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The Science Nook on Elderberry and Cold Symptoms/Duration

by Jenna Koroly, MS, RD, CSOWM, CDN

Elderberries are violet-black in color, which comes from their anthocyanin make-up. These berries may have antioxidant, anti-diabetic, and anti-inflammatory effects [i]. In one randomized, placebo-controlled trial, 15 mL of elderberry syrup 4 times per day showed influenza-like symptom relief 4 days earlier and significantly decreased rescue medication use compared to placebo [ii]. With the holiday season and New Year bringing increased travel to see family and friends, we highlight the study below, on the use of elderberry extract in air-travelers.



Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial

Journal: Nutrients

This randomized, double-blind placebo-controlled trial included 312 individuals in Australia. All participants were traveling overseas on a 7 hour minimum flight, with a layover of less than 12 hours, and a minimum of 4 days spent at the destination.

Participants took elderberry capsules or a placebo (600 mg/day) starting 10 days before travel and 900 mg/day starting 1 day before travel until 4-5 days after arriving at the destination.

Surveys were completed 10 days and 2 days before travel and 4-5 days after travel. Participants recorded cold symptoms in a diary each day. Cold diagnosis was assessed using the Jackson Score (which separates a cold from isolated symptoms). Assessments included stress, general well-being, and quality of life related to respiratory symptoms.

The authors found that:

1. Both the intervention and placebo groups had an increase of participants with significant respiratory symptoms.

2. Elderberry supplementation from 10 days before travel to 4-5 days after arriving at the destination decreased symptom load and shortened duration of cold by two days.

3. There was no significant effect observed on mental health [i].


For the Patient and Caregiver

Elderberry supplementation may be beneficial at times of travel to reduce respiratory symptoms and cold duration, as well as during cold and flu season. Although the focus of nutrition should be placed on a plant-based eating pattern high in vegetables, fruits, and whole grains [iii], elderberry supplementation may find a place when respiratory symptoms are experienced, particularly in settings that tend to lead to more cold viruses, such as on airplanes.


For the Healthcare Team

Elderberry supplementation may be an appropriate recommendation for patients at the onset of respiratory symptoms or when exposed to others in a tight setting, such as while traveling. More studies are needed on elderberry to better understand its health benefits, and research is warranted on elderberry supplementation specifically in the cancer patient population.



[i] Tiralongo E, Wee S, & Lea R. (2016). Elderberry supplementation reduces cold duration and symptoms in air-travellers: a randomized, double-blind placebo-controlled clinical trial. Nutrients,8: 182. doi:10.3390/nu8040182.

[ii] Zakay-Rones Z, Thom E, Wollan T, & Wadstein J. (2004). Randomized study of efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. The Journal of International Medical Research, 32: 132-140.

[iii] Schwingshackl L, Schwedhelm C, Galbete C, and Hoffmann G. (2017). Adherence to mediterranean diet and risk of cancer: an updated systematic review and meta-analysis. Nutrients, 9: 1063. doi:10.3390/nu9101063.

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