What Elderberries Can (and Can’t) Do for Your Health

Wouldn’t it be great if a pie filling doubled as medicine? It’s a thought you may have when walking past shelves filled with elderberry gummies, extracts and powders. But do any of them actually work?

The honest answer is: We don’t know. Integrative medicine specialist Naoki Umeda, MD, explains.

What are elderberries?

Elderberries — the fruit of flowering plants in the Sambucus genus — have been used in food and traditional medicines for thousands of years. The berries have to be cooked before they’re consumed. They’re toxic when eaten raw, and can cause diarrhea, nausea and vomiting.

Once cooked, elderberries have a tart, earthy flavor that pairs well with sweet fruits, citrus fruits and honey. They’re used to make jams, jellies and wines. Some dry them and add them to baked goods for an extra zing or pop of color.

Dr. Umeda says elderberry is a common ingredient in traditional Native American and European medicine. It’s perhaps best known today as a natural cold and flu treatment, but advocates say it works on everything from headaches to sciatica.

You can buy elderberry products in many forms, ranging from pills and syrups to lozenges and lotions.

But can elderberry really prevent or treat health conditions? Dr. Umeda explains that — while there’s no harm in eating foods with elderberries in them — there’s no reason to take a supplement.

Potential health benefits

Elderberries are rich in many key nutrients, but there’s little evidence to support their use as a home remedy.

“Elderberries are considered a healthy food,” Dr. Umeda explains. “They’re a low-calorie source of antioxidants, dietary fiber and vitamin C. But there isn’t any definitive data about the health benefits. So, in that regard, I’m pretty skeptical.”

There’s not much research on elderberries. And the studies that do exist often contradict each other. That’s likely due to problems like small sample sizes, issues controlling for outside factors, and variation in elderberry type, age, preparation and dosing. That’s why the National Center for Complementary and Integrative Health says there isn’t enough evidence to draw conclusions.

The best evidence we have that elderberries have healing properties comes from personal experiences, or anecdotally, not controlled experiments. They’ve been used for thousands of years, and many people swear by them.

That’s a good reason to do more research. But it’s not enough for providers like Dr. Umeda to recommend elderberry supplements.

Here are some of the most common health claims about elderberries.

May combat cold, flu and other respiratory infections.

Elderberries are perhaps best known as a cold and flu treatment. But studies to determine how well they work have mixed results.

For example, a 2019 study found that elderberry fights the flu in many different ways. A little over a year later, another study found no evidence that elderberry reduces the length or severity of the flu.

May support heart health

Some test tube studies, like one from 2024, suggest elderberry might help lower cholesterol levels without harming your liver. But more research is needed to confirm that it has the same effect in humans.

May help balance blood sugar

A non-human study suggests that elderberries can reduce both blood sugar and insulin production (and thereby, lower insulin resistance) without causing major side effects.

It’s an exciting idea, but thorough human testing is needed to prove that elderberry could be a useful addition to a diabetes management program.

May promote gut health

Elderberries are sometimes used to treat constipation, but there’s little science proving it’s an effective laxative. (If it is, it’s likely because elderberries contain fiber and antioxidants, which are both crucial for a healthy microbiome.)

May support healthy skin

A 2023 test tube study found that the antioxidants in fermented elderberry extract may reduce inflammation and protect skin cells from damage. But more research is needed to assess whether it could be a useful ingredient in anti-aging products.

May have antiviral properties

While some studies have been promising, there’s not enough evidence to suggest that elderberry products can kill any viruses. In fact, the U.S. Food and Drug Administration (FDA) issued several warning letters in 2020 over claims that they could prevent, treat or cure COVID-19.

It’s worth noting that, in the case of COVID-19, elderberries may even be harmful. A 2022 study raised concerns that elderberries could provoke a cytokine storm in people with COVID-19, sending their immune system so far into overdrive that it causes tissue damage and organ failure.

May have antibacterial properties

A 2021 study found that the phenolic acids and flavonoids in elderberries have antibacterial properties. But the study didn’t address whether it has the same effect in a human body that it does in a test tube.

May have cancer-fighting properties

A 2017 test tube study found that certain phytochemicals in elderberries may be helpful in killing cancer. More studies are needed to determine whether elderberry has the same effect on cancer cells inside the human body.

Risks and side effects

While there’s little evidence to support the health claims around elderberries, Dr. Umeda says they’re generally considered safe for most people when properly prepared — but there are exceptions.

Consider skipping them if you:

• Are allergic to elderberries: If you notice symptoms of an allergic reaction like shortness of breath or hives, contact your primary care provider or (if your symptoms are severe) emergency services.
• Are pregnant or breastfeeding: There’s no meaningful research about how elderberry consumption impacts pregnancy or breastfeeding. Dr. Umeda recommends avoiding them to err on the side of caution.
• Are taking diuretics: Elderberry is a natural diuretic, meaning it makes you pee more. If you take medications that have diuretic effects, doubling up could dehydrate you.
• Have gastrointestinal (GI) issues: Some people find elderberry products upset their GI tract. Common symptoms include nausea, vomiting and diarrhea.
• Are immunocompromised: If you’re immunocompromised, you should avoid elderberry. It’s possible the berries could overstimulate your immune system, make your medications less effective or worsen your symptoms.

If you’re considering taking elderberry supplements, Dr. Umeda recommends speaking with your provider first.

Keep in mind that supplements aren’t reviewed by the U.S. Food and Drug Administration (FDA). As raw elderberries are toxic, it’s important to only buy third-party tested products that are certified safe. If you experience any side effects, stop using them.

Final thoughts

The health benefits of elderberries are likely overstated. And they could be harmful in certain situations and for certain people. But what if you’re just a fan of cooking with them? Do you have to wash your nana’s prize-winning elderberry jam down the drain?

Dr. Umeda doesn’t think so.

“Many people enjoy the taste of elderberries. And that’s totally OK,” he reassures. “If you like elderberry syrup or jam, you can eat it. It’s a healthy food when cooked properly. But do I think you need to add it to your diet or take a supplement? No.”