Does elderberry cause hives? Understanding the risk of allergic reactions

October 8, 2025 •

4 min read

According to Drugs.com, signs of an allergic reaction to elderberry can include hives, rash, and difficult breathing. While most people tolerate the supplement well, it is possible for an elderberry allergy to manifest as a skin rash or hives.

Quick Summary

Allergic reactions to elderberry are possible, though uncommon, and can present as hives or a skin rash. Other side effects often result from improper preparation, and certain individuals should avoid the supplement.

Key Points

Allergic Reactions Are Possible: Though rare, an elderberry allergy can cause hives and other signs of hypersensitivity.
Allergy vs. Toxicity: Hives are an allergic response, whereas nausea and severe vomiting are typically caused by ingesting uncooked or raw parts of the elderberry plant.
Salicylate Sensitivity: Elderberries contain salicylates, and some people may experience rash or gastrointestinal issues due to a food intolerance, not an allergy.
Seek Medical Attention: If you develop hives, breathing difficulties, or swelling after taking elderberry, stop use and seek immediate medical help.
High-Risk Groups: Individuals with autoimmune conditions, pregnant or breastfeeding women, and those on specific medications should consult a doctor before using elderberry supplements.
Diagnosis is Possible: Allergists can confirm an elderberry allergy using diagnostic tests like skin prick tests or IgE blood tests.

The Link Between Elderberry and Hives

Elderberry, derived from the Sambucus plant, is a popular herbal supplement known for its purported immune-boosting properties. It is widely available in syrups, gummies, and capsules. For most people, consuming properly prepared elderberry products is safe. However, in rare cases, a person can have an allergic reaction to elderberry, with hives (urticaria) being a potential symptom.

An allergic reaction occurs when the immune system mistakenly identifies a harmless substance, like a protein in elderberry, as a threat. This triggers the release of chemicals like histamine, which can cause swelling, itching, and the characteristic welts associated with hives. If you experience hives or other signs of an allergic reaction after taking elderberry, it is crucial to stop using the product and seek medical attention, especially if symptoms are severe.

Causes of Skin Reactions from Elderberry

Beyond a true allergic reaction, other factors can lead to skin or gastrointestinal issues after elderberry consumption.

Allergic Hypersensitivity

As a type I hypersensitivity, an elderberry allergy involves the production of specific IgE antibodies. For some, this can be a reaction to the elderberry pollen, which acts as an inhalant allergen. Researchers have also observed potential cross-reactivity with other allergens, such as grass pollen. This kind of immune response is what leads to hives, angioedema (swelling), and, in severe cases, anaphylaxis.

Salicylate Sensitivity

Elderberries contain salicylates, natural compounds also found in aspirin and other foods. Individuals with salicylate sensitivity may experience gastrointestinal upset, headaches, and sometimes skin rashes or itching after consuming elderberry products. This is a food intolerance, not a true allergy, and does not involve the same immune system pathway that causes hives.

Cyanogenic Glycoside Toxicity

If not prepared correctly, elderberry can be toxic. Uncooked or unripe berries, as well as the leaves, stems, bark, and seeds, contain cyanogenic glycosides. Ingesting these raw components can lead to cyanide poisoning, causing severe nausea, vomiting, and diarrhea. While these symptoms are primarily gastrointestinal, the toxic effects can also include dizziness, weakness, and, indirectly, skin irritation due to the body's overall systemic distress. It is imperative to only consume elderberry products from reputable sources that guarantee proper processing. The Cleveland Clinic offers additional information on elderberry's potential risks based on information from a medical doctor.

Recognizing the Signs of an Elderberry Allergy

Allergic reactions can range from mild skin irritations to severe, life-threatening conditions. Be aware of the following symptoms:

Hives (Urticaria): Itchy, raised welts on the skin.
Rash: Red, swollen, or blistered skin.
Angioedema: Swelling of the mouth, face, lips, tongue, or throat.
Respiratory Symptoms: Wheezing, difficulty breathing, or tightness in the chest.
Gastrointestinal Distress: Nausea, vomiting, or stomach cramps.
Anaphylaxis: A severe, multi-system allergic reaction that requires immediate emergency medical attention.

Elderberry Side Effects: Allergy vs. Intolerance vs. Toxicity

Understanding the source of your reaction is key to managing it. The following table compares the symptoms and causes of different types of adverse reactions to elderberry.


Feature	Allergic Reaction (Type I)	Salicylate Intolerance	Cyanogenic Glycoside Toxicity
Onset	Typically rapid, minutes to hours after exposure.	Varies, can be delayed for hours.	Rapidly after consuming uncooked or raw parts.
Cause	Immune system overreaction to elderberry protein.	Non-immune sensitivity to salicylate compounds.	Presence of toxic cyanide-producing compounds.
Skin Symptoms	Hives (urticaria), itching, swelling (angioedema).	Rash, itching, flushing.	Systemic irritation can cause flushing or rashes, but not the primary symptom.
Other Symptoms	Wheezing, difficulty breathing, anaphylaxis.	Headaches, GI upset, nasal congestion.	Severe nausea, vomiting, diarrhea, weakness.

High-Risk Groups and Precautions

Certain individuals should be particularly cautious or avoid elderberry products entirely:

Autoimmune Conditions: People with autoimmune diseases like multiple sclerosis (MS), rheumatoid arthritis (RA), or psoriasis should consult a doctor before use. Elderberry may stimulate the immune system, which can potentially worsen these conditions or interfere with immunosuppressant medications.
Pregnancy and Breastfeeding: There is insufficient research on the safety of elderberry during pregnancy or breastfeeding, so it is recommended to avoid it to err on the side of caution.
Immunocompromised Individuals: If you have a compromised immune system, it's best to avoid elderberry due to concerns it could overstimulate the immune response.
Medication Interactions: Elderberry can act as a diuretic, so those taking diuretic medications should be cautious. It is also contraindicated with certain medications for autoimmune conditions, including steroids.

Conclusion

While an uncommon occurrence, an allergic reaction to elderberry can cause hives and other significant symptoms. These reactions are distinct from the gastrointestinal distress caused by consuming raw or improperly prepared elderberries, which contain toxic compounds. Individuals should always purchase elderberry products from reliable sources to ensure they are properly processed and avoid raw plant parts. If a skin rash, hives, or difficulty breathing occurs after taking elderberry, discontinue use immediately and seek medical evaluation. For those with pre-existing health conditions, especially autoimmune diseases, a discussion with a healthcare provider is essential before starting any elderberry supplement.

For more detailed information on elderberry side effects, consult resources like the Drugs.com entry on Elderberry Side Effects.

Frequently Asked Questions

No, allergic reactions to elderberry are considered uncommon, though possible. Most people can consume properly prepared elderberry products without issue. However, individuals with other allergies, like grass pollen, may be more susceptible to cross-reactivity.

The initial signs can vary but often include skin reactions like hives, rash, and itching. Other symptoms can include sneezing, watery eyes, and respiratory issues like wheezing or shortness of breath.

An allergic reaction is an immune response that can cause hives, swelling, and breathing problems, even from properly cooked elderberry. A 'bad reaction' or toxicity, resulting from uncooked parts, typically causes severe gastrointestinal distress but not a true immune-mediated allergy.

Stop taking the elderberry product immediately. For mild reactions, an over-the-counter antihistamine may help. If symptoms like swelling of the face, tongue, or difficulty breathing occur, seek emergency medical care.

Yes, children can experience allergic reactions to elderberry, just like adults. It is best to consult a healthcare provider before giving any herbal supplements to a child.

Diagnosis typically involves a medical evaluation by an allergist. They may perform diagnostic tests, such as a skin prick test or a specific IgE blood test, to confirm a sensitivity to elderberry.

Only properly prepared elderberry products are safe. Uncooked berries, leaves, stems, or bark contain toxic cyanogenic glycosides and should never be consumed. Always purchase supplements from a reputable source to ensure safety.