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Elderberry Syrup for Cold and Flu – The Unbiased Scientific Truth, Evidence-Based Health Benefits, Side Effects & More

Learn more about Elderberry syrup's possible side effects, potential health benefits including research and other important information here!

Elderberry Syrup

Elderberry juice syrup has been used for centuries as a home remedy to treat the cold and flu. (Photo by Shutterstock)

 

Elderberry Syrup Overview

In this age of the COVID19 pandemic, people may be tempted to turn to anything that will prevent, cure or reduce symptoms of a nasty flu or virus. Sales for various supplements to “improve immunity” are on the rise, but are they worth it?

Elderberry syrup, made from the dark purple fruit of an elderberry bush, has been touted for centuries to be effective in reducing symptoms of the common cold and flu.

More recent research[1] suggests it may also offer pain relief and be of some use to individuals with metabolic conditions such as obesity and diabetes. Like other dark berries such as blueberries and blackberries, elderberries are high in the antioxidant anthocyanin.

The type of elderberry used most often in supplements comes from the European elder known as black elderberry or Sambucas nigra. Various supplemental forms of elderberry are available including gummies, lozenges, syrups, and teas.
 

Potential Health benefits

One reason that elderberries may have health benefits is related to the antioxidant anthocyanin. Antioxidants work to reduce cellular damage from free radicals (unstable compounds that do cellular damage) that are produced in the body due to metabolism, pollution, smoking and other chemical reactions that occur in the body. Anthocyanin also has antiviral ability that could prevent or limit the symptoms of some common infections[2].
 

Colds and Flu

Colds and flu are both caused by a virus, so antibiotics won’t touch them, but may alter a healthy gut microbiome. Elderberry syrup has been utilized as a homeopathic remedy to reduce the duration and severity of symptoms of illness when used within the first 2 days that symptoms appear. A few small studies support this claim.

In a 2016 Australian study[3] of 312 long-haul airline passengers, subjects that took elderberry extract 10 days before and 5 days after their flight had half the number of sick days due to colds or flu than those that did not.

A more recent meta-analysis published in 2019 of 180 subjects with cold and flu found that black elderberry syrup[4] significantly reduced upper-respiratory symptoms. The authors note this is likely a safer alternative than antibiotics or other medications that get prescribed for viral infections.

Thus far, there are not many studies[5] to support the use of elderberry syrup in prevention of colds or flu, though a 2012 study in rats hinted that it may help prevent infection due to the flu by promoting an immune response.

 

Pain Relief

The anti-inflammatory effects of anthocyanins may be responsible for elderberry being used for pain reduction. The antioxidants in elderberries prevent the production of a chemical called nitric oxide by the body’s immune system.

Nitric oxide[6] acts by signaling the body’s immune cells to produce compounds that cause inflammation in response to disease or injury. Pain and swelling are reduced when this response is prevented.

A small 2016 study[7] found that topical elderberry may be beneficial in those suffering from knee osteoarthritis when compared to a common topical analgesic. The authors caution that longer term and larger studies are needed.
 

Constipation

Tea prepared with dried elderberry may also be beneficial in relieving constipation. A compound called anthraquinone that is also present in rhubarb and senna.

This compound exerts a laxative effect[8] by increasing intestinal pressure and promoting gut peristalsis to promote laxation.

In addition, a small study using elderberry along with other phytotherapeutic compounds in tea has found it to be an effective laxative in those dealing with chronic constipation.

Elderberry tea appears safe, though pregnant or lactating women[9] are advised not to use herbal preparations until more research is available.
 

Diabetes

As the rate of diabetes is on the rise, safe methods to prevent or treat it are often sought after.

A 2017 Norwegian study[10] suggests that the use of elderberries enhanced the uptake of fatty acids and glucose in skeletal muscle tissue. Anthocyanins in elderberries act as strong antioxidants in skeletal muscle and have antidiabetic properties.

Another study suggests elderberries and other Nordic berries enhance uptake of glucose in human liver cells. The authors believe the phenolic compounds[11] of the berries assisted in glucose control.

 

Obesity

Like diabetes, obesity has certainly reached epidemic proportions in the US. In addition to limited physical activity and consumption of excess calories, oxidative stress and chronic inflammation may play a role in the development of obesity.

A 2019 study using elderberry extract suggested it may impact various hormones such as leptin and adiponectin. In addition, in vitro studies indicate that elderberry extract may impact digestive enzymes by inhibiting them. This will reduce the absorption of dietary lipids (fats) and carbohydrates.

Another review study published in 2017 in Nutrients reviews the therapeutic value of elderberries in treating obesity. The biological activity of anthocyanins found in elderberry and other fruits containing this antioxidant may show promise in the treatment of obesity by reducing inflammation.

 

Potential Side Effects

While a moderate intake of cooked elderberries is considered safe to eat, eating too many berries may cause diarrhea, abdominal cramps or stomach ache related to its laxative effects. When used for medicinal purposes, cooked or dried elderberries are only advised for use.

The leaves, roots, bark, and stems of elderberries are NOT safe for consumption as they contain a toxic compound called cyanogenic glycoside. Trace amounts of this substance are also found in unripe elderberries and may release cyanide (poison) in the body when consumed. To be safe, only eat cooked elderberries or syrup prepared by cooking them.

There is not enough research on the safe use of elderberries in children, pregnant women or breastfeeding women. Therefore, to be safe, these populations are advised not to use elderberry preparations.
 

Final thoughts

While elderberry syrup and extracts may show promise in reducing symptoms of cold and flu, reducing pain and potentially preventing diabetes and obesity, individuals taking medications that suppress the immune system should avoid elderberry as it may interact with medications.

Those with chronic conditions such as cancer, liver or kidney disease, lupus, MS, rheumatoid arthritis, and other diseases should consult with their doctor prior to trialing this and other dietary supplements.

Elderberry extract and syrup in addition to all dietary supplements are not approved by the FDA. Consumers should use their best judgment and discuss supplements with a pharmacist or their MD before trying.

Sources

Health Insiders relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

1. Zielińska-Wasielica J, Olejnik A, Kowalska K, Olkowicz M, Dembczyński R. Elderberry (Sambucus nigra L.) Fruit Extract Alleviates Oxidative Stress, Insulin Resistance, and Inflammation in Hypertrophied 3T3-L1 Adipocytes and Activated RAW 264.7 Macrophages. Foods. 2019 Aug 8;8(8):326. doi: 10.3390/foods8080326. PMID: 31398785; PMCID: PMC6724042.
2. Nikolaeva-Glomb L, Mukova L, Nikolova N, Badjakov I, Dincheva I, Kondakova V, Doumanova L, Galabov AS. In vitro antiviral activity of a series of wild berry fruit extracts against representatives of Picorna-, Orthomyxo- and Paramyxoviridae. Nat Prod Commun. 2014 Jan;9(1):51-4. PMID: 24660461.
3. Tiralongo, E.; Wee, S.S.; Lea, R.A. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients 2016, 8, 182. https://doi.org/10.3390/nu8040182
4. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials.
5. Christiane Schön, Yvonne Mödinger, Franziska Krüger, Cornelia Doebis, Ivo Pischel, Bernd Bonnländer. (2021) A new high-quality elderberry plant extract exerts antiviral and immunomodulatory effects in vitro and ex vivo. Food and Agricultural Immunology 32:1, pages 650-662.
6. Elderberry and Elderflower Extracts, Phenolic Compounds, and Metabolites and Their Effect on Complement, RAW 264.7 Macrophages and Dendritic Cells
7. Jabbari M, Hashempur MH, Razavi SZ, Shahraki HR, Kamalinejad M, Emtiazy M. Efficacy and short-term safety of topical Dwarf Elder (Sambucus ebulus L.) versus diclofenac for knee osteoarthritis: A randomized, double-blind, active-controlled trial. J Ethnopharmacol. 2016 Jul 21;188:80-6. doi: 10.1016/j.jep.2016.04.035. Epub 2016 Apr 26. PMID: 27125590.
8. Cirillo C, Capasso R. Constipation and Botanical Medicines: An Overview. Phytother Res. 2015 Oct;29(10):1488-93. doi: 10.1002/ptr.5410. Epub 2015 Jul 14. PMID: 26171992.
9. Picon PD, Picon RV, Costa AF, Sander GB, Amaral KM, Aboy AL, Henriques AT. Randomized clinical trial of a phytotherapic compound containing Pimpinella anisum, Foeniculum vulgare, Sambucus nigra, and Cassia augustifolia for chronic constipation. BMC Complement Altern Med. 2010 Apr 30;10:17. doi: 10.1186/1472-6882-10-17. PMID: 20433751; PMCID: PMC2874511.
10. Ho GT, Kase ET, Wangensteen H, Barsett H. Phenolic Elderberry Extracts, Anthocyanins, Procyanidins, and Metabolites Influence Glucose and Fatty Acid Uptake in Human Skeletal Muscle Cells. J Agric Food Chem. 2017 Apr 5;65(13):2677-2685. doi: 10.1021/acs.jafc.6b05582. Epub 2017 Mar 24. PMID: 28303711.
11. Ho GTT, Nguyen TKY, Kase ET, Tadesse M, Barsett H, Wangensteen H. Enhanced Glucose Uptake in Human Liver Cells and Inhibition of Carbohydrate Hydrolyzing Enzymes by Nordic Berry Extracts. Molecules. 2017 Oct 24;22(10):1806. doi: 10.3390/molecules22101806. PMID: 29064442; PMCID: PMC6151378.
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Lisa Andrews, MEd, RD, LD

Lisa Andrews, MEd, RD, LD is a Registered Dietitian and Owner of Sound Bites Nutrition in Cincinnati, OH....

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