Honey for Sore Throat and Cough: What Science Says

When you wake up with a scratchy throat or a nagging cough, reaching for honey is not just an old wives' tale—it is backed by serious science. Multiple peer-reviewed studies have found that honey performs as well as, or better than, many over-the-counter cough suppressants. Major health organizations including the World Health Organization now recommend honey as a first-line treatment for coughs.

This comprehensive guide examines what researchers have discovered, explains why honey works, and provides practical protocols for using it effectively.

The Research: What Studies Actually Show

The Landmark Penn State Study (2007)

A groundbreaking study published in the Archives of Pediatrics & Adolescent Medicine compared three treatments for children with upper respiratory infections: honey, dextromethorphan (DM, the active ingredient in most cough syrups), and no treatment.

Study design:

105 children ages 2-18 with upper respiratory infections
Random assignment to honey, honey-flavored DM, or no treatment
Parents rated cough frequency, cough severity, and sleep quality

Results:

Honey outperformed both alternatives across all measures:

Cough frequency: Honey provided the greatest reduction
Cough severity: Honey was most effective
Sleep quality for children: Honey produced the best improvement
Sleep quality for parents: Honey again performed best

The researchers concluded that honey "may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection."

The Cochrane Review (2012, 2018 updates)

Cochrane Reviews are considered the gold standard for medical evidence. Their systematic review of honey for acute cough examined multiple randomized controlled trials.

Key findings:

Honey probably reduces cough symptoms more effectively than no treatment
Honey may be more effective than diphenhydramine (Benadryl)
Honey performs comparably to dextromethorphan
No serious adverse effects were reported

The review noted that while evidence quality varied, the consistent direction of results across studies supported honey's effectiveness.

The BMJ Evidence-Based Medicine Review (2020)

A more recent systematic review and meta-analysis examined 14 studies with nearly 1,800 participants. Published in BMJ Evidence-Based Medicine, this comprehensive analysis concluded:

Honey was more effective than usual care for improving cough symptoms
Effects were particularly significant for cough frequency and cough severity
Honey provided a safe, widely available, and cheap alternative to antibiotics

The researchers specifically noted honey's potential as an alternative to antibiotic prescriptions for upper respiratory infections, which often receive antibiotics despite being viral (and thus unresponsive to antibiotics).

WHO Recommendation

The World Health Organization includes honey in its guidelines for treating coughs in children. The WHO states that honey can be used as a demulcent (soothing agent) for cough relief in children over one year of age.

This official recognition from a major global health organization reflects the accumulated evidence supporting honey's effectiveness.

Additional Supporting Research

Numerous other studies support honey's efficacy:

Malaysian study (2010): Found honey significantly more effective than a placebo for nocturnal cough in children.

Israeli study (2012): Compared three types of honey (eucalyptus, citrus, and labiatae) to placebo and found all three improved cough symptoms and sleep quality.

Iranian study (2013): Found honey combined with coffee more effective than prednisolone (a steroid medication) for persistent post-infectious cough.

Why Honey Works: The Mechanisms

Honey's effectiveness against coughs and sore throats stems from multiple complementary mechanisms:

Demulcent Effect

Honey's thick, viscous texture physically coats and soothes irritated throat tissue. This mechanical barrier:

Protects nerve endings from irritation
Reduces the tickling sensation that triggers coughing
Provides immediate (though temporary) relief
Lubricates dry, inflamed tissue

The demulcent effect explains why honey provides near-instant relief—within seconds of swallowing, you feel the soothing coating.

Antimicrobial Properties

Raw honey contains multiple antimicrobial compounds that may help fight infection:

Hydrogen peroxide: Produced by the enzyme glucose oxidase, this provides broad-spectrum antibacterial activity.

Methylglyoxal: Found in varying amounts depending on floral source (highest in Manuka honey), this compound has potent antibacterial effects.

Bee defensin-1: An antimicrobial peptide bees add to honey during production.

Low water activity: Honey's high sugar concentration and low moisture create an environment hostile to bacteria.

Acidic pH: Honey's pH of 3.2-4.5 inhibits many bacterial species.

While honey will not cure a viral infection (the cause of most coughs), its antimicrobial properties may:

Help prevent secondary bacterial infections
Reduce bacterial load in the throat
Support the body's natural immune response

Anti-Inflammatory Action

Chronic inflammation in throat tissue worsens cough symptoms. Honey contains:

Flavonoids: Including chrysin, pinocembrin, and pinobanksin

Phenolic acids: Such as caffeic acid and ferulic acid

Other antioxidants: That reduce oxidative stress

These compounds reduce inflammation in irritated tissues, decreasing swelling and pain. Studies have shown honey's anti-inflammatory effects comparable to some pharmaceutical agents.

Salivation Stimulation

Honey's sweetness stimulates salivary glands, producing more saliva that:

Naturally lubricates and soothes the throat
Helps thin mucus for easier clearing
Contains its own antimicrobial compounds (lysozyme, lactoferrin)
Maintains moisture in oral and throat tissues

Central Cough Suppression

Emerging research suggests honey may affect the brain's cough center similarly to dextromethorphan, but through different pathways. The sweet taste appears to trigger neurological responses that dampen the cough reflex.

One theory involves opioid receptors—sweet tastes release endorphins that may suppress cough signaling. This would explain why honey's effectiveness exceeds what its physical properties alone would predict.

Osmotic Effects

Honey's high sugar concentration creates osmotic pressure that:

Draws fluid from inflamed tissues (reducing swelling)
May help thin mucus secretions
Creates an environment difficult for pathogens

How to Use Honey for Maximum Effectiveness

Basic Dosing

Adults and children over 12:

1-2 teaspoons (5-10 ml) as needed
Can be repeated every 2-3 hours
Take before bed for nighttime cough

Children 6-12 years:

1 teaspoon (5 ml) as needed
Up to 4 times daily

Children 1-5 years:

½ teaspoon (2.5 ml) as needed
Up to 3 times daily

Children under 1 year:

NEVER give honey to infants due to botulism risk

Method 1: Straight from the Spoon

The simplest and often most effective method:

Measure honey onto a spoon
Let it slide slowly down your throat
Resist the urge to swallow quickly
Allow the honey to coat throat tissues
Avoid drinking for 10-15 minutes to maintain coating

This direct approach maximizes the demulcent effect by keeping honey in contact with irritated tissue longer.

Method 2: Honey and Warm Water

For those who find straight honey too sweet:

Heat water to warm (not hot—below 110°F to preserve enzymes)
Dissolve 1-2 tablespoons honey in 1 cup water
Sip slowly, allowing liquid to coat the throat
Can add lemon juice for additional vitamin C

This method also provides hydration, important during illness.

Method 3: Honey and Lemon

The classic combination:

Ingredients:

1 tablespoon raw honey
Juice of half a lemon
1 cup warm water

Instructions:

Heat water to warm (not boiling)
Add lemon juice
Stir in honey until dissolved
Sip slowly

Why it works: Lemon adds vitamin C for immune support and acidic compounds that may enhance antimicrobial effects. The combination is more palatable than honey alone for many people.

Method 4: Honey Ginger Tea

For additional soothing and anti-inflammatory benefits:

Ingredients:

2-inch piece fresh ginger, sliced
2 cups water
2 tablespoons raw honey
Optional: lemon juice

Instructions:

Bring water and ginger to a boil
Reduce heat and simmer 10 minutes
Strain into cups
Let cool to warm temperature
Stir in honey
Add lemon if desired

Ginger provides additional anti-inflammatory compounds and helps settle nausea that sometimes accompanies illness.

Method 5: Honey and Herbal Tea

Combine honey with throat-soothing herbs:

Best herbs for sore throats:

Marshmallow root: Additional demulcent effect
Slippery elm: Coats and soothes
Licorice root: Anti-inflammatory and soothing (avoid with high blood pressure)
Chamomile: Calming and mildly anti-inflammatory
Peppermint: Cooling sensation, may help with congestion

Method:

Brew herbal tea according to package directions
Let cool to drinking temperature
Add 1-2 teaspoons honey
Sip slowly

Method 6: Nighttime Protocol

For maximum nighttime relief:

30 minutes before bed:

Take 1 tablespoon honey straight
Follow with warm honey-lemon water
Use a humidifier in bedroom
Elevate head slightly when sleeping

This protocol addresses cough from multiple angles and often provides significant improvement in sleep quality.

Which Honey Works Best?

Raw vs. Processed

For sore throats and coughs, raw honey offers advantages:

Raw honey provides:

Active enzymes with antimicrobial properties
Full spectrum of antioxidants and flavonoids
Intact bee pollen and propolis compounds
Maximum antibacterial activity

Processed honey loses:

Most enzyme activity (destroyed by heat)
Significant antioxidant content
Pollen and propolis
Some antimicrobial effectiveness

For medicinal purposes, raw honey is the better choice.

Darker vs. Lighter Honey

Research indicates darker honeys contain higher antioxidant levels:

Buckwheat honey: Very dark, robust flavor, highest antioxidant content. Multiple studies have specifically used buckwheat honey with excellent results.

Manuka honey: Contains high levels of methylglyoxal (MGO), providing enhanced antibacterial properties. More expensive but may be worth it for stubborn infections.

Wildflower honey: Variable depending on floral sources. Generally good balance of properties and flavor.

Clover honey: Lighter, milder. Still effective but may contain fewer antioxidants.

For coughs and sore throats, buckwheat honey has the strongest research support, but any raw honey will help.

Local vs. Non-Local

For cough and sore throat relief specifically, local origin matters less than it does for allergy purposes. Any quality raw honey from any region will work for symptomatic relief.

Honey vs. Over-the-Counter Medications

Factor	Honey	Dextromethorphan (DM)	Diphenhydramine
Effectiveness	Equal or superior	Effective	Less effective than honey
Side effects	Minimal	Drowsiness, dizziness, nausea	Strong drowsiness, dry mouth
Safe for children 1+	Yes	Age restrictions vary	Not for young children
Additional benefits	Antioxidants, antimicrobial	None	None
Cost	Comparable	Comparable	Comparable
Taste	Pleasant	Often unpleasant	Often unpleasant
Natural	Yes	No	No

When to Choose Honey

Children over 1 year (when OTC options have age restrictions)
When you want to avoid drug side effects
For nighttime use when you need sleep
When you prefer natural remedies
For mild to moderate coughs
As a first-line treatment before trying medications

When Medications May Be Appropriate

Severe symptoms not responding to honey
When specific medication benefits are needed (antihistamine for allergies, etc.)
As directed by healthcare provider
When honey is not available

Important Cautions and Contraindications

Never Give Honey to Infants Under 12 Months

This cannot be stressed enough. Honey may contain Clostridium botulinum spores that infant digestive systems cannot handle, potentially causing infant botulism—a serious, potentially fatal illness.

This applies to ALL honey:

Raw or pasteurized
Local or imported
Any variety or source

Pasteurization does not destroy botulism spores. There are no exceptions to this rule.

People with Bee Allergies

If you have known allergies to bee stings, bee pollen, or other bee products, exercise caution with honey—particularly raw, unfiltered varieties. Start with a tiny amount and monitor for reactions.

Diabetes

Honey affects blood sugar. If you have diabetes:

Count honey toward your carbohydrate intake
Monitor blood sugar when using honey for illness
Consider that illness itself affects blood sugar
Consult your healthcare provider

Not a Cure for Underlying Conditions

While honey effectively soothes symptoms, it does not:

Kill viruses causing your cold
Cure bacterial infections (though it may help)
Replace medical treatment for serious conditions

Seek medical attention if:

Symptoms persist beyond 7-10 days
You develop high fever (over 101.3°F)
You have difficulty breathing
Symptoms significantly worsen
You have underlying health conditions

Dental Considerations

Honey is sticky and contains sugars. After using honey for throat relief:

Rinse with water if possible
Do not brush teeth immediately (can spread honey to more tooth surfaces)
Wait 30 minutes before brushing
Consider dental health in choosing frequency of use

Making It Part of Your Cold Care Routine

At the First Sign of Symptoms

When you notice throat scratchiness or tickling:

Take 1 teaspoon of raw honey immediately
Follow with warm honey-lemon water
Repeat every 2-3 hours

Early intervention often reduces symptom severity and duration.

Throughout the Day

Take honey before meals to avoid nausea
Stay hydrated between honey doses
Use throat lozenges with honey for convenience when out
Keep a honey jar at your desk or workspace

At Bedtime

The most important dose is before sleep, when coughing typically worsens:

Take 1 tablespoon of honey 30 minutes before bed
Use a humidifier
Elevate your head
Keep honey by bedside for middle-of-night symptoms

The Recovery Period

Continue honey use even as symptoms improve:

Residual irritation benefits from continued soothing
Preventing cough helps tissue heal
Tapering off gradually is fine

Frequently Asked Questions

How quickly does honey work?

The demulcent (coating) effect is immediate—within seconds. Cough suppression typically begins within 15-30 minutes. Most studies show significant improvement in overnight cough within the first night of use.

Can I use honey with other cold medications?

Generally yes, but:

Space them out if taking multiple cough suppressants
Be aware of total symptom medication you're taking
Consult pharmacist if unsure about interactions
Watch for additive drowsiness with sedating medications

Is it OK to heat honey for tea?

For cough relief, warm (not hot) temperatures are ideal. Very hot liquids may degrade some beneficial enzymes, but the demulcent and antimicrobial properties largely remain. Warm honey-lemon water is a perfectly valid approach.

How much honey is too much when sick?

There is no strict upper limit, but practical guidelines:

3-4 tablespoons daily is reasonable for adults
More than this adds significant calories without additional benefit
Monitor for digestive upset at higher doses
Balance against total sugar intake

Why does my cough get worse at night?

Several factors contribute:

Lying down allows post-nasal drip to trigger cough
Decreased swallowing during sleep reduces throat clearing
Dry bedroom air irritates tissues
Circadian variations in inflammation

This is why bedtime honey dosing is particularly important.

The Bottom Line

Honey is one of the few natural remedies with strong scientific support for a common health complaint. Multiple high-quality studies demonstrate that honey performs as well as or better than standard cough medicines, with fewer side effects and additional health benefits.

For adults and children over one year, honey is an excellent first-line treatment for coughs and sore throats associated with upper respiratory infections. It works through multiple mechanisms—coating and soothing tissue, reducing inflammation, fighting microbes, and potentially suppressing the cough reflex at a neurological level.

Keep a jar of raw honey in your medicine cabinet alongside your thermometer. When cold and flu season arrives, you'll be glad you did—and so will anyone else in your household who catches the bug.

Stock up on raw honey before cold season hits. Our California Raw Honey is never heated or ultra-filtered, preserving the antimicrobial and anti-inflammatory compounds that make honey effective for soothing sore throats. Shop now.