What is Black elder?

Black elder (Sambucus nigra) is a shrub or small tree that grows across Europe. Two parts are used: the creamy-white flowers and the small, dark purple berries. German speakers call it Holunder or Fliederbeere.

People take it mainly for colds and flu-type illness. Elderberry comes as syrup, gummies, lozenges and capsules. Elderflower is sold as a dried tea and as a sweet cordial.

One safety point comes first. Raw berries, leaves, bark, roots and stems can make you ill.

They hold cyanogenic glycosides (compounds that can release cyanide). Eating them raw can cause vomiting and diarrhoea. Cooking the ripe berries breaks these compounds down, which is why jams, syrups and cordials are safe.

Here is the honest verdict on the evidence. A few small trials suggest elderberry may shorten a cold by a day or so. The best-run trial, in children with flu, found no benefit at all.

Long use in folk medicine is not proof that a remedy works. It is not proof that it is safe either.

How does Black elder work?

No one has shown how elderberry works in the human body.

In test tubes, elderberry extract can block flu virus from entering cells. In cell studies it also shifts cytokines (immune signal chemicals). Whether either of these things happens inside you is not known.

The berries are rich in anthocyanins (the dark purple pigments). These act as antioxidants in laboratory tests. That lab finding does not mean they ease a cold.

Elderflower tea was long believed to bring on sweating and break a fever. That idea comes from folk practice, not from trials. Warm fluid and rest may explain much of the comfort people report.

Some lab work also shows elderberry slowing certain bacteria. This has not been tested as a treatment in people. Treat it as a laboratory finding only.

What forms does Black elder come in?

Elderberry and elderflower are sold in many everyday forms.

Berry forms: - Syrup, often sweetened with sugar or honey. - Gummies, chewable lozenges, capsules and tablets of dried extract. - Juice, jam, cordial and country wine.

Flower forms: - Loose dried flowers and teabags. - Elderflower cordial and pressé, plus tinctures in alcohol. - Flowers dipped in batter and fried, as food.

Strength varies a lot between products. A gummy may hold a tiny amount of fruit. A standardised extract may hold far more.

Labels rarely let you compare the two. Syrups and gummies are often high in sugar. That matters if you have diabetes, or if you are giving them to a child often.

Home preparation carries the main risk. Never use raw berries, leaves, bark or stems. Cooking ripe berries is what makes them fit to eat.

Where it comes from:

Elder has deep roots in European folk medicine. Records of its use run from the ancient Greeks and Romans through medieval herbals to modern hedgerow cooking.

Folk healers used elderflower tea as a hot drink for fevers and chills. They believed it brought on sweating. Berries were cooked into syrups and wines and taken through the winter.

The tree carried strong folklore. In parts of Germany and Scandinavia an "elder mother" was said to live in it. Woodsmen asked her leave before cutting a branch.

Flowers were also used in washes and poultices for the skin and eyes. Bark and leaves were used as strong purges in older practice. Those uses are now seen as unsafe and have been dropped.

Elderberry syrup only became a mass-market cold product in recent decades. The folk record is about tea, wine and jam, not capsules.

What does Black elder help with?

• Common cold symptoms: This is the best-studied use, and the evidence is still thin. In one study of air travellers, elderberry extract was linked to shorter and milder colds. The study was small and partly funded by a maker. It is reasonable to try, but do not expect much.
• Flu-type illness: Folk practice used elderberry syrup through the flu season. One small trial in adults reported symptoms easing several days sooner. A later, better-run trial in children with confirmed flu found no benefit. Elderberry is not a substitute for a flu vaccine or for antiviral medicine (medicine that fights viruses).
• Sore throat and cough: Lozenges and warm syrups coat the throat and can feel soothing. That comfort may come from the warmth, the sugar and the fluid. No good trial shows elderberry itself shortens a cough.
• Fever and chills (traditional sweating tea): Elderflower tea was the classic European fever drink, often mixed with peppermint and yarrow. The sweating effect has not been confirmed in trials. A fever that is high, or that lasts more than three days, needs a doctor, not tea.
• Blocked nose and sinuses: Elderflower appears in several European mixed herbal products for sinus trouble. Those products hold other herbs too, so the credit cannot be given to elder alone. Elderflower on its own has not been tested well for this.
• Mild constipation: Cooked berries hold fibre and fruit sugars that loosen stools. This is a food effect more than a medicine effect. Large amounts simply cause cramps and diarrhoea.

Which foods are rich in Black elder?

1. Cooked elderberry jam and jelly
2. Elderberry syrup and cordial
3. Elderberry wine
4. Elderflower cordial and pressé
5. Elderflower tea

Practical Tips:

Elder is an ordinary hedgerow food across Europe, but only after cooking. Ripe berries are boiled into jam, syrup, wine and pie filling. The flowers are steeped for cordial or fried in batter.

Never eat the berries raw, and never use leaves, bark or stems in food. Strain out the stalks before cooking, since they hold more of the harmful compounds.

If you forage, be sure of the plant. Dwarf elder (Sambucus ebulus) is a low, herb-like relative and is poisonous.

What are the side effects of Black elder?

• Nausea
• Vomiting, mainly after raw or unripe berries
• Diarrhoea and stomach cramps
• Weakness or dizziness after eating raw plant parts
• Skin rash or itching
• Allergic reaction, including swelling or wheeze
• Sugar load from syrups and gummies

Good to know:

Properly cooked elderberry products are well tolerated by most people. Side effects are usually mild and settle when you stop.

The serious problems come from raw material. Raw berries, leaves, bark and stems have caused outbreaks of vomiting, cramps and weakness. One well-known case involved juice pressed from uncooked berries and leaves.

Allergy is uncommon but real. Elder is in the same plant family as honeysuckle, and flower products can trigger hay fever-type symptoms in sensitive people.

Stop taking it and get medical help if you get swelling of the lips, face or throat, a widespread rash, or trouble breathing.

How much Black elder should you take?

• Recommended daily: The amounts below are the kind printed on labels. They are not a plan for you, and your product may differ. Adult labels often carry: - Elderberry syrup: roughly 10 to 15 ml a day, split into doses. - Dried berry extract capsules: often 300 to 600 mg a day. - Dried elderflower tea: about 3 to 5 g per cup. Children's products are weaker and carry their own age limits. Follow the label on the pack you hold. Never make a preparation from raw berries, leaves, bark, roots or stems. Cooking ripe berries is what makes them safe to swallow.
• Best time of day: The time of day does not matter much. Spread the doses across the day if you are taking more than one. Some people like elderflower tea in the evening because it is warm and calming. That is a comfort choice, not a proven effect.
• With or without food: You can take it with or without food. Take it with a meal if it unsettles your stomach. Syrups and gummies are often high in sugar. Rinse your mouth after a sweet syrup, and count the sugar if you have diabetes.
• Time to effect: If elderberry helps a cold at all, people report feeling it within a day or two. It may also do nothing. The largest flu trial showed no benefit, so a lack of effect is a normal outcome. It will not work faster if you take more. Larger amounts mainly upset the stomach.
• How long to take it: Elderberry is normally used as a short course during an illness. Most labels suggest a few days, and up to about ten. There is no good safety data on taking it every day for months. If you want to use it long term, ask your doctor or pharmacist first. If your symptoms last more than about a week, or get worse, stop guessing and get checked.