Elderberry is one of the most commonly used medicinal plants in the world.

Traditionally, Native Americans used it to treat infections, while the ancient Egyptians used it to improve their complexions and heal burns. It’s still gathered and used in folk medicine across many parts of Europe.

Today, elderberry is most often taken as a supplement to treat cold and flu symptoms.

However, the raw berries, bark and leaves of the plant are also known to be poisonous and cause stomach problems.

This article takes a closer look at elderberry, the evidence supporting its health claims and the dangers associated with eating it.

What Is Elderberry?

Elderberry Plant and Berries

Elderberry refers to several different varieties of the Sambucus tree, which is a flowering plant belonging to the Adoxaceae family.

The most common type is Sambucus nigra, also known as the European elderberry or black elder. This tree is native to Europe, though it is widely grown in many other parts of the world as well (1, 2).

S. nigra grows up to 30 feet (9 meters) tall and has clusters of small white- or cream-colored flowers known as elderflowers. The berries are found in small black or blue-black bunches (1).

The berries are quite tart and need to be cooked to be eaten. The flowers have a delicate muscat aroma and can be eaten raw or cooked (1).

Other varieties include the American elder, dwarf elder, blue elderberry, danewort, red-fruited elder and antelope brush (1).

Various parts of the elderberry tree have been used throughout history for medicinal and culinary purposes (2).

Historically, the flowers and leaves have been used for pain relief, swelling, inflammation, to stimulate the production of urine and to induce sweating. The bark was used as a diuretic, laxative and to induce vomiting (1).

In folk medicine, the dried berries or juice are used to treat influenza, infections, sciatica, headaches, dental pain, heart pain and nerve pain, as well as a laxative and diuretic (2).

Additionally, the berries can be cooked and used to make juice, jams, chutneys, pies and elderberry wine. The flowers are often boiled with sugar to make a sweet syrup or infused into tea. They can also be eaten fresh in salads (1).

Summary Elderberry refers to several varieties of the Sambucus tree, which has clusters of white flowers and black or blue-black berries. The most common variety is Sambucus nigra, also known as European elderberry or black elderberry.

Health Benefits of Elderberry

There are many reported benefits of elderberries. Not only are they nutritious, but they may also fight cold and flu symptoms, support heart health and fight inflammation and infections, among other benefits.

High in Nutrients

Elderberries are a low-calorie food packed with antioxidants.

100 grams of fresh berries contain 73 calories, 18.4 grams of carbs and less than 1 gram each of fat and protein (3).

Plus, they have many nutritional benefits. Elderberries are:

  • High in vitamin C: There are 6–35 mg of vitamin C per 100 grams of fruit, which accounts for up to 60% of the recommended daily intake (3, 4).
  • High in dietary fiber: Elderberries contain 7 grams of fiber per 100 grams of fresh berries, which is over one-quarter of the recommended daily intake (4).
  • A good source of phenolic acids: These compounds are powerful antioxidants that can help reduce damage from oxidative stress in the body (4, 5).
  • A good source of flavonols: Elderberry contains the antioxidant flavonols quercetin, kaempferol and isorhamnetin. The flowers contain up to 10 times more flavonols than the berries (4).
  • Rich in anthocyanins: These compounds give the fruit its characteristic dark black-purple color and are a strong antioxidant with anti-inflammatory effects (4, 6).

The exact nutritional composition of elderberries depends on the variety of plant, ripeness of the berries and environmental and climatic conditions. Therefore, servings can vary in their nutrition (4, 7).

Summary Elderberries are a low-calorie food packed with vitamin C, dietary fiber and antioxidants in the form phenolic acids, flavonols and anthocyanins. The flowers are particularly rich in flavonols.

May Improve Cold and Flu Symptoms

Black elderberry extracts and flower infusions have been shown to reduce the severity and length of influenza (8).

Commercial preparations of elderberry for the treatment of colds come in various forms, including liquids, capsules, lozenges and gummies.

One study of 60 people with influenza found that those who took 15 ml of elderberry syrup four times per day showed symptom improvement in two to four days, while the control group took seven to eight days to improve (9).

Another study of 64 people found that taking 175-mg elderberry extract lozenges for two days resulted in significant improvement in flu symptoms, including fever, headache, muscle aches and nasal congestion, after just 24 hours (10).

Furthermore, a study of 312 air travelers taking capsules containing 300 mg of elderberry extract three times per day found that those who got sick experienced a shorter duration of illness and less severe symptoms (11).

Further large-scale studies are required to confirm these results and determine if elderberry may also play a role in preventing influenza (8).

Note that the majority of research has only been performed on commercial products, and there is little information about the safety or efficacy of homemade remedies (8).

Summary Elderberry extract has been found to reduce the length and severity of symptoms caused by the influenza virus. While these results are promising, further large-scale human studies are needed.

High in Antioxidants

During normal metabolism, reactive molecules may be released that can accumulate in the body. This can cause oxidative stress and lead to the development of diseases like type 2 diabetes and cancer (12, 13, 14).

Antioxidants are natural components of foods, including some vitamins, phenolic acids and flavonoids, that are able to remove these reactive molecules. Research suggests that diets high in antioxidants may help prevent chronic disease (5, 12, 15).

The flowers, fruits and leaves of the elderberry plant are excellent sources of antioxidants. For example, anthocyanins found in the berries have 3.5 times the antioxidant power of vitamin E (4, 15, 16, 17).

One study comparing 15 different varieties of berries and another study comparing types of wine found that elderberry is one of the most effective antioxidants (18, 19).

Additionally, one study found that antioxidant status improved in people one hour after drinking 400 ml of elderberry juice. Another study in rats found that elderberry extract helped reduce inflammation and oxidative tissue damage (20, 21).

While elderberry has shown promising results in the lab, research in humans and animals is still limited. Generally, consuming it in the diet has only a small effect on antioxidant status (17).

In addition, the processing of elderberries, such as extraction, heating or juicing, can reduce their antioxidant activity (4).

Therefore, products like syrups, juices, teas and jams may have reduced benefits compared to some results seen in laboratory studies (16).

Summary Elderberry fruits, leaves and flowers are strong antioxidants. However, their protective effects in humans appear to be weak. Additionally, the processing of the berries and flowers can reduce their antioxidant activity.

May Be Good for Heart Health

Elderberry may have positive effects on some markers of heart and blood vessel health.

Studies have shown elderberry juice may reduce the level of fat in the blood and decrease cholesterol. In addition, a diet high in flavonoids like anthocyanins has been found to reduce the risk of heart disease (17, 22).

Nonetheless, one study in 34 people given 400 mg of elderberry extract (equivalent to 4 ml of juice) three times a day for two weeks found no significant reduction in cholesterol levels (23).

However, another study in mice with high cholesterol found that a diet including black elderberry reduced the amount of cholesterol in the liver and aorta but not the blood (24).

Further studies found that rats fed with foods containing polyphenols extracted from elderberry had reductions in blood pressure and were less susceptible to organ damage caused by high blood pressure (25, 26).

Furthermore, elderberries may reduce levels of uric acid in the blood. Elevated uric acid is linked to increased blood pressure and negative effects on heart health (4, 27).

What’s more, elderberry can increase insulin secretion and improve blood sugar levels. Given that type 2 diabetes is a major risk factor for heart and vascular disease, blood sugar control is important in preventing these conditions (4, 8).

A study found that elderberry flowers inhibit the enzyme α-glucosidase, which may help lower blood sugar levels. Also, research on diabetic rats given elderberry showed improved blood sugar control (4, 15, 28).

Despite these promising results, a direct reduction in heart attacks or other symptoms of heart disease has not yet been demonstrated, and further studies in humans are needed.

Summary Elderberry has some benefits for heart health, such as reducing cholesterol, uric acid and blood sugar levels. However, further research is needed to demonstrate if these effects are significant in humans.

Other Health Benefits

There are many other reported benefits of elderberry, though most of these have limited scientific evidence:

  • Helps fight cancer: Both European and American elder have been found to have some cancer-inhibiting properties in test-tube studies (5, 8, 29).
  • Fights harmful bacteria: Elderberry has been found to inhibit the growth of bacteria like Helicobacter pylori and may improve symptoms of sinusitis and bronchitis (8).
  • May support the immune system: In rats, elderberry polyphenols were found to support immune defense by increasing the number of white blood cells (30).
  • Could protect against UV radiation: A skin product containing elderberry extract was found to have a sun protection factor (SPF) of 9.88 (31).
  • May increase urination: Elderberry flowers were found to increase the frequency of urination and amount of salt excretion in rats (32).
  • May have some antidepressant properties: One study found mice fed 544 mg of elderberry extract per pound (1,200 mg per kg) had improved performance and mood markers (33).

While these results are interesting, further research is needed in humans to determine if the effects are truly significant.

Moreover, it’s important to note that there is no standardized method for measuring the number of bioactive components like anthocyanins in these commercial products.

One study showed that depending on the method used to measure anthocyanins, a supplement could claim to contain 762 mg/L but really only contain 4 mg/L. Therefore, determining the effects of currently available products may be difficult (17).

Summary Elderberry is associated with many additional health benefits, such as fighting cancer and bacteria, immune support, UV protection and diuretic effects. However, these claims have limited evidence, and further research is needed.

Health Risks and Side Effects

While elderberry has some promising potential benefits, there are also some dangers associated with its consumption.

The bark, unripe berries and seeds contain small amounts substances known as lectins, which can cause stomach problems if too much is eaten (2).

In addition, the elderberry plant contains substances called cyanogenic glycosides, which can release cyanide in some circumstances. This is a toxin also found in apricot seeds and almonds (1, 34).

There are 3 mg of cyanide per 100 grams of fresh berries and 3–17 mg per 100 grams of fresh leaves. This is just 3% of the estimated fatal dose for a 130-pound (60-kg) person (2, 35).

However, commercial preparations and cooked berries do not contain cyanide, so there are no reports of fatalities from eating these. Symptoms of eating uncooked berries, leaves, bark or roots of the elderberry include nausea, vomiting and diarrhea (2).

There is one report of eight people falling ill after drinking the juice from freshly picked berries, including the leaves and branches, from the S. mexicana elder variety. They experienced nausea, vomiting, weakness, dizziness, numbness and stupor (36).

Luckily, toxic substances found in the berries can be safely removed by cooking. However, the branches, bark or leaves should not be used in cooking or juicing (2).

If you are collecting the flowers or berries yourself, ensure that you have correctly identified the plant as American or European elderberry, as other types of elderberry may be more toxic. Also, be sure to remove any bark or leaves before use.

Elderberry is not recommended for children and adolescents below 18 years of age or pregnant or lactating women. While no adverse events have been reported in these groups, there is not enough data to confirm that it is safe (2).

Summary The uncooked berries, leaves, bark and roots of the elderberry plant contain the chemicals lectin and cyanide, which can cause nausea, vomiting and diarrhea. Cooking the berries and seeds will remove the cyanide.

The Bottom Line

While elderberry has been associated with many promising health benefits, most of the research has only been conducted in a lab setting and not tested extensively in humans.

Therefore, elderberry cannot be recommended for any particular health benefit.

Reasonable evidence supports its use to reduce the length and severity of flu symptoms. Also, it may support heart health, improve antioxidant status and have a variety of anti-cancer, anti-diabetes and anti-inflammatory effects.

Moreover, elderberry is a flavorful addition to a healthy diet and good source of vitamin C, fiber and antioxidants.