Sambucus nigra · herb
Evidence tier: limited
Strengthens immune response and reduces duration of colds and flu
Anthocyanins and flavonoids such as quercetin show antiviral and immune signalling effects in the lab; Wieland 2021 found no evidence that elderberry overstimulates the immune system in people.
Limited and uncertain. NCCIH calls the evidence for flu and other respiratory illnesses limited and preliminary. A 2021 systematic review of 5 RCTs concluded elderberry may not prevent colds and may shorten colds and flu, but the evidence is uncertain (PMID 33827515). The largest US trial, in 87 people aged 5 and over with flu, found no benefit from 15 ml of syrup taken for 5 days (PMID 32929634). An earlier meta analysis was more positive (PMID 30670267), but the newer trial and review temper it.
No authority sets a dose. The null flu trial used 15 ml of syrup twice a day for ages 5 to 12 and 4 times a day for 13 and over, for 5 days (PMID 32929634). Doses differ by product and extract strength, so labels are not comparable.
Only cooked or commercially processed berry products; never raw or unripe berries. Trials started it at the first signs of a cold or flu and used it for about 5 days. If it is used at all, keep to short courses; it does not appear to prevent colds (PMID 33827515). Not for people with autoimmune conditions or on immune suppressing medicine without a doctor's advice.
Well tolerated at standard doses. Uncooked or unprocessed berries contain toxic compounds and must be avoided. Cooked/concentrated extract is safe. May cause mild GI upset or laxative effect in sensitive individuals.
Pregnancy: avoid
Breastfeeding: avoid
Active compounds: cyanidin-3-glucoside, cyanidin-3-sambubioside, quercetin, rutin, chlorogenic acid, anthocyanins (cyanidin glycosides), sambunigrin (cyanogenic glycoside in leaves, bark, raw or unripe berries)
Remedies using Black Elderberry · Browse by body system · Check it against what you take
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.