Awaiting clinical review. This page is built from sourced entries but has not yet been signed off by a pharmacist or clinician.
Natural remedies for coughs & colds
Direct answer
Honey is the best-supported option here for a cough in children over 12 months: the Cochrane review rated it Moderate (3), finding it probably eases cough more than no treatment or placebo, though mostly after a single night. For adults and for shortening a cold, nothing has been shown to work reliably; elderberry is rated Limited (2) on small, mostly maker-funded trials of very low certainty. The caution that matters most: never give honey to a baby under 12 months, and liquorice products that still contain glycyrrhizin raise blood pressure and lower potassium.
Compare the options
Click a column heading to sort.
| Rated for | Typical form & use | Main caution | |||
|---|---|---|---|---|---|
| Honey Bee product (Apis mellifera) | Moderate | Cough in children with colds | Honey, 1–2 teaspoons (NHS advice) | Never give to babies under 12 months (botulism) | Same night |
| Echinacea Echinacea purpurea/angustifolia | Limited | Treating a cold once it starts | E. purpurea juice, 6–9 ml a day | Allergy risk, esp. with daisy-family allergy | About a week |
| Elderberry Sambucus nigra (ripe fruit, cooked) | Limited | Shortening common colds | Standardised syrup or extract, 5 days | Raw or unripe berries, leaves and stems are toxic | 2–3 days |
| Marshmallow root Althaea officinalis (root) | Limited | Mouth and throat irritation with dry cough | Root macerate, 0.5–3 g in 150 ml water | Not for children under 3 (cough use) | Same night |
| Liquorice root Glycyrrhiza glabra (root) | Traditional | Cough with a cold | Whole root tea, 1.5–2 g in 150 ml | Glycyrrhizin raises blood pressure, lowers potassium | 2 weeks |
| Slippery elm Ulmus rubra (inner bark) | Traditional | Sore throat | Powdered bark; no dose established | No proven dose; safety in pregnancy unknown | About a week |
- Rated for
- Cough in children with colds
- Form
- Honey, 1–2 teaspoons (NHS advice)
- Onset
- Same night
- Rated for
- Treating a cold once it starts
- Form
- E. purpurea juice, 6–9 ml a day
- Onset
- About a week
- Rated for
- Shortening common colds
- Form
- Standardised syrup or extract, 5 days
- Onset
- 2–3 days
- Rated for
- Mouth and throat irritation with dry cough
- Form
- Root macerate, 0.5–3 g in 150 ml water
- Onset
- Same night
- Rated for
- Cough with a cold
- Form
- Whole root tea, 1.5–2 g in 150 ml
- Onset
- 2 weeks
- Rated for
- Sore throat
- Form
- Powdered bark; no dose established
- Onset
- About a week
Quick picks
Rated Moderate (3) for cough in children over 12 months: the Cochrane review of six trials (899 children) found it probably reduces cough more than no treatment or placebo, and may work about as well as dextromethorphan. Most children were treated for one night, and it must never be given to a baby under 12 months because of infant botulism.
Gentlest optionMarshmallow rootRated Limited (2) for a dry cough with a sore, irritated throat. The EU regulator accepts it as a soothing demulcent on long-standing use alone and lists no known side effects, but there is no placebo-controlled trial; the evidence is uncontrolled pharmacy surveys. Take it 30 to 60 minutes apart from other medicines.
Traditional favouriteSlippery elmRated Traditional (1) for sore throat: we found no controlled trial of slippery elm on its own, so whether it works is unknown. LiverTox describes it as generally recognised as safe with no evidence of liver harm, but no source we opened gives a tested dose.
Talk to a doctor first if…
Who should avoid
Never give honey to a baby under 12 months (risk of infant botulism); the NHS also advises limiting added sugar, honey included, for children aged 4 or under. Avoid glycyrrhizin-containing liquorice if you have high blood pressure, heart, kidney or liver disease, low potassium, or are pregnant. Echinacea is not recommended by the EU regulator for children under 12 or people with autoimmune disease or weakened immunity, and can cause severe allergic reactions in people with daisy-family allergies. Never eat raw elderberries, leaves or stems, and do not give marshmallow root to children under 3.
Known interactions
Liquorice with diuretics, digoxin and other heart-rhythm drugs, corticosteroids, stimulant laxatives such as senna and blood-pressure medicines (severity 3): the EU regulator advises against the combinations because low potassium can trigger heart-rhythm problems and liquorice can counteract blood-pressure drugs. Echinacea and immunosuppressants (severity 2) is a theoretical concern. Marshmallow root may delay the absorption of other medicines, so take it apart from them.
Before you reach for an ingredient
For a cold or cough, the simple measures below are what the NHS suggests first, alongside honey, which has better trial support for children's cough than any herb here.
- For a cough, the NHS advises rest, plenty of fluids, and staying at home if you have a high temperature or feel unwell; paracetamol or ibuprofen can ease any pain. A cough usually clears up on its own within 3 to 4 weeks. Decongestants and cough medicines containing codeine will not stop a cough, and some cough medicines should not be given to children under 12.8
- For a cold, the NHS advises rest, plenty of fluids, a warm lemon and honey drink or salt-water gargles for a sore throat (gargling is not suitable for children), and steam from a hot shower for a blocked nose. Paracetamol or ibuprofen from a pharmacy can ease aches and a temperature.7
- Antibiotics do not help colds, which are caused by viruses, and the NHS says there is little evidence that vitamin C, echinacea or garlic help you get better faster. See a GP for a cold that has not improved after 10 days, a temperature over 3 days, or a cough lasting more than 3 weeks; get urgent help if you find it hard to breathe, have chest pain or cough up blood.7,8
Questions people ask
Does honey really help a cough?
For children over 12 months with a cold, probably yes. The Cochrane review found moderate-certainty evidence that it reduces cough more than no treatment or placebo, though most trials lasted one night and the reviewers said there was no strong evidence either way. It is never for babies under 12 months. Marshmallow root is a traditional soothing herb for dry cough, but its human evidence is uncontrolled surveys.
Does elderberry shorten a cold?
Possibly by a day or two, but the evidence is weak. In one trial of air travellers who caught a cold, those on elderberry had fewer total cold days (57 versus 117), but only 29 people caught one and the makers funded it. The systematic review rated the certainty very low.
Does echinacea help once you have a cold?
Not reliably. Of seven treatment trials in the Cochrane review that measured how long colds lasted, only one found a significant effect over placebo, and the review concluded echinacea has not been shown to help treat colds.
Is liquorice safe for a cough?
Not for everyone. The EU regulator lists liquorice root as a traditional expectorant for cough with a cold, but that rests on long-standing use alone. Liquorice containing glycyrrhizin can raise blood pressure and lower potassium, so check the label and ask a pharmacist first if you have heart, kidney or liver disease or take regular medicines.
Sources
- Cochrane review Karsch-Völk M, Barrett B, Kiefer D, Bauer R, Ardjomand-Woelkart K, Linde K. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2014.
- Systematic review Wieland LS, Piechotta V, Feinberg T, et al. Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complement Med Ther. 2021.
- Regulator monograph European Medicines Agency HMPC. European Union herbal monograph on Althaea officinalis L., radix (EMA/HMPC/436679/2015). 2016.
- Regulator monograph European Medicines Agency HMPC. European Union herbal monograph on Glycyrrhiza glabra L.; Glycyrrhiza inflata Bat.; Glycyrrhiza uralensis Fisch., radix (EMA/HMPC/108399/2024). Final, revision 1, 2026.
- Regulator/health agency Slippery Elm. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. NIDDK. 2012 (updated 2024).
- Cochrane review Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM. Honey for acute cough in children. Cochrane Database Syst Rev. 2018.
- Health service guidance NHS. Common cold. National Health Service (page last reviewed 22 March 2024).
- Health service guidance NHS. Cough. National Health Service (page last reviewed 8 December 2023).
Draft, awaiting clinical review