Prepare the Ingredients: Gather all your ingredients. If you're using fresh ginger, peel and slice it. Measure out the elderberries, cloves, cinnamon, and honey.
Combine and Simmer: In a large pot, combine the elderberries, ginger, cloves, cinnamon, and star anise (if using) with the water. Bring the mixture to a boil, then reduce the heat and let it simmer for about 45 minutes to an hour, or until the liquid has reduced by half.
Strain the Mixture: Once the mixture has reduced, remove it from the heat and let it cool slightly. Using cheesecloth or a nut milk bag, strain the liquid into a large bowl, pressing on the berries to extract as much juice as possible.
Add Honey: Allow the liquid to cool to lukewarm temperature (this helps preserve the beneficial properties of the honey). Stir in the honey until it is fully dissolved. If you're using vodka, add it at this stage as well.
Store the Syrup: Pour the elderberry syrup into air-tight glass storage containers and store them in the refrigerator. The syrup can last up to three months in the fridge or six months if you've added vodka.
Dosage: For adults, a typical dosage is 1 tablespoon per day for immune support, or 1 tablespoon every 2-3 hours if you're experiencing cold or flu symptoms. For children, reduce the dosage to 1 teaspoon.