Bilberry (Vaccinium myrtillus)
   
Bilberry (Vaccinium myrtillus)
Synonyms
Bilberry, a close relative of blueberry, has a long history of medicinal use. The dried fruit has been popular for the symptomatic treatment of diarrhea, for topical relief of minor mucus membrane inflammation, and for a variety of eye disorders, including poor night vision, eyestrain, and myopia.
Bilberry fruit and its extracts contain a number of biologically active components, including a class of compounds called anthocyanosides. These have been the focus of recent research in Europe.
Bilberry extract has been evaluated for efficacy as an antioxidant, mucostimulant, hypoglycemic, anti-inflammatory, "vasoprotectant," and lipid-lowering agent. Although pre-clinical studies have been promising, human data are limited and largely of poor quality. At this time, there is not sufficient evidence in support of (or against) the use of bilberry for most indications. Notably, the evidence suggests a lack of benefit of bilberry for the improvement of night vision.
Bilberry is commonly used to make jams, pies, cobblers, syrups, and alcoholic/non-alcoholic beverages. Fruit extracts are used as a coloring agent in wines.
Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Uses based on scientific evidenceGrade*Chronic venous insufficiency
Chronic venous insufficiency is a condition that is more commonly diagnosed in Europe than in the United States, and may include leg swelling, varicose veins, leg pain, itching, and skin ulcers. A standardized extract of bilberry called vaccinium myrtillus anthocyanoside (VMA) is popular in Europe for the treatment chronic venous insufficiency. However, there is only preliminary research in this area, and more studies are needed before a recommendation can be made.
C
Retinopathy
Based on animal research and several small human studies, bilberry may be useful in the treatment of retinopathy in patients with diabetes or high blood pressure. However, this research is early, and it is still unclear if bilberry is beneficial for this condition.
C
Diabetes mellitus
Bilberry has been used traditionally in the treatment of diabetes, and animal research suggests that bilberry leaf extract can lower blood sugar levels. Human research is needed in this area before a recommendation can be made.
C
Cataracts
Bilberry extract has been used for a number of eye problems, including the prevention of cataract worsening. At this time, there is limited scientific information in this area.
C
Painful menstruation (dysmenorrhea)
Preliminary evidence suggests that bilberry may be helpful for relief of menstrual pain, although more research is necessary before a firm conclusion can be drawn.
C
Atherosclerosis ("hardening" of the arteries"), peripheral vascular disease
Bilberry has sometimes been used traditionally to treat heart disease and atherosclerosis. There is some laboratory research in this area, but there is no clear information in humans.
C
Diarrhea
Bilberry is used traditionally to treat diarrhea, but there is no reliable research in this area.
C
Fibrocystic breast disease
There is limited research suggesting a possible benefit of bilberry in the treatment of fibrocystic disease of the breast. More study is needed before a recommendation can be made.
C
Stomach ulcers (peptic ulcer disease)
Bilberry extract has been suggested as a treatment to help stomach ulcer healing. There is some support for this use from animal studies, but there is no reliable human evidence in this area.
C
Night vision
Traditional use and several unclear studies from the 1960s and 1970s suggest possible benefits of bilberry on night vision. However, more recent well-designed studies report no benefits. Based on this evidence, it does not appear that bilberry is helpful for improving night vision.
D
* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Angina, angiogenesis, antioxidant, arthritis, bleeding gums, cancer, cardiovascular disease, chemoprotectant, common cold, cough, dermatitis, dysentery, eye disorders, fevers, glaucoma, gout, heart disease, hemorrhoids, high blood pressure, high cholesterol, kidney disease, leukemia, liver disease, oral ulcers, pharyngitis, poor circulation, prevention/stopping of lactation (breast milk flow), retinitis pigmentosa, scurvy, skin infections, stomach upset, urine blood, urinary tract infection, vision improvement.
Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Standardization
Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. A component from bilberry extract called VMA ( Vaccinium myrtillius anthocyanoside) is standardized to contain 25% anthocyanidin, and has been used in many European studies. However, the strength and dosing of preparations available in the United States may differ from those used in European studies.
Adults (18 years and older)
General use : Doses recommended by some experts based on traditional use include fresh berries 55 to 115 grams three times daily, or 80 to 160 milligrams of aqueous extract three times daily by mouth (standardized to 25% anthocyanosides).
Circulatory and eye use : Doses of bilberry VMA extract from 80 to 480 milligrams daily in 2 to 3 divided doses by mouth have been used in studies. A common dose is 80 milligrams of extract twice daily (standardized to contain 25% anthocyanidin).
Diarrhea : Dried fruit 4 to 8 grams by mouth with water two times per day has been used traditionally, or decoction of dried fruit by mouth three times per day (made by boiling 5 to10 grams of crushed dried fruit in 150 milliliters of water for 10 minutes and straining while hot), or cold macerate of dried fruit by mouth three times per day (made by soaking dried crushed fruit in 150 milliliters of water for several hours). Experts have warned that patients should use dried bilberry preparations, because the fresh fruit may actually worsen diarrhea.
Painful menstruation (dysmenorrhea) : There is limited research using 160 milligrams of bilberry VMA extract taken by mouth twice daily for eight days, started three days prior to the start of the menstrual period.
Peptic ulcer disease : Half a cup of fresh bilberries or 20 to 40 milligrams of standardized anthocyanidin extract three times per day by mouth has been used.
Mucus membrane swelling : Some experts recommend using a mouthwash gargle of 10% dried fruit decoction as needed.
Children (younger than 18 years)
There is not enough scientific evidence to recommend the use of bilberry in children.
Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
People with allergies to plants in the Ericaceae family or to anthocyanosides may have reactions to bilberry. However, there are no reliable published cases of serious allergic reactions to bilberry.
Side Effects and Warnings
Bilberry is generally believed to be safe in recommended doses for short periods of time, based on its history as a foodstuff. There are no known reports of serious toxicity or side effects, although if taken in large doses, there is an increased risk of bleeding, upset stomach, or hydroquinone poisoning.
Based on human use, bilberry fresh fruit may cause diarrhea or have a laxative effect. Based on animal studies, bilberry may cause low blood sugar levels. Caution is therefore advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary. In theory, bilberry may decrease blood pressure, based on laboratory studies. With the use of bilberry leaf extract, there is a theoretical increased bleeding risk, although there are no reliable published human reports of bleeding. Caution is advised in patients with bleeding disorders, taking drugs that may increase the risk of bleeding, or prior to some surgeries and dental procedures.
Pregnancy and Breastfeeding
There is not enough scientific evidence to recommend the safe use of bilberry in pregnancy or breastfeeding, although eating bilberry fruit is believed to be safe based on its history of use as a foodstuff. One study used bilberry extract to treat pregnancy-induced leg swelling (edema), and no adverse effects were reported.
Methodology
This patient information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration () .
Selected references
1. Bomser J, Madhavi D, Singletary K, et al. In vitro anticancer activity of fruit extracts from species. Planta Med 1996;62(3):212-216.
2. Erlund I, Marniemi J, Hakala P, et al. Consumption of black currants, lingonberries and bilberries increases serum quercetin concentrations. Eur J Clin Nutr. 2003 Jan;57(1):37-42.
3. Hou DX. Potential mechanisms of cancer chemoprevention by anthocyanins. Curr Mol Med. 2003 Mar;3(2):149-59. Review.
4. Katsube N, Iwashita K, Tsushida T, et al. Induction of apoptosis in cancer cells by Bilberry (Vaccinium myrtillus) and the anthocyanins. J Agric Food Chem. 2003 Jan 1;51(1):68-75.
5. Laplaud PM, Lelubre A, Chapman MJ. Antioxidant action of extract on human low density lipoproteins in vitro: initial observations. Fundam Clin Pharmacol 1997;11(1):35-40.
6. Levy Y, Glovinsky Y. The effect of anthocyanosides on night vision. Eye 1998;12 ( Pt 6):967-969.
7. Muth ER, Laurent JM, Jasper P. The effect of bilberry nutritional supplementation on night visual acuity and contrast sensitivity. Altern Med Rev 2000;5(2):164-173.
8. Rasetti FRM, Caruso D, Galli G, et al. Extracts of L. leaves and L. fruits prevent photo induced oxidation of low density lipoprotein cholesterol. Phytomed 1997;3:335-338.
9. Roy S, Khanna S, Alessio HM, et al. Anti-angiogenic property of edible berries. Free Radic Res. 2002 Sep;36(9):1023-31.
10. Savickiene N, Dagilyte A, Lukosius A, Zitkevicius V. [Importance of biologically active components and plants in the prevention of complications of diabetes mellitus] Medicina (Kaunas). 2002;38 (10) :970-5. Lithuanian.
11. Viana M, Barbas C, Bonet B, et al. In vitro effects of a flavonoid-rich extract on LDL oxidation. Atherosclerosis 1996;123(1-2):83-91.
12. Zadok D, Levy Y, Glovinsky Y. The effect of anthocyanosides in a multiple oral dose on night vision. Eye 1999;13 ( Pt 6):734-736.
THIS EVIDENCE-BASED MONOGRAPH WAS PREPARED BY THE NATURAL STANDARD RESEARCH COLLABORATION ().
January 01, 2004 
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