If you are raising an eyebrow at the buzz around elderberry, you are not alone. It is understandable to feel skeptical of an ingredient that has been used in traditional cold remedies for hundreds of years — clearly pre-dating the practice of clinical research. 

For science-minded individuals, history-of-use is often less important than data-based evidence. 

Elderberry (Sambucas), however, satisfies both forms of legitimacy. 

The problem is that a lot of misinformation about elderberry has been circulating the internet on two ends of the misinformation spectrum. Claims about elderberry as a cure for COVID-19 are just as unverified as claims that it is just a wives tale. We want to help set the record straight on the potential health benefits of elderberry that are supported by solid research.

What is elderberry’s history as a medicinal herb?

The name of the plant, Sambucas, dates back to Greco-Roman times (approximately 350 B.C.E.), and various medicinal uses were described by Hippocrates [1]. In 1644 a 230-page book was written on medical uses for the elder tree, The Anatomy of the Elder Tree, by Martin Blockwich [1]. 

When colonists observed the indigenous people of the “New World”, they recorded that elderberries were being used medicinally and as a dye for baskets [1]. Colonial cookbooks contain recipes for foods such as “elderberry jam for colds” or elderberry vinegar to “disperse tough, thick phlegm” [1].

On top of coughs and flu, elderberry has been used to treat a long list of complaints from venereal disease to fevers and inflammation, constipation to general pain [1]. Again, all of this was before clinical science could confirm or debunk its action in the body.

What does modern science indicate about the health benefits of elderberry?

In vitro lab studies have shown that elderberry extract does exhibit antiviral activity, shutting down the replication of many types of flu viruses, as well as rhinovirus, which is responsible for the common cold [2-4]. 

The mechanism behind this effect is credited to a specific type of antioxidant found in elderberries: anthocyanins (or more specifically cyanidin 3-glucoside and cyanidin 3- sambubioside) [5]. These anthocyanins may even play a protective role against some resistant strains of influenza [5].

Anthocyanins (found in elderberries, but also other dark purple-colored fruits such as grapes and currants) have been shown in laboratory and clinical studies to possess antidiabetic, anticancer, anti-inflammatory, antimicrobial, and anti-obesity effects, as well as effects associated with the prevention of cardiovascular diseases [6]. 

While the bioavailability of anthocyanins from certain foods and wine has been questioned, oral supplementation of elderberry is associated with increased levels of anthocyanins in blood plasma [7].

Clinical trials have shown that elderberry supplementation is associated with quicker recovery from upper respiratory tract symptoms, whether taken at the onset of symptoms or as a preventative before air travel [8,9].

When/how should I take elderberry?

Elderberry extract is an herbal that can be taken either as a stand-alone supplement or as an ingredient in an immune support formula, such as Acute Immune Boost from Metabolic Maintenance

Looking at the data from clinical trials and in vitro studies, elderberry extract appears to be most effective against viruses if taken early. In this case “early” could mean either as a preventative measure, bolstering the function of the immune system when viral threat seems to be high, or at the onset of symptoms, bolstering the function of the immune system when you know it is already battling a bug.

It bears emphasizing that, as a supplement, elderberry is not meant to treat or prevent any disease. It may however support the healthy function of the immune system, which is especially important when the risks of contracting upper respiratory infection are high (such as during air travel). 

Elderberry has been (and continues to be) clinically tested in its ability to support the human immune system at times of routine seasonal viruses, but no conclusive evidence has been presented showing a support role for elderberry in more serious illness. Claims related to elderberry and COVID are largely speculative at this time and should not be considered credible. 

References

  1. Brobst, Joyce, et al., “The Herb Society of America’s Essential Guide to Elderberry”. The Herb Society of America. 2013. https://www.herbsociety.org/file_download/inline/a54e481a-e368-4414-af68-2e3d42bc0bec#:~:text=The%20story%20of%20Sambucus%2C%20elderberry,26).
  2. Porter, Randall S., and Robert F. Bode. “A review of the antiviral properties of black elder (Sambucus nigra L.) products.” Phytotherapy Research 31.4 (2017): 533-554.
  3. Knudsen, B. F., and K. V. Kaack. “A review of human health and disease claims for elderberry (Sambucus nigra) fruit.” I International Symposium on Elderberry 1061. 2013.
  4. Kinoshita, Emiko, et al. “Anti-influenza virus effects of elderberry juice and its fractions.” Bioscience, biotechnology, and biochemistry (2012): 120112.
  5. Kannan, S., and P. Kolandaivel. “The inhibitory performance of flavonoid cyanidin-3-sambubiocide against H274Y mutation in H1N1 influenza virus.” Journal of Biomolecular Structure and Dynamics 36.16 (2018): 4255-4269.
  6. Khoo, Hock Eng, et al. “Anthocyanidins and anthocyanins: colored pigments as food, pharmaceutical ingredients, and the potential health benefits.” Food & nutrition research 61.1 (2017): 1361779.
  7. Han, Hao, et al. “Anthocyanins Are Converted into Anthocyanidins and Phenolic Acids and Effectively Absorbed in the Jejunum and Ileum.” Journal of Agricultural and Food Chemistry 69.3 (2021): 992-1002.
  8. Kong, Fan-kun. “Pilot clinical study on a proprietary elderberry extract: Efficacy in addressing influenza symptoms.” Online Journal of Pharmacology and Pharmacokinetics 5 (2009): 32-43.
  9. Tiralongo, Evelin, Shirley S. Wee, and Rodney A. Lea. “Elderberry supplementation reduces cold duration and symptoms in air-travellers: A randomized, double-blind placebo-controlled clinical trial.” Nutrients 8.4 (2016): 182.