Elderberry For The Immune System

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Understanding elderberry

Elderberry fruits are the small, purple, blue-black or red berries of the European or black elder tree (Sambucus nigra).1 

Various types of elder trees are found across the Northern Hemisphere, in Europe, Asia, North Africa and North America. They are often growing in sunny locations, at the edges of woodlands and along hedgerows. The flowering period of elder in the UK is in late May and June - the tiny  white flowers develop into berries after pollination by insects.1 Each flower then develops into a berry (elderberry), which ripens from late summer to autumn. 

Elderberry is a favourite of foragers. However, the flowers and berries are the only edible parts of the elder tree - even these are mildly toxic when they are raw, so they must be cooked before use to destroy the toxic chemicals inside them.2 However, after cooking, they are perfect for adding a summery flavour or scent to desserts and drinks. 

Aside from their distinctive fragrance and taste, elderberries have also been renowned for their uses in folk medicine for centuries.3 They are still the go-to herbal remedy for many people today when they start experiencing symptoms of respiratory disease.

Dried or cooked elderberry fruit and elderflowers have traditionally been used as a homemade remedy to fight seasonal respiratory diseases, such as the common cold and influenza (flu).3 More recently, elderberry and elderflower preparations have appeared on the market in very accessible forms, such as herbal tea, gummy elderberry supplements, elderberry extract, or elderberry syrup. 

You may be wondering if the impressive health-boosting claims listed on the colourful packages of elderberry supplementation products are justified. In this article, we explore the benefits of elderberry for the immune system, as well as its other uses. 

Benefits of the elderberry for the immune system

The evidence to support the health benefits of elderberry is limited by the small number of studies and clinical trials to test the effectiveness of elderberry as a treatment or supplement. However, some studies have demonstrated that elderberries may benefit  the immune system.4 The antioxidant properties of elderberry have also shown promise in preventing the development of certain chronic diseases associated with inflammation.5 

Elderberry is rich in substances called anthocyanins. Anthocyanins are phenolic compounds, which are a group of chemicals that are naturally found in some fruits, vegetables, and cereals. Anthocyanins are coloured pigments, which give fresh elderberries their dark purplish colour.6 

Anthocyanins may play a role in stimulating the immune system. Some studies have shown that anthocyanins can attach to certain structures (glycoproteins) found on the surfaces of some virus particles - the viruses rely on these structures to be able to enter the cell and cause infection. By shielding these structures, anthocyanins may be able to support immune health by preventing the spread of an infection.4 Elderberry extracts have been found to inhibit flu viruses (influenza A and influenza B) in this way.7 

Although the anthocyanins found in elderberries have been shown to interfere with certain viruses in lab experiments, there is no conclusive evidence to suggest that elderberry supplementation can prevent you from catching common cold or flu.4 However, several studies have shown that elderberry can help to significantly reduce the duration of an illness, by around 3-4 days4, 7. It was also found that the symptoms of the common cold and flu were milder in patients who  consumed elderberry products. Therefore, taking an elderberry supplement when you are feeling under the weather with a cold may offer the immune support needed to speed up your recovery. 

When  taking any other medicinal products, ensure that you read any leaflets that come with your elderflower or elderberry supplements carefully before use. If you find that your symptoms do not improve or last longer than one week while taking the elderberry product, seek medical advice on further treatment. The European Medicines Agency advises that elderflower and elderberry medicines should only be used in adults and adolescents over 12 years of age.8For help deciding if elderberry supplementation is right for you, or to determine an appropriate dose, speak to a pharmacist or healthcare professional. 

Nutritional facts of elderberry

The health benefits of elderberry can be attributed to its unique nutritional content. The elderberry contains an impressive assortment of vitamins, including

  • Vitamin C (34.10-116.70 mg/100 g)9
  • Vitamin B2 (65 mg/100 g)9
  • Vitamin B7 (17 mg/100 g)9
  • Vitamin B9 (1.8 mg/100 g)9
  • Vitamin A ( 600 IU/100 g)9
  • Vitamin E (α-Tocopherol)9

Although elderberries are abundant in vitamin C, it has been found that the amount present in the fruit differs between elder trees that were cultivated and those that grow in the wild.9Furthermore, the vitamin content of the elderberry fruit can be affected by the climate, harvesting time, and a specific variety of the elder tree.9 

Elderberry is a rich source of phenolic compounds. It is particularly abundant in a specific type of phenolic compound known as anthocyanins. Cyanidin-3-glucoside and cyanidin-3-sambubioside are some of the most abundant anthocyanins found in elderberries.3Phenolic compounds are renowned for their impressive health benefits and antioxidant properties. The anthocyanins found in elderberry fruit may be capable of reducing inflammation in the body, due to their antioxidant properties.5 The anthocyanins can prevent harmful free radicals from damaging cells through oxidative stress. 

As with vitamins, the amount of phenolic compounds present in the elderberry may also depend on different factors, such as the growing season, the tree variety, and the ripeness of the berries.9

Other benefits of elderberry

Apart from its proven application in the treatment of certain viral respiratory diseases, elderberry has also shown promise as a treatment for illnesses associated with obesity.5

People with obesity may experience chronic inflammation. Chronic inflammation has been linked to a risk for conditions such as heart disease, type II diabetes mellitus, and cancer. Some scientists believe that counteracting chronic inflammation may be the key to reducing the burden of these conditions in people with obesity.5

The anthocyanins present in elderberries, due to their antioxidant properties, can reduce the damaging effects of reactive oxygen species (ROS) on the cells in the body. In this way, anthocyanin intake from elderberries may help to lower inflammation levels in the body. Therefore, consuming elderberries may help to regulate the inflammation associated with obesity, and this may help to prevent diseases linked to chronic inflammation.5 

Some studies have also suggested that elderberry may also be a potentially useful addition in the treatment of type II diabetes.3 It has been shown that consumption of anthocyanins - the phenolic compounds present in elderberries - can help to regulate blood sugar levels by attenuating resistance to insulin.3 Insulin is a hormone that helps to control the amount of sugar present in the bloodstream. 

Aside from their use as health foods and supplements, elderberry fruit has also proven useful as a natural food colourant and dye.6 A by-product derived during the production of elderberry juice, known as elderberry pomace, can also be used as an organic fertiliser for plants.3 

Elderberry risks and side effects

Risks

Although elderberry supplementation can be beneficial to immune health, it is important to fully understand all parts of the elder plant before foraging for elderberries to use as a home remedy or supplement. 

Elderberry can be harmful to your health if it is not prepared correctly - this is because all parts of the elderberry plant contain toxic compounds known as cyanogenic glycosides.3 However, these compounds can be degraded through appropriate treatment with heat, which makes the elderberries safe to eat. It is therefore very important to ensure that your elderberries are thoroughly cooked before consumption.2 After they have been cooked, the berries can be safely used to make syrups, pie fillings, elderberry jam or jelly, and many other unique recipes. 

If you plan to forage in the wild for your own elderberries, ensure that you wash them well before cooking and eating. 

Side effects 

After careful preparation and cooking, elderberries are safe to consume for most people and are generally unlikely to cause side effects. Ensure that you are well-informed on how to prepare elderberry fruit for eating if you would like to prepare your own elderberry foods or drinks from scratch. 

However, accidentally consuming fresh elderberries without prior cooking can lead to some unpleasant and potentially dangerous side effects, due to the toxic compounds present in the uncooked, raw berry.2 Eating raw, unripe elderberries can cause nausea (a feeling that you may be sick), vomiting, and diarrhoea (passing loose or liquid stool more than normal for the person).2  Consuming larger quantities of raw elderberry can cause more serious symptoms. 

Elderberry also contains an allergen (Sam n1), which may cause allergic reactions in some people.3

If you notice any unusual symptoms after eating elderberries, consult your doctor for advice. 

Summary

Elderberry and elderflower preparations may effectively relieve early symptoms of the common cold and flu. Due to their high anthocyanin content, consuming elderberries may also help to reduce inflammation. If you would like to forage for your own elderberries to eat, ensure that they are cooked properly to avoid unpleasant and potentially serious side effects. 

References

  1. Woodland Trust. Elder. [Internet] [Cited: 2022 Dec 1]. Available from: https://www.woodlandtrust.org.uk/trees-woods-and-wildlife/british-trees/a-z-of-british-trees/elder/
  2. National Center for Complementary and Integrative Health. Elderberry. [Internet] [Cited 2022 Dec 1. Available from: https://www.nccih.nih.gov/health/elderberry
  3. Mlynarczyk K, Walkowiak-Tomczak D, Lysiak GP. Bioactive properties of Sambucus nigra L. as a functional ingredient for the food and pharmaceutical industry. J Funct Foods. 2018 Jan;40:377-390
  4. Wieland LS, Piechotta V, Feinberg T, Ludeman E, Hutton B, Kanji S, et al. Elderberry for prevention and treatment of viral respiratory illness: a systematic review. MBC Complement Med Ther. 2021 Apr 7;21(1):112
  5. Lee Y, Yoon Y, Yoon H, Park H, Song S, Yeum K. Dietary anthocyanins against obesity and inflammation. Nutrients. 2017 Oct 1;9(10):1089
  6. Da Silva RFR, Barreira JCM, Heleno SA, Barros L, Calhelha RC, Ferreira ICFR. Anthocyanin profile of elderberry juice: a natural-based bioactive colouring ingredient with potential food application. Molecules. 2019 Jul;24(13):2359
  7. Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomised study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. Int J Med Res. 2004;32:132-140
  8. European Medicines Agency. Elderflower. [Internet] [Cited 2022 Nov 30] Available from: https://www.ema.europa.eu/en/documents/herbal-summary/elder-flower-summary-public_en.pdf
  9. Pascariu OA, Israel-Roming, F. Bioactive compounds from elderberry: extraction, health benefits, and food applications. Processes. 2022 Nov 4;10(11):2288

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Katarzyna Drzewinska

Master of Biology, Bachelor of Science, Biochemistry, University of Leeds

Katarzyna is a graduate of the MBiol, BSc Biochemistry (International) programme from the University of Leeds, UK. Her previous laboratory research projects have focussed on environmental microplastics and natural product discovery (antibiotics), but she has found her true passion in medical writing - particularly making scientific literature accessible for the general reader.

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