Can Elderberry Cure Your Cold Symptoms?

The supplements are marketed as an immune-boosting remedy, but like all pills and potions, can come with risks for some

Kimberly Goad,

AARP

Comments

En español

Published February 19, 2025

Getty Images

You’re laid low by a fever, chills, runny nose, congestion. Can elderberry deliver relief?

Thanks to what are believed to be the herbal supplement’s immune-boosting superpowers (the tiny purple berry is loaded with vitamins and antioxidants), elderberry is having something of a moment.

A growing number of people are reaching for elderberry juice, syrup, gummies, capsules, tea and tablets to help them power their way through a cold or the flu, while others are simply looking to reap the perceived health benefits. All, despite the fact that high-quality research into whether elderberry actually helps prevent and treat common respiratory infections is lacking, and the small studies that do exist are far from conclusive.

Complicating matters, elderberry supplements — like all herbal supplements — are not subjected to the same rigorous testing, manufacturing and labeling standards as prescription and over-the-counter medications.

For example, the label on an herbal supplement can include broad promises about the product’s impact on the body — that it “reduces stress” or “promotes digestive comfort.” And unlike highly scrutinized prescription and over-the-counter medications, standardization with supplements is lacking.

“Unlike with pharmaceutical drugs, there’s no requirement that botanicals need to be prepared in any standardized way,” says Pieter Cohen, M.D., an internist at Cambridge Health Alliance and associate professor of medicine at Harvard Medical School, who studies supplement safety. “What we’ve found when we analyze botanical supplements is that the amount of active compound varies widely from one brand to another. So when you go to the store and buy elderberry, you have no idea what you’re getting.”

What is elderberry?

According to The Plant Humanities Lab, the dark violet-black berry’s beginning as a go-to for colds and flu dates back to 400 B.C. That’s when Hippocrates — the Greek physician known as the “father of medicine” — called the elder plant his “medicine chest” because of the many health woes it seemed to treat — from constipation to hemorrhoids to insect bites and upper respiratory infections.

Although there are a number of elderberry varieties, it’s the black elderberry (Sambucus nigra) that’s believed to possess the most immune-boosting bona fides. It’s among the richest sources of plant compounds known as polyphenols, specifically anthocyanins, which have been shown to help immune function.

Supplements aren’t without risks, side effects

When people are considering any health intervention, they should take two things into account, says Mary L. Hardy, M.D., a botanical medicine and integrative medicine expert with the Academy of Integrative Health and Medicine. “The first is safety, and a close second is efficacy. Is it safe, and does it work?”

Apart from the big caveat with elderberry — when eaten raw, the berries can be poisonous and make you sick — “it has a good safety record,” says Hardy, citing a review of studies published in 2021 in BMC Complementary Medicine and Therapies. Although the researchers found that the evidence for effectiveness was mixed, they concluded that the herb appeared to be a safe option for soothing upper respiratory symptoms.

It’s easy to assume that anything as ubiquitous as elderberry — supplements are sold online and on store shelves — isn’t capable of doing serious harm. But doctors and public health professionals caution that’s not true, especially for people with chronic conditions.

“Elderberry may overstimulate the immune system, which can worsen autoimmune diseases such as rheumatoid arthritis, lupus, or multiple sclerosis, and it can react with certain medications or cause upset stomach,” says Maria Portela, M.D., associate professor at George Washington School of Medicine and Health Sciences and chief of Family Medicine.

If you have a high fever or a preexisting condition like COPD (chronic obstructive pulmonary disease) or diabetes, in addition to those mentioned above, talk to your doctor before taking any supplement.

Another consideration: “Elderberry may help relieve symptoms, but it shouldn’t replace antiviral medications such as oseltamivir (Tamiflu) or baloxavir (Xofluza) for high-risk populations such as people who are immunocompromised,” Portela says. “Unlike elderberry, these medications have undergone rigorous clinical trials and are FDA-approved for influenza treatment," she says.

If you take any type of medicine or supplement, you should also check with your doctor before trying elderberry.

“Elderberry and other botanical supplements can interact with other medications or supplements and might have other side effects,” Cohen says. “In the case of elderberry, it might have a diuretic effect or make people a little dehydrated. But that effect is unpredictable because you can’t really know how much of the active ingredient is in the supplement. Because of the lack of standardization, you’re in a bind.”

Shopping for supplements: What to look for

If your doctor gives you the green light and you want to add elderberry to your cold and flu cabinet, some clues on the label can help you choose wisely, Hardy says.

For instance, in addition to the common name (elderberry), look for the botanical name (Sambucus nigra) on the label. “If I picked up an herbal product and it had the common name but not the scientific name, I would put that product back,” Hardy says.

In addition, she says, “a good label will also tell you which part of the plant was used (that should be the berry); how the product was managed (for instance, as crushed dried berry or as an extract); as well as how much of a marker compound is in that extract.” In herbal supplements, the quantity of a marker compound is a tip-off to the quality of the product.

Although there are no guarantees that herbal supplements will live up to their claims or be side-effect-free, the following seals of approval offer some assurance that what’s on the label matches what’s in the product: USP (United States Pharmacopeia), NSF (NSF International), or CL (ConsumerLab.com). All of these indicate the product has been tested, audited and certified by an independent organization, “though it’s important to remember that doing so doesn’t guarantee a product’s safety,” Portela says.

Bottom line: “Elderberry supplements may offer mild benefits in reducing the duration and severity of colds or flu,” Portela says. “It should not, however, replace flu vaccines, antiviral medications, or supportive treatments such as hydration and rest.”

%{postComment}%

Kimberly Goad is a New York-based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Prevention, Health and Reader's Digest.