Cold Symptoms, Treatment, and Alternative Approaches

Like the flu, a cold is also caused by viruses. However, flu symptoms are usually quite a bit worse than cold symptoms. Cold symptoms can go away, linger for one to two weeks, or evolve into something different or even worse.  

To get a cold under control and get optimal relief, it is important to understand your cold symptoms, treatment, and alternative approaches. A cold usually occurs 1-3 days after exposure. It often begins with a scratchy or sore throat and progresses to congestion, sneezing, increased mucus, a cough, sometimes ear pressure, and popping. By about day three or four, it has become a full-blown cold. By days five to seven, things usually start clearing up except the cough, which can linger...and linger...and linger. 

A Bad Cold

PREVENTION

Of course, there are preventive measures, like vaccines, that can help you stay well. But there is no conventional medicine to prevent a cold otherwise. There may be herbal and alternative treatments. The following basics are essential to staying well.

REST AND SLEEP      

According to research published by the NIH, sleep quality is essential in maintaining immunity

and decreasing susceptibility to the common cold. Studies show that those with poor sleep efficiency and shorter sleep duration had lower resistance to colds. Seven to nine hours of sleep are ideal. When you are sick, try to get nine to ten hours of sleep.

HYDRATION          

Hydration is essential to a functioning immune system. Fluids help your body eliminate wastes and toxins through the skin, urine, and feces. They also allow the skin to create a barrier against bacteria and mucus, which helps flush foreign bodies from the respiratory tract. While few studies have shown hydration to be essential in immunity, fluids are vital to flushing toxins out of your body and maintaining the lymph flow necessary to fight infection. Coffee and Tea are now an acceptable means of hydration. Straw-colored urine indicates adequate hydration (they have gotten away from the eight glasses of water a day recommendations).

NUTRITION

Good nutrition is essential in maintaining a functioning immune system. Lack of protein, essential vitamins, and minerals zinc, selenium, iron, copper, vitamins A, C, E, and B-6) can cause the immune system to fail. Even obesity can cause the immune system to fail: Excess calories are often from nutrient-poor foods. Harvard School of Public Health has published a helpful article on basic nutritional recommendations and immunity. Some supplements claim to enhance immunity (see below).

EXERCISE

Exercise usually helps to enhance immunity in healthy individuals. However, excessive or intense exercise (more than 90 minutes of great exertion, as in a marathon) can actually decrease immunity because increased cortisol levels during intense exercise can reduce immunity. This is why some people can develop post-marathon illnesses and colds. 

Should I exercise when I am sick? There are different schools of thought on this. According to the Mayo Clinic, if you are an avid exerciser and have a fever or if your symptoms are "below the neck" (chest congestion, cough, body aches, or stomach issues), you should either abstain for the duration of your illness or change to lower-impact aerobics like walking. 

STRESS

Avoid stress. We see so many kids in the clinic after finishing their finals while they are rehearsing for a big show, sick folks after a marathon, accountants in the spring during tax time, and people in the middle of closing on a house and moving because they are neglecting their health and giving in to stress!

Stress can be a person's worst enemy because it weakens the immune system and can wreak havoc on vital signs and pain levels. Viruses love a weakened immune system: Cold sores, shingles, and cold symptoms appear when a person is stressed. Chronic problems like stomach ulcers and hypertension start appearing when a person is stressed. In our day and age, this is difficult to avoid, but there are ways to mitigate it.

Of course, this is all in an ideal world—I cannot imagine doing office chair exercises in my exam room between patients because there is just NO EXTRA time between patients! There is no time to digest lunch. And you get home from work at 8 pm, make dinner, tidy up the house, tend to family matters, and go to bed "early" so I can get up early the next morning at 6:45 to go to work again? Exercise? Who has time for that? How DO you maintain a "healthy life-work balance" that everyone encourages you to live? It's life in the fast lane but ultimately, maybe it is all about organizing, prioritizing, and delegating. Easier said than done. 

If you are around other people with colds, keep your distance from sick people, wash your hands often, and keep your health optimal by taking multivitamins, hydrating, getting plenty of rest, avoiding stress, etc.

Hand Washing is Essential

SUPPORT IMMUNE FUNCTION

Vitamins and Minerals

Multivitamins can be helpful for your immune function (and body in general), But mega doses of most vitamins are not likely the key. In fact, some excess vitamins can be harmful (especially the fat-soluble vitamins A, D, E, and K, which build up in your body and can cause potential harm to your liver). Multivitamins are your best bet.

You can also have lab tests done to check some vitamin levels (vitamins A, D, C, K, and B-complex vitamins). For example, you can go to Quest Labs and order your own tests. Beware, they can be costly.

Vitamin supplements can be recommended or prescribed based on your lab levels. If you don't want to spend that money, eat a nutritious diet. Remember: Garbage in, garbage out.

Vitamin C - According to studies, vitamin C supplementation may help with prevention if you are experiencing stressful events. Otherwise, vitamin C does not help prevent it. It reportedly helps when you have a cold. Reportedly, it does shorten the duration of respiratory symptoms. As soon as you develop signs of a sore throat or cold, take 1,000 milligrams of vitamin C daily and consume vitamin C-rich foods. 

Vitamin D - A few years back, there was so much sudden hype on low vitamin D levels that I thought it might be a lab "scam." Were labs trying to get people to do more expensive lab tests? Were pharmaceutical companies trying to sell more Vitamin D? Nearly 50% of the patients coming to our clinic had low vitamin D levels! Then, the studies started coming out:  During the last several years, we have learned more about the vital role of Vitamin D in many of the body's functions and how essential it is to good health maintenance. Vitamin D plays a very significant role in building our immunity. 

We usually get most of our vitamin D from the sun, and very little is available from food. Our indoor, often sedentary lifestyle (in addition to other factors) has caused many people's vitamin D levels to suffer, some to the point where it affects one's immune function, causing autoimmune problems and decreasing immunity. The vitamin D levels at the labs are spendy but standardized now. Because of vitamin D deficiency, they should be tested. You can do this through a lab or online tests sent to your home. 

Zinc is a mineral that can be taken for prevention before symptoms begin and can also thwart a cold by killing viruses. It can also be started at the beginning of the cold to thwart worsening. Zinc increases immunity.

​Zinc is effective for prevention and kills viruses. Studies show that if zinc lozenges or syrup are started within 24 to 48 hours of symptom onset, it may significantly reduce the duration and severity of cold symptoms.

Elderberry—When COVID-19 began, people flocked to elderberry products as a protective measure. They flocked to anything that "might work." Most sources do not recognize elderberry as a preventive agent but as an agent that may help with viral symptoms. It does have antibacterial and antiviral properties and may be helpful with viral illnesses.

Some other vitamins and minerals also play a crucial role in immunity. These include: Vitamin A, Vitamin B6, Vitamin E, Folic acid, iron, and selenium. Our bodies do not make these vitamins or minerals (except vitamin D from the sun). With an adequate diet, we get these through the foods we eat. While many multivitamins contain these, planning according to individual needs is ideal. For example, some of these can interact with each other: calcium can place older adults at cardiac risk, older people tend to have more deficiencies than other age groups, and so on.

Cold Symptoms, Treatment, and Alternative Approaches-

APPROACHES TO YOUR COLD SYMPTOMS

Suppose you do get sick and develop symptoms of a cold. In that case, your goal of treatment will be to 1) make yourself comfortable by controlling symptoms and 2) keep those symptoms from worsening and progressing into a sinus infection, ear infection, bronchitis, pneumonia, or all of the above. To learn more about your symptoms and how to make them better with conventional over-the-counter treatments, alternative remedies, or prescriptive treatment, click on the link(s) below.   

Natural and Herbal Remedies for a Cold

Several respected botanicals claim to build immunity when taken regularly. Many of those same herbal supplements can also be taken to try to control symptoms of acute colds or flu. Some of these are listed below.

Panax Ginseng   - Another immune-boosting plant with an excellent reputation for fighting viruses, bacteria, and fungal infections. Intermittent use is generally recommended, particularly during cold and flu season. - Stay on it for a month or two, then off for a month or two. This can also be taken DURING a cold to shorten it up.

Astragalus  - This herbal supplement also has a good reputation for limiting and containing cold symptoms, especially if started as soon as symptoms begin.

Pelargonium Sidiodes—This herbal medicinal herb reportedly has antimicrobial and antiviral properties. It is used for prevention, or when a person gets sick, it reportedly helps them recover more quickly. Reputable research and reviews support its use for a cold. It is now sold over-the-counter as UMCKA, Umckaloabo, and Kaloban—as a plant-derived pharmaceutical that can boost immunity and possibly hasten recovery when you are ill.

Andrographis paniculata has antiviral, antibacterial, and anti-inflammatory properties. It can be used to prevent and support common cold/viral symptoms. It is best taken regularly during cold and flu season. NIH has posted some good research on this. 

Echinacea is a well-known supplement that may prevent colds. It inhibits inflammation and has antiviral and antibacterial properties. Once you do have a cold or virus, it reduces symptoms and shortens the duration of the common cold by 1.4 days.

Tulsi (Holy Basil) has been shown to enhance the immune response. According to research, Tulsi has antibacterial, antiviral, and antifungal properties,  which help prevent and fight off illness. It has been a popular herb in India for centuries. 

Hyssop - This can be used both to prevent colds and to support cold symptoms. It reportedly has antiviral, antibacterial, and antifungal properties.  

Goldenseal is used as a preventative measure against colds. It has antiviral, antibiotic, antifungal, and anti-inflammatory properties. It is one of the most popular herbs for illness prevention and symptom relief. It is best taken during cold and flu season.

Licorice Root—Researchers have found that licorice root enhances immunity. It has very effective antiviral, anti-inflammatory, and antimicrobial properties. It can also help with active symptoms. If you have any chronic conditions, you must check for any contraindications before using licorice.

Quercetin is typically found in fruits and vegetables but is also produced in concentrated form. According to an NIH study, it has some antiviral properties—it can reportedly arrest a virus early in the course of illness (1). 

A Person Wearing a Mask to Avoid Germs

Over-the-Counter-Cold Medicines

These over-the-counter medicines should ideally be geared to your symptoms: Runny nose or congestion, sore throat, cough, sneezing:

In general, use as directed over-the-counter as directed:

• Acetaminophen (common: Tylenol) or ibuprofen (common: Motrin, Advil, Naproxen) for a fever and body aches, headaches, sore throat

• A decongestant (common: Sudafed-tends to raise blood pressure and can make it tough to sleep) (Afrin Nasal Spray-3 days ONLY) to stop a drippy nose during the day or decrease congestion to help you breathe.

• Nasal Steroid - fluticasone (common: Flonase), decreases inflammation in the sinus but can take a couple of days to work.

• An antihistamine, like diphenhydramine (common: Benadryl), loratadine (common: Claritin), or others - the Allegra or Zyrtec, for the runny nose at night

• A cough suppressant like plain dextromethorphan (common: Delsym, Robitussin)

  and - as directed - but again, stay well hydrated. Use guaifenesin (Mucinex) if your mucus becomes too thick (will often be like this in the morning). Note: links in blue (above) will provide further information about treating these symptoms.

  
  

Multi-symptom Medications: You can also consider multi-symptom medications, which offer an “all-in-one” approach. However, keep in mind that they often treat symptoms you might not have, so you could end up taking a component of the medicine you don’t need.

Here are some of the more popular multi-symptom, over-the-counter cold and flu medications-

• Mucinex-Fast Max - Acetaminophen(common: Tylenol)(pain and fever) , dextromethorphan (common: Robitussin or Delsym)(cough), guaifenesin (expectorant) (common: Mucinex), phenylephrine (decongestant)

• Dayquil - Dextromethorphan ((common: Delsym, Robitussin)(cough): Acetaminophen (common: Tylenol), phenylephrine (decongestant)

• Nyquil - Nighttime med - Dextromethorphan (common: Delsym, Robitussin)(cough), acetaminophen (common: Tylenol) (pain and fever), and doxylamine (antihistamine) (drying and sleep) Robitussen Multi-symptom - Acetaminophen (common: Tylenol)(pain and fever), Dextromethorphan (cough) (common: Delsym, Robitussin), phenylephrine (decongestant), guaifenesin (expectorant)(common: Mucinex)

• Tylenol Cold and Flu - Acetaminophen (Tylenol)(pain and fever), dextromethorphan (common: Delsym, Robitussin)(cough medicine), phenylephrine (decongestant)

• Advil Multi-symptom Cold and Flu - Ibuprofen (common: Motrin or Advil), phenylephrine (decongestant), chlorpheniramine (antihistamine) (drying, sneezing and sleep)

• Theraflu - Acetaminophen (Tylenol for pain and fever), diphenhydramine (common: Benadryl) (antihistamine to dry runny nose and help sleep), phenylephrine (decongestant), guaifenesin (common: Mucinex)(expectorant)

• Alka Seltzer Plus - Acetaminophen (common: Tylenol), chlorpheniramine (antihistamine for drying sinus, sneezing and sleep), phenylephrine (decongestant)

• Coridan HBP - Acetaminophen (common: Tylenol), chlorpheniramine (antihistamine)

  
  

Some important notes about multi-symptom medications:

1) As you can see, these combo multi-symptom medications have lots of different things in them: Cough medications, antihistamines, decongestants, and expectorants. Much of the time, you don't have all of the symptoms these medications address.

2) You are more likely to have side effects because there are more medicines your body might react to.

3) A LOT of people tend to duplicate their medicine, or take too much medicine medicine when they take multi-symptom medications: Without realizing that these multi-symptom medications almost all contain acetaminophen (common: Tylenol) or ibuprofen (common: Motrin, Advil), people take additional Tylenol or Ibuprofen on the side to feel better and end up taking too much. Be careful with this: Read your labels.

4) Phenylephrine was recently found to be ineffective, so taking that as a component is like taking a placebo.

Prescriptive Treatment for Colds

• Antihistamines: For severe congestion or allergic components (e.g., hydroxyzine, carbinoxamine).

• Cough suppressants: Stronger versions than OTC, like benzonatate (Tessalon Perles), Promethazine with codeine

• Nasal sprays: Some prescription-strength steroid nasal sprays, like fluticasone (Flonase) or ipratropium (common: Atrovent), for congestion or postnasal drip.

• Pain/fever medications: Prescription strength Ibuprofen (800 mg)

Facts About Cold Viruses:  Q&A

How long are viruses contagious? 

Many cold viruses can live on a hard surface for up to seven days and on a soft surface for a much shorter period. No matter how long they live, most become very weak and less infectious after 24 hours. The flu virus lives for only about 24 hours. 

How does a cold virus spread?

Cold viruses are typically spread through the air from coughing and sneezing. They can travel several feet to another victim. They can also be spread through direct contact, but it is not as common.

Why do I get a watery, runny nose and cough when I get a cold?

Cold viruses enter the nose, mouth, or eyes and tend to colonize the nasal passages and sinus, where more mucus forms in the body's attempt to fight it off and get rid of it.

When is a person most contagious with the flu?

A person is most contagious in the first few days (including a couple of days before symptoms).

What time of year are viruses the most common? Why?

More viral illnesses - or colds - show up in fall and winter because viruses thrive in the cold, dry air (most bacteria, on the other hand, like a warm, moist environment).

I get two or three colds every year. Why do I get sick so much?

It could be because of your occupation (have you been exposed to many people?). Do you travel a lot? (Travelers tend to get sick a good bit, particularly those who fly.) It could be because you have young children, but it is important to note that most people normally get 2-3 colds per year, so if you think you get sick a lot...maybe it is normal. There are one billion colds every year in the US.

Can I catch a cold from being cold and/or wet?

There are many mixed opinions on this. Overall, most agree that being in cold air can lower your core body temperature, thereby lowering your immunity and causing you to catch a cold more easily. But getting wet apparently does not contribute to illness unless it makes you colder and causes your temperature to drop even more.