Elderberry vs Echinacea: Which Is Better for Colds?
Elderberry and echinacea aren't competing for the same job. Echinacea has mostly been studied for preventing colds, and the best summary is that it may slightly lower your chance of catching one. Elderberry has mostly been studied once people are already sick, and small trials found it shortened colds and flu and made them milder. Neither has strong enough evidence to call a sure thing, and both have a few people who should check with a doctor first.
Walk down any pharmacy aisle in November and you'll find both, often in the same bottle. Here's what each herb is, what the trials actually found, how they compare side by side, and whether it makes sense to take them together. For everything about elderberry on its own, our guide to elderberry goes deeper.
What they are
Elderberry is the dark purple fruit of the black elder tree, Sambucus nigra. It's made into syrups, gummies, capsules and tinctures, and it has to be prepared: raw or unripe berries, leaves and stems can make you sick. Our guide to elderberry side effects explains which parts of the plant are poisonous.
Echinacea is a group of North American plants in the daisy family, best known as the purple coneflower, Echinacea purpurea. Products use the flowers, leaves, stems or roots, and they vary a great deal from brand to brand, which is one reason the research on echinacea is so mixed.
Elderberry vs echinacea at a glance
| Elderberry | Echinacea | |
|---|---|---|
| Part used | Cooked or extracted berries | Flowers, leaves, stems or roots |
| Mostly studied for | Getting over colds and flu faster | Catching fewer colds |
| Best evidence | Shorter, milder colds and flu in small trials | May slightly lower the chance of catching a cold |
| Weak spot | Not shown to stop you catching a cold | Little clear effect once a cold has started |
| Main safety point | Never eat the berries raw | Allergic reactions, especially with daisy-family allergies |
What the research says about echinacea
Echinacea has been tested in a lot of people, and the results pull in two directions.
- The optimistic reading. A 2007 meta-analysis of 14 studies found echinacea cut the odds of developing a cold by 58% and shortened colds by about a day and a half.
- The cautious reading. A 2014 Cochrane review of 24 trials with more than 4,600 people found that no single prevention trial showed a significant difference on its own, though pooling them suggested a 10% to 20% lower risk of catching a cold. Of the seven treatment trials that measured how long colds lasted, only one found echinacea helped.
- A large, long trial. In a 2012 trial of 755 healthy adults who took an Echinacea purpurea extract for four months, the echinacea group had fewer colds and fewer days with a cold than the placebo group, with side effects no different from placebo. The benefit was clearest in people who kept taking it.
The National Center for Complementary and Integrative Health sums it up this way: echinacea may slightly reduce your chances of catching a cold, and it's still unclear whether it shortens one.
What the research says about elderberry
Elderberry's trials are fewer and smaller, but they're more consistent, and they point at the other end of the illness.
- Flu symptoms. In a randomized, placebo-controlled trial in Norway, adults with flu-like symptoms who took elderberry syrup for five days felt better about four days sooner than those on placebo, and needed less other medicine.
- Colds around travel. In a trial of 312 air travelers, those taking elderberry extract who caught a cold had it for about two days fewer, with milder symptoms. They didn't catch fewer colds, though.
- Across the trials. A 2019 meta-analysis pooling 180 participants found elderberry substantially reduced upper respiratory symptoms, and a 2021 systematic review of five randomized trials found it may shorten colds and ease symptoms, while noting the evidence is still limited.
So which is better for colds?
It depends on what you're hoping for:
- You want to catch fewer colds this winter: echinacea is the one that's been studied for that, with a small and uncertain benefit. Elderberry hasn't been shown to prevent colds.
- You've just come down with something: elderberry has the better evidence for getting over it faster. Echinacea has mostly not helped once a cold has started.
- You want a daily habit through the season: either can be part of one. Many people keep elderberry in their routine through the colder months so it's already there when they need it.
Neither replaces sleep, fluids and washing your hands, and neither is a reason to skip the doctor if you have a high fever, trouble breathing or symptoms that keep getting worse.
Can you take elderberry and echinacea together?
Many products already combine them, and there's no known harmful interaction between the two herbs. Because they've been studied for different stages of a cold, pairing them makes some sense. The cautions simply add up: if either herb isn't right for you, the combination isn't either.
How to take each
- Elderberry: as a prepared syrup, gummy, capsule or tincture, following the label. The trials used short courses during illness. How much depends a lot on the form, and our article on how much elderberry to take per day breaks it down. A tincture is one of the easiest forms to keep up daily.
- Echinacea: follow the product label. According to NCCIH, it's likely safe for most adults for short periods, and products differ widely in which plant parts and species they use, so stick to one product rather than mixing several.
Who should be careful
Echinacea, per NCCIH:
- Some people have allergic reactions, which can be severe. Take extra care if you're allergic to ragweed, daisies, marigolds or chrysanthemums, which are in the same plant family
- The most common side effects are stomach upset and nausea
- It may interact with some medicines, including those that suppress the immune system, so ask your doctor if you take any regular medication
- Talk to your child's doctor before giving it to a child; some children in a trial developed rashes
Elderberry, per NCCIH:
- Never eat raw or unripe berries, leaves or stems; they can cause nausea, vomiting and severe diarrhea
- Check with your doctor first if you're pregnant or breastfeeding, have an autoimmune condition, or take immune-suppressing, diabetes or diuretic medication
Both herbs are a question for your doctor if you have an autoimmune condition or take medication that affects the immune system.
Our Elderberry Soothe & Defend tincture
Our Elderberry Soothe & Defend tincture is made from whole elderberries rather than concentrate, with mullein leaf, nettle leaf, ginger root, cinnamon bark, whole cloves and sweet orange peel, in an alcohol-free vegetable glycerin base. It doesn't contain echinacea. The label says one dropper a day with a meal, which makes it easy to keep in the routine through the cold months. It's made by hand in small batches in Holmes County, Ohio, and the rest of our seasonal range is in Daily Defense.
Frequently asked questions
Is elderberry or echinacea better for a cold?
Once you have a cold, elderberry has the better evidence for shortening it. For catching fewer colds in the first place, echinacea is the one that's been studied, with a small and uncertain benefit.
Can I take elderberry and echinacea at the same time?
Yes, for most healthy adults. There's no known harmful interaction between them. Check with your doctor first if you have an autoimmune condition, take immune-suppressing medication or are pregnant.
Is echinacea safe to take every day?
NCCIH describes it as likely safe for most adults for short periods. The longest large trial ran for four months. If you plan to take it longer, ask your doctor.
Does elderberry prevent colds?
It hasn't been shown to. In the air travel trial, people taking elderberry caught as many colds as everyone else, but theirs were shorter and milder.
Who should not take echinacea?
People allergic to daisy-family plants such as ragweed, and anyone taking medication that suppresses the immune system, should check with a doctor first. Ask your child's doctor before giving it to a child.
Is elderberry or echinacea better for the flu?
Elderberry is the one with a flu trial behind it: adults with flu-like symptoms felt better about four days sooner on elderberry syrup. See a doctor for the flu, especially if you're in a higher-risk group.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. This article is general information and not medical advice. Talk to your healthcare provider before starting any supplement, particularly if you are pregnant or nursing, take prescription medication, or have an autoimmune condition.