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Home / All About Herbs / About (European) Elder Monograph

Black elder tree

© 2018 Steven Foster

A elder monograph for the home

Latin Name: Sambucus nigra

Common Names: European elder, black elder, elderberry, elder flower, sambucus

This elder monograph provides basic information about European elder—common names, usefulness and safety, and resources for more information.


Elder Basics

  • European elder is a tree native to Europe and parts of Asia and Africa, and it also grows in the United States. The name “elder” comes from the Anglo-Saxon word “aeld,” meaning fire. The terms “elder flower” and “elderberry” may refer to either European elder or a different herb called American elder. This fact sheet focuses only on European elder.
  • Various parts of the elder tree, including the bark, leaves, flowers, fruits, and roots, have long been used in traditional medicine.
  • Currently, elderberry and elder flower are used as dietary supplements for flu, colds, constipation, and other conditions.
  • The dried flowers (elder flower) and the dried ripe or fresh berries (elderberry) of the European elder tree are used in teas, extracts, and capsules.

Elder Health Research

  • A small number of studies in people have evaluated European elder for various health conditions. Some of these studies used products that included several ingredients, so the actions of individual ingredients are unclear.

Elder Research Summary

  • Although some preliminary research indicates that elderberry may relieve flu symptoms, the evidence is not strong enough to support its use for this purpose.
  • A few studies have suggested that combination products containing elder flower and other herbs might be helpful for sinusitis, but because the products contain multiple ingredients, it’s unclear what role, if any, elder flower plays in their effects.
  • There’s not enough information to show whether elder flower and elderberry are helpful for any other purposes.
  • Researchers funded by the National Center for Complementary and Integrative Health (NCCIH) are studying the antioxidant effects of extracts from elderberry and their possible relevance to the body’s defense against infection.

Elder Safety

  • The leaves, stems, raw and unripe berries, and other plant parts of the elder tree contain a toxic substance and, if not properly prepared, may cause nausea, vomiting, and severe diarrhea. Because the substance may also be present in the flower, consuming large amounts of the flower might be harmful; however, no illnesses caused by elder flower have been reported.

Elder References

  • Elderberry. Natural Medicines Web site. Accessed at on April 9, 2015. [Database subscription].
  • Elder flower. In: Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000:103-105.
  • Elderflower. Natural Medicines Web site. Accessed at on April 9, 2015. [Database subscription].
  • Mumcuoglu M, Safirman D, Ferne M. Elderberry. In: Coates PM, Betz JM, Blackman MR, et al., eds. Encyclopedia of Dietary Supplements. 2nd ed. New York, NY: Informa Healthcare; 2010:235-240.
  • Vlachojannis JE, Cameron M, Chrubasik S. A systematic review on the sambuci fructus effect and efficacy profilesPhytotherapy Research. 2010;24(1):1-8.

PubMed Articles About Sambucus nigra

Source: National Center for Biotechnology Information (NCBI)[Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; [1988] – [cited 2018 Apr 5]. Available from:

Macknin, M., Wolski, K., Negrey, J., Mace, S., (2021) Elderberry Extract Outpatient Influenza Treatment for Emergency Room Patients Ages 5 and Above: a Randomized, Double-Blind, Placebo-Controlled Trial.

Black elderberry, used medicinally for centuries, decreased influenza duration by 4 days in three previous peer-reviewed trials. US elderberry sales, possibly related to a "high severity" and "high activity" influenza season from January to March 2018, more than doubled from 2017 to 2018 to > $100 million.

Di Stadio, A., Della Volpe, A., Korsch, FM., De Lucia, A., Ralli, M., Martines, F., Ricci, G., (2021) Difensil Immuno Reduces Recurrence and Severity of Tonsillitis in Children: A Randomized Controlled Trial.

Oral supplements (OS) support the immune system in fighting upper airways infection. This study aimed to analyze the effect of Difensil Immuno (DI) on the recurrence of tonsillitis and fever in children. A multicentric randomized clinical trial was conducted. One-hundred and twenty children with chronic tonsillitis were randomly assigned to group A, B or control. Patients in group A were treated with 10 mL of DI for 90 consecutive days, patients in group B underwent treatment with 15 mL of DI for 45 consecutive days. The following data were collected at baseline (T0), T1 and T2: tonsillitis and fever episodes, tonsillar volume, blood test results. One-way ANOVA was used to analyze within and between variances. Patients in group A and B statistically improved their clinical parameters (episode of tonsillitis and fever, tonsillar volume) when compared to control group both at T1 and T2. However, T1 variances were more consistent in group A than in group B. All patients in the study groups improved their clinical outcomes. No statistically significant variances were observed in blood parameters both at T1 and T2. Our results suggest that children treated with DI had fewer episodes of tonsillitis and fever and a reduction in their tonsillar volume.

Akram, M., Tahir, IM., Shah, SMA., Mahmood, Z., Altaf, A., Ahmad, K., Munir, N., Daniyal, M., Nasir, S., Mehboob, H., (2018) Antiviral potential of medicinal plants against HIV, HSV, influenza, hepatitis, and coxsackievirus: A systematic review.

Viral infections are being managed therapeutically through available antiviral regimens with unsatisfactory clinical outcomes. The refractory viral infections resistant to available antiviral drugs are alarming threats and a serious health concern. For viral hepatitis, the interferon and vaccine therapies solely are not ultimate solutions due to recurrence of hepatitis C virus. Owing to the growing incidences of viral infections and especially of resistant viral strains, the available therapeutic modalities need to be improved, complemented with the discovery of novel antiviral agents to combat refractory viral infections. It is widely accepted that medicinal plant heritage is nature gifted, precious, and fueled with the valuable resources for treatment of metabolic and infectious disorders. The aims of this review are to assemble the facts and to conclude the therapeutic potential of medicinal plants in the eradication and management of various viral diseases such as influenza, human immunodeficiency virus (HIV), herpes simplex virus (HSV), hepatitis, and coxsackievirus infections, which have been proven in diverse clinical studies. The articles, published in the English language since 1982 to 2017, were included from Web of Science, Cochrane Library, AMED, CISCOM, EMBASE, MEDLINE, Scopus, and PubMed by using relevant keywords including plants possessing antiviral activity, the antiviral effects of plants, and plants used in viral disorders. The scientific literature mainly focusing on plant extracts and herbal products with therapeutic efficacies against experimental models of influenza, HIV, HSV, hepatitis, and coxsackievirus were included in the study. Pure compounds possessing antiviral activity were excluded, and plants possessing activity against viruses other than viruses in inclusion criteria were excluded. Hundreds of plant extracts with antiviral effect were recognized. However, the data from only 36 families investigated through in vitro and in vivo studies met the inclusion criteria of this review. The inferences from scientific literature review, focusing on potential therapeutic consequences of medicinal plants on experimental models of HIV, HSV, influenza, hepatitis, and coxsackievirus have ascertained the curative antiviral potential of plants. Fifty-four medicinal plants belonging to 36 different families having antiviral potential were documented. Out of 54 plants, 27 individually belong to particular plant families. On the basis of the work of several independent research groups, the therapeutic potential of medicinal plants against listed common viral diseases in the region has been proclaimed. In this context, the herbal formulations as alternative medicine may contribute to the eradication of complicated viral infection significantly. The current review consolidates the data of the various medicinal plants, those are Sambucus nigra, Caesalpinia pulcherrima, and Hypericum connatum, holding promising specific antiviral activities scientifically proven through studies on experimental animal models. Consequently, the original research addressing the development of novel nutraceuticals based on listed medicinal plants is highly recommended for the management of viral disorders.