Several species of Sambucus produce elderberries. Most research and publications refer to Sambucus nigra. Other species with similar chemical components include the American elder or common elder (Sambucus canadensis), antelope brush (Sambucus tridentata), blue elderberry (Sambucus caerulea), danewort (Sambucus ebulus), dwarf elder (Sambucus ebulus), red-fruited elder (Sambucus pubens, Sambucus racemosa), and Sambucus formosana. American elder (S. canadensis) and European eder (S. nigra) are often discussed simultaneously in the literature since they have many of the same uses and contain common constituents.

European elder grows up to 30 feet tall, is native to Europe, but has been naturalized to the Americas. Historically, the flowers and leaves have been used for pain relief, swelling/inflammation, diuresis (urine production), and as a diaphoretic or expectorant. The leaves have been used externally for sitz baths. The bark, when aged, has been used as a diuretic, laxative, or emetic (to induce vomiting). The berries have been used traditionally in food as flavoring, and in the preparation of elderberry wine and pies.

The flowers and berries (blue/black only) are used most often medicinally. They contain flavonoids, which are found to possess a variety of actions, including antioxidant and immunologic properties. Although hypothesized to be beneficial, there is no definitive evidence from well-conducted human clinical trials currently available regarding the use of elder.

The bark, leaves, seeds and raw/unripe fruit contain the cyanogenic glycoside sambunigrin, which is potentially toxic.

Almindelig hyld, baccae, baises de sureau, battree, black berried alder, black elder, black elderberry, boor tree, bountry, boure tree, Busine (Russian), Caprifoliaceae (family), cyaniding-3-glucoside, cyaniding-3-sambubioside, devil's eye, elderberry, elderberry anthocyanins, elderberry bark agglutinin, elderberry juice, ellanwood, ellanwood, ellhorn, European alder, European elder, European elderberry, European elderflower, European elder fruit, frau holloe, German elder, Holunderblüten, Holunderbeeren, lady elder, nigrin b , peonidin 3-glucoside, peonidin monglucuronide, peonidin 3-sambubioside, old gal, old lady, pipe tree, Rubini® (elderberry extract), Sambreo, sambuco (Italian), Sambucus sieboldiana (Japanese), Sambucipunct Sambucus, Sambuci flos, Sauco (Spanish), Schwarzer holunder (German), sieboldin-b, stinking elder, Sureau noir (French), sweet elder, tree of doom, yakori bengestro.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Bacterial sinusitis (Grade: C)
Elder has been observed to reduce excessive sinus mucus secretion in laboratory studies. There is only limited research specifically using elder to treat sinusitis in humans. Combination products containing elder and other herbs (such as Sinupret®) have been reported to have beneficial effects when used with antibiotics to treat sinus infections, although the majority of this evidence is not high quality and requires confirmation with better research.

Bronchitis (Grade: C)
There is a small amount of research of the combination herbal product Sinupret® in patients with bronchitis. This formula contains elder flowers (

High cholesterol (Grade: C)
There is no reliable human evidence currently available evaluating elder alone as a treatment for high cholesterol. Early study reports that elderberry juice may decrease in serum cholesterol concentrations and an increase in low-density lipoprotein (LDL) stability. Additional research is needed in this area before a firm conclusion can be reached. Elder should not be used in the place of other more proven therapies, and patients are advised to discuss with their primary healthcare provider before using elderberry for treatment of high cholesterol.

Influenza (Grade: C)
Human study reports that elderberry juice may improve flu-like symptoms, such as fever, fatigue, headache, sore throat, cough and aches, in less than half the time that it normally takes to get over the flu. However study designs are weak, therefore it remains unclear whether there is truly any benefit from elder for this condition. Additional research is needed in this area before a firm conclusion can be reached. Elder should not be used in the place of other more proven therapies, and patients are advised to discuss influenza vaccination with their primary healthcare provider. It should be noted that the berries must be cooked to prevent nausea or cyanide toxicity.