Claim 09 · Infections

Kadha, honey, giloy: "prevents or cures COVID and viral infections".

As forwarded

Warm water, kadha (tulsi, cinnamon, black pepper, dry ginger, raisin), golden milk and chyavanprash, forwarded as prevention or cure for COVID and viral infections, "as recommended by the Ministry of AYUSH".

Widely shared from March 2020 onward, often quoting the Ministry of AYUSH advisory of 31 March 2020 [S1], which recommended these measures. The forwards drop the advisory's own disclaimer. Reach figure: not available. Reach not available

Verdict

Exaggerated

Honey eases a cough for a day or two and warm drinks soothe a sore throat, but nothing in a kadha prevents or cures COVID or any virus; the AYUSH advisory itself said it was not a treatment, and giloy has been linked to serious liver injury in dozens of Indian patients.

Supported

On honey for a cough:Honey eases a cough for a day or two.

Unsupported

On preventing or curing COVID or any virus:Nothing in a kadha prevents or cures COVID or any virus; the AYUSH advisory itself said it was not a treatment.

What the evidence says

Supported

Symptom relief: supported. A Cochrane review of 6 randomised trials (899 children aged 1–18) found honey probably reduces cough more than placebo or salbutamol for up to three days and probably relieves cough and improves sleep better than no treatment, with moderate-certainty evidence; beyond three days it probably offers no advantage. Honey is not advised for infants under 12 months because of botulism risk. [S2]

Unsupported

Prevention or cure: unsupported. The AYUSH advisory described its measures as things that "may possibly boost an individual's immunity", stated "there is no medicine for COVID-19 as of now", and ended: "The above advisory does not claim to be treatment for COVID 19". [S1] The later AYUSH National Clinical Management Protocol restricted itself to mild cases ("This protocol is for management of mild COVID-19"), referred all severe cases, described its formulations as "in addition to standard approaches of care and prevention", said evidence drew on classical texts, biological plausibility and ongoing studies, and cited no trial results. [S3]

Dangerous

Giloy (Tinospora cordifolia) and the liver. A Mumbai case series described six patients (median age 55) who took giloy for a median of 90 days as a COVID "immune booster" and developed acute hepatocellular jaundice (median peak bilirubin 17.5 mg/dl, AST 1350, ALT 812) with autoimmune-hepatitis-like features; four had silent underlying chronic liver disease; one died. RUCAM causality: probable in 2, possible in 4. The authors: giloy "seems to induce an autoimmune-like hepatitis or unmask an underlying autoimmune chronic liver disease". [S4]

Dangerous

The follow-up multicentre study: 43 patients from 13 tertiary hospitals across nine Indian locations (April 2020–July 2021); jaundice in 77%; chronic liver disease flare in 51%, acute hepatitis in 44%, acute liver failure in 2; ANA positive in 42%; RUCAM probable in 67%, possible in 33%; 4 deaths (9%) and 2 liver transplants. Conclusion: giloy is linked to acute hepatitis with autoimmune features and may unmask silent autoimmune liver disease; "herbal" and "natural" do not mean "safe". [S5]

Safety note

Safety note: giloy and the liver, both positions

The hepatology case series [S4][S5]: two independent publications, 49 patients in all, with 5 deaths and 2 liver transplants, link giloy taken as an "immune booster" to acute hepatitis with autoimmune features, assessed with RUCAM causality scoring and biopsy.

The Ministry of AYUSH's response (PIB, 7 July 2021) [S6][S7] called the link "completely misleading", argued the plant may have been the look-alike Tinospora crispa, that doses and co-medication were unclear, and asserted "The efficacy of TC in managing various disorders is well established." The 2022 multicentre study addressed causality with RUCAM and biopsy, but acknowledged it was retrospective, could not measure doses, and did not botanically verify every product.

Stop giloy and seek care at any sign of jaundice (yellow eyes, dark urine, itching, loss of appetite). Herbal remedies must not delay hospital care for breathlessness or low oxygen. [S4][S5]

Honest note

ICMR guidance specifically on herbal prevention was not located in this research (not available). The specific WHO prevention page was not opened. Giloy has centuries of use and the ministry's botanical-misidentification argument has not been fully excluded, since most case series did not test the products consumed; equally, no randomised trial shows kadha, giloy or turmeric prevents infection, and the liver-injury series are now two independent publications covering 49 patients with 5 deaths. The Nagral 2021 full text was read via a text mirror, not the journal site. Cochrane 2018, PIB 2020 and 2021, Nagral 2021 and Kulkarni 2022 are all pre-2023; COVID-specific guidance has largely been withdrawn or archived, while the honey evidence and the liver-injury findings remain current. The reviewer should check whether a newer Cochrane update exists.

What to do instead

Breathlessness, chest pain, oxygen saturation below 94%, confusion, or fever beyond 3–4 days: call 108 or 112 or go to a hospital. No home drink treats these; the AYUSH protocol itself refers all severe cases. [S3]
Prevention that is evidence-based: vaccination per the national schedule, hand hygiene, masks in crowded indoor settings during outbreaks, ventilation. (WHO guidance; the specific WHO page was not opened in this research.)
For cough and sore throat in adults and children over 1 year: honey in warm water is reasonable for up to three days. Never give honey to infants under 12 months. [S2]
Giloy and other herbal "immune boosters": avoid prolonged daily use; stop immediately and see a doctor if you develop yellow eyes, dark urine, itching or loss of appetite; people with diabetes, thyroid disease, any autoimmune condition or known liver disease should not self-medicate. [S4][S5]
Kadha with pepper, ginger and cinnamon is a warm drink; it is fine as comfort but not a reason to delay testing or care.

Sources

S1
Ministry of AYUSH advisory on self-care during COVID-19 (Press Information Bureau release).Tier 2 ministry advisory · 31 March 2020
pib.gov.in/PressReleasePage.aspx?PRID=1609524
S2
Cochrane. Honey for acute cough in children (CD007094).Tier 1 · 10 April 2018; check for a newer update
cochrane.org/evidence/CD007094/honey-acute-cough-children
S3
Ministry of AYUSH. National Clinical Management Protocol based on Ayurveda and Yoga for management of COVID-19.Tier not graded in the research file · 2020; ministry protocol
nia.nic.in/pdf/National-Clinical-Management-Protocol-based-on-Ayurveda-Covid-19.pdf
S4
Nagral A et al. Herbal immune booster-induced liver injury in the COVID-19 pandemic: a case series. Journal of Clinical and Experimental Hepatology 2021 (n=6).Tier 3-level case series in a society journal · 2021; full text read via a text mirror, not the journal site
distantreader.org/stacks/cord/cord-0959660-xfcylzp3.txt
S5
Kulkarni AV et al. Tinospora cordifolia (giloy)-induced liver injury during the COVID-19 pandemic: multicenter nationwide study from India. Hepatology Communications 2022;6:1289–1300 (n=43).Tier 3 · 2022
pmc.ncbi.nlm.nih.gov/articles/PMC9134809
S6
Ministry of AYUSH response on giloy and liver damage (PIB, 7 July 2021), reproduced at TaxGuru.Tier not graded in the research file · ministry statement, reproduction
taxguru.in/corporate-law/relating-giloy-liver-damage-completely-misleading.html
S7
Medical Dialogues. "Misleading, flawed, incomplete": AYUSH Ministry dismisses study linking giloy to liver damage.Circulation only; not evidence · 2021; report on the ministry response
medicaldialogues.in/amp/ayush/ayurveda/news/misleading-flawed-incomplete-ayush-ministry-dismisses-study-linking-giloy-to-liver-damage-79505

Tiers are as graded in the research file. "Circulation only" sources document that a claim circulates and are never cited as evidence. Where a primary paper could not be opened, the page says so in the Honest note.

Reviewed by

Medical review: being arranged

Every evidence sentence on this page traces to the sources listed above, but no registered physician has yet signed it off. When one has, their name, registration number and date of review will appear here. Until then, read this page as a sourced guide, not as medical advice: for any symptom, call 108 or 112, or see a doctor.

Corrections

No corrections yet. Write to [email protected].