It is often said that honey is an effective cough suppressant, but is it true? This is probably the most frequently studied health claim relating to honey, and there have been a number of clinical trials on this subject. Some of the more recent studies include:
- In a 2007 study, 105 children from ages 2 to 18 were selected. These children had been coughing at night due to upper respiratory tract infections. On two consecutive nights, the children were given either a teaspoon of buckwheat honey, a teaspoon of honey flavored cough syrup, or nothing. The parents were then asked to complete a survey with questions about cough frequency, cough severity, and the quality of sleep of both the children and their parents. Honey consistently ranked first in terms of best results,with cough syrup ranking second, and no treatment coming in last.
- In a 2010 study, 139 children aged 2 to 5, each having upper respiratory infections, were randomly assigned to one of four groups. Group 1 was given a dose of honey before bedtime. Groups 2 and 3 were given one of two different types of cough syrup, and group 4 was a control group that received no treatment. Again, in terms of cough frequency and severity, and also sleep quality, the children receiving honey fared the best.
- In a 2012 study, 270 children aged 1 to 5 years old had all been diagnosed with an upper respiratory infection, which was causing nocturnal coughing. At bedtime, the children were given 1.5 teaspoons of one of the following honey varieties: eucalyptus, citrus or wildflower (primarily sage, mint and thyme blossom). A control group was given a dose of date extract that was similar in color and texture to honey. Neither the parents nor the doctors knew which child received which dose. Parents were then asked about cough severity and frequency the next day. The children receiving the doses of honey all did better than the placebo group, and there was no significant difference in results between the 3 honey varieties.
Based on these and other studies, in 2013 two pediatricians recommended honey as the best treatment for young children (ages 1 to 5) with upper respiratory infections. According to these doctors, not only does honey produce superior results as compared to cough syrup, but improper use of over the counter cough medications can actually be harmful. Tragically, between 1983 and 2012, 118 child deaths were attributed to the misuse of cough and cold syrups. ("A spoonful of honey helps a coughing child sleep," by Dr. Ashkin and Dr. Mounsey. The Journal of Family Practice, March 2013.)
How Does Honey Help to Stop Coughing?
Your nasal passages and your throat are covered with mucous membranes. These membranes are thin layers of skin that secrete mucus. Mucus is a thick fluid that helps to protect these open and sensitive areas of the body from dust, dirt and also pathogens such as bacteria and viruses. Mucus actually traps these invaders, and then removes them from the body. But sometimes these defenses are breached, and germs get through to the membranes. When this happens, the mucus membranes become inflamed and irritated. This irritation is what causes you to cough. In addition, mucus production is compromised and the very germ protection you need is now missing.
To provide relief, the body needs a mucous substitute. Honey is just what the doctor ordered. Honey is a demulcent - a substance that contains gummy and slimy chemicals called mucilage materials. These materials relieve irritation of mucus membranes by forming a protective film over these membranes via direct contact.
But cough syrup is also a demulcent, so why does honey work better in clinical trials? One reason is that honey is naturally more sticky than a typical cough syrup, so the protective coating stays in place longer where it is most needed (i.e., the back of the throat). Cough drops are also a demulcent. When the hard candy is dissolved by saliva, it has the same effect as cough syrup. But here again, the coating effect of cough drops wears off faster than a dose of raw honey.
The natural anti-bacterial properties of raw honey is another reason that honey outperforms cough syrup and cough drops. Raw honey contains an enzyme called glucose oxidase. When combined with the sodium and moisture found in saliva, small amounts of this enzyme are converted into hydrogen peroxide - a common disinfectant. Thus, not only is the honey forming a protective barrier over irritated membranes, but the raw honey is also producing hydrogen peroxide to help neutralize the infection that caused the irritation in the first place.
But wait, there's more! Honey is also hydroscopic, which means that it attracts water. Honey actually pulls water out of bacteria cells, which essentially kills the cells through dehydration. And then honey has a low pH of between 3.2 and 4.5, which makes it more acidic. Bacteria prefer either neutral or slightly alkaline environments. So honey is a "good" acid that creates an environment where certain bacteria can no longer thrive.
Raw honey will also contain small amounts of propolis. Propolis is a sticky substances that bees make out of tree resin. In the beehive, propolis has two primary uses. First, it is used like a glue to bind parts of the beehive together and to patch holes and cracks. Second, propolis is an anti-septic, which attacks and kills certain types of bacteria, viruses and fungi.
Finally, honey contains a number of plant chemicals that were present in the nectar and pollen gathered by the bees. These phytochemicals include carotenoids, phytosterols, phenolics and peptides. Without going into a lot of organic chemistry, these chemicals send signals to the body's immune system to release healing substances called cytokines, some of which have anti-inflammatory properties.
Given these multiple substances in raw honey which give it such amazing, natural healing properties (anti-bacterial, anti-inflammatory, anti-septic and immune boosting), it is no wonder why raw honey beats out cough syrup and cough drops that may only have one or two active ingredients. Not only is raw honey more effective, but ounce for ounce, it is less expensive than most branded cough syrups. That sure sounds like a win-win to us.
Does the honey variety make a difference for cough suppression?
There is not a lot of research on this question. In the clinical studies described earlier, the variety of honey did not seem to make a difference in the results. There is some anecdotal evidence that thicker and darker honey like buckwheat is better for cough suppression. But the most important factor is that the honey must be raw and unfiltered. Raw honey means that it has not been pasteurized (i.e., heated to over 160 degrees Fahrenheit). While some purists assert that raw honey should never be warmed in any way, we believe that warming the honey to around 105 degrees so as to facilitate bottling does not degrade the qualities of raw honey in any significant way. It is also important that the honey is not filtered so that the pollen and propolis particles remain in the honey. Raw honey does require straining to remove little bits of bees and beeswax, but at Smiley Honey we use a 300 micron strainer that does not remove any of the beneficial pollen.
We also believe that raw linden honey is a very good choice for cough suppression. Linden honey comes from the nectar of linden tree flowers. Linden trees are also known as lime trees (in England) or basswood trees (in the USA). For centuries, herbalists have known that tea made from dried linden flowers is beneficial for respiratory ailments. Linden tea contains phytochemicals that help reduce inflammation of mucous membranes (similar to the effect of raw honey). Since raw linden honey will contain pollen from linden flowers, we believe this may offer a synergistic one-two punch for knocking back the bacteria responsible for the upper respiratory infection. It certainly seems like a good idea for a clinical trial - testing the effectiveness of linden honey for coughs and colds, versus other types of raw honey.
How to take honey for coughs and colds
The two primary methods for taking raw honey for wellness reasons are straight from the spoon, or dissolved in warm water (including herbal tea). All of the clinical trials described above gave honey to the children straight from a spoon. This method certainly makes sense in terms of directly and immediately coating and soothing your irritated mucous membranes. We recommend this method for the final dose of raw honey before bedtime. The suggested dose of raw honey for cough relief is 1 to 2 teaspoons. This honey dose can be taken 4 or 5 times per day, and it is best to wait until after any coughing spasms have ended before taking a dose. The final dose of the day should be taken about 30 minutes before bedtime.
Taking raw honey dissolved in warm water is also very beneficial. Just remember that the water must be warm and NOT HOT so that it does not degrade the beneficial enzymes found in raw honey. A number of nutritionists recommend that first thing in the morning, before eating or drinking anything else, dissolve a teaspoon or two of raw honey in a cup of warm water, and then stir in the juice of a half of a fresh lemon. This drink has significant cleansing and healing benefits, in addition to the anti-cough benefits already discussed.
Throughout the day, perhaps mid morning and mid afternoon, we recommend a cup of herbal tea with raw honey. When brewing the tea, bring some water to a simmer and then pour over the tea bag in your favorite mug. Allow the tea to seep for a good long while to extract all of the beneficial nutrients, and also to make sure that the tea is not too hot before adding the raw honey.
Final Words of Caution
Raw honey should never be given to children under 1 year old. In rare cases, raw honey many contain botulism spores. The immune systems of infants are not sufficiently developed to handle botulism, and this can lead to severe illness and even death.
Also, while raw honey is an effective form of relief for common coughs, it will not do much against more aggressive bacterial infections such as strep throat. For these conditions, see a doctor.
The content of this article is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a doctor or other qualified health care provider with any questions you may have regarding a medical condition.