Elderberry - A Natural Remedy: Benefits, Uses, & Safety Tips for Families

A jar of elderberry syrup surrounded by elderberries.

This powerful little berry has stood the test of time, with medicinal use dating back to Hippocrates, who referred to it as the “medicine chest” of herbs.

A favorite amongst crunchy moms everywhere, elderberry has earned its place as a staple in family medicine cabinets—especially during cold and flu season. This powerful little berry has stood the test of time, with medicinal use dating back to Hippocrates, who referred to it as the “medicine chest” of herbs (1). In this article, we’ll explore the science-backed benefits of elderberry, its mechanisms within the body, potential risks, and how to decide if it’s a good fit for your family’s wellness routine.

The Nutrient Profile of Elderberry

Elderberries are small dark purple berries packed with a range of immune-supporting nutrients. They are rich in vitamin C and are loaded with powerful antioxidants, including anthocyanins and phenolic acids (2,3). These antioxidants help protect cells from oxidative stress, which can weaken immune responses over time. Anthocyanins, the compounds responsible for elderberry’s deep color, are especially beneficial for balancing immune activity and promoting a healthy inflammatory response.


To learn more about how antioxidants work in the body, read this article: Everything You Need To Know About Antioxidants.

Traditional Uses of Elderberry

Elderberry has a long history of use in traditional herbal medicine, with records of its use dating back centuries (1). In traditional European folk medicine, elderberry was commonly used much as it is today — to provide temporary relief of mild symptoms associated with minor upper respiratory conditions, such as fever discomfort, nasal congestion, and occasional coughing (4).


Today, elderberry continues to be a very popular choice in natural wellness practices worldwide. Its gentle nature, versatility, and time-proven history make it a family-friendly option for supporting seasonal health and comfort.

How Elderberry Works

Many berries are rich in vitamins and antioxidants, so what makes elderberry so special? 


Elderberry stands out for its role in supporting healthy immune function and promoting a balanced inflammatory response. Here’s a closer look at the science:

Researchers have investigated elderberry's potential role in supporting immune function and promoting healthy inflammatory processes. Elderberry preparations have been linked to healthy macrophage activity—immune cells that release cytokines, the signaling proteins essential for immune regulation (5,6). A balanced immune response, involving both pro-inflammatory and anti-inflammatory cytokines, is key to overall immune health, and elderberry may offer supportive benefits in this regard (7,8,9).


In addition, elderberry is rich in flavonoids and anthocyanins, potent antioxidants that have been researched for their interaction with reactive oxygen species. This antioxidant activity may help support the body’s defenses against oxidative stress (10,11), providing a dual action of immune support and oxidative balance.


To learn more about what constitutes a healthy inflammatory response, read this article: Understanding & Supporting A Healthy Inflammatory Response

A bunch of elderberries hand from a tree branch.

When & How to Consume Elderberry

Elderberry is traditionally consumed as a syrup, which can be homemade using dried berries or purchased. Once you have your elderberry syrup on hand, you can also get started on making gummies, which are a kid-favorite. Elderberry is also often used as an ingredient in various herbal glycerites to support the immune response. Be aware that elderberries should not be consumed raw, as they contain compounds that can be toxic if not properly prepared.

  • Seasonal Support: When consumed regularly, elderberry may help support the immune system.

  • Acute Support: Elderberry is often used to provide targeted support during times of seasonal discomfort, with research suggesting it may help temporarily ease symptoms associated with minor, uncomplicated colds & flus. Taking elderberry at the first sign of a sniffle may help maximize its benefits.

  • Year-Round Antioxidant Support: Due to its antioxidant properties, elderberry can be beneficial beyond the cold season, helping to maintain good health through all the stressors of everyday life — helping with antioxidant, immune, and inflammatory balance. If you’re considering elderberry for long-term use, many practitioners recommend taking a week off every month or two to prevent overuse and help the body maintain balance. Check in with your healthcare provider about what's right for your family.

The Importance of Properly Prepared Elderberry

Raw, unripe, or unprocessed elderberries contain cyanogenic glycosides — compounds that can release cyanide in the body. While these cyanogenic glycosides are safely digested in small quantities (such as those found in foods like almonds and chickpeas), ingestion of improperly prepared of elderberries can lead to toxic levels of cyanogenic glycosides, though this is very rare, with one known case reported in thirty years (12,13). To avoid risks, always choose elderberry products from reputable manufacturers with expertise in proper preparation and safety standards.


A Note on Elderflower: The Lesser-Known Part of the Elderberry Plant


Though often overshadowed by the berry, the elderflower offers its own set of benefits that make it a staple in herbalism. Herbalists frequently choose elderflower for its mild diaphoretic properties (3), supporting the body’s natural response to seasonal discomforts like fevers without suppressing them. Like elderberries, elderflowers are also rich in flavonoids, which can help maintain balance in the face of occasional inflammation and oxidative stress.


To learn more about supporting the immune system through the colder months, I recommend reading this guide: Dr. Green Life Fall & Winter Immune Support Guide

Who Should Exercise Caution Before Taking an Elderberry Remedy?

While elderberry is safe and beneficial for most people, concerns are sometimes expressed for certain populations:

  1. Individuals with Autoimmune Conditions (Theoretical)
    It is sometimes theorized that elderberry’s stimulating effect on the immune system may influence autoimmune responses, potentially leading to symptom flares. I wasn’t able to find any evidence of this, and I haven’t personally experienced this in my practice, but it is worth being conscious of if you have an autoimmune condition.

  2. Individuals Taking Immunosuppressant Medications 
    I generally advise caution with elderberry supplements for individuals on immune-suppressing medications, as elderberry’s effects on the immune system may potentially interfere with these treatments. It’s best to consult with a healthcare provider.

  3. Pregnant and Breastfeeding Women
    Limited research exists on elderberry’s safety during pregnancy and breastfeeding, but herbalists generally agree that elderberry is safe for pregnant and breastfeeding moms. To learn more, read this article: Is It Safe To Take Elderberry Syrup While Pregnant Or Breastfeeding?

  4. Babies 
    Infants under one who are ready for solids can generally have high quality elderberry preparations as long as they do not contain honey.

Summary

Elderberry is a popular natural remedy for supporting immune health, particularly during cold and flu season. Rich in powerful antioxidants, and immune-modulating compounds, elderberry helps maintain healthy immune defenses and provides temporary relief from minor cold & flu symptoms. Traditionally consumed as a syrup, elderberry can also be consumed as gummies and in herbal glycerites. It’s best not to consume raw elderberries, as they can be toxic without proper preparation. Elderberry is a time tested remedy that is largely regarded to be quite safe; however, as with all supplements, consult your healthcare provider to help make a choice that is right for you and your family. 

PRODUCTS MENTIONED IN THIS ARTICLE

References:

  1. Krawitz C, Mraheil MA, Stein M, Imirzalioglu C, Domann E, Pleschka S, & Hain T. (2011). Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. BMC Complement Altern Med. Feb 25;11:16. doi: 10.1186/1472-6882-11-16. PMID: 21352539; PMCID: PMC3056848.

  2. Kaack K, & Austed T. (1998). Interaction of vitamin C and flavonoids in elderberry (Sambucus nigra L.) during juice processing. Plant Foods Hum Nutr. 1998;52(3):187-98. doi: 10.1023/a:1008069422202. PMID: 9950080.

  3. Młynarczyk K, Walkowiak-Tomczak D, Staniek H, Kidoń M, & Łysiak GP. (2020). The Content of Selected Minerals, Bioactive Compounds, and the Antioxidant Properties of the Flowers and Fruit of Selected Cultivars and Wildly Growing Plants of Sambucus nigra L. Molecules. Feb 17;25(4):876. doi: 10.3390/molecules25040876. PMID: 32079214; PMCID: PMC7070723.

  4. Młynarczyk K, Walkowiak-Tomczak D, & Łysiak GP. (2018). Bioactive properties of Sambucus nigra L. as a functional ingredient for food and pharmaceutical industry. J Funct Foods. Jan;40:377-390. doi: 10.1016/j.jff.2017.11.025. Epub 2017 Dec 22. PMID: 32362939; PMCID: PMC7185606.

  5. Aguzzi, C., Marinelli, O., Zeppa, L., Santoni, G., Maggi, F., & Nabissi, M. (2020). Evaluation of anti-inflammatory and immunoregulatory activities of Stimunex® and Stimunex D3® in human monocytes/macrophages stimulated with LPS or IL-4/IL-13. Biomedicine & Pharmacotherapy, 132, 110845. https://doi.org/10.1016/j.biopha.2020.110845

  6. Torabian, G., Valtchev, P., Adil, Q., & Dehghani, F. (2019). Anti-influenza activity of elderberry (Sambucus nigra). Journal of Functional Foods, 54, 353–360. https://doi.org/10.1016/j.jff.2019.01.031

  7. Barak V, Halperin T, & Kalickman I. (2001). The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw. Apr-Jun;12(2):290-6. PMID: 11399518.

  8. Borish LC, & Steinke JW. (2003). Cytokines and chemokines. J Allergy Clin Immunol. Feb;111(2 Suppl):S460-75. doi: 10.1067/mai.2003.108. PMID: 12592293.

  9. Schön, C., Mödinger, Y., Krüger, F., Doebis, C., Pischel, I., & Bonnländer, B. (2021). A new high-quality elderberry plant extract exerts antiviral and immunomodulatory effects in vitro and ex vivo. Food and Agricultural Immunology, 32(1), 650–662. https://doi.org/10.1080/09540105.2021.1978941

  10. Andrés CMC, Pérez de la Lastra JM, Juan CA, Plou FJ, & Pérez-Lebeña E. (2022). The Role of Reactive Species on Innate Immunity. Vaccines (Basel). Oct 17;10(10):1735. doi: 10.3390/vaccines10101735. PMID: 36298601; PMCID: PMC9609844.

  11. Mattioli R, Francioso A, Mosca L, & Silva P. (2020). Anthocyanins: A Comprehensive Review of Their Chemical Properties and Health Effects on Cardiovascular and Neurodegenerative Diseases. Molecules. Aug 21;25(17):3809. doi: 10.3390/molecules25173809. PMID: 32825684; PMCID: PMC7504512.

  12. Appenteng MK, Krueger R, Johnson MC, Ingold H, Bell R, Thomas AL, & Greenlief CM. (2021). Cyanogenic Glycoside Analysis in American Elderberry. Molecules. Mar 4;26(5):1384. doi: 10.3390/molecules26051384. PMID: 33806603; PMCID: PMC7961730.

  13. Evive. (2022, January 23). Recalling our Immunity smoothie. https://blog.evivenutrition.ca/en/news/recalling-our-immunity-smoothie/

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