September 17, 2023

Assessing the Safety of Elderberry in the Context of COVID-19 By Tina McManus, ND

 Assessing the Safety of Elderberry in the Context of COVID-19 By Tina McManus, ND

Assessing the Safety of Elderberry in the Context of COVID-19 By Tina McManus, ND

Black elder, also known as Elderberrys and elderflowers, have a long history of being used to combat common colds, flu, and even cold sores. Despite no clinical trials studying elder-berry extract’s efficacy against COVID-19, given its traditional uses and relative safety, it is a logical choice. Nevertheless, a theory suggesting Elderberry might be unsafe for COVID-19 has gained traction online. Let’s dissect this notion:

Severe cases of COVID-19 often exhibit an excessive inflammatory response known as a “cytokine storm.” Cytokines are chemical messengers used by immune cells for communication and execution of their functions. An amplified inflammatory cytokine level can result in increased cell damage and death, potentially leading to multi-system organ failure and death. Elder-berry stimulates the immune system, potentially causing a surge in cytokine release. It’s hypothesized that Elderberry could aggravate COVID-19 by escalating the likelihood of a “cytokine storm,” thereby increasing the risk of viral septic shock. Can elderberry extract be safe and effective in COVID-19, or could it instigate a cytokine storm? The answer needs to be clarified due to the lack of specific human studies, and case reports validating this claim.

What is the Existing Knowledge Regarding Elderberry?

The theory of elderberry extract inciting cytokine release comes from an in vitro study using white blood cells (monocytes) from 12 healthy donors. After exposure to Sambucol, containing elder-berry extract, monocytes released multiple times more inflammatory cytokines than when exposed to LPS, a highly provocative part of gram-negative bacteria cell walls. The study concluded Elderberry’s antiviral effects might be due to its immune system stimulation.

While such a study is intriguing, it’s crucial to understand the difference between “in vitro” and “in vivo” studies. The former is conducted in test tubes or Petri dishes, not living organisms, while the latter is performed in living creatures like animals or humans. In vitro, studies are preliminary tests to explore potential effects, but their findings can’t be directly applied to humans due to our complexity compared to test tubes. Even animal study results sometimes translate to humans. Hence we must tread carefully when interpreting this study’s results.

Another in vitro study discovered that elder-berry extract could neutralize infectious bronchitis by dismantling the virus membrane, making it non-infectious. Although this study can’t be directly applied to human COVID-19 cases due to its in vitro nature and the virus genus difference, the authors hypothesized that the results might be potentially relevant to human-affecting coronaviruses.

Elderberry’s Role in the Common Cold

The most relevant information comes from randomized, controlled human trials. A double-masked, placebo-controlled study examined elderberry extract’s effect on the duration and symptoms of colds in 312 long-distance flight travelers. While the frequency of cold episodes didn’t differ significantly between the elderberry and placebo groups, the mean duration was about two days shorter, and the symptom severity was lower in the elder-berry group. The study, conducted in 2013-2014 before the discovery of SARS-CoV-2, doesn’t specify the viruses involved. However, it suggests a potential relevance to COVID-19 if another human coronavirus caused the cold.

Elderberry’s Influence on the Flu

Another RCT with 60 participants examined elderberry extract in treating influenza A and B. The study revealed a significant symptom reduction in the treatment group, with symptoms relieved about four days earlier than in the placebo group. Despite the flu being caused by a different virus than COVID-19, it’s plausible that Elderberry’s safe history could apply to COVID-19 given similar complications like pneumonia and death can result from the flu.

The argument against Elder-berry’s safety in COVID-19 hinges on the assumption that Elderberry triggers an extensive increase of inflammatory cytokines. However, Elderberry contains many components, each potentially contributing to its antiviral properties differently. Besides potentially amplifying the immune response, Elderberry could combat viral infections by disrupting the virus-cell membrane, preventing virus cells from attaching to host cells, inhibiting hemagglutination, and hindering viral replication. Elderberry also demonstrates antibacterial properties, which is significant in avoiding bacterial pneumonia following a viral respiratory infection.

We should note that the cytokine storm in COVID-19 affects only a small subset of patients, with 80% of infected individuals exhibiting mild symptoms. There is no evidence to suggest that elder-berry consumption will worsen COVID-19, mainly because this question has yet to be thoroughly researched. Considering Elder-berry’s centuries-long use and proven safety, likely, most people won’t react adversely to it, and it might even be effective against coronaviruses. This requires further investigation! Traditionally, Elderberry is used early in an infection to lessen the disease’s impact, so a cautious approach would be to stop taking Elder-berry a few days after symptom onset, especially if symptoms intensify.


In conclusion, using Elderberry as a supportive measure in managing COVID-19 remains a topic of discussion. Based on historical use and some contemporary research, Elder-berry shows promising results against common colds, flu, and potentially even coronaviruses. However, concrete conclusions are yet to be reached, given the complexity and uniqueness of COVID-19 and the speculative nature of its possible interaction with immune responses. Ultimately, the safety and efficacy of Elder-berry in the context of COVID-19 need more rigorous investigation and human trials to substantiate the claims. Until then, it’s advisable to use Elder-berry with caution and discontinue its use if symptoms of COVID-19 worsen.


Can I use Elderberry to prevent COVID-19?

While Elder-berry has traditionally been used to ward off common colds and flu, no scientific evidence supports its use in preventing COVID-19. More research is needed.

Could Elder-berry cause a “cytokine storm” in COVID-19 patients?

This concern stems from a theory that Elder-berry could stimulate the immune system, potentially leading to an overactive immune response or “cytokine storm.” However, this has yet to be conclusively proven in COVID-19, and it remains a topic of scientific debate.

Is it safe to use Elder-berry if I have COVID-19?

With specific studies on Elderberry’s effect on COVID-19, it’s easier to answer this question definitively. While Elder-berry has a long history of safe use for other conditions, you should always consult a healthcare provider if you have COVID-19.

Can Elderberry reduce the duration of my cold or flu?

Some studies suggest that Elderberry can help to reduce the duration and severity of cold and flu symptoms. However, each individual may react differently, and it’s always best to consult a healthcare provider.

Are there any known side effects of Elderberry?

Elderberry is generally considered safe for most people when used appropriately. Some potential side effects may include allergic reactions, stomach upset, or skin reactions. If you revel in adverse reactions, you should prevent the usage of elderberry and seek advice from a healthcare provider.


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