What Is Elderberry Syrup? What to Know About Elderberries

Elderberry is an age-old remedy used to treat cold and flu symptoms, but its benefits may come with some risks. Here's what you need to know.

Elderberry: The rise of an age-old remedy

It took a modern-day pandemic to skyrocket the popularity of an age-old remedy. Interest in elderberry, along with other immune-boosting supplements, has risen with the Covid-19 pandemic, according to the American Botanical Council. But, will drinking a spoonful of the dark purple syrup really save you from days and nights of body aches, coughs, and sneezes? Should you maybe even buy elderberry soup?

Here’s everything you need to know about elderberry, a long-used, feel-better supplement for cold and flu season, including nutrition facts, benefits, and risks.

What is elderberry?

Elderberry is a plant native to Europe, Northern Africa, and Western and Central Asia that blooms with white flowers and produces dark almost-black berries. There are more than 20 species of elderberry, but the most well-known and most commonly used in products is Sambucus nigra L.

The use of elderberry dates far back to Hippocrates in ancient Greece, and has continued through the centuries. “Both ancient Egyptians and Native Americans have been known to use elderberry to treat a flu or cold,” says Amy Knoblock-Hahn, RDN, founder and owner of Whole Food is Medicine in St. Louis, Missouri.

Nutrition facts about elderberry

Elderberry is poisonous when consumed raw, Knoblock-Hahn points out. That means you’re going to be consuming elderberry as a syrup, juice, jam/jelly, or lozenge. The nutrition facts will vary widely depending on the product. Here’s a look at what’s in one tablespoon of 100 percent elderberry juice:

Calories: 30

Protein: 1 g

Fat: 0 g

Carbohydrate: 5 g

Fiber: 1 g (4 percent Daily Value for women; 3 percent DV for men)

Sugars: 5 g

Calcium: 5 mg (1 percent DV)

Iron: 0.2 mg (1 percent DV for women; 3 percent DV for men)

Vitamin C: 5 mg (7 percent DV for women; 6 percent DV for men)

A bottle of elderberry syrup and elderberriesMadeleine_Steinbach/Getty Images

How elderberry may improve your health

Elderberry extract may belong in winter’s flu-fighting kit. While elderberry has long been used to fight back sniffles and sneezes, research has been mixed.

However, a small study of 180 people published in Complementary Therapies in Medicine in 2019, found that taking elderberry at the onset of upper respiratory symptoms decreases the duration of those symptoms compared to a control group. It worked even better for the flu than colds. (Whether or not participants got the flu vaccine didn’t have any impact on the effects of supplementing with elderberry.)

Meanwhile, a 2016 study in Nutrients on air travelers suggested that elderberry extract could reduce the duration of cold symptoms by two days compared to a placebo.

It appears that elderberry works similarly to traditional antiviral medications, such as oseltamivir (Tamiflu), as it may interfere with an enzyme of the flu virus, says Knoblock-Hahn.

However, when it comes to the novel coronavirus specifically, “no published research studies have evaluated the use of elderberry for Covid-19,” says Dallas-based registered dietitian Alicia Galvin. If you are sick with Covid-19, consult with your doctor about proper treatment. (Here are the Covid-19 symptoms to watch for.)

It contains antioxidants

One clue that it’s an antioxidant bonanza: Elderberry has a very deep blue-purple almost black hue, a sign of its antioxidants within.

“Elderberries contain vitamin C, flavonols, and anthocyanins, which are all antioxidants that are very helpful in supporting the immune system,” says Galvin. Antioxidants fight oxidative stress that can contribute to a variety of chronic illnesses, as well as general aging. (Here are the best antioxidant-rich foods.)

It may promote heart health

Thanks to its antioxidants, “there is some limited data showing that elderberry is possibly helpful in heart health by lowering blood pressure, increasing insulin sensitivity, and balancing blood sugar,” says Galvin.

Eating elderberries isn’t enough; you’ll still want to stick to a smart eating plan. Overall, a heart-healthy diet includes a variety of fruits and vegetables, whole grains, low-fat dairy, poultry and fish, nuts, and legumes, and oils like olive oil, according to the American Heart Association.

Are elderberries safe?

Do not consume raw elderberries—they contain toxic substances called cyanogenic glycosides that can cause a type of cyanide toxicity if not cooked well enough. Consuming small amounts of the raw berries can lead to nausea and vomiting and diarrhea. These poisonous compounds are eliminated once the berries are cooked.

There’s a risk that if you make an elderberry product at home from raw berries, enough of these toxic substances could still remain and cause gastrointestinal symptoms (on top of the coughing and sneezing).

When pregnant

If you are pregnant, ask your health care provider before taking any supplement or medication to treat an upper respiratory infection. Elderberry hasn’t been proven safe for women who are pregnant or breastfeeding.

Issues with supplements

There are concerns about the adulteration of elderberry products, which means that additional ingredients may be added (like extracts from black rice), and falsified certificates of analysis (CoAs) from suppliers who later go on to provide the product to supplement manufacturers, warns the American Botanical Council.

Buy elderberry products from trusted brands that are transparent about where their ingredients come from.

What’s more, “supplements are not regulated in the United States. That means your elderberry product may or may not have as much elderberry as claimed,” says Knoblock-Hahn.

Rather than taking a supplement, she recommends supporting your immune system by eating a variety of colorful produce (including these immune-boosting foods), getting the sleep you need (aim for 8 hours), exercising daily, and avoiding tobacco products and excessive alcohol.

How to take elderberry

You can take elderberry in several forms: juice (in which you mix a small amount with water and drink), syrup, lozenges, lollipop, and capsules. Syrups and juices are more concentrated, and so they can be more effective, says Galvin. However, lozenges and capsules can be more convenient.

If you choose a juice, syrup, lozenge, or lollipop, read the label to see how much sugar has been added, and make sure that it fits in with your nutritional goals that day.

Studies, like this one published in the Journal of International Medical Research, show about a half-ounce of elderberry syrup, 175 mg in lozenges, or 300 mg of elderberry extract three times daily has potentially beneficial effects on flu symptoms, according to Galvin. However, she advises to always follow dosing instructions on the label.

If you’re choosing to take elderberry with the hope of alleviating cold or flu symptoms, take the recommended dose of syrup within 48 hours of developing symptoms, advises Galvin.

Start popping lozenges within 24 hours, she says. Some research suggests you should take elderberry for three to five days at the beginning of your illness.

Want to make your own syrup at home? Here’s an elderberry syrup recipe.

The last word

Elderberry should only be considered as a complementary therapy if/when approved by your doctor. It should not be a substitute for the flu shot to fight the flu. There are some studies that seem to support the various health claims of elderberry, but research is limited. Remember, consult your doctor before you start taking elderberry for any health-related ailments.

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Medically reviewed by Elisabetta Politi, CDE, MPH, RD, on February 16, 2021