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Key Takeaways
- Elderberry can cause digestive symptoms, allergic reactions, and toxic effects, especially when raw, improperly prepared, or taken in excess of the recommended dose.
- Elderberry may interact with medications and may not be safe for people with autoimmune conditions, children, or during pregnancy.
- Use properly processed products, follow dosing instructions, and consult a healthcare provider before using elderberry.
Elderberry is a common supplement marketed as supporting the immune system, especially during cold and flu season. While it may be safe in small amounts, taking too much elderberry or using it incorrectly may lead to side effects, some of which may be serious.
1. Nausea, Vomiting, and Diarrhea
Digestive issues are the most commonly reported side effects of elderberry. High doses may cause nausea, stomach cramps, vomiting, or diarrhea.
These symptoms are more likely when elderberry is taken in concentrated forms, such as syrups, gummies, or capsules, or when it’s used for longer than recommended. These digestive symptoms usually improve after stopping elderberry.
2. Toxic Effects From Raw or Improperly Prepared Elderberry
Raw elderberries, their leaves, stems, and bark of the plant contain compounds called cyanogenic glycosides, which can release cyanide when eaten.
Cyanide exposure can cause severe nausea and vomiting, dizziness, weakness, and trouble breathing.
Most commercial elderberry products are cooked or processed to remove these toxins. However, homemade elderberry syrups, teas, or juices may still contain harmful compounds if they aren’t prepared correctly.
3. Immune System Overstimulation
Elderberry has immunomodulatory effects in lab studies and small clinical studies, but its impact on immune activity in humans is not well established.
Because of concerns about immune activation, elderberry is often used cautiously or avoided in people with autoimmune disease, unless advised by a healthcare provider. Always talk with your healthcare provider before taking elderberry.
4. Interactions With Medications
Elderberry may interact with some medications, especially when taken regularly or in large amounts.
Since some studies show it can stimulate immune activity, there is concern that it could interact with immunosuppressant medications, potentially making them less effective, although clinical evidence in humans is limited. People taking immunosuppressants should discuss use with a healthcare provider.
Limited evidence suggests elderberry may affect glucose metabolism. People using diabetes medications should discuss use with their healthcare provider.
Research on specific medication interactions is limited, so anyone taking prescription medications should talk with their healthcare provider before using elderberry supplements.
5. Allergic Reactions
Some people may be allergic to elderberry. Mild allergic reactions can include itching, rash, or hives.
More serious reactions can include swelling of the lips, face, or throat, or trouble breathing, and require immediate medical care. Stop using elderberry if any allergy symptoms appear and seek emergency medical care for symptoms of a severe reaction.
6. Rare But Serious Health Effects
Some serious health problems linked to elderberry use have been reported, although these are not common.
Isolated case reports describe severe gastrointestinal illness and acute inflammation of the pancreas (pancreatitis) following elderberry supplement use. While rare, these cases highlight the importance of proper dosing and preparation.
There is limited safety data on elderberry use in children, and toxic effects have been reported. Children may be more vulnerable to adverse effects from raw or improperly prepared elderberry products.
7. Pregnancy and Breastfeeding Safety Concerns
There is insufficient reliable research to determine whether elderberry is safe to take during pregnancy or while breastfeeding.
Since there is limited safety data and the potential for toxic effects, most experts recommend avoiding elderberries during pregnancy and while breastfeeding.
How to Use Elderberry Safely
Dietary supplements are not regulated by the Food and Drug Administration (FDA) as strictly as prescription medications. They are not required to undergo the same premarket (before sale to the public) safety and effectiveness testing as medications.
Guidance to follow for using elderberry safely includes:
- Avoid raw elderberries and improperly prepared homemade products.
- When choosing a dietary supplement, look for products from reputable brands that clearly list ingredients and dosages and have been independently tested by third-party organizations for quality and purity.
- Follow dosing instructions on supplement labels.
- Talk with a healthcare provider if you have a medical condition or take medications.