Elderberry Supplements Review

Find the Best Elderberry Supplement. Tests and Reviews of Popular Elderberry Supplements & CL's Top Picks.

Medically reviewed and edited by Tod Cooperman, M.D.

Last Updated : 03/24/2021 | Initially Posted: 02/01/2020

Elderberry Supplements Reviewed by ConsumerLab.com

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Table of Contents

Summary

· What is elderberry? Elderberry is a small purple berry from the European (or black) elder bush ( Sambucus nigra ). Among the berry's chemical constituents are phenolic compounds that include anthocyanosides that laboratory tests show to have immune-stimulating, anti-microbial, and other properties (see What It Is).

· What does elderberry do? There is mixed evidence on whether or not elderberry extracts can lessen or reduce the duration of cold and flu symptoms. There is no evidence that elderberry prevents colds or flu. The chemical make-up of these extracts and the most effective dosing, has not been well-defined (see What It Does).

· COVID-19 UPDATE: Due to its immune-stimulating properties, elderberry is being promoted by some to help fight coronavirus (SARS-CoV-2) infection (COVID-19). This has not been proven and there is concern that elderberry could potentially contribute to the damaging "cytokine storm" that occurs with the disease. See the COVID-19 section for details.

· What did CL's tests of elderberry find? ConsumerLab found that the amounts of anthocyanosides in elderberry products ranged more than 2,000-fold — from as little as 0.03 mg to 69.3 mg per suggested serving. This suggests that each product was made with at least some, if not a large amount, of elderberry. However, it is still not clear what amount, if any, indicates that a product will be effective. Even two versions of a popular and clinically-tested elderberry brand differed significantly in their amounts of anthocyanosides and neither formulation exactly matched what was shown to work clinically (see What CL Found).

· Which is the best elderberry supplement? Due to a lack of clinical and scientific research, it remains difficult to know whether any of the elderberry supplements truly work. However, for those still interested in trying elderberry, CL selected two Top Picks for Elderberry — one that provides the most anthocyanosides and the other that appears to be most similar (although not identical) to a product shown to work clinically.

· Elderberry safety and side effects: Elderberry supplements are generally well tolerated, although allergic reactions can occur. Do not eat raw elderberries, as they can be toxic. For more details see Concerns and Cautions.

What It Is:

Elderberry is the small purple fruit of the European elder (Sambucus nigra), a bush that is also known as black elder and is native to Europe but also grows in the United States. Elderberry is a rich source of phenolic compounds, particularly anthocyanins, which give the berries their dark purple color. Laboratory tests indicate that these compounds have antioxidant, anticarcinogenic, immune-stimulating, antibacterial, antiallergic and antiviral properties (Veberic, Food Chem 2009). Anthocyanins are naturally attached to sugar molecules, and it this combination, known as anthocyanosides, that ConsumerLab measured in products and reported in this Review. The berries also contain flavonoids such as quercetin and rutin, and a hemagglutinin protein Sambucus nigra agglutinin-III (SNA-III) (Mach, Biochem J 1991; Senica, J Sci Food Agric 2017).

Eating uncooked, raw, or unripe elderberries can nausea, vomiting, weakness and dizziness because they can contain toxic compounds (Senica, J Sci Food Agric 2017). Elder bark, roots and leaves also contain these toxic compounds (Ulbricht, J Diet Suppl 2014). However, elderberry preparations (powders, concentrates, and extracts) are typically made with only the berry and are expected to have been processed to remove these compounds. In limited clinical trials, described below, they have been generally well-tolerated.

What It Does:

Most of the research with elderberry has focused on its effects on the immune system and antiviral activity. In laboratory studies, a particular elderberry extract, Sambucol (Razei Bar Ltd), has been shown to increase the production of inflammatory cytokines (proteins that are released by the body to help fight infection) in human blood (Barak, Eur Cytokine Netw 2001). Elderberry extract and certain elderberry flavonoids have also been shown to inhibit the replication and hemagglutination of human flu viruses, including certain strains of Influenza A and B, and H1N1 (Zakay-Rones, J Altern Complement Med 1995; Roschek, Phytochemistry 2009).

In people, the evidence is mixed as to whether elderberry helps for cold and flu. Several small, company-funded clinical studies have suggested elderberry may reduce the symptoms (and shorten the duration of symptoms) of colds and flu, but a study that was not company-funded did not show a benefit. Much of the research to-date has used various formulations of Sambucol. No studies have shown elderberry to prevent colds or flu, and a study that evaluated potential cardiovascular effects found no benefit.

Clinical evidence regarding flu and colds
The following three, company-funded, clinical studies indicated benefits in treating flu or colds with elderberry extracts, while a more recent study, further below, did not.

A clinical trial in Israel among 27 children and adults with flu (various strains of influenza A and B) found that Sambucol (2 tablespoons per day for children and 4 tablespoons daily for adults) taken for three days reduced the average length of illness compared to placebo (2.7 days of illness vs. 4 days, respectively) (Zakay-Rones, J Altern Complement Med 1995). [Be aware that the Sambucol formula used in this study was described as "a syrup containing elderberry juice, raspberry extract, glucose, citric acid, and honey," and may differ somewhat from Sambucol formulations currently on the market: Some, for example, do not contain raspberry extract or honey, or have additional ingredients such as vitamin C and zinc.] A slightly larger study in Norway among 60 men and women (ages 18 to 55) with laboratory-confirmed flu infection who took the same Sambucol formula (3 teaspoons taken four times daily with meals) or placebo starting approximately one day after developing symptoms and continuing for five days, found that those who took the elderberry reported significant improvements in symptoms (i.e. aches and pains, cough and congestion) four days sooner, on average, than those who took the placebo (3 days versus 7 days). However, both groups fully recovered from the flu within the same amount of time (8 days) (Zakay-Rones, J Int Med Res 2004).

A study among 64 men and women (average age 40) in China found that an elderberry lozenge containing 175 mg of elderberry extract taken within 24 hours of developing flu symptoms (four times daily -- one before each meal and one before bed) for two days significantly reduced fever, headache, muscle aches, nasal congestion and cough compared to placebo. After two days, flu symptoms were completely resolved in 28% of those who took the elderberry, while none of those taking the placebo was symptom-free. The study was funded by the maker of the lozenge (ViraBLOC, HerbalScience Singapore Pte. Ltd) (Kong, Online J Pharmacol Pharmacokinet 2009).

A study in the U.S. among 87 adults (average age 36) and children age 5 and older (average age 8) with laboratory-confirmed flu infection (about half of whom were given oseltamivir (Tamiflu)) found that Sambucol, taken daily for five days (within 48 hours of onset of symptoms), did not improve symptoms or reduce the number of days ill compared to placebo. Additionally, among participants who did not take Tamiflu, symptoms lasted for an average of two days longer with Sambucol compared to placebo. The dosage for adults in the study was 3 teaspoons of Sambucol four times daily, and, for children, 3 teaspoons twice daily. Each 3-teaspoon serving contained the "fruit juice equivalent" to 5.7 grams of black elderberry, as well as glucose syrup, purified water, citric acid potassium sorbate, blackcurrant flavor, and cranberry. [Note: Sambucol Black Elderberry Syrup tested in this Review contains similar ingredients but without blackcurrant flavor or cranberry.] Unlike Sambucol formulations found to be beneficial in other studies, the formulation used in this study did not contain raspberry extract or honey, but the researchers theorized that "the absence of a 'small amount' of honey seems unlikely to have affected results." The makers of Sambucol provided the elderberry product used in the study but did not provide funding (Macknin, J Gen Intern Med 2020).

A placebo-controlled study in Australia investigated whether elderberry extract could prevent colds or reduce cold symptoms when traveling. In the study, 312 men and women took two capsules of elderberry extract daily for two to 10 days before overseas air-travel which was increased to 3 capsules for one day before travel and to four capsules for five days after arriving at their destination. Elderberry supplementation did not reduce the incidence of colds while traveling, but among those who developed a cold, the extract did reduce the duration of colds by about two days, as well as the severity of cold symptoms. Each elderberry capsule contained 300 mg of elderberry extract (22% polyphenols (i.e., quercetin and its glycosides, rutin), 15% anthocyanins (i.e., cyanidin and pelargonidin glycosides) (Tiralongo, Nutrients 2016). This extract was manufactured by Iprona AG, Italy, which funded the study, and is distributed in the U.S. by BerryPharma.

COVID-19 (SARS-CoV-2)
Some websites have promoted the use of elderberry extract to help fight infection with SARS-CoV-2, the coronavirus that causes COVID-19. This proposed use stems from studies (such as those above) suggesting possible benefit with colds and flu that are also caused by viruses (mostly influenza viruses) but there is no direct evidence that elderberry extract can prevent infection with coronavirus or treat COVID-19.

There is also some concern that taking elderberry could increase the risk of the "cytokine storm" that occurs when the body overreacts to coronavirus in severe COVID-19 infections and damages the lungs (Mehta, Lancet 2020). The concern was prompted by results of a small study that showed taking the elderberry exact Sambucol increased pro-inflammatory cytokines in a dose-dependent manner (i.e. a higher dose of extract resulted in higher levels of cytokines) in the blood of healthy volunteers (Barak, Eur Cytokine Netw 2001). This increase could actually be helpful in fighting an infection. On the other hand, some animal studies and small studies in people suggest that elderberry can modestly decrease levels of pro-inflammatory cytokines, which could be helpful in treating rheumatoid arthritis and, possibly, atherosclerosis (Kirichenko, Phytomedicine 2016). It is not known if elderberry extract would cause a cytokine "storm" in COVID-19.

Other uses
A study among 52 healthy postmenopausal women (average age 58) in England found that taking 500 mg of elderberry extract daily for three months did not decrease blood pressure, total cholesterol, LDL cholesterol or triglyceride levels, nor reduce markers of inflammation in the blood (such as CRP) compared to placebo. The extract was taken as two capsules in the morning and two at night, with the total daily dose providing 500 mg of elderberry anthocyanin (as cyanidin-3-glucoside). Supplementation did not affect fasting blood sugar levels or measures of kidney (i.e. urea, and creatinine ) and liver function (i.e. bilirubin, ALP, ALT or GGT enzyme levels) (Curtis, J Nutr 2009).

Quality Concerns and Tests Performed:

Neither the FDA nor any other federal or state agency routinely tests elderberry supplements, or other dietary supplements, for quality prior to sale. Quality issues for elderberry supplements can include the following:

· Labeled Amount — Does the product really contain the labeled and/or expected amount of total phenolic compounds and anthocyanins? Tests reported in 2020 by the supplement manufacturer Nature's Way of eight elderberry supplements and 25 elderberry extracts used to make supplements revealed that two supplements and five extracts contained no elderberry and were often not the same color as authentic elderberry extract (normally very dark purple). In addition, 14 extracts contained low amounts of a key anthocyanin in elderberry extract. Adulterants in the products included black rice extract, oat bran, and vitamin C. The problems were speculated to be due to increased demand for elderberry extract in the U.S. coupled with the difficulty of some manufacturers to obtain high-quality extract due to COVID-19-related shipment delays. Product identities were not disclosed (American Botanical Council, Botanical Adulterants Monitor 2020). Wide-scale testing of 532 samples of bulk powder, bulk extracts, and finished dietary supplements containing or claiming to contain elderberry found that 58 (10.9%) failed identity specifications in an analysis coordinated through the Botanical Adulterants Prevention Program. The most frequent adulterant was, again, black rice (Oryza sativa) extract, a relatively low-cost ingredient ($14 per kilogram vs. $160-$300 for elderberry extract) that contains some but not all of the anthocyanidin compounds found in elderberry. Product identities were not disclosed (Gafner, HerbalGram 2021).

· Purity — Does the product contain potentially dangerous amounts of toxic heavy metals such as lead, cadmium, and arsenic, which plants may be absorbed from the soil in which they are grown. This is of particular concern with products containing whole elderberry, as opposed to extracts, since contaminants are often removed during the extraction process.

ConsumerLab.com, as part of its mission to independently evaluate products that affect health, wellness, and nutrition, purchased many leading elderberry supplements sold in the U.S. Products listing whole herbs as ingredients were tested to determine whether they were free of unacceptable levels of lead, cadmium, and arsenic.

Products were also tested to determine if they possessed the specific compounds expected of elderberry. Elderberry products should contain particular phenolic compounds, such as anthocyanosides (more generally referred to as anthocyanins) although, the specific amounts to be expected of these compounds has not been well defined.

Products have been standardized to various levels total phenolic compounds or have made no claim at all. In June of 2019, the USP published a monograph pertaining specifically to extracts of European elderberry, Sambucus nigra, requiring that at least 17% of the extract weight be specific anthocyanosides. Most of the products in this Review, however, were purchased only three months later and were likely formulated and produced prior to release of the USP monograph. It is not uncommon after publication of a new USP monograph for the monograph to be challenged, modified, and/or even withdrawn. Consequently, in this Review, although we tested and compared all extract-containing products to this new standard, we did not apply the standard as a requirement for Approval. Most elderberry extracts available for purchase by supplement manufacturers at this time remains standardized to concentrations of anthocyanosides lower than the 17% required by the USP.

See Testing Methods and Passing Score for more details.

What CL Found:

Although testing of the products showed no problems in terms of heavy metal contamination, and all products contained anthocyanosides and other phenols expected in elderberry, the amounts of these compounds per daily serving ranged tremendously, as shown in the graph below (in which anthocyanosides are shown in dark purple and total phenols are shown in light purple).

Boron per Pill or Unit

In terms of anthocyanosides, New Chapter Elderberry Force (made with 335 mg of elderberry extract) provided, by far, the greatest amount per serving -- 69.3 mg. This is about 10 times the amount in the product with the next highest amount, GNC Elderberry Fruit, about 70 times as much as in Nature's Answer Sambucus and Sambucol Black Elderberry Syrup, and more than 100 times the amount in the other products. The product with the lowest amount of anthocyanosides per serving was Havasu Nutrition Premium Elderberry Gummies with just 0.03 mg.

New Chapter was the only extract to meet the new USP standard of 17% anthocyanosides (it provided 20.7% -- although a small portion of this may be attributable to 50 mg of black currant extract also included as an ingredient). Interestingly, Sambucol's Elderberry Syrup, which is the most clinically-tested form of elderberry and claims 3,800 mg of elderberry extract, provided just 1.1 mg of anthocyanosides, which is only 0.03% of the extract. This finding begs the question of what relevance, if any, the new USP standard has to the efficacy of an elderberry product. It also makes one wonder why Sambucol syrup, being an extract, does not contain more anthocyanosides — although it does contain 21 mg of total phenolic compounds. Strangely, a serving of Sambucol's Effervescent Tablets provides just 18% of the amount of anthocyanosides (0.2 mg) as the syrup. One might assume that these two Sambucol products would be more similar in terms anthocyanosides, but they are not.

Top Picks:

Relying on an elderberry supplement to reduce or shorten cold or flu symptoms requires a big leap of faith because 1) the clinical trials with elderberry, as described earlier, have mainly been funded by the companies that make elderberry products, 2) no one seems to have defined the levels of compounds to which an elderberry product should be standardized to be effective, and 3) even the product with the most relevant clinical evidence (Sambucol) is now sold in formulations that don't seem to match the original tested formula.

If you are still interested in trying an elderberry supplement, our Top Picks would be Sambucol Black Elderberry Syrup because it is probably the closest of the tested products to the original Sambucol, and New Chapter Elderberry Force because it was the only product we tested that met the new USP standard for elderberry extract.

The regular suggested adult daily serving of Sambucol syrup is two teaspoons (77 cents). For New Chapter it is one daily capsule (with food) (67 cents). Sambucol suggests the two-teaspoon dose be taken four times daily "for intensive use." For children ages 4 and under, the dosing is halved.

Test Results by Product:

Listed below are the test results for 10 elderberry supplements, which are listed alphabetically within two categories: 1) capsules, gummies and tablets, and 2) liquids. ConsumerLab.com selected seven of these products. Three others (each indicated with a CL flask) were tested at the request of their manufacturers/distributors through CL's voluntary Quality Certification Program and are included for having passed testing.

Shown for each product are the labeled amount and form of elderberry, the serving size recommended on the label, the amounts of anthocyanosides and total phenols found in testing, and whether or not the product passed heavy metal testing. Products listed as "Approved" met their label claim and ConsumerLab.com's quality criteria (see Passing Score). Those that did not are listed as "Not Approved" with an explanation of the problem found. Price comparisons are in the fourth column, special features are listed in the fifth column, and the full list of ingredients is in last column.

Results of ConsumerLab.com Testing of ELDERBERRY SUPPLEMENTS

(Click arrows or swipe left or right to see all columns)

Approval Status

Product Name
(Suggested Serving on Label)

Claimed Elderberry and Key Ingredients Per Suggested Daily Servingⓘ

Test Findings Per Suggested Daily Serving

Cost for Suggested Daily Serving

[Price per 1 mg anthocyanosides]

Price

Notable Features Per Daily Serving, Including Pill Sizeⓘ

Full List of Ingredients Per Daily Serving

Capsules/Gummies/Tablets:

APPROVED

GNC Elderberry Fruit 550 mg

Dist. by General Nutrition Corporation

2 capsules

600 mg elderberry fruit extract (15% polyphenols [90mg])

500 mg elderberry fruit (powder)

Take one capsule two times daily.

2 capsules

7.1 mg anthocyanosides
(0.6% of extract/ powder)

134.1 mg total phenols

Heavy Metalsⓘ: Pass

$0.38

[$0.05]

$18.99/100 capsules

Large capsule

No Sugar, No Artificial Colors, No Artificial Flavors, Sodium Free, No Wheat, Gluten Free, No Soy, No Dairy.

2 capsules

Elderberry Fruit Extract (Sambucus nigra) (15% Polyphenols = 90 mg) 600 mg, Elderberry Fruit Powder (Sambucus nigra) 500 mg.

Other Ingredients: Vegetable Cellulose Capsule, more...

APPROVED

Havasu Nutrition Premium Elderberry Gummies

Dist. by Havasu Nutrition

2 gummies

100 mg black elderberry (powder)

Take two gummies daily preferably with a meal or as directed by your healthcare provider.

2 gummies

0.03 mg anthocyanosides
(0.03% of powder)

125.6 mg total phenols

Heavy Metalsⓘ: Pass

$0.48

[$15.46]

$14.30/60 gummies

Medium/large circular berry shaped gummy

2 gummies

Vitamin C 90 mg, zinc 7.5 mg, sodium 20 mg

2 gummies

Calories 15, Total Carbohydrate 4 g, Total Sugars [Includes 3 g Added Sugars] 3 g, Vitamin C (Ascorbic Acid) 90 mg, Zinc (Zinc Citrate) 7.5 mg, Sodium 20 mg, Black Elderberry (Sambucus nigra L.) 100 mg, more...

APPROVED

Nature's Way® Sambucus Standardized Elderberry

Dist. by Nature's Way Brands, LLC

$ Price Check

2 gummies

50 mg black elder extract (BioActives®) (from 3.2 g of premium cultivar elderberries)

Adults and children 4 years of age and older, chew 2 gummies daily.

2 gummies

0.4 mg anthocyanosides
(0.8% of extract)

129.9 mg total phenols

Heavy Metalsⓘ: Pass

$0.53

[$1.42]

$15.99/60 gummies

Large berry shaped gummy

2 gummies

Vitamin C 90 mg, zinc 7.5 mg, sodium 15 mg

Gelatin-Free. No Artificial Colors or Flavors. Gluten Free. Contains no yeast, wheat, soy, dairy, eggs, or peanuts.

2 gummies

Calories 15, Total Carbohydrate 4 g, Total Sugars [Includes 2 g Added Sugars] 3 g, Vitamin C (ascorbic acid) 90 mg, Zinc (as zinc citrate) 7.5 mg, Sodium 15 mg, Black Elder (Sambucus nigra L.) Extract (berry) [standardized to BioActives® from 3.2 g of premium cultivar elderberries] 50 mg, more...

APPROVED

Top Pick

New Chapter® Elderberry Force™

Dist. by New Chapter, Inc.

1 capsule

335 mg European elder berry extract

One capsule daily with food.

1 capsule

69.3 mg anthocyanosides
(20.7% of extract)
Meets USP standard for extracts of at least 17% anthocyanosides

73.1 mg total phenols

Heavy Metalsⓘ: Pass

$0.67

[$0.01]

$19.99/30 vegan capsules

Large vegan capsule

1 capsule

Black currant 50 mg

Kosher. 100% Vegan. Non-GMO. Gluten-Free. No artificial flavors or colors.

1 capsule

European Elder Berry (Sambucus nigra) (berry) 335 mg, Black Currant (Ribes nigrum) (fruit) 50 mg.

Other Ingredients: Capsule (hypromellose) and maltodextrin.

APPROVED

Sambucol® Black Elderberry

Dist. by PharmaCare US, Inc.

$ Price Check

1 effervescent tablet

150 mg black elderberry juice extract

Dissolve one tablet in one 8 to 12 oz glass of water (to taste) to make a berry flavored drink. Do not exceed 4 tablets per day.

1 tablet

0.2 mg anthocyanosides
(0.1% of extract)

58.3 mg total phenols

Heavy Metalsⓘ: Pass

$0.53

[$2.52]

$7.88/15 effervescent tablets

Very large circular effervescent tablet

1 tablet

Vitamin C 60 mg, zinc 7.5 mg

Sugar Free. No Artificial Flavors. Suitable for Vegetarians and Vegans. Free from Gluten, Yeast, Egg and Lactose. No Preservatives.

1 tablet

Vitamin C (as ascorbic acid) 60 mg, Zinc (as zinc sulphate monohydrate) 7.5 mg, Black Elderberry Juice (as extract) 150 mg.

Other Ingredients: Citric acid, sodium bicarbonate (acidity regulator), maltodextrin, more...

APPROVED

Vitacost Elderberry Complex

Dist. by Vitacost.com®

1 capsule

460 mg European elder (fruit) (powder)

Take 1 capsule daily with food or as directed by a healthcare professional.

1 capsule

0.2 mg anthocyanosides
(0.04% of powder)

8 mg total phenols

Heavy Metalsⓘ: Pass

$0.06

[$0.37]

$7.19/120 capsules

Large capsule

1 capsule

115 mg European elder (flower) (powder)

Free of: Milk, Eggs, Peanuts, Tree Nuts, Crustacean Shellfish, Fish, Soy, Gluten, Titanium Dioxide.

1 capsule

European Elder (fruit) 460 mg, European Elder (flower) 115 mg.

Other Ingredients: Gelatin, microcrystalline cellulose, vegetable stearic acid, vegetable magnesium stearate and silicon dioxide.

Liquids:

APPROVED

365® [Whole Foods] Liquid Elderberry

Dist. by Whole Foods Market

1 tsp [5 ml]

500 mg elderberry concentrate (10:1)

Take 1 teaspoon (5 ml) 1 to 3 times daily.

1 tsp [5 ml]

0.3 mg anthocyanosides
(0.01% of concentrate)

5.5 mg total phenols

Heavy Metalsⓘ: Pass

$0.43

[$1.45]

$9.99/4 fl oz [118 ml] bottle (approx. 23 servings)

Vegan. No Sugar Added.

Precaution: Produced In A Facility That Processes Tree Nuts, Milk, Eggs, Shellfish, Fish, Wheat And Soy.

1 tsp

Calories 15, Total Carbohydrate 4 g, Elderberry (10:1 Concentrate) (Sambucus nigra) (Fruit) 500 mg.

Other Ingredients: Vegetable Glycerin, De-Ionized Water, more...

APPROVED

Garden of Life® Mykind Organics Elderberry Immune Syrup

Dist. by Garden of Life, LLC

$ Price Check

6.5 ml

1.5 g organic black elderberry fruit extract and juice concentrate

Adults and children 13 and older: Take 6.5 mL up to two times per day (serving cup included). Children under 13: Take 1/2 serving once daily under careful, adult supervision.

6.5 ml

0.1 mg anthocyanosides
(0.005% of extract/ concentrate)

70.1 mg total phenols

Heavy Metalsⓘ: Pass

$0.74

[$10.61]

$22.09/6.59 fl oz [195 ml] bottle (approx. 30 servings)

6.5 ml

Vitamin C 36 mg, zinc 1.3 mg, organic immune blend 227 mg, organic Echinacea purpurea extract 50 mg, organic rosemary extract 50 mg

Kosher. USDA Organic seal. Non GMO Project Verified seal. Certified Vegan Vegan.org seal, more...

6.5 ml

Calories 20, Total Carbohydrate 4 g, Dietary Fiber 1 g, Total Sugars [Includes 0 g Added Sugars] 0 g, Vitamin C 36 mg, Zinc 1.3 mg, Organic Sambucus Blend [Organic Black Elderberry Fruit (Sambucus nigra L.) Extract and Juice Concentrate] 1.5 g, more...

APPROVED

Nature's Answer® Sambucus

Mfd. by Nature's Answer®

$ Price Check

2 tsp [10 ml]

2.5 g black elderberry juice concentrate (from 12,000 mg of black elderberries)

For daily maintenance: Adults and children over 12 years of age, take two (2) teaspoons daily. Children 6-12 years of age, take one (1) teaspoon daily, more...

2 tsp [10 ml]

0.9 mg anthocyanosides
(0.2% of concentrate)

44.8 mg total phenols

Heavy Metalsⓘ: Pass

$0.82

[$0.94]

$19.57/8 fl oz [240 ml] bottle (approx. 24 servings)

Non GMO Project Verified seal. Kosher. Gluten Free. Vegan.

2 tsp

Calories 40, Total Carbohydrates 9 g, Total Sugars 1 g, Black Elderberry (Sambucus nigra) [Juice Concentrate from 12,000 mg of Black Elderberries] 2.5 g (2,500 mg).

Other Ingredients: Vegetable Glycerin, Purified Water, Citric Acid.

APPROVED

Top Pick

Sambucol® Black Elderberry Syrup

Dist. by PharmaCare US, Inc.

2 tsp [10 ml]

3,800 mg elderberry extract

For Daily Maintenance: Adults and Children over 4 years: Take 2 teaspoons (10 ml) daily. For Intensive Use: Adults and Children over 4 years: Take 2 teaspoons (10 ml) four times daily.

2 tsp [10 ml]

1.1 mg anthocyanosides
(0.03% of extract)

21.1 mg total phenols

Heavy Metalsⓘ: Pass

$0.77

[$0.70]

$9.24/4 fl oz [120 ml] bottle (approx. 12 servings)

Free From Gluten, Dairy, Soy, Wheat, Nuts, Artificial Color And Flavors.

2 tsp

Calories 30, Total Carbohydrate 8 g, Sugars 8 g, Elderberry Extract (berry) 3.8 g.

Other Ingredients: Glucose Syrup, Purified Water, Citric Acid, Potassium Sorbate (To Retard Spoilage).

Unless otherwise noted, information about the products listed above is based on the samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time, so be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not necessarily be of the same quality as what was tested.

The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information.

ConsumerTips™:

As noted earlier, much of the research on elderberry has been conducted using a particular extract, Sambucol. The original Sambucol formula, used in most of these studies, is described as containing 38% standardized elderberry extract plus small amounts of raspberry extract, glucose, citric acid and honey (Zakay-Rones, J Int Med Res 2004). However, be aware that various Sambucol products currently on the market may differ in terms of the amount of extract they contain and other added ingredients. For example, the Sambucol Black Elderberry Syrup tested in this Review does not include raspberry extract or honey. Sambucol Black Elderberry Effervescent Tablets contain vitamin C (60 mg) and zinc (7.5 mg), neither of which are part of the original formula, and we found that it provided a much lower amount of anthocyanosides than the syrup. [Note that even the maximum suggested dose of four effervescent tablets per day would provide less zinc (30 mg) than has been shown to help reduce cold symptoms, and zinc in the form of a lozenge may be more effective for this use (see the What It Does section of the Zinc Supplements and Lozenges Review for more about using zinc for colds)]. Sambucol Homeopathic Temporary Cold & Flu Symptom Relief Tablets, which was not included in this Review, contains only minute amounts of elderberry because, by definition, homeopathic ingredients are typically diluted to contain just a small fraction of the actual ingredient.

Dosage
For reducing flu symptoms — 3 teaspoons of elderberry extract (Sambucol) taken four times daily with food (Zakay-Rones, J Int Med Res 2004); 4 tablespoons daily (or 2 tablespoons daily for children) has also been used (Zakay-Rones, J Altern Complement Med 1995).

For alleviating cold symptoms — 600 mg of elderberry extract in capsule form taken daily for 8 days before a flight, and 900 mg daily taken 4 to 5 days after arrival, has been shown to reduce the symptoms and duration of colds when traveling, but does not reduce the risk of getting a cold (Tiralongo, Nutrients 2016).

How to Take
Elderberry extracts can be taken with or without food. If preferred, liquid extracts can be added to foods and beverages such as yogurt or juice. Elderberry has a rich Concord-grape-like taste and most liquids and chewables include a sweetener such as glucose or glycerin.

Storage
Extracts should be stored in a cool, dry place.

Concerns and Cautions:

In clinical trials, elderberry powders and extracts have generally been well-tolerated, without adverse effects. Formulations containing vitamin C and/or zinc may cause heartburn or stomach upset in some people. Although rare, be aware that a case of acute pancreatitis was reported in 2019 in a 51-year-old man after he took two to three doses of elderberry extract (Sambucol). He reported having similar symptoms (abdominal pain, nausea, and vomiting) years prior after taking one dose of the same extract. His condition improved after treatment with steroids (Weissman, Dig Dis Sci 2019).

Elderberry can potentially cause allergic reactions such runny nose, sneezing, and stuffiness, or shortness of breath in people who are allergic to grass pollen (Forster-Waldl, Clin Exp Allergy 2003).

Due to a lack of research, elderberry extracts and pills should not be taken by women who are pregnant or breastfeeding (Porter, Phytother Res 2017).

Uncooked and unripe elderberries should not be consumed because they can contain toxic compounds that can cause nausea, vomiting, diarrhea, weakness and dizziness (Senica, J Sci Food Agric 2017). Elderberry bark, roots and leaves also contain these toxic compounds (Ulbricht, J Diet Suppl 2014).

To further assist consumers, ConsumerLab.com licenses its flask-shaped CL Seal of Approved Quality (see The CL Seal) to manufacturers for use on labels of products that have passed its testing. ConsumerLab.com will periodically re-evaluate these products to ensure their compliance with ConsumerLab.com's standards.

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease. Consumers should inform their healthcare providers of the dietary supplements they take.

Latest Clinical Research Updates for Elderberry Supplements

Does Elderberry Help With Flu Symptoms?

9/22/2020

Did giving Sambucol (an elderberry extract) to people diagnosed with flu reduce the severity or shorten the duration of symptoms? Find out what a recent study showed in the What It Does section of our Elderberry Supplements Review. Also see our Top Picks among elderberry supplements.