Aronia Berry by Mountain Meadow Herbs

POSSIBLY INEFFECTIVE

• Cardiovascular disease (CVD). Oral chokeberry does not appear to improve body composition, cholesterol levels, blood pressure, or glycemic control in individuals with or at risk for CVD. Details: Most clinical research, including a meta-analysis of 7 clinical trials, shows that taking chokeberry does not reduce body mass index, cholesterol levels, blood pressure, or glucose levels in patients with a history of or risk factors for CVD (92374,102900,103183). The meta-analysis does, however, show that chokeberry can increase high-density lipoprotein (HDL) by around 1.5 mg/dL when compared with placebo. However, this improvement is unlikely to be clinically significant (103183).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Age-related cognitive decline. It is unclear if oral chokeberry is beneficial for preventing or treating age-related cognitive decline. Details: A small clinical study in healthy adults aged 40-60 years who are at risk for cognitive decline due to age and obesity shows that taking a specific chokeberry extract (Brainberry, Bioactor BV) 90 mg daily for 24 weeks improves psychomotor speed when compared with placebo. However, taking 150 mg daily has no effect. Also, neither dose improves attention, cognitive flexibility, mood, brain-derived neurotrophic factor levels, or vascular parameters such as carotid artery blood flow (105540).
• Age-related macular degeneration (AMD). Although there has been interest in using oral chokeberry for AMD, there is insufficient reliable information about the clinical effects of chokeberry for this purpose.
• Athletic performance. Limited-quality research on the use of oral chokeberry for improving athletic performance is mixed. Details: A small clinical study in semi-professional soccer players in Poland shows that taking lyophilized black chokeberry extract 6 grams daily for 90 days improves performance on a 20-meter shuttle run test when compared with placebo (111116). However, another small clinical trial in a similar study population shows that drinking chokeberry juice 200 mL daily for 7 weeks does not improve performance on the 20-meter shuttle run test when compared with placebo (111115). The disparate findings may be due to differences in the chokeberry formulations and study durations.
• Burning mouth syndrome. It is unclear if topical chokeberry is beneficial in patients with burning mouth syndrome. Details: A small clinical study in menopausal patients with burning mouth syndrome shows that rinsing with 15 mL of chokeberry juice for 5 minutes three times daily for 4 weeks reduces symptoms of burning mouth syndrome when compared to baseline (111117). The validity of these findings is limited by a lack of placebo control group.
• Cancer. Although there has been interest in using oral chokeberry for cancer, there is insufficient reliable information about the clinical effects of chokeberry for this purpose.
• Cellulite. Although there has been interest in using oral chokeberry for cellulite, there is insufficient reliable information about the clinical effects of chokeberry for this purpose.
• Diabetes. It is unclear if oral chokeberry is beneficial in patients with type 2 diabetes. Details: A small, open-label clinical study in patients with type 2 diabetes shows that drinking chokeberry juice 50 mL three times daily for 3 months does not improve fasting blood glucose, glycated hemoglobin (HbA1c), cholesterol levels, blood pressure, or measures of kidney function when compared to baseline (111118).
• Hypercholesterolemia. It is unclear if oral chokeberry is beneficial in patients with hypercholesterolemia. Details: A small clinical study in males with mild hypercholesterolemia shows that drinking chokeberry juice 250 mL daily might decrease low-density lipoprotein (LDL) cholesterol levels when compared to baseline. Chokeberry juice was consumed for 6 weeks, followed by a 6-week break, and then consumed for another 6 weeks. No reduction in LDL cholesterol levels was seen after the first 6 weeks; however, LDL cholesterol levels decreased by 17% from baseline after another 6 weeks of consumption (92369). Due to the conflicting outcomes and lack of control group, it is not clear if chokeberry lowers LDL cholesterol levels.
• Hypertension. Some limited-quality evidence suggests that oral chokeberry might lower blood pressure in patients with hypertension; however, conflicting results exist, and the available studies have all been short-term. Details: One small clinical study in patients with slightly high blood pressure or mild hypertension shows that drinking chokeberry juice 200 mL daily for 4 weeks improves systolic and diastolic blood pressure, both while awake and on average over a 24-hour period, when compared to baseline (92372). However, this study is limited by a lack of control group. Another small clinical study in patients with mild hypertension shows that drinking chokeberry juice 300 mL mixed with chokeberry powder 3 grams daily for 8 weeks reduces daytime diastolic blood pressure by 1.6 mm Hg when compared with placebo; however, this effect is modest, at best, and 24-hour ambulatory blood pressure and daytime systolic blood pressure were not improved (98086). Chokeberry juice in combination with other berries has also been evaluated for hypertension. A small clinical study in patients with mild hypertension shows that drinking a specific juice (Mana Blue or Optijuice, Tine SA), containing juice from chokeberries, grapes, cherries, and bilberries, 500 mL daily for 12 weeks modestly improves systolic blood pressure, but not diastolic blood pressure, when compared with a placebo juice (92371). It is unclear if this effect is due to chokeberry, other components of the juice, or the combination.
• Kidney failure. It is unclear if oral chokeberry is beneficial in patients with kidney failure. Details: A small clinical study in patients with chronic kidney disease and hemodialysis-induced anemia shows that taking chokeberry extract 30 mL daily for 30 days improves some measures of anemia, including levels of hemoglobin, lactate dehydrogenase, and ferritin, when compared to baseline (111120). The validity of these findings is limited by a lack of placebo control group.
• Male infertility. Although there has been interest in using oral chokeberry for male infertility, there is insufficient reliable information about the clinical effects of chokeberry for this purpose.
• Metabolic syndrome. Some limited-quality clinical research suggests that oral chokeberry might improve blood pressure and lipid levels in patients with metabolic syndrome. Details: Two small clinical studies in adults with metabolic syndrome show that taking a specific extract of chokeberry (Aronox, Naturex) 300 mg daily for 2 months reduces systolic blood pressure by 8%, diastolic blood pressure by 6%, total cholesterol levels by 6%, and low-density lipoprotein (LDL) cholesterol levels by 8% to 9%, but does not affect blood glucose levels or body composition, when compared to baseline (92363,92364). The validity of these results is limited by the lack of a control group. An open-label case series of patients with metabolic syndrome shows that taking a standardized chokeberry extract (Alixir 400 Protect, Pharmanova) 30 mL daily for 4 weeks decreases body weight when compared to baseline. It also decreases LDL cholesterol in females and total cholesterol in females with diabetes, increases high-density lipoprotein (HDL) cholesterol levels in females without diabetes, and decreases triglycerides in both males and females with diabetes, when compared to baseline (105542). The validity of these results is limited by the study design, analysis of multiple subgroups, and the lack of a control group. Another small clinical study in adults with metabolic syndrome shows that drinking a citrus juice containing chokeberry extract 5% 300 mL daily for 6 months lowers total cholesterol levels by 8% when compared to baseline and by 12% when compared with placebo (92365). However, it is unclear if these findings are due to chokeberry, other ingredients in the juice, or the combination.
• Obesity. Oral chokeberry has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in females with overweight or obesity and at least one risk factor for cardiovascular disease shows that drinking a combination of chokeberry, apple, blueberry, and cranberry juice 300 mL daily for 6 weeks does not reduce body weight, body mass index (BMI), or blood pressure but might improve total cholesterol and high-density lipoprotein (HDL) cholesterol when compared to baseline (111121). Additionally, a small clinical study in postmenopausal patients with abdominal obesity shows that drinking 100 mL of chokeberry juice enriched with glucomannan fiber 2 grams daily as part of a regular diet for 4 weeks reduces BMI by 3%, waist circumference by 4%, and systolic blood pressure by 8% when compared to baseline (92368). The patients in this study were sedentary and following moderately unhealthy diets. It's unclear how chokeberry juice compares to dieting or exercising to improve these outcomes. Overall, the lack of control groups limits the validity of the findings above. It is also unclear whether the findings are due to chokeberry, other ingredients, or the combination.
• Rheumatoid arthritis (RA). Although there has been interest in using oral chokeberry for RA, there is insufficient reliable information about the clinical effects of chokeberry for this purpose.
• Urinary tract infections (UTIs). It is unclear if oral chokeberry is beneficial for the prevention of UTIs. Details: A moderate-sized clinical study in elderly adults residing in nursing homes shows that drinking chokeberry juice an average of 89-156 mL daily for 3 months does not reduce UTI occurrence rate or the use of antibiotics when compared with placebo (92367). More evidence is needed to rate chokeberry for these uses.

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POSSIBLY SAFE ...when used orally and appropriately in medicinal amounts, short term. Capsules and juices containing chokeberry have been used with apparent safety in clinical studies lasting up to 90 days (92363,92364,92366,92368,92369,92371,92372,92374,92375,98086)(111115,111116).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in medicinal amounts.

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ANTICOAGULANT/ANTIPLATELET DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = B Theoretically, chokeberry might increase the risk of bleeding when taken with anticoagulant or antiplatelet drugs.  Details Clinical and in vitro research suggests that chokeberry extract can temporarily inhibit platelet aggregation and decrease clot formation (92364,92427).

ANTIDIABETES DRUGS Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = B Theoretically, chokeberry might increase the risk of hypoglycemia when taken with antidiabetes drugs.  Details Some clinical research shows that chokeberry decreases levels of blood glucose in some patients with diabetes (92373). However, other clinical research suggests that chokeberry has no significant effect on blood glucose levels (111118).

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES Interaction Rating = Moderate Be cautious with this combination. Severity = Moderate •  Occurrence = Possible •  Level of Evidence = D Theoretically, chokeberry might increase levels of drugs metabolized by CYP3A4.  Details In vitro research shows that chokeberry inhibits CYP3A4 (92425). In humans, there is one case report of a drug interaction with trabectedin, a CYP3A4 substrate, which is hypothesized to have been caused by chokeberry inhibition of CYP3A4 (92426).

TRABECTEDIN (Yondelis) Interaction Rating = Moderate Be cautious with this combination. Severity = High •  Occurrence = Possible •  Level of Evidence = D Theoretically, chokeberry might increase the effects and adverse effects of trabectedin.  Details In one case report, a patient drinking chokeberry juice developed rhabdomyolysis induced by trabectedin, a cytochrome P450 3A4 (CYP3A4) substrate. It is possible that inhibition of CYP3A4 by chokeberry juice might have inhibited the metabolism of trabectedin and increased trabectedin levels in this patient (92426).

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General ...Orally, chokeberry seems to be well tolerated.
Most Common Adverse Effects:
Orally: Constipation, diarrhea, nausea, stomach cramps, vomiting.

Gastrointestinal ...Orally, chokeberry juice may cause adverse gastrointestinal effects. In one small clinical study, around 14% of patients reported constipation, diarrhea, or gastrointestinal motility issues while drinking 100 mL of chokeberry juice daily for 90 days (92375). In another small clinical study, around 53% of patients reported diarrhea, loss of appetite, nausea, stomachache, stomach cramps, or vomiting while drinking 100 mL of chokeberry juice twice daily for 6 weeks (111119).

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