What Science Says About Treating Colds

With so many things that don’t help — antihistamines, nasal steroid sprays, African geranium, vitamin C, vitamin D — what does really work to treat colds?

By Eva Briggs

Antibiotics not only won’t help with your cold, but they can lead to future resistant bacterial infections, and cause side effects including allergic reactions and diarrhea.
Antibiotics not only won’t help with your cold, but they can lead to future resistant bacterial infections, and cause side effects including allergic reactions and diarrhea.

I’m sitting here surrounded by boxes of tissues. Yes, it’s that time of year again. Cold season. Time for a look at what science says about treating colds.

Another term you may hear for the common cold is upper respiratory infection. It means exactly the same thing. Colds are the most common acute illness in the United States.

They are caused by an assortment of viruses — rhinovirus, parainfluenza virus, adenovirus, enterovirus, respiratory syncytial virus, metapneumovirus.

Sadly, infection with one virus offers no immunity to future colds caused by other strains.

Symptoms include nasal congestion, runny nose, sore throat, cough, low-grade fever and generally feeling yucky. Eventually the common cold will go away on its own. But before you improve, you will feel lousy for 10 days. The cough can linger even longer, especially among smokers. Colds in children often drag on for two or three weeks.

When people hear the word infection, they often think antibiotics are the answer. Antibiotics won’t help since viruses, not bacteria, cause colds. Antibiotics not only won’t help, but they can lead to future resistant bacterial infections, and cause side effects including allergic reactions and diarrhea.

A host of other things are ineffective for treating colds. Antihistamines alone, taken by mouth, don’t work. Cough medicines including codeine are no more effective than placebo for cough. Nasal steroid sprays help for allergies but they don’t make cold symptoms less severe or lead to faster recovery. Steam, or heated humidified air, does not speed the recovery from respiratory infections. Also ineffective are Echinacea, African geranium, vitamin C, vitamin D, and vitamin E. Vitamin E actually causes more severe respiratory symptoms than placebo!

With so many things that don’t help, what does really work? First, analgesics help for aches pains, and fever. This includes acetaminophen and ibuprofen.

Azelastine (brand name Astelin) is a nasal antihistamine that does seem to help, especially in reducing cough. Antihistamines in combination with decongestants are helpful. Nasal decongestants sprays, such as oxymetazolone, can decrease nasal congestion. But use cautiously for no longer than three days. Prolonged use of nasal decongestants leads to rebound, worsening nasal congestion when the dose wears off. A probiotic called “Lactobacillus casei” shortens the course of colds when taken every day throughout cold season. Zinc started within three days of the onset of a cold, continued until the cold resolves, also reduces cold duration.

There is that old standby honey. It actually works better than commercial cough medicines. Honey is not safe for children under 1 year old. The dose studied was half a teaspoon at bedtime for children ages 2 to 5, one teaspoon at bedtime for children ages 6 to 11, and two teaspoons at bedtime for older children and adults.

What a great way to support our local New York state apiaries!

Local honey contains more of the good ingredients and fewer contaminants than supermarket honey.

In children under age 4, over-the-counter cold medicines produce more side effects than benefit. Another useful treatment is petrolatum ointment with camphor, menthol and eucalyptus oils, such as the brand name Vicks VapoRub. Since it works by inhalation, rub it on the chest and throat. For some strange reason, many of my patients believe in rubbing it on the feet. There is no reason to do that.

Some diseases resemble the common cold. As I write this in the middle of September, we have already seen our first cases of influenza at the urgent care. Influenza usually starts more suddenly, has a high fever, severe body aches, and a dry hacking cough. Remember it’s now time to get your flu shot.

Bacterial sinusitis often occurs as a complication of an upper respiratory infection. Some characteristics that help distinguish bacterial sinusitis from a cold include failure to start improving in 10 days, fever and double sickening. This last term refers to a cold that starts to improve and then takes a turn for the worse.

Allergic rhinitis is associated with nasal congestion and runny nose, sneezing and itching. It often recurs at the same time every year.

If you have an upper respiratory tract infection, here are reasons to return to your doctor: fever greater than 101°F, productive cough, shortness of breath, severe headache or severe facial pain.

I’ve taken my honey and I’m grabbing my box of tissues now and heading to bed!

Eva Briggs is a medical doctor who works at two urgent care centers in the Syracuse region.

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