When Antivirals Are Not Indicated, Natural Products Can Help Alleviate Flu Symptoms


For otherwise healthy patients, natural products can help alleviate flu symptoms when antivirals are not indicated.

Oseltamivir phosphate (Tamiflu) and similar drugs (neuraminidase inhibitors or baloxavir) are often used to alleviate flu-like symptoms and prevent complications from the flu in high-risk populations.

These drugs can shorten the duration of the influenza symptoms by about half to 3 days. The benefit has been greatest when started in the first 24 to 30 hours of onset of flu symptoms. It also reduces the severity of the flu and risk of complications, but the catch is it only works on susceptible strains of the influenza A and B. It doesn’t work on every cold and respiratory virus that can occur during the cold and flu season.1

A 2011 meta-analysis found that when Tamiflu was given to people with flu-like symptoms, only 28% had a reduction in lower respiratory tract complications. However, 37% of those who tested positive for the influenza A or B virus had a reduction in lower respiratory tract complications.2

As a result of these findings, Tamiflu and similar drugs are reserved for patients with asthma, and other conditions that put them at high risk for hospitalizations and complications from the flu. Many otherwise healthy patients do not qualify for these drugs, because they have the same outcome regardless. Using Tamiflu in healthy people can also cause drug resistance and therefore put those need antivirals at risk of not getting the preventative care they need.

However, otherwise healthy patients do have other options, and natural products can alleviate flu symptoms for them.

There are many natural products on the market that claim antiviral properties and emerging evidence indicates that they work. I don’t want to single out any 1 product, but I do want to point out one particular study. This study showed that natural products have the potential to be equally as effective as Tamiflu.

The study tested elderberry juice concentrate and echinacea extracts against Tamiflu 75 mg bid for 5 days. The results showed equal rates of recovery and reduced the rates of influenza-related respiratory complications in adults and children.

Other products with optimistic results are elderberry syrup, elderberry lozenges, and zinc lozenges. Liquids and lozenges are very popular forms of antiviral products because it is thought that the extended contact time at the site of action yields better results.

A 2015 meta-analysis of 3 randomized trials on zinc acetate lozenges for the common cold (dosages of 80 to 92 mg per day) found that zinc acetate lozenges shortened the duration of nasal discharge by 34% (95% CI: 17% to 51%), nasal congestion by 37% (15% to 58%), sneezing by 22% (−1% to 45%), scratchy throat by 33% (8% to 59%), sore throat by 18% (−10% to 46%), hoarseness by 43% (3% to 83%), and cough by 46% (28% to 64%). Zinc lozenges shortened the duration of muscle ache by 54% (18% to 89%), but there was no difference in the duration of headache and fever.4

There have also been good results from echinacea products in the medical literature, but finding these products for sale on the market can be difficult since there are many echinacea plant species and many different plant parts that yield various results. There is the flower part, the stem, the leaves, and the roots. All these different parts of the various species make it difficult in finding a product that yields consistent and good results.

The flu season is a difficult time. Nothing will stop the cold and flu viruses 100% of the time, but natural products can lessen the severity and shorten the duration. Healthy patients who do not qualify for antivirals do have options.

Get ready, get set, here comes the flu!


  • Dobson J, Whitley RJ, Pocock S, et al. Oseltamivir treatment for influenza in adults: a meta-analysis of randomised controlled trials. Lancet. 2015;385(9979):1729. Epub 2015 Jan 30.
  • Hernán MA, Lipsitch M. Oseltamivir and risk of lower respiratory tract complications in patients with flu symptoms: a meta-analysis of eleven randomized clinical trials. Clin Infect Dis. 2011;53(3):277. Epub 2011 Jun 15.
  • Raus K, Pleschka S, Klein P, et al. Effect of an echinacea-based hot drink versus oseltamivir in Influenza treatment: a randomized, double-blind, double-dummy, multicenter, noninferiority clinical trial. Curr Ther Res Clin Exp. 2015;20;77:66-72.
  • Hemilä H, Chalker E. The effectiveness of high dose zinc acetate lozenges on various common cold symptoms: a meta-analysis. BMC Fam Pract. 2015;16:24. Published 2015 Feb 25. doi:10.1186/s12875-015-0237-6

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