Elderberry
Also known as: Sambucus nigra, black elderberry
Systematic reviews and a meta-analysis of randomized trials indicate elderberry may reduce the duration and severity of upper respiratory symptoms and influenza, but the evidence is moderate-to-low certainty and further larger trials are needed. No clinical evidence links elderberry supplementation to harmful cytokine-driven inflammation in the reviewed studies.
Last reviewed: 2026-10-14 · 5 indexed studies
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Overview
Elderberry (Sambucus nigra) is used orally in syrups and extracts to relieve symptoms of upper respiratory infections. Randomized trials and meta-analyses report reductions in symptom severity and duration for colds and influenza, though evidence certainty is limited.
Mechanism & Function
Mechanism of Action
Proposed actions from the reviewed literature include modulation of inflammatory markers and possible antiviral effects seen in symptomatic improvement; some studies report changes in ex vivo cytokine production after ingestion, but clinical inflammatory harms were not observed.
Physiological Role
Contains bioactive compounds that may influence inflammatory signalling and viral symptoms, contributing to shorter symptom duration and lower symptom scores in some trials.
Primary Pathways
Performance / Health Relevance
Not primarily an ergogenic agent; relevance is to symptomatic relief and possibly faster recovery from viral respiratory illness rather than physical performance enhancement.
Evidence Review
Practical Use & Dosage
- Minimum Effective Dose
- 15 ml elderberry syrup, four times daily (as used in a randomized influenza treatment trial)
- Optimal Range
- Not established for prevention; acute treatment doses in trials varied and are not firmly established beyond the cited syrup regimen
- Upper / Caution Level
- Not established
- Timing
- Used at onset of symptoms for treatment in trials; one prevention trial used a standardized extract during travel
- Best Format
- Syrup or standardised liquid extract (formats studied in trials)
- Bioavailability
- Not established in the provided abstracts
- Absorption Considerations
- Not established in the provided abstracts
Safety & Interactions
Side Effects
- •Few adverse events reported in the included trials; no clinical inflammatory harms identified in the reviewed studies
Monitoring
No specific monitoring recommendations reported in the provided abstracts.
Frequently Asked Questions
Auto-generated from indexed evidence — dosage, safety, interactions, and more.
When is Elderberry typically used or indicated?
Elderberry is most commonly used for: Support for upper respiratory symptoms, Symptom relief for colds and influenza, Shortening duration of acute viral respiratory illness. Contains bioactive compounds that may influence inflammatory signalling and viral symptoms, contributing to shorter symptom duration and lower symptom scores in some trials.
How does Elderberry work?
Proposed actions from the reviewed literature include modulation of inflammatory markers and possible antiviral effects seen in symptomatic improvement; some studies report changes in ex vivo cytokine production after ingestion, but clinical inflammatory harms were not observed.
What is the recommended dose of Elderberry?
The optimal range is Not established for prevention; acute treatment doses in trials varied and are not firmly established beyond the cited syrup regimen. with a minimum effective dose of 15 ml elderberry syrup, four times daily (as used in a randomized influenza treatment trial). Best taken: Used at onset of symptoms for treatment in trials; one prevention trial used a standardized extract during travel. Upper / caution level: Not established.
What are the side effects of Elderberry?
Reported side effects include: Few adverse events reported in the included trials; no clinical inflammatory harms identified in the reviewed studies. Monitoring: No specific monitoring recommendations reported in the provided abstracts.
How strong is the evidence for Elderberry?
Evidence level: Moderate (overall score 64/100), based on 5 indexed studies on SuppIndex.
Research & References (5)
Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review.
Systematic review of elderberry for prevention and treatment of viral respiratory infections; included five randomized trials. Found elderberry may reduce duration and severity of colds and may reduce influenza duration, but evidence was uncertain. No clinical evidence linking elderberry to harmful cytokine-driven inflammation; some small studies showed effects on inflammatory markers.
Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials.
Meta-analysis of randomized controlled trials (total N=180) found that black elderberry supplementation substantially reduced upper respiratory symptoms with a large mean effect size across included trials.
Select Dietary Supplement Ingredients for Preserving and Protecting the Immune System in Healthy Individuals: A Systematic Review.
Systematic review of select dietary supplement ingredients for preserving immune function in healthy individuals included elderberry among ingredients studied. While some studies point to benefit, gaps prevent firm conclusions about overall efficacy for resilience or prevention.
Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial.
Randomized, double-blind placebo-controlled trial of 312 air travellers using a standardised membrane-filtered elderberry extract. The number of cold episodes did not differ significantly, but the placebo group had longer total cold days and higher average symptom scores, indicating shorter and less severe colds with elderberry.
Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections.
Randomized, double-blind placebo-controlled trial in 60 adults with influenza-like illness compared elderberry syrup (15 ml four times daily for 5 days) to placebo. Symptoms resolved on average 4 days earlier and use of rescue medication was lower in the elderberry group.
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Research Overview
Moderate EvidenceCite this ingredient
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Stable URL
https://thesuppindex.com/ingredients/elderberry
SuppIndex. (2026). Elderberry: Evidence summary, dosage and clinical studies. Retrieved October 16, 2026, from https://thesuppindex.com/ingredients/elderberry
Based on 5 indexed studies · Evidence level: Moderate.
Goal Ratings
Stack Compatibility
Commonly combined with other over-the-counter cold remedies in practice, but interactions were not evaluated in the provided studies.