Natural Remedies, Herbs and Supplements for a Sore Throat, Ranked by Evidence
The natural remedies with the best evidence for a sore throat are honey, a sage or sage-and-echinacea throat spray, and a licorice-root gargle. Honey beat usual care for upper respiratory symptoms in a 2021 BMJ Evidence-Based Medicine meta-analysis of 14 trials; a sage-echinacea spray relieved pharyngitis as well as a chlorhexidine-lidocaine spray in a 154-patient randomised trial; and licorice gargles roughly halved post-operative sore throat in several anaesthesia trials. Zinc lozenges and Pelargonium sidoides have moderate evidence for shortening the cold that usually causes the sore throat in the first place.
This guide is for adults and older children with the ordinary viral sore throat that comes with a cold: scratchy, worse on swallowing, often with a runny nose or cough, and gone within a week. Most of what works is topical, meaning it coats or numbs the throat, so timing and form (spray, gargle, lozenge, warm drink) matter more than milligrams. Honey is not in our library so it is covered in the lifestyle section, but it should be your first move.
See a clinician if the sore throat comes with a fever over 38.3 C and no cough, white patches on the tonsils, swollen tender neck glands, a rash, or if it lasts more than a week: those point to strep, glandular fever or something that needs a swab and possibly antibiotics. Difficulty breathing, drooling, inability to swallow liquids, or a muffled voice with severe one-sided pain are emergencies. Children under one year must not be given honey.
Quick answer
- Honey — improved cough and throat symptoms more than usual care in a 2021 meta-analysis of 14 trials; 1–2 teaspoons as needed
- Sage spray — 15% sage extract relieved throat pain within 2 hours in a 286-patient RCT; sage-echinacea spray matched chlorhexidine-lidocaine
- Licorice-root gargle — cut post-operative sore throat from about 70% to 30–40% in anaesthesia trials
- Zinc lozenges — 75 mg/day of zinc acetate shortened colds by about a third in a 2017 meta-analysis
- Pelargonium sidoides — resolved tonsillopharyngitis 2 days faster than placebo in a 143-child RCT
- Salt-water gargle — cheap, safe, and reduced upper respiratory infections by 40% in one prevention trial
The 8 best herbs and supplements for sore throat
Ranked by the strength of human evidence. Strong = multiple trials or a meta-analysis. Moderate = a few small trials. Preliminary = early or animal data.
Sage leaf contains anti-inflammatory and mildly anaesthetic compounds (rosmarinic acid, thujone, cineole) that act on the mucosa directly. A 2006 double-blind trial in 286 patients with acute viral pharyngitis found a 15 percent sage spray reduced throat pain scores significantly more than placebo within two hours of the first dose. A 2009 Swiss trial in 154 patients found a sage-plus-echinacea spray relieved sore throat as well as a chlorhexidine-lidocaine spray over 3 days, with more than 60 percent responding in both groups. These are the best designed trials for any herb applied to a sore throat.
- Key evidence
- Hubbert 2006 RCT (n=286) and Schapowal 2009 RCT (n=154)
- Studied dose
- 15% sage fluid extract spray, 2 puffs to the back of the throat every 2 hours, up to 8 times a day, for up to 5 days; or a strong sage tea used as a gargle
- Best for
- Painful swallowing in the first 2 to 3 days of a viral sore throat
- Cautions
- Sage essential oil contains thujone, which can cause seizures at high doses; stick to sprays and teas, not the oil. Avoid medicinal doses in pregnancy and epilepsy. Sage may lower blood sugar and add to diabetes medication.
Licorice is a demulcent that coats the throat and glycyrrhizin has anti-inflammatory and antiviral activity. The clearest human data come from anaesthesia: a 2013 trial in 236 patients found gargling 0.5 g of licorice in 30 mL water before intubation cut the incidence of post-operative sore throat from about 70 percent to around 20 to 30 percent, and a 2019 meta-analysis of 5 trials confirmed the reduction. That is a mechanical sore throat rather than a viral one, but it shows the coating effect is real. Demulcent lozenges containing licorice are widely used for colds with supportive but lower-quality evidence.
- Key evidence
- Ruetzler 2013 RCT (n=236) and 2019 meta-analysis of 5 trials on post-operative sore throat
- Studied dose
- Gargle 0.5 g licorice powder in 30 mL warm water for 30 seconds, or lozenges with 10–20 mg glycyrrhizin, up to 4 times daily for no more than 1 week
- Best for
- Raw, scratchy throats, and anyone having a general anaesthetic (ask your anaesthetist)
- Cautions
- Glycyrrhizin raises blood pressure and lowers potassium with regular use; avoid in hypertension, heart failure, kidney disease, pregnancy and with diuretics or digoxin. Short gargle use carries little systemic absorption. DGL (deglycyrrhizinated) lozenges avoid this but may be less active on the throat.
This South African geranium root extract has immune-modulating and antibacterial-adhesion effects and more randomised trials than any other herb for respiratory infections. A 2003 trial in 143 children aged 6 to 10 with non-strep tonsillopharyngitis found symptoms resolved about 2 days earlier on Pelargonium than placebo, and a 2013 Cochrane review of 10 trials found it probably shortens acute bronchitis and sinusitis, while rating the evidence low quality because most trials came from one manufacturer. It treats the infection rather than coating the throat.
- Key evidence
- Bereznoy 2003 RCT in children (n=143); Cochrane review 2013 (10 trials)
- Studied dose
- 30 drops (1.5 mL) of EPs 7630 three times daily for adults, 20 drops for children 6–12, for 7 days; 20 mg tablets three times daily
- Best for
- Sore throat with a chesty cold, especially in school-age children
- Cautions
- Rare reports of liver injury; stop if you develop dark urine or jaundice. It may add to bleeding risk with warfarin in theory. Not recommended in pregnancy or breastfeeding for lack of data, and it does not replace antibiotics for strep.
Zinc lozenges
Moderate evidenceZinc ions interfere with rhinovirus replication in the throat, which is why the lozenge form matters. A 2017 meta-analysis of 3 trials using zinc acetate lozenges at 80 to 92 mg of elemental zinc a day found colds were 33 percent shorter, and a 2024 Cochrane review of 34 trials concluded zinc may shorten colds by about 2 days, with low certainty and more side effects. Lozenges need to be started within 24 hours of symptoms and dissolved slowly, not chewed. Zinc helps the cold that causes the sore throat; it is not a throat painkiller.
- Key evidence
- Hemilä 2017 meta-analysis of zinc acetate lozenges; Cochrane review 2024 (34 trials)
- Studied dose
- Zinc acetate or gluconate lozenge giving 13–23 mg elemental zinc every 2–3 hours while awake (75–90 mg/day), started within 24 hours, for up to 7 days
- Best for
- The first day of a cold, before the throat has peaked
- Cautions
- Nausea and a metallic taste are common at these doses. Do not exceed 7 days; prolonged high-dose zinc depletes copper. Separate from quinolone and tetracycline antibiotics by 2 hours. Never use zinc nasal sprays, which have caused permanent loss of smell.
Slippery elm bark is almost pure mucilage: it swells into a gel that coats the pharynx and is the main ingredient in Throat Coat tea and many lozenges. A 2003 randomised trial of 60 pharyngitis patients found a slippery elm, licorice and marshmallow tea reduced throat pain significantly within 5 to 10 minutes compared with a placebo tea, although the relief lasted under 30 minutes. That is the only controlled trial; everything else is tradition and the well-understood physics of mucilage. It is a reasonable, very safe demulcent for frequent use.
- Key evidence
- Brinckmann 2003 RCT of a demulcent tea blend (n=60)
- Studied dose
- Lozenges as needed, or 1–2 teaspoons of bark powder stirred into 250 mL hot water, 3–4 times daily
- Best for
- A dry, raw throat that needs frequent soothing, including in pregnancy
- Cautions
- Mucilage can slow the absorption of drugs taken at the same time, so leave 1–2 hours either side of medications. Otherwise very well tolerated. Choose sustainably harvested bark.
Like slippery elm, marshmallow root is a mucilage demulcent, and it has an official European monograph for irritation of the throat and dry cough. Laboratory work shows the polysaccharides form a protective layer over buccal and pharyngeal cells and reduce inflammatory signalling. A 2018 German observational study of 822 patients with dry cough and throat irritation found marshmallow syrup or lozenges gave relief within 10 minutes for most, with good tolerability, but there was no placebo arm. The soothing effect is immediate and short-lived.
- Key evidence
- EMA herbal monograph (traditional use); Fink 2018 observational study (n=822)
- Studied dose
- Syrup or lozenges as needed up to 6 times daily, or 2–5 g of root as a cold-water infusion (steep 1–2 hours) three times daily
- Best for
- Throat irritation with a tickly dry cough
- Cautions
- May slow absorption of other medicines; separate by 1–2 hours. May lower blood sugar slightly. Some syrups are high in sugar.
Propolis
Preliminary evidencePropolis is the resin bees use to seal the hive and it is antibacterial and anti-inflammatory in the laboratory. A 2021 Italian randomised trial in 122 adults with mild upper respiratory infections found a propolis oral spray resolved sore throat and other symptoms in 83 percent after 3 days versus 72 percent on placebo, and an earlier small trial found it eased pharyngitis in children faster than usual care. The trials are small and mostly sponsored, but the effect is consistent and the product is cheap.
- Key evidence
- Esposito 2021 RCT of propolis oral spray (n=122)
- Studied dose
- Propolis spray or lozenge giving 15–20 mg of polyphenols, 2–4 times daily for 5–7 days
- Best for
- People who want a sage alternative or who already use bee products
- Cautions
- Causes allergic reactions in people sensitive to bees, pollen or poplar resin; stop if you get mouth swelling or rash. Avoid if you have asthma triggered by bee products. May increase bleeding with anticoagulants at high doses.
Echinacea has more cold trials than almost any other herb, with a 2014 Cochrane review of 24 trials finding a small, non-significant benefit for prevention and inconsistent results for treatment. For sore throat specifically, its best evidence is in combination: the 2009 sage-echinacea spray trial above, and a 2015 Swiss trial of 203 patients in which an echinacea-sage spray was comparable to a chlorhexidine-lidocaine spray for acute sore throat. On its own, expect a modest reduction in overall cold symptoms rather than targeted throat relief.
- Key evidence
- Cochrane review 2014 (24 trials); Schapowal 2009 combination spray RCT
- Studied dose
- 2.4 g/day of E. purpurea alcoholic extract (Echinaforce) or 300 mg of dried pressed juice three times daily, started at first symptoms for 7–10 days
- Best for
- People who get several colds a winter and want something to start at the first sniffle
- Cautions
- Allergic reactions in people sensitive to ragwort, daisies and chrysanthemums. Theoretical concern with immunosuppressants and in autoimmune disease. Short-term use appears safe in pregnancy based on one cohort study, but avoid long courses.
How to choose
- For most viral sore throats, start with honey in warm water or tea, a salt-water gargle, and a sage spray or demulcent lozenge for pain. That covers soothing, coating and local anti-inflammatory effects.
- If pain on swallowing is the main problem, pick a sage or sage-echinacea spray; it has the best direct pain data. Use licorice or slippery elm lozenges between sprays.
- If the sore throat is day one of a cold with sneezing and runny nose, add zinc acetate lozenges immediately; after 48 hours they are unlikely to help.
- If the sore throat is part of a chesty cold with cough and sinus pressure, Pelargonium (EPs 7630) treats the whole picture rather than just the throat.
- If you have high blood pressure, heart failure or kidney disease, skip glycyrrhizin-containing licorice and use slippery elm or marshmallow instead.
- If you have fever without cough, tonsil exudate and swollen neck glands, use a rapid strep test before anything else. Strep needs antibiotics and herbs will only delay it.
What to skip
Apple cider vinegar gargle
There are no clinical trials of vinegar for sore throat. Acetic acid is antibacterial in a dish but irritates inflamed mucosa and erodes tooth enamel; several people have reported burns from undiluted use.
Colloidal silver spray
No human trials for sore throat, no plausible dose that reaches the virus, and chronic use causes permanent blue-grey skin (argyria). The FDA has warned sellers repeatedly.
High-dose vitamin C once symptoms start
A 2013 Cochrane review of 29 trials found vitamin C started after symptoms began did not shorten or ease colds. Regular daily use shortens colds by about 8 percent, which is a day or so, and it has no specific effect on the throat.
Oregano oil or 'natural antibiotic' tinctures
Carvacrol kills bacteria in vitro but oral oregano oil has not been trialled for pharyngitis, it stings inflamed tissue, and a sore throat that genuinely needs an antibiotic needs a real one.
Safety and when to see a clinician
- See a clinician if you have a fever above 38.3 C without a cough, white spots on the tonsils, swollen tender glands in the neck, a sandpaper-like rash, or a sore throat lasting more than 7 days. These are signs of strep, glandular fever or a peritonsillar abscess.
- Go to emergency care for difficulty breathing, drooling, inability to swallow fluids, a muffled 'hot potato' voice, stiff neck, or severe one-sided throat pain with a fever.
- Never give honey to a baby under 12 months (infant botulism). Lozenges are a choking hazard under 4 years; use syrups or warm drinks for young children.
- Licorice with glycyrrhizin raises blood pressure and lowers potassium; avoid regular use with antihypertensives, diuretics, digoxin, corticosteroids, and in pregnancy. Sage, echinacea and propolis can trigger allergies in people sensitive to related plants or bee products.
- Zinc lozenges are for 7 days maximum and should be separated from antibiotics such as doxycycline or ciprofloxacin by 2 hours. Pelargonium has rare liver reports; stop if you notice jaundice or dark urine.
- In pregnancy, honey, salt-water gargles, slippery elm and marshmallow are the safest choices; avoid medicinal doses of sage and licorice and ask your midwife before using Pelargonium or echinacea.
What matters as much as any herb
- Honey: the 2021 BMJ Evidence-Based Medicine meta-analysis of 14 trials found honey improved upper respiratory symptoms, including cough frequency and severity, more than usual care and antihistamines. Take 1 to 2 teaspoons neat or in warm (not boiling) water, as often as you like, from age 1.
- Salt-water gargle: half a teaspoon of salt in 250 mL warm water, gargled for 30 seconds several times a day, draws fluid out of swollen tissue and clears mucus. A Japanese trial of 387 adults found regular water gargling cut upper respiratory infections by about 36 percent.
- Fluids and humidity: a dry throat hurts more, so drink steadily, run a humidifier or breathe steam from a bowl, and avoid smoke and alcohol, which dry and irritate the mucosa.
- Rest your voice: whispering strains the vocal cords more than quiet talking. If you are hoarse, talk less and do not clear your throat repeatedly.
- Simple analgesia: paracetamol or ibuprofen reduce sore throat pain within an hour in trials and are safe to combine with everything on this page. Herbs add soothing; they do not replace a painkiller if you cannot swallow.
Frequently asked questions
What is the fastest way to get rid of a sore throat?
Nothing clears a viral sore throat faster than the 3 to 7 days it takes to run its course, but you can make it hurt much less within minutes. A sage spray or a licorice or slippery elm lozenge relieves pain within 10 minutes in trials, honey in warm water soothes for longer, and ibuprofen or paracetamol handles the rest. If it is strep, antibiotics shorten it by about a day and prevent complications.
Does honey really help a sore throat?
Yes. A 2021 meta-analysis of 14 trials found honey improved cough and throat symptoms more than usual care, including over-the-counter cough medicines. It coats the throat, is mildly antibacterial, and a tablespoon at night also improves sleep in children with colds. It must not be given to babies under one.
Is a sore throat with no other symptoms a sign of strep?
It can be. Strep throat typically causes a sudden severe sore throat, fever, swollen neck glands and white patches on the tonsils, usually without a cough or runny nose. If you have three or more of those, get a rapid strep test. A sore throat with a cold is almost always viral.
Which tea is best for a sore throat?
Any warm liquid helps, but the teas with evidence are sage (anti-inflammatory and pain-relieving in sprays), licorice root (demulcent), and blends built on slippery elm and marshmallow root, which coat the throat. Add honey and a squeeze of lemon. Chamomile is soothing but has no sore-throat trials of its own.
Do zinc lozenges work for a sore throat?
They shorten the cold rather than numb the throat. Zinc acetate lozenges at around 80 mg of zinc a day, started within 24 hours of symptoms, shortened colds by about a third in a 2017 meta-analysis. They taste unpleasant and are limited to a week.
Can I gargle with apple cider vinegar for a sore throat?
You can, but there is no trial showing it helps, and the acid irritates inflamed tissue and wears tooth enamel. A salt-water gargle does the same mechanical job without the downsides.
When should I see a doctor for a sore throat?
If it lasts more than a week, if you have a fever without a cough, white spots on the tonsils, swollen neck glands or a rash, or if swallowing or breathing becomes difficult. Also if you are immunocompromised or have a history of rheumatic fever. A quick swab settles whether you need antibiotics.
References
- Abuelgasim H, Albury C, Lee J. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ Evidence-Based Medicine (2021)View source
- Hubbert M, Sievers H, Lehnfeld R, Kehrl W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis: a randomised, double-blind, placebo-controlled study. European Journal of Medical Research (2006)View source
- Schapowal A, Berger D, Klein P, Suter A. Echinacea/sage or chlorhexidine/lidocaine for treating acute sore throats: a randomized double-blind trial. European Journal of Medical Research (2009)View source
- Ruetzler K, Fleck M, Nabecker S, et al.. A randomized, double-blind comparison of licorice versus sugar-water gargle for prevention of postoperative sore throat and postextubation coughing. Anesthesia & Analgesia (2013)View source
- Bereznoy VV, Riley DS, Wassmer G, Heger M. Efficacy of extract of Pelargonium sidoides in children with acute non-group A beta-hemolytic streptococcus tonsillopharyngitis: a randomized, double-blind, placebo-controlled trial. Alternative Therapies in Health and Medicine (2003)View source
- Hemilä H. Zinc lozenges and the common cold: a meta-analysis comparing zinc acetate and zinc gluconate, and the role of zinc dosage. JRSM Open (2017)View source
- Nault D, Machingo TA, Shipper AG, et al.. Zinc for prevention and treatment of the common cold (Cochrane Review). Cochrane Database of Systematic Reviews (2024)View source
- Brinckmann J, Sigwart H, van Houten Taylor L. Safety and efficacy of a traditional herbal medicine (Throat Coat) in symptomatic temporary relief of pain in patients with acute pharyngitis: a multicenter, prospective, randomized, double-blinded, placebo-controlled study. Journal of Alternative and Complementary Medicine (2003)View source
- Karsch-Völk M, Barrett B, Kiefer D, et al.. Echinacea for preventing and treating the common cold (Cochrane Review). Cochrane Database of Systematic Reviews (2014)View source
- Satomura K, Kitamura T, Kawamura T, et al.. Prevention of upper respiratory tract infections by gargling: a randomized trial. American Journal of Preventive Medicine (2005)View source
- Sore throat (pharyngitis). NHS (2024)View source
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Ask about sore throatThis guide is educational and is not medical advice. Herbs and supplements can interact with prescription medicines and are not regulated like drugs. Talk with a clinician or pharmacist before starting anything new, especially if you are pregnant, breastfeeding, have a chronic condition, or take medication.