Some people start elderberry in September; others keep it in the cupboard until the first sniffle. The research doesn’t settle it cleanly, but it does give some useful clues.
Written by Vita Globe Editorial Team | Reviewed against randomized controlled trials, CDC guidance and NIH resources
When should you start taking elderberry?
There is no research on the “best” start date. Most elderberry trials began treatment after people got sick, and those found possible symptom relief[1][2]. The one trial that started beforehand, in air travelers who began 10 days before their flight, found shorter, milder colds but not significantly fewer colds[3]. So starting early is a routine choice, not a proven prevention strategy.
Caveat: The most important thing to start early in the season is your flu vaccine: the CDC says September and October are generally good times[4].
Sources: Zakay-Rones et al., 2004 · Tiralongo et al., 2016 · CDC flu vaccine · Verified 2026-09-27
IN THIS ARTICLE
When did people start elderberry in the trials?
Timing varied by study:
| Study | When elderberry started | Result |
|---|---|---|
| Zakay-Rones 2004 | After flu symptoms began; 5 days of syrup | Symptoms relieved about 4 days sooner[1] |
| Tiralongo 2016 | 10 days before an intercontinental flight, continued through travel | Shorter, milder colds; number of colds not significantly different[3] |
| Macknin 2020 | After flu illness, in emergency department patients | No difference from placebo[5] |
Put together, the evidence is mostly about using elderberry once symptoms appear. Details on each trial are in Elderberry for Flu: What the Clinical Trials Found.
Is there any reason to start before you get sick?
The strongest argument is practical rather than scientific: if a product is already part of your routine, you won’t have to run out for it when you feel off. The air-travel trial is the closest thing to evidence for this approach, and it found shorter and milder colds among those who started early, even though they didn’t catch fewer colds[3].
Timing matters more clearly for vitamin C. A Cochrane review found regular vitamin C slightly shortened colds, while starting after symptoms appeared didn’t seem to help[6]. That is one reason combination products are often started in the fall. We cover this in Why Fall Is the Right Time to Start Vitamin C.
How does elderberry fit with your flu shot?
Elderberry is not a replacement for flu vaccination. The CDC recommends a flu vaccine every season for everyone 6 months and older, with rare exceptions, and says September and October are generally good times, ideally by the end of October. It takes about two weeks after vaccination for protective antibodies to develop[4].
A sensible fall checklist looks like this:
- Book your flu shot for September or October[4].
- If you use elderberry or a vitamin C and zinc product, start it as a routine around the same time, following the label.
- Check your zinc total across all supplements; the adult upper limit is 40 mg a day[7].
- Keep the basics: sleep, handwashing and staying home when sick.
How long should you keep taking it?
Trials lasted days to a few weeks, and there is no data on months of continuous use[1][3]. Many people use elderberry through the colder months and then stop. If you plan to take it for the whole season, consider taking breaks, and check Can You Take Elderberry Every Day?. Check Who Should Not Take Elderberry? too, particularly if you are pregnant, breastfeeding or on medication.
The honest summary
- No study has identified a best start date for elderberry.
- Most positive trials started after symptoms began.
- Starting early didn’t reduce the number of colds in the one trial that tested it.
- Your flu shot is the time-sensitive part of fall planning.
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Frequently asked questions
Should I take elderberry before or after getting sick?
Most trials gave it after symptoms began[1]. Starting beforehand hasn’t been shown to prevent colds[3].
What month should I start elderberry?
There is no evidence-based month. Many people start in early fall, alongside their flu shot in September or October[4].
Can I take elderberry after my flu shot?
We found no known conflict, but if you take medications or have a medical condition, ask your provider before adding any supplement.
How quickly should I start elderberry when I feel a cold coming on?
In the flu trials, people started elderberry once they were already sick, and the 2004 trial ran for 5 days[1]. Follow your product’s label.
Is elderberry worth taking every winter?
Evidence is limited and mixed; one flu trial found no benefit[5]. It may modestly ease symptoms for some people. See What Is Elderberry Good For? for the full picture.
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
- 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
- Tiralongo E, Wee SS, Lea RA. Elderberry supplementation reduces cold duration and symptoms in air-travellers: a randomized, double-blind placebo-controlled clinical trial. Nutrients. 2016;8(4):182. doi:10.3390/nu8040182
- Centers for Disease Control and Prevention. Who Needs a Flu Vaccine. Updated September 18, 2025. cdc.gov/flu
- 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
- Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;CD000980. doi:10.1002/14651858.CD000980.pub4
- Office of Dietary Supplements, National Institutes of Health. Zinc: Fact Sheet for Health Professionals. Updated January 6, 2026. ods.od.nih.gov
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.
