Join Dr. Van Dyken as she discusses the research behind black elderberry and upper respiratory tract infections. Will it work for influenza or COVID-19?
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Today, we will be reviewing the evidence on elderberry in the treatment of upper respiratory tract infections. Many claims have been made regarding elderberry; it’s almost legendary when it comes to traditional medicinal treatment of cold and flu symptoms.
In this video, we will review the origins and traditional uses of elderberry, then we will discuss some studies that have been done examining its efficacy. We will quickly branch off and talk about why it is thought to have action against cold and flu viruses, and finally, we will answer the big, important question – should we be taking elderberry extract to prevent and/or treat upper respiratory infections?
Let’s back up a moment and talk about the problem. Cough, nasal congestion, nasal discharge, sore throat, and other upper respiratory symptoms are signs of an upper respiratory infection. Most of these upper respiratory infections are caused by viruses, such as the common cold – which is typically due to rhinovirus – and influenza. Then, let’s add in the recent debut of the novel Coronavirus and its associated illness – COVID-19. This virus is rapidly spreading throughout the world and as of the date of this recording has infected over 105 thousand people across more than 100 countries and has caused over 3500 deaths. Clearly, we need to stop the spread of this virus.
But what about black elderberry? In regards to COVID-19, that virus is so new we just don’t have a lot of information on it yet. We do, however, have some research on elderberry and influenza A and B, as well as the common cold.
The best study we have to date was published in 2004. This was a randomized, double blind, placebo controlled trial involving 60 patient’s from 18-50 4 years old. These patients developed influenza symptoms and were then randomized into 2 groups. One group got elderberry extract, and the other group got a placebo syrup. They both had 15 mL 4 times daily for 5 days. Researchers found that the elderberry group reported improvement of symptom severity as well as decreased duration of symptoms. The elderberry group had symptoms for 3-4 days, and the placebo group had symptoms for 7-8 days. So these researchers concluded that elderberry extract offers an efficient, safe and cost effective treatment for influenza.
A second, randomized, double blind placebo controlled trial done on air travelers showed decrease in symptoms severity, and a decrease in symptom duration. They found that symptoms lasted 4.75 days in the elderberry group, and 6.88 days in the placebo group. This showed – for the first time – that elderberry may be effective for decreasing respiratory symptoms during travel on long-haul flights. These results were found with taking 600–900 mg of elderberry extract daily. It is worth noting that despite these findings, they did not reach statistical significance.
A third, randomized, double blind placebo controlled trial looked at 27 individuals who were experiencing early flu symptoms. Twenty-three of them tested positive for influenza B. Half were randomized to take elderberry extract, the other half were given a placebo. Of note, the elderberry extract was started within 48 hr of onset of symptoms. The majority of the group that took the elderberry extract noticed a decrease in the severity of their symptoms and they had complete resolution of their symptoms after just 3 days. The same could not be said for the placebo group.
So, back to the million dollar question: should we be taking elderberry extract for prevention of upper respiratory infections, maybe even to prevent COVID-19 infection?
As I stated above, the data on COVID-19 is in its infancy – we just don’t know much about it yet. When it comes to influenza, though, we have pretty good data suggesting elderberry extract, if taken within 48 hours of symptom onset, can reduce symptom severity and duration. We wave very weak data suggesting that elderberry can prevent the infection in the first place, so Its unclear whether taking it “just because” to prevent infection will be beneficial. The good news though is, if prepared the correct way, elderberry extract is safe to use with very side effects.
At the end of the day, I’m not going to be taking elderberry extract to prevent upper respiratory infection – but I would start taking it if I were to develop symptoms.
Image credits:
Wikimedia Commons:
By Famartin – Own work, CC BY-SA 4.0,
By Anton Lefterov, Ph.D.,
By Kolforn,
*all other images: shutterstock
