5 Top Herbs for Treating Fever (A Vitalist Guide)

The febrile illness (fever) season has been rough this year. From influenza to COVID and more, people have had intense, lingering fevers, and healing has been taking a long time. I’m using the term “febrile illness,” rather than naming the specific virus, because, as herbalists, we have a consistent approach to addressing fever regardless of the virus or bacteria involved. The discussion and recommendations in this post apply to fever due to any cause.

Notes on the Treatment and Suppression of Fevers

Before we get into herbal remedies for fever, let’s talk about why suppressing a fever (including taking NSAIDS like aspirin and Advil, or Tylenol) is not usually a good idea, whether we’re using a drug or an herb. The result of artificially bringing down a fever is suppression.

It is common to view the fever as a problem that should be solved. Fevers make us feel miserable, they disrupt our sleep, and basically incapacitate us. However, fever is a vital, intelligent, and important response that functions to heal your body and resolve the infection more quickly. It’s best not to suppress a fever unless it is dangerously high for an extended period. As vitalist herbalists, we need to know how to support a fever to be more efficient and effective, and to speed up the febrile response so that both the fever and the pathogen resolve more quickly.

Feed a Cold, Starve a Fever

It is best to fast when you have a fever because, when you eat, your blood and vital force are diverted to the GI tract to digest the food. During that time, your blood isn’t on the surface, so it can’t do the job it needs to during the fever. This is why traditional wisdom tells us to “starve a fever, and feed a cold.” Once you’ve been running a fever for a day or two, one of the signs of improvement is a return of your appetite. 

When the fever has abated, but digestion hasn’t returned to normal, bitter tonic herbs can help get the digestive secretions and enzymes going again. Yarrow is excellent for this purpose.

Diaphoretic Herbs for Treatment of Fever

The way to address fever in traditional herbalism is with a class of remedies called diaphoretics. Diaphoretics are herbs used specifically in febrile diseases, and there are two main categories: stimulant and relaxant.

Stimulant Diaphoretics

Stimulant diaphoretics are warming, spicy, pungent, aromatic herbs that stimulate circulation and warm the core. With these herbs, we’re aiming to drive blood to the surface so that internal heat can ultimately be vented to the periphery. If you’ve ever eaten something really spicy that made you sweat, you have experienced the effect of a stimulant diaphoretic.

Relaxant Diaphoretics

Relaxant diaphoretics are more nuanced than stimulant diaphoretics. These herbs relax constriction at the surface of the body (the pores, capillary beds, and circulation) and allow these to open up. We call these surface-relieving remedies because they relieve tension at the surface.

If you build a big fire in your fireplace, it will make your house really hot. Then, if you open up the windows to release the heat, that’s essentially what a relaxant diaphoretic does.

Many diaphoretic herbs have properties that support other symptoms of a febrile disease. Some are expectorants, some are decongestants, and some are antimicrobials or antibacterials. In Chinese medicine, the metal element is said to rule the lungs and the skin. Many of our diaphoretic herbs are also respiratory herbs, such as Black Cohosh (Cimicifuga racemosa), Lobelia (Lobelia inflata), Osha (Ligusticum porteri), Thyme (Thymus vulgaris), and Oregano (Origanum sp.)

Usually, fevers are accompanied by coughs, and many herbs are both expectorant and diaphoretic, which is especially useful for influenza or COVID. It is part of nature’s intelligent design that these herbs address multiple aspects of an illness!

Herbal Administration for Fevers

The best way to prepare herbs when treating a fever is as hot tea. Use an infusion for lighter plant parts such as leaves and flowers, or a decoction for denser parts such as roots, bark, berries, and seeds. Hot tea is best because hot water is itself diaphoretic. If you drink hot water, it will make you sweat, which is ideal for delivering these herbs. The heat of the tea helps the herbs volatilize upward and outward to the surface of the body. You can use tinctures in hot water in a pinch, and it will also work.

5. Elderflower (Sambucus spp.) for Fever

There are many species of Sambucus, such as Black Elderberry (Sambucus nigra), Blue Elderberry (Sambucus cerulea), Sambucus canadensis, and here in the Pacific Northwest, Red Elderberry (Sambucus racemosa). 

Elderflower Tastes, Actions, and Energetics

Elderflower is a classic relaxant diaphoretic fever remedy in traditional European herbalism. It relaxes peripheral tension in the vasculature and pores, releasing internal heat. One of the great things about Elderflower is its mild taste. This is important to keep in mind with herbs in general: if you’re taking them as a tea and the tea tastes horrible, it will be challenging for people, especially children, to drink.

Elderflower is a great remedy for children. Not only is the taste mild, but it’s also a very effective remedy, so it’s a good choice for adults too. To a degree, Elderflower will inhibit viral replication (what many would call “antiviral”). The term “antiviral” is confusing because people see the word and think the herb will kill any virus, but that isn’t the case. It is important to distinguish which specific viruses an herb has been studied for, and whether that study was in a petri dish (in vitro), which means the herb or compound must come into direct contact with the virus to have its “antiviral” effect. It doesn’t necessarily mean the herb will have a systemic effect.

The research with Elder is specifically for the influenza virus, and this is where we see it having the broadest range of applications. However, Elderflower can be very helpful for a wide variety of febrile conditions, especially those that are termed “eruptive febrile conditions.” These are fevers accompanied by an eruptive skin condition, such as chicken pox or measles. Anytime there is an eruptive skin condition accompanied by a fever, Elderflower is a great choice to help the condition run its course and clear up more quickly. The berries of the Elder plant are not notably diaphoretic, so Elderberry syrup and lozenges, for example, will not have the effects you need in the case of fever.

Elderflower has been shown to inhibit a variety of bacteria, including Salmonella, Staphylococcus, and MRSA, so it can be used topically as a wash for these conditions.

Elderflower Preparation and Dosage 

• 1 teaspoon dried Elderflower, finely ground
• 8 oz boiling water
• Pour the boiling water over the herb.
• Infuse covered for 30 to 40 minutes, keeping the water hot throughout the infusion (use a coffee pot with a warmer if you have one).
• Strain and serve.

4. Lemon Balm (Melissa officinalis) for Fever

Lemon Balm Tastes, Actions, and Energetics

Another ideal herb for kids is Lemon Balm (Melissa officinalis). It has a light, lemony, citrusy flavor that most children find quite palatable.

Like Elderflower, Lemon Balm is a relaxant diaphoretic, so it relieves peripheral tension. It is also a nervine, so it calms the nervous system and mind and promotes overall relaxation, making it ideal for children.​

Lemon Balm is an aromatic mint, so it is a digestive carminative. It is common with fevers to also have an upset stomach and nausea. Lemon Balm is ideal because it helps calm a person, relieves an upset stomach, and helps them slip into sleep. As we all know, sleep is an important medicine for recovery from a febrile illness, and Lemon Balm is ideal for this.

​Lemon Balm is another herb that, if you look online, you’re almost guaranteed to see people talking about it as an “antiviral.” From my understanding, all of the research on Lemon Balm as an “antiviral” is specifically related to topical use on the herpes virus. There is no research suggesting that Lemon Balm kills influenza or COVID, so I don’t think Lemon Balm should be considered an antiviral for any viral infection other than herpes. For herpes, topical Melissa essential oil has been shown to be effective, but it is very expensive, and most mint family plants have some degree of inhibitory effect on herpes when used topically.

Lemon Balm Preparation and Dosage

• 1 teaspoon dried Lemon Balm, finely ground
• 8 oz boiling water
• Pour the boiling water over the herb.
• Infuse covered for 30 to 40 minutes, keeping the water hot throughout the infusion (use a coffee pot with a warmer if you have one).
• Strain and serve.

3. Yarrow (Achillea millefolium) for Fever

We’re moving into slightly stronger territory with our third herb, Yarrow (Achillea millefolium). When I was at Bastyr University studying herbal actions and properties, we would often consult our materia medica list, which was organized by Latin name. For what seemed like every action, the first herb on the list was Achillea millefolium because it starts with ‘A’ and is followed by a ‘c’. I thought to myself, “What is this herb? It seems like it does just about everything.” Indeed, Yarrow is a reliable, versatile diaphoretic among other things.

Yarrow Tastes, Actions, and Energetics

Yarrow is both bitter and aromatic; both a stimulant and a relaxant diaphoretic, making it very versatile. Typically, fevers move through a cycle, alternating between heat and chills as your hypothalamus raises and lowers the set point for your body temperature. When the temperature set point is high, but the fever hasn’t quite reached it, you’ll have chills. When the set point reaches that heightened level, you feel hot and have a noticeable fever, then if your temperature drops back down, you feel cold again. When you feel cold, it’s best to use a stimulant diaphoretic to raise your fever more quickly. Once you’re up there, you feel hot, tense, and you may have a headache and feel achy. In this case, a relaxant diuretic will help to vent the periphery and release the internal heat of the fever. You can use Yarrow at any stage, and it will work.

Yarrow is antimicrobial, antibacterial, and inflammation-modulating. If you have inflammation in the upper respiratory tract and lungs, and general heat patterns, it can help calm that down. Yarrow is also an aromatic decongestant, so it can be very useful for upper sinus congestion, such as a stuffy nose, and for excess mucus production. It can help open the airways, so if there’s a restrictive cough with tension in the bronchioles, it can help relax them.

Yarrow is not a nervine, so it won’t calm you down overall, but it does have a slight spasmolytic, relaxant effect on the respiratory tract and in the periphery, with the pores and capillary beds. Similar to Elderflower, Yarrow is great for supporting the progression of eruptive febrile conditions. For rashes such as measles or chickenpox, Yarrow is very useful.

Yarrow can be used after the fever has subsided as a simple bitter tonic to get the digestive system back in order by stimulating the digestive secretions and enzymes.

Yarrow Preparation and Dosage

Yarrow is usually too bitter for kids on its own unless their palate is trained to accept the bitter taste and to take herbs in general. In that case, it’s best to combine it with something that improves the taste, such as Lemon Balm or Elderflower.

• 1 teaspoon dried Yarrow, finely ground
• 8 oz boiling water
• Pour the boiling water over the herb.
• Infuse covered for 30 to 40 minutes, keeping the water hot throughout.
• Strain and serve.
• For a more palatable tea, mix 1 part Elderflower, 1 part Lemon Balm, and ½ part Yarrow for children / 1 part Yarrow for adults.

2. Black Cohosh (Cimicifuga/Actaea racemosa) for Fever

Black Cohosh Tastes, Actions, and Energetics

Black Cohosh’s main action is as a spasmolytic, making it excellent for tension, constriction, and spasm of smooth and skeletal muscle. In Chinese medicine, this corresponds to excess wind, and in Ayurveda, to excess vāta. It is a nervine and mild sedative, so it calms the nervous system down. 

In the uterus, it eases menstrual cramps, while in the respiratory system, it eases bronchiole tension in asthmatic conditions. It can be used for ureter spasms in cases of kidney stones. Black Cohosh also relaxes the smooth muscles surrounding the arterioles and capillaries, opening them up on the surface to relieve internal heat. It is an excellent relaxant diaphoretic.

Black Cohosh is considered an anodyne because it relieves pain caused by muscle spasms. When you have a fever, your muscles get really achy, and Black Cohosh is specific for fever with tension and achy muscles. It relaxes musculoskeletal tension, easing pain. Its nervine and sedative actions make it effective for disrupted sleep due to fever and headaches. When you have a high fever, the blood is pushed up and out, and for some, this results in wind heat headaches. The wind is due to constriction and tension, and the heat is due to the blood pushing up into the head. You may see a red face, red, bloodshot eyes, and the head often feels hot and full of pressure. Black Cohosh is a cooling, relaxing remedy that can help relax the blood vessels, ease constriction, and ease the headache that accompanies the fever.

Black Cohosh has expectorant properties, so it’s excellent for constricted coughs. If the respiratory system is constricted, breathing can become difficult, and it’s common to experience spasmodic coughing fits. That’s where Black Cohosh can be helpful, especially when combined with Wild Cherry bark, Wild lettuce, and Licorice.

I got really sick around my birthday this year, and had a very high fever for four days, with a terrible headache. My muscles, bones, and head hurt, and I couldn’t sleep. I was using my usual diaphoretic remedies. However, we’re all our own worst herbalists, so it can be difficult to diagnose and select the right remedies for yourself, especially when you feel like crap. That’s why Black Cohosh had slipped my mind until one evening, when I was lying there suffering, I prayed, “Please show me the remedy,” and Black Cohosh popped into my head. We didn’t have any of the bulk herb for making a decoction, but I did have some tincture. So I put some of the tincture in hot water, drank it down, lay down, and paid attention. I could feel that everything was tense and stuck, and the vital force wasn’t moving. Then, everything relaxed, opened up, and the headache went away. I fell right to sleep, and that was the turning point for my fever. I woke up the next morning, still feeling awful, but way better than I had been feeling.

Black Cohosh Preparation and Dosage

I don’t recommend this herb for kids, as it’s strong, acrid, and bitter, and therefore is not a pleasant-tasting herb. It may upset a child’s stomach. Note that Black Cohosh can cause headaches at higher dosages.

• ½ teaspoon of recently dried Black Cohosh root/rhizome 
• 8 oz water 
• Decoct by bringing to a boil and simmering for 15 minutes
• Turn off the heat and steep covered for 30-45 minutes. 
• Strain and serve.

As a tincture:

• Add 1-3 ml to a cup of hot water and drink.

1.Boneset (Eupatorium perfoliatum) for Fever

My number one, favorite diaphoretic herb for fever is Boneset (Eupatorium perfoliatum). This is one of our great North American remedies, traditionally used for febrile conditions of all types.

Boneset Tastes, Actions, and Energetics

Boneset is extremely bitter, strongly relaxant, and diaphoretic. Energetically, it is very cooling and drying. Boneset is an ideal choice for alternating chills and fever (intermittent fever), which is an indication of wind. You can think of this as a scenario where people put on covers because they feel chilly, then get really hot and kick them off to cool down, and then get cold again. Wind can include tension, constriction, spasm, or involuntary movements. It can also include alternating symptoms or symptoms that move from one area of the body to another. 

Boneset is a specific remedy for bone pain during a fever. The bone pain I’m describing is a deep pain distinct from myalgia or muscle pain (for which Black Cohosh is more specific). In Chinese medicine, which has poetic ways of naming things, there’s a cool term for this called “steaming bone syndrome.” Steaming bone syndrome is a key indication for Boneset.

The herbs we have discussed thus far can be used for all varieties of febrile conditions, but Boneset is specifically indicated for viral and bacterial fevers, such as measles, influenza, COVID, Dengue fever, West Nile Virus, and malaria. It is intensely bitter and, in that way, strongly antimicrobial, antibacterial, and possibly antiviral. Just as very bitter herbs are not comfortable in our mouths, I believe they create an uncomfortable environment for pathogens in the body as well. 

Boneset also appears to have stimulant effects on the immune system. Paul Bergner says that some properties in Boneset seem to stimulate immunity. I’m not sure whether it’s because it boosts immune cells or if the immunostimulant property is more due to its diaphoretic action, but in my own experience using this herb, it does feel like it can boost the immune system.

Boneset is a stimulant expectorant, but it doesn’t fit the pattern of most stimulant expectorants, which are hot, pungent, aromatic, resinous herbs. Boneset is a bitter, stimulant expectorant, excellent for clearing phlegm from the lungs, which is useful because coughs often accompany febrile conditions.

Boneset Preparation and Dosage

• ½ teaspoon dried Boneset, finely ground
• 8 oz boiling water
• Pour the boiling water over the herb.
• Infuse covered for 30 to 40 minutes, keeping the water hot throughout.
• Strain and serve.

*Note: In large doses, Boneset can be emetic due to its extreme bitterness. Though this herb works best as a tea, it can be challenging to take. On a personal note, like most people, I don’t like the bitter taste, and I usually have a strong physical reaction to it. However, I’ve found that when I really need Boneset, I can tolerate it. Other people have noticed that as well. This is a very strong, bitter remedy, so it isn’t the best choice for children. 

Other Top Herb Choices for Fever

My favorite runner-ups for fever are Ginger (Zingiber officinale), Thyme (Thymus vulgaris), Black Pepper (Piper nigrum), Garlic (Allium sativum), Rosemary (Salvia rosmarinus), and Oregano (Origanum vulgare). These are commonly found in people’s kitchens and are aromatic spices that are useful for treating fever. *Don’t use Sage (Salvia officinalis) because it’s anti-diaphoretic, so that’s the opposite action we’re looking for. Herbs that are commonly found in people’s kitchens are especially useful if you’re doing distance consults with people. You can ask them to go through their spice cabinet and tell you what they have available, and then they can make a tea from what they have on hand. 

Osha (Ligusticum porteri) is another good one for coughs, and it’s also a circulatory stimulant, making it great for fever. I also love Blue Vervain (Verbena hastata) as a relaxant diaphoretic.

A Therapeutic Regimen for Fevers

• Take a hot bath
• Drink your hot, diaphoretic tea (choose one or more herbs from the list we just covered and make your tea as directed above).
• When you get out of the bath, do a wet sock treatment: Get a pair of wool socks, soak them in cold water, and put them on your feet. Put another thick pair of dry, wool socks over the wet socks. This is a simple hydrotherapy technique for fevers.
• Change the bedsheets daily if you (or the person you’re caring for) is sweating.
• Air out the room daily and if possible, fumigate with Myrrh, Frankincense, Cedar, Copal, Sage, or any resinous, aromatic herb. Breathe in the smoke a bit, even if you have a cough. It will cleanse your lungs.
• If you don’t want to or cannot use smoke for fumigation, volatilize essential oils in a diffuser, and then open up the windows and air it out.
• Fast on water with electrolytes and broth.
• Take supplements such as zinc, vitamin C, and other indicated herbs.
• For sinus congestion use decongestants.
• If you have a cold, damp cough, use stimulant expectorants. If you have a dry cough, use demulcent expectorants. If the cough is constricted, use relaxant expectorants.
• To support your immune system, use Echinacea, Andrographis, and other immune supports in conjunction with the diaphoretic teas. Though Echinacea can help support immunity, contrary to popular belief, when you have a fever, Echinacea won’t help the fever. Use diaphoretics to address the fever, and you’ll be amazed at how quickly they speed up the febrile process, helping you overcome it much more quickly. On the other hand, if you suppress the fever with NSAIDs or Tylenol, you are likely to turn a one- or two-day fever into a four- or five-day fever.

I hope this discussion will serve you well when you encounter your next bout of fever in yourself, a family member, or a client.

FAQ About Herbal Fever Remedies

Should you suppress a fever?

In most cases, no. Fever is an intelligent healing response that helps the body resolve infection more efficiently. Traditional herbalism focuses on supporting the fever rather than suppressing it, unless the fever becomes dangerously high or prolonged.

Can suppressing a fever prolong illness?

According to traditional herbalism, suppressing fever may slow the body’s healing process and prolong recovery time. Instead, supporting the fever with the right herbs and other techniques may help the illness resolve more quickly.

What are diaphoretic herbs?

Diaphoretic herbs support the body during fever by promoting sweating, improving circulation, and helping heat move outward to the surface of the body.

What is the difference between stimulant and relaxant diaphoretics?

Stimulant diaphoretics are warming, circulation-moving herbs that help raise and vent the fever. Relaxant diaphoretics relieve tension at the body’s surface, open the pores, and help release trapped heat.

Why are hot teas preferred for fever remedies?

Hot water is naturally diaphoretic and helps the herbs move upward and outward through the body. Preparing fever herbs as hot teas enhances their effectiveness and supports sweating.

Which fever herbs are best for children?

Elderflower and Lemon Balm are among the best options for children because they are gentle, effective, and relatively pleasant-tasting.

Which herb is best for alternating chills and fever?

Yarrow and Boneset are especially helpful for alternating chills and fever because they combine stimulant and relaxant diaphoretic properties.

Which herb is best for a fever with body aches and muscle tension?

Black Cohosh is especially useful for fevers accompanied by muscle aches, tension, headaches, and difficulty sleeping.

Why is Boneset considered such a strong fever remedy?

Boneset is deeply bitter, strongly diaphoretic, and traditionally used for intense febrile illnesses with chills, bone pain, and respiratory involvement.

Is it okay to eat during a fever?

Traditional herbalism generally recommends fasting during a fever, focusing on water, electrolytes, and broth. Digestion requires energy and circulation that the body may need elsewhere during the febrile response.

Can kitchen herbs help with fever?

Yes. Common kitchen herbs such as Ginger, Thyme, Garlic, Rosemary, Oregano, and Black Pepper can all support circulation, sweating, and respiratory function during fever. Sage should be avoided, however, because it has an anti-diaphoretic, meaning it reduces sweating rather than supporting it.

Is “antiviral” an accurate way to describe herbs?

Generally speaking, no. Many herbs labeled “antiviral” have only been studied against specific viruses or in laboratory settings. Herbalists often focus more on how a remedy supports the body’s healing response rather than assuming it directly kills viruses.

How long should you steep medicinal teas for fever?

Most of the herbs discussed are prepared by infusing them covered in hot water for 30–40 minutes to keep the tea strong and therapeutically active.