Elderberry

Background

• Elderberry is the dark purple berry of the European or black elder tree, which grows in Europe, North America, Western Asia, and North Africa.
• Elderberry has been used in folk medicine to treat colds and flu.
• Elderberry is promoted as a dietary supplement for colds, flu, and other conditions. It has also been promoted for COVID-19, but there is no good evidence to support its use.

How Much Do We Know?

• A small number of studies have evaluated elderberry for colds, flu, and other upper respiratory infections. Little research has been done in people on other uses of elderberry.

What Have We Learned?

• Some preliminary research suggests that elderberry may relieve symptoms of flu, colds, or other upper respiratory infections.
• The U.S. Food and Drug Administration (FDA) and Federal Trade Commission have taken action against companies that marketed elderberry products with unsubstantiated claims of effectiveness for COVID-19.
• There’s not enough information to show whether elderberry is helpful for any other health purposes.

What Do We Know About Safety?

• Raw or unripe elderberries and other parts of the elder tree, such as the leaves and stem, contain poisonous cyanide-producing substances that can cause nausea, vomiting, and severe diarrhea; cooking eliminates this toxin. Large quantities of the toxin may cause serious illness.
• If you take any type of medicine, talk with your health care provider before using elderberry or other herbal products; some herbs and medicines interact in harmful ways.
• Little is known about whether it’s safe to use elderberry for health purposes during pregnancy or while breastfeeding.

Keep in Mind

• Don’t rely on elderberry for prevention or treatment of COVID-19. There is insufficient evidence to know if it can help with symptoms.
• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.
• Federal Regulation of Herbal Products
  • Depending on what’s in them, how they’re intended to be used, and how they’re administered (orally or topically), herbal products are regulated in a variety of ways. Many herbal products intended for oral use are marketed as dietary supplements. The rules for making and distributing dietary supplements are less strict than those for drugs.
  • Unlike drugs, dietary supplements are not approved by the FDA before they are sold to the public. When public health concerns arise about the safety of a dietary supplement or an ingredient including an herb, the FDA can take action to protect the public. Manufacturers and distributors of supplements are responsible for evaluating the safety and labeling of their products before marketing to ensure that they meet all regulatory requirements.

For More Information

• Using Dietary Supplements Wisely
• Know the Science: How Medications and Supplements Can Interact
• Know the Science: How To Make Sense of a Scientific Journal Article

Key References