Elderberry (Sambucus nigra)
The traditional immune remedy with clinical evidence for reducing cold and flu duration
Also known as: Sambucus nigra • Black Elderberry • Sambucol • European Elderberry
Overview
Elderberry (Sambucus nigra) is a dark purple berry that has been used for centuries as a folk remedy for colds and flu. Modern research has validated its traditional use, with clinical trials showing elderberry extract can reduce the duration and severity of upper respiratory infections. The active compounds — anthocyanins, flavonoids, and lectins — have direct antiviral activity (inhibiting viral entry and replication) and immunomodulatory effects (stimulating cytokine production). A meta-analysis found elderberry supplementation substantially reduced upper respiratory symptoms. Elderberry is one of the most popular natural immune supplements, with sales surging during cold and flu season.
Key Benefits
Cold & Flu Duration Reduction
A meta-analysis of randomized controlled trials found elderberry supplementation substantially reduced upper respiratory symptoms. Individual studies show cold duration reduced by an average of 2 days and flu symptoms reduced by 3-4 days when elderberry is started within 48 hours of symptom onset.
Direct Antiviral Activity
Elderberry compounds inhibit viral entry into cells by binding to viral surface proteins. In vitro studies show activity against influenza A and B, and some evidence against other respiratory viruses. The anthocyanins and lectins in elderberry physically block viral attachment.
Immune System Stimulation
Elderberry stimulates the production of inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) that activate immune cells to fight infection. It also increases antibody production and enhances the activity of natural killer cells.
Antioxidant Protection
Elderberries are extremely rich in anthocyanins and other polyphenols, giving them one of the highest ORAC (antioxidant capacity) scores of any fruit. These antioxidants reduce oxidative stress during infection and support overall immune function.
Dosage & How to Take
For acute illness: 600-1,500mg elderberry extract daily, divided into 3-4 doses, starting within 48 hours of symptoms. For prevention: 300-600mg daily during cold/flu season. Most studies use standardized extracts equivalent to Sambucol.
| Purpose | Dose | Notes |
|---|---|---|
| Acute cold/flu treatment | 600-1,500 mg/day extract | Divide into 3-4 doses. Start within 48 hours of symptoms. |
| Prevention (cold/flu season) | 300-600 mg/day | Daily during high-risk periods |
| Syrup form (Sambucol) | 15 mL (1 tbsp), 4x/day | Standard dosing for the syrup formulation |
| Lozenges | 175 mg, 4x/day | Convenient for sore throat |
Best Time to Take
During illness, take every 3-4 hours. For prevention, once daily. Start treatment as early as possible after symptom onset.
With or Without Food
Can be taken with or without food. Syrup forms are often taken directly.
Forms & Bioavailability
| Form | Absorption | Best For | Notes |
|---|---|---|---|
| Standardized Extract Capsules | Good | Precise dosing, travel | Standardized to anthocyanin content. Convenient. |
| Elderberry Syrup | Good | Children, pleasant taste | Sweet taste. Check sugar content. Popular for families. |
| Elderberry Gummies | Good | Compliance, taste | Popular but often lower dose per gummy. Check actual elderberry content. |
| Elderberry Lozenges | Good | Sore throat, direct contact | Provides local antiviral contact in the throat. |
Side Effects & Safety
Common
- Mild GI upset
- Nausea at high doses
Rare
- Allergic reactions
- Cytokine storm concern (theoretical — see FAQ)
Contraindications
- NEVER consume raw elderberries, leaves, or bark (contain cyanogenic glycosides — toxic)
- Autoimmune diseases (elderberry stimulates immune function)
- Immunosuppressant medications
Interactions
Elderberry stimulates immune function; may counteract immunosuppressive drugs
Elderberry may lower blood sugar; monitor if on diabetes medications
Elderberry has mild diuretic effects; may be additive with diuretic medications
Scientific Research
Elderberry Meta-Analysis
Elderberry supplementation substantially reduced upper respiratory symptoms in a meta-analysis of randomized controlled trials
Elderberry for Flu
Elderberry extract reduced flu duration by an average of 4 days compared to placebo when started within 48 hours
Elderberry for Air Travelers
Elderberry supplementation reduced cold duration and severity in air travelers, who have elevated infection risk
Food Sources
Frequently Asked Questions
Medical Disclaimer
This content is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before starting any supplement regimen, especially if you have pre-existing health conditions or are taking medications. The statements on this page have not been evaluated by the Food and Drug Administration.