What Works For Treating the Common Cold
Hi, thank you for coming back for the latest edition of Beyond Primary Care’s blog- what works for treating the common cold. In Beyond Primary Care blogs we highlight healthcare news, advice for medical conditions, and how membership for care works! Beyond Primary Care is an insurance free, membership based family medicine clinic. Beyond Primary Care is the highest rated Direct Primary Care clinic serving patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne counties giving families and employers peace of mind about healthcare costs by providing affordable and accessible primary care services.
In this blog post, we wanted to introduce our patients and prospective patients on what works for treating the common cold.
No Antibiotics Needed
You may have had a conversation with your doctor before about your cough / cold symptoms. Did it go like this?
Patient: “I’ve had congestion and a cough for five days now. I need antibiotics. I have to get better before my trip / important work project / meeting / reunion / wedding / party / date.”
Doctor: “Based on your history and my examination of your body, it is most likely a viral infection. Antibiotics won’t help… but we can try other things.”
Patient: “I had the exact same symptoms last year and my doctor gave me antibiotics. I was better within three days.”
Doctor (mental eyeball roll): “You likely would have been better just as fast without antibiotics.”
Antibiotics are great and routinely save millions of peoples lives against infections that would otherwise end in severe disability or death. However, the use of antibiotics, and often overuse, misuse or unnecessary use- can result in antibiotic resistance. Further, most common colds do not respond to the medication.
Between 90-98% of sinusitis infections are viral/ None will respond to antibiotics.
Only 5-10% of sore throat cases in adults are caused by strep throat.
What Is The Common Cold
At least 200 virus can cause the common cold. It is often spread through airborne droplets that are coughed or sneezed into the air by a sick person. These droplets are then inhaled by another person. Colds can also be spread when a sick person touches you or a surface that you then touch.
As annoying as it may be, a cough is a natural reflex to protect ourselves from aspiration- that is a food, drink, or mucous entering into our airway system- thus minimizing chances of pneumonia.
Treatment For The Common Cold
The best advice towards treating the common cold is remembering that it may take a multi-modal approach, meaning there is not one thing out there that will do the work all by itself. If you have ever walked down the cold and flu aisle at your local pharmacy, it is overwhelming the amount of products that advertise decongestion or eliminating coughs.
One product or way of treating cold symptoms may not provide effective or immediate relief. That being said, it also is advisable to have a healthy dose of skepticism about concoctions or products that promote to treat many symptoms all at once.
Single-ingredient products will have a lower chance for side effects. Single ingredient medications and common remedies include:
Nasal steroids
These medicines do a great job reducing overall inflammation. The side effects (if any) are pretty minimal–usually just dryness inside the nose or very mild nosebleeds, and the doses are low enough that they don’t tend to cause the problems we associate with systemic oral steroids. And, as of very recently, two of them (Flonase and Nasacort) are available over the counter and in generic forms.
Antihistamines
These are what most people think of as 'allergy medicine.' Benadryl (diphenhydramine) is an old-school antihistamine that still works, but its sedating properties make it a poor choice for work or school days. Second generation antihistamines such as Zyrtec, Allega, or Claritin are both non-drowsy, once-daily medications that are available in generic forms over the counter and can be used with children. All of these medications do the same thing- help decrease excess mucous, though different ones may work better in different individuals. If one doesn't work, try another.
Saline Nasal Rinses
This is an ancient practice that has been shown to have benefit in relieving both allergy and cold symptoms. The traditional method is the Neti Pot; though a plastic suction bulb (a ‘bugger sucker’ for infants) works great too. To make your own, use 2 tablespoons of kosher salt (iodine free), and 1 cup (8 oz) of lukewarm sterile bottled or boiled water. For the sake of liability, everyone recommends using boiled or distilled water based on two extremely unfortunate Louisianans that used tap water containing amoebas. To do rinse, stand over a sink. Place the tip (not entire nose piece) of the nozzle into the nose aiming slightly away from the septum (the midline wall that divides your nostrils). Lean your head forward. Rinse each nostril x2-4 / day. After each rinse, blow nose, and repeat rinse. Yes, what comes out of your nose is disgusting and you may get a salty taste in your mouth, but you will feel better. This is perfectly safe to do- with practice- on infants six months and older.
Sore Throat / Cough Syrup
Shelves of cough and sore throat medicine are not really about good medicine, they are about marketing.
Cough syrups at stores have either a cough suppressant like Dextromethophan (an ingredient in drugs such as Robitussin and Delysm) or an antihistamine like Diphenhydramine (an anti-histamine, see above. This ingredient is in drugs such as Benadryl or Dimetapp). So, what then do you give to yourself or kids for a sore throat and cough? The answer may already be in your cupboard. Honey is at least effective, if not more effective, then many of the products you see at the drugstore.
Using honey with warm tea can calm a scratchy throat, and honey has natural antibacterial properties too.
It can not be stated enough, never give honey to children who are less than 1 year old (giving raw honey to children < 1 can be fatal).
Once such honey concoction for sore throats and coughs from Beyond Primary Care is as follows:
3/4 cup raw honey
1/4 cup extra virgin olive oil
3 tbl lemon juice
2 tbl vanilla extract
1/2 tsp ground ginger
Heat the above ingredients in a small saucepan until warm and mixed. Do not heat above 110F. This is a small amount of liquid and will not take a long time to warm.
Children 1 year-6 years: take 1/2 tsp three times daily as needed
Children 6 years and older (adults too): take 1 tsp three times daily as needed
The above recipe makes enough syrup for multiple doses. You may store the liquid in a cool, dark location at room temperature for 30 days as needed.
Humidifiers
Humid air helps clear up cough-inducing mucous and moisturizes nasal passages and airways for easier breathing. Adding a few drops of Eucalyptus essential oils- which has antiviral and antimicrobial properties gave give the air a boost.
Drinking plenty of water
Drinking water isn’t going to make your cough or other symptoms go away, but being dehydrated will work against you. If you are dehydrated, the lining in your mouth and nose dries out, resulting in you feeling more irritated.
Getting plenty of rest
Sleep is when your body naturally repairs itself. When you sick, it gives your immune system time to fight. Proper rest can help reduce the overall duration of symptoms.
Propping up on a pillow
Sleep slightly sitting up or elevate your head with pillows to reduce post-nasal drip.
What Does Not Work To Treat The Common Cold
People require and deserve medications that treat their symptoms safely and effectively. There are a handful of common over-the-counter medications that do not do this.
In September of 2023, advisers to the FDA announced that oral phenylephrine- not to be confused with the behind-the-counter ingredient pseudoephedrine- simply does not work. Modern studies, when well conducted- showed no improvement in congestion with phenylephrine. Phenylephrine, which is an active ingredient in some versions of Sudafed, Mucinex, and Dayquil products- sometimes are labeled ‘PE” on packages.
Many of the ingredients mentioned that you may find in the cold and flu aisle of your pharmacy have been on store shelves for decades, ‘grandfathered’ in during a sweeping FDA review in 1972 when the rigorous investigative process used by today’s studies were simply not in place. Companies use these same un-tested products and create new products without those medicines actually being tested to see if they work.
While it is now available over-the-counter, we continue to recommend against the use of the nasal sprays Afrin. While this medication is potent and may result in immediate relief, it also has the unwanted side effect of ‘rebound congestion’ - where the congestion is the same or worse off- if the nasal spray is used longer than three days. Because a cold or sinus infection is characterized by symptoms lasting up to three weeks, taking a nasal spray such as Afrin is often counter productive towards long-term relief.
Patience Needed
Remember that coughs and other common cold symptoms can take 7-21 days to resolve, with an average duration of 18 days. However, its not out of the ordinary for symptoms such as a cough to last for weeks, even up to a month after a viral illness while your body heals.
Thank you for reading
If you’re concerned about your common cold, consider making an appointment with Dr. Jeff O’Boyle at Beyond Primary Care. Please see our scheduling link.
