Elderberry
Specifically for Flu
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Why it works for Flu:
Elderberry's effectiveness against influenza stems from multiple mechanisms of action. It has both direct antiviral effects by blocking viral glycoproteins and indirect effects through immune system modulation ScienceDirectNatural Medicine Journal. The primary mechanisms include:
1. Direct Antiviral Action:
- Elderberry blocks viral glycoproteins, particularly hemagglutinin (HA) and neuraminidase (NA), which are essential for viral entry and replication Anti-influenza activity of elderberry (Sambucus nigra) - ScienceDirect
- The active compound cyanidin 3-sambubioside binds to influenza neuraminidase, blocking specific segments of the enzyme active site and preventing viral release Anti-influenza activity of elderberry (Sambucus nigra) - ScienceDirect
- Compounds from elderberries can directly inhibit the virus's entry and replication in human cells Elderberry compounds could help minimize flu symptoms, study suggests | ScienceDaily
2. Immune System Enhancement:
- Elderberry increases expression of pro-inflammatory cytokines IL-6, IL-8, and TNF, supporting immune response Anti-influenza activity of elderberry (Sambucus nigra) - ScienceDirect
- It activates phagocytes and increases their migration to inflamed tissues Sambucus nigra (black elder) as alternative treatment for cold and flu - PMC
3. Active Compounds:
- The antiviral activity is attributed to anthocyanidin compounds—phytonutrients responsible for giving the fruit its vivid purple coloring Elderberry compounds could help minimize flu symptoms, study suggests | ScienceDaily
- The primary active compounds are cyanidin 3-glucoside and cyanidin 3-sambubioside, which boost immune function and exhibit anti-viral effects Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials - ScienceDirect
How to use for Flu:
For Active Flu Treatment:
- Adults and children ≥13 years: 15 ml of elderberry syrup 4 times daily for 5 days Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled Trial | Journal of General Internal Medicine
- Children 5-12 years: 15 ml twice daily for 5 days Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled Trial | Journal of General Internal Medicine
- Some studies have used 1 tablespoon of elderberry syrup extract four times daily for flu treatment Elderberry: Supplement Information From WebMD
For Prevention:
- A conservative daily serving for immune system support is 1 teaspoon of elderberry syrup per day How Much Elderberry Should I Take?
Timing:
- For best results, elderberry extract should be taken within the first 24 hours of flu symptoms Elderberry syrup for flu? Here are the facts. | Novant Health | Healthy Headlines
- Treatment should begin within 48 hours of the first symptoms for maximum effectiveness Elderberry for Flu: Effectiveness, Benefits, Dosage, Side Effects
Duration:
- Clinical trials used elderberry for 5-6 days during active treatment Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial - PMC
- Continue taking for an additional 48 hours after symptoms subside Black Elderberry Cold & Flu Relief Tablets - 30 count – Sambucol USA
Important Usage Notes:
- Only use cooked elderberries or commercially prepared extracts—never consume raw elderberries as they contain toxic compounds WebMD
- Elderberry extract is possibly safe when taken for up to 12 weeks, but long-term safety beyond this is unknown ELDERBERRY: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews
Scientific Evidence for Flu:
1. Zakay-Rones et al. (2004):
- A randomized, double-blind, placebo-controlled study of 60 patients with influenza A and B found that symptoms were relieved on average 4 days earlier in those receiving elderberry extract compared with placebo Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections - PubMed
2. Zakay-Rones et al. (1995):
- Earlier study confirmed elderberry's effectiveness against influenza with significant symptom reduction Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections - PubMed
3. Tiralongo et al. (2016):
- Randomized trial of 312 air travelers found elderberry supplementation reduced cold duration and symptoms Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial - PMC
4. Meta-Analysis Results:
- A meta-analysis of 180 participants found elderberry supplementation substantially reduced upper respiratory symptoms with a large effect size of 1.717 Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials - ScienceDirect
- Elderberry appears to reduce symptoms caused by influenza virus substantially more effectively than upper respiratory symptoms caused by the common cold Elderberry’s Anti-viral Activity: An Update | Natural Medicine Journal
5. Recent Contradictory Study:
- A 2020 study by Macknin et al. found no evidence that elderberry benefits flu duration or severity, contradicting previous studies and demonstrating the need for further research Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled Trial | Journal of General Internal Medicine
6. Systematic Review (2021):
- A comprehensive systematic review concluded that elderberry may reduce the duration of influenza but noted the evidence is uncertain due to small study sizes and methodological concerns Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review | BMC Complementary Medicine and Therapies | Full Text
Specific Warnings for Flu:
1. Raw Elderberry Toxicity:
- Raw or unripe elderberries, leaves, or stems contain compounds that produce cyanide and can cause nausea, vomiting, severe diarrhea, or more serious effects if consumed in large quantities Drugs.comWebMD
- Large quantities of the toxin may cause serious illness Elderberry: Usefulness and Safety | NCCIH
2. Contraindications:
- People with autoimmune diseases (multiple sclerosis, lupus, rheumatoid arthritis) should avoid elderberry as it might overstimulate the immune system and worsen symptoms WebMDRxList
- Not recommended for children under 5 years, pregnant women, or breastfeeding mothers due to insufficient safety data WebMDWebMD
3. Drug Interactions:
- 111 medications are known to interact with elderberry, including immunosuppressant drugs Elderberry Interactions Checker - Drugs.com
- May have additive effects with antidiabetic drugs due to hypoglycemic activity Elderberry | Memorial Sloan Kettering Cancer Center
- Can increase effects of laxatives and diuretics Elderberry | Memorial Sloan Kettering Cancer Center
- May interfere with immunosuppressive medications used after organ transplants or for autoimmune conditions WebMDRxList
4. Duration Limits:
- Safety for use longer than 12 weeks is unknown ELDERBERRY: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews
- Supplements seem to have few risks when used daily for up to five days Elderberry: Supplement Information From WebMD
5. Special Populations:
- People scheduled for surgery should stop using elderberry at least two weeks before the operation as it may affect blood sugar levels and slow blood clotting Elderberry Allergy: Symptoms, Risks, and Safety Measures 2025 | Wyndly
- May not be helpful in people with lung conditions ELDERBERRY: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews
6. Quality Concerns:
- Herbal supplements lack regulated manufacturing standards and some have been contaminated with toxic metals or other drugs Elderberry Uses, Side Effects & Warnings
- Look for products that have been tested and adhere to stringent manufacturing practices Elderberry syrup for flu? Here are the facts. | Novant Health | Healthy Headlines
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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