Toggle Nav

Discover How Elderberry Affects Gut, Immune, and Respiratory Health

elderberry plants with berries
  • Elderberry contains anthocyanins—plant compounds that support gut, lung, and immune health
  • New research suggests that anthocyanins promote the growth of “good bacteria”
  • Elderberry anthocyanins support a healthy “gut-lung axis,” meaning that these plant compounds may directly impact lung health through their actions on the gut

The importance of supporting immune and respiratory health is at an all-time high. As a result, many people are making healthy lifestyle changes to support their immune system, such as reducing stress, getting enough exercise and sleep, eating healthy foods, and taking dietary supplements as needed. One such supplement that many include in their immune support regimen is the ancient herb, elderberry. 

Elderberry is a medicinal plant that has been used for thousands of years. Several species of the elderberry plant grow throughout the world, with the European elder plant (Sambucus nigra) being the most common type. Historically, many different parts of the elderberry plant have been used to address infection, cough, congestion, joint pain, and skin irritation.1 The fruits (elderberries) are now the most commonly used part of the plant for supporting respiratory and immune health.2 Elderberries are the violet-black berries that contain significant amounts of anthocyanins—vital molecules known for their powerful antioxidant and immune-supportive properties.3,4

What are anthocyanins?

Anthocyanins are a group of over 700 plant compounds known as flavonoids.5 Naturally abundant in plant foods, anthocyanins provide a rich source of antioxidants and are responsible for the vibrant blues, purples, blacks, and red-orange colors of many fruits and vegetables. A higher intake of these colorful flavonoids is associated with good cardiovascular health, glucose control, and cognitive health6,7 Thanks to their powerful antioxidant capacities, anthocyanins also benefit the health of gut bacteria.8

Anthocyanin-rich elderberry extracts help promote the “good bacteria” 

When consuming elderberry anthocyanins, only a tiny fraction of these compounds are absorbed in the small intestine. Instead, the bulk of these flavonoids enter the large intestine where they are broken down by gut bacteria. During this process, gut bacteria “modify” the structure of anthocyanins into an array of molecules that slows the growth of “bad bacteria”.9 Additionally, anthocyanins provide beneficial bacteria with substances that promote their growth. Modified anthocyanins are then rapidly absorbed through the colon and enter the bloodstream. Once these vital compounds reach the blood circulation, they provide support for the organs such as the lungs, heart, skin, and brain.10,11

Elderberry supports lung health through the gut-lung axis

A new concept, known as the “gut-lung axis,” suggests that the bacteria in our gut may also directly impact lung health.12 Evidence supporting this connection comes from studies showing that those with the highest intake of anthocyanins had lower rates of declining lung function, compared to individuals with the lowest intake of anthocyanins.13

Elderberry has been shown to shorten the duration of common respiratory ailments

Several studies have reported that elderberry supplements help to shorten the duration of common respiratory ailments.2 In a trial led by Israeli virologist Dr. Mumcuoglu, it was reported that participants receiving elderberry supplements showed signs of recovery from the flu within two days versus the six days that it took for those receiving the placebo.14

A 2016 study out of Australia reported that airline passengers who supplemented with elderberry extract ten days before and five days after their flight experienced a two-day quicker recovery time from the cold than those taking placebo capsules.15 To date, most of the studies have reported similar benefits, showing that elderberry extracts can help shorten the duration of the cold and flu, and may even help ameliorate symptom severity.2

Because these studies support the age-old use of elderberry, many people have added elderberry extracts to their immune and respiratory support regimens. 


Elderberry anthocyanins are highly bioavailable flavonoids that promote the health of several body systems. Consumption of a colorful diet abundant in anthocyanins is associated with good cardiovascular health, respiratory performance, glucose control, and cognitive health. New research suggests that anthocyanins contained in elderberries promote a healthy balance of gut bacteria. Including elderberry with other supplements such as vitamin D, zinc, omega-3curcumin, and probiotics are likely to act synergistically in supporting immune and respiratory health.

Adin Smith, MS is a Science Researcher and Writer for Nordic Naturals. He holds a Masters Degree in Nutrition, and believes that many health conditions are the result of suboptimal nutrient status. For this reason, Adin is committed to informing others about the latest research in nutrition, lifestyle modification, and dietary supplements.

1. Ulbricht C, et al. J Diet Suppl. 2014. 11(1): p. 80-120.
2. Hawkins J, et al. Complement Ther Med. 2019. 42: p. 361-365.
3. Młynarczyk K, et al. J Funct Foods. 2018. 40: p. 377‐390.
4. Mohammadi Pour P, et al. Front Pharmacol. 2019. 10: p. 1207.
5. Wallace TC, Giusti MM. Foods. 2019. 8(11): p. 550.
6. Kimble R, et al. Crit Rev Food Sci Nutr. 2019. 59(18): p. 3032‐3043.
7. Xu H, Luo J, et al. Medicine. 2018. 97(19).
8. Tian L, et al. Crit Rev Food Sci Nutr. 2019. 59(6): p. 982-991.
9. Bresciani L, et al. J Agric Food Chem. 2020. 68(7): p. 1837-1843.
10. Yang L, et al. Adv Nutr. 2017. 8(5): p. 684‐693.
11. Bell L, et al. 2015. Nutrients. 7(12): p. 10290‐10306.
12. Enaud R, et al. Front Cell Infect Microbiol. 2020. 10: p.9.
13. Mehta AJ, et al. Am J Clin Nutr. 2016. 103(2): p. 542‐550.
14. Zakay-Rones Z, et al. J Altern Complement Med. 1995. 1(4): p. 361‐369.
15. Tiralongo E, et al. Nutrients. 2016. 8(4): p. 182.