Whether you’re a parent with school aged children, or work in a busy environment, where you generally have contact with lots of people, chances are you’ve picked up a cold or two along the way. You have an even better chance of catching a virus than you do a bacterial infection, which means your cold can’t be treated with antibiotics.

If you’re like most patients we see, more often than not you reach for the “staple” over the counter medications seeking relief from your symptoms. It’s no lie that the common cold can interrupt your daily life, but how effective are decongestants and cold relief medications “truly” when it comes to treating the common cold?

What Causes The Common Cold, And What Are The Symptoms?

Millions, if not billion of dollars are spent every year on remedies for the common cold, and categorically “None of them work”. Why? The common cold is caused by over 200 different viruses and none of them are destroyed or cured by any of the known medications. Consequently, when one has a cold, the symptoms, and not the virus, are what are typically treated with the myriad of formulations available.

The most common symptoms of a cold include:

• Runny nose
• Sneezing
• Congestion
• Cough
• Sore/scratchy throat
• Mild aches and pains

Why over the counter medications are not an effective solution for the common cold.

Looking at the different symptoms above let’s see what’s available, and most importantly what should be avoided. This past October a great article was published in the British Medical Journal (BMJ 2018;363:k3786) entitled “What treatments are effective for common cold[sic] in adults and children,”they investigated the effectiveness of treatments for the common cold. Distilling their findings, one can only say the following:

Decongestant nasal sprays have a small effect on congestion of the nose; antihistamines have, at best, a small effect on a runny nose; and nothing influences sneezing associated with a cold.

Almost all the other remedies, touted by many to work, have no evidence of an effect as demonstrated by studies or the scientific literature. For instance, the following have not been shown to have any effect on the nasal symptoms of a cold including:

• Chinese herbs
• Echinacea
• Eucalyptus oil
• Garlic
• Ginseng
• Honey
• Vapor rubs
• Heated humidified air
• Zinc

Using Nasal Decongestant to Treat Sinusitis and Sinus Congestion.

Looking back at those interventions that may have an effect upon nasal symptoms, we need to use some caution. Nasal decongestant sprays, especially if used more than three days, or more often than the packaging states, can result in significant rebound nasal congestion.

The result is you’re more congested when it wears off, and it’s harder to breathe through your nose. In rare cases, nasal decongestant sprays can cause a medical condition- rhinitis medicamentosa – that may require treatment with steroids.

People with heart conditions (including rhythm problems) and high blood pressure need to be very cautious when using nasal decongestant sprays and should check with their health care provider.

Remember, the purpose of the runny nose and increased mucus production are the body’s response to a viral invasion/attack. Mucous helps to wash out debris and viral particles and it also carries certain immune system components.

Saline nose sprays and steam inhalation are probably the least harmful. They help to thin the mucus and wash away debris; but remember, the studies have not shown them to be effective. Nonetheless, like the proverbial grandma’s chicken soup, these treatments feel good.

Using Antihistamines To Treat A Runny Nose And Cold Symptoms.

Antihistamines work best for treating allergies, but as a side effect can cause drying of the nose; hence their use for a runny nose. Be aware, however, that drying the nose too much can also cause some thickening of the mucous and decreases drainage, a situation not always desired in those who are prone to sinus infections.

Antihistamines can be problematic in people with certain medical conditions such as glaucoma, and prostate issues. The concurrent dry mouth and (depending upon the medication) sedation, can also be issues of concern.

Expectorants Versus Suppressants For Your Cough Symptoms

A cough is your body’s way of clearing mucus and debris from the respiratory tract. So, with a cold it is of some benefit, but that benefit is quickly outweighed by the nuisance of a persistent cough with your cold, and the fact that you are spreading the virus around. There are two types of drugs that are used for coughs:

• Expectorants, such as guaifenesin
• Cough suppressants such as dextromethorphan

Guaifenesin-containing preparations do not suppress a cough; but by a complicated mechanism, they help to promote mucus production and result in some ‘thinning of the mucous”. Many people experience nausea and stomach irritation with high doses of this medication.

Dextromethorphan is the most commonly used cough suppressant and is available in regular and long-acting formulations. Be aware that there can be interactions between this drug and certain antidepressants, so check with your pharmacist or healthcare provider first.

If you are experiencing persistent cough with no relief it’s important to check with your healthcare provider to make sure that you are not suffering from a more serious health condition such as bronchitis or pneumonia. At Truesdale Health in Fall, River MA we have primary care offices for both adult medicine and pediatrics. If you don’t have a primary care physician you can contact anyone of our physician’s offices and inquire about accepting new patients.

How Your Fever Helps Your Body Fight A Cold Caused By A Viral Infection.

A fever is the body’s response to an infection. In some instances, it serves a useful
purpose, such as stimulating immune cell function and slowing down viral
reproduction.

A low-grade fever with a cold may not need treatment. Body aches and a headache might. It is beyond the scope of this blog to discuss when or why a fever may need to be treated; that is why your Truesdale Health doctor’s office is available. Should it need treatment, acetaminophen is most commonly used and has fewer side effects and drug interactions than the anti-inflammatory drugs (ibuprofen, naproxen, etc.).

Getting Rid Of A Sore Or Scratchy Throat.

Unless the Streptococcal test or culture is positive, there is little role for antibiotics in treating this symptom. Most non-Streptococcal (non-Strept) sore throats can be treated with the following:

• Salt water gargles
• Lozenges
• Agents that soothe and prevent dryness

Using Antibiotics To Treat Viral Cold Symptoms

Colds are caused by viruses- that frequently mutate- and antibiotics are not effective against viruses; furthermore, the antivirals used to treat influenza are not effective against the cold-causing viruses. The British Medical Journal article that I alluded to classified only one group of medications as “Likely to be harmful” when used to treat the common cold- antibiotics.

Antibiotics have absolutely no role in treating the common cold. To be clear, let me repeat it: “ANTIBIOTICS HAVE ABSOLUTELY NO ROLE IN TREATING THE COMMON COLD”.

What Works Best For Symptoms Of The Common Cold?

Whatever does the least harm, is used for the shortest amount of time, and is understood by you that it may do little. The tried and true advice still pertains:

• Get rest,
• Drink plenty of fluids
• Take measures to prevent spreading it to others (wash your hands, cover your mouth when coughing or sneezing, and stay home).

But foremost of all, when in doubt as to what to do, call your healthcare provider- that’s why Truesdale Health is here!

Henry R. Vaillancourt MD, MPH, is a Truesdale Health member and specialist in Public Health and Prevention.