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Encyclopedia/Botanical/TEM · Folk medicine · TCM/encyclopedia-elderberry

Elderberry

Sambucus spp.
Sources
26 listed
Best forFor anyone curious about a traditional Central European household herb taken at the early onset of a cold, as elderflower tea or as cooked elderberry syrup.
Clinical evidence
Real World Significance
92Exceptionally high historical significance
SafetyUse with cautionCaution rating reflects the cyanogenic glycoside toxicity of raw berries (sambunigrin, destroyed by cooking) and the foraging risk of confusion with Sambucus ebulus.
Tradition
Common preparations
TeaSyrupCuvéeCooked fresh berriesStandardised extract

In short

Summary of findings for quick reference

Elderberry is not a footnote of botany; it is one of the historically most significant medicinal plants of Europe and beyond. The plant group appears across many centuries in medical, household, and folk-medical sources. Depending on the source base, the references span from ancient Mediterranean traditions through European household pharmacies to North American and East Asian Sambucus traditions.

Modern clinical research applies a markedly narrower standard of proof. That is important because it makes scientific claims testable. At the same time, this standard captures only a small slice of what has been documented, passed on, and practically used over a long history.

For elderberry both levels point in the same direction: an exceptionally strong historical significance and a modern research picture that is not yet settled, but already clear enough to place elderberry as a serious plant group in everyday use and in the history of phytotherapy. For concrete therapeutic claims, however, the clinical and legal bar stays narrower.

Clinical evidence ↔ Historical significance
We display two separate evidence categories: clinical evidence from modern trials and historical significance from documented healing tradition. Both are valuable, but they answer different questions.
Read more

In every encyclopedia entry we evaluate two distinct categories of evidence. Clinical evidence as used in trials meets a narrower but scientifically essential bar. At the same time, the hundreds of thousands of plant species worldwide have only partially been captured and tested in modern studies.

Alongside the trial picture our researchers compile a comprehensive overview of where and since when a plant has been used across different traditions of natural medicine. When a plant has been used as a medicinal plant in many cultures across many generations, that historical significance deserves to be visible too.

Our position: a truly informative overview emerges only when both categories sit side by side. We communicate transparently what counts as what.

01
Overview

Overview

Black elderberry, Sambucus nigra, is a European native shrub that has held a central place in the household herbal cabinet of German speaking Europe for centuries. In an Austrian Bauerngarten you often find it growing along the farmyard hedge. Two distinct plant parts carry their own tradition: the fragrant elderflower (Sambuci flos) and the ripe cooked berries (Sambuci fructus). Both are traditionally taken at the early onset of a cold, the flower as a sweat inducing tea, the berries usually as a syrup or cordial.

Modern research has focused on the anthocyanins of the dark berry, in particular cyanidin-3-glucoside and cyanidin-3-sambubioside. Small clinical trials such as Tiralongo et al. 2016 in air travellers, the meta-analysis by Hawkins et al. 2019 and the earlier study by Zakay-Rones et al. 2004 sketch a cautiously positive but modest picture for cold onset and duration. There is no approved EFSA health claim for elderberry; the traditional use monograph covers the elderflower (Sambuci flos) at the early onset of a cold, while the EMA declined to establish a monograph for the berry (Sambuci fructus) in 2014. Elderberry is the plant Christiane began making recipes from in 1968 for friends and family, and so it stands at the beginning of our family tradition.

Elderflower (Sambuci flos) is the flowering part of the plant covered within this umbrella elderberry entry. It is distinct from the berry, traditionally taken as a sweat inducing tea at the onset of a cold, and carries its own traditional use monograph. A dedicated elderflower page is planned.

02
History

History

Elderberry is one of the oldest medicinal plants of German speaking Europe. In the farmhouse garden and the monastery gardens of the early middle ages it was a matter of course; the Carolingian monk Walahfrid Strabo named sambucus among the plants of his monastery garden in the Hortulus around 840 CE. In folk medicine the household elder at the farmyard fence was regarded as a protective plant and as a reliable home remedy for the first cold days of the year. The flowers are usually harvested in June, the ripe berries in late August or early September.

In the nineteenth century German language Naturheilkunde documented elderflower and elderberry as a sweat inducing remedy at the early onset of a cold; the tradition continues in the Commission E monograph from 1986 and is now formally covered by the monograph for the traditional use of the flower at the early symptoms of a cold. Christianes Naturkraft sources elderberry from Steiermark, Burgenland and Niederösterreich, the Alpenvorland regions rather than the high Alps. Christiane began making elderberry syrup and small extracts for friends and family in 1968, and that Holundersirup stands at the beginning of our family tradition.

03
Mechanism

Mechanism

The dark berry of Sambucus nigra contains a characteristic group of anthocyanins, in particular cyanidin-3-glucoside and cyanidin-3-sambubioside; these compounds give elderberry juice its deep colour and are the most studied chemical class of the plant. Flavonoids such as rutin and quercetin and other plant polyphenols are also present. Laboratory work such as Roschek et al. 2009 has described elderberry flavonoids binding to influenza virus surfaces in vitro. Observations of this kind explain why the plant has been studied in the context of cold and influenza symptoms, but they are not a demonstration of a clinical effect.

A second pharmacologically important compound is sambunigrin, a cyanogenic glycoside found mainly in the raw berries, the unripe berry parts and the bark and leaves. In the stomach sambunigrin can release small amounts of hydrocyanic acid, and even a small portion of raw berries can cause nausea and vomiting. Heating reliably destroys sambunigrin, which is why traditional preparations of elderberry always cook the berries. In dried or freshly infused elderflower, sambunigrin plays no comparable role. How much anthocyanin actually reaches the bloodstream from a spoon of syrup or a cup of tea is modest; the everyday dose is not the dose used in the clinical trials.

A second class of active compounds has come into focus in more recent laboratory work: the pectic polysaccharides released from the berry pulp into water based preparations. Their backbone of galacturonic acid, galactose, arabinose and rhamnose was the active fraction in a 2022 dendritic cell study by Stich and colleagues (PMID 35409309); the water extract activated immune cell maturation while an ethanolic extract with more than twice the anthocyanin density did nothing. The polysaccharides do not partition into ethanol, which means an alcoholic tincture loses them whatever the bottle's anthocyanin density. A briefly cooked, water extracted syrup carries both classes. This is one piece of laboratory evidence behind the long staying power of the European Hausholunder preparation.

Modern research on elderberry has focused on the duration and severity of cold and influenza symptoms. The current systematic review by Wieland and colleagues from 2021 (PMID 33827515), conducted with Cochrane methodology, gives the picture in plain terms: elderberry may reduce cold and flu duration, but the evidence is uncertain. The synthesis covers Tiralongo and colleagues 2016 (PMID 27023596), a randomised trial in 312 international air travellers in which the elderberry arm reported shorter and milder colds; the older Zakay-Rones and colleagues 2004 (PMID 15080016) randomised study in influenza, which reported earlier symptom resolution; and the meta-analysis by Hawkins and colleagues from 2019 (PMID 30670267), which pooled four trials with 180 participants and reported a direction consistent but modest signal.

The most rigorous independent confirmatory trial is Macknin and colleagues 2020 (PMID 32929634), a randomised controlled trial in 87 emergency department patients with PCR confirmed influenza A or B. The primary endpoint was null at 5.3 versus 4.9 days of symptoms. A post hoc subgroup that took elderberry without oseltamivir trended about two days worse, not better. Honest reading: the positive trials are real, the most independent confirmatory trial was not. The encyclopedia therefore stops short of saying elderberry shortens a cold or flu.

Beyond cold and flu the public picture of elderberry is much broader than the evidence supports. Two human trials on cardiovascular biomarkers (Curtis and colleagues 2009, PMID 19793846; Murkovic and colleagues 2004) found no chronic effect on cholesterol, blood pressure, or fasting glucose; the class level signal for anthocyanin rich berries comes from blueberry, chokeberry and cranberry, not from elderberry. Two cousin species pilot trials in mild cognitive impairment (Curtis 2024, PMID 38673938; Musich 2025, PMID 40002317) used American elderberry, Sambucus canadensis, not the European elder; we name them here as cousin context, not as direct evidence. There is no approved EFSA health claim for elderberry; the monograph covers the flower, Sambuci flos, as a traditional herbal medicinal product for the early onset of a cold, and a 2014 Public Statement declined to establish an equivalent monograph for the berry.

04
Evidence

Evidence

6 Outcomes evaluated. Sorted by grade.
OutcomeClassGradeEffectStudiesRefs
Adults during the cold and flu season
May shorten, evidence uncertain5 studies[1][4]
International air travellers
Shorter, milder in one trial1 study[2]
Patients with influenza like or PCR confirmed influenza
Mixed, recent null trial2 studies[3][5]
Human dendritic cells, in vitro
Lab signal only (in vitro)3 studies[8][9][7]
Healthy adults
Biomarker shift only2 studies[21][22]
Adults at the early onset of a cold
Traditional use (EMA, flower)[10][11]
05
Usage

Usage

Forms and preparation

For a classic elderflower tea, place one to two teaspoons of dried elderflowers in about one hundred and fifty millilitres of hot water, cover the cup and let it steep for around ten minutes, then strain. Drink the tea warm, traditionally one to three cups a day in the early days of a cold. For simple household use of the berries, fully ripe fresh elderberries are slowly cooked with roughly the same weight of sugar, strained and filled hot as elderberry syrup into clean bottles; once opened, store in the refrigerator and use within a few weeks. Important: elderberries are never processed or eaten raw. Only cooking reliably destroys the sambunigrin in the berries. If you forage the berries yourself, check that the cluster hangs downward from a woody shrub; upright berry clusters on a herbaceous stem are a warning sign for dwarf elder. Standardised elderberry extracts from the pharmacy are a practical alternative to home preparation and are the form typically used in clinical research.

Dosage

The EMA HMPC monograph gives a usage period of up to about a week for the traditional use of the elderberry at the early onset of cold symptoms; the precise dose depends on the preparation and its standardisation. In household use elderberry syrup is often taken as one to two tablespoons two to three times a day in hot water, again for a few days at the start of a cold. Elderflower tea is traditionally drunk at one to three cups a day. For standardised pharmacy preparations follow the dosing instruction on the pack. Two practical notes: elderberry syrup contains sugar. If you have diabetes or you are watching your blood sugar, count this amount in. And elderberry is intended as short help in the acute phase, not as a daily long term supplement. If symptoms last for more than a few days, high fever develops, or you feel distinctly worse, that is a reason to see a doctor, not a reason to take more syrup.

06
Safety

Safety

Safety profile
Raw elderberries are toxic. They contain sambunigrin, a cyanogenic glycoside that can release hydrocyanic acid in the stomach, and even small portions of raw berries can cause nausea and vomiting. Cooking reliably destroys sambunigrin. When foraging, take care: Sambucus ebulus, the dwarf elder, is a dangerous lookalike. It grows as a herbaceous plant rather than a woody shrub, stays distinctly shorter, and its berries stand upright in flat clusters rather than hanging down. Sambucus racemosa, the red berried elder, is not a safe alternative either; its red berries are likewise problematic raw. In pregnancy and breastfeeding the data are thin. The EMA HMPC monograph recommends, out of caution, that concentrated elderberry preparations are avoided in pregnancy and breastfeeding; a moderate culinary amount of elderberry syrup is traditionally treated differently, and if in doubt talk with your doctor or midwife. For autoimmune disease in general we recommend strong caution and a physician check before regular use. A 2024 cross sectional study of 673 patients (Faden et al., PMID 39233452) reported that elderberry was associated with the highest exacerbation rate among the supplements studied in dermatomyositis and in cutaneous lupus; for active dermatomyositis or active cutaneous lupus, and for transplant recipients on immunosuppressants, we recommend avoiding regular elderberry use unless your treating physician explicitly clears it. If you take blood thinners (warfarin) or medication for diabetes, let your prescriber know if you start or stop a regular elderberry preparation; the interactions are theoretical but more relevant for these groups. Do not give elderberry syrup that has been sweetened with honey to infants under one year. For older children, tea and cooked elderberry syrup in small age appropriate amounts are part of the household tradition; the move to standardised pharmacy preparations belongs in the hands of the paediatrician. If you live with an autoimmune condition, especially active dermatomyositis or cutaneous lupus, talk to your treating physician before regular elderberry use. A 2024 cross sectional study of 673 patients (Faden and colleagues, PMID 39233452) found elderberry associated with the highest exacerbation rate among the supplements studied, 62 percent in dermatomyositis and 50 percent in cutaneous lupus. The European Medicines Agency also flags a theoretical concern about immune stimulation in this group. For transplant recipients or patients on systemic immunosuppression, including biologics for autoimmune disease, avoid elderberry preparations unless your prescriber explicitly clears them. A rare but documented Type I allergy to elder is on record (Förster-Waldl 2003, PMID 14656358); if you have a known elderberry allergy, do not consume.

Drug interactions

Documented or flagged interactions are limited. Warfarin: a single WHO-UMC case in the EMA fructus assessment report reported an INR shift; inform your prescriber if you start or stop a regular elderberry preparation. Immunosuppressants and biologics (azathioprine, mycophenolate, cyclosporin, tacrolimus, infliximab, adalimumab, rituximab, systemic corticosteroids): a theoretical interaction from cytokine stimulation in vitro; default is to avoid elderberry in this group unless the treating physician explicitly clears it. No documented signal for antihypertensives, theophylline, or CYP3A4 substrates such as statins, calcium channel blockers or oral contraceptives; the in vitro CYP3A4 work on elderberry alone is null (Schroeder-Aasen 2012). For antidiabetics there is no clinical hypoglycaemia signal, but watch your blood sugar when starting a new sugar containing preparation.

Contraindications

Hypersensitivity to elderberry, including known Type I allergy to Sam n 1. Pregnancy and breastfeeding for concentrated medicinal preparations, per . Children under 12 years for elderflower as a medicinal product and under 18 years for elderberry fruit as a medicinal product, both per EMA; cooked Hollersaft as a household food is treated separately by tradition. Active dermatomyositis or cutaneous lupus, per the Faden 2024 flare rate signal. Transplant recipients or patients on systemic immunosuppression.

Side effects

Generally well tolerated in traditional amounts. Occasional mild gastrointestinal upset has been described, particularly with larger amounts of unfamiliar syrup, and rare allergic reactions are on record. If signs of an allergic reaction develop (rash, swelling, breathing difficulties) stop use immediately and seek medical advice.

07
Look-alikes

Look-alikes

Botany
Family
Adoxaceae
Native regions
Europe, Western Asia, North Africa
Harvest window
Flowers June to July; ripe berries late August to early September
Habitat
Black elderberry grows in Central Europe from the lowlands up into the Alpine foothills, often along woodland edges, in hedges, along streams and paths and in farmhouse gardens. In Austria you traditionally find it at the farmyard fence, often as the so called Hausholunder right beside the house.
Identification & foraging
Woody shrub or small tree, three to eight metres tall, with opposite pinnate leaves. In late spring to early summer large, flat, white to cream coloured flower umbels with a strong scent. In late summer dark purple black glossy berries in drooping clusters, each berry with three small seeds. The young wood is pithy on the inside.

Toxic look-alikes

Toxic

Sambucus ebulus (Zwergholunder, dwarf elder)

Dwarf elder is a herbaceous plant, not a woody shrub; it usually grows only one to two metres tall. The berries stand upright in flat clusters rather than hanging down as in black elderberry, and rubbing the leaves releases an unpleasant herbaceous smell. The berries of dwarf elder are toxic.

Toxic

Sambucus racemosa (Roter Holunder, red berried elder)

Red berried elder bears red berries rather than black and flowers earlier in the year (April to May) than black elderberry (May to June). The raw berries are problematic and are not used in household preparations.

08
FAQs

FAQs

Can I eat elderberries raw?

No. Raw elderberries contain sambunigrin, a cyanogenic glycoside that can release hydrocyanic acid in the stomach, and even a small portion can cause nausea and vomiting. Cooking reliably destroys sambunigrin. For this reason traditional preparations of elderberry always cook the berries, as syrup, juice, cordial or stewed fruit. Elderflowers can be infused fresh or dried as a tea; sambunigrin plays no comparable role there.

How do I tell black elderberry apart from dwarf elder?

Three cues are the most useful. Black elderberry (Sambucus nigra) is a woody shrub that grows three to eight metres tall, with drooping berry clusters. Dwarf elder (Sambucus ebulus) is a herbaceous plant, usually only one to two metres tall, and its berries stand upright in flat clusters rather than hanging down. Rubbing the leaves of dwarf elder also releases an unpleasant herbaceous smell. If in doubt, leave the berries.

Is elderberry safe during pregnancy and breastfeeding?

The data are thin. The EMA HMPC monograph recommends, out of caution, that concentrated elderberry preparations are avoided in pregnancy and breastfeeding. A moderate culinary amount of elderberry syrup or an infusion of elderflowers is traditionally treated differently; if in doubt talk with your doctor or midwife.

When in the course of a cold should I take elderberry?

The EMA HMPC monograph names traditional use at the early onset of cold symptoms, in other words early rather than at the peak. The small clinical trials of elderberry in colds were carried out in a similarly early window. Elderberry is meant as short help in the acute phase, not as a daily long term supplement and not as a curative treatment. If symptoms last for more than a few days, high fever develops, or you feel distinctly worse, that belongs in the hands of a doctor.

Can children have elderberries or elderberry syrup?

Cooked elderberry syrup in small age appropriate amounts and elderflower tea in a light concentration are part of the Austrian household tradition for older children. Raw berries are off limits, including for snacking during the harvest. Do not give syrup that has been sweetened with honey to infants under one year; for this age group talk with the paediatrician in general. For standardised pharmacy preparations follow the age related dosing instruction on the pack.

What is the Macknin 2020 study, and why does it matter?

Macknin and colleagues 2020 (PMID 32929634) is the most rigorous independent randomised controlled trial of elderberry in PCR confirmed influenza A or B. 87 patients seen in an emergency department were randomised to Sambucol or matched placebo. The primary endpoint, symptom duration, was null at 5.3 versus 4.9 days. A post hoc subgroup analysis suggested that participants who took elderberry without oseltamivir had symptoms about two days worse, not better. This is the inconvenient trial, and the encyclopedia cites it because honest grading includes inconvenient findings.

Why is there no EU 'immune support' health claim on elderberry?

The European Food Safety Authority opined on the relevant claim in 2011 and judged it not supported by pertinent human data; the elderberry respiratory health claim under ID 2137 received a negative opinion (EFSA Journal 2011;9(6):2248). Three other elderberry claims remain on the EU 'botanicals on hold' list, none yet authorised. The only legally authorised 'immune system' claim that an elderberry containing supplement can carry today is the vitamin C claim ('Vitamin C contributes to the normal function of the immune system'), and it requires that the product deliver at least 12 milligrams of vitamin C per portion and that the claim be worded as a vitamin C attribute, not an elderberry attribute.

09
References

26 sources.

  1. Wieland LS, Piechotta V, Feinberg T, Ludeman E, Hutton B, Kanji S, Seely D, Garritty C. Wieland LS, Piechotta V, Feinberg T, Ludeman E, Hutton B, Kanji S, Seely D, Garritty C (2021). Elderberry for prevention and treatment of viral respiratory illnesses, a systematic review. BMC Complementary Medicine and Therapies 21(1):112.. 2021. doi:10.1186/s12906-021-03283-5
  2. Tiralongo E, Wee SS, Lea RA. Tiralongo E, Wee SS, Lea RA (2016). Randomized, double-blind, placebo-controlled trial of elderberry supplementation in international air travellers. Nutrients 8(4):182.. 2016. doi:10.3390/nu8040182
  3. Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Zakay-Rones Z, Thom E, Wollan T, Wadstein J (2004). Randomized study of oral elderberry extract in adults with influenza A and B infection. Journal of International Medical Research 32(2):132 to 140.. 2004. doi:10.1177/147323000403200205
  4. Hawkins J, Baker C, Cherry L, Dunne E. Hawkins J, Baker C, Cherry L, Dunne E (2019). Meta-analysis of randomized controlled trials on black elderberry (Sambucus nigra) for upper respiratory symptoms. Complementary Therapies in Medicine 42:361 to 365.. 2019. doi:10.1016/j.ctim.2018.12.004
  5. Macknin M, Wolski K, Negrey J, Mace S. Macknin M, Wolski K, Negrey J, Mace S (2020). Elderberry extract outpatient influenza treatment for emergency room patients ages 5 and above, a randomised controlled trial. Journal of General Internal Medicine.. 2020. doi:10.1007/s11606-020-06170-w
  6. Roschek B Jr, Fink RC, McMichael MD, Li D, Alberte RS. Roschek B Jr, Fink RC, McMichael MD, Li D, Alberte RS (2009). In vitro study of elderberry flavonoid binding to H1N1 influenza virions. Phytochemistry 70(10):1255 to 1261.. 2009. doi:10.1016/j.phytochem.2009.06.003
  7. Krawitz C, Mraheil MA, Stein M, Imirzalioglu C, Domann E, Pleschka S, Hain T. Krawitz C, Mraheil MA, Stein M, Imirzalioglu C, Domann E, Pleschka S, Hain T (2011). Inhibitory activity of a standardised elderberry liquid extract against clinically relevant human respiratory bacterial pathogens and influenza A and B viruses. BMC Complementary and Alternative Medicine 11:16.. 2011. doi:10.1186/1472-6882-11-16
  8. Stich L et al.. Stich L et al. (2022). Pectin-rich polysaccharide fractions from black elderberry juice induce dendritic cell maturation and T cell activation, while ethanol extracts do not.. 2022. PMID:35409309
  9. Ho GTT, Wangensteen H, Barsett H. Ho GTT, Wangensteen H, Barsett H (2015 and 2016). Elderberry and elderflower extracts, phenolic compounds, and metabolites and their effect on complement, RAW 264.7 macrophages and dendritic cells.. 2016. PMID:27475233
  10. European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). EMA HMPC Community herbal monograph on Sambucus nigra L. (fructus and flos). 2014.
  11. European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). Public statement on Sambucus nigra L., fructus. EMA/HMPC/32465/2013, 28 January 2014.. 2014.
  12. European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). Assessment report on Sambucus nigra L., fructus. EMA/HMPC/44208/2012, 28 January 2014.. 2014.
  13. Bundesgesundheitsamt, Aufbereitungskommission E. Bundesgesundheitsamt, Aufbereitungskommission E. Monograph on Sambuci flos (Holunderblueten). Bundesanzeiger Nr. 50, 13 March 1986.. 1986.
  14. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific opinion on the substantiation of health claims pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2011;9(6):2248. Negative opinion for ID 2137 Sambucus nigra respiratory health.. 2011. doi:10.2903/j.efsa.2011.2248
  15. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Poisoning from elderberry juice, California, August 1983. MMWR Morbidity and Mortality Weekly Report 33(11), 23 March 1984.. 1984. PMID:6708250
  16. Faden DF, Concha JJS, Werth VP. Faden DF, Concha JJS, Werth VP (2024). Patient-reported supplement use and disease flare in dermatomyositis and cutaneous lupus erythematosus, a cross-sectional study, n=673.. 2024. PMID:39233452
  17. Foerster-Waldl E, Marchetti M, Schoell I, Focke M, Radauer C, Kinaciyan T, Nentwich I, Jaeger S, Schmid ER, Boltz-Nitulescu G, Scheiner O, Jensen-Jarolim E. Foerster-Waldl E, Marchetti M, Schoell I, Focke M, Radauer C, Kinaciyan T, Nentwich I, Jaeger S, Schmid ER, Boltz-Nitulescu G, Scheiner O, Jensen-Jarolim E (2003). Type I allergy to elderberry (Sambucus nigra) is elicited by a 33.2 kDa allergen with significant homology to ribosomal inactivating proteins. Clinical and Experimental Allergy 33(12):1703 to 1710.. 2003. doi:10.1111/j.1365-2222.2003.01811.x
  18. Vlachojannis JE, Cameron M, Chrubasik S. Vlachojannis JE, Cameron M, Chrubasik S (2015). Quantification of anthocyanins in elderberry and chokeberry dietary supplements. Phytotherapy Research.. 2015. doi:10.1002/ptr.5284
  19. Curtis PJ, Kroon PA, Hollands WJ, Walls R, Jenkins G, Kay CD, Cassidy A. Curtis PJ, Kroon PA, Hollands WJ, Walls R, Jenkins G, Kay CD, Cassidy A (2009). Cardiovascular disease risk biomarkers and liver and kidney function are not altered in postmenopausal women after ingesting an elderberry extract rich in anthocyanins for 12 weeks. Journal of Nutrition 139(12):2266 to 2271.. 2009. doi:10.3945/jn.109.113126
  20. Bell DR, Gochenaur K. Bell DR, Gochenaur K (2006). Direct vasoactive and vasoprotective properties of anthocyanin-rich extracts. Journal of Applied Physiology 100(4):1164 to 1170.. 2006. doi:10.1152/japplphysiol.00626.2005
  21. Reider SJ et al.. Reider SJ, Watts R, Stewart S, Watson AJM, Kennedy NA, Brain CE, Liddle FS, Garrod-Ketchley CM, Tooth D, Brain S, Cumming F, Tringham M, Hayee B (2022). Pleiotropic effects of black elderberry on the human gut microbiome.. 2022. PMID:36143265
  22. Teets C et al.. Teets C et al. (2024). Acute black elderberry juice consumption modulates the gut microbiome and substrate oxidation in healthy adults, a 1-week crossover RCT.. 2024. PMID:39458549
  23. Curtis AF et al.. Curtis AF et al. (2024). American elderberry (Sambucus canadensis) anthocyanin supplementation in older adults with mild cognitive impairment, pilot RCT.. 2024. PMID:38673938
  24. Musich AJ et al.. Musich AJ et al. (2025). American elderberry (Sambucus canadensis) MCI pilot RCT extension.. 2025. PMID:40002317
  25. Jabbari M, Hashempur MH, Razavi SZ, Shahraki HR, Kamalinejad M, Emtiazy M. Jabbari M, Hashempur MH, Razavi SZ, Shahraki HR, Kamalinejad M, Emtiazy M (2016). Efficacy and short-term safety of topical Dwarf Elder (Sambucus ebulus L.) versus diclofenac for knee osteoarthritis, a randomised, double-blind, active-controlled trial.. 2016. PMID:27619828
  26. Walahfrid Strabo. Walahfrid Strabo. Hortulus (Liber de cultura hortorum), ca. 840 CE. Carolingian monastic herbalism poem listing the plants of the monastery garden, including sambucus.. 840.

About this entry

This encyclopedia is published by Christianes Naturkraft. Christianes elderberry syrups are made from Haschberg cultivar berries grown in the Steiermark Alpenvorland, briefly cooked and water extracted in the traditional Hausholunder way, and supplemented with ElderCraft, a standardised water extracted black elderberry concentrate of the kind studied in the Tiralongo 2016 trial in international air travellers. We try to write this entry the way a researcher would read the evidence, with our grading kept honest where the trials are mixed or absent; this disclosure is here so you can read the entry knowing where it comes from.

Legal notice: The depiction of historical significance and traditional use is context within our encyclopedia and not a health claim for any product, not a treatment promise, and not a substitute for medical advice. What may be stated on product labels, product pages, or in advertising is governed by the applicable legal requirements.