Elderberry
Specifically for COVID-19
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Why it works for COVID-19:
Elderberry (Sambucus nigra) has measurable antiviral activity in lab studies and some moderate-quality clinical evidence that it shortens symptom duration for influenza/colds, but as of now there is no high-quality clinical evidence proving elderberry cures or reliably treats COVID-19 in humans.
Lab (in-vitro) studies show elderberry extracts and their anthocyanin/polyphenol constituents can inhibit viral replication and interfere with viral proteins. For influenza the extract appears to block influenza hemagglutinin/neuraminidase (preventing entry and release). For SARS-CoV-2, several recent in-vitro studies report dose-dependent reduction of viral replication (including variants) in cultured human lung cells, suggesting elderberry compounds can interfere with the coronavirus replication cycle in the lab. ScienceDirect MDPI
The likely active constituents are anthocyanins (e.g., cyanidin-3-glucoside), flavonoids and phenolics, which can bind viral glycoproteins and/or affect enzymes needed for replication; elderberry also has polysaccharides and other compounds that show immunomodulatory effects in cell studies. Lab findings do not automatically translate to benefit in people, but they provide a plausible biological rationale. Alternative Medicine Review MDPI
How to use for COVID-19:
Important: There is no authorised, evidence-based dosing for treating COVID-19. Human dosing information comes from influenza/cold trials and from clinical trials of elderberry products (not specifically approved for COVID). Common experimental regimens used in published influenza trials and registered COVID-era trials:
- Influenza RCTs (example): 15 mL elderberry syrup four times daily (i.e., 60 mL/day) given at onset of symptoms for several days was the regimen in a randomized influenza trial used widely as a reference. That trial reported shorter symptom duration vs placebo for influenza-like illness. (This is the regimen often cited in product literature and used in subsequent COVID-era studies.) SAGE Journals Accurate Clinic
- COVID-era clinical trial protocols (registered): The randomized “BERRY”/Sambucol® trials for COVID-19 used 15 mL four times daily as the intervention in their design (this is an investigational regimen — trials ongoing or recently completed). If you are looking to replicate dosing from trials, that is the most consistently reported regimen. Health Research Authority ctv.veeva.com
Practical points drawn from trial/regimen descriptions and product monographs: use a commercial, standardized, pasteurized elderberry product (syrup/capsule) containing Sambucus nigra fruit; follow the product label for adults and pediatric products for children. Do not use raw/unripe elderberries or homemade uncooked preparations (toxicity risk — see Warnings). f.hubspotusercontent40.net Accurate Clinic
Scientific Evidence for COVID-19:
- Randomized trials for influenza/colds (not COVID): Small RCTs found elderberry syrup reduced the duration and severity of influenza symptoms when started early (e.g., Zakay-Rones et al. and follow-up RCTs; meta-analyses summarize modest benefit). These are the primary human data supporting symptomatic benefit for influenza-type illnesses. sambucol-phiz.com SAGE Journals UW Family Medicine & Community Health
- Systematic reviews: Reviews using Cochrane-style methods conclude there is limited evidence that elderberry may shorten duration of upper respiratory infections, but the trials are small and of variable quality; reviewers emphasize results are promising for colds/flu but insufficient to claim elderberry prevents or treats COVID-19. BioMed Central Europe PMC
- COVID-specific evidence:
- Preclinical / in-vitro: Several recent in-vitro papers (cell culture) show elderberry extracts inhibit SARS-CoV-2 replication and variants in lab models — this is promising mechanistic evidence but is not proof of clinical benefit in humans. MDPI
- Human COVID trials: As of the sources currently available, there were registered randomized trials testing Sambucol® (e.g., the BERRY study and other trials), and a few small clinical/preprint trials (e.g., Immunodaat® in a small open trial for post-COVID symptoms), but no large, peer-reviewed randomized controlled trial proving elderberry as an effective treatment for acute COVID-19. Where human COVID trials exist they are small, sometimes not yet peer-reviewed, and results are preliminary. Health Research Authority MedRxiv ctv.veeva.com
Summary on evidence: existing human RCT evidence supports a modest, early-use symptomatic benefit for influenza/colds, lab data show elderberry can inhibit SARS-CoV-2 in cells, but there is not (yet) convincing, high-quality clinical trial evidence that elderberry cures or reliably treats COVID-19 in people. sambucol-phiz.com MDPI BioMed Central
Specific Warnings for COVID-19:
Not an approved COVID therapy: The FDA has issued warnings to companies making unproven COVID treatment/prevention claims for elderberry products; supplements are not FDA-approved drugs for COVID-19. Do not substitute elderberry for medical care when you have moderate–severe COVID-19 or risk factors for severe disease. U.S. Food and Drug Administration ConsumerLab.com
Raw/unripe plant parts are toxic: Raw elderberry fruit, leaves, bark and seeds contain cyanogenic glycosides (can cause nausea, vomiting, diarrhea or cyanide toxicity). Only use cooked/pasteurized, standardized commercial preparations or properly processed products. WebMD UAB Medicine
Pregnancy & breastfeeding: Human safety data are limited. Guidance documents and drug/supplement references advise caution; many clinicians recommend avoidance or discussing with your clinician during pregnancy or lactation because safety has not been established. WebMDParents
Medication interactions / immune conditions: Elderberry has immuno-modulatory effects in lab studies. Theoretically it could interact with immunosuppressant drugs (e.g., corticosteroids, drugs used after organ transplant or for autoimmune disease) or alter immune responses — discuss with your prescribing clinician before combining; drug interaction checkers list potential interactions and recommend caution. Elderberry may also affect blood sugar and other medications in some reports — check with a pharmacist/doctor. Drugs.com RxList
Cytokine-storm concern — what the evidence actually says: Early speculation during the pandemic suggested "immune-boosting" herbs like elderberry might worsen a COVID cytokine storm. That concern was based mainly on small in-vitro immune cell experiments and theoretical reasoning. Subsequent reviews found no clinical evidence that elderberry causes cytokine storm in people, and many experts consider the lab signal insufficient to prove harm — but caution is still advised in severe COVID or in people on immunosuppression. Holistic Primary Care BioMed Central
Quality and labelling: Dietary supplements are variably regulated. Product quality, anthocyanin standardization, contamination, and accurate dosing labels vary — choose reputable manufacturers and check for good-manufacturing practices or third-party testing if using a product. The FDA has acted against companies making illegal disease claims. U.S. Food and Drug Administration worldnaturopathicfederation.org
General Information (All Ailments)
What It Is
Elderberry refers to the dark purple berries of the Sambucus nigra plant, also known as the European elder or black elder. These berries have been used for centuries in traditional medicine, especially in Europe and North America, for their potential immune-boosting and antiviral properties. The most common form used in health products comes from the ripe berries, though the flowers are also used for teas and syrups. Elderberry is commonly available as syrups, lozenges, gummies, capsules, and teas.
The raw berries, bark, and leaves of the elder plant are toxic when unripe, as they contain cyanogenic glycosides — compounds that can release cyanide. However, properly cooked or processed elderberries are safe to consume and rich in beneficial compounds such as anthocyanins, flavonoids, and vitamin C.
How It Works
Elderberry’s health effects are primarily attributed to its bioactive compounds, especially anthocyanins, which are potent antioxidants. These compounds help neutralize free radicals — unstable molecules that can damage cells and contribute to inflammation and disease.
In terms of immune function, elderberry appears to support the body’s natural defenses by:
- Enhancing immune response: Certain studies suggest elderberry can increase the production of cytokines, which are signaling molecules that regulate immune activity.
- Antiviral effects: Laboratory research has shown that elderberry extracts may inhibit the replication of certain viruses, including influenza strains. The compounds seem to prevent viruses from binding to and entering host cells, potentially shortening the duration and severity of symptoms.
- Anti-inflammatory action: The flavonoids in elderberry may reduce inflammation, which is beneficial during infections when inflammation can contribute to discomfort and fatigue.
While these mechanisms are supported by some scientific studies, results vary, and more rigorous clinical research is still needed.
Why It’s Important
Elderberry has gained popularity as a natural remedy for colds and flu. Its importance lies in its potential to:
- Shorten the duration of respiratory infections: Some clinical trials have reported that elderberry extract can reduce the length and severity of cold and flu symptoms when taken early.
- Provide antioxidant protection: The high levels of anthocyanins and vitamin C help combat oxidative stress, supporting overall cellular health and resilience.
- Offer a plant-based immune supplement: For those seeking natural alternatives to synthetic medications, elderberry is an appealing option due to its long history of traditional use and relatively mild side effect profile when prepared properly.
Beyond immunity, elderberry may also contribute to heart and metabolic health due to its anti-inflammatory and antioxidant effects, though more evidence is needed in these areas.
Considerations
While elderberry can be beneficial, there are important points to consider:
- Raw berries are toxic: Unripe or uncooked elderberries contain cyanogenic compounds that can cause nausea, vomiting, and diarrhea. Only properly prepared or commercial products should be used.
- Quality varies: Supplements are not tightly regulated, so product potency and purity can differ widely. Look for standardized extracts from reputable brands.
- Possible interactions: Elderberry may interact with immune-suppressing medications (e.g., for autoimmune conditions or organ transplants), as well as with certain diabetes or diuretic drugs.
- Pregnancy and children: There’s limited safety data for use during pregnancy or in young children, so caution is advised.
- Evidence limitations: Although some studies show promising results, the overall body of scientific evidence remains moderate, and elderberry should not replace conventional medical treatment for serious infections.
Helps with these conditions
Elderberry is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Common Cold
Antiviral activity (in vitro). Elderberry extracts and specific polyphenols (especially anthocyanins such as cyanidin glycosides) have been shown in l...
Flu
Elderberry's effectiveness against influenza stems from multiple mechanisms of action. It has both direct antiviral effects by blocking viral glycopro...
COVID-19
Elderberry (Sambucus nigra) has measurable antiviral activity in lab studies and some moderate-quality clinical evidence that it shortens symptom dura...
Whooping Cough
Elderberry has some supportive and fairly consistent data for shortening symptoms of viral upper-respiratory infections (common cold / influenza) when...
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Helps With These Conditions
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