elderberry

Elderberry is the dark-colored fruit of the European, or black, elder tree (Sambucus nigra), a plant found across Europe, North America, western Asia, and North Africa. The berries are cooked and sold as dietary supplements in a range of forms, including syrups, gummies, lozenges, capsules, and teas, and the plant has a long tradition of use in folk medicine.

Relatively few studies have looked at elderberry, and most of them focus on colds, flu, and other upper respiratory infections, with little research on other uses. According to NCCIH, some preliminary research suggests elderberry may help relieve symptoms of flu, colds, or other upper respiratory infections, but conclusive evidence from high-quality clinical trials is lacking, so it isn't established that the supplement works. There isn't enough information to know whether elderberry helps with any other health conditions, and there is no good evidence that it prevents or treats COVID-19. The FDA and Federal Trade Commission have acted against companies that marketed elderberry products with unsubstantiated claims.

There is no established or government-recommended dose for elderberry, and authoritative NCCIH sources do not specify standardized amounts. Because commercial products differ widely in concentration and form (syrups, gummies, capsules, lozenges), follow the directions on the individual product label. Given that evidence of benefit is limited and elderberry could affect the rest of your care, talk with your doctor or pharmacist before starting it, especially if you are pregnant, breastfeeding, or managing a health condition.

Cooked elderberries and commercially manufactured elderberry supplements are generally considered safe for most people. However, raw or unripe berries, along with other parts of the elder plant such as the leaves and stems, contain cyanide-producing substances that can be poisonous; cooking the berries removes this toxin. Little is known about whether elderberry is safe to use for health purposes during pregnancy or while breastfeeding, so it is best avoided in those situations unless a clinician advises otherwise.

Consuming raw or unripe elderberries, or other parts of the plant, can cause nausea, vomiting, and severe diarrhea because of their cyanide-producing compounds, and eating large amounts may lead to more serious illness. Cooked berries and manufactured supplements are much less likely to cause these effects, but, as with any supplement, individual reactions remain possible.

NCCIH cautions that some herbs and medicines can interact in harmful ways. The authoritative sources do not list any specific, confirmed elderberry-drug interactions, but because interactions are possible, you should tell all of your healthcare providers about any elderberry product you use and check with a doctor or pharmacist before combining it with prescription or over-the-counter medications.