Elderberry supplements, syrup, tea and gummies get popular every flu season, now more than ever -and for good reason. Research has noted this herbal supplement can stimulate the immune system. A more vigilant immune response may mean fewer colds and flues. But what about those with autoimmune disease? They already have overactive immune systems. Can people with autoimmune disease take elderberry? would it make their autoimmune disorder worse? It's a valid question. Let's look at the research and see what it says.
What is Elderberry Used For
Elderberry (Sambucus nigra) has a long history of use. In the past, the herb has been to treat:
- liver problems
- insect repellant
and many other things. These days however the supplement is used to battle the flu.
Can It Prevent Flu?
These days the berries are used to modulate the immune system and reduce colds and the flu. So, does it? In one investigation 60 people with influenza (the flu) symptoms were given 15 ml of Sambucol elderberry syrup or a placebo 4 times a day for 5 days.
Those using the supplement recovered 4 days sooner.
Other studies have also found elderberry effective at reducing the duration and severity of colds and influenza virus symptoms. So this is not a scam.
Most supplements use the black berries of the plant. The berries are what you should look for.
Whether or not the supplement prevents the flu, may depend on the type of virus you're infected with. For example, the elderberry appears to prevent the H1N1 virus from entering cells. Blocking the virus entry into cells should reduce infections. The H1N1 influenza A virus was associated with the 1918 Spanish Flu that killed millions.
Whether it prevents other strains of the flu from entering cells needs more study.
While all this is good, if elderberry ramps up the immune response, would this be bad for those with autoimmune disease, who already have overly aggressive immune systems? Examples of autoimmune disorders include:
- type I diabetes
- rheumatoid arthritis
- hashimoto's thyroid disease
- multiple sclerosis
Let's look at the evidence.
Does Elderberry Worsen Autoimmune Disease?
To date, there is no conclusive human proof that black elderberry supplements are harmful to people who have autoimmune disorders. Reports of it worsening of autoimmune diseases like rheumatoid arthritis, lupus or thyroid problems cannot be located.
So why do some people say it may be harmful?
Research shows the supplement increases cytokines. Cytokines are made by the immune system. Some cytokines are pro-inflammatory. Too much inflammation may make autoimmune conditions worse.
In one study, Sambucol supplements were given to 12 healthy people.
Their blood was then analyzed.
Several pro-inflammatory cytokines were increased. The greatest increase was seen in a cytokine called tumor necrosis factor-alpha (TNF alpha) which has been linked to autoimmune conditions like rheumatoid arthritis and Chronis disease.
While this may seem alarming, remember the people in this study were healthy. They did not have an autoimmune disease. It's possible healthy people and those with autoimmune diseases may react differently.
The real test would be to give supplements to people with autoimmune disease and see if it made their symptoms worse. For example, would supplements:
- make rheumatoid arthritis symptoms worse
- raise thyroid auto-antibodies
Investigations like these could not be located.
So, claims elderberry makes worsens autoimmune disease seems to be theoretical. Of course, lack of evidence does not mean its safe for autoimmune disease. If there are problems, it may depend on what autoimmune disorder you had. This is why most experts recommend speaking to your doctor first.
Does It Work Better With…
Some supplements may contain combinations of elderberry with:
or things thought to ramp up the immune system. There is little proof that other ingredients make elderberry work better.
Elderberry Side Effects
Who should not take black elderberry? Generally, the supplement side effects are few and far in between. No toxicity to the liver or other issues has been reported. Most people have no serious ill effects when taking quality-made supplements. No reports of elderberry making autoimmune disorders worse could be located. The proof so far appears to be theoretical.
While there are reports of side effects include nausea, vomiting, or diarrhea, these appear rare for dietary supplements especially when taken for short periods of time.
Here are some things to consider when taking this supplement. This list is not complete:
- start with less than recommended for the first week to see how you respond
- don't take elderberry all the time. Long term use is not known.
- never eat raw uncooked elderberry plants
- when consumed raw, the bark, root and leaves contain a chemical called sambunigrin which can produce the poison, cyanide. The berries do not have this harmful compound.
- stop taking at least 2 weeks before surgery
- speak to your doctor if you're pregnant or breastfeeding
- elderberry may have interactions with medications and other supplements
Elderberry supplements may be ill-advised for people taking immune-suppressing drugs. That said, reports of the supplement making immune reducing drugs less effective could not be located.
To Take Or Not To Take
So, is it safe for autoimmune disease? Generally, studies show elderberry can reduce your symptoms of flu virus infections. This is good. While there seems to be no concrete proof elderberry makes the autoimmune disease worse, it's best to check with your doctor to see if it's right for you. Lack of proof doesn't mean there's nothing to it. The only way to really know is to test it. Hopefully, one day those studies will be performed.
Catherine Pendergraft says
Thanks for the information. I have an autoimmune disease- Amyopatholic Dermatomyositis and Hypothyroidism. I have Elderberry tincture but have been hesitant to take it. I have used Sambucol with no noticeable side effects.
Joe Cannon says
Catherine, thanks for sharing. I’m glad the review helped you. I’m also glad you have not had any problems with Sambucol too. If you have any other supplement questions let me know and I’ll see what I can turn up for you.
Rebecca Seaver says
I have rheumatoid arthritis and have been taking elderberry every cold season for 3 years and have not noticed any flare-ups.
great write up by the way thanks so much. I appreciated the emphasis on science. You really brought “clarity” to this subject 🙂
Joe Cannon says
Rebecca, thanks so much for sharing this! Glad elderberry has not had any side effects when you used it. 🙂
Laurel Fitzhugh says
My theory, based on… Intuition? Nothing? Is that elderberry normalize the immune system and makes it more responsive to physiological and environmental factors. I have RA and elderberry does not trigger it.
Joe Cannon says
Laural, thanks so much for stopping by and giving your thoughts. I am so glad to hear elderberry does not make your RA worse. Until studies are done the only way to know is for people like you to share what happened to them. Thank you so much 🙂
Hi Joe, I’ve often wondered the same thing about immune-boosting supplements because I have rheumatoid arthritis. But I take some anyways and haven’t noticed any increase in my RA symptoms. I’ve never taken Elderberry. For example, even pre-and probiotics are supposed to stimulate the immune system.
As you know, I’m not home from 6 days in the hospital for sepsis and an infected abscess after a cervical spine decompression surgery. Because I’m on an antibiotic (Cefazolin/Ancef) 3 times daily for 6 weeks, I MUST take a probiotic. So far, and without my RA med (XELJANZ, which I cannot take for the duration) no increased symptoms of RA have happened. Praise the Lord!
But, yes, there should be studies on how immune stimulants affect people with autoimmune diseases!
I see my Rheumatologist in June, and hopefully I’ll remember to ask her this question. Thank you for looking out for us autoimmune people. There are so many of us!
And I think you will be invaluable to the doctor above! After all, he used your review as the initial starting point in his educational material!!
Joe Cannon says
Roseann, I’m glad to hear you are steadily improving and that your noticed no worsening of your RA symptoms. That’s definitely something you don’t want to flair up during this challenging time.
Richard Fulton M.D. says
I’ve been following you for a few years and appreciate your contribution the supplement noise/conundrum and your evidence-based approach.
An email I sent to my fam re: their Optimal Response to COVID-19 has grown into a 4-5 page update, eBook, and 3 week course I’ll be sending to hundreds of others. Website coming soon to automate all this directed to our “2nd Line of Defense” of boosting our immune system and reducing stress to weather an infection IF our preventive measures (1st Line) somehow fail.
Are you interested in participating somehow in the supplement area (which is a very small part of the big picture, BTW)?
Email me and I can explain more/send examples. Website is almost done.
Joe Cannon says
Richard, thanks for chiming in. I’d agree the supplements would be a smaller part of the Covid cure than the other things which I’m sure we’ve all heard on the news. Im not sure how I could help but I’ll drop you a quick email.