by Eric Yarnell, ND, RH(AHG)
Last updated 7 Jan 2026
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Table of Contents
Clinical Highlights
Elder fruit is a delicious, nutritious food, as well as being antimicrobial (mainly antiviral) and cardioprotective.
Elder flower is a delicious, mild-to-moderate potency diaphoretic.
Elder fruit (blue/black varieties) and flower are extremely safe, though consuming too much may cause diarrhea. Seeds of Sambucus racemosa (red fruits) and bark of all species should be avoided due to potential toxicity.
Elder flower is a delicious, mild-to-moderate potency diaphoretic.
Elder fruit (blue/black varieties) and flower are extremely safe, though consuming too much may cause diarrhea. Seeds of Sambucus racemosa (red fruits) and bark of all species should be avoided due to potential toxicity.
Sambucus cerulea habit, central Oregon, early summer (photo copyright Eric Yarnell, ND, 2026)
Sambucus racemosa habit, NW Washington, late spring (photo copyright Eric Yarnell, ND, 2026)
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Sambucus nigra habit, Auchmuthie, Scotland, mid-summer (photo copyright Eric Yarnell, ND, 2026)
Sambucus canadensis ripe fruit (Creative Commons share-alike 3.0 license, Cmeusburger)
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Clinical Fundamentals
Part Used: the fully ripe black or blue fruit of S. nigra, S. canadensis, and S. cerulea (and likely other species), fresh or dried, as well as the fresh (preferable) or dried (inferior but still medicinal) flowers of any species.
Drying has been shown to somewhat reduce the flavonoid content of the fruits (Stuppner. et al. 2020).
Taste: sweet and sour, blue and black fruits are delicious (red fruits from some species are must less pleasant and not recommended for consumption without careful removal of all seeds),
Major Actions:
Major Organ System Affinities
Major Indications:
In a double-blind, randomized trial of 312 Australian travelers on an overseas flight, elderberry extract was compared to placebo for prevention of URIs (Tiralongo, et al. 2016). Though the frequency of URIs was not significantly different between the group, the severity and duration of symptoms was significantly less in the elderberry group compared to placebo. The product used in this study was a "membrane-filtered elderberry" extract of the fruits of S. nigra Haschberg variety grown in Austria, standardized to contain 22% polyphenols and 15% anthocyanins, and the dose used was just 600 mg once per day for 10 d before travel and 900 mg once per day for 5 d while flying and after arrival. This is nevertheless a dramatically lower dose and a very different dose form compared to the positive studies on elderberry syrup discussed above.
One trial randomized 120 Italian children with recurrent tonsillitis to one of two doses of an elderberry-containing formula or no treatment (Di Stadio, et al. 2020). This commercial formula contained 112 mg of S. nigra, 7.5 mg zinc, Lactobacillus acidophilus strain HA122 10 million CFU, arabinogalactans 10 mg, vitamin D 10 mcg, vitamin E 30 mg, and vitamin C 90 mg in 10 ml. One group received 10 ml once a day for 90 d, another received 15 ml once a day for 45 d, and one group received no preventive treatment. No child taking the formula at either dose needed antibiotics in the follow-up period, whereas half of untreated controls were treated with them. Frequency of tonsillitis episodes were significantly lower in both groups taking the elderberry-containing formula compared to controls. There were no significant adverse effects.
Major Constituents:
Adverse Effects:
Essentially none, though the seeds of red-fruited varieties and the bark of all species are potentially hazardous, at least in part due to cyanogenic glycoside content. This must be balanced against the fact that the fresh young bark was commonly utilized by the Eclectics as a diaphoretic (Felter 1922).
Excessive intake of fresh fruit of any species may cause diarrhea.
Sambucus canadensis fruit, fruit juice, and seeds contain negligible to no cyanogenic glycisides; when present they are at such small levels they pose no threat (Appenteng, et al. 2021)
Contraindications:
None
Drug Interactions:
Very likely synergistic with anti-influenza drugs.
Drying has been shown to somewhat reduce the flavonoid content of the fruits (Stuppner. et al. 2020).
Taste: sweet and sour, blue and black fruits are delicious (red fruits from some species are must less pleasant and not recommended for consumption without careful removal of all seeds),
Major Actions:
- Fruit
- Antimicrobial (mainly antiviral)
- Inflammation modulating (Curtis, et al. 2024; Farahani, et al. 2021))
- Cardioprotective (Olas 2026; Kirichenko, et al. 2016)
- Nutritive (in food doses)
- Flower
- Diaphoretic
- Antiviral (probable)
Major Organ System Affinities
- Respiratory Tract (fruit and flowers)
- Immune System (flowers)
Major Indications:
- Upper and lower respiratory infections, treatment and prevention
- Atherosclerosis prevention/reversal (Kirichenko, et al. 2016)
In a double-blind, randomized trial of 312 Australian travelers on an overseas flight, elderberry extract was compared to placebo for prevention of URIs (Tiralongo, et al. 2016). Though the frequency of URIs was not significantly different between the group, the severity and duration of symptoms was significantly less in the elderberry group compared to placebo. The product used in this study was a "membrane-filtered elderberry" extract of the fruits of S. nigra Haschberg variety grown in Austria, standardized to contain 22% polyphenols and 15% anthocyanins, and the dose used was just 600 mg once per day for 10 d before travel and 900 mg once per day for 5 d while flying and after arrival. This is nevertheless a dramatically lower dose and a very different dose form compared to the positive studies on elderberry syrup discussed above.
One trial randomized 120 Italian children with recurrent tonsillitis to one of two doses of an elderberry-containing formula or no treatment (Di Stadio, et al. 2020). This commercial formula contained 112 mg of S. nigra, 7.5 mg zinc, Lactobacillus acidophilus strain HA122 10 million CFU, arabinogalactans 10 mg, vitamin D 10 mcg, vitamin E 30 mg, and vitamin C 90 mg in 10 ml. One group received 10 ml once a day for 90 d, another received 15 ml once a day for 45 d, and one group received no preventive treatment. No child taking the formula at either dose needed antibiotics in the follow-up period, whereas half of untreated controls were treated with them. Frequency of tonsillitis episodes were significantly lower in both groups taking the elderberry-containing formula compared to controls. There were no significant adverse effects.
Major Constituents:
- Flavonoids, including high levels of flavonols and anthocyanins
Adverse Effects:
Essentially none, though the seeds of red-fruited varieties and the bark of all species are potentially hazardous, at least in part due to cyanogenic glycoside content. This must be balanced against the fact that the fresh young bark was commonly utilized by the Eclectics as a diaphoretic (Felter 1922).
Excessive intake of fresh fruit of any species may cause diarrhea.
Sambucus canadensis fruit, fruit juice, and seeds contain negligible to no cyanogenic glycisides; when present they are at such small levels they pose no threat (Appenteng, et al. 2021)
Contraindications:
None
Drug Interactions:
Very likely synergistic with anti-influenza drugs.
Pharmacy Essentials
Glycerite of fruit or flower: 1:2–1:3 w:v ratio, 100% glycerin (preferred over tincture for fruit)
Dose:
Acute, adult: 4–10 ml q2–3h, adjusted to body size
Chronic, adult: 2–10 ml bid-tid, adjusted to body size
Child: as adult but adjusted for body size
Syrup or miel: though commonly utilized, these expose patients to a potentially significant amount of simple carbohydrates, which can both be immunosuppressive in acute infectious diseases and of course have long term metabolic consequences. Glycerite is strongly encouraged as a superior, safe, equally tasty alternative to these dose forms.
Tincture of fruit or flower: 1:2–1:3 w:v ratio, 30% ethanol
Dose:
Acute, adult: 4–10 ml q2–3h, adjusted to body size
Chronic, adult: 2–10 ml bid-tid, adjusted to body size
Child: as adult but adjusted for body size
Infusion of flower: 3–5 g (1 heaping tbsp) of dried flowers steeped, covered, in 250 ml of water of recently boiled water, for 15 min. The amount of water used can be adjusted to patient taste in subsequent cups. Best drunk hot for diaphoretic effects.
Dose:
Acute adult: 1 cup drunk before/during a hot bath daily during acute infection
Chronic, adult: not typically used
Child: as adult but adjusted for body size
Capsules of fruit:
Dose:
Acute, adult: 1–2 g q2–3h during acute infection
Chronic, adult: 1–2 g bid for infection prevention
Child: as adult but adjusted for body size
If you need help formulating with this herb, or any other, you can use the formulation tool. Remember that when using this herb in a formula, due to synergy, you can usually use less.
Dose:
Acute, adult: 4–10 ml q2–3h, adjusted to body size
Chronic, adult: 2–10 ml bid-tid, adjusted to body size
Child: as adult but adjusted for body size
Syrup or miel: though commonly utilized, these expose patients to a potentially significant amount of simple carbohydrates, which can both be immunosuppressive in acute infectious diseases and of course have long term metabolic consequences. Glycerite is strongly encouraged as a superior, safe, equally tasty alternative to these dose forms.
Tincture of fruit or flower: 1:2–1:3 w:v ratio, 30% ethanol
Dose:
Acute, adult: 4–10 ml q2–3h, adjusted to body size
Chronic, adult: 2–10 ml bid-tid, adjusted to body size
Child: as adult but adjusted for body size
Infusion of flower: 3–5 g (1 heaping tbsp) of dried flowers steeped, covered, in 250 ml of water of recently boiled water, for 15 min. The amount of water used can be adjusted to patient taste in subsequent cups. Best drunk hot for diaphoretic effects.
Dose:
Acute adult: 1 cup drunk before/during a hot bath daily during acute infection
Chronic, adult: not typically used
Child: as adult but adjusted for body size
Capsules of fruit:
Dose:
Acute, adult: 1–2 g q2–3h during acute infection
Chronic, adult: 1–2 g bid for infection prevention
Child: as adult but adjusted for body size
If you need help formulating with this herb, or any other, you can use the formulation tool. Remember that when using this herb in a formula, due to synergy, you can usually use less.
Other Names
Current Latin Binomials (Applequist 2015):
Sambucus canadensis L (by some called S. nigra ssp canadensis (L) Bolli)
Sambucus cerulea Raf (by some called S. nigra ssp cerulea (Raf) Bolli)
Sambucus nigra L
Latin synonyms:
S. canadensis: S. mexicana C Presl ex DC, S. simpsonii Rehder, S. oropola Donn Sm, Aralia sololensis Donn Sm
English Common Names
For S. canadensis: American elder, American black elder, Canadian elder, Canadian black elder, common elder, Florida elder, Mexican elder, desert elder
For S. cerulea: blue elder
For S. nigra: elder, common elder, black elder, European elder, bore tree, bour tree, danewort, elder bush, European alder, European black elder, pipe tree, sambu, tree of medicine, tree of music, woody elder, boon tree, borral, bour-tree, bull-tree, devil's wood, dog-tree, eldern, eller, ellet, Judas-tree, scaw, scawen, tea-tree, trammon, whit-aller
Albanian Common Name: shtog
Arabic Common Names: خمان أسود, البلسان, البيلسان الكبير, الخابور, خمان
Armenian Common Names: Կտտկենի սև, Կտտկենի (թանթրվենի) Սև
Basque Common Names: saukue, sakutie, seukue, flautagaixe
Catalan Common Names: saüc, saüquer, soguer
Czech Common Name: bez černý
Danish Common Names: almindelig hyld, hyld, hyldebær, alm
Dutch Common Names: gewone vlier, vlier
Esperanto Common Names: nigra sambuko, nigrabera sambuko, sambuko nigra, sambuko nigrabera
Estonian Common Name: must leeder
Faroese Common Name: ylliniviður
Farsi Common Name: آقطی سیاه
Finnish Common Names: mustaselja, mustaheisi
French Common Names: grand sureau, sureau noir, sambéquier, sambu, sureau, sureau commun, arbre de Judas, seu, sureau noir, grand sureau, sus
Georgian Common Names: ანწლი (ants'li'), დიდგულა (didgula)
German Common Names: schwarzer Holunder, Holunder, Hollunder, schwarze Holunder, Alhorn, Alhornbaum, Backholder, Baumholder, Baumholunder, Betschel, echter Holunder, Eiderbaum, Elder, Eliederbaum, Eller, Ellhorn, Fleder, Flieder, Fliederbaum, Holder, Holderbusch, Holler, Hollerbusch, Huskolder, Keilken, Kelkenbusch, Kischke, Schwarzholder, Aashornbaum
Greek (Modern) Common Name: Σαμπούκος, Ακτή, Κουφοξυλιά, Σαμβούλος η μέλαινα
Hebrew Common Names: סמבוק שחור, סמבוק
Hungarian Common Names: fekete bodza, bodza
Icelandic Common Names: svarthyll, yllir
Irish Common Name: trom, tromm. In the Ogham alphabet (used to write early and Old Irish), the letter for R (ruis, "red") is associated with Sambucus nigra.
Italian Common Names: sambuco comune, sambuco negro, sambuco nero, sambucus, zambuco
Japanese Common Names: セイヨウニワトコ, せいようにわとこ
Kurdish (Northern) Common Names: bazgeya reş
Latvian Common Names: kliederis, plūdu koks, plūšu koks, pliederis, melnais plūškoks
Lithuanian Common Name: juoduogis šeivamedis
Macedonian Common Name: бозел
Mandarin Chinese Common Name: 接骨木属 jiē gǔ mù shǔ
Manx (Gaelg) Common Name: tramman
Norweigan Common Names: svartyllir, , svarthyll, hyll, hærsbutre
Papiamentu Common Name: sauku
Polish Common Names: bez czarny, czarny bez, dziki bez czarny, dziki czarny bez
Portuguese Common Names: sabugueiro, candelheiro, canineiro, flor-de-sabugueiro, galacrista, rosa-de-bem-fazer, sabugo, sabugueirinho, sabugueiro-negro, sabugueiro-preto
Romanian Common Names: holer, hoz, iboz, scorpat, soc
Russian Common Name: Бузина чёрная
Scottish Gaelic (Gàidhlig) Common Names: droman, dromanach, drumanach, troman, druman, buthraidh, buthtraidh, rath-fàs ("sprout of good luck")
Serbian Common Names: Зова/Zova, Базга (bazga)
Slovak Common Name: baza čierna
Slovenia Common Names: črni bezeg, bezeg, bezeg črni
Spanish Common Names: saúco, cañilero, canillero, caúco negro, sabuco
Swedish Common Names: fläder, äkta fläder, hyll, vanlig fläder
Turkish Common Names: ağaç mürver, mürver, şifalı mürver
Ukrainian Common Name: Бузина чорна
Welsh (Cymru) Common Names: ysgawen, ysgaw, ysgawlwyn cyffredin, bedwen
Native American Common Names for S. canadensis (grouped linguistically and geographically):
Tsalagi (Cherokee, Southern Iriquoian) Common Name: ᎪᏒᎦ (gosvɂga)
Californian languages:
Yok-Utian (Costanoan/Ohlone) Common Names: čišna, čišša, čisa, cininan
Chumash (isolate) Common Name: kaias
Salinan (isolate) Common Name: tutakol
Native American Common Names for S. cerulea (grouped linguistically and geographically):
hən̓q̓əmin̓əm̓ (Halkomelem, Salish) Common Names: th’í:kwekw, th’íqweqw, th’íkwekwelhp (“to prickle”); fruit: t̓huykwikw (island dialect)
nlaka'pamuctsin (Thompson, Salish) Common Names: c’íkʷukʷ
nuxalk (Bella Coola) Common Name: słkumł (dried fruit)
SENĆOŦEN (Saanich, Salish) Common Name:t̓thikʷíkʷíłč (shrub), t̓thikʷíkʷ (fruit)
Séliš (Montana Salish, Salish) Common Name: c̓kʷikʷ
Snchitsu’umshtsn (Couer d’Alene, Salish) Common Name: c̓ékʷəkʷ
təw'ánəxʷ (Skokomish or Twana, Salish) Common Name: ciqʷi’qʷay (shrub), ciqʷi’qʷ (fruit)
xʷləmiʔčósən (Lummi, Salish) Common Name: tsīkwi’ku
ńseĺxčiń (Okanagan, Sahaptin) Common Names: ćkʷəkʷiłp (shrub), ćkʷikʷ (fruit)
Sambucus canadensis L (by some called S. nigra ssp canadensis (L) Bolli)
Sambucus cerulea Raf (by some called S. nigra ssp cerulea (Raf) Bolli)
Sambucus nigra L
Latin synonyms:
S. canadensis: S. mexicana C Presl ex DC, S. simpsonii Rehder, S. oropola Donn Sm, Aralia sololensis Donn Sm
English Common Names
For S. canadensis: American elder, American black elder, Canadian elder, Canadian black elder, common elder, Florida elder, Mexican elder, desert elder
For S. cerulea: blue elder
For S. nigra: elder, common elder, black elder, European elder, bore tree, bour tree, danewort, elder bush, European alder, European black elder, pipe tree, sambu, tree of medicine, tree of music, woody elder, boon tree, borral, bour-tree, bull-tree, devil's wood, dog-tree, eldern, eller, ellet, Judas-tree, scaw, scawen, tea-tree, trammon, whit-aller
Albanian Common Name: shtog
Arabic Common Names: خمان أسود, البلسان, البيلسان الكبير, الخابور, خمان
Armenian Common Names: Կտտկենի սև, Կտտկենի (թանթրվենի) Սև
Basque Common Names: saukue, sakutie, seukue, flautagaixe
Catalan Common Names: saüc, saüquer, soguer
Czech Common Name: bez černý
Danish Common Names: almindelig hyld, hyld, hyldebær, alm
Dutch Common Names: gewone vlier, vlier
Esperanto Common Names: nigra sambuko, nigrabera sambuko, sambuko nigra, sambuko nigrabera
Estonian Common Name: must leeder
Faroese Common Name: ylliniviður
Farsi Common Name: آقطی سیاه
Finnish Common Names: mustaselja, mustaheisi
French Common Names: grand sureau, sureau noir, sambéquier, sambu, sureau, sureau commun, arbre de Judas, seu, sureau noir, grand sureau, sus
Georgian Common Names: ანწლი (ants'li'), დიდგულა (didgula)
German Common Names: schwarzer Holunder, Holunder, Hollunder, schwarze Holunder, Alhorn, Alhornbaum, Backholder, Baumholder, Baumholunder, Betschel, echter Holunder, Eiderbaum, Elder, Eliederbaum, Eller, Ellhorn, Fleder, Flieder, Fliederbaum, Holder, Holderbusch, Holler, Hollerbusch, Huskolder, Keilken, Kelkenbusch, Kischke, Schwarzholder, Aashornbaum
Greek (Modern) Common Name: Σαμπούκος, Ακτή, Κουφοξυλιά, Σαμβούλος η μέλαινα
Hebrew Common Names: סמבוק שחור, סמבוק
Hungarian Common Names: fekete bodza, bodza
Icelandic Common Names: svarthyll, yllir
Irish Common Name: trom, tromm. In the Ogham alphabet (used to write early and Old Irish), the letter for R (ruis, "red") is associated with Sambucus nigra.
Italian Common Names: sambuco comune, sambuco negro, sambuco nero, sambucus, zambuco
Japanese Common Names: セイヨウニワトコ, せいようにわとこ
Kurdish (Northern) Common Names: bazgeya reş
Latvian Common Names: kliederis, plūdu koks, plūšu koks, pliederis, melnais plūškoks
Lithuanian Common Name: juoduogis šeivamedis
Macedonian Common Name: бозел
Mandarin Chinese Common Name: 接骨木属 jiē gǔ mù shǔ
Manx (Gaelg) Common Name: tramman
Norweigan Common Names: svartyllir, , svarthyll, hyll, hærsbutre
Papiamentu Common Name: sauku
Polish Common Names: bez czarny, czarny bez, dziki bez czarny, dziki czarny bez
Portuguese Common Names: sabugueiro, candelheiro, canineiro, flor-de-sabugueiro, galacrista, rosa-de-bem-fazer, sabugo, sabugueirinho, sabugueiro-negro, sabugueiro-preto
Romanian Common Names: holer, hoz, iboz, scorpat, soc
Russian Common Name: Бузина чёрная
Scottish Gaelic (Gàidhlig) Common Names: droman, dromanach, drumanach, troman, druman, buthraidh, buthtraidh, rath-fàs ("sprout of good luck")
Serbian Common Names: Зова/Zova, Базга (bazga)
Slovak Common Name: baza čierna
Slovenia Common Names: črni bezeg, bezeg, bezeg črni
Spanish Common Names: saúco, cañilero, canillero, caúco negro, sabuco
Swedish Common Names: fläder, äkta fläder, hyll, vanlig fläder
Turkish Common Names: ağaç mürver, mürver, şifalı mürver
Ukrainian Common Name: Бузина чорна
Welsh (Cymru) Common Names: ysgawen, ysgaw, ysgawlwyn cyffredin, bedwen
Native American Common Names for S. canadensis (grouped linguistically and geographically):
Tsalagi (Cherokee, Southern Iriquoian) Common Name: ᎪᏒᎦ (gosvɂga)
Californian languages:
Yok-Utian (Costanoan/Ohlone) Common Names: čišna, čišša, čisa, cininan
Chumash (isolate) Common Name: kaias
Salinan (isolate) Common Name: tutakol
Native American Common Names for S. cerulea (grouped linguistically and geographically):
hən̓q̓əmin̓əm̓ (Halkomelem, Salish) Common Names: th’í:kwekw, th’íqweqw, th’íkwekwelhp (“to prickle”); fruit: t̓huykwikw (island dialect)
nlaka'pamuctsin (Thompson, Salish) Common Names: c’íkʷukʷ
nuxalk (Bella Coola) Common Name: słkumł (dried fruit)
SENĆOŦEN (Saanich, Salish) Common Name:t̓thikʷíkʷíłč (shrub), t̓thikʷíkʷ (fruit)
Séliš (Montana Salish, Salish) Common Name: c̓kʷikʷ
Snchitsu’umshtsn (Couer d’Alene, Salish) Common Name: c̓ékʷəkʷ
təw'ánəxʷ (Skokomish or Twana, Salish) Common Name: ciqʷi’qʷay (shrub), ciqʷi’qʷ (fruit)
xʷləmiʔčósən (Lummi, Salish) Common Name: tsīkwi’ku
ńseĺxčiń (Okanagan, Sahaptin) Common Names: ćkʷəkʷiłp (shrub), ćkʷikʷ (fruit)
Interchangeability of Species
All black- and blue-fruited species appear to be interchangeable clincially; the author can attest from direct clinical experience that this is true of Sambucus cerulea, S. canadensis, and S. nigra. The flowers of any of these species, as well as S. racemosa as discussed below, can be used.
Sambucus racemosa (red elder): produces red fruit which are much more toxic and thus not utilized as medicine. It has a racemose (shaped like the flame of a candle) inflorescence. Red elders in general tend to be smaller than black- or blue-fruited elders, and grow at lower altitude. It is also known as sth'íwéq'elh in Halq̓eméylem (Upriver Halkomelem), ts'ehwt'aane' in 'Atna' kenaege' (Ahtna), t'cu'matas in Cowlitz, stsīwukī'ktc in Nəxʷsƛ̓ay̓əmúcən (Klallam), tsīkī''ē in qʷi·qʷi·diččaq (Makah), ts'pa''aput in kʷoʔlí·yo (Quileute), k'lo'manix in Kʷínaył (Quinault), ts!a'bat in dxʷləšúcid (Skagit dialect), ts'abtadts in dxʷləšúcid (Skykomish dialect), s'tsa'bt in dxʷləšúcid (Snohomish dialect), st'sa'btats in dxʷləšúcid (Squaxin dialect), s'stap't in dxʷləšúcid (Swinomish dialect), and sk!a'lxad in təw'ánəx (Skokomish).
Sambucus racemosa (red elder): produces red fruit which are much more toxic and thus not utilized as medicine. It has a racemose (shaped like the flame of a candle) inflorescence. Red elders in general tend to be smaller than black- or blue-fruited elders, and grow at lower altitude. It is also known as sth'íwéq'elh in Halq̓eméylem (Upriver Halkomelem), ts'ehwt'aane' in 'Atna' kenaege' (Ahtna), t'cu'matas in Cowlitz, stsīwukī'ktc in Nəxʷsƛ̓ay̓əmúcən (Klallam), tsīkī''ē in qʷi·qʷi·diččaq (Makah), ts'pa''aput in kʷoʔlí·yo (Quileute), k'lo'manix in Kʷínaył (Quinault), ts!a'bat in dxʷləšúcid (Skagit dialect), ts'abtadts in dxʷləšúcid (Skykomish dialect), s'tsa'bt in dxʷləšúcid (Snohomish dialect), st'sa'btats in dxʷləšúcid (Squaxin dialect), s'stap't in dxʷləšúcid (Swinomish dialect), and sk!a'lxad in təw'ánəx (Skokomish).
Advanced Clinical Information
Additional Actions:
S. nigra fruit extracts were shown to stimulate monocyte production of various cytokines, most notably tumor necrosis factor alpha, in vitro (Barak, et al. 2001). These same extracts increased in vitro production of pro- and anti-inflammatory cytokines from monocytes derived from healthy human volunteers (Barak, et al. 2002). It is likely that elder has a balanced effect on the immune system and is not a simple immunostimulant.
Lignans from stem bark of the Asian species S. williamsii were shown to stimulate osteoblastic activity in vitro (Yang, et al. 2007).
Additional Indications:
- Antiherpetic (Morag, et al. 1996)
- Anti-influenza (fruit, Roschek, et al. 2009)
- Diuretic (flowers, Rebuelta, et al. 1983)
- Inflammation modulating (Barak, et al. 2002)
- Osteoblast stimulating (bark, Yang, et al. 2007)
S. nigra fruit extracts were shown to stimulate monocyte production of various cytokines, most notably tumor necrosis factor alpha, in vitro (Barak, et al. 2001). These same extracts increased in vitro production of pro- and anti-inflammatory cytokines from monocytes derived from healthy human volunteers (Barak, et al. 2002). It is likely that elder has a balanced effect on the immune system and is not a simple immunostimulant.
Lignans from stem bark of the Asian species S. williamsii were shown to stimulate osteoblastic activity in vitro (Yang, et al. 2007).
Additional Indications:
- Congestive heart failure (flowers)
- Dry eyes (Goh, et al. 2024)
- Eczema, topical (Farahani, et al. 2021)
- Eye strain prevention (Rossi, et al. 2021)
- Gingivitis (Kim, et al. 2022b)
- Halitosis (Kim, et al. 2022a)
- Inflammation, chronic, low-grade (Curtis, et al. 2024)
- Neuralgia
- Rheumatoid arthritis
- Sciatica
Classic Formulas
Dr. Chrisopher’s Cough and Bronchitis Tea
See ingredients in the table below
Combine and infuse in 1 pint recently boiled water for 15 min, strain, add honey as desired, and drink at least 3 cups per day.
Reference: Christopher JR (1996) School of Natural Healing (Springville: Christopher Publications)
See ingredients in the table below
Combine and infuse in 1 pint recently boiled water for 15 min, strain, add honey as desired, and drink at least 3 cups per day.
Reference: Christopher JR (1996) School of Natural Healing (Springville: Christopher Publications)
Herb |
Part |
Amount of herb |
Action |
Althaea officinalis (marshmallow) |
leaf |
0.25 tsp |
demulcent |
Tussilago farfara (coltsfoot) |
leaf |
0.5 tsp |
demulcent, spasmolytic |
Glechoma hederacea (ground ivy) |
leaf |
0.5 tsp |
spasmolytic |
Glycyrrhiza glabra (licorice) |
root |
0.5 tsp |
corrigent, inflammation modulating, antiviral, spasmolytic, demulcent |
Sambucus canadensis (American elder) |
leaf |
0.5 tsp |
diaphoretic, inflammation modulating, antiviral |
Monograph from Eclectic Materia Medica (Felter 1922)
The flowers and the fresh inner bark of Sambucus canadensis Linné (Nat. Ord. Caprifoliaceae). An indigenous shrub growing in low, damp grounds and waste places. Dose, 5 to 60 grains (bark).
Common Names: Elder, American Elder.
Principal Constituents.–Valeric acid, tannin, volatile oil, and a resin.
Preparation.–Specific Medicine Sambucus. Dose, 1 to 60 drops.
Specific Indications.–In skin diseases when the tissues are full, flabby, and edematous, the epidermis separates and discharge of serum is abundant, forming crusts; indolent ulcers, with soft edematous edges; mucous patches with free secretions; post-scarlatinal dropsy; low deposits in or depravation of tissues.
Action and Therapy–External. An ointment of sambucus has been successfully used in weeping eczema, and in old ulcers as a stimulant when the tissues are full and flabby and attended with a discharge of serum.
Internal. Sambucus is stimulant; the flowers in warm infusion are diaphoretic; the cold infusion, diuretic and alterative. Preparations of the green inner bark are excellent agents in edematous conditions, especially in skin diseases showing a tendency to ulceration, with watery discharges and boggy edges. The epiderm separates easily and the weeping secretions form crusts. Probably its most direct indication is depravation of tissue, with edema and deposits of cacoplastic material. Sambucus is useful in catarrhal nasal obstruction in infants and in the dropsy following scarlet fever. It deserves further study in edematous conditions. A strong decoction of the fresh inner bark of the root (bark 1 ounce, water 32 fluidounces, boiled down to 16 fluidounces) in doses of two to four fluidounces, will sometimes promptly empty the tissues of dropsical effusion and act slightly upon the bowels.
Common Names: Elder, American Elder.
Principal Constituents.–Valeric acid, tannin, volatile oil, and a resin.
Preparation.–Specific Medicine Sambucus. Dose, 1 to 60 drops.
Specific Indications.–In skin diseases when the tissues are full, flabby, and edematous, the epidermis separates and discharge of serum is abundant, forming crusts; indolent ulcers, with soft edematous edges; mucous patches with free secretions; post-scarlatinal dropsy; low deposits in or depravation of tissues.
Action and Therapy–External. An ointment of sambucus has been successfully used in weeping eczema, and in old ulcers as a stimulant when the tissues are full and flabby and attended with a discharge of serum.
Internal. Sambucus is stimulant; the flowers in warm infusion are diaphoretic; the cold infusion, diuretic and alterative. Preparations of the green inner bark are excellent agents in edematous conditions, especially in skin diseases showing a tendency to ulceration, with watery discharges and boggy edges. The epiderm separates easily and the weeping secretions form crusts. Probably its most direct indication is depravation of tissue, with edema and deposits of cacoplastic material. Sambucus is useful in catarrhal nasal obstruction in infants and in the dropsy following scarlet fever. It deserves further study in edematous conditions. A strong decoction of the fresh inner bark of the root (bark 1 ounce, water 32 fluidounces, boiled down to 16 fluidounces) in doses of two to four fluidounces, will sometimes promptly empty the tissues of dropsical effusion and act slightly upon the bowels.
Monograph from the Physio-Medical Dispensatory (Cook 1869)
SAMBUCUS CANADENSIS
ELDER
Description: Natural Order, Caprifoliaceae. This is the rank shrub so troublesome to farmers in many sections of the country, growing in moist and rich clays. Stem five to seven feet, with a large pithy center. Leaves of seven to eleven pinnate leaflets, which are oblong-oval, acute, and serrate. Flowers numerous, small, white, lightly fragrant, in very large, compact, and compound
cymes; calyx and corolla five-parted. Fruit a round, smooth, juicy, deeply purplish-black berry. Flowering in June, and ripening the berries in September.
Properties and Uses: The flowers contain a small quantity of volatile oil, which may be obtained by distillation, and becomes as stiff as butter on cooling. Their aroma, when fresh, is strong and rather pleasant; but becomes feeble by age. An ounce to a quart of water makes an infusion that is diffusibly relaxant and mildly diaphoretic, gently nervine, and useful in measles, recent colds, and as a soothing diuretic. It .is used in erysipelas; and the leaves are also reputed an alterant, but are of little service as such. They make a useful fomentation and soothing poultice. The berries are sweetish, and by many are used as food. Their medicinal action is that of a mild laxative and secernent. Some physicians value them in eruptive and gouty maladies; and Dr. W. T. Craig, of Illinois, used to value them above blackberries when prepared as a cordial with the spices. They make a light and very pleasant wine, but lack sufficient saccharine material to yield a preservative quantity of alcohol; whence it is necessary to add two pounds of brown sugar to each gallon of the expressed juice, and treat in the general manner directed for wines. It is slightly laxative, and deserves preference over the greater portion of poisoned wines brought from abroad. The inner bark, when fresh, is a strong hydragogue cathartic and emetic, reputed powerful in dropsy, but not worthy of use. When dried, it is much less active, and acts upon the bowels and the secretions in general as a relaxing and stimulating alterant. Though at one time in much repute in dropsy, syphilis, and herpetic skin diseases, it is now seldom employed. A pound of this bark slowly digested with a pound of warm lard and four ounces of spermaceti, makes a green ointment that deserves the good opinion of the profession in burns, scalds, ringworm, and similar cases.
ELDER
Description: Natural Order, Caprifoliaceae. This is the rank shrub so troublesome to farmers in many sections of the country, growing in moist and rich clays. Stem five to seven feet, with a large pithy center. Leaves of seven to eleven pinnate leaflets, which are oblong-oval, acute, and serrate. Flowers numerous, small, white, lightly fragrant, in very large, compact, and compound
cymes; calyx and corolla five-parted. Fruit a round, smooth, juicy, deeply purplish-black berry. Flowering in June, and ripening the berries in September.
Properties and Uses: The flowers contain a small quantity of volatile oil, which may be obtained by distillation, and becomes as stiff as butter on cooling. Their aroma, when fresh, is strong and rather pleasant; but becomes feeble by age. An ounce to a quart of water makes an infusion that is diffusibly relaxant and mildly diaphoretic, gently nervine, and useful in measles, recent colds, and as a soothing diuretic. It .is used in erysipelas; and the leaves are also reputed an alterant, but are of little service as such. They make a useful fomentation and soothing poultice. The berries are sweetish, and by many are used as food. Their medicinal action is that of a mild laxative and secernent. Some physicians value them in eruptive and gouty maladies; and Dr. W. T. Craig, of Illinois, used to value them above blackberries when prepared as a cordial with the spices. They make a light and very pleasant wine, but lack sufficient saccharine material to yield a preservative quantity of alcohol; whence it is necessary to add two pounds of brown sugar to each gallon of the expressed juice, and treat in the general manner directed for wines. It is slightly laxative, and deserves preference over the greater portion of poisoned wines brought from abroad. The inner bark, when fresh, is a strong hydragogue cathartic and emetic, reputed powerful in dropsy, but not worthy of use. When dried, it is much less active, and acts upon the bowels and the secretions in general as a relaxing and stimulating alterant. Though at one time in much repute in dropsy, syphilis, and herpetic skin diseases, it is now seldom employed. A pound of this bark slowly digested with a pound of warm lard and four ounces of spermaceti, makes a green ointment that deserves the good opinion of the profession in burns, scalds, ringworm, and similar cases.
Botanical Information
Botanical Description, Sambucus nigra:
Grows as a shrub or small tree up to 10 m tall. Flowers are small with five white petals growing in panicles. They have an overpowering, sweet odor that attracts bees and other insects. Produces a black drupe with 3–5 seeds. Leaves are deciduous, pinnate, and usually stipulate. All blue- and black-fruited elders have a root system and stems that overwinter except dwarf elders which die back to the ground and grow new stems each year. Seeds are spread by animals that eat the fruit.
Native range:
S. canadensis: east of the Rocky Mountains
S. cerulea: west of the Rocky Mountains
S. nigra: widespread across Europe including the Caucasus, Ireland, England, and all but northernmost Scotland, except absent from most of southern Spain, southernost Italy, and all but southernmost Scandinavia.
S. racemosa: widespread in North America except not in the Rocky Mountains, Texas, or the South
Grows as a shrub or small tree up to 10 m tall. Flowers are small with five white petals growing in panicles. They have an overpowering, sweet odor that attracts bees and other insects. Produces a black drupe with 3–5 seeds. Leaves are deciduous, pinnate, and usually stipulate. All blue- and black-fruited elders have a root system and stems that overwinter except dwarf elders which die back to the ground and grow new stems each year. Seeds are spread by animals that eat the fruit.
Native range:
S. canadensis: east of the Rocky Mountains
S. cerulea: west of the Rocky Mountains
S. nigra: widespread across Europe including the Caucasus, Ireland, England, and all but northernmost Scotland, except absent from most of southern Spain, southernost Italy, and all but southernmost Scandinavia.
S. racemosa: widespread in North America except not in the Rocky Mountains, Texas, or the South
Native range of Sambucus nigra, per Atkinson and Atkinson 2002.
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Native range of North American species of Sambucus, per Burrows and Tyrl 2013.
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Harvest, Cultivation, and Ecology
Cultivation: only S. nigra appears to be cultivated to any large degree, but all three medicinal species discussed here are relatively easy to cultivate. There are many cultivars of S. nigra.
Wildcrafting: widespread and common. Harvesting the fruit or the flowers does not harm any of the three main medicinal species.
Ecological Status: none of the three main medicinal species discussed here (S. cerulea, S. canadensis, or S. nigra) is threatened or endangered in any way. They are widespread in the wild and at least S. nigra is cultivated to a substantial degree.
Wildcrafting: widespread and common. Harvesting the fruit or the flowers does not harm any of the three main medicinal species.
Ecological Status: none of the three main medicinal species discussed here (S. cerulea, S. canadensis, or S. nigra) is threatened or endangered in any way. They are widespread in the wild and at least S. nigra is cultivated to a substantial degree.
References
Acuna UM, Atha DE, Ma J, Nee MH, Kennelly EJ (2002) “Antioxidant capacities of ten edible North American plants” Phytother Res 16(1):63–5.
Appenteng MK, Krueger R, Johnson MC, et al. (2021) "Cyanogenic glycoside analysis in American elderberry" Molecules 26(5):1384.
Applequist WL (2015) "A brief review of recent controversies in the taxonomy and nomenclature of Sambucus nigra sensu lato" Acta Hortic 1061:25–33.
Atkinson M, Atkinson E (2002) "Biological flora of the British Isles: Sambucus nigra L" J Ecology 90:895–923.
Barak V, Halperin T, Kalickman I (2001) “The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines” Eur Cytokine Netw 12(2): 290–6.
Barak V, Birkenfeld S, Halperin T, Kalickman I (2002) "The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines" Isr Med Assoc J 4(11 Suppl):919–22.
Beckett G, Beckett K (1979) Planting Native Trees and Shrubs (Jarrold)
Burrow GE, Tyrl RJ (2013) Toxic Plants of North America, 2nd ed (Wiley-Blackwell).
Chrubasik C, Maier T, Dawid C, et al. (2008) "An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction" Phytother Res 22(7):913–8.
Cook WH (1869) Physio-Medical Dispensatory: A Treatise on Therapeutics, Materia Medica, and Pharmacy in Accordance With the Principles of Physiological Medictaion (Cincinnati: Self-Published) Reprinted at medherb.com
Curtis AF, Musich M, Costa AN, et al. (2024) "Feasibility and preliminary efficacy of american elderberry juice for improving cognition and inflammation in patients with mild cognitive impairment" Int J Mol Sci 25(8):4352.
Di Stadio A, Della Volpe A, Korsch FM, et al. (2020) "Difensil Immuno reduces recurrence and severity of tonsillitis in children: A randomized controlled trial" Nutrients 12(6):1637.
Ebrahimzadeh MA, Nabavi SF, Nabavi SM (2009) "Antioxidant activities of methanol extract of Sambucus ebulus L. flower" Pak J Biol Sci 12(5):447–50.
Farahani AM, Aryanian Z, Memariani Z, et al. (2021) "A comparison of the effect of topical preparation of Sambucus ebulus L. and hydrocortisone on hand eczema: A double-blind randomized controlled trial" J Altern Complement Med 27(4):323–30.
Felter HW (1922) Eclectic Materia Medica, Pharmacology and Therapeutics (Sandy, OR: Eclectic Medical Publications, reprinted 1998).
Frank T, Janssen M, Netzet G, et al. (2007) "Absorption and excretion of elderberry (Sambucus nigra L.) anthocyanins in healthy humans" Methods Find Exp Clin Pharmacol 29(8):525–33.
Goh KM, Tan ESS, Lim CSY, et al. (2024) "Effect of dietary supplementation with lutein, zeaxanthin, and elderberries on dry eye disease (DED) and immunity: A randomized controlled trial" Nutrients 16(24):4366.
Kim YR, Nam SH (2022a) "The effect of mouthwash with Sambucus williamsii var. coreana extract on halitosis: A randomised, double-blind, placebo-controlled study" Oral Health Prev Dent 20:305–12.
Kim YR, Nam SH (2022b) "A randomized, placebo-controlled clinical trial evaluating of a mouthwash containing Sambucus williamsii var. coreana extract for prevention of gingivitits" Sci Rep 12(1):11250.
Kirichenko TV, Sobenin IA, Nikolic D, et al. (2016) "Anti-cytokine therapy for prevention of atherosclerosis" Phytomedicine 23(11):1198–210.
Lee J, Finn CE (2007) "Anthocyanins and other polyphenolics in American elderberry (Sambucus canadensis) and European elderberry (S. nigra) cultivars" J Sci Food Agric 87(14):2665–75.
Macknin M, Wolski K, Negrey J, Mace S (2020) "Elderberry extract outpatient influenza treatment for emergency room patients ages 5 and above: A randomized, double-blind, placebo-controlled trial" J Gen Intern Med 35(11):3271–7.
Morag A, Mumcuoglu M, Baybikov T, et al. (1996) "Inhibition of sensitive and acyclovir-resistant HSV-1 strains by an elderberry extract in vitro" X Intl Congress of Virology, Jerusalem, 11–16 August [abstract].
Murkovic M, Adam U, Pfannhauser W (2000) "Analysis of anthocyane glycosides in human serum" Fresenius J Analytic Chem 366:379–81.
Olas B (2026) "Comparative review of cardioprotective potential of various parts of Sambucus nigra L., Sambucus williamsii Hance, and their products" Int J Mol Sci 27(1):460.
Rebuelta M, et al. (1983) "Study of the diuretic effect of different preparations of Sambucus nigra L" Plant Méd Phytothér 17:173–81 [in French].
Rieger G, Müller M, Guttenberger H, Bucar F (2008) "Influence of altitudinal variation on the content of phenolic compounds in wild populations of Calluna vulgaris, Sambucus nigra, and Vaccinium myrtillus" J Agric Food Chem 56(19):9080–6.
Roschek B Jr, Fink RC, McMichael MD, et al. (2009) "Elderberry flavonoids bind to and prevent H1N1 infection in vitro" Phytochemistry 70:1255–61.
Rossi GCM, Scudeller L, Bettio F, Milano G (2021) "A pilot, phase II, observational, case-control, 1-month study on asthenopia in video terminal operators without dry eye: Contrast sensitivity and quality of life before and after the oral consumption of a fixed combination of zinc, L-carnitine, extract of elderberry, currant and extract of Eleutherococcus" Nutrients 13(12):4449.
Stuppner S, Mayr S, Beganovic A, et al. (2020) "Near-infrared spectroscopy as a rapid screening method for the determination of total anthocyanin content in Sambucus Fructus" Sensors (Basel) 20(17):4983.
Tiralongo E, Wee SS, Lea RA (2016) "Elderberry supplementation reduces cold duration and symptoms in air-travellers: A randomized, double-blind placebo-controlled clinical trial" Nutrients 8(4):182.
Turek S, Cisowski W (2007) "Free and chemically bonded phenolic acids in barks of Viburnum opulus L. and Sambucus nigra L" Acta Pol Pharm 64(4):377–83.
Walz B, Chrubasik S (2008) "Impact of a proprietary concentrate of Sambucus nigra L. on urinary pH" Phytother Res 22(7):977–8.
Wu X, Gu L, Prior RL, McKay S (2004) "Characterization of anthocyanins and proanthocyanidins in some cultivars of Ribes, Aronia, and Sambucus and their antioxidant capacity" J Agric Food Chem 52(26):7846–56.
Yang XJ, Wong MS, Wang NL, et al. (2007) "Lignans from the stems of Sambucus williamsii and their effects on osteoblastic UMR106 cells" J Asian Nat Prod Res 9(6-8):583–91.
Zakay-Rones Z, Thom E, Wollan T, Wadstein J (2004) “Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections” J Int Med Res 32(2):132–40.
Zakay-Rones Z, Varsano N, Zlotnik M, et al. (1995) "Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L) during an outbreak of influenza B in Panama" J Alt Comp Med 1(4):361–9.
Appenteng MK, Krueger R, Johnson MC, et al. (2021) "Cyanogenic glycoside analysis in American elderberry" Molecules 26(5):1384.
Applequist WL (2015) "A brief review of recent controversies in the taxonomy and nomenclature of Sambucus nigra sensu lato" Acta Hortic 1061:25–33.
Atkinson M, Atkinson E (2002) "Biological flora of the British Isles: Sambucus nigra L" J Ecology 90:895–923.
Barak V, Halperin T, Kalickman I (2001) “The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines” Eur Cytokine Netw 12(2): 290–6.
Barak V, Birkenfeld S, Halperin T, Kalickman I (2002) "The effect of herbal remedies on the production of human inflammatory and anti-inflammatory cytokines" Isr Med Assoc J 4(11 Suppl):919–22.
Beckett G, Beckett K (1979) Planting Native Trees and Shrubs (Jarrold)
Burrow GE, Tyrl RJ (2013) Toxic Plants of North America, 2nd ed (Wiley-Blackwell).
Chrubasik C, Maier T, Dawid C, et al. (2008) "An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction" Phytother Res 22(7):913–8.
Cook WH (1869) Physio-Medical Dispensatory: A Treatise on Therapeutics, Materia Medica, and Pharmacy in Accordance With the Principles of Physiological Medictaion (Cincinnati: Self-Published) Reprinted at medherb.com
Curtis AF, Musich M, Costa AN, et al. (2024) "Feasibility and preliminary efficacy of american elderberry juice for improving cognition and inflammation in patients with mild cognitive impairment" Int J Mol Sci 25(8):4352.
Di Stadio A, Della Volpe A, Korsch FM, et al. (2020) "Difensil Immuno reduces recurrence and severity of tonsillitis in children: A randomized controlled trial" Nutrients 12(6):1637.
Ebrahimzadeh MA, Nabavi SF, Nabavi SM (2009) "Antioxidant activities of methanol extract of Sambucus ebulus L. flower" Pak J Biol Sci 12(5):447–50.
Farahani AM, Aryanian Z, Memariani Z, et al. (2021) "A comparison of the effect of topical preparation of Sambucus ebulus L. and hydrocortisone on hand eczema: A double-blind randomized controlled trial" J Altern Complement Med 27(4):323–30.
Felter HW (1922) Eclectic Materia Medica, Pharmacology and Therapeutics (Sandy, OR: Eclectic Medical Publications, reprinted 1998).
Frank T, Janssen M, Netzet G, et al. (2007) "Absorption and excretion of elderberry (Sambucus nigra L.) anthocyanins in healthy humans" Methods Find Exp Clin Pharmacol 29(8):525–33.
Goh KM, Tan ESS, Lim CSY, et al. (2024) "Effect of dietary supplementation with lutein, zeaxanthin, and elderberries on dry eye disease (DED) and immunity: A randomized controlled trial" Nutrients 16(24):4366.
Kim YR, Nam SH (2022a) "The effect of mouthwash with Sambucus williamsii var. coreana extract on halitosis: A randomised, double-blind, placebo-controlled study" Oral Health Prev Dent 20:305–12.
Kim YR, Nam SH (2022b) "A randomized, placebo-controlled clinical trial evaluating of a mouthwash containing Sambucus williamsii var. coreana extract for prevention of gingivitits" Sci Rep 12(1):11250.
Kirichenko TV, Sobenin IA, Nikolic D, et al. (2016) "Anti-cytokine therapy for prevention of atherosclerosis" Phytomedicine 23(11):1198–210.
Lee J, Finn CE (2007) "Anthocyanins and other polyphenolics in American elderberry (Sambucus canadensis) and European elderberry (S. nigra) cultivars" J Sci Food Agric 87(14):2665–75.
Macknin M, Wolski K, Negrey J, Mace S (2020) "Elderberry extract outpatient influenza treatment for emergency room patients ages 5 and above: A randomized, double-blind, placebo-controlled trial" J Gen Intern Med 35(11):3271–7.
Morag A, Mumcuoglu M, Baybikov T, et al. (1996) "Inhibition of sensitive and acyclovir-resistant HSV-1 strains by an elderberry extract in vitro" X Intl Congress of Virology, Jerusalem, 11–16 August [abstract].
Murkovic M, Adam U, Pfannhauser W (2000) "Analysis of anthocyane glycosides in human serum" Fresenius J Analytic Chem 366:379–81.
Olas B (2026) "Comparative review of cardioprotective potential of various parts of Sambucus nigra L., Sambucus williamsii Hance, and their products" Int J Mol Sci 27(1):460.
Rebuelta M, et al. (1983) "Study of the diuretic effect of different preparations of Sambucus nigra L" Plant Méd Phytothér 17:173–81 [in French].
Rieger G, Müller M, Guttenberger H, Bucar F (2008) "Influence of altitudinal variation on the content of phenolic compounds in wild populations of Calluna vulgaris, Sambucus nigra, and Vaccinium myrtillus" J Agric Food Chem 56(19):9080–6.
Roschek B Jr, Fink RC, McMichael MD, et al. (2009) "Elderberry flavonoids bind to and prevent H1N1 infection in vitro" Phytochemistry 70:1255–61.
Rossi GCM, Scudeller L, Bettio F, Milano G (2021) "A pilot, phase II, observational, case-control, 1-month study on asthenopia in video terminal operators without dry eye: Contrast sensitivity and quality of life before and after the oral consumption of a fixed combination of zinc, L-carnitine, extract of elderberry, currant and extract of Eleutherococcus" Nutrients 13(12):4449.
Stuppner S, Mayr S, Beganovic A, et al. (2020) "Near-infrared spectroscopy as a rapid screening method for the determination of total anthocyanin content in Sambucus Fructus" Sensors (Basel) 20(17):4983.
Tiralongo E, Wee SS, Lea RA (2016) "Elderberry supplementation reduces cold duration and symptoms in air-travellers: A randomized, double-blind placebo-controlled clinical trial" Nutrients 8(4):182.
Turek S, Cisowski W (2007) "Free and chemically bonded phenolic acids in barks of Viburnum opulus L. and Sambucus nigra L" Acta Pol Pharm 64(4):377–83.
Walz B, Chrubasik S (2008) "Impact of a proprietary concentrate of Sambucus nigra L. on urinary pH" Phytother Res 22(7):977–8.
Wu X, Gu L, Prior RL, McKay S (2004) "Characterization of anthocyanins and proanthocyanidins in some cultivars of Ribes, Aronia, and Sambucus and their antioxidant capacity" J Agric Food Chem 52(26):7846–56.
Yang XJ, Wong MS, Wang NL, et al. (2007) "Lignans from the stems of Sambucus williamsii and their effects on osteoblastic UMR106 cells" J Asian Nat Prod Res 9(6-8):583–91.
Zakay-Rones Z, Thom E, Wollan T, Wadstein J (2004) “Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections” J Int Med Res 32(2):132–40.
Zakay-Rones Z, Varsano N, Zlotnik M, et al. (1995) "Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L) during an outbreak of influenza B in Panama" J Alt Comp Med 1(4):361–9.