The EASY guide to deciding whether to try something for COVID

When you are choosing whether or not to do something for your health, take it EASY! All four factors - 1) Effects, 2) Access, 3) Safety, and 4) You – can help you make a decision.

Julie heard that taking the herb elderberry could help with COVID symptoms if she got sick.¹ But she also read that elderberry might increase inflammation during COVID so she was confused. She used the EASY guide to learn more and sort out some details:

Effects: Elderberry is the dark purple berry of the European or Black elder tree (Latin name Sambucus nigra). The ripe, cooked elder berries are often made into jams and pies and are also used as medicine. Traditionally, elderberry fruit extract has been used for the common cold and the flu.² Some studies in cells have found that elderberry was effective against a human coronavirus and that it seemed to work best early in an infection.^3,4 These results may not reflect what would happen in a person because they were done in cells, in one study the extract used was from stem, not berries and was a different species of elder (Formosana nakai) than is most commonly used (Nigra), and the viruses tested were similar, but different than COVID. A review of 4 small human studies with a total of 180 patients concluded that elderberry extract might shorten the length of having upper respiratory symptoms from the flu or a cold when started within the first 24 hours of having symptoms.⁵ Elderberry seemed to have a greater effect against symptoms of flu than the common cold. There is some concern that elderberry may cause increased inflammation during later stages of an infection.¹ The evidence for this is limited to studies in cells.^3,6 Since most research has tested the use of elderberry at the first signs of symptoms, it seems reasonable to start early and if symptoms worsen, discontinue use. As of this writing, there were no human studies on the use of elderberry and COVID.

Access: Elderberry extract is commonly available in many forms such as capsule, syrup, and alcoholic extract. Be sure that the label indicates that it contains Sambucus nigra fruit. Typical amounts recommended are based on limited evidence.⁷ When it is taken either as a preventative or during the early stages of experiencing cold or flu symptoms, suggested doses range from 650 to 1,500 mg per day, divided into 2-3 doses. A 30-day supply ranges from $5.00 to $15.00 depending on the brand and dose.