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Supplements for a Sore Throat: What Helps, What Doesn't, and When to See a Doctor

Most sore throats are viral and get better within about a week; pain relief such as paracetamol or ibuprofen and enough fluids come first. Among supplements, andrographis eased sore throat more than placebo in adults with colds (grade B), while honey and zinc lozenges have smaller, less certain effects (grade C). Never give honey to a baby under 1, as it can cause botulism. See a clinician for fever without a cough, pus on the tonsils or trouble swallowing.

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A sore throat (pharyngitis) usually comes from a virus, and most people feel better within about a week, with or without antibiotics (NICE). Strep throat, the bacterial kind that antibiotics do help, is behind only about 1 in 10 sore throats in adults and 3 in 10 in children (CDC). This guide covers adults.

The short version

  • Andrographis by mouth (adults with colds, against placebo): less sore throat in pooled small trials. Grade B (Hu 2017; Cáceres 1999).
  • Zinc acetate lozenges (199 adults with colds, against placebo lozenges): a scratchy throat cleared about a third sooner; sore throat itself was not clearly shorter. Grade C for the throat (Hemilä 2015).
  • Honey (14 studies of colds and similar infections, most in children, some of honey mixtures; against usual care): better overall symptom scores and less coughing; no clear gain over placebo. Never for babies under 12 months (botulism). Grade C (Abuelgasim 2021; CDC).
  • Sage spray, a coating herbal tea and pelargonium: one placebo-controlled trial each; the pelargonium trial was in children. Grade C (Hubbert 2006; Brinckmann 2003; Bereznoy 2003).
  • Licorice gargle before surgery (adults given a breathing tube, against no painkiller): fewer sore throats afterwards; swallowed regularly, licorice raises blood pressure. Grade B for the gargle (Kuriyama 2019; Penninkilampi 2017).
Option (who, compared with what)What trials foundSize of effectGrade
Andrographis by mouth (adults with colds, vs placebo)Less sore throatLarge on a pooled score (314 people)B
Zinc acetate lozenges (199 adults with colds, vs placebo)Scratchy throat shorter; sore throat not clearly33% and 18% (not significant) shorterC
Honey (14 studies, most in children, some honey mixtures; vs usual care)Better overall scores, less coughingThroat pain not pooled aloneC
Sage spray (one trial of three strengths, vs placebo spray)Less throat pain over 2 hours with the 15% sprayOne trialC
Probiotic K12 lozenges (mostly children, vs placebo or nothing)Fewer strep throats only against nothing4 poor-quality trialsC, mixed
Licorice gargle before surgery (609 adults, vs no painkiller)Fewer sore throats after a breathing tubeRisk ratio 0.44 (5 trials)B

What helps a sore throat fast?

Pain relief and fluids come first. NICE (England) advises paracetamol or, where suitable, ibuprofen, and enough to drink. Adults may try medicated lozenges with a numbing agent, an anti-inflammatory or an antiseptic, though "they may only help to reduce pain by a small amount"; NICE found no evidence on plain lozenges or mouthwashes (NICE). The NHS adds warm salt-water gargles (not for children), cool or soft foods, and sucking ice or hard sweets, though nothing small and hard for young children, who could choke (NHS).

Is honey good for a sore throat?

Grade C: a small easing of overall cold symptoms and cough, not throat pain measured alone. Across 14 studies in colds and other nose and throat infections, honey beat usual care on combined symptom scores (3 studies) and on cough frequency and severity (8 and 5 studies); the 2 placebo-controlled studies showed no clear difference. Most of these studies were in children, and some used honey mixed with other ingredients, such as coffee, so the results fit adults taking plain honey less well (Abuelgasim 2021).

No honey at all before 12 months: it can give babies botulism, a severe food poisoning, so keep it out of their food, drinks, formula and pacifiers (CDC).

Do zinc lozenges help a sore throat?

Grade C for the throat itself, though lozenges shorten colds by about a third (grade B, Hemilä 2017). In 3 placebo-controlled trials, 199 adults with colds, most starting within a day, sucked zinc acetate lozenges every few hours while awake. A scratchy throat cleared 33% sooner and hoarseness 43% sooner, but sore throat ran 18% shorter, too uncertain to rule out chance, though the authors suspect a missed effect (Hemilä 2015).

Those throat trials used 80 to 92 mg of zinc daily for under 2 weeks, more than double the 40 mg a day set as the adult upper limit. Weeks at 50 mg a day or more can block copper absorption, leaving you short of copper, and weaken immunity, so use lozenges only while the cold lasts and stay above the limit longer only if a clinician is checking your blood (NIH ODS; check my stack). In zinc treatment trials of every form, minor complaints like an unpleasant taste or stomach upset were commoner than on placebo (16 trials, 2,084 people) (Nault 2024).

Never put zinc in your nose. After over 130 reports of lost smell, the FDA warned in 2009 against three nasal zinc cold products; the loss "may be long-lasting or permanent" (FDA).

Does andrographis help a sore throat?

Grade B: less sore throat than placebo, from small trials. Andrographis (Andrographis paniculata) is a bitter Asian herb. A 2017 review pooled less sore throat (314 people) and less cough against placebo; its placebo trials used the herb alone, plus one report on a blend with Siberian ginseng, and three of the four had low or medium risk of bias, though few trials said how products were made (Hu 2017). In one, 158 adults with colds in Chile taking the herb alone for 5 days had milder sore throats than the placebo group by day 2 and day 4 (Cáceres 1999).

Across 10 trials and 3 monitoring studies, about 1 in 10 trial participants had a minor side effect, mostly stomach upset or a rash; serious ones were very rare (Worakunphanich 2021). A high-dose trial of andrographolide, its main chemical, was halted after side effects that included anaphylaxis (a severe allergic reaction) in one person (Calabrese 2000).

Do throat sprays, herbal teas or pelargonium help?

  • Sage spray (applied to the throat), grade C: in a trial of 286 people with a viral sore throat, split between three strengths of sage spray and a placebo spray, the 15% spray eased pain more than placebo over the first 2 hours; side effects were mild, such as dryness or burning (Hubbert 2006). An echinacea and sage spray and a numbing chlorhexidine and lidocaine spray had similar response rates at 3 days (64% and 58%, 154 people aged 12 and over), but without a placebo group that can't show either beat nothing; a herbal-medicine company whose medical head was an author paid for it (Schapowal 2009). Echinacea products shortened colds in only 1 of 7 treatment trials (Karsch-Völk 2014).
  • Coating herbal tea, grade C: in 60 adults with pharyngitis, a commercial "demulcent" tea, the kind meant to coat the throat, eased pain on swallowing more than a placebo tea for the 30 minutes after a cup (Brinckmann 2003). For the classic coating herbs, slippery elm and marshmallow root, a PubMed search on 9 November 2026 returns 6 papers, none testing either herb alone; LiverTox, a US liver-injury database, rates slippery elm generally safe (LiverTox).
  • Pelargonium, grade C, children only: in 143 children aged 6 to 10 with non-strep throat and tonsil inflammation, 6 days of a liquid extract of Pelargonium sidoides root (a South African geranium) lowered symptom scores more than placebo by day 4 (Bereznoy 2003). This is the only sore-throat trial, and it was in children. A 2013 Cochrane review rated the pelargonium evidence low or very low quality and found no reliable data for respiratory infections other than bronchitis, sinusitis and colds (Timmer 2013).

Can probiotics prevent strep throat?

Grade C, mixed. Streptococcus salivarius K12, an oral probiotic sold as lozenges, has 4 trials (1,846 people), all of poor quality. Over 6 months, 222 children aged about 3 taking it had fewer strep throats than children given nothing (16% against 49%), but in 1,314 schoolchildren aged 5 to 14, allotted K12 or placebo by odd or even birth date, positive strep swabs differed little (7.8% against 8.8%) (Wilcox 2019; Doyle 2018). In 60 adults in hospital with severe tonsillitis, K12 or a placebo added to penicillin changed nothing measured (Gilbey 2015).

Does licorice help a sore throat?

Grade B, but only as a gargle or similar throat treatment before surgery. In 5 trials (609 adults given a breathing tube for surgery), topical licorice before the anesthetic cut the risk of a sore throat afterwards by more than half against controls given no painkiller (risk ratio 0.44), with no significant side effects (Kuriyama 2019). It is an anesthetic-team step and says nothing about swallowing licorice.

Swallowed regularly, licorice can raise blood pressure and lower blood potassium. Across 18 small studies (337 people) of products supplying 100 mg or more a day of glycyrrhizic acid, a compound in licorice root, systolic pressure rose about 5 mmHg from baseline and potassium fell (Penninkilampi 2017). NCCIH links large or long-term use to an irregular heartbeat and cardiac arrest, warns that small amounts have harmed people with hypertension, heart or kidney conditions or a salty diet, and notes interactions with corticosteroids (NCCIH).

Elderberry, vitamin C or apple cider vinegar for a sore throat?

  • Elderberry, grade C: trials measured colds and flu as a whole; it may not lower your odds of a cold, and any shortening is uncertain (Wieland 2021). Raw or unripe berries, leaves and stems release cyanide and bring on vomiting and severe diarrhea (NCCIH).
  • Vitamin C (against placebo): daily, it made adults' colds about 8% shorter (grade A); started once a cold began, it had no consistent effect (grade B for that null result) (Hemilä 2013).
  • Apple cider vinegar: of 57 papers on vinegar and sore throat or tonsillitis in a PubMed search on 9 November 2026, none is a vinegar trial. Vinegar can injure: a vinegar tablet damaged one user's esophagus (Hill 2005), a 15-year-old drinking an under-diluted vinegar drink every day ended up vomiting blood from esophageal ulcers (Chang 2020), and in healthy adults tooth-wear scores rose 18% from baseline over 8 weeks of twice-daily diluted vinegar drinks, but not on a low-acid vinegar pill (Anderson 2021).

What we'd skip

  • Zinc gels, swabs or sprays in the nose (FDA).
  • Vinegar shots or tablets (Hill 2005; Chang 2020).
  • Licorice tea, sweets or extracts swallowed daily, above all with hypertension or heart or kidney trouble (Penninkilampi 2017; NCCIH).
  • Propolis (bee glue) throat sprays and sweets, which can trigger allergy: case reports describe a swollen voice box and anaphylactic shock after throat use for pharyngitis (Hsu 2004) and allergic mouth inflammation from propolis throat candies (Zhang 2020).

Safety and interactions

  • Zinc and antibiotics: the ciprofloxacin label wants the antibiotic taken a minimum of 2 hours before, or 6 hours after, anything with zinc in it, and the tetracycline label says zinc reduces that drug's absorption (ciprofloxacin label; tetracycline label). On any antibiotic, ask your pharmacist how to space lozenges.
  • Echinacea: allergic reactions, sometimes severe, and stomach upset; NCCIH sees conflicting evidence on drugs cleared by the liver and theoretical reasons for interactions with immune-suppressing medicines (NCCIH).
  • Pelargonium: more side effects than on placebo in the Cochrane trials, none serious (Timmer 2013). Liver injury has been reported, and the link is uncertain: German drug-safety reviewers read spontaneous reports as showing some liver-harming potential, a later causality analysis of those 15 cases found the evidence unconvincing (Teschke 2012), and a Berlin hospital study judged pelargonium a possible cause in 1 of 198 liver-injury cases (Douros 2016). If your eyes or skin turn yellow or your urine darkens, stop it and get checked.
  • Sage: common sage contains thujone, toxic in large amounts, so high doses or long use may be unsafe (NCCIH).
  • Probiotics: 60 case reports and 7 case series describe 93 people with infections tied to probiotics, half from a yeast strain; the reviewers judged them not risk-free for some patient groups (Costa 2018). Seriously ill or immunosuppressed? Ask first.
  • Pregnancy: use any of these only as advised by your midwife or obstetric team. NCCIH says sage may be unsafe in pregnancy because of thujone, and that about 250 g of licorice a week can raise the risk of birth before 38 weeks (NCCIH sage; NCCIH licorice). The 40 mg zinc limit holds in pregnancy too (NIH ODS).
  • Breastfeeding? Ask your midwife, doctor or a lactation specialist, who can check what passes into breast milk. Short zinc-lozenge courses should not harm the baby (LactMed zinc); sage traditionally dries up milk, untested (LactMed sage); avoid heavy long-term licorice (LactMed licorice); echinacea lacks nursing safety data (LactMed echinacea).
  • Children: ask your child's doctor before any of these.

When to see a doctor

  • Call 911 (999 in the UK) for trouble breathing, being unable to swallow, drooling, or a high-pitched noise when breathing in (NHS); these can signal epiglottitis, swelling that can block the windpipe (NHS).
  • Emergency care for a possible throat abscess (quinsy): severe pain worsening fast, usually on one side, swelling inside the mouth, trouble opening it, a muffled voice or a hard-to-turn head (NHS; MedlinePlus).
  • A clinician soon for possible strep throat: sudden throat pain with fever, swollen front-of-neck glands, pus or white patches on the tonsils or tiny red spots on the roof of the mouth, usually without a cough or runny nose; a quick test confirms it and antibiotics help; untreated, strep can spread and cause abscesses or rheumatic fever, and a rash may mean scarlet fever (CDC).
  • Same-day advice for a very high temperature, little or dark urine (dehydration), or a weak immune system, as from chemotherapy (NHS).
  • Your doctor if it hasn't improved in a week, keeps coming back, or comes with a lump in the mouth or neck or a mouth ulcer lasting over 3 weeks, possible signs of mouth cancer (NHS; NHS).

Don't stop a prescribed medicine on your own; ask the prescriber or pharmacist. Under 18? Ask a clinician first.

FAQ

What helps a sore throat fast? Paracetamol or ibuprofen and enough fluids; medicated lozenges may ease pain a little. Andrographis eased sore throat more than placebo in adults with colds (grade B), and a sage spray eased pain for 2 hours in one trial (grade C).

Is honey good for a sore throat? A little: in studies that were mostly in children, some using honey mixtures, it beat usual care for overall cold symptoms and coughing, not clearly placebo, and throat pain wasn't pooled alone (grade C). Never give honey to a baby under 12 months.

Do zinc lozenges help a sore throat? They shorten colds, but in 3 trials of adults with colds sore throat itself was not clearly shorter (grade C). The trials used 80 to 92 mg a day for under 2 weeks, above the 40 mg adult limit that guards against low copper. Never put zinc in your nose.

Is elderberry or apple cider vinegar good for a sore throat? Elderberry's trials measured colds and flu as a whole, with small, mixed results (grade C). A PubMed search finds no vinegar trials for sore throat, and strong vinegar has injured the esophagus.

Sources

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