Caroline Wallace combines two of her passions—science writing and complementary and alternative medicine, along with her knowledge of DoTERRA Essential Oils.
Image of elderberries and elderberry extract

2022 Update: Elderberry Extracts

The season of sneezing and coughing is upon us, bringing some people’s busy schedules to a screeching halt and putting a damper on holiday festivities. Staying hydrated, getting enough rest, and eating a diet with plenty of fresh fruits and vegetables can help support your overall health. Many people also take supplements – such as elderberry extract – to “boost their immune system” to reduce the chance of catching the “crud.”


  • Elderberry extract reduces viral activity in lab-based cell culture experiments
  • Elderberry improves immune response in cell culture
  • Elderberry reduces common cold symptoms when it is taken soon after symptom onset
  • Elderberry may reduce influenza symptoms when it is taken very soon after symptom onset
  • Elderberry extract does not cause serious side effects when used short term

Keep reading to learn more about the science that led to those conclusions:

In 2020 I shared a scientific overview of elderberry extracts, which I summarized:

“Elderberry extract does appear to shorten the duration and severity of colds and influenza. While the number of clinical trials on this topic is limited, the studies that have been conducted have provided compelling data. While the exact biological mechanism is not yet clear, the extract from Sambucus nigra berries seems to impair the virus while amplifying the anti-viral immune response via more cytokine production.”

The SARS-CoV-2 pandemic had many negative impacts on society and people’s lives. Still, one silver lining is that it led to more research into the efficacy and mechanisms of action (MOA) of natural compounds. Efficacy refers to the ability of a compound to produce the desired result, and the mechanism of action is how a compound biologically interacts with your body.

For this scientific overview of Sambucus nigra, I used the PubMed search term “Elderberry Extract“. In 2020, this search term returned 361 results. As of this publication date, this search term produced 448 results. Of the 87 new publications, several studies were designed to figure out how elderberry extract works in the body and if it is effective in different human conditions. This focus is a sharp contrast to what I wrote about the studies that I read in 2020: “Very few studies actually looked at the function of Sambucus nigra extract in humans/human cells.” The difference shows that researchers are beginning to determine how these natural remedies, which have been passed down through the generations, can help support our health. This knowledge allows us, as educated consumers, to select products that can safely and effectively support our health.

What Is Elderberry Extract?Image of elderberries

Elderberry extract is most commonly made from the berries from the Sambucus nigra plant. These large shrubs are native to most of Europe and North America and produce multiple clusters of tiny black berries. The raw berries, leaves, and stems are poisonous! They contain a compound called cyanogenic glycosides, which is converted into a toxin called cyanide when consumed. The cyanogenic glycosides are destroyed when the elderberries are cooked, and the beneficial compounds are retained. Therefore, only cooked elderberries should be eaten!

The main active compounds in elderberries are antioxidant compounds, including polyphenol flavonoids and quercetins. The compounds in elderberries have been studied for their:

    • Immune stimulating potential
    • Antioxidant potential
    • Anti-viral activity
    • Antibacterial activity
    • Antitumor potential

Antiviral Properties of Elderberry ExtractAntiviral cartoon image

Previously, I shared the results from three clinical studies that showed that elderberry extract could shorten the duration and severity of cold (2016 study) or influenza (1995 study and 2004 study) symptoms. A 2020 review compiled evidence from five clinical studies (including two that I previously reviewed) with a total of 936 adults. They concluded that herbal preparations of elderberry – when taken within 48 hours of the onset of acute respiratory viral infection – may reduce the duration and severity of influenza and common cold symptoms in adults. Additionally, the review noted that there were no serious side effects in any of the studies.

However, the results with elderberry extract have not been consistent. A study titled “Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled Trial” tested whether elderberry extract decreases influenza’s duration and severity. This study gave a standard amount of elderberry extract to 43 patients (44 people received a placebo). They found no evidence that elderberry shortens influenza symptoms.

There are many possible explanations of why there is variation between study results. Plants get different levels of medicinal compounds depending on where they are grown, and different plant sources were used for these studies. The extracts likely varied in purity and potency. Also, everyone has a different baseline level of health. Elderberry extract may be more effective at preventing or shortening common cold and influenza symptoms than it is at shortening symptoms when a person is already sick.

How Does Elderberry Extract Work?Microscope cartoon

One of the challenges of researching natural compounds is that HOW they work is often unclear. Elderberry extract may work in two ways. It may directly impact viruses, or it may improve the virus-fighting function of the immune system. There is early evidence that elderberry extract works both ways.

A recent study found that water-based elderberry extract caused dendritic cell maturation, leading to stronger T cell immune responses. Dendritic cells detect the presence of something foreign in the body, like a virus or bacteria, and then trigger the T cells in a certain way so the T cells can kill the foreign substance. Elderberry extracts can also support anti-inflammatory and antioxidant activity in cells, but this has not yet been tested in people. Another review looked at the effects of herbal compounds, including elderberry extract, on coronavirus. Elderberry extract did have a good effect on reducing the viral titer in cell culture.

Final Thoughts

Despite the new literature, the efficacy of elderberry extracts remains unclear. However, that is not a negative thing; it should not stop a person from taking elderberry extract if they choose to do so. The scientific literature shows that elderberry extract:

    • Reduces viral activity in cell culture
    • Improves immune response in cell culture
    • Reduces common cold symptoms when it is taken soon after symptom onset
    • May reduce influenza symptoms when it is taken very soon after symptom onset
    • Does not cause serious side effects when used short term (long-term use has not been tested) 

There is a wide range of elderberry extracts on the market, which can be overwhelming. For a more cost-effective cold-season remedy, you can make your own elderberry extract at home!

Disclaimer: This article should not replace individual clinical judgment or professional medical advice.

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