Elderberry Syrup is Not a Daily Supplement, and What to Use Instead

Many mommy bloggers, Facebook group followers, and even some holistic health practitioners often recommend taking 1 teaspoon elderberry syrup daily during cold and flu season. This period of time can easily last 5-6 months out of the whole year. The families that follow this practice will often attribute this daily elderberry syrup to staying well during the winter. 

Despite this anecdotal success, please don’t consume elderberry syrup daily for months on end. 

elderberry fire cider jars

Elderberry Increases Inflammatory Cytokines

Cytokines are used by the body to signal the immune system to mount a response. Some are inflammatory, some not. Types of cytokines include the interleukins (IL) and tumor necrosis factor (TNF), among others. 

When we are sick, this cytokine response can be fabulous. It means the immune system is on its way to identify the infection and clear it quickly. 

Elderberry has cytokine-releasing properties (various inflammatory interleukins and tumor necrosis factor, to be more specific), which is a component of what makes it so effective at combating colds and the flu. It supports the mobilization of a swift immune response so that the body can act before the virus establishes itself and kicks into high production. Elderberry also prevents influenza virus from entering the cells, blocks influenza virus replication, and increases phagocytosis to gobble up infected cells, so cytokine production is not the only benefit. These are all fabulous things…when you’ve actually encountered a virus or are already sick.

A study on elderberry’s effects on the immune system study concludes, “…in addition to its antiviral properties, Sambucol Elderberry Extract and its formulations activate the healthy immune system by increasing inflammatory cytokine production. Sambucol might therefore be beneficial to the immune system activation and in the inflammatory process in healthy individuals or in patients with various diseases.” 

One might argue that this study gives permission to take elderberry every day since it does “activate the healthy immune system.” The problem with this study is that it’s not longitudinal; it’s not looking at what happens when the healthy immune system is activated for months on end such as when elderberry is consumed daily as a prophylactic through the colder months. 

Microbes. Photo by Andrzej Pobiedziński from FreeImages

Daily consumption of elderberry can contribute to a steady release of ILs and TNF.

Remember above we discussed that some can be inflammatory. A little TNF can even be protective in limited circumstances. However, ongoing TNF production can be an issue: 

“Chronic exposure to a low dose of TNF may cause cachexia [ongoing muscle loss], wasting syndrome, and depression… TNF is a vital player in animal models of endotoxin-induced septic shock, and in chemotherapy-induced septic shock in late-stage lung cancer patients. TNF plays a central role in autoimmune diseases such as rheumatoid arthritis (RA), inflammatory bowel diseases including Crohn’s disease and ulcerative colitis, multiple sclerosis, systemic lupus erythematosus and systemic sclerosis. Finally, TNF has emerged as an important risk factor for tumorigenesis [formation of cancerous tumors], tumor progression, invasion and metastasis. TNF is a key intermediary of cancer-associated chronic inflammation.” 

ILs, meanwhile, can also be helpful during an illness but it’s not a great idea to constantly bath the cells in when not sick. Elderberry stimulates release of IL-1 and IL-8, among others. IL-1 is responsible for that beneficial infected-cellular gobbling during illness, but can also lead to cachexia. IL-8 signals immune cells to move in to respond and helps to kill pathogens, but also increases blood vessel supply – which tumors require to thrive. 

Remember, sometimes inflammatory TNF and ILs can be good. 

But I don’t want any of the risk for developing chronic illness from ongoing daily dosing of elderberry just to prevent a few days of flu.

So What’s a Parent To Do? 

I do keep elderberry on hand and dose it when sick or knowingly exposed to flu and colds. My family is just getting over a bought of flu and I had us dose elderberry syrup every 30-60 minutes during waking hours. We got through the flu pretty rapidly. And then we tapered off and eventually stopped taking it daily again. 

To maintain the immune system through cold and flu season, instead of adding in a ton of supplements, here are some tips and tricks: 

Astragalus root tongues
  1. Eat lots of fresh fruits and veggies, providing nutrients to support the immune system and repair any damage caused by illness
  2. Curb sugar! Eliminate all added and refined sugars, and limit sugar to that in whole fruits. Sugar has been shown to weaken the immune system at least 5 hours, even from a glass of orange juice. 
  3. Prioritize sleep. Get plenty of rest, including full nights of sleep. Our immune systems do great work when we sleep, but we don’t always let them do their jobs!
  4. Minimize your reaction to stressful circumstances. Stress won’t go away, but we can change how we view and respond to it. Stress weakens the immune system, making us more susceptible to infections. (Remember the friend that always gets sick after a huge test or work deadline? That’s why.)
  5. Optimize vitamin D – some research suggests that those with optimal D serum levels had more robust immune responses. Have your 25(OH)D levels tested; I generally recommend them being around 40-60 ng/mL. 
  6. Connected to vitamin D – get plenty of sunshine and fresh air to increase vitamin D and stimulate health and wellness. Being outside in nature is calming and can reduce stress.
  7. Look into astragalus tincture or root if you feel you do need a daily immune support. Astragalus has been used for this purpose in traditional Chinese medicine. 

Cheers to a cold-and-flu-free winter season, without the use of daily elderberry!


Barak, V., Halperin, T., & Kalickman, I. (2001). The effect of Sambucol, a black elderberry-based, natural product, on the production of humancytokines: I. Inflammatory cytokines. European Cytokine Network, 12(2), 290–296. Retrieved from https://www.ncbi.nlm.nih.gov/m/pubmed/11399518/

Brett, N. R., Lavery, P., Agellon, S., Vanstone, C. A., Goruk, S., Field, C. J., & Weiler, H. A. (2018). Vitamin D status and immune health outcomes in a cross-sectional study and a randomized trial of healthy young children. Nutrients, 10(6), 680. doi:10.3390/nu10060680

Chu, W.-M. (2013). Tumor necrosis factor. Cancer Left, 328(2), 222–225. doi:10.1016/j.canlet.2012.10.014

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Justiz Vaillant, A. A. & Qurie, A. (2019). Interleukin. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK499840/

Sanchez, A., Reeser, J. L., Lau, H. S., Yahiku, P. Y., Willard, R. E., McMillan, P. J., Cho, S. Y., … & Register, U. D. (1973). Role of sugars in human neutrophilic phagocytosis.American Journal of Clinical Nutrition, 26(11), 1180–1184.

Torabian, G., Valtcheva, P., Adil, Q, & Dehghania, F. (2019). Anti-influenza activity of elderberry (Sambucus nigra). Journal of Functional Foods, 54, 353-360. https://doi.org/10.1016/j.jff.2019.01.031

Xiaoxia, L., Qu, L., Dong, Y., Han, L., Liu, E., Fang, S … Wang, T. (2014). A review of recent research progress on the Astragalus genus. Molecules, 19(11), 18850-18880. doi:10.3390/molecules191118850

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