Elderberry
Elderberry is used for cold and influenza symptoms. Clinical evidence is limited and product quality varies.
Overview
What is elderberry?
Elderberry is a dark berry from the European elder tree. It has historical use as an antiviral cold and influenza remedy and may be effective for this purpose.
Dosage
A typical dose of elderberry extract is 175 to 900 mg per day.
Effect graph
Effect heatmap
SupplementDEX Database
13 conditions for , and rated at least stars. All purchase bands. No minimum star filter.
Database Snapshot
Most elderberry research is concentrated in a handful of conditions.
- Flu accounts for 5 of 21 studies (24%).
- Oral health accounts for 4 of 21 studies (19%).
- Upper respiratory tract infections accounts for 2 of 21 studies (10%).
- Sparse coverage remains for Upper respiratory tract infections, Asthenopia, Cardiovascular disease.
Safety
Elderberry should only be consumed in supplement form as the fruit, leaves and other parts of the elderberry plant contain sambunigrin. A toxin, sambunigrin may cause nausea, vomiting, dizziness and diarrhea.
Case reports have linked elderberry consumption to acute pancreatitis. [PubMed]
Frequently Asked Questions
References
Sources21 references
SupplementDEX uses only high-quality sources to determine supplement effectiveness.
SupplementDEX Database · Flu
5 references1.SupplementDEX Database: Flu — Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled Trial2020
In 87 ER patients with influenza over 5 days, elderberry extract did not significantly reduce time to symptom resolution (4.9 vs 5.3 days) or complete recovery (8.7 vs 8.6 days) versus placebo.
2.SupplementDEX Database: Flu — Effect of an Echinacea-Based Hot Drink Versus Oseltamivir in Influenza Treatment: A Randomized, Double-Blind, Double-Dummy, Multicenter, Noninferiority Clinical Trial2015
In 473 influenza patients over 10 days, Echinaforce Hotdrink was noninferior to oseltamivir for clinical recovery (90.1% vs 84.8% by day 10) with fewer complications (2.5% vs 6.5%) and adverse events.
4.SupplementDEX Database: Flu — Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections2004
In 60 influenza patients (18–54 years) over 5 days, elderberry syrup (15 mL four times daily) relieved symptoms ~4 days earlier and reduced rescue medication use versus placebo.
5.SupplementDEX Database: Flu — 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 Panama1995
During an influenza B outbreak, Sambucol-treated patients showed improvement in 93.3% within 2 days versus 91.7% within 6 days with placebo (p < 0.001), with near-complete cure in 2–3 days versus ≥6 days.
3.Pilot Clinical Study on a Proprietary Elderberry Extract : Efficacy in Addressing Influenza Symptoms. See external sourceExternal source
6.SupplementDEX Database: Lower respiratory tract infections — Primary care experience on Stimunex® gocce in children with recurrent respiratory infections: a real-world study during the COVID-19 pandemic era2022
In 298 children with recurrent respiratory infections, 4 months of Stimunex (Sambucus, beta-glucan, zinc, vitamin D) versus standard care reduced infection number and duration and was well tolerated during the COVID-19 pandemic.
7.SupplementDEX Database: Upper respiratory tract infections — Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review2021
A systematic review of 5 RCTs found elderberry may reduce cold duration/severity and influenza duration (evidence uncertain), with no clinical evidence of harmful immune overstimulation.
8.SupplementDEX Database: Upper respiratory tract infections — Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials2018
A meta-analysis of 180 participants across RCTs found elderberry supplementation substantially reduced upper respiratory symptom burden, presenting a large mean effect size.
SupplementDEX Database · Eczema
1 reference9.SupplementDEX Database: Eczema — A Comparison of the Effect of Topical Preparation of Sambucus ebulus L. and Hydrocortisone on Hand Eczema: A Double-Blind Randomized Controlled Trial2021
In 81 hand eczema patients over 4 weeks, topical Sambucus ebulus reduced HECSI and itching comparably to hydrocortisone, with significantly better dermatology life quality index scores in the S. ebulus group (p = 0.02).
SupplementDEX Database · Oral health
4 references10.SupplementDEX Database: Oral health — A randomized, placebo-controlled clinical trial evaluating of a mouthwash containing Sambucus williamsii var. coreana extract for prevention of gingivitits2022
In 64 adults over 5 days, a Sambucus williamsii mouthwash significantly improved O'Leary index, plaque index, gingival index, and subgingival plaque versus saline control.
11.SupplementDEX Database: Oral health — Effect of an herbal mouth rinse in preventing periodontal inflammation in an experimental gingivitis model: a pilot study2022
In 62 adults in an experimental gingivitis model over 2 weeks, herbal mouth rinse HM-302 significantly reduced gingival index increase versus water control (p = 0.006), with no serious adverse events.
12.SupplementDEX Database: Oral health — Localized reduction of gingival inflammation using site-specific therapy with a topical gingival patch2012
In 26 periodontitis patients, a topical gingival patch reduced gingival crevicular fluid beta-glucuronidase at 24 hours in 17/22 treated sites versus 3/14 controls (p = 0.002), suggesting localized anti-inflammatory benefit.
13.SupplementDEX Database: Oral health — A phase II trial of a transmucosal herbal patch for the treatment of gingivitis2011
In 53 gingivitis patients over 3 days, transmucosal herbal periodontal patches significantly reduced gingival index on days 4 and 15 and beta-glucuronidase on days 4 and 8 versus placebo patches.
SupplementDEX Database · Asthenopia
1 reference14.SupplementDEX Database: Asthenopia — A Pilot, Phase II, Observational, Case-Control, 1-Month Study on Asthenopia in Video Terminal Operators without Dry Eye: Contrast Sensitivity and Quality of Life before and after the Oral Consumption of a Fixed Combination of Zinc, L-Carnitine, Extract of Elderberry, Currant and Extract of Eleutherococcus2021
In 30 video terminal workers over 1 month, a fixed oral supplement with zinc, L-carnitine, elderberry, black currant, and eleuthero significantly improved contrast sensitivity and reduced eyestrain scores (−14.1 vs −2.3) versus control.
15.SupplementDEX Database: Cardiovascular disease — 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 weeks2009
In 52 postmenopausal women over 12 weeks, 500 mg/day elderberry anthocyanins did not significantly change cardiovascular risk biomarkers or liver/kidney function versus placebo.
16.SupplementDEX Database: Chronic obstructive pulmonary disease — Clinical Effectiveness of a Combination of Black Elder Berries, Violet Herb, and Calendula Flowers in Chronic Obstructive Pulmonary Disease: The Results of a Double-Blinded Placebo-Controlled Study2020
In 60 COPD patients over 6 months, Inflaminat (elderberry, violet, calendula) significantly improved BCSS symptoms (3.0 to 1.9) and FEV1 (66% to 73%) versus placebo.
17.SupplementDEX Database: Cognitive performance — Effects of the active botanical blend "WKUP GT" on attention and cognitive functions after lunch in healthy volunteers2024
In 30 healthy adults in a crossover trial, WKUP GT (carob, guarana, green tea, elderberry) after lunch improved rapid visual information processing and multitasking versus placebo, without raising systolic blood pressure like caffeine.
SupplementDEX Database · Common cold
1 reference18.SupplementDEX Database: Common cold — Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial2016
In 312 economy-class air travelers, elderberry extract significantly reduced cold duration (57 vs 117 days) and average symptom scores (247 vs 583) versus placebo, though cold episode counts did not differ significantly.
SupplementDEX Database · Constipation
1 reference19.SupplementDEX Database: Constipation — SYNBIO® Probiotic and Antioxidant Dietary Supplementation: Clinical Trial Evaluation of Potential Effects on Airline Flight Crew Members' Well-Being2023
In 40 airline crew over 30 days, SYNBIO probiotic plus elderberry extract improved psychological well-being, increased lactobacilli/bifidobacteria, and raised salivary IgA versus placebo.
SupplementDEX Database · Dry eye
1 reference20.SupplementDEX Database: Dry eye — Effect of Dietary Supplementation with Lutein, Zeaxanthin, and Elderberries on Dry Eye Disease (DED) and Immunity: A Randomized Controlled Trial2024
In 110 adults over 20 days, lutein (6 mg), zeaxanthin (1 mg), and elderberry (100 mg) significantly improved Ocular Surface Disease Index scores (26.7% improvement) versus placebo; immune questionnaire changes were not significant.
SupplementDEX Database · Dyslipidemia
1 reference21.SupplementDEX Database: Dyslipidemia — Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study2004
In 34 healthy volunteers over 2 weeks, elderberry capsules (400 mg, 10% anthocyanes, t.i.d.) showed only a small nonsignificant cholesterol decrease (199 to 190 mg/dl) and no change in LDL oxidation resistance versus placebo.