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From foods you can’t eat to medications you can’t use, it can feel like there’s a laundry list of items that you need to steer clear of when you’re pregnant. When you’re feeling under the weather, you may wonder if it’s safe to take certain natural remedies to speed recovery.

Many pregnant people are beginning to look for homeopathic or drug-free remedies that are derived from natural ingredients. And if you’re fighting a cold or flu, a particularly popular option is elderberry.

But is it safe to take elderberry when you’re pregnant? The short answer is, we don’t know. And for that reason alone, you may want to avoid it. Here’s what you need to consider.

Elderberry is often touted as an all-natural herbal remedy and an alternative to traditional over-the-counter (OTC) cold and flu medications. It’s a plant that’s been used for medicinal purposes for centuries, dating as far back as ancient Egypt.

In one 2019 meta-analysis of studies conducted on non-pregnant people with flu and cold symptoms, those who took elderberry had reduced upper respiratory symptoms. And a2016 study suggested elderberry decreased the duration and severity of colds in air travelers.

But on the other hand, another recent study suggested that elderberry isn’t effective in shortening the flu or even reducing symptoms.

So while there’s evidence that elderberry may be helpful, the conflicting studies show that more research is needed.

Unfortunately, there just isn’t enough scientific data to confirm whether elderberry is specifically safe for you to consume during pregnancy. So, we would recommend speaking with your physician before adding elderberry to your list of remedies.

But we do know that the way you consume elderberry can also impact whether or not it’s safe.

The elderberry plant contains lectin and cyanide, two chemicals that can induce nausea, diarrhea, and vomiting. If you eat elderberry in its raw or uncooked form, you may experience these symptoms. But if you cook the plant — or use a commercially prepared remedy — you’re less likely to have those side effects.

That being said, we do have one older study — actually, a survey — of pregnant women who used supplements (including elderberry) during pregnancy. One survey taker reported stomach upset while taking elderberry. Besides the obvious issue of small numbers, we also need more recent research.

Other precautions

One of the main reasons why you should consider elderberry with caution is that the plant is categorized as a supplement. This means it’s not approved by the Food and Drug Administration (FDA) and isn’t monitored in the same way as OTC medications or prescription drugs.

As a result, if you’re buying commercially prepared elderberry products, you’ll need to make sure that the company you’re buying from is reputable. One way to do this is to see if it follows the Good Manufacturing Practices guidelines.

If your doctor gives the OK and you decide to take elderberry, you may experience other benefits aside from cold or flu relief. Though not medically proven to help in all these areas, elderberry has traditionally been used to reduce symptoms for:

  • upper respiratory infections
  • toothaches
  • sinus infections
  • headaches accompanying flu-like symptoms
  • sciatica
  • hay fever
  • chronic fatigue syndrome
  • constipation

Elderberry can be taken in a variety of forms, including the following:

Homemade

Talk to your doctor first. If they’re OK with you trying elderberry for your symptoms, you can get fresh or dried elderberries and make a DIY elderberry syrup simply by cooking them down with a sweetener, such as sugar. Cooking the berries will get rid of the cyanide and lectin so you can avoid the adverse side effects.

If you make a syrup that uses honey as the natural sweetener, remember not to serve it to children under the age of 1 to avoid the risk of infant botulism.

Commercially prepared

There are plenty of commercially prepared elderberry products in a range of forms:

  • syrups
  • teas
  • powders
  • gummies

Although there are many choices, remember that these products can hold special risks for pregnant people. Check with your doctor before picking up even commercially prepared forms of elderberry.

If you’re (rightfully) concerned about the lack of research on elderberry during pregnancy, then you may want to support your immune system in other, more evidence-based ways.

For example, zinc supplements may help boost your immune health and help you meet your nutrient needs during pregnancy.

The recommended dietary allowance of zinc is higher during pregnancy — 11 milligrams (mg) vs. 8 milligrams when you’re not pregnant. But keep in mind that your daily intake shouldn’t exceed 40 mg, which is lower than what many supplements sold specifically as cold and flu remedies contain.

Other ways to keep yourself healthy during pregnancy include:

  • eating a balanced diet composed of whole grains, lean protein, fruits and vegetables, and limited sugar
  • taking a nutritionally complete prenatal supplement
  • engaging in physical activity
  • getting plenty of rest

Always speak with your physician before taking any medications or supplements.

No one likes to be sick, and that’s even truer when you’re pregnant. Although certain natural remedies are safe for pregnant people, there’s currently not enough evidence to support the safe use of elderberry supplements during pregnancy.

If you’re looking for a safe natural alternative to OTC medications when you’re feeling under the weather, you should always speak with your physician to make sure that anything you’re taking is safe for both you and your baby.