Elderberry for Colds and Flu: Does It Actually Work? Here's What the Research Says

Elderberry syrup and a cup of tea, a popular home remedy for colds

Elderberry may modestly shorten a cold or the flu, but the evidence is small and low in certainty, it hasn't been shown to prevent illness, and raw elderberries are toxic. If you're curious, here's what the best studies found, how to use it safely, and who should skip it.

What Is Elderberry?

Elderberry is the dark purple berry of the European or black elder tree (Sambucus nigra). It has a long history in folk medicine for colds and flu, and today it's sold as syrups, capsules, and gummies.

What the Research Actually Shows

The National Center for Complementary and Integrative Health (NCCIH) says only a small number of studies have looked at elderberry for colds, flu, and other upper respiratory infections, and that some preliminary research suggests it may relieve symptoms. Here are the key findings:

  • A 2019 meta-analysis in Complementary Therapies in Medicine pooled four randomized trials with a total of 180 participants. It found that elderberry supplementation reduced the duration and severity of upper respiratory symptoms from colds and flu.
  • A 2016 air-travel trial gave elderberry extract to 312 economy-class passengers on long-haul flights. Among those who developed a cold, symptoms were milder and lasted about two days less. But elderberry didn't reduce how many people got sick, and only 29 people developed cold symptoms, so the result rests on a small group.
  • Flu studies have reported symptoms ending 3 to 4 days sooner when elderberry was started at the onset of symptoms. These were small studies in adults.
  • Children: A 2020 randomized trial in 87 children with flu found no benefit.
  • Overall certainty: A 2021 systematic review (Wieland et al.) judged the overall evidence for elderberry in viral respiratory illness to be low to very low certainty.

In plain English: there's a possible small benefit, but nothing you should count on.

Evidence at a Glance

Question What the evidence says
Can it shorten a cold or the flu? Possibly, by a couple of days in small studies. Low certainty.
Does it prevent colds? Not shown. In the air-travel trial, it didn't reduce how many people got sick.
Does it work for children? Studies are mostly in adults, and a 2020 trial in children with flu found no benefit.
Does it help with COVID-19? No good evidence.
Is it safe raw? No. Raw or unripe elderberries are toxic.

What It Hasn't Been Shown to Do

Prevent infection. The air-travel trial found no drop in the number of people who caught a cold.

Reliably boost immunity. There isn't enough high-quality evidence to say elderberry prevents viral infections or improves immune function in a predictable way for healthy people. The same goes for other trendy "immune boosters," like cold showers.

Treat or prevent COVID-19. NCCIH says no published studies have evaluated elderberry for COVID-19 and that people shouldn't rely on it. The FDA has also acted against unsubstantiated claims that elderberry prevents or treats diseases, including COVID-19.

Safety: Raw Elderberries Are Toxic

Raw or unripe elderberries, along with the leaves, stems, and bark of the elder tree, contain cyanide-producing compounds that can cause nausea, vomiting, and severe diarrhea. Neurological symptoms like weakness and dizziness have also been reported. Cooking eliminates the toxin. In one reported case, 11 people got sick after drinking juice made from raw elderberries, leaves, and branches. Some people can also have an allergic reaction to elderberry extracts.

Who Should Skip It or Ask First

  • Pregnant or breastfeeding women: NCCIH says little is known about safety, and Memorial Sloan Kettering advises avoiding it.
  • Children: Most studies are in adults, so it's hard to make evidence-based recommendations for kids. Talk to your pediatrician first, and check labels, because added ingredients in syrups and gummies can change the safety profile.
  • People with allergies, chronic illness, or immune conditions: Elderberry is promoted as immune-stimulating, so ask your doctor first, especially if you take medications that affect your immune system.

If You Want to Try It

  • Never eat raw elderberries or any other part of the plant. Use a properly prepared commercial product, or cook the berries thoroughly.
  • Start at the first sign of symptoms. That's when the studies gave it.
  • Follow the product label. Studies used different extracts and doses, and there's no proven dose.
  • Check the label for added ingredients, especially in gummies and syrups.
  • Stop if you get nausea, vomiting, diarrhea, or an allergic reaction.
  • Don't use it in place of medical care or the flu shot.

What Helps Instead (or Alongside)

For a cough, see what the research says about honey for cough (not for babies under 1). For children under 6, Mayo Clinic advises against over-the-counter cough and cold medicines, except fever reducers and pain relievers, so ask your pediatrician what's safe.

See a doctor if a cough lasts more than a few weeks, or comes with fever, shortness of breath, wheezing, fainting, or bloody or pink-tinged phlegm.

The Bottom Line

Elderberry isn't a cold cure, and it isn't hype with nothing behind it. Small trials suggest it might shorten symptoms by a couple of days, but the evidence is low in certainty, it hasn't been shown to prevent illness, and it's not for pregnancy or raw use. If you try it, use a properly prepared product and keep your expectations modest.

Frequently Asked Questions

Does elderberry cure colds or flu?
No. Small studies suggest it may modestly shorten symptoms, but the overall evidence is low in certainty.

Does elderberry prevent colds?
It hasn't been shown to. In the air-travel trial, elderberry didn't reduce how many people got sick.

Is elderberry safe for kids?
Most studies are in adults, and a 2020 trial in children with flu found no benefit. Ask your pediatrician first, and never give children raw elderberries or other parts of the plant.

Can I eat raw elderberries?
No. Raw or unripe elderberries are toxic and can cause nausea, vomiting, and severe diarrhea. Cooking eliminates the toxin.

Does elderberry help with COVID-19?
There's no good evidence that it does. NCCIH advises against relying on it.

Is elderberry safe during pregnancy?
Little is known, and Memorial Sloan Kettering advises avoiding it. Ask your doctor.

Sources: NCCIH (NIH), "Elderberry"; Hawkins et al., Complementary Therapies in Medicine (2019;42:361-365); Tiralongo et al., Nutrients (2016;8:182); Wieland et al., BMC Complementary Medicine and Therapies (2021), "Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review"; Martini, Journal of Primary Health Care (2021), "Elderberry"; Memorial Sloan Kettering Cancer Center, "Elderberry" (About Herbs); Children's Mercy Kansas City, "Elderberry: Is the Herbal Remedy Safe for Kids?" (2021); Mayo Clinic, "Cough: When to see a doctor" and "Honey: An effective cough remedy?"

Looking for more evidence-based home remedies? See whether apple cider vinegar helps acid reflux.

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