“Natural” doesn’t automatically mean safe for everyone. Elderberry has a decent short-term safety record in trials, but there are groups who should skip it or talk to a clinician first.
Written by Vita Globe Editorial Team | Reviewed against NIH guidance, clinical references and peer-reviewed research
Who should not take elderberry?
Anyone who is pregnant or breastfeeding should avoid elderberry or check with a clinician first, because little is known about its safety in those groups[1][2]. People taking medicines, especially for diabetes, or diuretics or laxatives, should ask a provider first because of possible additive effects[2]. And no one should eat raw or unripe elderberries, leaves or stems[1].
Caveat: Most interaction warnings are based on how elderberry is thought to act, not on documented cases, so they are precautions rather than proven risks.
Sources: NCCIH · Memorial Sloan Kettering · Verified 2026-09-27
IN THIS ARTICLE
Is elderberry safe during pregnancy or breastfeeding?
This is the clearest “skip it unless your doctor says otherwise” group. NCCIH says little is known about whether elderberry is safe to use during pregnancy or while breastfeeding[1]. Memorial Sloan Kettering’s clinical reference goes further, advising people to avoid it during pregnancy or lactation because of potential toxicity and stomach upset[2].
The trials that exist were run in non-pregnant adults (and in one case, adults and children 5 and older), so there simply isn’t data to reassure anyone here[3][4].
Does elderberry interact with medications?
NCCIH’s general advice is that anyone taking medicine should talk with a health care provider before using elderberry or other herbal products, because some herbs and drugs interact in harmful ways[1]. Memorial Sloan Kettering flags three specific categories[2]:
| Medicine type | Possible concern |
|---|---|
| Diabetes medicines | Elderberry may lower blood sugar, adding to the drug’s effect |
| Diuretics (“water pills”) | Elderberry may increase urination, an additive effect |
| Laxatives | Possible additive effect |
These warnings come from how elderberry is thought to work rather than from documented cases, but they are good reasons to check with your pharmacist. If you take a combination product, also look at the other ingredients. Many elderberry gummies include zinc and vitamin C, and zinc has its own interaction list and an upper limit of 40 mg a day for adults[5]. We explain how to add up totals in Elderberry, Vitamin C & Zinc: Why the Combo?.
Should children take elderberry?
Children are not automatically excluded. The 2020 emergency department flu trial enrolled patients ages 5 and up[4]. But many supplements haven’t been tested in children, and kids’ bodies can react differently from adults’[6]. Always check the product label for an age range, since many elderberry gummies are made for adults only, and talk with your pediatrician. Our guide Elderberry for Kids: Age, Dose & Safety goes into detail.
Who should never eat raw elderberries?
Everyone. Raw or unripe elderberries, and the leaves and stems of the elder tree, contain cyanide-producing substances that can cause nausea, vomiting and severe diarrhea; cooking eliminates the toxin[1]. In 1984, a group of people in California got sick after drinking juice pressed from elderberries along with leaves and branches[7]. If you forage or make your own syrup, read Are Elderberries Poisonous? Raw vs. Prepared first.
What about autoimmune conditions or serious illness?
You will often read that people with autoimmune conditions should avoid elderberry because it might “overstimulate” the immune system. A 2021 systematic review looked specifically at this concern during the COVID-19 pandemic and found no evidence that elderberry overstimulates the immune system, while stressing that the evidence on both benefits and harms is uncertain[3]. Because the data are thin, anyone with an autoimmune condition, a transplant, or who takes immune-suppressing medicines should make the decision with their specialist.
And if you have a high fever, trouble breathing, or you are in a higher-risk group for flu complications, elderberry is not a substitute for seeing a clinician. Seek care promptly; nothing in the elderberry research replaces that.
The honest summary
- Avoid or ask first: pregnancy and breastfeeding.
- Ask your pharmacist: diabetes medicines, diuretics, laxatives, immune-suppressing drugs.
- Kids: only products labeled for their age, and with your pediatrician’s input.
- Everyone: never eat raw berries, leaves or stems.
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 is not intended for anyone under 18, and our label advises checking with a healthcare provider first if you are pregnant, nursing, taking medication or have a medical condition.*
Frequently asked questions
Can elderberry raise blood pressure?
We did not find good evidence that elderberry raises blood pressure. If you take blood pressure medicine, particularly a diuretic, ask your provider before adding it[2].
Can you take elderberry with an autoimmune disease?
A systematic review found no evidence that elderberry overstimulates the immune system, but the evidence is limited[3]. Talk with your specialist first.
Is elderberry bad for your liver or kidneys?
We did not find reliable evidence of liver or kidney harm from prepared elderberry products. Short trials reported few side effects[3]. If you have liver or kidney disease, check with your doctor before any new supplement.
Can I take elderberry with antibiotics?
There is no well-documented interaction, but NCCIH recommends talking to your provider before combining any herb with medicine[1]. Elderberry doesn’t treat bacterial infections.
What happens if you take too much elderberry?
Large amounts of improperly prepared elderberry can cause nausea, vomiting and diarrhea[1]. With combination gummies, the bigger concern is often the zinc, which has an adult upper limit of 40 mg a day[5]. See Can You Take Elderberry Every Day?.
Sources
- National Center for Complementary and Integrative Health. Elderberry: Usefulness and Safety. Updated November 2024. nccih.nih.gov/health/elderberry
- Memorial Sloan Kettering Cancer Center. Elderberry. About Herbs, Botanicals & Other Products. Updated March 27, 2023. mskcc.org
- 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
- 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
- Office of Dietary Supplements, National Institutes of Health. Zinc: Fact Sheet for Health Professionals. Updated January 6, 2026. ods.od.nih.gov
- National Center for Complementary and Integrative Health. 10 Things To Know About Dietary Supplements for Children and Teens. nccih.nih.gov
- Centers for Disease Control. Poisoning from elderberry juice — California. MMWR Morb Mortal Wkly Rep. 1984;33(13):173. cdc.gov/mmwr
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.
