Does Elderberry Work for Colds and Flu? The Best Flu Trial Found No Benefit
Small early trials looked strong, but a larger, independently run trial of lab-confirmed flu found elderberry did not shorten symptoms. It does not appear to stop you catching a cold.
By Kymata Health Editorial Published Last checked
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NOW Foods Elderberry, 500 mg, 60 Veg Caps
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Label: 1 veg capsule: 500 mg elderberry fruit 10:1 concentrate (Sambucus nigra).
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Key takeaways
From 7 sources- In 87 emergency-room patients with lab-confirmed flu, elderberry syrup for 5 days did not shorten symptoms (5.3 vs 4.9 days to mild symptoms, p = 0.57)3.
- A 2004 trial of 60 adults reported flu symptoms eased about 4 days sooner, but it was small and its authors asked for a larger confirmatory study2.
- In 312 long-haul air travellers, elderberry capsules did not significantly reduce the number of colds (12 vs 17), though total cold days were lower; the trial was funded by the extract maker1.
- A 2021 systematic review found elderberry may not lower the risk of catching a cold, and found no evidence that it overstimulates the immune system4.
- Raw or unripe berries, leaves and stems can cause vomiting and severe diarrhea; NCCIH says cooking eliminates the toxin5.
What this article covers
1 evidence profileThe evidence, graded
Pulled from the trial tables in our evidence profiles. Grades follow our evidence-grading policy.
Graded findings
5 rows- CGrade CInfluenza duration and severity (lab-confirmed flu)No effect Days until symptoms were mild or gone did not differ (5.3 vs 4.9 days, p=0.57), nor did days to full resolution (8.6 vs 8.7, p=0.87). A post hoc analysis found elderberry alone did about 2 days worse than placebo alone.Elderberry · RCT · n=87 · 2020 · PMID 32929634
- DGrade DInfluenza symptom durationImproved Symptoms were relieved on average 4 days earlier, and rescue medication use was lower, than with placebo syrup.Elderberry · RCT · n=60 · 2004 · PMID 15080016
- CGrade CCatching a cold during long-haul air travelNo effect Cold episodes were 12 with elderberry vs 17 with placebo, not a significant difference (p=0.4).Elderberry · RCT · n=312 · 2016 · PMID 27023596
- DGrade DCold duration and severityImproved Total cold days were 57 with elderberry vs 117 with placebo (p=0.02), and average symptom scores over those days were lower (247 vs 583, p=0.05).Elderberry · RCT · n=312 · 2016 · PMID 27023596
- DGrade DUpper respiratory symptomsImproved Pooled analysis found elderberry substantially reduced upper respiratory symptoms, with a large mean effect size.Elderberry · Meta-analysis · n=180 · 2019 · PMID 30670267
Where these trials agree: Elderberry and colds, counted row by row in the Consensus finder.
The short answer
The evidence for elderberry is small and conflicting4. A 2021 systematic review rated the evidence uncertain for shorter colds or shorter flu, and found elderberry may not reduce the risk of catching a cold4. The most rigorous flu trial found no benefit at all3.
Elderberry is not a substitute for antiviral medicine, and NCCIH says there is no good evidence for it against COVID-195.
Flu: early wins, then a null trial
In a 2004 Norwegian trial, 60 adults aged 18 to 54 with flu-like symptoms for 48 hours or less took 15 mL of elderberry or placebo syrup four times a day for 5 days2. Symptoms were relieved on average 4 days earlier with elderberry, and rescue medication use was lower2. The authors said the findings needed confirming in a larger study2. The authors of the later emergency-room trial note that at least two of the three earlier positive flu trials were funded by the manufacturer3.
That larger test was an FDA Investigational New Drug, investigator-initiated trial in 3 emergency rooms of one US Midwestern health system3. It was funded by the Wendel Family Foundation and Cleveland Clinic research funds; the maker, PharmaCare, supplied the Sambucol extract and placebo but no money3. It enrolled 87 patients aged 5 and older with PCR-confirmed influenza and symptoms for under 48 hours3. Days until all symptoms were none or mild were 4.9 on placebo and 5.3 on elderberry (p = 0.57), and days to full resolution were 8.7 and 8.6 (p = 0.87)3.
The trial was powered above 0.90 to detect a 2-day benefit3. A post hoc analysis suggested people taking elderberry alone, without oseltamivir, did about 2 days worse than placebo alone3.
Colds: fewer cold days, not fewer colds
An Australian trial gave 312 economy-class passengers flying overseas elderberry extract capsules or placebo from 10 days before travel to 4 to 5 days after arrival1. Colds occurred in 12 people on elderberry and 17 on placebo, not a significant difference (p = 0.4)1. Total cold days were 57 vs 117 and symptom scores were lower, but only 29 people caught a well-defined cold16.
The study was funded by Iprona AG, the maker of the extract, which supplied the capsules and was partly involved in the design6.
A 2019 meta-analysis reported a large pooled reduction in upper respiratory symptoms, but it included only 180 participants and predates the null emergency-room flu trial73.
Safety and who should avoid it
A 2021 systematic review concluded elderberry may be a safe option for viral respiratory illness and found no evidence that it overstimulates the immune system, though the evidence on harms is uncertain4. Take extra care in these situations:
- Anyone making home remedies: raw or unripe berries, leaves and stems contain cyanide-producing substances that can cause nausea, vomiting and severe diarrhea; cooking eliminates the toxin5.
- Pregnancy and breastfeeding: little is known about safety5.
- People at high risk from flu: elderberry is not a substitute for antiviral medicine, and it did not shorten lab-confirmed flu in the best trial3.
- People on regular medicines: NCCIH advises talking with a clinician before using elderberry or other herbal products5.
Quick answers
Common questions
4 answersWhat dose of elderberry was studied?
Can elderberry stop me catching a cold?
Is elderberry safe for kids?
The emergency-room trial included children aged 5 and older at twice-daily dosing, but it found no benefit3.
Does elderberry help with COVID-19?
NCCIH says there is no good evidence for it, and FDA and FTC have acted against companies making such claims5.
Keep reading
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Where to buy Elderberry
Products from brands we partner with that contain Elderberry. Check the amount per serving against the doses studied, and the label for other ingredients.
Elderberry products from partner brands
1 product Paid links · we earn a commission- Quick pickHerbsProNOW Foods Elderberry, 500 mg, 60 Veg Caps
1 veg capsule: 500 mg elderberry fruit 10:1 concentrate (Sambucus nigra)
$8.92one-timeChecked Oct 14, 2026
References
7 sources. Numbers in the text link here.
Sources cited in this article
7 sources- 1Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical TrialNutrients, 2016 · PMID 27023596
- 2Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infectionsJ Int Med Res, 2004 · PMID 15080016
- 3Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled TrialJ Gen Intern Med, 2020 · PMID 32929634
- 4Elderberry for prevention and treatment of viral respiratory illnesses: a systematic reviewBMC Complement Med Ther, 2021 · PMID 33827515
- 5Elderberry: Usefulness and Safety (Last Updated: November 2024)National Center for Complementary and Integrative Health (NCCIH), 2024
- 6Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers (full text, Conflicts of Interest)Nutrients via PubMed Central (PMC4848651), 2016
- 7Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trialsComplement Ther Med, 2019 · PMID 30670267
Elderberry and other dietary supplements are not intended to diagnose, treat, cure or prevent any disease, and these statements have not been evaluated by the FDA. Talk to your clinician or pharmacist before starting a supplement, especially if you take prescription medicines. Product links on this page are paid partner links.