Elderflower has a distinct use from elderberry and is traditionally used to support healthy and effective innate immune responses, especially in the realm of regulating elevated body temperature. While the berries are one of the most popular modern herbal medicines, the widespread popularity of the berries is a relatively recent phenomena. Elderflower is a diaphoretic, meaning that it helps to open the pores, allow for sweating, and ‘releasing the exterior’, which can be helpful for those who have trouble mounting an efficient immune response. The diaphoretic nature of elder flower can also be helpful for skin health. Elderflower can be coated in batter and fried to make elderflower fritters, but elderberries use in food is much more common. Elderberries can be prepared into wine, jam, juice, syrup, gummies, or extracts for supplements. Traditionally, they were commonly used to enhance the flavor and color of other foods and beverages. Ancient ethnobotanists have recorded the uses of elderberries, and due to its actions and availability it was deemed a ‘peasant medicine’. Traditional uses of elderberries include normalizing the functions of the gastrointestinal tract, supporting a healthy body temperature and perspiration during an acute immune challenge, and as supporting the resilience of the body throughout the difficult winter months. The native Americans of the southwest used a different species of elder for similar purposes, in addition to using the berries and flowers as a diuretic. While not considered common, some cultures also utilize the leaves, bark, and roots of the elder plant. As with many plants including apples, the seeds of the elder plant can contain cyanide. Cyanide evaporates at 78.26° F 9, and elderberries are usually prepared using heat which mitigates the safety concern. Modern research is beginning to elucidate elder’s immune supporting mechanisms. Both elderflower and elderberry are rich in polyphenols, which have antioxidant activity. Oxidative stress is often produced during an immune response, and having sufficient antioxidant storage in the body may help to maintain the health and integrity of tissues. Elderberry and elderflower extracts have also been shown in-vitro to modulate cellular nitric oxide production and immune cells such as macrophages and their release of eicosanoids. In-vitro studies of elderberry extracts have demonstrated that elderberry agglutinins may bind to viral haemagglutinin protein, supporting healthy cells against viral invasion & propagation, while not being cytotoxic. In a clinical trial performed on 312 passengers on a long, overseas flight, elderberry supplementation was shown to support respiratory health though self-reported symptom scores compared to placebo.