- Renae Wortz NP-C
The new year is finally here...which means we are in the thick of cold season! As a Nurse Practitioner, I treat many miserable patients suffering a multitude of respiratory ailments, from simple runny noses to full-blown pneumonia at my family practice clinic. Most adults will experience at least 2-4 occurrences of the common cold throughout the year, though it is most pervasive during the fall and winter months. Symptoms of the common cold can last 7 - 10 days and include:
- Nasal complaints - runny nose, sneezing, stuffiness
- Sore or scratchy throat
- Dry cough
- Watery, burning eyes
- Low-grade fever, chills
- Fatigue, malaise
- Muscle aches
Throughout my work day, I often encounter confusion from patients about the myriad of treatments, herbal remedies and over-the-counter medications which claim to treat or cure the common cold. Does it work? Is it harmful? Can I take it with my other meds? Do I need antibiotics? Well, first of all, no, antibiotics are not indicated for the common cold which is a viral infection. Antibiotics treat bacterial infections making them ineffective at killing virusus; in fact, treating a cold with antibiotics may actually be harmful due to potential side effects. Most of the time, our bodies will eventually fight off cold viruses, however, complications can arise that require medical attention. When is a trip to the clinic necessary? Here are some general guidelines:
- Persistent fever greater than 101 degrees F
- Difficulty breathing/chest pain
- Persistent green/yellow discharge or facial pain
- Cough lasting more than two weeks
- Severe throat pain or difficulty swallowing
- Vomiting/inability to keep fluids down
Since there is no cure for the common cold, the mainstay of treatment is symptom management which can be achieved with a little self-care, natural remedies and over-the-counter medications if needed. Having a cold is serious business....most of us can’t afford to be down-and-out with a case of the sniffles! Here is our free, printable resource for easy reference along with some tips to help simplify your medicine cabinet and get you on your way to recovery fast. Note: The information in this review applies to adults only, consult a pediatric-trained medical professional for specific information regarding the care of children. See additional information at the bottom of this post.
I am a strong advocate for health promotion and disease prevention by leading a healthy lifestyle. Prevention is surely better than experiencing illness and needing to medicate! Here are several common sense but effective ways to help stave of the common cold.
Frequent Hand Washing - Hands are dirty...wash them! Washing your hands frequently is probably the best way to prevent the transmission of cold viruses. Scrub all surfaces of your hands with regular soap and water for at least 20 seconds and make sure to dry them on a clean towel. Antibacterial hand soap is popular but not necessary and may actually promote the growth of mutated, hard-to-kill germs. Use antibacterial hand sanitizer only when access to soap and water is not available.
Frequent House Cleaning - Once again, preventing the transmission of germs growing on frequently used surfaces in your home is important for cold prevention. Use a natural solution of ½ water, ½ white distilled vinegar (a natural antiseptic) and a splash of rubbing alcohol in a spray bottle to effectively clean the hard surfaces in your home. If someone in your home has lowered immunity (due to cancer or other chronic illness), you have been exposed to someone with a serious infectious illness or for infrequent deep cleaning purposes, use a store bought disinfectant or dilute bleach solution.
Regular Exercise - Research has shown that moderate exercise, at least 30 minutes 3-5 times/week, has a role in boosting immune function and preventing illness.
Sleep - Sleep deprivation lowers immunity and slows the body’s natural recovery process. Aim for at least 7-9 hours/night.
Nutrition - A healthy, balanced diet is vital to overall health and disease prevention. Eat at least 5-7 servings of fruits/vegetables a day. “Eating all colors of the rainbow” will help you get the vitamins and minerals you need; make sure to include foods high in Vitamin C (citrus fruits, bell peppers, spinach) and Vitamin A (carrots) for an extra immunity boost. Include complex carbohydrates (whole grain breads, cereals) and high quality proteins (lean meats, eggs, soy). Drink plenty of water to stay hydrated and a daily cup of green tea for it’s antioxidant properties.
Probiotics - There is such a thing as good bacteria which lives in our bodies to help keep the bad, disease-causing germs at bay. Eat a daily serving of yogurt, kefir or take a probiotic supplement to keep the good bacteria flourishing.
Garlic - Garlic has been used as an herbal remedy for centuries due to it’s antibiotic and antioxidant properties. Eat several cloves of fresh, raw garlic a day for health promotion. Chop it up and swallow whole for better palatability, or take a garlic supplement.
Vitamin C Supplements - Our bodies absorb nutrients best by eating them in real foods, however, sometimes it is helpful to take vitamin supplements if our diet is lacking or an extra boost is needed. There is good evidence that Vitamin C supplementation may help prevent the common cold and decrease the severity of cold symptoms with regular use. Take 250 - 1000 mg of Vitamin C a day during cold season.
Echinacea - Echinacea is one of the most popular herbal supplements used for the prevention of colds. Unfortunately, research studies have found conflicting results regarding it’s effectiveness; historically it has been used to help prevent the common cold and shorten the course of illness if taken regularly or at the onset of symptoms. Try Echinacea purpurea 300 mg orally three times/day but do not take regularly for longer than 8 weeks at a time.
Influenza Vaccine - Everyone should get a flu vaccine. While it doesn’t specifically target cold viruses, it does prevent flu which can become a complication from any respiratory illness. Children, elderly people, pregnant woman and those with a compromised immune system are especially at risk.
Self-Care and Home Remedies
At the first sign of that inevitable scratchy throat or stuffy nose, it is important that you take a step back from your busy routine and give yourself a little TLC. In the end, you will reap the benefits by experiencing fewer sick days, alleviation of cold symptoms and less overall crankiness. Further, many effective cold treatments can be found in your kitchen cupboards or by using common household implements...you can be on the road to recovery without leaving the house!
Rest - Once again, give your body a chance to recover by getting adequate sleep!
Increased Oral Fluids - Stay well hydrated to help immune function, flush germs and thin mucus. Drink water, plain or sparkling with a slice of lemon, 100% fruit juices (in moderation as they can be high in sugar) and broths which are often loaded with protein and vitamins from the slow-cooking of meat and vegetables.
Nutrition - A balanced diet is best but make sure to include a variety of these super foods to help support immune function, healing and recovery: Citrus fruits, berries, carrots, red bell peppers, spinach, garlic, mushrooms, yogurt, whole grain cereals, chicken soup, seafood and green tea. Also, spicy foods (curry, cayenne pepper) can help loosen mucus and relieve nasal congestion.
Warm Liquids - Warm liquids in general can help relieve nasal stuffiness (by inhaling the steam) and ease sore throat. Try various teas (especially ginger, chamomile, lemon balm and green teas) with a tablespoon of honey or lemon juice.
Homemade Cough Syrup - A quick internet search can produce scores of homemade cough remedies using common pantry ingredients. My simple favorite combines ¼ cup apple cider vinegar and ¼ cup of raw local honey. Take 1 tablespoon of the mixture every 4 hours.
Humidified Air/Steam Inhalation - You can buy a fancy vaporizer or make one of your own! Pour 2 cups of boiling water in a glass bowl, position your face 8-10 inches over the bowl and cover your head with a towel to trap steam. Inhale deeply through your nose and exhale through your mouth. Use as often as possible to relieve nasal congestion and sore throat, and of course use care to prevent burns from the hot steam and boiling water.
Nasal Rinse - Using a salt water nasal rinse 2-3 times a day can help flush germs, reduce inflammation and relieve nasal congestion. Boil 8 oz. of water (to kill bacteria) and let it cool to room temperature. Mix with ¼ tsp. salt and flush your nasal passages by inhaling the liquid from a clean palm, or by using a clean nasal spray bottle, dropper or netti pot.
Gargles - Again, there are many recipes for homemade gargling solutions to help soothe sore throats but my favorite is the tried-and-true salt water gargle. Mix ¼ - ½ tsp salt with 8 oz. water and gargle solution for comfort as needed.
Moist Heat - Muscle achiness is a common complaint amongst cold sufferers. Use a heating pad or take a warm shower or bath to get the added benefit of steam inhalation for your nasal and oral passages.
Herbs and Vitamins
Health food stores boast a wide variety of vitamins and herbal remedies claiming to cure a multitude of common, chronic and serious illnesses. My health education focused on traditional Western medicine but I am open to many of the time-honored herbal and integrative treatments that are available. However, I always recommend that patients select these treatments with care and discuss specifics with a medical professional prior to use. Despite being all-natural, herbals, homeopathic medications and high-dose vitamins can have serious side effects, are not always safe to use during pregnancy and may interact dangerously with other herbs and prescription medications. Also, herbal and vitamin formulations are not monitored by the FDA and many promote health claims that are not supported by good scientific research. Sometimes health claims are just that, a claim, and possibly a waste of money. That being said, many herbal remedies are beneficial, are worth a try and certainly can’t hurt with the proper precautions.
Zinc - Zinc is a mineral found in foods (meats, dairy and fortified cereals have the highest amounts) and is necessary for cell function, protein building and healing in our bodies. Research has found that takinga zinc supplement at the onset of cold symptoms may reduce the length of illness and severity of symptoms. Currently there are no specific recommendations regarding zinc dosage for treating colds. I recommend following the package instructions and avoid high doses of zinc for extended periods of time. Lozenges are most effective; avoid nasal sprays.
Eucalyptus Ointment (Eucalyptus globulus)- The astringent vapors from the eucalyptus plant can help to clear nasal passages if ointment is rubbed beneath nose for inhalation.
Peppermint (Mentha piperita) - Menthol is the active ingredient in peppermint for treating the common cold and works to relieve stuffiness, thin mucus and sooth sore throat. Use it in lozenge form (Ricola) or brew fresh or dried leaves in a tea.
Slippery Elm (Ulmas fulva): Slippery elm has been long been used to help coat and soothe sore throats, though does not have clear scientific research to confirm effectiveness. To make tea: Pour 2 cups of boiling water over 4 grams of powder and steep for 3-5 minutes. Also try lozenges.
Herbs for Steam Inhalation: Adding herbs in the form of fresh or dried leaves or essential oils (add 3 drops per 2 cups of boiling water) can make steam baths more effective at treating cold symptoms. Try Eucalyptus, Peppermint, Sage, Rosemary and Tea Tree Oil to help loosen congestion and relieve cough.
Oils - Try herb-infused oils to help relieve muscle aches associated with the common cold. Lavender (Lavendula officinalis) is an especially effective herb for relieving muscle aches along with gentle massage. For nasal dryness and irritation, rub a few drops of sesame oil into nostrils twice a day.
*See Echinacea and Vitamin C under prevention section
Sometimes natural remedies just aren’t enough to get you through the day during a bout of severe cold symptoms. Whether you have an important presentation at work, need to take care of small children or just can’t seem to get a good night’s sleep, the drugstore supplies an array of medicines that can help make cold symptoms more bearable. Most of these medications are safe with appropriate use, but as usual, consult a medical professional if you are concerned about interactions with prescription medications, are pregnant, nursing, have a chronic illness or any other concerns.
Another word of caution, take care when using the many combination cold medicines available. For example, many cold medicines include the pain reliever, acetaminophen; make sure you do not overdose on this medication by popping a few extra pills along with the cold remedy. Also, make sure you use medications to treat only the symptoms you are experiencing. If all you have is a runny nose, a combination drug that treats nasal symptoms, fever and cough will expose you to unnecessary medications and their respective side effects. Be vigilant about reading labels and learn the generic names and indications for common cold medicines to prevent confusion.
Decongestants (to clear nasal passages)
Pseudoephedrine (Sudafed): 60 mg orally every 4-6 hours
Phenylephrine (Sudafed PE): 10 mg orally every 4 hours
Oxymetazoline (Afrin): 2-3 sprays per nostril every 12 hours
Phenylephrine (Neo-Synephrine): 2-3 sprays per nostril no more than every 4 hours
*Do not use decongestant nasal sprays for longer than three days in a row as they may cause rebound stuffiness
Cough Suppressants (for a dry cough)
Dextromethorphan (Delsym): 10 - 20 mg by mouth every 4 hours as needed
Expectorants (for a productive cough)
Guaifenisin (Mucinex): 200 - 400 mg orally every 4 hours;
*Take with 8 oz. water
Topical Anesthetics (Numbs sore throat)
Benzocaine (Cepacol), Phenol (Chloraseptic) Hexylresorcinol/Dyclonine (Sucrets)
See package inserts for specific drug dosing
*Can use lozenges, sprays or dissolving strips
Pain Relievers/Fever Reducers
Acetaminophen (Tylenol) 325 - 1000 mg orally every 6 hours
Ibuprofen (Advil): 400 mg orally every 4-6 hours
Naproxen (Aleve): 250-500 mg orally every 12 hours
*Ibuprofen and Naproxen are better at relieving muscle aches due to their anti-inflammatory properties; take with food
* This article is intended for informational use relevant to adults only, does not apply to the treatment of children and is not intended to diagnose or treat any illness. Consult your health care provider regarding specific recommendations (including all treatments, vitamins, herbs and medications) especially if you are pregnant, nursing, take daily medications, are chronically ill or have any other concerns.
Renae Wortz is a board certified Adult Nurse Practitioner. She received her graduate degree from the University of Nebraska Medical Center and currently works in a busy family practice clinic caring for a variety of patients with acute and chronic illnesses. Renae is especially passionate about health promotion and disease prevention through education and living a balanced and healthy lifestyle. To learn more about what a Nurse Practitioner is and does click here. She is also the Be Whole editor for www.momcoloredglasses.com, an online magazine for moms where she writes articles about healthy, sustainable and mindful living. Renae lives with her husband Jeremy and son Elliot in Southwest Michigan.