcare provider or pharmacist and read the dosage directions on the product label before taking it. Type I allergy to elderberry (Sambucus nigra) is elicited by a 33.2 kDa allergen with significant homology to ribosomal inactivating proteins. J Int Med Res. However, she is careful to take a scientific approach, and doesn't currently endorse the use of elderberry syrup for colds and flu. Online Journal of Pharmacology and Pharmacokinetics 2009;5:32-43. Leads from the MMWR. There are also recipes for elderberry-based medications dating back toAncient Egypt. Because of its powerful effects on health, elderberry supplements could potentially interact with several medications. Canadian Poisonous Plants Information System. 2020 Sep 14. doi: 10.1007/s11606-020-06170-w. View abstract. Medicinal use of this product has not been approved by the FDA. Iran J Pharm Res. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination. Hashimotos thyroiditis and other autoimmune diseases are serious conditions and must be handled with care. 2010 Jan;24(1):1-8. If you make your own syrup, rather than buying it in a health food or grocery store, you can safely store it in the refrigerator for three months. 2017;72(1):82-7. This herb is available in syrup, juice and tea form. Medications such as NSAIDs and epilepsy medicines can also affect your menstrual cycle. Grbic J, Wexler I, Celenti R, et al. For starters, elderberries contain vitamins A, B6 and C. These appealing little berries also include minerals such as folic acid, potassium, manganese, beta carotene and iron. These powerful little berries have a higher flavonol content than blueberries, blackberries, cranberries and goji berries. Some herbalists put black elder flower on the list ofmost effective herbs used for treating hay fever-like symptoms. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for chronic constipation. Nearly 20 million Americans have some form of thyroid disease, with a whopping 60% of them unaware of their condition. In traditional or folk medicine, the elder plant was used as a laxative to relieve constipation. The dark, purplish berries are frequent supporters of bodily healing in Ayurveda, the worlds oldest branch of natural medicine. Therefore, it is important to talk to your healthcare provider about any supplements you plan to take and check in about potential interactions with other supplements or medications. Other drugs may affect elderberry, including prescription and over-the-counter medicines, vitamins, and herbal products. It is not certain whether elderberry is effective in treating any medical condition. Elderberry causes few side effects when used as directed. Murkovic M. Abuja PM, Bergmann AR, et al. The most tested product in research (Sambucol) is now sold in different formulations that are not consistent with the original form that was studied. Can elderberry cause side effects? First and foremost, elderberry is known for its ability to help . The Poison Plant Patch, Novia Scotia Museum, 2007. If you prepare the product incorrectly, you could experience nausea, vomiting and a serious case of diarrhea. Elderberries are naturally high invitamin C, vitamin A,vitamin B6, iron andpotassium, among several other essential nutrients. It is well adapted to a wide range of habitats. Dr. Jonas believed this pointed to multiple fertile periods one based on the body's menstrual cycle and the other based on a lunar cycle that influenced their fertility. Her experience ranges from counseling cardiac rehabilitation clients to managing the nutrition needs of complex surgical patients. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. Instead, they contained elderflower or were mixed with other ingredients, such as black rice extract or purple carrot extract. Ulbricht C, Basch E, Cheung L, et al. There is no significant evidence to support that it may exacerbate the immune system. If you appreciate foods that are pleasing to your taste buds and that also seem to offer health benefits and practical uses, you're likely acquainted with black elderberry. Poisoning from elderberry juice. Elderberry appears to have few side effects when used properly for short periods of time of up to five days. Elderberry is marketed mostly for immune support. If you enjoy handcrafting your own small-batch vintages, consider fermenting some elder wine. 2016;8(2):59-66. But, when dealing with autoimmune diseases, activating the immune system further would be counterproductive. Products are available in many forms, including: In addition to the various forms, elderberry is available as a single supplement or in combination with other nutrients. Raw elderberry contains a substance similar to cyanide. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. Viapiana A, Wesolowski M. The phenolic contents and antioxidant activities of infusions of Sambucus nigra L. Plant Foods Hum Nutr. Unripened, raw elderberries can release toxins into your body. Heres what you need to know, including its many benefits. Generally, commercial preparations dont cause adverse reactions when used at recommended dosages. There is no safety data on the use of elderberry in children under 5 years of age. Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. Its content of bioflavonoids, antioxidants and vitamin A makes it awesome for skin health. You may report side effects to FDA at 1-800-FDA-1088. Picon PD, Picon RV, Costa AF, et al. First, check the package for the daily recommended dosage, and don't exceed that amount, states the University of Rochester Medical Center.