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Bilberry: Microcirculation Enhancer

[Bilberries as antioxidants | The circulatory system | Cardiac benefits of bilberry]
[Bilberry effects on the eye | Anti-ulcer activity | Details of use | Safety]

For many years, Europeans have been using an extract from bilberry (vaccinium myrtillus), the European version of the American blueberry, to strengthen the human capillary system. Bilberry is used specifically to prevent and treat fragile capillaries and capillaries which leak either fluid or blood into the tissues.

Primary uses of Bilberry extract:

  • Eye health and vision
  • Microcirculation
  • Spider veins and varicose veins
  • Capillary strengthening before surgery

Fragile blood vessels are sometimes related to high blood pressure, diabetes or atherosclerosis. Capillary fragility shows up as a serious medical problem if it results in hemorrhage, stroke, heart attack or blindness resulting from diabetic or hypertensive damage to the retina. Less serious effects include a tendency toward easy bruising, varicose veins, "spider veins", poor night-vision and coldness, numbness or cramping of the legs. As a "circulatory microplumber", bilberry extracts help prevent such problems by strengthening the capillaries and other small blood vessels, and bilberry acts to increase the flexibility of red blood cell membranes.

Bilberry extracts are made from bilberries; the fruit of the bilberry plant. The bilberries are extracted and concentrated to fortify the levels of beneficial chemicals called anthocyanins, which are the coloring compounds in the skin and juice of the bilberry. These bilberry anthocyanin pigments belong to one of the most important and best-studied classes of medicinal compounds in recent years, the flavonoids.

Bilberries as Antioxidants
As with other flavonoids, the bilberry compounds are antioxidants, which protect cells and membranes from damage caused by "free radicals". Free radicals are highly reactive fragments of chemicals, which are broken off during the metabolism of both toxic and non-toxic compounds in the body. When free radicals encounter healthy cell membranes in the body, they can cause damage to these membranes, impairing their functionality and leading to premature death of the cell. Thus, antioxidants, or "free radical scavengers", are considered to be anti-ageing compounds, and are also thought to be anticarcinogenic, since free radicals can also damage DNA, leading to mutations in cells. Bilberry flavonoids are special though. Bilberry flavonoids have specific effects on both the blood vessels and on the blood cells which flow through them, by maintaining the flexibility of their cell membranes. Through this bilberry induced action, the capillaries are better able to stretch, increasing blood flow, and red blood cells are better able to deform into a shape which allows them to pass through very narrow capillaries.

The Circulatory System
The human circulatory system is an extraordinary piece of plumbing. Starting at the body's core - the heart, lungs and digestive system - it distributes through a network of increasingly smaller vessels the food, water and oxygen, necessary to the survival of every cell in our bodies. The tiniest vessels, the capillaries, are so small that some allow red blood cells to pass only in single file. While most people understand the overall workings of the circulatory system, as a big pump that pumps liquid through tubes, few are aware of the complex interactions of chemical mediators, nerves and muscles in the blood vessels themselves. The amount of blood flow, and consequently, nourishment and oxygenation, must be balanced between the brain and the body's core or trunk, and the periphery, including the skin and limbs. Blood vessels have muscles which allow them to constrict or to dilate, raising and lowering blood pressure. Selective restriction of vessels is a response to cold, conserving the body's heat for vital organs while allowing hands and feet to become cold when necessary. The cells of the capillaries can also allow holes to open between cells, allowing fluid and blood cells to flow into tissue, which is the basis of inflammation, by which our bodies respond to injury. With age, all blood vessels lose flexibility and become partially blocked by calcium and fatty deposits.

Like Ginkgo biloba, bilberry extracts have been used to treat circulatory insufficiency of the legs, a condition which affects many elderly persons. Clinical trials have shown the effectiveness of bilberry on venous insufficiency of the lower limbs, whether or not age was a contributing factor to the problem.1,2 In fact, subjects in these two bilberry trials ranged from 18 to 75 years old. Testing documented the bilberry induced increase both in flexibility (distensibility) of the capillaries with bilberry use and in "deformability" of red blood cells; bilberry restoring normal blood flow.

Another clinical test of bilberry demonstrated the ability of bilberry extract to treat varicose veins in the legs.3 This bilberry test demonstrated a significant improvement in the symptoms of "varicose syndrome" such as cramps, heaviness, swelling of the calf and ankle, and numbness which can also result from impaired circulation. In all these trials using bilberry, there were no significant side effects of the bilberry extract, even when the normal bilberry dose was exceeded by 50%.

Another common cause of unpleasant changes in microcirculation is pregnancy. Both varicose veins and hemorrhoids are common during pregnancy due to blood pressure and volume fluctuations. A standardized bilberry extract was studied in two clinical trials totaling 115 women with venous insufficiency and hemorrhoids following pregnancy.4,5 Both bilberry studies documented an improvement in symptoms, including pain, burning and pruritis, all of which disappeared in most cases. Again, no side effects were noted from the use of bilberry.

Cardiac Benefits of Bilberry
In addition to strengthening the capillaries, preventing breakage, hemorrhage, bruising and leakage, research has shown that regular use of the bilberry flavonoids can decrease the disposition of calcium plaque on blood vessels.6 This deposition is commonly known as atherosclerosis or "hardening of the arteries." Since bilberry is also a blood thinner, that is, bilberry inhibits platelet aggregation, which is the beginning of clot formation, bilberry seems to possess an impressive range of effects as a cardio productive agent.7

So highly regarded are the capillary strengthening effects of bilberry anthocyanins that bilberry is used in Europe prior to surgery to prevent bleeding. For this purpose, patients are treated continuously with bilberry prior to an operation to prevent pre-and post-operative bleeding and post-operative hemorrhage.

Bilberry Effects on the Eye
The eye is especially susceptible to compromised circulation. Both diabetes and hypertension are notorious for causing pathological changes in the retina, which compromises vision. In a 1987 clinical bilberry study, Italian researchers demonstrated in forty patients a significant improvement in vision and measurable microcirculation resulting from bilberry anthocyanins.9 Improvement was around 80% in both measurements. Bilberry's effects in improving normal and night vision have been known since World War II, when British pilots used bilberry jam to improve their bombing accuracy in night raids. In the late 1960's, research confirmed bilberry could increase the activity of enzymes in the eye responsible for energy production.10,11 The bilberry extracts also reduced the amount of time it takes the eyes to adapt to darkness after exposure to bright light.12,13

Anti-Ulcer Activity
Perhaps one of the least known benefits of bilberry extract is its anti-ulcer activity. Although it is commonly used in Europe for this purpose, American publications and products have focused primarily on its blood vessel effects and especially its benefits for the eyes. However, research shows that bilberry extracts can protect against ulcers from a variety of causes, including the typical causes of stress or stomach hyper-acidity, but also ulcers resulting as side-effects of the use of anti-inflammatory drugs like aspirin and the corrosive effect on the stomach lining produced by alcohol. The flavonoids appear to dramatically increase the secretion of mucus in the stomach, which protects it's lining from ulcer formation.14

Details of Use
The form if bilberry which has been the subject of most of the European research is a standardized bilberry extract with 36% bilberry anthocyanosides. The dosage used is 160 to 320 mg of this bilberry extract, given once or twice daily.

Bilberry fruit is a safe food herb with no known toxicity. No adverse effects have been reported in clinical studies. The typical dose of extract equates to around three bowls of bilberries a day, which would not be expected to cause any toxic effects. 
Side effects: None known.15
Contraindications: None known.15
Drug interactions: None known.15


  1. Guerrini M. (1987) Report on clinical trial of bilberry anthocyanosides in the treatment of venous insufficiency of the lower limbs. Instituto di Patalogia Speciale Medica e Methodologia Clinica, Universita di Siena.
  2. Corsi S. (1987) Report on trial of bilberry anthocyanosides (Tegens - Inverni della Beffa) in the medical treatment of venous insufficiency of the lower limbs. Casa di Cura S. Chiara, Florence, Italy.
  3. Gatta L. (1982) Controlled clinical trial among patients designed to assess the therapeutic efficacy and safety of Tegens 160. Ospedale Filippo del Ponte, Varese, Italy.
  4. Teglia L, Vaccinium myrtillus anthocyanosides (Tegens) in the treatment of venous insufficiency of lower limbs and acute piles in pregnancy [in Italian] (1987) Quaderni di Clinica Osterica Gynecologica 42:221.
  5. Baisi F. (1987) Report on clinical trial of bilberry anthocyanosides in the treatment of venous insufficiency in pregnancy and of post-partum hemorrhoids. Predidio Ospedaliero di Livorno, Italy.
  6. Kadar A. et al. (1979) Arch Tierernahr 29(12):845-58.
  7. Pulliero G. et al. (1989) Fitoterapia 60:69.
  8. Gentile A. (1987) Use of bilberry anthocyanosides to prevent hemorrhage in preparation for ENT surgery. Istituti Ospitalieri di Verona, Italy.
  9. Perossini M, Guidi G, Chiellini S. Siravo D. (1987) Clinical study of bilberry anthocyanosides in the treatment of diabetic and hypertensive microangiopathy of the retina. Ann. Ottalm. E Clin. Ocul. 12:1173.
  10. Cluzel C. et al. (1969) C. R. Soc. Biol. 163(1):147-50.
  11. Cluzel C. et al. (1970) Biochem. Pharmacol. 19:2295.
  12. Badstide P. et al. (1968) Bull. Soc. Opthal. Fr. 68:801.
  13. Jayle GE, Aubert L. The action of anthocyanins glucosides on the scoptopic and mesopic vision of the normal subject [in French]. (1964) Therapie 19:171.
  14. Cristoni A, Magistretti MJ. Antiulcer and healing activity of Vaccinium myrtillus anthocyanosides. Farmaco Ed Prat 1987;42:29-43.
  15. Blumenthal M, Busse W, Goldberg A, et al. eds. The Complete German Commission E Monographs. Austin, TXP: The American Botanical Council: Boston: Integrative Medical Communications, 1998

This article is reprinted with exclusive permission from the Herb Research Foundation

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