In a timely health alert, BBC's Dr Xand van Tulleken has urged the British public to reconsider reaching for over-the-counter cough medicines this winter. The public health expert delivered his crucial advice during an appearance on BBC Morning Live on Friday, 19 January 2026.
NHS Guidance: Why Cough Syrup Isn't Recommended
Speaking to presenters Helen Skelton and Gethin Jones, Dr Xand, a specialist in public and global health, stressed the official NHS position. "The NHS itself does not recommend cough syrup," he stated clearly. Instead, the health service advocates for a simpler, natural alternative. "It recommends lemon and honey."
He explained that a hot drink made with lemon and honey can be "just as good" as many medicinal syrups, particularly for dry, tickly coughs. The remedy works by coating the throat, which helps to soothe irritation and calm the cough reflex. The NHS website confirms this, noting the mixture has a "similar effect to cough medicines."
Red-Flag Symptoms: When a Cough Becomes Serious
The discussion on the programme was prompted by new research indicating that common viruses like human rhinovirus can lead to pneumonia in adults. Dr Xand used the platform to outline the critical warning signs that indicate a cough needs medical attention.
He advised that anyone with a persistent cough lasting more than three weeks should consult a GP, in line with NHS guidance. Beyond this timeframe, he detailed specific "red flag" symptoms that demand immediate action:
- Shortness of breath without a clear cause.
- High fever or chills that persist.
- Chest pain associated with coughing.
- Producing very thick mucus that is hard to shift.
- Extreme fatigue or becoming "extremely worn out."
Dr Xand also highlighted more severe, urgent warning signs, including lips or fingertips turning blue (indicating low oxygen), confusion, a rapid heart rate, and a high fever that won't subside.
The Evidence Behind the Cough Syrup Warning
The warning against cough syrup is backed by scientific review. Studies, including those from the respected Cochrane Collaboration, suggest many over-the-counter remedies perform little better than a placebo for short-term coughs in adults and children.
While ingredients like suppressants (e.g., dextromethorphan) may offer some temporary relief, evidence indicates simpler measures are often more effective. These include staying hydrated, taking pain relievers like paracetamol for discomfort, and, for those over one year old, using honey.
Dr Xand shared a personal note of caution, reflecting on how pneumonia can develop insidiously. "Pneumonia you can sort of slip under quite gently. It's not a dramatic illness but it can be fatal," he said, emphasising the importance of monitoring symptoms and seeking early medical help if they worsen.
