Elderberry (Sambucus nigra)

Tier 2 — promising · Cold/Flu · Immunity

Traditional remedy with mixed modern evidence. The Hawkins 2019 meta-analysis of 4 small RCTs reported a ~2-day reduction in upper-respiratory symptom duration, but the larger Macknin 2020 RCT in children with influenza (Clinical Infectious Diseases) found no benefit over placebo and possibly a longer symptom course. Rich in antioxidants. Best used at the first sign of illness rather than daily. Generally well tolerated; raw berries, bark and leaves contain cyanogenic glycosides and must be cooked.

Dose: 15 mL syrup × 4 daily for 3–5 days within 48 hrs of onset