Native Americans used tea made from elderberry flowers to treat respiratory infections. They also used the leaves and flowers in poultices applied to wounds, and the bark, suitably aged, as a laxative. The berries are frequently made into beverages, pies, and preserves, but they have also been used to treat arthritis.
A product containing elderberry, as well as small amounts of echinacea and bee propolis, has been widely marketed as a cold and flu remedy. Weak evidence suggests that this mixture may stimulate the immune system and also inhibit viral growth.1 In a preliminary double-blind study, this mixture was found to reduce symptoms and speed recovery from influenza A, the type of influenza for which flu shots are given.5 A few of the participants in this study had influenza B (a milder form of influenza), and the elderberry mixture appeared to be helpful for them as well. Another preliminary double-blind study evaluated people with influenza B, and also found benefit.2
Based on promising results in an uncontrolled study, researchers performed a small double-blind, placebo-controlled study on the potential benefits of elderberry for improving cholesterol levels.6 Unfortunately, at the dose used, no benefits were evident.
Elderberry-flower tea is made by steeping 3 to 5 g of dried flowers in 1 cup of boiling water for 10 to 15 minutes. A typical dosage is 1 cup 3 times daily. Standardized extracts should be taken according to the directions on the product's label.
Elderberry flowers are generally regarded as safe. Side effects are rare and consist primarily of occasional mild gastrointestinal distress or allergic reactions. Nonetheless, safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established.
1. Barak V, Halperin T, Kalickman I. The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw. 2001;12:290–296.
2. Zakay-Rones Z, Varsano N, Zlotnik M, et al. 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;1:361–369.
3. Shapira-Nahor B. The effect of Sambucol on HIV infection in vitro. Annual Israel Congress of Microbiology, February 6–7, 1995.
4. Morag A, Mumcuoglu M, Baybikov T, et al. Inhibition of sensitive and acyclovir-resistant HSV-1 strains by an elderberry extract in vitro [abstract]. Phylotherapie. 1997;25:97–98.
5. Zakay-Rones Z., Thom E., Wollan T., et al. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. Journal of International Medical Research. 2004;32:132-140.
6. Murkovic M, Abuja PM, Bergmann AR, et al. 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;58:244-9.
Last reviewed December 2015 by EBSCO CAM Review Board Last Updated: 12/15/2015