- Elderberry: Benefits and Dangers
- Health benefits of elderberry
- What Is Elderberry?
- Health Benefits and Uses
- How to Use Elderberry
- Safe to Eat? Potential Risks and Side Effects
- Potential Drug Interactions
- Why You Need Elderberry This Cold and Flu Season
- What is elderberry good for?
- Elderberry for colds and flu
- What is Elderberry?
- Health Benefits of Elderberry
- Possibly Effective:
- 2) Other Bacterial and Viral Infections
- 3) Gum Inflammation
- 4) Constipation
- Insufficient Evidence:
- 5) Heart Disease
- 6) Skin Health
- Animal and Cellular Research (Lacking Evidence)
- Limitations and Caveats
- Elderberry Side Effects & Safety
- Elderberry Supplements & How to Use
- How Much Elderberry Should I Take?
- Adverse Reactions
- Uses and Pharmacology
- More about elderberry
- Drug Status
- Drugs.com Mobile Apps
Elderberry: Benefits and Dangers
There are many reported benefits of elderberries. Not only are they nutritious, but they may also fight cold and flu symptoms, support heart health and fight inflammation and infections, among other benefits.
High in Nutrients
Elderberries are a low-calorie food packed with antioxidants.
100 grams of fresh berries contain 73 calories, 18.4 grams of carbs and less than 1 gram each of fat and protein (3).
Plus, they have many nutritional benefits. Elderberries are:
- High in vitamin C: There are 6–35 mg of vitamin C per 100 grams of fruit, which accounts for up to 60% of the recommended daily intake (3, 4).
- High in dietary fiber: Elderberries contain 7 grams of fiber per 100 grams of fresh berries, which is over one-quarter of the recommended daily intake (4).
- A good source of phenolic acids: These compounds are powerful antioxidants that can help reduce damage from oxidative stress in the body (4, 5).
- A good source of flavonols: Elderberry contains the antioxidant flavonols quercetin, kaempferol and isorhamnetin. The flowers contain up to 10 times more flavonols than the berries (4).
- Rich in anthocyanins: These compounds give the fruit its characteristic dark black-purple color and are a strong antioxidant with anti-inflammatory effects (4, 6).
The exact nutritional composition of elderberries depends on the variety of plant, ripeness of the berries and environmental and climatic conditions. Therefore, servings can vary in their nutrition (4, 7).
Summary Elderberries are a low-calorie food packed with vitamin C, dietary fiber and antioxidants in the form phenolic acids, flavonols and anthocyanins. The flowers are particularly rich in flavonols.
May Improve Cold and Flu Symptoms
Black elderberry extracts and flower infusions have been shown to reduce the severity and length of influenza (8).
Commercial preparations of elderberry for the treatment of colds come in various forms, including liquids, capsules, lozenges and gummies.
One study of 60 people with influenza found that those who took 15 ml of elderberry syrup four times per dayshowed symptom improvement in two to four days, while the control group took seven to eight days to improve (9).
Another study of 64 people found that taking 175-mg elderberry extract lozenges for two days resulted in significant improvement in flu symptoms, including fever, headache, muscle aches and nasal congestion, after just 24 hours (10).
Furthermore, a study of 312 air travelers taking capsules containing 300 mg of elderberry extract three times per day found that those who got sick experienced a shorter duration of illness and less severe symptoms (11).
Further large-scale studies are required to confirm these results and determine if elderberry may also play a role in preventing influenza (8).
Note that the majority of research has only been performed on commercial products, and there is little information about the safety or efficacy of homemade remedies (8).
Summary Elderberry extract has been found to reduce the length and severity of symptoms caused by the influenza virus. While these results are promising, further large-scale human studies are needed.
High in Antioxidants
During normal metabolism, reactive molecules may be released that can accumulate in the body. This can cause oxidative stress and lead to the development of diseases like type 2 diabetes and cancer (12, 13, 14).
Antioxidants are natural components of foods, including some vitamins, phenolic acids and flavonoids, that are able to remove these reactive molecules. Research suggests that diets high in antioxidants may help prevent chronic disease (5, 12, 15).
The flowers, fruits and leaves of the elderberry plant are excellent sources of antioxidants. For example, anthocyanins found in the berries have 3.5 times the antioxidant power of vitamin E (4, 15, 16, 17).
One study comparing 15 different varieties of berries and another study comparing types of wine found that elderberry is one of the most effective antioxidants (18, 19).
Additionally, one study found that antioxidant status improved in people one hour after drinking 400 ml of elderberry juice. Another study in rats found that elderberry extract helped reduce inflammation and oxidative tissue damage (20, 21).
While elderberry has shown promising results in the lab, research in humans and animals is still limited. Generally, consuming it in the diet has only a small effect on antioxidant status (17).
In addition, the processing of elderberries, such as extraction, heating or juicing, can reduce their antioxidant activity (4).
Therefore, products like syrups, juices, teas and jams may have reduced benefits compared to some results seen in laboratory studies (16).
Summary Elderberry fruits, leaves and flowers are strong antioxidants. However, their protective effects in humans appear to be weak. Additionally, the processing of the berries and flowers can reduce their antioxidant activity.
May Be Good for Heart Health
Elderberry may have positive effects on some markers of heart and blood vessel health.
Studies have shown elderberry juice may reduce the level of fat in the blood and decrease cholesterol. In addition, a diet high in flavonoids like anthocyanins has been found to reduce the risk of heart disease (17, 22).
Nonetheless, one study in 34 people given 400 mg of elderberry extract (equivalent to 4 ml of juice) three times a day for two weeks found no significant reduction in cholesterol levels (23).
However, another study in mice with high cholesterol found that a diet including black elderberry reduced the amount of cholesterol in the liver and aorta but not the blood (24).
Further studies found that rats fed with foods containing polyphenols extracted from elderberry had reductions in blood pressure and were less susceptible to organ damage caused by high blood pressure (25, 26).
Furthermore, elderberries may reduce levels of uric acid in the blood. Elevated uric acid is linked to increased blood pressure and negative effects on heart health (4, 27).
What’s more, elderberry can increase insulin secretion and improve blood sugar levels. Given that type 2 diabetes is a major risk factor for heart and vascular disease, blood sugar control is important in preventing these conditions (4, 8).
A study found that elderberry flowers inhibit the enzyme α-glucosidase, which may help lower blood sugar levels. Also, research on diabetic rats given elderberry showed improved blood sugar control (4, 15, 28).
Despite these promising results, a direct reduction in heart attacks or other symptoms of heart disease has not yet been demonstrated, and further studies in humans are needed.
Summary Elderberry has some benefits for heart health, such as reducing cholesterol, uric acid and blood sugar levels. However, further research is needed to demonstrate if these effects are significant in humans.
Other Health Benefits
There are many other reported benefits of elderberry, though most of these have limited scientific evidence:
- Helps fight cancer: Both European and American elder have been found to have some cancer-inhibiting properties in test-tube studies (5, 8, 29).
- Fights harmful bacteria: Elderberry has been found to inhibit the growth of bacteria like Helicobacter pylori and may improve symptoms of sinusitis and bronchitis (8).
- May support the immune system: In rats, elderberry polyphenols were found to support immune defense by increasing the number of white blood cells (30).
- Could protect against UV radiation: A skin product containing elderberry extract was found to have a sun protection factor (SPF) of 9.88 (31).
- May increase urination: Elderberry flowers were found to increase the frequency of urination and amount of salt excretion in rats (32).
- May have some antidepressant properties: One study found mice fed 544 mg of elderberry extract per pound (1,200 mg per kg) had improved performance and mood markers (33).
While these results are interesting, further research is needed in humans to determine if the effects are truly significant.
Moreover, it’s important to note that there is no standardized method for measuring the number of bioactive components like anthocyanins in these commercial products.
One study showed that depending on the method used to measure anthocyanins, a supplement could claim to contain 762 mg/L but really only contain 4 mg/L. Therefore, determining the effects of currently available products may be difficult (17).
Summary Elderberry is associated with many additional health benefits, such as fighting cancer and bacteria, immune support, UV protection and diuretic effects. However, these claims have limited evidence, and further research is needed.
In some parts of the world, herbal remedies for common ailments that have been passed down through generations are an accepted part of life.
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“If you have acid reflux, you drink chamomile tea. If you have abdominal bloating, you drink ginger or peppermint tea,” says Irina Todorov, MD, an integrative medicine physician.
With cold and flu season nearing, people who take this approach may be reaching for elderberry. Teas and syrups made from the elderberry plant have been commonly used to fight upper respiratory infections and boost immunity for hundreds of years.
There are many different kinds of elderberry plants, but the flowers and berries of Sambucus nigra, commonly known as European elder, are the most studied and used in herbal formulas, Dr. Todorov says.
Elderberry-based supplements — syrups, gummies, lozenges, pills and teas — are believed to work by supplying the body with antioxidants and boosting its natural immune response. But are they actually effective in controlling flu symptoms?
What the research says about elderberry
One proprietary formulation of elderberry extract sold under the name Sambucol® has shown an ability to fight flu symptoms in a few small studies, Dr. Todorov says.
In one randomized study of 60 adults with flu-like symptoms, those who took 15 mL of the elderberry syrup four times a day saw symptoms clear up on average four days earlier than those who took a placebo syrup.
Another study tested its effectiveness in air travelers. Those who took the elderberry syrup had a shorter duration of cold symptoms that were less severe than the control group.
Although these studies are promising, don’t forgo your flu shot to take elderberry. These studies are small, and more research on a large scale is needed to support the recommendation of elderberry as a method of prevention or treatment for cold and flu, Dr. Todorov says.
Suggested by Cleveland Clinic
Will Vitamin C or Zinc ‘Immune Boosters’ Help My Cold?
But properly prepared berries and flowers from the European elder plant seem to carry a low risk of adverse effects, according to the National Center for Complimentary and Integrative Health. (Other parts of the plant, however, should not be eaten, and women who are pregnant or breastfeeding are not recommended to take elderberry, the NCCIH says.)
So for most people, it likely wouldn’t hurt to include elderberry as part of a healthy diet as flu season approaches, along with foods high in vitamin C, vitamin B6 and vitamin E, to support the immune system. Of course, check with your doctor, and make sure you select a quality product.
Choosing a quality product
“One approach is to use specific products that have been studied in clinical research with positive effect,” Dr. Todorov says.
Another approach is to read the label carefully and look for the following information:
- Common name and botanical name of the active ingredient. It’s important to know which species of herb is used, as different species even within the same family may have different effects on the body.
- Part of the plant that was used for this specific product. Different parts of the same plant can have different effects. For example, the roots, bark and unripe or uncooked berries from the elder plant contain toxic compounds and should not be used in raw form.
- Whether a whole herb or an extract of the herb is used. If it’s an extract, is it a standardized extract, and what is the active ingredient?
- Manufacturer’s name and contact information
- Lot number
- Expiration date that has not yet passed
“Although some studies indicate that elderberry extract may relieve cold and flu symptoms, more research on a large scale is needed to support these findings,” Dr. Todorov concludes. “Meanwhile, I will continue to enjoy herbal tea made from elderflower and jam from elderberry as part of my diet.”
Azadmehr A, Ziaee A, Ghanei L, Fallah Huseini H, Hajiaghaee R, Tavakoli-Far B, Kordafshari G. A Randomized Clinical Trial Study: Anti-Oxidant, Anti-hyperglycemic and Anti-Hyperlipidemic Effects of Olibanum Gum in Type 2 Diabetic Patients. Iran J Pharm Res. 2014 Summer;13(3):1003-9. View abstract.
Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6.. View abstract.
Bitsch I, Janssen M, Netzel M, et al. Bioavailability of anthocyanidin-3-glycosides following consumption of elderberry extract and blackcurrant juice. Int J Clin Pharmacol Ther 2004;42:293-300. View abstract.
Cao G, Prior RL. Anthocyanins are detected in human plasma after oral administration of an elderberry extract. Clin Chem 1999;45:574-6. View abstract.
Curtis PJ, Kroon PA, Hollands WJ, et al. Cardiovascular disease risk biomarkers and liver and kidney function are not altered in postmenopausal women after ingesting an elderberry extract rich in anthocyanins for 12 weeks. J Nutr 2009;139:2266-71. View abstract.
Forster-Waldl E, Marchetti M, Scholl I, Focke M, et al. Type I allergy to elderberry (Sambucus nigra) is elicited by a 33.2 kDa allergen with significant homology to ribosomal inactivating proteins. Clin Exp Allergy 2003;33:1703-10. View abstract.
Frank T, Sonntag S, Strass G, Bitsch I, Bitsch R, Netzel M. Urinary pharmacokinetics of cyanidin glycosides in healthy young men following consumption of elderberry juice. Int J Clin Pharmacol Res. 2005;25(2):47-56. View abstract.
Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. View abstract.
Kong F. Pilot clinical study on a proprietary elderberry extract: efficacy in addressing influenza symptoms. Online Journal of Pharmacology and Pharmacokinetics 2009;5:32-43.
Kunitz S, Melton RJ, Updyke T, et al. Poisoning from elderberry juice. MMWR 1984;33:173-4.
Murkovic M. Abuja PM, Bergmann AR, et al. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr 2004;58:244-9. View abstract.
No author. Leads from the MMWR. Poisoning from elderberry juice. JAMA 1984;251:2075. View abstract.
Pathol Health Sci 2016;8(2) 59-66.
Roschek B, Fink RC, McMichael MD, et al. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry 2009;70:1255-61. View abstract.
Samuels N, Grbic JT, Saffer AJ, et al. Effect of an herbal mouth rinse in preventing periodontal inflammation in an experimental gingivitis model: a pilot study. Compend.Contin.Educ.Dent. 2012;33:204-11. View abstract.
Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13. View abstract.
Tiralongo E, Wee SS, Lea RA. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients. 2016 Mar 24;8(4). pii: E182. View abstract.
Van Damme EJ, Roy S, Barre A, et al. The major elderberry (Sambucus nigra) fruit protein is a lectin derived from a truncated type 2 ribosome-inactivating protein. Plant J 1997;12:1251-60. View abstract.
Vlachojannis JE, Cameron M, Chrubasik S. A systematic review on the sambuci fructus effect and efficacy profiles. Phytother Res. 2010 Jan;24(1):1-8. View abstract.
Wu X, Cao G, Prior RL. Absorption and metabolism of anthocyanins in elderly women after consumption of elderberry or blueberry. J Nutr 2002;132:1865-71. View abstract.
Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res 2004;32:132-40. View abstract.
Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1995;1:361-9. View abstract.
Health benefits of elderberry
The elderberry contains certain compounds and substances that might have a beneficial impact on health.
We take a look at the evidence behind some of the main reported health benefits of elderberries:
Fighting colds and flu
There is some evidence to support the claim that elderberry can help treat colds and flu, though the available studies are small.
A systematic review from 2010 concluded that elderberries might have antioxidant and antiviral effects, though the authors state that more research is needed.
In one study, 60 people with flu-like symptoms took 15 milliliters (ml) of elderberry syrup four times a day. Their symptoms improved 4 days before the people who took a placebo.
In another study, 32 people with flu-like symptoms took lozenges containing 175 milligrams (mg) of elderberry extract four times a day for 2 days. After 24 hours, they reported an improvement in symptoms, such as fever, headache, muscle aches, and nasal congestion.
A double-blind, randomized control trial looked at whether elderberry extract could prevent people from experiencing cold-like symptoms after traveling on an airplane. People took lozenges containing 300 mg of elderberry extract and 150 mg of rice flour twice a day for 10 days before traveling.
Researchers found that the capsules did not prevent the symptoms, but people who took elderberry had less severe symptoms that lasted for a shorter time.
Elderberry fruit contains high levels of flavonoids, which means it might have anti-inflammatory and antioxidant properties. These help to protect healthy cells from harmful free radicals that play a role in skin problems.
The American Nutrition Association (ANA) suggest that using an elderberry face wash can help fight acne because of its antiseptic effects.
Elderberries contain high levels of vitamin A. The ANA also say that elderberries may soothe the skin, help ease the appearance of age spots, and prevent or lessen wrinkles.
- Azadmehr A, Ziaee A, Ghanei L, Fallah Huseini H, Hajiaghaee R, Tavakoli-Far B, Kordafshari G. A Randomized Clinical Trial Study: Anti-Oxidant, Anti-hyperglycemic and Anti-Hyperlipidemic Effects of Olibanum Gum in Type 2 Diabetic Patients. Iran J Pharm Res. 2014 Summer;13(3):1003-9. View abstract.
- Bagchi D, Roy S, Patel V, He G, Khanna S, Ojha N, Phillips C, Ghosh S, Bagchi M, Sen CK. Safety and whole-body antioxidant potential of a novel anthocyanin-rich formulation of edible berries. Mol Cell Biochem. 2006 Jan;281(1-2):197-209. View abstract.
- Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 2001;12:290-6.. View abstract.
- Bitsch I, Janssen M, Netzel M, et al. Bioavailability of anthocyanidin-3-glycosides following consumption of elderberry extract and blackcurrant juice. Int J Clin Pharmacol Ther 2004;42:293-300. View abstract.
- Cao G, Prior RL. Anthocyanins are detected in human plasma after oral administration of an elderberry extract. Clin Chem 1999;45:574-6. View abstract.
- Curtis PJ, Kroon PA, Hollands WJ, et al. Cardiovascular disease risk biomarkers and liver and kidney function are not altered in postmenopausal women after ingesting an elderberry extract rich in anthocyanins for 12 weeks. J Nutr 2009;139:2266-71. View abstract.
- Elderberry (Sambucus species). The Poison Plant Patch, Novia Scotia Museum, 2007. Available at: http://museum.gov.ns.ca/poison/?section=species&id=117 (Accessed 16 October 2009).
- European elder. Canadian Poisonous Plants Information System. Available at: http://www.cbif.gc.ca/pls/pp/ppack.jump?p_null=all&p_psn=121&p_type=all&p_sci=comm&p_x=px (Accessed 16 October 2009).
- Forster-Waldl E, Marchetti M, Scholl I, Focke M, et al. Type I allergy to elderberry (Sambucus nigra) is elicited by a 33.2 kDa allergen with significant homology to ribosomal inactivating proteins. Clin Exp Allergy 2003;33:1703-10. View abstract.
- Frank T, Janssen M, Netzet G, Christian B, Bitsch I, Netzel M. Absorption and excretion of elderberry (Sambucus nigra L.) anthocyanins in healthy humans. Methods Find Exp Clin Pharmacol. 2007 Oct;29(8):525-33. View abstract.
- Frank T, Sonntag S, Strass G, Bitsch I, Bitsch R, Netzel M. Urinary pharmacokinetics of cyanidin glycosides in healthy young men following consumption of elderberry juice. Int J Clin Pharmacol Res. 2005;25(2):47-56. View abstract.
- Grbic J, Wexler I, Celenti R, et al. A phase II trial of a transmucosal herbal patch for the treatment of gingivitis. J Am Dent.Assoc. 2011;142:1168-75. View abstract.
- Kong F. Pilot clinical study on a proprietary elderberry extract: efficacy in addressing influenza symptoms. Online Journal of Pharmacology and Pharmacokinetics 2009;5:32-43.
- Kunitz S, Melton RJ, Updyke T, et al. Poisoning from elderberry juice. MMWR 1984;33:173-4.
- Murkovic M. Abuja PM, Bergmann AR, et al. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr 2004;58:244-9. View abstract.
- No author. Leads from the MMWR. Poisoning from elderberry juice. JAMA 1984;251:2075. View abstract.
- Pathol Health Sci 2016;8(2) 59-66.
- Picon PD, Picon RV, Costa AF, et al. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for chronic constipation. BMC Complement Altern Med. 2010;10:17. View abstract.
- Raus K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. . Curr Ther Res Clin Exp. 2015;20;77:66-72. doi: 10.1016/j.curtheres.2015.04.001. View abstract.
- Roschek B, Fink RC, McMichael MD, et al. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry 2009;70:1255-61. View abstract.
- Samuels N, Grbic JT, Saffer AJ, et al. Effect of an herbal mouth rinse in preventing periodontal inflammation in an experimental gingivitis model: a pilot study. Compend.Contin.Educ.Dent. 2012;33:204-11. View abstract.
- Samuels N, Saffer A, Wexler ID, et al. Localized reduction of gingival inflammation using site-specific therapy with a topical gingival patch. J.Clin.Dent. 2012;23:64-7. View abstract.
- Schroder-Aasen T, Molden G, Nilsen OG. In vitro inhibition of CYP3A4 by the multiherbal commercial product Sambucus Force and its main constituents Echinacea purpurea and Sambucus nigra. Phytother Res 2012;26(11):1606-13. View abstract.
- Tiralongo E, Wee SS, Lea RA. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients. 2016 Mar 24;8(4). pii: E182. View abstract.
- Van Damme EJ, Roy S, Barre A, et al. The major elderberry (Sambucus nigra) fruit protein is a lectin derived from a truncated type 2 ribosome-inactivating protein. Plant J 1997;12:1251-60. View abstract.
- Vlachojannis JE, Cameron M, Chrubasik S. A systematic review on the sambuci fructus effect and efficacy profiles. Phytother Res. 2010 Jan;24(1):1-8. View abstract.
- Wu X, Cao G, Prior RL. Absorption and metabolism of anthocyanins in elderly women after consumption of elderberry or blueberry. J Nutr 2002;132:1865-71. View abstract.
- Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res 2004;32:132-40. View abstract.
- Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1995;1:361-9. View abstract.
Looking for a natural remedy that has a long history of medicinal use? There’s evidence that the elderberry plant may have been cultivated by prehistoric man. There are also recipes for elderberry-based medications dating back to Ancient Egypt.
However, most historians typically trace its healing abilities back to Hippocrates, the ancient Greek known as the “father of medicine,” who described the plant as his “medicine chest” because of the wide array of health concerns it seemed to cure. Whether we’re talking cavemen, ancient Egyptians or ancient Greeks, this natural remedy definitely goes way back, which is why it’s no wonder it’s known as one of the top antiviral herbs on the planet.
Health benefits of the elder plant include naturally improving sinus issues, nerve pain, inflammation, chronic fatigue, allergies, constipation and even cancer. When used within the first 48 hours of onset of symptoms, the extract may even help relieve and shorten the duration of cold and flu symptoms as well. For this reason, the government actually employed the use of elderberry to fight the flu during the 1995 Panama flu epidemic.
So does elderberry syrup really work? What exactly does it do? And how can you use it to promote better health? Here’s what you need to know, including its many benefits.
What Is Elderberry?
Sambucus is a genus of flowering plants in the family Adoxaceae. The different species of Sambucus are commonly called elderberry or elder. The berries and flowers of the elder plant are used as medicine.
Elderberry is native to Europe, Africa and parts of Asia, but it’s become common in the U.S. It has deciduous leaves, white flowers (elderflowers) and berries that turn from green to red to black when ripe. Elder is commonly found growing in woodlands and hedgerows.
Sambucus nigra is the full scientific name of the most common variety used for medicinal purposes, as well as the species on which the majority of scientific research has been conducted. It’s a deciduous tree growing up to 32 feet tall with cream-white flowers and blue-black berries. Other common names for Sambucus nigra include black elder, European elder, European elderberry and European black elderberry. The elderberry bush or elderberry tree yields the berries that are commonly used in syrups, jams and wine, among other medicinal and culinary delights.
In addition to black elderberry, there are several other varieties available as well. Some of the most common include:
- Black lace elderberry
- Red elderberry
- Adams elderberry
- Lemon lace elderberry
- Black beauty elderberry
- Blue elderberry
- York elderberry
European elder flowers contain approximately 0.3 percent of an essential oil composed of free fatty acids and alkanes. The triterpenes alpha- and beta-amyrin, ursolic acid, oleanolic acid, betulin, betulinic acid and a variety of other minor components have been identified. Elderberry fruit contains quercetin, kaempferol, rutin, and phenolic acids. It also contains flavonoids, which have antioxidant properties that can help prevent cell damage, and anthocyanidins, which are chemical compounds that are known to have immune-boosting properties.
The raw berries are made up of 80 percent water, 18 percent carbohydrates, and less than 1 percent each of protein and fat. Elderberries are naturally high in vitamin C, vitamin A, vitamin B6, iron and potassium, among several other essential nutrients.
Health Benefits and Uses
1. Provides Cold and Flu Relief
One of the most well-studied elderberry syrup benefits is its powerful immune-boosting properties. The berries contain chemical compounds called anthocyanidins, which are known to have immunostimulant effects.
Research actually shows that elderberry extract is a safe, efficient and cost-effective treatment for cold and flu symptoms.
A 2016 study published in Nutrients showed that elderberry supplementation was able to reduce cold duration and symptoms in air travelers. Travelers using this herb from 10 days before travel until four to five days after arrival overseas experienced, on average, a two-day shorter duration of their colds as well as a noticeable reduction in cold symptoms.
Several studies have found benefits to support the use of elderberry syrup for flu symptoms as well. Specifically, the flavonoids in the extract bind to the H1N1 human influenza virus as well as the H5N1 avian influenza virus.
A 2009 study randomized patients into two groups. One group was given four doses of 175-milligram proprietary elderberry extract daily, and the other group received a placebo for two days. The group treated with the extract showed significant improvement in most flu symptoms, while the placebo group showed no improvement in symptom severity. Researchers conclude that the extract is effective in controlling influenza symptoms.
Another study published in the Journal of International Medical Research showed that when the extract is used within the first 48 hours of the onset of flu symptoms, it can shorten the duration of flu symptoms by an average of four days.
2. Reduces Sinus Infection Symptoms
With elderberry’s anti-inflammatory and antioxidant properties, it makes sense that it can help treat sinus issues. A sinus infection is a condition in which the cavities around the nasal passages become inflamed, and this antiviral herb has promise as a sinus infection natural remedy.
A study conducted by the Institute of Complementary Medicine’s Department of Internal Medicine at the University Hospital in Zurich, Switzerland examined the use of a product called Sinupret, which contains elderberry extract. The researchers used Sinupret to treat bacterial sinusitis along with an antibiotic (doxycycline or vibramycin) and a decongestant. Interestingly enough, those who took the combination did better compared to those who did not take Sinupret at all.
3. Lowers Blood Sugar
Both the elder flower and the berry have traditionally been used to treat diabetes. Research has confirmed that extracts of elderflower stimulate glucose metabolism and the secretion of insulin, which could potentially help lower blood sugar levels.
Research published in the Journal of Nutrition evaluated black elderberry’s insulin-like and insulin-releasing actions in vitro. The study found that an aqueous extract of elder significantly increased glucose transport, glucose oxidation and glycogenesis without any added insulin. Glycogenesis is the process by which excess sugar is cleared out of the bloodstream and into your muscles and liver to help maintain normal blood sugar.
Furthermore, a 2017 animal study published in the International Journal of Molecular Sciences noted that elderberries can serve as a potential source of bioactive compounds for formulations used for the management of diabetes. Researchers found that both lipophilic and polar extracts of the berry lowered insulin resistance in rats with type 2 diabetes.
4. Acts as a Natural Diuretic
A diuretic is a substance that promotes the production of urine. Doctors prescribe diuretics when the body retains too much fluid, which is a common problem in older adults. Thanks to its ability to act as a natural diuretic, elderberry has been shown to promote both urination and bowel moments to help protect against fluid retention.
5. Promotes Regularity
Some research suggests that elderberry tea benefits constipation and can help support regularity and digestive health. A small, randomized trial found that a specific compound containing elderberries along with several other plants could act as an effective natural laxative for the treatment of constipation.
Unfortunately, however, there are currently no studies evaluating elderberry itself for constipation relief, so more research is still needed.
6. Supports Skin Health
Elderberry has made its way into cosmetic products, and for good reason. Its content of bioflavonoids, antioxidants and vitamin A makes it awesome for skin health. Not only that, but researchers also suspect that a compound found in the berry could give a natural boost to skin.
Anthocyanin is a type of natural plant pigment found in elderberry that has been shown to have anti-inflammatory and antioxidant properties. Some researchers suspect that this compound may improve skin’s structure and condition to enhance overall skin health.
7. Eases Allergies
In addition to using elderberry syrup for colds, the flowers of the elder plant are also known to be an effective herbal allergy remedy. Since allergies involve an overreaction of the immune system as well as inflammation, the herb’s ability to improve immune function and calm inflammation can help provide allergy relief.
Some herbalists put black elder flower on the list of most effective herbs used for treating hay fever-like symptoms. It can be used for allergies on its own or in combination with other herbs and natural remedies.
8. Could Have Cancer-Fighting Effects
Edible berry extracts like elderberry extract are rich in anthocyanins and have been shown to have a broad spectrum of therapeutic, pharmacologic and anti-carcinogenic properties. In vitro studies specifically indicate that the elderberry has some chemopreventive properties, which can help inhibit, delay or reverse cancer formation.
One study published in the Journal of Medicinal Food compared the anticancer properties of European and American elderberry fruits. European elderberry (Sambucus nigra) is known for its medicinal use and contains anthocyanins, flavonoids and other polyphenolics, which all contribute to the high-antioxidant capacity of its berries. American elderberry (Sambucuscanadensis) has not been grown or promoted as a medicinal plant like its European relative.
This study tested extracts of both berries to assess anticancer potential and found that both demonstrated significant chemopreventive potential. Additionally, the American elder extract showed inhibition of ornithine decarboxylase, which is an enzyme marker related to the promotion stage of cancer formation. Thus, elderberries show potential as cancer-fighting foods.
9. May Improve Heart Health
Although studies have found mixed results, some research suggests that elderberry extract may improve heart health. For example, one animal model showed that giving mice with high cholesterol and HDL cholesterol dysfunction anthocyanin-rich black elderberry extract helped reduce hepatic cholesterol levels and improved HDL function. This may be due to the presence of anthocyanins, which are polyphenols that have demonstrated antioxidant and anti-inflammatory activities.
Another study found that elderberry extract may have beneficial effects on high blood pressure. When polyphenols extracted from the plant were administered with renin inhibitors to rats with hypertension, they reduced arterial pressure. Researchers suggest that using polyphenols to lower blood pressure may also help reduce the side effects of blood pressure-lowering medications and improve overall quality of life.
How to Use Elderberry
Wondering where to buy elderberry and how to start adding it to your diet? It is available at many local health stores and online retailers and can be purchased in a variety of different forms. Elderberry gummies, elderberry wine and elderberry juice are all popular options for getting your fix of this incredible ingredient.
When it comes to colds, flu and upper respiratory issues, elderberry syrup is very popular. There are high-quality brands readily available for purchase, or you can find many online resources for how to make elderberry syrup to try making it at home. Most elderberry syrup recipe options out there involve simmering elderberries with a bit of water and a variety of other healing herbs for 45 minutes to an hour.
Elderberry tea is another great option, especially if you use elderberry for flu and cold symptoms. You can either buy teabags or purchase dried berries or flowers and make a tea by combining one tablespoon of berries or flowers with eight ounces of water. Try adding honey, lemon, cinnamon or mint to give the flavor and health benefits a hearty boost.
Not a fan of hot teas or black elderberry syrup? Then you can try elderberry juice, which is sweet, tart and refreshing. Just be sure not to purchase one that has too much added sugar.
Safe to Eat? Potential Risks and Side Effects
Despite the many health benefits associated with this medicinal plant, there are several elderberry side effects to consider as well. Ripe, cooked berries from most of the Sambucus species are edible. However, you should not consume raw berries or other parts of the plant since they contain a cyanide-inducing chemical, which can result in diarrhea and vomiting. Generally, commercial preparations don’t cause adverse reactions when used at recommended dosages.
Elderberry appears to have few side effects when used properly for short periods of time of up to five days. Occasionally, however, elderflowers and elderberries can cause allergic reactions. Discontinue use if you have a mild allergic reaction, and seek medical attention if you have a serious allergic reaction.
Using elderberry syrup for kids is not recommended unless you’ve consulted with your pediatrician. If you’re pregnant or breastfeeding, don’t take it, as research is lacking on its effects on fetal health and development.
If you have an autoimmune disease, such as rheumatoid arthritis, ask your doctor before taking elderberry because it may stimulate the immune system. If you have any other ongoing health concerns, talk with your health care provider before taking it as well. People with organ transplants should not take elderberry.
Potential Drug Interactions
Because of its powerful effects on health, elderberry could potentially interact with several medications. If you currently take any of the following medications, you should talk to your health care provider before using an elderberry supplement or any other elder plant products:
- Diabetes medications
- Diuretics (water pills)
- Immunosuppressants, including corticosteroids (prednisone), and medications used to treat autoimmune diseases
- Theophylline (TheoDur)
- Elderberry is a type of plant that is cultivated for its medicinal properties and used to treat a variety of conditions.
- What are the benefits of elderberry? It may provide relief from cold and flu symptoms as well as allergies and sinus infections. It may also help lower blood sugar, improve heart health, support healthy skin and act as a natural diuretic.
- This herb is available in syrup, juice and tea form. It can be purchased at many health stores or made at home.
- What are the side effects of elderberry? Although commercial preparations are generally safe for consumption, eating raw elderberry may cause symptoms like nausea, diarrhea and vomiting.
- Using this antiviral herb is not recommended for women who are pregnant or breastfeeding, children, or those with autoimmune disorders.
- Does elderberry interact with medications? If you’re on chemotherapy or take diabetes medications, diuretics, immunosuppressants, laxatives or other medications, talk to your doctor before starting supplementation.
Read Next: 10 Holy Basil Benefits: Tulsi Helps Anxiety, Acne & More
Why You Need Elderberry This Cold and Flu Season
What is elderberry good for?
Elderberry has been used since ancient times as a laxative and diuretic. In more recent history, it has been used to treat colds as well—which is what it’s most well known for today. (10)
In addition to these more common uses, elderberry has a number of traditional uses: (10)(11)
- Other types of pain
- Blood pressure control
- Blood sugar regulation
- Reduction of uric acid levels
However, while there’s anecdotal and historical evidence for these uses, they don’t have much science behind them. Most research on elderberry focuses on its immune-boosting properties.
Elderberry for colds and flu
Because of its antioxidant and immune-boosting properties, elderberry gets a lot of attention come cold and flu season. And with good reason.
Plenty of lab research (in other words, research not done on humans) has shown that elderberry extracts can fend off cold and flu. One study, for instance, found that two of the flavonoids in elderberry bind to the flu virus H1N1 and prevent it from infecting host cells. (12)
But promising lab research doesn’t always translate into effective treatments in humans. So we look to human research to confirm what lab research tells us might work. When it comes to elderberry, the human research is preliminary but encouraging.
Can elderberry keep you healthy while traveling?
One study looked at cold and flu symptoms at a time when our immune systems seem to go on vacation—when we go on vacation. (13) Long flights can be tough on the body, between the recirculating air on the plane, proximity to other people’s germs, and general exhaustion. All of that can add to an increased risk of respiratory illness.
So in this study, researchers gave 312 economy class passengers traveling from Australia to an overseas destination either elderberry extract or a placebo. They then had the participants record their upper respiratory health and cold symptoms during and after their travel.
The researchers found that the people in the placebo group had more colds, and that their colds lasted significantly longer than for the people in the group receiving elderberry extract.
Elderberry and flu recovery time
Other research has tried to determine whether elderberry can help people kick the flu faster. One study gave either elderberry extract or placebo to people with the flu, within the first 48 hours after symptoms started. (14) Treatment lasted for three days.
The researchers found that after three days, symptoms had resolved completely in 13 out of 15 of the people receiving elderberry. In the placebo group, no such luck. Only 4 out of 12 were symptom-free in the same time period.
In another study, people with flu symptoms were given that same elderberry extract or placebo four times a day for five days. The majority of people who took the elderberry noted “pronounced improvement” after only three to four days. In the placebo group, that same improvement didn’t come for seven to eight days. (15)
Elderberry is among the most popular natural remedies for the common cold and flu symptoms. It helps fight other viral infections and may also protect the heart. However, some parts of the plant are toxic. Keep reading to learn elderberry benefits, side effects, and how to use it.
What is Elderberry?
Elderberries are glossy, tart, deep-purple fruits of the Sambucus tree. Among many varieties, the most common one is the European elder or black elderberry (Sambucus nigra) .
Native to Europe, black elderberry today grows across America, Asia, and North Africa. The tree is up to 30 feet tall, with a brownish-gray bark and fragrant white flowers. The fruits are small, dark-colored berries, sometimes appearing almost black .
- Helps fight the cold and flu
- Kills viruses & bacteria
- Great nutritional value
- Relieves gum inflammation
- May protect the skin and heart
- Most benefits lack solid clinical evidence
- Leaves, seeds, bark, and raw berries are potentially toxic
- May not be safe for pregnant or breastfeeding women
Uses in Traditional Medicine
All parts of black elderberry are used in folk medicine. The flowers and leaves are natural remedies for reducing pain, swelling, and inflammation. Preparations from the bark are taken to stimulate urination and bowel movements. Fresh or dried berries are thought to relieve headaches, toothaches, low back pain, respiratory infections, as well as constipation .
Recent research voices the traditional wisdom. Flavonoids discovered in the flowers and fruits of elderberry trees have antiviral, anti-inflammatory, and antioxidant properties. People use it to combat flu, respiratory infections, and more .
Furthermore, Sambucus nigra has become popular in the food industry. The berries are often used to make refreshing, sweet-tart juices, jams, jellies, pies, punches, and wines. Elderflowers are boiled to prepare a soothing, creamy tea or syrup or added to the batter when baking .
Black, Blue, and Red Elderberry – What’s the Difference?
Elderberry supplements – such as syrups, lozenges, capsules, tea, and powder – are all typically made from the European, black elderberry (Sambucus nigra) .
The three other well-known elderberry varieties include the following :
- American elderberry (Sambucus canadensis)
- Blue elderberry (Sambucus cerulea), and
- Red elderberry (Sambucus racemosa)
All elderberries are rich in anthocyanins, powerful antioxidants responsible for the red, blue, and purple berry color variations .
Although both European and American elderberry abound in antioxidants, the European variety is higher in specific ones (phenolics and flavonoids). Anthocyanins deepen the color of plants, which explains the greater potency of black elderberry, especially compared to the red variety .
Red and blue elderberry, native to the North American continent, may offer distinct health benefits. Native people would collect these berries in the summer and store them in a safe place for medicinal use during the winter months. Research on their effects is limited, however, so this post will focus on the black variety.
Black elderberry is rich in bioactive components, the most important ones being :.
- Flavonoids (rutin, quercetin, anthocyanins), which have antioxidant, anti-inflammatory, and anti-viral properties
- Provitamin A (carotenoids) and vitamin C.
Elderberries are low-calorie fruits, high in nutrients and antioxidants. Their precise nutritional content depends on the ripeness of the fruit, environmental conditions, and the plant variety .
100 g of fresh elderberries contain only 73 calories and will provide 28% of your daily fiber requirement. Plus, the fruits are rich in vitamins – such as vitamin C and provitamin A (carotenoids) – and minerals – including iron, potassium, and phosphorus .
Black elderberry’s nutrient profile and Recommended Daily Intake (RDI) based on a 2,000 calorie diet is listed below :
The leaves, berries, and flowers are high in antioxidants (flavonoids, phenolics, and anthocyanins) that lower oxidative stress and balance the immune system. Elderberries have the highest amount of flavonoids compared to 28 different species of berries .
Some common preparation methods can lower certain nutrients and antioxidants, such as high extraction temperature, cooking, or juicing. Expectedly, elderberry teas, juices, jellies, and wines will be lower in active components than the fresh herb or its standardized extracts .
Health Benefits of Elderberry
Sambucol is a popular, widely-available brand of standardized elderberry extracts. In clinical studies with over 80 people with influenza A or B, taking Sambucol syrup for 5 days relieved flu symptoms 4 days faster than the placebo .
Elderberry lozenges (four times per day) reduced fever, headache, muscle pain, and nasal congestion within 48 hours in a clinical study on 64 people with the flu .
Elderberry syrup also decreased the duration of flu-like symptoms in chimpanzees .
Flavonoids in elderberry may prevent infection from the influenza A and B viruses, which are responsible for the yearly seasonal flu epidemics. In test tubes, elderberry could bind to both viruses and prevent them from entering cells and multiplying .
Symptoms of the flu and the common cold often overlap, but colds are caused by different viruses and are usually milder
Frequent travelers are under stress – long flights and layovers put a strain on the immune and respiratory system. In one clinical study of 312 people traveling overseas from Australia, elderberry extract reduced the severity and duration of common cold symptoms, compared to the placebo .
Reducing Inflammation & Swelling
Non-steroidal anti-inflammatory drugs are common ingredients in cold and flu products (such as Advil); they reduce symptoms such as swelling, pain, and stuffiness. A combination of elderberry and other herbs (gentian root, cowslip flowers, sorrel, vervain wort) might work in a similar way: it lowered inflammatory enzymes COX-2 and messengers (PGE-2) in rats .
2) Other Bacterial and Viral Infections
In clinical studies with over 2,300 people with a bacterial sinus infection, a combination of elderberry and other herbs (gentian root, cowslip flowers, sorrel, vervain wort) reduced inflammation, headaches, and nasal discharge .
In test tubes, elderberry extracts blocked the growth of bacteria that cause malaria and a myriad of other health problems (including Plasmodium falciparum, Streptococcus, Escherichia coli, Staphylococcus, Bacillus, Salmonella, and Helicobacter pylori) .
It was also active against the herpes simplex virus, which causes cold sores .
3) Gum Inflammation
In several clinical studies with more than 200 people, an herbal mouth rinse containing elderberry and echinacea decreased gum inflammation (gingivitis), bleeding, and plaque size .
In a clinical study of 20 people with constipation, a tea containing elderberry, anise, fennel, and Alexandrian senna increased the number of evacuations per day and improved bowel movements. It’s unclear to what extent elderberry helped since senna is a well-known laxative .
No valid clinical evidence supports the use of elderberry for any of the conditions in this section. Below is a summary of up-to-date animal studies, cell-based research, or low-quality clinical trials which should spark further investigation. However, you shouldn’t interpret them as supportive of any health benefit.
5) Heart Disease
Flower and berry extracts, together with asparagus, reduced body weight, and improved blood pressure and quality of life in a clinical study on 80 people .
In another study on 34 healthy people, elderberry juice for 2 weeks slightly decreased cholesterol levels (by 9 mg/dL) and oxidative stress, compared to the placebo .
In animals, elderberry extracts lowered blood pressure, liver cholesterol, blood triglycerides, and fat buildup – all of which increase the risk of heart disease. Plus, they increased glutathione, one of the most important antioxidant enzymes in the body .
However, elderberry extract had no effect on inflammatory biomarkers, blood fat or sugar levels in a clinical study on 52 healthy postmenopausal women, given over 12 weeks .
Elderberry may protect the heart by reducing blood pressure and cholesterol, but the evidence is inconclusive.
6) Skin Health
Elderberry is rich in flavonoids, phenolics, and vitamin C, and provitamin A, which decrease oxidative stress, prevent skin damage, improve skin elasticity, and lessen wrinkles .
A formula containing elderberry, common hawthorn, and dwarf everlast extracts had a sun protection factor (SPF) of almost 10, meaning that these herbs can naturally protect from UV rays .
Animal and Cellular Research (Lacking Evidence)
Elderberry extract acts as an immuno-modulator: it can calm an overactive immune system or activate an overly-suppressed one .
Enhancing Immune Defense
In studies on human cells, elderberry syrup (Sambucol) increased the production of inflammatory cytokines (IL-1b, TNF-alpha, IL-6, IL-8) needed to activate immune cells. Elderberry syrup also increased the anti-inflammatory cytokine IL-10, which might help restrict the immune response and prevent it from getting out of hand .
Elderberry extracts stimulated the production of white blood cells (T-helper cells, macrophages), which increase overall immune defense .
Preventing Immune Overactivity
Elderberry and elderflower extracts may balance an overactive immune system by blocking nitric oxide production in cells. Overproduction of nitric oxide has been linked to inflammatory autoimmune diseases .
Elderberry may balance the immune system, but clinical studies are lacking to draw any conclusions.
Elderberry extracts prevented insulin spikes and insulin resistance in mice fed a high-fat diet .
Based on test-tubes experiments, they might work by :
- Promoting insulin production
- Transferring sugar from the blood into cells and tissues
- Breaking down sugar in cells
- Blocking the enzymes (α-glucosidase and α-amylase) that digest carbs, which helps lower blood sugar spikes after meals
According to limited animal studies, elderberry may help:
- Improve IBD symptoms .
- Reduce ulcer-causing Helicobacter pylori infections .
- Boost mood and fight depression .
Clinical studies are lacking to back up these benefits.
Limitations and Caveats
Some potential benefits of elderberry are limited to animal and cell-based studies.
Some clinical trials had a small number of participants, and some of their findings are debatable. The benefits and contribution of elderberry are unclear in studies using multi-herbal formulas.
Elderberry Side Effects & Safety
When used in adequate amounts, elderberry tea, extracts, and other products are generally safe and well-tolerated. However, there are important safety precautions to consider when it comes to this herb.
The bark, leaves, roots, as well as raw or unripe berries, contain a toxic compound (sambunigrin) which can lead to cyanide poisoning. Consumption of raw elder products may cause nausea, vomiting, diarrhea, and even lead to hospitalization .
In 1984, 8 people became sick after drinking juice from fresh berries, leaves, and branches of Sambucus Mexicana tree. They suffered from nausea, vomiting, weakness, dizziness, stomach pain, numbness, and impaired consciousness .
The levels of the toxic compounds in raw berries are not extremely high but may still cause serious health problems. Cooked berries and standardized extracts are safe to consume .
Fresh elderberries contain lectins, which may also cause a reaction in sensitive people. Cooking the berries reduces their lectin content .
Some people are allergic to elderberry and will experience typical symptoms: runny nose, itchy or red eyes, and difficulty breathing .
However, elderberry allergies affect only 0.6% of the general population, according to a study of over 3.5K randomly tested people .
Pregnancy and Breastfeeding
Pregnant and breastfeeding women should avoid elderberry supplements due to the lack of safety data .
Herb-drug interactions can be dangerous and, in rare cases, even life-threatening. Always consult your doctor before supplementing and let them know about all drugs and supplements you are using or considering.
Based on its possible benefits, elderberry may, in theory, interact with the following drugs:
- Diabetes medication
- Blood pressure-lowering drugs
Elderberry Supplements & How to Use
Supplements are made from elderberry fruits or flowers. They are available as powder, syrup, tablets, capsules, and lozenges .
You can also purchase raw, frozen or dried berries, as well as elderberry juice or tea .
Sambucol is a clinically-tested standardized elderberry extract, available as syrup, gummies, capsules, and chewable tablets.
The syrup contains 38% of the standardized elderberry extract. The same potency is used in adults and kids (called Anti-Viral Flu Care), only the dosage differs.
The other formulation for kids called Cold & Flu contains 47mg of the extract per tablet, along with vitamin C, zinc, and Echinacea. Aside from these, the Cold & Flu softgel formulation for adults also contains white willow.
Tip: Watch out for Sambucol homeopathic formulations (such as “Cold and Flu Relief Homeopathic” and “Cold & Flu Sinus Relief”). These don’t contain the standardized elderberry extract but homeopathic dilutions with trace amounts of active compounds. The efficacy of such products is unproven.
To make your own syrup, you will need:
- 3½ cups water
- 2/3 cup dried elderberries (or 1 1/3 cups fresh or frozen)
- 1 cup of raw honey or brown rice syrup
- Put the berries and water in a saucepan (you can also add other herbs, such as ginger, cinnamon, and cloves)
- Place over medium heat and gradually bring to a boil. Then decrease to simmer for around 45 minutes, stirring often
- Once about half of the liquid evaporated, remove from heat and let it cool to room temperature
- Mash the berries carefully and pour through a strainer into a bowl
- Add the honey or brown rice syrup and place the mix in a saucepan again
- Bring to a boil and continue to cook for 10-30 minutes until the mixture thickens
- Take the mixture off the stove and allow it to cool
- Transfer to a glass jar
- Store your syrup in the refrigerator
The below doses may not apply to you personally. If your doctor suggests using elderberry, work with them to find the optimal dosage according to your health condition and other factors.
For flu or cold, 15ml elderberry syrup (Sambucol) four times a day for five days is recommended. Alternatively, take a 175 mg elderberry lozenge four times a day, for two days. Since various formulations exist, it’s best to follow the instructions on the label .
For bacterial sinus infections, 2 tablets of a multi-ingredient herbal Sinupret (elderberry flowers, gentian root, verbena, cowslip flower, and sorrel) three times a day, for up to 2 weeks .
For lowering blood fats, 400 mg elderberry powder or 5ml elderberry juice (containing 10% anthocyanins) three times a day, for at least 2 weeks .
For gum inflammation, 15 ml of a multi-herbal rinse (with elderberry, Centella, and Echinacea) for 60 seconds twice a day for adults and children older than 12 is recommended. For younger children, a 10 ml rinse twice a day is advised .
Clinical studies support the traditional use of black elderberry for reducing flu and cold symptoms, other infections, and gum inflammation. It may also protect the heart and skin, but more research is needed.
Standardized extracts and cooked berries are safe for a general population. Children, pregnant and breastfeeding women should avoid them, while others should consult their doctor before supplementing. Stem, bark, leaves, and raw berries can be toxic.
How Much Elderberry Should I Take?
August 31, 2015 0 Comments
How much elderberry should I take?
Norm’s Farms makes a variety of elderberry supplements for the whole family. Our line of elderberry supplements includes Elderberry Extract, made from whole elderberries and containing no added sugars or other ingredients, our Elderberry Wellness Syrup, which is made with our Elderberry Extract to which we had honey, cloves and cinnamon for a delicious and throat-soothing syrup that tastes like Christmas, our Elderberry Extract Children’s Formula, which is 50% Elderberry Extract and 50% unsweetened blueberry juice and contains no added sugars or other ingredients, our ElderCran, which contains Elderberry Extract and organic cranberry juice and, soon to be released, our organic Elderberry Gummies which also contain probiotics. We are often asked “How much elderberry should I take”? We provide serving recommendations on our products like all manufacturers of nutritional supplements, but if you have made your own elderberry extract or syrup you may want some advice on how much to take and how often. Our advice is based upon our own experience and the hundreds of research articles we have read over the years, but is no substitute for the advice you should obtain from your health care professional. The following information is not intended to diagnose, treat or cure; it is simply a summary of the literature and our experience.
All products containing elderberry available for purchase on line, in health food and natural remedy stores will provide the recommended serving on the label. Be sure to read the label carefully, and pay particular attention to storage requirements. Elderberry is a highly perishable fruit and, if not preserved in alcohol or syrup, will quickly ferment or spoil. The following advice is for the DIY individual that has made their own elderberry syrup or extract and is looking for serving recommendations.
The Many Uses of Elderberry
Elderberry has been used by traditional cultures throughout the world for a variety of health issues. Elderberry has been recommended for boosting weakened immune systems, for warding off colds and flu, and for many other health issues including constipation, and not surprisingly, most people want to know “how much elderberry should I take”?
Many people assume that because elderberry is a fruit, the liquid expressed through the extraction process is a juice, and that it can be consumed just like a juice. This is not true. While everyone responds to elderberry differently, some people are quite sensitive to the laxative properties of elderberry and report that a tablespoon of elderberry extract per day works as a laxative for them. Other people may be able to consume up to 2 ounces per day before they experience gastrointestinal symptoms; the point is that elderberry should be consumed by the teaspoon, not by the glass.
If you are interested in adding elderberry to your diet for its immune system boosting properties, a teaspoon of home-made elderberry syrup per day is a conservative recommended daily serving. The few studies that have been done to determine why elderberry activates the immune system indicate that the anthocyanins in elderberry are associated with greatly increased immune system coordination. One studyshowed that elderberry boosts the production of immune cytokines. Cytokines act as messengers within the immune system and help to regulate the immune response. Studies need to be done to determine the effects, negative or positive, of long term elderberry use.
If you are interested in elderberry for warding off colds and flu, like all antivirals, elderberry works best if taken at the first signs of a respiratory illness. Elderberry contains an anti-viral agent called “antivirin” which helps prevent viruses from invading our cells. If you are fighting cold and flu symptoms, a conservative recommendation is to take up to 4 teaspoons per day until symptoms subside.
Studies indicate that elderberry may have diuretic and blood sugar lowering properties, too, so, as with all herbal medicines, if you are considering adding elderberry to your diet, do your research and consult your physician to ensure that elderberry won’t interact with any prescriptions medicines you may already be taking. We’ve done some of the research work for you in our summary below. We’ve also got some great recipe ideas for incorporating elderberry into your diet. Our favorite is Elderberry Wellness Tea. If you missed elderberry season this year you can always stock up on our elderberry supplements (and get a nice discount when you buy it by the case).
A Summary of the State of the Research
The following chart is excerpted from an article written by the folks at Chamberlin’s Natural Foods. It does a nice job of discussing the evidence behind some of the purported health benefits of elderberry and the research that still needs to be done.
|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.||GRADE *|
|Early research suggests that elder may have antiviral benefits. One study found that elderberry juice may improve flu symptoms such as fever, fatigue, headache, sore throat, cough, and aches, in less than half the usual recovery time of the flu. However, the study was small, and it should be noted that the berries must be cooked to prevent nausea or poisoning. In another study, elderberry appeared to improve cough, fever, headache, mucus discharge, muscle aches, and nasal congestion. More research is needed before firm conclusions can be made.||B|
|Evidence on the use of elder alone for bronchitis is lacking. The combination product Sinupret®, which contains elder, has been used to treat acute bronchitis and sinus infection. There is some evidence that Sinupret® may have benefits for this condition compared to other medications. More information is needed.||C|
|Early study suggests that a combination product containing elder may help treat chronic constipation in as little as two days. More research is needed before firm conclusions can be made.||C|
|Elder has been used in combination with other products to reduce gum disease and inflammation. Significant results were seen four days after treatment. A combination mouthwash containing elder significantly decreased gum disease when used three times daily for 14 days. Further study is needed on the possible effects of elder alone.||C|
|Early study suggests that long-term elderberry use may lack heart health benefits in postmenopausal women. More research is needed in this area.||C|
|Evidence on the use of elder alone as a treatment for high cholesterol is lacking. One study reports that elder may have benefits for people with this condition. However, more research is needed in this area.||C|
|Limited study has looked at elder for sinus infection in humans. Combination products containing elder (such as Sinupret®) have been reported to have benefits when used with antibiotics. Research suggests that such products may help improve swelling, drainage, headache, and nasal congestion. More evidence is needed on the possible benefits of elder alone.||C|
|Elderberry has been studied for possible weight loss benefits. A significant difference has been seen in body weight, blood pressure, and quality of life. However, further study is needed before conclusions may be made.||C|
|* 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 for this use (it may not work) F: Strong scientific evidence against this use (it likely does not work)|
Common Name(s): Sweet elder , common elder , elderberry , sambucus , Sambucol
Limited clinical trials have been conducted. Elderberry extracts may have some value in the treatment of influenza and appear to have antioxidant potential.
The bioavailability of active constituents in elderberry extracts is considered to be poor. Trials are lacking to provide dosing information. For the treatment of influenza, 15 mL of syrup taken 4 times per day for 5 days has been used in clinical trials.
Contraindications have not been identified.
Information regarding safety and efficacy in pregnancy and lactation is lacking.
None well documented.
Consumption of uncooked berries may result in vomiting and diarrhea. Commercial preparations generally do not cause adverse reactions at the recommended dosage. Type 1 allergy to elderberry (positive skin prick tests) has been recorded.
Poisonous alkaloids, lectins, and cyanogenic glycosides are present in some plant parts. Short-term use of elderberry extract preparations appears to be relatively safe; however, long-term toxicological studies are lacking.
The American elder is a tall shrub that grows to 4 m, and is native to North America. The European elder grows to approximately 10 m and has been naturalized to the United States. The tree has light brown/grey bark and narrow, dark green leaves. Clusters of white-cream flowers have a particular fragrance and develop into dark purple-black berries. 1 , 2
Elder flowers and berries have been used in traditional medicine and as a flavoring for centuries. In folk medicine, the flowers have been used for their diuretic and laxative properties and as an astringent. Various parts of the elder have been used to treat cancer and many other unrelated disorders. Distilled elder flower water has been used as a scented vehicle for topical preparations, and extracts are used to flavor foods as well as alcoholic beverages. The fruits have been used to make elderberry wine. 3
European elder flowers contain approximately 0.3% of an essential oil composed of free fatty acids and alkanes. The triterpenes alpha- and beta-amyrin, ursolic acid, oleanic acid, betulin, betulic acid, and a variety of other minor components have been identified. 4 The elder leaf contains sambunigrin, a cyanogenic glucoside (0.042% by weight). 5 Leaves of S. nigra express 2 classes of thaumatin-like proteins. The fruit-specific, thaumatin-like proteins accumulate only during the final stages of fruit ripening. 6
The fruit of the elderberry contains phenolics, including quercetin, kaempferol, rutin, and phenolic acids and anthocyanins. High-performance liquid chromatography and mass spectrometry have been used to identify individual anthocyanins, which give the berry its color, and include cyanidin 3-sambubioside-5-diglucoside, cyanidin-3,5-diglucoside, cyanidin 3-sambubioside, and cyanidin 3-glucoside. 7 , 8 The total anthocyanin content varies during the growing season and by cultivar. Vitamins A and C are also present, and antioxidant capacity of the berry has been estimated to be similar to that of black raspberries, blackberries, and other dark-fleshed small fruit. 9 , 10
The Sambucus species has been studied for its lectin composition, which has hemagglutinin characteristics useful in blood typing. 7 , 11
Uses and Pharmacology
In vitro studies have shown that elderberry extracts exert activity against the influenza virus A (including H1N1) and B and the herpes simplex virus. Laboratory studies also suggest an inhibitory effect on the infectivity of the HIV virus. 12 , 13 , 14 , 15 , 16
Research reveals no animal data regarding the use of elderberry extracts for antiviral effects.
Although in vitro data are promising, few clinical trials have been conducted examining the efficacy of elderberry extracts for the treatment of influenza. 15 , 16 When used within the first 48 hours of onset of symptoms, elderberry extracts reduced the duration of influenza versus placebo. 12 , 17 Anecdotal reports exist for elderberry use in HIV. 16
A stimulatory effect on insulin secretion by the polyphenolic content of elderberry fruit has been shown in diabetic rats. 18 In vitro studies using rat abdominal muscle showed increased insulin secretion in response to flower extracts. 19 , 20
Although traditionally used for diabetes, clinical trials are lacking. Elderberry has been evaluated in combination with asparagus for weight reduction. 21 , 22
Research reveals no animal data regarding the use of elderberry extracts for lipid-lowering effects.
In a placebo-controlled study among healthy volunteers, there was only a small and statistically insignificant change in cholesterol in the elderberry-treated group compared with placebo. The dosage used in the study may have been too low (anthocyanin 10%). 23 No change was found in healthy volunteers consuming 500 mg of anthocyanins daily for 12 weeks in another study. 24
Elder flowers are considered to have diuretic and laxative properties; however, the specific compounds responsible for these activities have not been well established. 2 , 25
The compound sambuculin A and a mixture of alpha- and beta-amyrin palmitate demonstrated hepatoprotective properties against carbon tetrachloride-induced liver damage. 26
Effects on anti-inflammatory markers including increased cytokine production have been demonstrated in vitro. 24 , 27
Antioxidant activity of elderberry extracts has been evaluated and is estimated to be similar to that of black raspberries, blackberries, and other dark-fleshed small fruit. 9 , 10 , 18 , 23 , 28 , 29
Induction of quinine reductase and cyclo-oxygenase-2 has been suggested to be responsible for anticancer effects in vitro. 30
The bioavailability of active constituents in elderberry extracts is considered to be poor. 16 , 31 , 32
Fruit syrups are commonly standardized to 30% to 38% elderberry extract. Powdered extracts are available as capsules and in liquid form.
Doses of 500 mg of anthocyanins per day were taken for 12 weeks in healthy volunteers, with no effect on cardiovascular disease biomarkers. 24
15 mL of syrup taken 4 times per day for 5 days has been used in clinical trials. 12
Information regarding safety and efficacy in pregnancy and lactation is lacking.
None well documented. Elderberry may potentiate the effects of insulin.
Consumption of uncooked berries may result in vomiting and diarrhea. Commercial preparations are generally considered relatively free from adverse effects at the recommended dosage. No adverse events were reported in a clinical trial evaluating the efficacy of elderberry extract in the treatment of influenza, 12 or in healthy volunteers consuming elderberry extract standardized to 500 mg of anthocyanins per day for 12 weeks. 24
Type 1 allergy to elderberry (positive skin prick tests) has been recorded. 16
Poisonous alkaloids, lectins, and cyanogenic glycosides are present in some plant parts. While elderberries are safe to consume, particularly when cooked, leaves and stems should not be crushed when making elderberry juice. Uncooked berries may produce nausea. A report of severe illness (nausea, vomiting, weakness, dizziness, numbness, and stupor) following the ingestion of juice prepared from elderberries exists. 16 , 33
Toxicity in children who used peashooters made from elderberry stems has been reported. 3
No effects were recorded on kidney and liver function markers in healthy volunteers consuming elderberry extract standardized to 500 mg of anthocyanins per day for 12 weeks. 24 Long-term toxicological studies are lacking. 16
3. Duke JA. CRC Handbook of Medicinal Herbs . Boca Raton, FL: CRC Press; 1985.
4. Inoue T, Sato K. Triterpenoids of Sambucus nigra and S. canadensis . Phytochemistry . 1975;14:1871.
5. Leung AY. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics . New York, NY: Wiley; 1980.
12. Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res . 2004;32(2):132-140.
13. Krawitz C, Mraheil MA, Stein M, et al. Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. BMC Complement Altern Med . 2011;11:16.
17. Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract ( Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med . 1995;1(4):361-369.
18. Ciocoiu M, Mirón A, Mares L, et al. The effects of Sambucus nigra polyphenols on oxidative stress and metabolic disorders in experimental diabetes mellitus. J Physiol Biochem . 2009;65(3):297-304.
20. Christensen KB, Petersen RK, Kristiansen K, Christensen LP. Identification of bioactive compounds from flowers of black elder ( Sambucus nigra L.) that activate the human peroxisome proliferator-activated receptor (PPAR) gamma. Phytother Res . 2010;24(suppl 2):S129-S132.
21. Chrubasik C, Maier T, Dawid C, et al. An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction. Phytother Res . 2008;22(7):913-918.
22. Hasani-Ranjbar S, Nayebi N, Larijani B, Abdollahi M. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. World J Gastroenterol . 2009;15(25):3073-3085.
23. Murkovic M, Abuja PM, Bergmann AR, et al. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr . 2004;58(2):244-249.
24. Curtis PJ, Kroon PA, Hollands WJ, et al. Cardiovascular disease risk biomarkers and liver and kidney function are not altered in postmenopausal women after ingesting an elderberry extract rich in anthocyanins for 12 weeks. J Nutr . 2009;139(12):2266-2271.
25. Picon PD, Picon RV, Costa AF, et al. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum , Foeniculum vulgare , Sambucus nigra , and Cassia augustifolia for chronic constipation. BMC Complement Altern Med . 2010;10:17.
26. Lin CN, Tome WP. Antihepatotoxic principles of Sambucus formosana . Planta Med . 1988;54(3):223-224.
27. Barak V, Birkenfeld S, Halpern T, Kalickman I. The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines. Isr Med Assoc J . 2002;4(suppl 11);919-922.
28. Roy S, Khanna S, Alessio HM, et al. Anti-angiogenic property of edible berries. Free Radic Res . 2002;36(9):1023-1031.
29. Nalliah RE, Phillips JS, Gaier AJ, Gochenaur KE, Bell DR. Experimental in vitro arterial reactivity and tissue culture solutions alter the time-dependent stability of anthocyanins from elderberry, chokeberry, and bilberry extracts. Int J Food Sci Nutr . 2009;60(suppl 1):209-219.
30. Thole JM, Kraft TF, Sueiro LA, et al. A comparative evaluation of the anticancer properties of European and American elderberry fruits. J Med Food . 2006;9(4):498-504.
32. Bitsch R, Netzel M, Sonntag S, Strass G, Frank T, Bitsch I. Urinary excretion of cyanidin glucosides and glucuronides in healthy humans after elderberry juice ingestion. J Biomed Biotechnol . 2004;2004(5):343-345.
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