Updated: Feb 2
I originally wrote this article in December 2018, but recently added citations for those of you who, like me, like to review research articles yourselves. Reading back through our story got me excited about elderberry all over again. Thankfully we haven't had the flu in our house for some time. My husband finally got the flu shot for the first time in 2019 after some major peer pressure from our kids (turned out to be a very effective strategy if you are looking for ways to motivate your spouse to vaccinate). And although we don't use elderberry prophylactically in our house, we know exactly what to run to if there are signs of illness.
I love that more and more people are realizing the power of elderberry. This is a great read for those who would like to understand the science behind this natural treatment.
There is no science yet showing the effects of elderberry and covid 19.
Always talk to your physician before starting any new supplement, as there are contraindications for taking elderberry with certain medications and medical conditions.
We have been unlucky enough to experience the flu in our house 3 times in the past 12 months. Based on the sentiment I hear from those I live with (eh hem... my husband)... there is an equal dislike for the flu as there is for mom manically chasing after you with the purell and sanitizer wipes anytime a surface is touched.
Needless to say, I have done some digging to figure out the best way to prevent and treat the flu from ever showing it's face in our home again. 'Tis the season!
I am not one to stand up and scream my opinion on hot topics... but if you want my opinion on the flu shot... keep reading.
I get the flu shot every year. My kids get the flu shot every year. My husband has never gotten the flu shot – says he still plans to get one this year – we shall see.
If there is a way to prevent getting the flu, or lessen the symptoms if we do get the flu, you better believe I am going to get it. That’s my selfish reason for vaccinating. My not selfish reason...? Herd immunity is the right thing to do to help our neighbors, coworkers, grocery store workers, and the rest of our community decrease the chance they get the flu as well.
A study from 2017 showed that the flu vaccine reduced the risk of flu-associated death in children by half (51%) among children with underlying high-risk medical conditions and by nearly two-thirds (65%) among healthy children. Three out of four children who die from the flu are not vaccinated.
Elderberry and the Flu
Two words that should be glued together in your brain... flu + elderberry.
When my husband had the flu last year, we didn’t initially realize it was the flu.... so he didn’t take Tamiflu or any alternative treatment. He was down for TWO solid weeks... like, sleep the entire day on Christmas, the week before, and the week after. When my son got the flu a few months later, I spotted it from a mile away, got a prescription for Tamiflu, took it to the pharmacy, and almost peed my pants when they told me it was going to cost $200. I was almost willing to shell out the $200 as I stood there with my credit card having flashbacks of my husband being down and out for TWO weeks... but decided to do some research into alternative ways to treat the flu to see if there were any other options.
OMG ya’ll! I had no clue about the amazingness of elderberry.
This stuff is nature’s medicine! And it’s not just for those who want to believe it works. There is solid research showing its effectiveness.
How does Elderberry work?
It suppresses the virus from replicating... less virus = less symptoms (66% less) and shorter amount of time being sick (3-4 days to be exact).
It has an anti-inflammatory effect... also helping to decrease the amount and severity of symptoms (aches, pains, and fever).
It stimulates your immune system to battle the virus... greatly contributing to the decreased duration of symptoms (perhaps having the biggest impact!)
Elderberry vs Tamiflu
I am a nurse – and in my experience, many people who work in the medical field dismiss alternative forms of preventing and treating illnesses. Some health care providers laugh or roll their eyes when patients ask about alternative ways to stay or become healthy. Perhaps they just don’t know anything about alternative forms of medicine, so maybe that is their defense mechanism? For me... as with all things in life, I am open-minded, and really depend on what has been scientifically proven to decide whether alternative or modern prevention/treatment is the best option for my family. Of course, every situation is unique. When determining whether alternative or modern medicine is the best option for you, you must consider your overall health and risks of anything you put in your body.
To provide a little perspective, let’s compare elderberry to Tamiflu.
Tamiflu shortens your flu symptoms by 1.5 days (compared to 3-4 days with elderberry). Of course, Tamiflu has been tested much more rigorously than elderberry, has which allows it to have the stamp of approval from the FDA for treatment of the flu for children as young as 2 weeks old.
What Can You Treat With Elderberry?
Elderberry is pretty amazing if you ask me. It is a berry that is found in the wild that acts as an antiviral to prevent and treat
the flu (influenza virus),
herpes simplex virus type 1 (primarily cold sores on your mouth),
respiratory syncytial virus (RSV),
certain bacteria that can cause upper respiratory tract infections (aka the common cold).
What to Buy?
Of course, all of these studies are completed by testing standardized elderberry preparations – meaning preparations that have a particular concentration and composition of the berries. This isn’t to say that homemade preparations won’t be effective... but, unless you are super scientific and know how to determine how many grams of elderberry you have per teaspoon, you can’t be sure that you have the correct concentration of elderberry to truly be effective.
So, what should you buy if you are buying a standardized elderberry syrup?
A few research studies chose a certain product, stating it was “high quality”. Assuming they did a good job vetting which preparations should be used, I just assume I use the same thing when treating my family.
Comes in liquid for the kiddos - Sambucol liquid extract
I have a hard time getting my kids to take this - even after mixing with applesauce or juice
Tablets for the adults - Sambucol tablets
I haven't tried the tablets, but the box says they are quick dissolving and taste good - so may work well for kiddos too
Based on our experience with icky flavors of the liquid and gummies, I would begin with the tablets for both kids and adults
For younger kids, try crushing and mixing into a small amount of applesauce, yogurt, ice cream, smoothie
They do have gummies, but they don't taste very good
How much: 4x/day (3.8 g/dose) - for treatment of the flu
NOTE this dose is for ADULTS! There should be instructions on all bottles for children of different ages.
Take within 12-24 hours of onset of symptoms to achieve the above results!
Prevention With Elderberry
Can or should you use elderberry for preventative care? The short answer is sure!
I wasn't able to find any studies that tested if taking a specific amount of elderberry on a daily basis decreased the chance that people would get the flu. But theoretically, if you already have the elderberry in your system when you are exposed to the flu, it should help prevent the flu to binding to your cells and from replicating, just as it does if the flu is already present.
PLUS elderberry has anti-inflammatory properties AND stimulates your immune system - both of which are great whether you have the flu or not. We just don't know how much to take on a regular basis to get these same effects.
Echinacea Hot Drink
One final recommendation for a “natural” treatment of the flu – because you never know when you are going to be unlucky enough to need this info. However, this would likely only be tolerated by older children or adults.
Echinacea is an herb that, like other herbal supplements, can be found in many forms including teas, extracts, capsules, and more. I found multiple convincing studies showing that an Echinacea Based Hot Drink (mixture of Echinacea extract + Elderberry extract) has a similar treatment effectiveness to Tamiflu.
Those treated with the Echinacea Hot Drink took slightly longer for their flu like symptoms to resolve (compared to Tamiflu), but symptoms were minimal by days 2-3 (similar to Tamiflu).
Echinacea reduced secondary bacterial infections (like pneumonia) even more than Tamiflu (6.5% of patients treated with Tamiflu had secondary illness vs just 2.5% of patients treated with Echinacea), and reduced the need for antibiotics similar to Tamiflu.
And the icing on the cake... there were no GI side effects with Echinacea, vs 10% of patients taking Tamiflu who have GI symptoms (that are sometimes severe enough to cause the patient to stop taking the Tamiflu).
What to buy?
How to take?
Add 5ml of Echinafroce Hot Drink to 150 ml of hot water 5x/day for the first 3 days, and 3x/day for the following 7 days
Why? If you prefer to drink a tea-like drink instead of taking Elderberry tablets or drinking Elderberry syrup, this could be a good alternative.
What Doesn't Work... Against the Flu
Some treatments I looked into that didn’t make the cut...
I did not find anything showing that Vitamin D is effective against the flu – but potentially against acute respiratory tract infections (colds). Vitamin D supplementation is clearly effective against acute respiratory tract infections for those with very low levels of vitamin D (<25) – a case to supplement if you have low vitamin D levels – or to get some more sun! There is a chance supplementing may also protect those with higher vitamin D levels, but it wasn't as clear as those with low Vitamin D levels. Vitamin D supplementation is most effective if taken daily or weekly (and NOT just in large doses when you are sick).
Oscillococcinum is an over the counter natural medicine that claims to treat cold/flu symptoms. Research studies have shown it has little to no effectiveness.
Flannery, et al. Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010–2014. Pediatrics, 2017, 139 (5).
Zakay-Rones, et al. Randomized Study of the Efficacy and Safety of Oral Elderberry Extract in the Treatment of Influenza A and B Virus Infections. The Journal of International Medical Research, 2004; 32: 132 – 140.
Krawitz et al. Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. BMC Complementary and Alternative Medicine, 2011, 11:16.
Kinoshita, et al. Anti-Influenza Virus Effects of Elderberry Juice and Its Fractions, Bioscience, Biotechnology, and Biochemistry, 2012, 76:9, 1633-1638,
Moodley, Bradley, and Kimberlin. Antiviral Treatment of Childhood Influenza: an update. Current Opinion Pediatrics, 2018, 30:438–447,
Malosh, et al. Efficacy and safety of oseltamivir in children: systematic review and individual patient data meta-analysis of randomized controlled trials. Clin Infect Dis. 2018;66(10):1492–1500.
Raus, et al. Effect of an Echinacea -Based Hot Drink Versus Oseltamivir in Influenza Treatment: A Randomized, Double-Blind, Double Dummy, Multicenter, Noninferiority Clinical Trial. Current Therapeutic Research. 2015; 77: 66-72.
Katie Ramirez, RN, BSN, CLC
Born Happy, Owner and Coach
Katie Ramirez is a Registered Nurse, Certified Lactation Counselor, and Coach for parents of babies and toddlers. She has spent more than a decade serving patients at major university hospitals such as Vanderbilt University and Penn State University Medical Centers. Katie now spends her time supporting and empowering parents of babies and toddlers as owner and coach for Born Happy.
Katie is the proud mother of two beautiful children, Roberto (age 7), and Veronica (age 5). She has a passion for health, wellness, and happy children, and believes that, with the necessary knowledge and support, all parents can live happy.
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