Elderberry and Flu Symptoms – What’s the Evidence?

Elderberry and Flu Symptoms

We have seen so many patients in the emergency department with “flu like symptoms”. This includes high fever, muscle aches, respiratory symptoms, occasional nausea and vomiting and overall fatigue. Flu symptoms can last over a week in some patients and in some cases result in serious complications like pneumonia and sepsis.

While I was in the health food store today, I could not help but notice a separate section of complementary alternative medical remedies (CAM) for the flu. I wondered which of these remedies have been studied in clinical trials and which have been shown to have any effectiveness in children.

One of the remedies that stood out is elderberry. Elderberry fruit (Sambucus nigra L.) has been used to address a variety of medical complaints but is receiving more popularity because of its promise in decreasing symptom duration of the flu.

What’s the evidence? While no large randomized control trials have been performed on elderberry and flu symptoms, results of smaller trials seem promising. One trial from 2004 compared outcomes of flu positive patients (18 -54 years) who received placebo or elderberry. Patients who received elderberry extract (sambucol) recovered 2-3 days faster than those who received placebo. Before you rush to buy out all the elderberry stock at your local store, remember these points:

1. Clinical trial results, while promising, are very small in number. More studies need to be done to support existing data.
2. The clinical trials that were done only looked at adults. I always urge caution in extrapolating results to children where no randomized clinical studies were done.
3. There can be significant variability in the quality of elderberry extract preparation. So, what you buy in a health food store might be very different from the preparation used in a clinical trial.

Bottom line: Elderberry extract seems promising in reducing the duration of flu like symptoms but has not been adequately studied to make any definitive recommendations. No large randomized trials have tested its use in children.

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