Echinacea vs Elderberry: Key Differences

Quick answer

Echinacea is a daisy-family flower sold as extracts, and elderberry is the dark fruit of Sambucus nigra. This site grades no benefit for either. Trials gave 2,400 mg of one echinacea extract or 600 to 900 mg of elderberry extract daily. Cautions differ: daisy-family allergy for echinacea, raw berries and leaves for elderberry.^1,2,3,4

Key facts

Echinacea is a group of flowering plants related to sunflowers and ragweed. Elderberry is the dark purple fruit of the black elder tree, Sambucus nigra.^3,4
Echinacea's active compounds are not well defined, and the mix differs between species and plant parts. Anthocyanins make up about 80% of elderberry's polyphenols.^1,5
Neither has a graded benefit here. For echinacea the reason is how much products differ. For elderberry it is mixed results in small trials, and no change in the blood markers measured in healthy people.^1,6,7
Elderberry anthocyanins are cleared quickly: in six healthy volunteers the half-life was about 1.9 to 2.6 hours, and less than 0.4% passed unchanged into urine within 7 hours.⁸
The cautions differ. Echinacea brings daisy-family allergy and a 10 day limit for its pressed juice, while elderberry brings poisonous raw plant parts and no safety data in pregnancy. NIH names one shared medicine caution.^2,3,4,9,10

What each one is

Echinacea species are perennials closely related to sunflowers, daisies and ragweed, native to areas east of the Rocky Mountains.³

Elderberry is the dark purple berry of the European or black elder tree, Sambucus nigra, which grows in Europe, North America, Western Asia and North Africa.⁴

Echinacea products are extracts of the root, the parts above ground or the whole plant, and US products often mix species. Elderberry supplements are mostly extracts of the berries, made into syrups, lozenges and capsules, and the trials NIH reviews used extracts rather than the fresh fruit.^1,2

Echinacea contains alkamides, polysaccharides, caffeic acid esters, terpenes and glycoproteins, but which of them are active is not well defined, and the mix differs between species.^1,11

Elderberry contains anthocyanins, flavonols and phenolic acids. Anthocyanins make up about 80% of its polyphenols.^2,5

Echinacea and elderberry side by side

Echinacea and elderberry compared for adults^{1,2,6,7,8,9,10,11,12}
Question	Echinacea	Elderberry
Part sold	Root, parts above ground or the whole plant of E. purpurea, E. angustifolia or E. pallida	The fruit of Sambucus nigra, mostly as an extract
Main compounds	Alkamides, polysaccharides, caffeic acid esters, terpenes and glycoproteins; the active ones are not well defined	Anthocyanins, flavonols and phenolic acids
How strength is set	No agreed marker: some products use echinacoside and others cichoric acid	Anthocyanin content varies: 30 mL of one commercial extract supplied 147 mg in one study and 278 mg in another
Amounts in trials	2,400 mg a day of one E. purpurea extract; pressed juice up to 6 to 9 ml a day in the European monograph	600 to 900 mg a day in capsules; 15 mL of syrup four times a day; 500 mg of anthocyanins a day in the longest trial
Longest use studied	4 months	12 weeks in healthy women
Upper limit	None set; the European monograph allows pressed juice for 10 days at a time	None set
Graded benefit here	None	None
European regulators	A herbal monograph for pressed juice of the fresh herb	Work on a monograph stopped in 2013 for lack of information on traditional use

Why neither has a graded benefit

No benefit is graded for echinacea. Nearly all of its human research asked about illness, which this site does not make claims about, and products differ so widely in species, plant part and preparation that a result with one product may not apply to another.^1,3,11

Echinacea studies have used different species, plant parts and preparations, so a result with one product may not apply to another.^1,11

None is graded for elderberry either. The five randomized trials a 2021 review found were small and short, and four of them were in people who were already unwell. The reviewers rated the evidence uncertain.⁶

In healthy people, the longest trial we found gave 52 postmenopausal women 500 mg of anthocyanins a day for 12 weeks, and a 2-week trial gave 34 young adults capsules of elderberry juice. Neither made a significant change in the blood markers measured.^7,13

Only a small share of elderberry anthocyanins is absorbed intact. In four older women given 720 mg of them in an extract, 0.077% appeared in urine within 4 hours.¹⁴

Forms and quality

There is no agreed marker for echinacea: some products are standardized to echinacoside and others to cichoric acid, and no single compound is known to be responsible for its activity.¹¹

Research funded by NCCIH suggests the activity of echinacea extracts depends partly on soil conditions that shape the bacteria living on the plant.³

Studies of elderberry have mainly used extracts rather than the berries themselves.²

Products differ in strength. In two small studies, 30 mL of a commercial elderberry extract supplied 147 mg of anthocyanins in one case and 278 mg in the other.^8,12

Neither herb has a recommended daily amount from NIH or NCCIH, so the label is the only guide to what a capsule holds. For both, look for the plant part and species on the label, and be wary of a product that names neither.^2,3,4

What's in ours

What’s in ours

Men's Multi: Immune Support, 110 mg per serving, from the label
Immune Support: Echinacea purpurea Extract, 200 mg per serving, from the label

What’s in ours

Immune Support: Elderberry Extract, 500 mg per serving, from the label

In our line, elderberry appears in one product, as a 500 mg extract row. Echinacea appears in two: as a 200 mg extract row in that same product, and inside a 110 mg plant blend in our Men's Multi that gives no echinacea share.^1,2

How the cautions differ

Cautions for echinacea and elderberry side by side^{1,2,3,4,5,6,9,10,15,16,17}
Caution	Echinacea	Elderberry
Allergy	Daisy-family plants such as ragweed, daisies and sunflowers; severe reactions are rare but possible	Allergic reactions are rare, and a known allergen, Sam n1, is present
Raw plant	No similar concern in the sources we read	Raw or unripe berries, leaves, stems, bark and seeds can release cyanide and cause nausea, vomiting and severe diarrhea
Pregnancy	Studies of several hundred exposed pregnancies showed no harm, but European regulators advise a doctor's opinion first	No animal or human studies found, and experts recommend against the supplements
Medicines	Might weaken medicines that suppress the immune system; named on the warfarin label; small studies found changes in levels of a test medicine cleared by liver enzymes	Might weaken medicines that suppress the immune system
Conditions	European regulators do not recommend it with autoimmune conditions, immune deficiency or white blood cell disorders	Experts advise caution with diabetes, because it might affect insulin and blood sugar levels
Other reports	Isolated reports of raised liver enzymes and liver injury, perhaps from a contaminant or the preparation; trouble sleeping	Few side effects and none serious in trials, though most trials did not check carefully

There are isolated reports of raised liver enzymes and liver injury linked to echinacea. NIH notes they may have been caused by a contaminant or the way the product was prepared.^1,18

The most common side effects are digestive: stomach upset, nausea, stomach pain and diarrhea.^3,19

Trials have reported few side effects and none serious, but most did not check for them carefully, so how often minor effects happen is uncertain.⁶

Ask your doctor or pharmacist before using either if you take a prescription medicine, are pregnant or nursing, or want to give it to a child. Ask about echinacea first if you have a daisy-family allergy, and about elderberry first if you have diabetes.^2,3,4

Questions people ask

Which is better, echinacea or elderberry?

This site grades no benefit for either, so it cannot rank them. The sources do show that they differ in the plant and part used, in what the trials gave people, and in their cautions.^1,6

Do echinacea and elderberry both interact with medicines?

NIH names the same caution for both: each might reduce the effect of medicines that suppress the immune system. Echinacea is also named on the warfarin label and the MedlinePlus warfarin page. Ask a pharmacist before combining either with a prescription medicine.^1,2,15,20

See what we make

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See the Full Measure line Immune Support Men's Multi

Sources

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.