Mythbusting Elderberry Syrup, Essential Oils, & Alternative Remedies for Kids

Cold and flu season is in full swing, and some local schools have closed a few days this year to prevent the spread of illness in classrooms. We’ve noticed a trend in families opting out of getting flu shots – instead relying on daily doses of elderberry syrup to prevent the flu and other viruses.

How effective is this home remedy and is it safe for kids? We asked a local expert and Nurse Practitioner, Ellie Tsikalas, about the right ways to use elderberry syrup and other natural options.

Elderberry Syrup & Essentials Oils: Can They Relieve Cold Symptoms?

Solid research and medical data on the benefit of these two homeopathic options is still limited at this point. Three main studies that you can find cited on the NIH website, from journals such as The Journal of International Medical Research and European Cytokine Network, concluded that the use of elderberry syrup in treatment against influenzas A and B may be effective at slightly diminishing severity of symptoms or duration of symptoms. Two of the studies were conducted only in test tubes, and in mice, respectively. The study conducted with two human groups with respiratory symptoms, one receiving a placebo substance and the other taking elderberry syrup, has been criticized for its small sample size of just 60 patients. The researchers concluded that while symptoms may have been reduced 3-4 days sooner in the elderberry group, a larger study is needed to say more affirmatively.

Conclusive medical information on essential oils is equally as limited and made more complicated by how many different oils there are, the vast differences in the non-regulated chemical concentration of those substances (one tea tree bottle to another), and the various delivery methods of the oils.

Though it has been hypothesized that certain oils could be beneficial for everything from hair loss to digestive issues to depression and more, for the purposes of this article let’s focus on their effect on common winter illnesses like colds and influenzas. Even families who do not consider themselves major users of homeopathy, are likely very familiar with a common commercial brand of Vapor Rub. Vapor Rub is camphor, eucalyptus, and menthol oils. A Pediatrics study in 2010 compared 138 children experiencing common cold symptoms who either received nightly vapor rub on their chest, plain petroleum on their chest, or nothing. Parents rated VR most favorably of the 3 for symptomatic relief of their child’s nocturnal cough, congestion, and sleep difficulty. But researchers also noted the highest rates of “adverse irritant effects” in the vapor rub group with none in the others (more on this below). Other oils that some believe have respiratory or anti-viral benefits such as thieves, lemon grass, or rosemary have only been tested in a lab on a cellular “in vitro” level and not in actual human patients compared to a placebo group.

I fully believe that with the rising popularity of herbs and oils, more scientific journals will start publishing larger and more conclusive studies on their risks and benefits versus the smaller (and some would argue potentially biased) studies of the alternative health groups. If more solid scientific proof emerges about the benefits & safety of these “natural remedies,” that would make those of us in the medical community feel more comfortable endorsing them in our practices.

Q.) Can elderberry syrup or essential oils PREVENT kids from getting sick or avoid the flu? 
In a large literature review by the Canadian Medical Association Journal in 2014, where they looked at studies of zinc, ginseng, and many other “home remedies,” no substance was found to prevent illnesses except for a slight benefit from Vitamin C and possibly probiotics. However, hand washing, sufficient sleep, and regular exercise was found to have more preventative and protective properties than any other herbal options.


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The only intervention medically, statistically, and conclusively proven in repeated clinical trials to prevent influenza is the annual influenza vaccine.

Know How Flu Vaccines Work

It is important to remember how vaccines work. In this case, the influenza vaccine takes a little bit of the dead virus and “introduces” it to your system. It says to your body “Look at this virus! Study it! Memorize it! Get to know it! And practice beating it up and destroying it!” That way, when the live version shows up in your body through actual infection later on, the real virus cannot “sneak by.”

Before you even begin to feel ill, your body recognizes it as an unwanted guest and defeats it quickly because it already learned how from the vaccine. If flu season and flu illness is like a big school exam, then the flu vaccine is like your teacher giving you a study guide and the majority of the answers ahead of time.

For myself, my family, and my patients, I recommend the “competitive advantage” of the flu vaccine every single season. I also like to remind everyone that certain patient groups, like babies under six months old, and kids fighting cancer, cannot receive the flu vaccine and have a lowered ability to fight off illness in general. It is up to the rest of us to not expose them to flu by being protected ourselves.

What About Oscillococcinum?

Speaking specifically about Oscillococcinum (which is made from diluted heart and liver of wild duck): comparing all the clinical studies between 2004 and 2014, The Cochrane Database concluded that “There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling.” One specific set of researchers found no evidence for prevention of flu and only the possibility of a decrease in existing symptoms by ¼ of a day’s time.

Q.) Is elderberry syrup and/or essential oils safe for kids to use? If yes, is there anyone who should avoid use these things?
I like this question more than the “how effective is this” question! One of my favorite things about my clinic is that it is incredibly culturally and ethnically diverse. Patients arrive to me with many preordained beliefs about illness and medicine that have been passed down via their home country, their religion, their family traditions etc. Making a cup of chamomile tea for a sick child can be as standard and obvious to one family as making a special salve for a wound is to another. So many times my job is not to tell a family how effective that closely held belief is. But it is always my job to make sure that family traditions, cultural practices, or homeopathic choices are doing no harm.


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Consuming elderberry raw or unripe can also increase the risk of dangerous toxin levels in the body. With any plant or wild fruit consumption, you always run the risk of nausea, diarrhea, cramping, and other GI symptoms. Elderberry also has parts of its plant that contains cyanide (a deadly poison), so the consumer has to trust that it was picked and processed in a knowledgeable way.

Diffusing Essential Oils Around Kids

Certain essential oils also carry known health risks. For example, multiple studies have shown lavender to be a “hormone disruptor” in your body. More specifically, ongoing exposure to lavender has been proven to cause gynecomastia (breast development) in boys. This fact is so widely accepted in the medical community, that it was even a question on the national boards I had to take to become a certified nurse practitioner! So while I may personally enjoy the smell of lavender, it is not something I want around my own pre-teen son very often. There are also documented cases of peppermint oil, cedar wood oil, wintergreen, and others being improperly ingested or used at too high of an amount and causing seizures, liver damage, and kidney failure.

But the biggest risk with any homeopathic or natural agent is always allergy and asthma. Many people have allergies to grass, plants, trees, flowers, honey, certain fruits and vegetables, etc. It is easy to see how that becomes a problem with any oil, herb, or substance that you have your child breathe in, apply to their skin, or swallow. Allergy rates for eucalyptus (like in Vapor Rub) may be up to 10% of the population. Among asthma sufferers the chance of being allergic to eucalyptus is even higher at 31%. While the suspected percentage of the population that would be allergic to elderberry is pretty small, we also know people allergic to honeysuckle can have a cross reaction to it.

I had a young clinic patient who kept coming to see me one winter for chronic cough. We ruled out RSV, bronchitis, pneumonia, sinus infection, acid reflux, and even asked if there was cigarette smoke in the home. After weeks of presuming this could be “cough variant asthma” and trying him on a fairly unsuccessful trial of inhaled albuterol, mom explained that she had been experimenting with various diffused oils for weeks “trying to get this cough to go away.” The mom had independently stopped the oils after about 2 months of zero progress and the cough finally subsided. Turns out, that little boy was allergic to pine, pollen, grass, and others.

Literal Pro-Tips About Homeopathic Remedies

There is no oversight for alternative treatments.

*The FDA does not regulate herbs, supplements, essential oils or other “alternative” treatments – no governing body does. So when you purchase those capsules or vials you are trusting that company to label the ingredients and amounts 100% accurately, as there is no other independent entity going in and making sure certain product standards are adhered to. When a parents shows me a bottle of something and asks me if it’s safe – even if I think the substance could be safe, I cannot guarantee that what is listed on the label is actually in that container.


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Please be careful & cautious.

If you are going to try “natural” remedies at home, please do so with caution and with close observation of your child. Please don’t assume something will always be harmless – the coconut oil that may have helped your first child with eczema may cause a terrible rash in baby #2. Also, keep all oils and supplements safely out of reach of kids the same way you would with prescription drugs, household cleaners, etc.

Please be skeptical and do your parental due diligence.

In this day and age, the idea of “fake news” is a hot topic. Just because a news site, or Facebook, or a friend group says a product helps with a certain medical issue does not mean it actually will, nor does that guarantee it will safely. And even when a “study” is quoted, many “studies” would not qualify for what most medical professionals would consider conclusive or scientific, based on who conducted it/funded it, who or what the test subjects were, how many subjects participated, how many variables were at play, etc.

Please be honest with your medical provider about use of “homeopathic” treatments.

We are not magicians or psychics and we are only as good as the information we are given. For example, certain herbs can either increase or decrease some prescription drug levels in your body. Knowing a certain herbal substance may be in you or your child’s system may affect which drug I think I can safely prescribe for you.

And the big one: please do not ever substitute home remedies for actual medical care from your trusted provider.

Children have died because care was not sought soon enough for an asthma attack or a flu case with complications, while “alternative” therapies were being tried first at home. An herb will never be a substitute for the flu vaccine. Strep throat cannot fix itself. It absolutely requires an antibiotic to be cured, and no essential oil can serve that purpose.

One of My Favorite Home Remedies…

Did you know there have been multiple studies on the health benefits of chicken noodle soup? We have long known that chicken noodle soup can be beneficial for gastrointestinal illness recovery. Its clear broth and simple carbs are easy for your bowel to digest and can aide with faster regeneration of healthy intestinal lining. But in studies by both Nebraska Medical Center and UPMC, it was theorized that chicken noodle soup could help respiratory illness as well. Their results showed a possible benefit of stimulated nasal clearance, decreased inflammation, and shorter duration of cold symptoms. Even more importantly, no risk of adverse effects with the soup were detected. So if a family comes to see, and I diagnose their child with a sinus and ear infection, and they are properly taking the necessary antibiotic I prescribed for them – by all means, I encourage them to have that nice warm “homeopathic” bowl of chicken soup along with it!

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ABOUT THE EXPERT: Ellie Tsikalas is a MSN, CRNP and a Johns Hopkins graduate. She is currently a Nurse Practitioner at BrightStarts Pediatrics. She is also a local mom theatre lover.