American elderberry is more shrub-like and can grow up to 8 to 10 feet high, while European black elder has the makings of a small tree and will reach 20 feet. Elderberries have been used for thousands of years. The best way to use them is in tea, jam, jelly, wine, syrup, or pies. Both its flowers and fruit have been used for jelly, wine, juice, and coloring. Elderberry is one of the most commonly used medicinal plants in the world and has natural antioxidants and vitamin C. It also has phenolic compounds, such as flavonoids and these are believed to be antiviral. It is most often taken as a supplement to treat cold and flu symptoms.