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Cough and Sore Throat

Cough and Sore Throat

Manuka honey is commonly used as a home remedy to relieve cough and sore throat. Laboratory studies have shown Manuka honey inhibits a range of bacteria associated with respiratory tract infections including Streptococcus pyogenes, a common cause of strep sore throat.

Clinical trials, supported by laboratory studies, have shown that honey can alleviate the symptoms/discomfort associated with cough and sore throat. In one randomised clinical trial in 300 children aged 1-5 years old treatment with honey reduced the frequency and severity of night-time cough, improving child and parents sleep (Cohen 2012).

A number of public health authorities recommend the use of honey for self-treatment of cough and sore throat. The Centre for Disease Control and Prevention (CDC) in the United States and the National Institute for Clinical Excellence (NICE) in the United Kingdom both recommend honey as a first-line self-care treatment for acute cough and sore throat in children (> 1 year old) and adults (CDC 2015, NICE 2019). The World Health Organisation (WHO) and Pharmaceutical Society of Australia (PSA) describe honey in syrup and lozenge form as a natural demulcent (World Health Organisation 2001, Pharmaceutical Society of Australia 2015). Demulcents supress cough by forming a temporary protective layer over the throat relieving the irritation and inflammation that triggers cough.

Manuka honey, being more complex than other honeys, contains a combination of compounds such as phenolic acids and flavonoids which are known to exhibit anti-inflammatory and antioxidant activity (Ambriz-Pérez 2016, Gutiérrez-Grijalva 2016, Inoue 2005). Consumption of high antioxidant honey increases blood plasma antioxidant levels (Schramm 2003) indicating that the honey antioxidant molecules are stable and can be absorbed by the body following ingestion. Manuka honey can also stimulate the body’s immune system through regulation of cytokine (immune signalling molecules) production (Ahmed 2018, Almasaudi 2017, Tonks 2007).

In addition to general demulcent effect, manuka honey may provide a soothing effect on throat discomfort through its inhibitory effect on the inflammatory enzyme myeloperoxidase (MPO) (Kato 2012, Medhi 2008, Prakash 2008). Myeloperoxidase is one of the body’s first line immune responses against infection, it produces hypochlorous acid and other reactive species that kill pathogens associated with upper respiratory tract infections (Strzepa 2017). However, the body’s immune response often over-reacts in presence of infection in order to rid pathogens. In the case of MPO, this results in excessive production of toxic substances which promotes inflammation leading to tissue damage and resulting sore throat. Modulation of MPO activity limits the damage to the throat lining which may account for the soothing effect of manuka honey. Two components responsible for MPO inhibition have been identified in manuka honey which include leptosperin (glycoside unique to certain Leptospermum honeys) and the phenolic compound methyl syringate (Kato 2012).

Benefits of consuming manuka honey

Note: Honey uses discussed in this section concern symptom relief of benign, self-limiting conditions and supporting general health and well-being. Medical advice should be sought for treatment of illnesses, diseases and medical disorders, we do not advise self-diagnosis or self-treatment with manuka honey in place of expert medical care. Honey should not be consumed by children under 1 year of age.