Elderberry is generally not recommended for certain groups of people, especially in supplement form, because of limited safety data and possible interactions.
People who should avoid elderberry
- Pregnant or breastfeeding individuals should avoid elderberry supplements because there is not enough reliable safety data and some expert and institutional guidance advises against use.
- Infants and young children are often advised not to use elderberry products, especially homemade or high‑dose forms, because of limited safety evidence and higher risk of gastrointestinal side effects.
- People with autoimmune diseases such as rheumatoid arthritis, lupus, or multiple sclerosis should avoid elderberry unless cleared by a specialist, since it can stimulate the immune system and potentially worsen symptoms.
Medication and health-related cautions
- Anyone taking immunosuppressant drugs (for example after an organ transplant, for autoimmune disease, or chemotherapy) should not take elderberry because it may oppose the effect of these medicines by boosting immune activity.
- People using diabetes medications, diuretics (water pills), or laxatives are often advised to avoid elderberry supplements because they may enhance the effects of these drugs and increase risks such as low blood sugar, dehydration, or overly strong laxative effect.
- Those with known allergies to elderberry or related plants (such as in the Caprifoliaceae family) should not take elderberry due to the risk of allergic reactions.
Forms that should not be taken
- No one should consume raw or unripe elderberries, or the leaves, stems, or bark, because these parts contain cyanogenic compounds that can cause nausea, vomiting, diarrhea, dizziness, numbness, and, in severe cases, poisoning.
- High doses of poorly prepared homemade elderberry products are particularly risky because they may not be cooked enough to inactivate toxic compounds.
When to talk to a doctor
- Anyone with chronic medical conditions, on prescription medications, or considering giving elderberry to a child should speak with a healthcare professional first to review potential interactions and appropriate dosing.
- People who experience abdominal pain, nausea, vomiting, diarrhea, dizziness, or neurologic symptoms after taking elderberry should stop using it and seek medical advice, as these can indicate toxicity or adverse reactions.
