So, I am sitting here on day 3 of a summer upper respiratory infection (URI) or commonly called a cold and I figured I would discuss what to expect, how to help yourself, and when to seek a medical professional.
Basically, a cold is an infection that can cause a myriad of symptoms most often including cough, congestion (mucus), sneezing, runny nose, sore throat, fevers, chills, muscle aches, fatigue, and generalized weakness. Occasionally it can also be accompanied by stomach aches, nausea, vomiting, and diarrhea or loose stools.
Most often these infections are caused by VIRUSES, and like, a lot of them. This can range from rhinovirus, metapneumovirus, adenovirus, Covid-19, the Flu, etc. Why is this important to know? Because, unfortunately, there is no treatment to fight off the infection. Even with the Covid-19 medication known as Paxlovid or one of the Flu medications known as Tamiflu, these medications may help boost immune support to keep things from getting worse but don't actually treat the infection. In fact, Tamiflu has only shown to decrease the duration of symptoms (length of time you are sick) on average by only 12 HOURS.
Usually, treatment is time. There are medications and home remedies to provide symptom support to help make things more bearable until your body can fight it off.
This is why often when you go to the doctor for a cold they will just give you over the counter medication recommendations. It's not because they DON'T want to help you. It's just because there really isn't anything they can prescribe to cure you. And it can feel frustrating and make you feel like you wasted your time and money for nothing. That's why I am writing this post!
So let's talk about some things we can do to help ourselves!
There are so many options available it feels so confusing and overwhelming. I am going to talk about these medications by symptom so you can wade through the hundreds of options available based on what you need and what will work best for your specific symptoms.
(Disclaimer: As a resident of the United States I will be using brand names available in the US. Please check your local pharmacy for similar brands if you are outside the US).
There actually are not very many medications that have been shown to be super helpful for a cough based on current studies. I will talk about some of the common stuff you will see.
Dextromethorphan: Found in Delsym or Mucinex. An antitussive (ati-cough). Studies have not shown great effectiveness for cough.
Guaifenesin: Found in brand names such as Robitussin and Mucinex. An expectorant. Basically it is suppose to loosen mucus and make it easier to cough out the mucus. Studies show mixed results in symptom improvement. Often needs increased fluid intake to work.
Lozenges: Brand names include Ricola or Halls, for example. Often they have menthol to give you that cooling feeling and other herbs which may provide slight relief but studies do not show much effectiveness.
Honey: There is actually some evidence that honey works as well if not better than the other over the counter medications to reduce your cough. (Avoid in those with allergies to honey or those under 1 years old as it can contain botulism which babies under 1 years old can not fight off).
If you have high blood pressure it is recommended to avoid certain decongestants as they can narrow blood vessels and increase your blood pressure. and interfere with your meds.
Pseudoephedrine: Found in brand names such as Mucinex or Sudafed. A decongestant. Has been shown to be effective in reducing congestion but may need to be purchased at a pharmacy as it is an ingredient in making meth.
Phenylephrine: Fund in brand names like Sudafed or Dayquil. A decongestant. There is so much buzz on this right now as this has recently been shown to be ineffective to reduce congestion.
Doxylamine or Diphenhydramine: Brand names include Unisom, Nyquil, and Benadryl. Antihistamines used to reduce congestion. Can cause drowsiness.
Nasal Rinses: A physical process of irrigating water from one nostril through the other to remove mucus. Use sterile or distilled water to reduce the risk of contracting bacteria and wash equipment after each use. If you plan to boil water wait for it to COOL DOWN before use to reduce the risk of burns.
Oxymetazoline: Brand Name Afrin. Reduces swelling of the nasal mucosa to help open the nasal passages. Do NOT use for more than 3 days as it can rebound swelling (called Rhinitis Medicamentosa) and can be addictive.
Coricidin HBP: A brand name medication that can help with congestion and is safe to take in those with high blood pressure.
Cepacol Drops: These lozenges specifically have Benzocaine which is a topical numbing agent that can provide temporary relief of a sore throat.
Chloraseptic Sprays: Active ingredient is Phenol. Similar to how Cepacol drops work as it is a topical anesthetic to help numb the throat and mouth.
Warm Salt Water Gargles: Has shown some effectiveness in reducing severity of a sore throat.
Lozenges: Again, has herbs and menthol to provide cooling feeling which may alleviate a sore throat.
Honey: Again, can work just as well as over the counter medications to help temporarily relieve a sore throat.
Acetaminophen: Brand name Tylenol. Can help reduce fevers and help with muscle aches and a sore throat. Metabolized through the liver so should be avoided or cautioned in those with liver issues or taking with alcohol.
Ibuprofen: Brand name Motrin or Advil. An anti-inflammatory that can help reduce pain and fever. Metabolized through the kidneys. Should be used in caution or avoided in those with chronic NSAID use, kidney issues, on blood thinners or bleeding disorders, stomach ulcers, gastrointestinal bleeding, pregnancy,
Nausea/Vomiting/Stomach Aches/Diarrhea
Bismuth Salicylate: Brand name is Pepto-Bismol. Can, in the short term, relieve nausea, vomiting, stomach aches, or diarrhea.
Loperamide: Brand name is Imodium. Anti-diarrhea medication.
Ginger: Used for stomach aches and nausea. Found often in teas and lozenges.
Peppermint: Similar as ginger above. Can help with stomach aches and nausea.
Dimenhydrinate: Brand name is Dramamine. An antihistamine that can reduce nausea. Can cause drowsiness.
Eat. Whatever you can stomach. Just eat. Your body needs fuel to help fight it off. Do not believe in the old adage "Feed a cold, starve a fever." That's nonsense. The body needs food to survive and strive. And don't worry about eating the healthiest. As long as you are getting your nutrients, vitamins, and minerals just eat whatever you can keep down and make you feel better.
Drink! Your body uses a lot of fluids to create mucus to help move the infection through your body. You may also be sweating more from fevers or chills and will lose some hydration. Drink some water. If you don't like the taste of water, sports drinks such as Gatorade or Powerade can be used and have electrolytes to help maintain balance when you find you are having trouble stomaching any solids or are losing electrolytes through vomiting or diarrhea. Stay away from alcohol. They can worsen dehydration.
Oh my goodness get some REST. Your body is using its energy to fight off the infection invading your body and needs all the extra energy it can get. Trying to "work through" or "power through is just going to make you feel worse in the long run, exacerbate symptoms, and may prolong your symptoms.
STAY HOME. YOU ARE CONTAGIOUS. STAY HOME. Even if it's mild. Even if it's just a virus. It is contagious Now, I understand this is not always be feasible if you are an adult with bills to pay. Or a child being forced to go to school or have important events or exams to attend. Or need to run errands to take care of yourself or your family. But if you can, just stay home.
If you can't stay home make some precautions. I know this is controversial (although it shouldn't be). Wear a mask. Often these infections are spread through respiratory droplets. Cough, sneezing, talking. This is how it spreads. Masks work not because they completely block air movement but block those big droplets from getting out into the open air or on surfaces.
Wash your hands frequently with soap and water. Use hand sanitizer if soap and water are unavailable. After you
Use a tissue to blow your nose
Touch your mouth, nose, or eyes.
This will help limit the spread of the infection. Washing your hands with soap and water for 20 seconds will not only kill some of the germs but the physical act of scrubbing will physical remove these germs as well.
Let's talk about Zinc. Some studies have shown it may reduce the length of time of symptoms with viral URIs. This usually needs to be started within 24 hours from the start of symptoms. It can also cause side effects such as nausea and bad taste. We are also unsure as to the mechanism of action or why it helps reduce the duration of infection. It definitely needs to be studied more but benefits may outweigh the risks.
WHEN TO SEEK PROFESSIONAL ADVICE/CARE
Now, like I said before, most of the time these are caused by viruses. However, there are a some bacteria and fungi that can also cause similar symptoms. These do actually require antibiotics or antifungal medications that need to be prescribed.
Also, some infections may hit you harder or more severely than others. Especially if you already have chronic respiratory conditions, are of older or younger age, or are immunocompromised. So, when do we seek help?
You are having any difficulty breathing.
Coughing fits that make it difficult for you to breathe.
You are unable to keep down any food or fluids or are weak from dehydration.
Severe sore throat that keeps you from eating or drinking.
High spiking fevers that don't seem to reduce or resolve with acetaminophen or ibuprofen or last longer than a few days.
Symptoms last more than 7-10 days without improvement or continue to worsen.*
You feel like you were getting better and then got worse again.**
You have questions or just want to make sure everything is OK.
*This specifically can be sign that you may have a bacterial or other serious infection as viruses for most people on average see peak symptoms on day 5 and improve within 7-10 days (10-14 for kids).
**This is what many medical professionals have coined "the double sickening" which basically means your body was already immunocompromised from the first viral infection and as it was being fought off you caught a secondary bacterial infection which made you feel worse again.
Again, this is just suppose to be general guidelines and education to help you feel better and what to expect. Even the same infections cause different symptoms and severity of symptoms from person to person. So, if you have any concerns or are just unsure do not be afraid to seek out care. I would never be upset with someone who came to me at my clinic to get checked out to make sure they are going to be OK. Better safe than sorry is always my motto!
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