Manuka honey does help with sore throats, and the evidence behind it is stronger than for most home remedies. A systematic review published in BMJ Evidence-Based Medicine found that honey significantly improved overall symptom scores, cough frequency, and cough severity in people with upper respiratory tract infections compared to usual care. The UK’s National Institute for Health and Care Excellence (NICE) now includes honey as a recommendation for acute cough before reaching for antibiotics.
Why Manuka Honey Works Differently
All honey has some antibacterial properties, but manuka honey contains unusually high levels of a compound called methylglyoxal (MGO), which is the main driver of its germ-killing ability. Regular honey contains trace amounts. Manuka honey contains between 38 and 761 mg/kg, depending on the batch and grade. This is what separates it from the bear-shaped bottle in your pantry.
Beyond the antibacterial effect, honey coats and soothes irritated throat tissue. Its thick consistency forms a protective layer that reduces the raw, scratchy feeling when you swallow. It also draws moisture from inflamed tissue, which can reduce swelling. These physical properties explain why even regular honey helps with sore throats, while the high MGO content gives manuka an additional edge against bacteria that may be contributing to the infection.
How It Compares to Over-the-Counter Remedies
The BMJ review compared honey head-to-head with common cough suppressants. Against dextromethorphan (the active ingredient in most OTC cough syrups), honey performed about equally well. There was no statistically significant difference in cough frequency, cough severity, or overall symptom improvement between the two. That’s notable because it means honey works roughly as well as the most widely used pharmacy option.
Against diphenhydramine (the antihistamine found in some nighttime cold medicines), honey actually came out ahead. Across four studies with 385 patients, honey produced significantly better results for overall symptoms, cough frequency, and cough severity. It also didn’t cause the drowsiness that diphenhydramine is known for.
NICE’s own review found that honey reduced bothersome cough by about 2 points on a 7-point scale compared to placebo, which is a meaningful improvement. It also improved sleep quality compared to no treatment or diphenhydramine, by roughly half a point to a full point on the same scale. Side effects were minimal: no significant increase in gastrointestinal problems or issues like nervousness, insomnia, or hyperactivity compared to placebo or dextromethorphan.
How to Use It
Take half a tablespoon to one tablespoon of manuka honey at a time, and let it coat your throat slowly rather than swallowing it quickly. You can take it straight off the spoon, stir it into warm (not boiling) water, or add it to tea. Very hot liquids will degrade some of the beneficial compounds, so let your drink cool enough to sip comfortably before stirring in the honey. Repeating this a few times a day, especially before bed, helps maintain the soothing coating on your throat.
Choosing the Right Grade
Manuka honey is sold with two main grading systems: UMF (Unique Manuka Factor) and MGO. Both reflect the concentration of methylglyoxal, just on different scales. Here’s how they roughly translate:
- UMF 5+ (MGO 83): Entry-level manuka. Has some antibacterial activity but is closer to regular honey in potency.
- UMF 10+ (MGO 263): A solid middle ground for sore throat relief. This is where most people start for therapeutic use.
- UMF 15+ (MGO 514): Higher potency, noticeably more expensive. The antibacterial activity is stronger, but whether the extra cost translates to meaningfully better sore throat relief isn’t well established.
For sore throat purposes, UMF 10+ or higher is a reasonable choice. Higher grades won’t hurt, but the price climbs steeply above UMF 15+, and most of the clinical research on honey and upper respiratory infections used standard honeys rather than ultra-premium grades.
Who Should Avoid It
Honey of any kind, including manuka, should never be given to children under 1 year old. This is a firm safety rule, not a soft guideline. Honey can contain spores of the bacterium that causes infant botulism, and a baby’s immature digestive system can’t neutralize them the way an older child’s or adult’s can. This includes even tiny amounts, like a drop on a pacifier.
For children over age 1, honey is considered safe and is specifically included in NICE guidance as an option for acute cough. The studies reviewed by NICE included children aged 1 to 17. If you have diabetes, keep in mind that manuka honey is still honey. A tablespoon contains roughly 17 grams of sugar, so factor it into your carbohydrate intake for the day.
What Manuka Honey Won’t Do
Honey is effective for symptom relief, but it isn’t a treatment for strep throat or other bacterial infections that require antibiotics. If your sore throat comes with a high fever, white patches on your tonsils, swollen lymph nodes, or lasts more than a week, something more than honey is likely needed. Most sore throats are caused by viruses, where antibiotics don’t help anyway and symptom management is the main game. That’s exactly where manuka honey fits best: easing the pain, reducing cough, and helping you sleep while your body fights off the infection on its own.