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Will Elderberry Extract Help You Recover from Flu?

Elderberry extract has antiviral activity in laboratory tests, but there are too few good clinical trials to show if it works for the flu.

Natural approaches to healing are getting extra attention right now, as people try hard to stay out of doctors’ offices if they can. After all, if you don’t have COVID-19, you don’t want to go anywhere other people might have it and give it to you. Some readers have been asking about elderberry extract (Sambucus nigra or Sambucus canadensis) to help treat the flu. Here are reports from a few members of the community.

Elderberry to Fight Colds, Flu or Bronchitis:

Q. I wish you would write about elderberry. Sambucus nigra (elderberry) extract has helped me recover from the flu many times, and I have taken it for over a decade.

When I recently had bronchitis and found it difficult to breathe, I took a teaspoon of elderberry extract mixed in warm water and found that I was able to breathe better within an hour. I take it once or twice a day when I have a cold, flu or bronchitis, and it works well and fast. Since it is a berry, I feel comfortable taking it and prefer the extract instead of other forms.

A. Elderberry shrubs grow in many parts of the northern hemisphere. Both Sambucus nigra in Europe and Sambucus canadensis in North America have long traditions as healing herbs.

Charlemagne is said to have encouraged the planting of elderberry bushes so that the healthful properties of these plants would be widely available. At the time, folk healers used it to promote digestive health, help ward off colds and flu and support resilience during the winter months.

Modern scientists have studied black elderberry. The numerous polyphenols and terpenoid compounds it contains may contribute to its benefits (Journal of Agricultural and Food Chemistry, April 13, 2022).

Researchers have conducted few clinical trials. However, a meta-analysis concluded that elderberry extract can ease symptoms like cough (Complementary Therapies in Medicine, Feb. 2019). You may be interested in our eGuide to Colds, Coughs & the Flu.

Can You Eat Elderberries?

Q. Ripe elderberries are absolutely delicious. I’ve made great syrups and jellies with them. You can even make elderberry pancakes and waffles (just make sure the fruit is RIPE). I don’t know if elderberries can help fend off cold viruses, but they sure are tasty.

I see them growing all over, especially near railroad tracks. It’s easy to make cuttings and grow new bushes from them.

A. You are quite right that elderberries are yummy and also that they must be ripe. Leaves, twigs and unripe berries contain toxins that can cause nausea, vomiting or diarrhea. Cooking can reduce or eliminate the toxin. Some people are more sensitive than others to these compounds.

You have probably collected your cuttings and fruit from American elderberry (Sambucus canadensis). Most of the research has been done on European elderberry (Sambucus nigra). Water-based extracts of these elderberries apparently modulate the immune system and may help fight off viral infections (International Journal of Molecular Sciences, April 1, 2022).

Elderberries are a rich source of anthocyanins. They have become much more popular over the last several years, probably because of their immune-enhancing effects (Molecules, March 31, 2023). If you don’t have access to fresh elderberries, keep reading to learn about choosing elderberry extract.

Will Elderberry Extract or Tea Help Sniffles?

Q. During cold season, I use elderberry seeds to make a tea as soon as I start to sniffle. It has stopped the cold in its tracks every time. My friend with COPD used to get pneumonia every fall but now takes elderberry daily and hasn’t had pneumonia in over ten years.

A. Traditionally, people have used the flowers or berries of elderberry bushes to treat coughs and colds. Although the extract has antiviral activity, a double-blind clinical trial did not show that it helps people recover more quickly from flu (Journal of General Internal Medicine, Nov. 2020).

Elderberry Extract for Influenza:

Q. Our daughter told us about taking elderberry extract. In fact, she brought us a bottle of the syrup. We’ve all been taking two tablespoons once per day.

She came down with the flu this winter and was running a fever of 100.3 degrees (F). Taking the elderberry extract, though, she recovered completely in just three days.

She doesn’t have insurance, so she didn’t see the doctor. But I had both Type A and Type B influenza last year myself, and it sure looked to us like she had the flu. We will all continue to take it on a daily basis, especially in these uncertain times.

What Is the Evidence on Elderberry?

A. Many readers have asked about elderberry extract to treat viral infections. Only a handful of clinical trials have examined its use for influenza or other viruses. One meta-analysis found that black elderberry extract can “substantially reduce upper respiratory symptoms” (Complementary Therapies in Medicine, Feb. 2019). In general, such upper respiratory symptoms are associated with colds or mild cases of the flu. Another study found that air travelers taking placebo had more colds and suffered longer with cold symptoms than those randomized to take elderberry extract (Nutrients, March 24, 2016).

Scientists examining the mechanism of action suggest that the anthocyanin compounds in elderberry have antiviral effects (Frontiers in Pharmacology, Nov. 8, 2019). However, a review found too few studies comparing elderberry extract to standard antiviral medications (Phytotherapy Resarch, April 2017).

According to The Medical Letter (Feb. 25, 2019),

“There is no acceptable evidence to date that elderberry is effective for prevention or treatment of influenza and its safety is unclear.”

A more recent review came to a similar conclusion:

“Elderberry may be a safe option for treating viral respiratory illness, and there is no evidence that it overstimulates the immune system. However, the evidence on both benefits and harms is uncertain and information from recent and ongoing studies is necessary to make firm conclusions.” (BMC Complementary Medicine and Therapies, April 7, 2021)

Coronavirus Questions:

Researchers in Taiwan found that the extract of Formosan elderberry is active against a common human coronavirus called NL63 (Virus Research, Nov. 2019). NL63 normally causes colds and other upper respiratory infections. Needless to say, no one has had a chance to study elderberry extract as a treatment for SARS-CoV-2, the coronavirus that causes COVID-19. Consequently, we do not know whether it would be helpful for a mild case.

Finding a High-Quality Elderberry Extract:

According to ConsumerLab.com, some popular elderberry products don’t actually contain much elderberry. The amounts of important compounds called anthocyanosides varied widely. Its analysis revealed that New Chapter Elderberry Force had the most. Please read the entire report for all the details.

ConsumerLab.com did not test a few elderberry products that we like. Gaia Herbs, formerly an underwriter of our radio show and podcast, takes great care with the purity and potency of its botanical medicines. The company also practices transparency through its Meet Your Herbs program. You will find elderberry extract as tablets, in syrup and in tonic at the website, GaiaHerbs.com. If you prefer gummies, Gaia Herbs makes delicious Black Elderberry Extra Strength Gummies.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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