Sambucol (elderberry extract, maintenance)

Tier 3 — weak evidence · Immunity · Prevention · Daily use

Evidence supports elderberry for treating active colds and flu when started within 48 hours of symptoms. However, no trial evidence supports daily maintenance use for immune "boosting" in healthy adults. Save it for when you actually get sick rather than taking it every day. Using it preventively is an unnecessary expense with no proven benefit.

Dose: Acute use only (15 mL × 4 daily for 3–5 days at symptom onset); daily maintenance use unsupported