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

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.

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.

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.

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.

Lisa Andrews, MEd, RD, LD

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