Black elderberry and colds: evidence, preparations and precautions

Sambucus nigra elder flower has a European traditional-use monograph for early cold symptoms. This is based on long-standing use, not robust clinical trials. For elderberries, the EMA did not establish a traditional monograph because strength and dosage information were insufficient.

A meta-analysis of three trials involving 180 people reported fewer upper-respiratory symptoms. A later review included five randomized trials and judged the possible effects on colds and influenza uncertain. Products, doses and populations differed. Laboratory mechanisms do not prove a clinical antiviral effect.

An elder-flower infusion is not a universal protocol for every elderberry product. Follow the product information for medicinal preparations. For food, use only correctly identified ripe berries and cook them; do not eat green berries, leaves or stems. Seek poison-centre advice after significant vomiting, diarrhoea, dizziness or malaise.

Ask a pharmacist or doctor if you take a diuretic, have a chronic condition or use regular medication. Do not replace prescribed treatment.

A cold usually resolves spontaneously within 7 to 10 days. Seek advice for worsening symptoms, breathing difficulty, high or persistent fever or a deteriorating general condition.

See the associated editorial evidence file.