The Health Benefits of Elderberry

This age-old cold and flu remedy may also have other benefits

Elderberry is dark purple fruit that comes from the elderberry shrub. It is a rich source of antioxidants known as anthocyanins.

Some people believe elderberry is effective in treating the common cold, flu, constipation, hay fever, and sinus infections. It's also been claimed to be useful in treating toothache, sciatica, and burns. Some of these claims have more evidence than others.

The European elder (black elderberry, Sambucus nigra) is the shrub species most often used in supplements. But other elder species also produce anthocyanin-rich berries. There are several elderberry supplement options and preparations. You can find them sold as gummies, lozenges, syrups, teas, and more.

This article will discuss elderberry and whether it has any health benefits. You will learn how to take it as well as about possible side effects, including some important warnings. This article will also describe interactions that can occur if you take elderberry alongside other supplements or medications.


Verywell / JR Bee

Health Benefits

Many of elderberry's health benefits are linked to anthocyanins.

These substances are said to:

  • Work by clearing the body of free radicals that damage cells at the DNA level
  • Have antiviral properties that may prevent or reduce the severity of certain common infections
  • Have anti-inflammatory benefits, modulating the body's immune response

Colds and Flu

Elderberry juice syrup has been used for centuries as a home remedy to treat the cold and flu, which are caused by viruses. There are some researchers who believe the syrup reduces the severity and duration of some infections and some evidence from small studies supports this claim.

A 2019 study on elderberry for both cold and flu suggested that the fruit greatly reduced upper airway symptoms.

In 2016, scientists in Australia examined the effects of elderberry in a group of airline passengers. They studied 312 passengers on a long flight.

The scientists reported that the passengers who used elderberry extract 10 days before and five days after their flight had 50% fewer sick days resulting from a cold than those who didn't take the extract. In addition, passengers who used elderberry had less severe colds based on a scoring of upper respiratory tract symptoms.

What elderberry did not appear to do was reduce the risk of getting a cold. Both the elderberry group and placebo group had more or less the same number of infections.

A 2012 study suggested that elderberry could help prevent influenza infection by stimulating an immune response.

Pain Relief

Anthocyanins are known to reduce inflammation. Those in elderberry do so by blocking the production of nitric oxide by the body's immune cells.

Nitric oxide serves as a signaling molecule that triggers inflammation, such as when you get injured or have a disease. By slowing down this response, pain and swelling may decrease.

Topical elderberry tinctures and salves have long been used in folk medicine to treat:

There have been few studies investigating elderberry's anti-inflammatory or pain-relieving benefits in humans.

Disease Prevention

Some alternative healthcare providers say that elderberry has antioxidant effects. They believe elderberries can reduce the risk of cancer and heart disease.

While it's true that antioxidant-rich diets may offer such benefits, there are no studies that have been conducted specifically correlating elderberry consumption with these disease outcomes.

Possible Side Effects

Ripe, cooked elderberry fruit is considered safe if you eat it in moderation. If you eat too many elderberries, you can get diarrhea, stomach ache, and abdominal cramping. And if elderberry is used as alternative medicine, you should only eat ripe or dried berries.


Certain parts of the elderberry plant contain a type of poison known as cyanogenic glycoside. These include the leaves, root, bark, and stems, in addition to the unripe, raw berry, If you chew unripe elderberries, cyanide can be released into your body. Even ripe berries contain trace amounts, so elderberries must be cooked before you eat them. The raw berries can make you sick.

Poisoning from elderberries is rarely life-threatening. But it may cause nausea, vomiting, diarrhea, dizziness, numbness, abdominal distention, and difficulty breathing. Get medical attention if you experience any of these symptoms after consuming an elderberry extract or unripe fruit.

Elderberry is not recommended for children, pregnant women, or nursing mothers. While no adverse events have been reported in these groups, there is not enough data to determine if it is safe over the long term.

Drug Interactions

Elderberry extracts may theoretically interact with drugs designed to suppress the immune system and could therefore interfere with their ability to work efficiently.

Examples include:

  • CellCept (mycophenolate)
  • Corticosteroid drugs like prednisone
  • Imuran (azathioprine)
  • OKT3 (muromonab-CD3)
  • Prograf (tacrolimus)
  • Rapamune (sirolimus)
  • Sandimmune (cyclosporine)
  • Simulect (basiliximab)
  • Zenapax (daclizumab)

Elderberries may stimulate the immune system. For this reason, people with autoimmune disorders should not use elderberry medications without guidance from a healthcare provider.

Dosage and Preparation

Elderberries have long been cultivated for food and to make natural medicines. Elderberry natural medicines are available in many forms, including:

  • Syrups
  • Teas
  • Capsules
  • Gummies
  • Tonics
  • Tinctures
  • Topical ointments

The ripe berry is tart and typically sweetened (like cranberries).

Treatment should start no later than 48 hours after the first appearance of cold or flu symptoms. As a general rule, you should not take more than the product manufacturer's recommended dosage.

Many commercial syrup manufacturers recommend 1 tablespoon (15 milliliters) of elderberry syrup taken four times daily to treat cold or flu symptoms. Elderberry lozenges (175 milligrams) can be taken twice daily.

Keep in mind that elderberry should never be used as a substitute for conventional medical care. Self-treating a condition and delaying standard medical treatment may have serious consequences.


Experts recommend taking an elderberry supplement no later than 48 hours after the first sign of symptoms. Never take more than the manufacturer's recommended dosage.

What to Look For

Elderberry-based medications are classified as dietary supplements by the Food and Drug Administration (FDA). Under this classification, they are not meant to be sold or marketed as a treatment for any medical condition. Because supplements are not required to undergo rigorous research or testing, they can vary significantly in quality.

To ensure quality and safety, only buy supplements that have been certified by an independent certifying body, such as the U.S. Pharmacopeia (USP), NSF International, or ConsumerLab.

Safety Warning

If you eat fresh berries, it is important that you purchase them from a reputable source. It is never safe to eat unknown berries in nature. This is because you don't know the potentially dangerous effects of wild fruit. If you have eaten an unknown berry and are experiencing adverse side effects, get medical attention immediately.


Elderberry is a fruit that some people claim can treat a variety of medical conditions. They believe elderberry is something that helps when you have a common cold or the flu. Some people believe that it can also help treat pain and constipation.

You can take elderberry supplements in several forms, including gummies, syrups, teas, and capsules. Elderberries should only be eaten if they are ripe or dried. Raw berries can make you sick.

Frequently Asked Questions

  • What is elderberry most commonly used for?

    Elderberry is most commonly used as a cough syrup. Research suggests elderberry juice syrup may help prevent and treat upper respiratory symptoms of colds and flu.

  • Is it safe to take elderberry every day?

    Commercially prepared elderberry syrup and supplements are generally regarded as safe and can safely be taken in amounts listed on the supplement label daily. However, homemade elderberry syrup—sometimes marketed as artisan, handcrafted, or small-batch—should be used with caution as it may contain small amounts of cyanide. Commercially made elderberry supplements do not contain cyanide and should be safe to take daily.  

  • How should I store fresh elderberries?

    Elderberries are best stored in the refrigerator if not consumed immediately.

  • How do you make elderberry syrup?

    Elderberry syrup can be made with dried elderberries, available for purchase online and in specialty health food stores.

    To make the syrup:

    1. Combine 2 cups of dried elderberries with 4 cups of cold distilled water in a heavy saucepan.
    2. Bring the water to a boil, reduce heat, and cook uncovered for 30 to 40 minutes, stirring regularly.
    3. Remove from the heat and let steep for 1 hour. Strain mixture into a large measuring cup covered with cheesecloth, reserving liquid and discarding the used berries.
    4. Allow the syrup to cool, then stir in 1 cup of honey. Pour mixture into a sterilized container.
    5. Seal and store in the refrigerator for up to three months.
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