Elderberry is one of the oldest and most commonly used medicinal plants in the world and has long been a go-to remedy for treating inflammation and upper respiratory diseases. But is elderberry’s reputation warranted? Does elderberry really work for colds? And is elderberry good for the flu?
Modern-day science has discovered numerous health benefits of elderberry as it relates to the common cold, influenza, and other types of immun suppressant conditions. What we want to know is whether or not elderberry can actually help you recover more quickly if your immune system us under attack.
What Is Elderberry?
The elderberry plant (Sambucus nigra, S. canadensis, S. caerulea), also known as Black Elder, European Elder, and Elder Flower, belongs to a family of flowering shrubs known as Sambucus or Elder. Originally native to Europe, this family of plants has now become naturalized in many parts of the world, including the U.S.
Cultivated for both medicinal and food purposes, the dark purple-black Sambucus berries are traditionally used to make teas, jams, pies, syrups, cordials, and wine.
Sambucus Nigra Is Recognized as a Safe Herbal Supplement
Sambucus nigra (black elderberry or Black Elder) is widely available commercially in the form of tablets, capsules, syrups, and gummies. In general, elderberry products are considered to be herbal supplements and are not FDA-approved for any indication, although the FDA has classified Black Elder as GRAS or “generally recognised as safe”.
The European elderberry (S. nigra L) contains anthocyanins, flavonoids, and other bioactive polyphenolic compounds that have been shown to contribute to its powerful antioxidant capacity. Other species of elderberries also contain these compounds, including the American (S. canadensis) and Blue Elder (S. caerulea), but S. nigra L is the variant of elderberry most studied and the most commonly used in supplements.
The Health Benefits of Elderberry: Is Elderberry Good for Colds and Flu?
Hippocrates (The Father of Modern Medicine) is credited with proclaiming 2,000 years ago that “This plant of God heals anything it touches!” Folk healers agreed with him and have used black elderberry for centuries to treat flu, cold, and sinusitis and its associated symptoms such as cough and sore throat.
Modern-day scientific and clinical evidence concerning black elderberry’s antibacterial and antiviral properties appears to support the wisdom of these ancient healers.
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Elderberry Is Both Antibacterial & Antiviral
For instance, in laboratory experiments, a standardized elderberry liquid extract was shown to have antimicrobial activity against multiple bacterial species that are responsible for upper respiratory tract infections.
This liquid extract was also shown to block the propagation of human flu viruses in laboratory experiments. A virus cannot reproduce on its own, but can only do so inside the cells of its living hosts. Each infected host cell is forced to rapidly produce thousands of identical copies of the original virus. This is known as virus propagation.
Elderberry Helps Fight Flu & Herpes Viruses
Elderberry had also previously been reported to have antiviral activity against flu viruses and the herpes simplex viruses HSV-1 and HSV-2, which cause cold sores and genital herpes, respectively.
In a laboratory experiment, two bioactive flavonoid compounds from elderberry extract (S. nigra L) were shown to bind to human flu viral particles, and when bound, block the ability of these viruses to infect host cells. S. nigra L extract was also seen to inhibit infectious bronchitis virus at an early point during infection, likely by rendering the virus unable to infect host cells.
Sambucus Nigra Acts in Multiple Ways Against the Flu Virus
Similarly, researchers from the University of Sydney’s Faculty of Engineering and IT have shown that Black Elder juice was effective at stopping the flu virus from infecting human cells in culture.
To their surprise, Black Elder juice was much more effective at preventing viral propagation at later stages in the flu cycle, after the cells had already been infected with the virus. These results indicate that elderberry acts in multiple ways against flu viruses.
Is Elderberry an Effective Therapy for People with Viral Flu Infections?
In the early 2000s, researchers set out to determine whether or not elderberry is an effective therapy for the flu. They conducted a study on 60 patients from Norway between the ages of 18 and 54 years during a time when influenza was present in the community. The study participants, who were all suffering from flu-like symptoms for 48 hours or less, were given 15 ml of elderberry or placebo syrup 4 times daily for 5 days as part of a randomized, double-blind, placebo-controlled study.
Faster Recovery & Less Medication Needed for Elderberry Group
The study authors noted that relative to patients receiving placebo, those receiving elderberry extract showed relief from their flu-like symptoms up to 4 days earlier, significantly lowering the need for rescue medication.
The researchers concluded that elderberry extract offers an efficient, safe, and cost-effective treatment for the flu, but noted that their findings needed to be confirmed in a larger study.
Significant Improvement in Symptoms
Similarly, a standardised elderberry extract (Now®) has been shown to prevent replication of at least 10 variants of human flu viruses in laboratory experiments. To test its effectiveness in people, a placebo-controlled, double blind study was carried out on a group of individuals who were treated either with the elderberry extract or control extract during an outbreak of the flu.
A significant improvement in symptoms, including fever, was seen in 93.3% of the individuals in the Sambucol-treated group within 2 days. In contrast, 91.7% of the patients in the control group showed an improvement, but only within 6 days. A complete cure was achieved within 2-3 days in nearly 90% of the Sambucol-treated group, but only within at least 6 days in the control group.
Considering the efficacy of the elderberry extract on the many strains of the flu virus in laboratory studies, the clinical results, its low cost, and absence of side-effects, the study authors stated they believed that this preparation could be a safe and effective flu treatment.
Does Elderberry Work for Colds?
A randomized, double-blind placebo-controlled clinical trial of 312 economy class passengers travelling from Australia to an overseas destination assessed the effects of treatment with Black Elder extract on cold episodes, duration, and symptoms.
More cold episodes were seen to occur in participants in the placebo group than in the elderberry extract group. Participants in the placebo group also had a significantly longer duration of cold episode days, with more reported symptoms – indicating that Black Elder extract significantly reduced cold duration and severity in these air travelers.
Black Elderberry for Upper Respiratory Infections
In 2019, a meta-analysis was carried out to quantify the effects of Black Elder supplementation on upper respiratory infections. In a total of 180 participants, supplementation was found to significantly reduce upper respiratory symptoms due to viral infections, suggesting thatBlack Elder might be an effective and safer alternative to prescription drugs for upper respiratory infections.
In a review article, scientists at Natural Standard Research Collaboration (NSRC), which evaluates natural therapies, assessed the results of three human trials on elderberries involving a total of 151 patients taking syrups or lozenges. In their assessment, the NSRC scientists gave the berry a grade of “B” denoting “good scientific evidence” for treatment of the flu, but stated that more research was needed.
Outlier Study Finds No Benefit
However, not all clinical studies on elderberry have had such positive outcomes. A study published in 2020 examined the results of 87 patients who had tested positive for the flu. These patients were randomly assigned to receive elderberry extract or a placebo for 5 days. At the end of the study, no differences were seen in the severity or duration of flu symptoms between the elderberry and placebo groups. Aware that their study results contradicted previous studies, the authors recommended that further studies were needed.
The Health Benefits of Elderberry for the Immune System
There is growing evidence to indicate that elderberry acts directly on the immune system. For instance, in laboratory experiments, three standardized black elderberry preparations were seen to increase production of five different pro- and anti-inflammatory cytokines. In particular, the production of pro-inflammatory cytokines was significantly increased, specifically a cytokine known as TNF-alpha.
Cytokines are a broad category of small proteins, also known as peptides, that play an important role in signaling between cells, including immune cells. In other words, black elderberry formulations may directly act on the immune system, potentially offering therapeutic benefits in patients with diseases in which their immune system is suppressed.
Elderberry Is Rich in Antioxidants
Dietary anthocyanins have been shown to reduce inflammation in animal models and black elderberry is one of the richest sources of anthocyanins. In laboratory experiments, black elderberry extract (as well as anthocyanins on their own) have been shown to reduce oxidative stress and combat inflammation.
Similarly, bioactive polyphenols extracted from Sambucus nigra were seen to increase levels of anti-inflammatory cytokines in an animal model of insulin-deficient diabetes.
Can Elderberry Help with Certain Kinds of Cancer?
Do the health benefits of elderberry even extend to cancer? In laboratory experiments, the effects of various fractions of Black Elder flower extracts were tested on bladder carcinoma cells. Of these, the butanolic fraction containing various bioactive flavonoid compounds was seen to have selectively toxic effects on bladder carcinoma cells.
Both cultivated Black Elder and wild American Elder berries show significant anticancer potential. Specifically, fractions of American Elder extract were seen to inhibit an enzyme known as ornithine decarboxylase, thereby affecting the promotion or proliferation stage of cancer formation.
Similarly, in laboratory experiments, treatment with a lectin compound from another species of Sambucus (S. sieboldiana) was seen to sensitize cancer cells to cell death.
Elderberry for Metabolic Dysfunction, Heart Health, HIV-AIDS & Constipation
Other potential health benefits of elderberry have to do with weight management and heart health. In a 2015 study, the effects of Black Elder extract were assessed in an animal model of obesity. After 16 weeks, animals given the extract showed significantly lower levels of serum insulin and triglycerides, along with improvements in markers of inflammation and insulin resistance – a condition which typically leads to diabetes.
Diminished Hardening of the Arteries
High-density lipoprotein cholesterol (HDL-C) is a risk factor that is considered to be protective against atherosclerosis (hardening of the arteries) and heart disease. The efficacy of Black Elder extract containing 13% anthocyanins was assessed in a laboratory animal model of hyperlipidemia and HDL-C dysfunction.
Although blood lipids did not differ significantly between groups after 6 weeks, the study authors observed significant reductions in atherosclerosis progression in animals given the Black Elder extract.
Elderberry and HIV-1/AIDS
Flavonoid compounds present in elderberry (and also in cinnamon and green tea), have been shown to bind to HIV-1 viruses and block their ability to infect their target cells . Additionally, elderberry extract was seen to have additive effects with enfuvirtide, a peptide HIV-1 fusion inhibitor.
Elderberry Is an Effective Treatment for Constipation
In a randomized, crossover, placebo-controlled, single-blinded trial with 20 patients presenting with chronic constipation, a phytotherapeutic (plant-based medicine) compound containing Black Elder was seen to be an effective laxative when taken for a 5-day period.
Do Not Consume Raw Elderberry
Although they have long been cultivated for medicinal and food purposes and the health benefits of elderberry are well-documented, they are not without some risk. Most importantly: elderberries should not be consumed raw! Uncooked elderberries contain poisonous cyanogenic glycosides and must be cooked properly before consumption, to avoid the risk of dangerous cyanide toxicity.
Elderberry leaves and stems also contain cyanogenic glycosides. After ingesting elderberry juice made from raw elderberries, leaves, and branches, people have experienced nausea, vomiting, dizziness, and numbness along with severe neurologic symptoms.
Elderberry and elderberry-containing products may have additive effects with antidiabetic drugs, diuretics , and laxatives.Be sure to consult with your doctor or a pharmacist before consuming elderberry if you are taking medication or have a health condition.