Everything You Need to Know About Elderberry

Cold and flu season comes every year when the temperatures drop. The chorus of coughing and sneezing starts to sound in the office, and at the same time, out come the tea, hand sanitizer, and vitamin C to keep the germs away. The search for anything and everything to boost the immune system starts. And one of the latest superfoods touted to help keep you healthy in cold months is the elderberry. "Elderberry recipes" are trending on Pinterest, and the purple berry is popping up in tons of immunity-supporting supplements, from gummies to lozenges to syrups.

But are elderberries actually a legit immunity booster? We asked an RD and a doctor to weigh in on the elderberry's health benefits.

What are elderberries?

"Elderberries are found in North America, Europe, Asia, and Northern Africa," says Seattle-based registered dietitian Ginger Hultin, spokesperson for the Academy of Nutrition and Dietetics and owner of Champagne Nutrition. "They can be used in cooking, often in desserts like other berries, and also have some medicinal benefits that likely come from their unique antioxidants."

As with other types of berries, elderberries are also rich in vitamin C and fiber. One cup of raw elderberries nutrients contains 10.2 grams of fiber and 52.2 milligrams of vitamin C.

The elderberry plant, called Sambucus nigra, has many parts, but it's the flowers and berries that pack the immunity punch.

What are elderberries used for?

Elderberries have been found to help minimize flu symptoms in a number of small studies, thanks to their antiviral properties. "There is evidence to show that they can support human immune systems in time of illness, so it's not surprising that they're emerging as a superfood now," Hultin says of the berries.

A 2019 study published in the Journal of Functional Foods found that compounds called anthocyanidin (phytonutrients that give elderberries their purple color) were found to inhibit the flu virus's entry and replication in human cells. Not only that, but it was also found to help strengthen the body's immune response to the flu virus.

Another study published in the Journal of International Medical Research also found that elderberry syrup was effective at shortening symptoms of the flu. The study participants took either a placebo or 15 milliliters of elderberry syrup four times a day for five days. The group that took the elderberry reported improvement of flu symptoms after three to four days, while the placebo group reported the same seven to eight days into the illness.

There's also a third study that had similar findings. A 2009 study published in the Online Journal of Pharmacology and PharmacoKinetics used elderberry extract lozenges for its study participants. Sixty-four study participants were divided into two groups, a placebo group and another that was given four doses of elderberry extract lozenges for two days. After 24 hours, the elderberry group self-reported significant improvement of their flu-like symptoms. And within 48 hours, 28 percent of the elderberry group reported they were totally void of all symptoms, while none in the placebo group reported the same thing.

Should you try elderberry supplements?

Like all herbal supplements, the FDA does not regulate them, meaning safety and standardization (making sure each batch has the same/correct potency) are up to the manufacturers and distributors.

"That doesn't mean there aren't good quality, trustworthy supplements out there, because there are," Hultin says. "Many companies pay for third-party testing to ensure purity and standardization of their products, so that's always something to check for on a label." She suggests checking out the FDA's website for tips on how to find the best dietary supplements.

And while many recipes can be found online for elderberry syrup, it's important to know that it can be extremely risky.

"You have to be really careful if you're doing your own at home," says Elizabeth Bradley, MD, medical director of the Center for Functional Medicine at the Cleveland Clinic. "You don't want to be taking in flowers and berries whole and raw. Ingesting uncooked elderberries can lead to poisoning."

Elderberries also contain cyanogenic glycosides, a toxic compound, so they need to be cooked to prevent cyanide poisoning. For that reason, you're better off buying pre-made elderberry products.

"I wouldn't recommend anything raw, and I suggest shying away from making your own," says Dr. Bradley. "You should take it if you're being exposed to more people and situations where you might get the flu (like in flu season), but pay attention to dosing instructions to avoid ending up with GI symptoms."

Are there any negative side effects of eating elderberry products?

Aside from the risk of cyanide poisoning (which you shouldn't have if you're using a safe elderberry supplement), other side effects of taking too much elderberry include gastric issues, like nausea, vomiting, and diarrhea, says Dr. Bradley.

And because many elderberry products come in syrup or gummy form, you'll want to pay attention to sugar content, too. Dr. Bradley recommends looking for gummies or syrup with less than five grams of sugar per serving.

Of course, elderberries are no substitute for the flu vaccine or medical help if you truly have a bad case of the flu.

"The most important thing to understand is that, if a person has flu-like symptoms, they need to seek medical attention," says Hultin. "They can inquire as to whether or not elderberry is safe for them as there are some potential interactions with medications that may need guidance, including immunosuppressants. Influenza is a very serious disease and should be supported by a medical team for safety."

If you're experiencing flu-like symptoms, elderberry products can be a useful way to relieve some of the pain associated with the illness. But the flu is still a serious condition that requires medical treatment, and elderberry products are a supplement, not a replacement for medical help.