Pharmacognosy · Vasoprotective · Commission E Recognised

Bilberry

Vaccinium myrtillus L. — recognised by the German Commission E and reviewed in the EU herbal monograph on the dried fruit, valued since the 1960s for anthocyanoside-rich extracts studied for vasoprotective, antioxidant and retinal-protective activity.

49 Primary Refs
12 Properties
Berry Parts Used
Researched
Last Updated
Primary Source Wikiphyto · NCBI PubMed · Fitoterapia
Family Ericaceae
French Pharmacopoeia List A · Commission E · EMA Monograph

Biological Overview

Vaccinium myrtillus L. is a low spreading sub-shrub of the Ericaceae family, native to acidic, humus-rich soils, forest floors and drying peat bogs across Europe and western Asia. Its dark blue-black berries are exceptionally rich in anthocyanosides, the polyphenolic pigments responsible for most of the fruit's documented vasoprotective and antioxidant activity. Both fruit and leaf are used medicinally, though prolonged leaf use carries cautions not shared by the fruit.

FamilyEricaceae
Anthocyanosides~0.5% fresh fruit
Catechin Tannins~10% (fruit)
Chromium9 ppm (leaf)

Taxonomy & Identification

Latin Name
Vaccinium myrtillus L.
Family
Ericaceae
Common Names
Bilberry, European Blueberry, Myrtille, Airelle, Bluet, Brimbelle
Parts Used
Fruit (primary), Leaf
Origin
Europe & western Asia (acidic soils, peat bogs)
Habit
Sub-shrub, 30–60 cm, angular erect stems

History & Tradition

Bilberry has long been gathered from heaths, moist coniferous forests and tundra-adjacent highlands across Europe and western Asia, prepared as herbal infusions, mother tinctures, fluid and dry extracts, and as jellies, preserves and dried fruit.

Modern pharmacological interest dates to the 1960s and accelerated through the 1970s–1990s, when foundational studies on Vaccinium myrtillus anthocyanosides established their vasoprotective and pharmacokinetic profile, followed by a comprehensive 1996 review consolidating the plant's phytochemistry and pharmacology.

In 2009, the Natural Standard Research Collaboration published a formal evidence-based systematic review of bilberry, and the European Medicines Agency has since issued a herbal monograph on the dried fruit, recognising activity also acknowledged by the German Commission E.

⚠ Naming Confusion

True bilberry (Vaccinium myrtillus) is sometimes called "blueberry" in North America, but the blueberry sold there is mainly harvested from related yet botanically distinct species — chiefly Vaccinium myrtilloides and Vaccinium angustifolium — produced principally in Maine and Quebec.

Research Timeline

Traditional Galenicals

Pre-modern Europe

Dried fruit infusions, fruit mother tinctures, fluid extracts, jellies, preserves and desiccated fruit in regional use. [43]

1976 — Pharmacological Characterization

Lietti et al., Arzneimittelforschung

Foundational studies establish vasoprotective activity and pharmacokinetics of bilberry anthocyanosides in animal models. [3][4]

1996 — Comprehensive Monograph

Morazzoni & Bombardelli, Fitoterapia

A major review consolidates phytochemical and pharmacological data on Vaccinium myrtillus L. [47]

2009 — Evidence-Based Systematic Review

Ulbricht et al., J Diet Suppl

Natural Standard Research Collaboration publishes a formal evidence-based systematic review of bilberry.

EU Herbal Monograph

European Medicines Agency

Final EU herbal monograph on Vaccinium myrtillus L. dried fruit confirms no contraindication during pregnancy.

Anthocyanosides — Deep Dive

Heterosides of delphinidin, malvidin and cyanidin make up roughly 0.5% of fresh bilberry fruit, and underlie nearly every pharmacological effect documented for the plant.

🩸

Vasoprotective Action

Bilberry anthocyanosides are more active than rutin in tests measuring capillary permeability and vascular resistance, with a notably long duration of action. [3][4]

💨

Platelet & Vasomotor Effects

Anthocyanosides and flavonoids inhibit platelet aggregation and stimulate vascular wall PGI2 activity, improving vasomotricity and microvascular blood flow redistribution. [7][8]

👁️

Retinal Antioxidant Protection

Anthocyanosides and anthocyanidins support regeneration of rhodopsin and protect the retina through antioxidant action, although a systematic review found human clinical trial evidence remains limited. [12][13]

🧬

Anti-angiogenic Effects

Anthocyanidins (delphinidin, cyanidin, malvidin) inhibit angiogenesis, with documented activity against retinal neovascularization implicated in diabetic retinopathy and glaucoma. [20][22]

⚠ Standardization Matters

Anthocyanin content varies widely between bilberry preparations

The pharmacological activity documented in the literature derives largely from standardized, anthocyanoside-rich extracts of the fruit — historically studied under names such as "Myrtocyan" — rather than from unstandardized dried fruit, tea infusions, or whole-fruit preparations of unknown anthocyanin content. [7]

Parts Used & Available Forms

The fruit is the primary part used, available across a spectrum of traditional and standardized preparations.

Dried Fruit & Infusions

Traditional herbal infusions prepared from dried bilberries, alongside jellies, preserves and dried whole fruit.

Infusion · Whole Fruit

Mother Tincture & Fluid Extract

Fruit mother tincture and fluid extract preparations, used in traditional phytotherapeutic practice.

Tincture · Fluid Extract

Standardized Dry Extract

Standardized dry extract of the fruit, the form most associated with the standardized anthocyanoside-rich preparations used in modern research.

Dry Extract · Standardized

Composition

Documented phytochemistry differs meaningfully between fruit and leaf — the basis for their distinct uses and safety profiles.

Fruit

AnthocyanosidesHeterosides of delphinidin, malvidin, cyanidin, pelargonidin, peonidin, hirsutidine & petunidin
~0.5%
Catechin TanninsCondensed tannin fraction of the fruit
~10%
ProanthocyanidolsDimers of catechol and epicatechol
Present
FlavonoidsHyperoside, quercetol & kaempferol heterosides
Present
Phenolic AcidsMalic, citric, quinic, chlorogenic, p-coumaric & ferulic acids
Present
Oligosaccharides & PectinsSoluble sugar and pectin fraction
3–7%
Trans-resveratrolStilbenoid compound
Trace

Leaf

Catechin Tannins & CatecholsEpicatechol, gallocatechol, epigallocatechol
1–7%
ProanthocyanidolsDimers of catechol and epicatechol
Present
FlavonoidsQuercetol & kaempferol heterosides
Present
IridoidsDocumented iridoid fraction
Present
Chlorogenic Phenolic AcidsPredominantly chlorogenic acid derivatives
Present
Quinolizidine AlkaloidsMyrtine & epimyrtine
Present
ChromiumLinked to documented hypoglycemic activity
9 ppm

Plant Properties — Pharmacodynamics

Documented predominantly for the fruit, anchored in anthocyanoside and tannin pharmacology.

12 Properties Vascular Ocular Antioxidant
🩸

Vasoprotective & Capillary-Strengthening

More active than rutin in tests of capillary permeability and vascular resistance, with a long duration of action and reduced edema. [5][6]

🧬

Antiplatelet Activity

Flavonoids and anthocyanosides inhibit platelet aggregation and adhesiveness, documented in preparations such as Myrtocyan. [7]

💨

Vasomotor & Microcirculatory Support

Stimulates vascular wall PGI2 activity and improves arterial vasomotion and microvascular flow redistribution. [8]

🫀

ACE-Inhibitory Activity

The whole extract inhibits angiotensin-converting enzyme activity in human endothelial cells, though isolated anthocyanidins alone are not active. [10]

🦴

Anti-inflammatory & Joint Protective

Improves articular function and reduces bone resorption, tissue swelling and osteophyte formation in animal arthritis models. [11]

👁️

Night Vision & Retinal Protection

Supports rhodopsin regeneration and provides antioxidant retinal protection, though robust human clinical trials remain lacking. [12][13]

🧠

Memory Support

Blueberry supplementation has been associated with improved memory performance in older adults in a controlled trial. [14]

🦠

Antibacterial (Urinary & Intestinal)

Inhibits adhesion of E. coli to bladder and intestinal walls and shows anti-biofilm activity, though with less clinical evidence than cranberry. [15][17]

☀️

Photoprotective (UVA/UVB)

Protects keratinocytes against UVA- and UVB-induced phototoxic stress and DNA damage. [18][29]

🔬

Anti-angiogenic & Ocular Protective

Inhibits angiogenesis, with activity implicated in diabetic retinopathy, age-related macular degeneration and glaucoma-related neovascularization. [20][36]

🛡️

Antioxidant

Protects against oxidative hepatic and renal damage, attributed to free-radical scavenging by anthocyanosides and tannins. [30][31]

⚖️

Metabolic Syndrome Support

Regular moderate intake of bilberries or anthocyanins is associated with reduced cardiovascular disease and type 2 diabetes risk. [28]

Clinical Indications

Traditional and modern phytotherapeutic uses, drawn directly from the documented indications for the whole plant.

🩸
Vascular & Circulatory Health
Venous & Capillary Disorders
  • Venous & capillary circulatory disorders: traditional indication supported by documented vasoprotective activity.
  • Raynaud's syndrome: documented traditional and pharmacological indication. [47]
  • Phlebitis prevention: including use in pregnant women, per traditional and EMA-reviewed use. [47]
👁️
Ocular Health
Vision & Retinal Conditions
  • Macular degeneration: documented indication linked to retinal antioxidant and anti-angiogenic activity. [48]
  • Retinal microcirculation support: traditional indication tied to vasoprotective and antioxidant mechanisms.
🌿
Gastrointestinal & Urinary
Digestive & Bladder Conditions
  • Colitis & functional bowel disorders: documented traditional indication for the whole plant.
  • Urinary tract infections: traditional indication, used similarly to related Vaccinium species such as cranberry.
  • Spasmodic colitis pain: documented traditional indication for symptom relief.
⚖️
Metabolic Syndrome
Diabetes, Obesity & Hypertension Prevention
  • Metabolic syndrome prevention & management: diabetes, obesity and hypertension, attributed to anthocyanoside content. [49]

Mode of Action

The documented mechanisms behind bilberry's vascular, ocular and antimicrobial effects.

🩸

Capillary Permeability & Vascular Resistance

Polyphenols act directly on capillary permeability and vessel wall resistance, with documented benefit for varicosities at the arterial-venous interface.

👁️

Rhodopsin Regeneration

Anthocyanosides and anthocyanidins support regeneration of rhodopsin (visual purple) in retinal photoreceptor cells. [12]

🧬

Free Radical Scavenging

Anthocyanosides and tannins act as antioxidants, neutralizing reactive oxygen species and reducing oxidative tissue damage. [30]

🦠

Bacterial Anti-Adhesion

Inhibits adhesion of E. coli and related uropathogens to bladder and intestinal mucosa, a mechanism shared with related Vaccinium species. [15]

Safety, Interactions & Precautions

Documented contraindications, drug interactions and precautions for fruit and leaf preparations.

⚠️

Adverse Effects

  • Chronic leaf use: prolonged therapeutic use of the leaf is not recommended due to risks documented in animal studies.
  • High-dose leaf toxicity: cachexia, anemia, jaundice and disturbed muscle tone observed in animals at very high doses (1.5 g/kg/day).
  • Fruit use: no contraindication to fruit use during pregnancy per the EMA herbal monograph.
🚫

Contraindications & Drug Interactions

  • Antidiabetic medications: theoretical additive hypoglycemic effect given documented hypoglycemic activity.
  • Antiplatelet drugs: potential interaction given documented antiplatelet and platelet-adhesiveness activity. [7][43]
  • Long-term leaf therapy: not recommended due to chronic-use risk profile, independent of any specific medication.
Clinical Disclaimer: This monograph is for educational and professional reference only. It does not constitute medical advice, diagnosis, or treatment guidance. Always consult a qualified healthcare provider before initiating any phytotherapeutic regimen, particularly if you are taking prescription medications, are pregnant, or have existing health conditions.

Frequently Asked Questions

Is bilberry the same plant as blueberry?
Not exactly. Vaccinium myrtillus, the true bilberry, is native to Europe and western Asia. What is commonly called blueberry in North America comes mainly from related but distinct species, Vaccinium myrtilloides and Vaccinium angustifolium, principally grown in Maine and Quebec.
Which part of the bilberry plant is used medicinally?
The fruit is the primary part used and carries the strongest evidence base. The leaf is also used traditionally, but prolonged therapeutic use of the leaf is not recommended due to documented risks in high-dose animal studies.
What are anthocyanosides and why are they important in bilberry?
Anthocyanosides are polyphenolic pigment glycosides, derived from delphinidin, malvidin, cyanidin, pelargonidin, peonidin, hirsutidine and petunidin, that make up about 0.5% of fresh bilberry fruit. They are considered responsible for most of the fruit's documented vasoprotective, antioxidant and retinal-protective activity.
Does bilberry improve night vision?
Bilberry anthocyanosides are documented to support regeneration of rhodopsin and provide antioxidant retinal protection in preclinical research. However, a systematic review of placebo-controlled trials found clinical evidence for improved night vision in humans is lacking.
Can bilberry help with urinary tract infections?
Bilberry extracts have documented antibacterial and anti-adhesion activity against E. coli and Proteus mirabilis, similar to related Vaccinium species such as cranberry. However, the clinical evidence supporting bilberry specifically for UTI prevention is considerably weaker than for cranberry (Vaccinium macrocarpon).
Is bilberry fruit safe to use during pregnancy?
According to the European Medicines Agency's herbal monograph on Vaccinium myrtillus dried fruit, there is no contraindication to fruit use during pregnancy, and it has traditionally been used for prevention of phlebitis in pregnant women.
Can bilberry interact with diabetes or blood-thinning medication?
Yes. Bilberry carries a theoretical additive effect with antidiabetic medications due to its hypoglycemic activity, and a potential interaction with antiplatelet drugs given its documented effect on platelet aggregation.
Is long-term use of bilberry leaf safe?
Prolonged therapeutic use of the leaf is not recommended. High-dose animal studies (around 1.5 g/kg/day) have documented cachexia, anemia, jaundice and disturbed muscle tone with chronic leaf exposure. These risks are not associated with fruit use.

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Additional Reference Literature

Wichtl M, Anton R. Plantes thérapeutiques: Tradition, pratique officinale, science et thérapeutique. Éd. Tec & Doc, Cachan. 1999. p.377.
Ulbricht C, et al. An evidence-based systematic review of bilberry (Vaccinium myrtillus) by the Natural Standard Research Collaboration. J Diet Suppl. 2009;6(2):162-200. PubMed PMID:22435415 →