Elderberry’s reputation for flu rests on a handful of trials. Some were strikingly positive. The most recent large-ish one was not. Here is what each study did, what it found, and how much weight it can bear.
Written by Vita Globe Editorial Team | Reviewed against randomized controlled trials, meta-analyses and NIH guidance
Does elderberry work for the flu?
Possibly, modestly, and the evidence is shaky. Two early trials using an elderberry extract reported faster flu recovery, including symptom relief about four days sooner in a 60-person trial[1][2]. A 2019 meta-analysis found a large effect on respiratory symptoms, but across just 180 people[3]. Then a 2020 randomized trial of 87 flu patients found no difference from placebo[4]. NIH calls the research preliminary[5].
Caveat: No trial has shown elderberry prevents the flu, and it is not a substitute for a flu vaccine or antiviral treatment from your doctor.
Sources: Zakay-Rones et al., 2004 · Hawkins et al., 2019 · Macknin et al., 2020 · Verified 2026-09-27
IN THIS ARTICLE
Why did researchers start testing elderberry for flu?
Interest took off in the 1990s after lab studies showed that a standardized black elderberry extract inhibited several strains of influenza virus in cell cultures[2]. Lab results like this are a reason to test something in people, not evidence that it works in people. Plenty of compounds that look promising in a dish don’t pan out in humans.
What did the early trials find?
1995, influenza B outbreak. During a 1993 influenza B outbreak in a kibbutz, researchers ran a placebo-controlled, double-blind study of the extract. They reported significant improvement in symptoms, including fever, within 2 days in 93.3% of the elderberry group, and a complete cure within 2 to 3 days in nearly 90% of that group, compared with at least 6 days in the placebo group[2]. The published abstract doesn’t report the number of participants.
2004, influenza A and B. In a randomized, double-blind trial, 60 adults aged 18 to 54 with flu symptoms took either elderberry syrup or placebo, 15 ml four times a day for 5 days. Symptoms were relieved on average 4 days earlier with elderberry, and the elderberry group used less rescue medication[1]. The authors themselves said the findings needed to be confirmed in a larger study[1].
What do the meta-analysis and systematic review say?
A 2019 meta-analysis pooled randomized trials of black elderberry for upper respiratory symptoms, covering 180 participants, and found a large reduction in symptoms[3]. That sounds impressive, but 180 people is a very small evidence base for any health question.
A 2021 systematic review, which also considered harms, was more cautious. It concluded elderberry may be a safe option for treating viral respiratory illness and found no evidence it overstimulates the immune system, but said the evidence on both benefits and harms is uncertain[6].
What about the trial that found no benefit?
In 2020, researchers published a randomized, double-blind, placebo-controlled trial run in three emergency departments between January 2018 and April 2019. Of 87 people with flu (ages 5 and up), 43 got elderberry extract and 44 got placebo. Time to symptom relief was essentially the same: about 5.3 days with elderberry and 4.9 days with placebo, a difference that wasn’t statistically significant[4].
The authors noted their result contradicted earlier positive trials and said more research was needed[4]. Differences in patients, products and study design could play a role, but nobody knows for sure.
The honest summary
- Two early, small trials: fast recovery with elderberry extract.
- A 2019 meta-analysis: large effect, but only 180 people in total.
- A 2020 emergency department trial: no benefit.
- Bottom line: possible modest symptom relief, low certainty, no evidence of prevention.
So should you take elderberry for flu?
It is a reasonable thing to try alongside, not instead of, proven measures. The CDC recommends a flu vaccine every season for everyone 6 months and older, with rare exceptions[7]. If you are in a higher-risk group or feel very unwell, call your doctor early rather than waiting to see whether a supplement helps.
If you do use elderberry, choose a product with a clear amount of Sambucus nigra extract per serving, follow the label, and check who should avoid it in Who Should Not Take Elderberry?. For colds as well as flu, see What Is Elderberry Good For?, and for timing, When to Start Elderberry for Cold & Flu Season.
Our option
Vita Globe Elderberry 150mg Gummies with Vitamin C & Zinc
Each two-gummy serving has 150 mg of elderberry fruit extract (30:1), plus 150 mg of vitamin C and 10 mg of zinc (as zinc gluconate), in a blueberry-flavored gummy. It is made for adults, taken as two gummies a day with a meal, and is vegan, gluten-free and non-GMO. Contains coconut (tree nut). Tested by an independent third-party lab. It isn’t intended to treat or prevent the flu. It is a convenient way to include elderberry in your seasonal routine, and it provides less elderberry than the doses used in the trials above.*
Frequently asked questions
How fast does elderberry work for flu?
In the 2004 trial, symptoms eased about 4 days sooner with elderberry syrup[1]. In the 2020 trial, there was no difference from placebo[4].
Is elderberry as good as Tamiflu?
There are no head-to-head trials, and elderberry isn’t an approved flu treatment. If you think you have the flu, talk to your doctor about antiviral options.
Can elderberry prevent the flu?
No trial has shown this. The research looked at symptoms after people got sick[6].
Should I take elderberry if I already got a flu shot?
There is no known conflict, but ask your provider if you take medications. See Who Should Not Take Elderberry?.
Does elderberry help with COVID-19?
There is no good evidence for that, and U.S. regulators have taken action against companies making such claims[5].
Sources
- Zakay-Rones Z, Thom E, Wollan T, Wadstein J. Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res. 2004;32(2):132-140. doi:10.1177/147323000403200205
- Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med. 1995;1(4):361-369. doi:10.1089/acm.1995.1.361
- Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: a meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019;42:361-365. doi:10.1016/j.ctim.2018.12.004
- Macknin M, Wolski K, Negrey J, Mace S. Elderberry extract outpatient influenza treatment for emergency room patients ages 5 and above: a randomized, double-blind, placebo-controlled trial. J Gen Intern Med. 2020;35(11):3271-3277. doi:10.1007/s11606-020-06170-w
- National Center for Complementary and Integrative Health. Elderberry: Usefulness and Safety. Updated November 2024. nccih.nih.gov/health/elderberry
- Wieland LS, Piechotta V, Feinberg T, et al. Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complement Med Ther. 2021;21(1):112. doi:10.1186/s12906-021-03283-5
- Centers for Disease Control and Prevention. Who Needs a Flu Vaccine. Updated September 18, 2025. cdc.gov/flu
About the Vita Globe Editorial Team
The Vita Globe Editorial Team researches and writes our wellness content, working from peer-reviewed research, systematic reviews and guidance from bodies such as the NIH and the FDA. We cite our sources inline and update articles when the evidence changes.
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This article is for informational purposes only and is not a substitute for medical advice. Talk to your healthcare provider before starting any new supplement, particularly if you are pregnant, nursing, taking medication, or caring for a child.
