What Is It?
Health Benefits
Dosage Information
Guidelines for Use
General Interaction
Possible Side Effects
Evidence Based Rating Scale

What Is It?

The elder shrub (Sambucus nigra L.) has long been famed as a source of the blue-black berries used to make elderberry wine and jelly. More important, its berries and flowers have been used medicinally for centuries to fight off respiratory infections and other ailments. American elder (Sambucus candensis L.) is found in the eastern part of North America.

What accounts for the plant's therapeutic properties is not well understood, but its healing effects are thought to originate in substances called flavonoids, which affect the body in a variety of ways. As antihistamines, flavonoids can be useful in the treatment of allergies. As antioxidants, they help counteract the cell destruction caused by toxic molecules called free radicals. And as antivirals, they aid the body in fighting off infection, which makes the elder a clinically very useful plant.

Although the effects of elder have not been clearly demonstrated in clinical trials, traditional medicine holds that elder is a diuretic (meaning it increases urination) and that it helps ease coughs. And many sources accept that the herb increases perspiration because of its long history and the results of animal studies.

Elder is part of the healing traditions of Greece and parts of Europe, and has also been incorporated into the Indian system of Ayurvedic medicine.

Health Benefits

Acting as an antioxidant, elder may protect the body against damage from free radicals. And although the action has not been conclusively proven, elder's long history as an herb used to promote sweating and urination may explain why it is believed to "flush out" colds and flu. It also has a reputation as an anti-inflammatory, but there is virtually no evidence to support this claim.

Specifically, elder flower may help to:

·  Fight flu and feverish colds. Sweating has long been used in many healing traditions to help "break" a fever. Because elder tends to produce perspiration, it may help the body to shed the viruses that cause colds and flu, although this is unproven. As drinking lots of fluids is known to hasten the duration of a fever, the diuretic effects of elder might help cold sufferers in a similar way.

In a study conducted on 60 adults infected with influenza A or B the treatment group receiving elderberry syrup, showed signs of improvement four days prior to the group receiving a placebo (1). The group receiving elderberry syrup also used less medication to combat the symptoms of their illness. The study concluded that elderberry is safe and cost-effective treatment for influenza, however larger trials are needed to prove efficacy in the population at large.  

Similar results were seen in a trial conducted on an influenza outbreak in Panama. This study revealed that in the group receiving the elderberry extract, 93.3% showed significant improvement in flu symptoms and fever after 2 days of starting elderberry extract supplementation. The average time to complete cure of the virus measured 2 to 3 days for the elderberry group versus 6 days for the non-elderberry group (2). These are promising results; scientists are quickly trying to ascertain whether what dosage and what length of treatment will be efficacious for the general public (3).

·  Control cough. A cup of elder flower tea may help to break up the bronchial secretions of chest colds and relieve coughs. It's uncertain, however, whether this results from an action of the herb itself, or from the heat and steam produced by the tea, which loosen mucus and make it easier to expel.

·  Protect against high cholesterol. Results from a small trial studying healthy adults showed the elderberry juice spray exhibited a small antioxidant effect and blood cholesterol (4). This study only included 34 participants, so more research is needed to determine what the optimal dose of elderberry juice to protect your heart health. As cardiovascular disease is a leading cause of disease in the U.S., this will be a very exciting field of inquiry in the coming years.  

·  Prevent free radical damage to cellular DNA. In preliminary lab research berry combination formulas containing elderberry helped to restrict tumor growth by cutting off blood vessels that supply tumors with life-sustaining blood (5). In some cases it reduced tumor growth by as much as 50%. These results while promising, do not offer conclusive results as to elderberry’s effectiveness in preventing tumor growth. More research will be needed to determine if berry formulations can be adjunctive or standard treatments for cancer (6).

·  Help fight viral infection such as herpes and HIV. Although research in this area is only in the beginning stages, elder extract is being investigated as a potential therapy for herpes and HIV because of its strong anti-viral properties. In preliminary trials of feline HIV (chosen because of the virus’s biological and pathological similarity to HIV) researchers found that elderberry may be an effective anti-vial agent against FIV (7). Of course, more research is needed before elderberry is accepted as a beneficial treatment in human HIV. However, as the spread of this disease progresses around the globe, more and more research will need to be conducted on integrative and cost-effective measures to treat this serious condition.

Note: If you are being treated for high cholesterol, cancer, herpes or HIV infection then you should consult your doctor before beginning elderberry supplementation. Elderberry alone cannot be used as a first line of defense in treating these conditions. Do not discontinue your prescription medication in favor of treatment with elder extract.


  • liquid
  • capsule
  • tea

Dosage Information

Special tips: --Store dried elder flowers in an airtight container that protects them from light and moisture.

--To use commercial preparations containing elder, follow the package directions.

--Elder is often sold in combination products for reducing fever, which blend it with yarrow flower and peppermint leaf.

For flu, cold, or cough: 1 to 2 teaspoons liquid extract (mixed with water) or a cup of elder tea, three to four times a day.

Guidelines for Use


·  To make tea, use 2 teaspoons of dried flowers per cup of water; drink as hot as possible.

·  Make fresh elder flower tea every time, rather than brewing large quantities.

Be sure to check out our Dosage Recommendation Chart which lists therapeutic dosages for specific ailments at a glance.

General Interaction

·  There are no known drug or nutrient interactions associated with elder.

Possible Side Effects

·  With normal use, there are no side effects associated with elder. Although the ripe berries are edible, if they are eaten raw or unripe they may cause nause, vomiting or diarrhea.



·  The flowers and ripe fruit of elderberry are safe to consume, especially when dried or cooked.

·  Elder roots, leaves, and stems can cause diarrhea, nausea, and vomiting, and should not be taken internally. The stems actually contain the potentially fatal poison, cyanide--do not consume them.

Evidence Based Rating Scale

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.


Supplement/ Therapy














Naturopathic physicians recommend using to help break up mucus. Organized studies are needed to measure benefit.









Some trials have shown benefit in reducing the duration of illness.





herpes/ HIV






Only preliminary animal studies at this time. More research is necessary before human trials can be conducted.





high cholesterol





Small preliminary trial shows benefit. Larger trials of longer duration needed before elder can be recommended as a standard treatment.



  1. Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res. 2004 Mar-Apr;32(2):132-40.
  2. Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M. 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 Panama. J Altern Complement Med. 1995 Winter;1(4):361-9.
  3. Jaber R. Respiratory and allergic diseases: from upper respiratory tract infections to asthma. Prim Care. 2002 Jun;29(2):231-61.
  4. Murkovic M, Abuja PM, Bergmann AR, Zirngast A, Adam U, Winklhofer-Roob BM, Toplak H. Effects of elderberry juice on fasting and postprandial serum lipids and low-density lipoprotein oxidation in healthy volunteers: a randomized, double-blind, placebo-controlled study. Eur J Clin Nutr. 2004 Feb;58(2):244-9.
  5. Bagchi D, Sen CK, Bagchi M, Atalay M. Anti-angiogenic, antioxidant, and anti-carcinogenic properties of a no
    Date Published: 04/18/2005
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