Elderberry has been used in traditional medicine for centuries.
© Illustration by Fei Meng
Elderberry has been revered for centuries as a go-to remedy for respiratory infections, fever, and inflammation — both acute and chronic.

The herb was detected in the charred remains of ancient settlements, leading some researchers to speculate that elder trees may have intentionally been cultivated thousands of years ago.

In traditional medicine, elderberry is used to treat diabetes, dry skin, diarrhea, headaches, constipation, conjunctivitis, rheumatism, and other ailments. Hippocrates, the "father of medicine," called elderberry his "medicine chest" because of its wide range of healing properties.

Ancient Egyptians used elderberry to treat burns and improve complexion. Native Americans used it to treat fever and cough, among other things. Elderberry was even featured in "The Family Physitian" (1696) as a remedy for scurvy, and it was a favorite plant among young boys for making popguns.

Elderberry gained modern recognition during the 1995 Panama flu epidemic, where it was reportedly used to combat the illness. A clinical trial conducted during the epidemic reported that nearly 90 percent of patients treated with elderberry extract fully recovered within two to three days, compared to six days or more for the placebo group.
elderberry epoch times
© Illustration by The Epoch Times, Shutterstock
Fun Facts
  • Native Americans used elderberry for a variety of purposes, including making flutes, which is why the elder tree is sometimes called the "tree of music."
  • The elder tree is often considered sacred in folklore, believed to protect homes from evil spirits.
  • Elderberries are used in jam, jelly, ice cream, wine, yogurt, pies, and herbal tea.
  • Elderflower cordial and elderberry wine were popular in medieval Europe and remain well-loved beverages today.
  • Some speculate that J.K. Rowling's "Elder Wand" in the "Harry Potter" series may have been inspired by the sacred and mystical associations of the elder tree in folklore.
Special Talents

Elderberry belongs to the Sambucus genus, which includes 20 species, but the most popular and extensively studied for immune support is black elderberry (Sambucus nigra), native to Europe, northern Africa, the Americas, and western Asia.

Due to its diverse blend of nutrients, elderberry can help combat acute illnesses like the common cold and possibly chronic diseases.

Its medicinal properties are largely attributed to its anthocyanins, the compounds responsible for elderberry's deep purple color. These antioxidants shield against inflammation and oxidative damage — two factors that can weaken the immune system.

In many countries, anthocyanins are prescribed as medicine because of their potential to protect against chronic conditions such as atherosclerosis.

Elderberries also contain vitamins A, B-complex, C, and E, essential minerals like zinc and magnesium, and antioxidants such as flavonols, carotenoids, phytosterols, and polyphenols, earning elderberry a reputation as a "superfruit."

1. Fights Colds and Flu

Research suggests that elderberry may help reduce the duration and severity of flu symptoms across several strains of influenza. Elderberry reduced the flu's duration by an average of four days in a clinical trial. When taken within 48 hours of symptom onset, elderberry significantly alleviated fever, headache, nasal congestion, and mucous discharge associated with the flu, according to a 2020 review. Symptoms in most adults improved by an average of 50 percent within two to four days. This effect may be due to elderberry's ability to block viral proteins, preventing viruses from infecting cells.

Elderberry also reduced cold symptoms in air travelers, according to a 2016 study.

2. Slows Cognitive Decline

A 2024 randomized controlled trial reported that patients with mild cognitive impairment who took elderberry for six months trended toward faster visuospatial problem-solving performance than controls. Several markers of inflammation were also reduced, which is significant because chronic inflammation is associated with cognitive decline. Elderberry juice shows promise in slowing Alzheimer's-related cognitive decline, the researchers concluded.

Similarly, a 2023 cell culture study highlighted elderberry's potential neuroprotective effects by demonstrating its ability to prevent oxidative stress-induced death of neuron-like cells, a major predictor of age-related cognitive decline. The findings suggest elderberry may address oxidative damage in neurological conditions, such as cognitive decline.

3. Combats Chronic Disease

Emerging research, primarily in animal and cell culture studies, suggests elderberry's potential in managing inflammatory and chronic conditions, although more studies are needed to confirm these effects in humans. Some of the most encouraging research is detailed below.

Heart Disease

In a placebo-controlled study, 34 healthy people consumed elderberry juice for two weeks. On average, participant cholesterol dropped from 199 to 190 milligrams per deciliter compared to the control group. The decrease was not statistically significant but did show a trend, leading the researchers to conclude that a higher dose may lead to a significant decrease. A second study reported that elderberry extract reduced aortic cholesterol levels in a widely used mouse model of atherosclerosis, indicating decreased progression of the condition.

A 2024 cell culture study found that elderberry inhibited foam cell formation, a critical step in atherosclerosis and heart disease, without triggering liver fat production. This suggests elderberry may help prevent heart disease by targeting the early stages of arterial plaque development, though further research is needed to confirm these effects in humans.

Diabetes

Elderberry has a history of being used as a traditional remedy for diabetes. In a 2016 study, four weeks of elderberry extract supplementation decreased insulin resistance and fasting blood sugar in Type 2 diabetic rats. Another study found that 16 weeks of black elderberry supplementation reduced insulin resistance, triglycerides, and inflammation in obese mice.

Huntington's Disease

Scientists are exploring the potential of elderberry as a therapy for Huntington's disease. In a 2021 study, compared with controls, rats with an experimental model of Huntington's disease demonstrated significant improvement in motor function and muscle coordination after treatment with elderberry.

Depression

Elderberry was also reported to be a natural antidepressant in a mouse model, according to a 2014 study. The researchers concluded that elderberry extracts "were safe and showed remarkable antidepressant activity."

Cancer

Black elderberry is rich in bioactive compounds, including antioxidants, that may contribute to cancer prevention and support cancer treatment. One notable compound, kaempferol — a flavonoid present in black elderberries — triggered the death of pancreatic cancer cells in both tumor-bearing mice and cell cultures, according to a 2021 study. Additionally, anthocyanins from elderberries caused melanoma cells to halt their proliferation and die in a 2017 cell culture study.

Other Possible Talents
  • Eczema: Topical elderberry treatment was as effective as hydrocortisone and scored better than hydrocortisone in quality of life in a 2021 randomized controlled trial involving 94 people with hand eczema.
  • Gingivitis: A 2022 randomized controlled trial found that elderberry-based mouthwash effectively targeted bacteria associated with periodontal disease. Researchers suggested it may help prevent the progression of gum disease. However, there is insufficient evidence to suggest superiority or recommend it over standard treatment, such as chlorhexidine mouthwash.
  • Stress Adaptation: Elderberry significantly helped rats adapt to chronic stress in a 2021 study. Specifically, elderberry lessened stress-induced behavioral changes by improving depression symptoms, cognition, and sexual behavior.
  • Seizure Reduction: Elderberry delayed the onset and duration of seizures in mice when convulsions were induced, according to a 2016 study.
Supporting Cast of Nutrients

Elderberry may have additive effects in combination with the following immune-supporting nutrients and ingredients:
  • Zinc and Vitamin C: When elderberry is combined with zinc and vitamin C — nutrients found in foods such as açai berries — it may decrease the duration and severity of a cold, according to a 2020 review.
  • Ginger: Known for its anti-inflammatory and antimicrobial properties, ginger can support elderberry by helping combat the flu and common cold, ease nausea and vomiting, soothe sore throats, and calm digestive discomfort.
  • Cloves: Used since ancient times to treat respiratory illnesses, clove adds to elderberry's infection-fighting power with its antiviral, antibacterial, and anti-inflammatory properties. As a natural expectorant, clove relieves colds, coughs, bronchitis, and other upper respiratory conditions.
  • Cinnamon: A warming spice with antioxidant, antiviral, and antimicrobial benefits, cinnamon is used in traditional medicine to protect against the common cold.
  • Honey: A natural preservative for elderberry syrup, honey is also packed with antimicrobial properties and soothes the throat. Compared with usual care, honey decreased cough frequency and severity of upper respiratory tract infections, according to a 2021 review. Its prebiotic effects support gut health, enhancing elderberry's immune-boosting effects, as up to 80 percent of the immune system resides in the gastrointestinal tract.
Recipe: Homemade Elderberry Syrup

This recipe is a powerhouse for immune support and is packed with anthocyanins and elderberry's supporting cast of nutrients. Plus, it's delicious!

Elderberry syrup can be consumed as is or added to juice, tea, smoothies, oatmeal, pancakes, açai bowls, or similar foods.

Use organic ingredients when possible.

Ingredients:
  • 2 cups dried elderberries (or 4 cups fresh)
  • 4 cups water
  • 1 cinnamon stick
  • 3 or 4 whole cloves, grated
  • 1 tablespoon fresh ginger, grated
  • 1 teaspoon ground açai berry
  • 1 cup raw honey (or substitute with maple syrup for infants under 1 year old)
Instructions:
  1. In a saucepan, combine elderberries, water, cinnamon, cloves, ginger, and açai.
  2. Bring to a boil, then reduce heat and simmer for 45 minutes.
  3. Remove from heat and let steep for 1 hour.
  4. Strain through a fine mesh sieve or cheesecloth, discarding solids.
  5. Let the liquid cool to room temperature, then stir in honey. Adjust the amount of honey based on the volume of elderberry decoction. Ensure the honey is at least half the amount of the liquid. For example, if you have 3 cups of decoction, add a minimum of 1 ½ cups of honey to prevent spoilage.
  6. Pour syrup into a sterilized jar and refrigerate for up to 2 months.
A common recommendation for adults is 1 tablespoon daily for prevention and up to 4 tablespoons daily when feeling unwell.

No-Fuss Ways to Get Elderberry

Elderberry can be purchased in various forms, including syrup, tea, juice, capsules, tablets, gummies, powders, tinctures, and lozenges.

Making your own or buying from a trusted source is recommended, as some elderberry products on the market may be adulterated.

Adulteration of elderberry products is widespread, with black rice extract and other unidentified materials commonly used as substitutes, according to a 2023 review. An analysis of 31 dietary supplements revealed that over 60 percent contained anthocyanin profiles inconsistent with authentic European elderberry, suggesting contamination with black rice, purple carrot, or S. nigra flowers — which contain significantly fewer anthocyanins than the berries.

Dosage

There is no established recommended dietary allowance (RDA) for elderberry. Limited evidence from clinical trials exists to establish dosage.

The dosage depends on product type and elderberry content. For example, one study used 1 tablespoon of elderberry syrup four times daily for adults with the flu. Regarding capsules, popular elderberry products range from 650 to 1,500 milligrams per day. Elderberry lozenges are often taken several times a day after a cold begins.

How to Optimize Absorption

To optimize the absorption of elderberry syrup, consider the following tips:
  • Take It With Food: Consuming elderberry syrup with a meal, especially one containing healthy fats, may enhance the absorption of its fat-soluble nutrients.
  • Pair It With Vitamin C: Combining elderberry syrup with vitamin C-rich foods (like oranges, bell peppers, or kiwi) can boost its immune-supportive effects.
  • Avoid Taking It With Coffee or Tea: Tannins and caffeine in coffee or tea can interfere with the absorption of some nutrients, so take elderberry syrup separately from these beverages.
  • Take It Consistently When Sick: Regular use, as directed, ensures its active compounds, such as anthocyanins, remain at effective levels in your system.
  • Use a Standardized Product: If you are not making your own, choose a syrup that is standardized for anthocyanin content to ensure you are getting a potent product.
  • Keep It Cool: Anthocyanins in elderberry juice decrease in content when exposed to heat, so keep the juice refrigerated.
Special Populations

Research is lacking to support the use of elderberry in pregnant or lactating women, according to a 2020 review. While elderberry may be safe for children over 1 year old, one review suggests that infants and children may be more susceptible to harmful effects, so use caution and consult a health care provider before use.

Elderberry stimulates the immune system, which can be beneficial for acute illness. However, some researchers are concerned it may overstimulate the immune system and increase the likelihood of a "cytokine storm," potentially exacerbating symptoms in people with autoimmune or chronic conditions.

However, a 2021 systematic review found no evidence that elderberry overstimulates the immune system and suggested the acute inflammatory response sometimes reported from elderberry consumption may decrease with continued supplementation.

Since the evidence is unclear, people with autoimmune diseases should consult a health care provider before using elderberry.

Toxicity

Raw or unripe elderberries, leaves, and stems contain cyanogenic glycosides, which can lead to nausea, vomiting, diarrhea, or serious illness when eaten. Cooking neutralizes these compounds. Elderberries also contain lectins, which can be toxic and cause an allergic reaction. Lectins can be neutralized by boiling elderberries for 10 minutes.

Elderberry is classified as generally recognized as safe (GRAS) by the U.S. Food and Drug Administration. However, human and long-term safety studies are lacking.

Interactions

Elderberry may interact with certain medications, such as:
  • Immunosuppressants
  • Diuretics
  • Diabetes medications
  • Steroids
  • Laxatives
  • Chemotherapy
  • Pazopanib
  • Theophylline
Consult a health care provider before using elderberry, especially if you are on medication.