Often called European blueberry, bilberry is closely related to American blueberry, cranberry, and huckleberry. The flesh of bilberry is red, and is traditionally used, like blueberries, in the preparation of jams, pies, cobblers, and cakes.
Bilberry fruit also has a long medicinal history. In the twelfth century, Abbess Hildegard of Bingen wrote of bilberry's usefulness for inducing menstruation. Over subsequent centuries, the list of uses for bilberry grew to include a bewildering variety of possibilities, from bladder stones to typhoid fever.
The modern use of bilberry dates back to World War II, when British Royal Air Force pilots reported that a good dose of bilberry jam just prior to a mission improved their night vision, often dramatically. Subsequent investigation showed that bilberry contains biologically active substances known as anthocyanosides. Some evidence suggests that anthocyanosides may benefit the retina, as well as strengthen the walls of blood vessels, reduce inflammation, and stabilize tissues containing collagen (such as tendons, ligaments, and cartilage).1-7
However, neither anecdote nor basic scientific evidence of this type can prove a treatment effective. Only double-blind, placebo-controlled studies can do that. (For more information, see the article Why Does This Database Rely on Double-blind Studies?) Regarding night vision, the balance of the evidence suggests that bilberry is not helpful. Slight evidence hints that bilberry might be helpful for diabetic retinopathy. One double-blind study suggests that bilberry might be helpful for hemorrhoids.
Finally, because the anthocyanosides in bilberry resemble the oligomeric proanthocyanidin complexes ( OPCs) found in grape seed and pine bark, bilberry has been recommended for all the same uses as those substances, including easy bruising, varicose veins, minor injuries, and surgery support.
A double-blind crossover trial of 15 individuals found no short- or long-term improvements in night vision attributable to bilberry.9 Similarly negative results were seen in a double-blind, placebo-controlled crossover trial of 18 subjects 10 and another of 16 subjects.11
In contrast, two much earlier controlled, but not double-blind, studies of bilberry found that the herb temporarily improved night vision.12,13 However, the effect was not found to persist with continued use. A later double-blind, placebo-controlled study on 40 healthy subjects found that a single dose of bilberry extract improved visual response for 2 hours.14
Visual benefits have also been reported in other small trials, but these studies did not use a placebo control group and are therefore not valid as evidence.15,16,17
A double-blind, placebo-controlled trial of bilberry extract in 14 people with diabetic retinopathy or hypertensive retinopathy (damage to the retina caused by diabetes or hypertension, respectively) found significant improvements in the treated group.18 However, the small size of this study makes the results less than fully reliable. Other studies are also cited as indicating benefits, but they were not double-blind and therefore mean little.19,20
Bilberry (whortleberry) fruit extract supplements were added to standard treatment for adults with type 2 diabetes resistant to diabetes medication and compared to placebo. Those who received the fruit extract had significant reductions in fasting blood glucose, glucose levels after eating, and HbA1c levels compared to regular treatment plus placebo.28
The standard dosage of bilberry is 120 to 240 mg twice daily of an extract standardized to contain 25% anthocyanosides.
Bilberry fruit is a food and, as such, is quite safe. Enormous quantities have been administered to rats without toxic effects.21,22 One study of 2,295 people given bilberry extract found a 4% incidence of side effects such as mild digestive distress, skin rashes, and drowsiness.23 Although safety in pregnancy has not been proven, clinical trials have enrolled pregnant women.24 Safety in young children, nursing women, or those with severe liver or kidney disease is not known. There are no known drug interactions. Bilberry does not appear to interfere with blood clotting.25
Little is known about the safety of bilberry leaf. Based on animal evidence that it can reduce blood sugar levels in people with diabetes, it is possible that use of bilberry leaf by people with diabetes could require a reduction in drug dosage.26
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1. Monboisse JC, Braquet P, Randoux A, et al. Non-enzymatic degradation of acid-soluble calf skin collagen by superoxide ion: Protective effect of flavonoids. Biochem Pharmacol. 1983;32:53-58.
2. Havsteen B. Flavonoids, a class of natural products of high pharmacological potency. Biochem Pharmacol. 1983;32:1141-1148.
3. Gabor M. Pharmacologic effects of flavonoids on blood vessels. Angiologica. 1972;9:355-374.
4. Mian E, Curri SB, Lietti A, et al. Anthocyanosides and the walls of the microvessels: further aspects of the mechanism of action of their protective effect in syndromes due to abnormal capillary fragility [in Italian; English abstract]. Minerva Med. 1977;68:3565-3581.
5. Pulliero G, Montin S, Bettini V, et al. Ex vivo study of the inhibitory effects of Vaccinium myrtillus anthocyanosides on human platelet aggregation. Fitoterapia. 1989;60:69-75.
6. Wegmann R, Maeda K, Tronche P, et al. Effects of anthocyanosides on photoreceptors. Cytoenzymatic aspects [translated from French]. Ann Histochim. 1969;14:237-256.
7. Cluzel C, Bastide P, Wegman R, et al. Enzymatic activities in the retina and anthocyanosides extracted from Vaccinium myrtillus (lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase, 6-phosphogluonate dehydrogenase, glucose-6-phosphate dehydrogenase, alpha-glycerophosphate dehydrogenase, 5-nucleotide, and phosphoglucose isomerase) [translated from French]. Biochem Pharmacol. 1970;19:2295-2302.
8. Cignarella A, Nastasi M, Cavalli E, et al. Novel lipid-lowering properties of Vaccinium myrtillus L. leaves, a traditional antidiabetic treatment, in several models of rat dyslipidaemia: a comparison with ciprofibrate. Thromb Res. 1996;84:311-322.
9. Muth ER, Laurent JM, Jasper P. The effect of bilberry nutritional supplementation on night visual acuity and contrast sensitivity. Altern Med Rev. 2000;5:164-173.
10. Zadok D, Levy Y, Glovinsky Y, et al. The effect of anthocyanosides on night vision tests. Invest Ophthalmol Vis Sci. 1997;38(suppl):633.
11. Levy Y, Glovinsky Y. The effect of anthocyanosides on night vision. Eye. 1998;12:967-969.
12. Jayle GE, Aubert L. Action of anthocyan glucosides on the scotopic and mesopic vision of the normal subject [in French; English abstract]. Therapie. 1964;19:171-185.
13. Jayle GE, Aubry M, Gavini H, et al. Study concerning the action of anthocyanoside extracts of Vaccinium myrtillus on night vision [in French]. Ann Ocul (Paris). 1965;198:556-562.
14. Bone K. Bilberry-The vision herb. MediHerb Prof Rev. 1997;59:1-4.
15. Sala D, Rolando M, Rossi PL, et al. Effect of anthocyanosides on visual performance at low illumination [in Italian; English abstract]. Minerva Oftalmol. 1979;21:283-285.
16. Gloria E, Peria A. Effect of anthocyanosides on the absolute visual threshold [in Italian; English abstract]. Ann Ottalmol Clin Ocul. 1966;92:595-607.
17. Caselli L. Clinical and electroretinographic study on activity of anthocyanosides [in Italian; English abstract]. Arch Med Intern (Parma). 1985;37:29-35.
18. Bone K. Bilberry-The vision herb. MediHerb Prof Rev. 1997;59:1-4.
19. Bone K. Bilberry-The vision herb. MediHerb Prof Rev. 1997;59:1-4.
20. Scharrer A, Ober M. Anthocyanosides in the treatment of retinopathies [translated from German]. Klin Monatsbl Augenheilkd. 1981;178:386-389.
21. Lietti A, Cristoni A, Picci M. Studies on Vaccinium myrtillus anthocyanosides. I. Vasoprotective and antiinflammatory activity. Arzneimittelforschung. 1976;26:829-832.
22. Lietti A, Forni G. Studies on Vaccinium myrtillus anthocyanosides. II. Aspects of anthocyanin pharmacokinetics in the rat. Arzneimittelforschung. 1976;26:832-835.
23. Eandi M. Post marketing investigation on TegensŴ preparation with respect to side effects. Unpublished results. Cited by: Morazzoni P, Bombardelli E. Vaccinium myrtillus. Fitoterapia. 1996;67:3-29.
24. Grismondi GL. Treatment of phlebopathies caused by stasis in pregnancy [translated from Italian]. Minerva Ginecol. 1981;33:221-230.
25. Scharrer A, Ober M. Anthocyanosides in the treatment of retinopathies [translated from German]. Klin Monatsbl Augenheilkd. 1981;178:386-389.
26. Cignarella A, Nastasi M, Cavalli E, et al. Novel lipid-lowering properties of Vaccinium myrtillus L. leaves, a traditional antidiabetic treatment, in several models of rat dyslipidaemia: a comparison with ciprofibrate. Thromb Res. 1996;84:311-322.
27. Villalba G. Anthocyanosides as a new vasculotrophic agent in patients with hemorrhoids. Medicina (Mex). 1974;54:73-76.
28. Kianbakht S, Abasi B, et al. Anti-hyperglycemic effect of Vaccinium arctostaphylos in type 2 diabetic patients: a randomized controlled trial. Forsch Komplementmed. 2013;20(1):17-22.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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