Cold remedies: What works, what doesn't, what

can't hurt
There's no cure for the common cold. But what about cold remedies that claim to
make you feel better faster? Find out what's effective — and what's not.
Cold remedies are almost as common as the common cold, and many are nearly as ancient. The use of
chicken soup as a congestion cure dates back centuries. But is longevity any guarantee that a cold
remedy works? Do effective cold remedies even exist? Here's a look at some common cold remedies
and what's known about them.

Cold remedies: What works

If you catch a cold, you can expect to be sick for about a week. But that doesn't mean you have to be
miserable. These remedies may help:

 Water and other fluids. You can't flush a cold out of your system, but drinking plenty of
liquids can help. Water, juice, clear broth or warm lemon water with honey helps loosen
congestion and prevents dehydration. Avoid alcohol, coffee and caffeinated sodas, which make
dehydration worse.

 Salt water. A saltwater gargle — 1/2 teaspoon salt dissolved in an 8-ounce glass of warm
water — can temporarily relieve a sore or scratchy throat.
 Saline nasal sprays. Over-the-counter saline nasal sprays combat stuffiness and
congestion. Unlike nasal decongestants, saline sprays don't lead to a rebound effect — a
worsening of symptoms when the medication is discontinued — and most are safe and
nonirritating, even for children.
 Chicken soup. Generations of parents have spooned chicken soup into their sick children.
Now scientists have put chicken soup to the test, discovering that it does have effects that might
help relieve cold and flu symptoms in two ways. First, it acts as an anti-inflammatory by inhibiting
the movement of neutrophils — immune system cells that participate in the body's inflammatory
response. Second, it temporarily speeds up the movement of mucus through the nose, helping
relieve congestion and limiting the amount of time viruses are in contact with the nose lining. So
which is better, homemade or canned? Researchers at the University of Nebraska compared
homemade chicken soup with canned versions and found that many, though not all, canned
chicken soups worked just as well as soups made from scratch.
 Over-the-counter cold medications. Nonprescription decongestants and pain relievers offer
some symptom relief, but they won't prevent a cold or shorten its duration, and most have some
side effects. If used for more than a few days, they can actually make symptoms worse. The
Food and Drug Administration (FDA) recommends that parents avoid such cold medicines for
children younger than age 2. And they are evaluating the safety of these medications in older
children.

Keep in mind that acetaminophen (Tylenol, others) can cause serious liver damage or liver
failure if taken in high doses. It's common for people to take Tylenol in addition to flu medications
that also contain acetaminophen, which can lead to drug overdoses. Read the labels of any cold
medication carefully to make sure you're not overdosing.

 Humidity. Cold viruses thrive in dry conditions — another reason why colds are more
common in winter. Dry air also dries the mucous membranes, causing a stuffy nose and scratchy
throat. A humidifier can add moisture to your home, but it can also add mold, fungi and bacteria if
not cleaned properly. Change the water in your humidifier daily, and clean the unit at least once
every three days.

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Cold remedies: What doesn't work

The list of ineffective cold remedies is long. A few of the more common ones that don't work include:

 Antibiotics. These destroy bacteria, but they're no help against cold viruses. Avoid asking
your doctor for antibiotics for a cold or using old antibiotics you have on hand. You won't get well
any faster, and inappropriate use of antibiotics contributes to the serious and growing problem of
antibiotic-resistant bacteria.

 Antihistamines. Some studies have suggested minimal reduction in sneezing and nasal
discharge with first-generation (sedating) antihistamines. However, results are conflicting and the
benefits may not outweigh the side effects.
 Over-the-counter (OTC) cough syrups. In cold season, nonprescription cough syrups
practically fly off the drugstore shelves. Some contain ingredients that may relieve coughing, but
the amounts are too small to do much good and may actually be harmful for children. Many
experts don't recommend their use in children. The FDA recommends that parents avoid cough
medicines for children younger than age 2. They are evaluating the safety of these medications
in older children. The American College of Chest Physicians strongly discourages the use of
these medications in children younger than 14, because they're not effective at treating the
underlying cause of cough due to colds.

Coughs associated with a cold usually last less than three weeks but could be present up to four
weeks. If a cough lingers longer than that, see your doctor. In the meantime, try soothing your
throat with warm lemon water and honey and humidifying the air in your house. Avoid giving
honey to infants.

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 Cold medicines for kids: What's the risk?

Cold remedies: What probably doesn't hurt

In spite of ongoing studies, the scientific jury is still out on popular cold remedies such as vitamin C,
echinacea and zinc. Here's an update on some common alternative remedies:

 Vitamin C. It appears that for the most part taking vitamin C won't help the average person
prevent colds. However, taking 200 milligrams (mg) or more does seems to benefit those who
engage in extreme physical exercise or who are exposed to extremely cold environments —
such as soldiers, skiers and marathon runners. Just what constitutes an optimum dose isn't
clear, but amounts in excess of 2,000 mg a day may cause nausea and diarrhea.

 Echinacea. Studies on the effectiveness of echinacea at preventing or shortening colds is

mixed. Some studies show no benefit. Others show a 10 percent to 30 percent reduction in
severity and duration when taken for seven to 10 days at the onset of the cold. Some people
swear by Airborne, a popular herbal cold remedy that's sold over-the-counter in many
drugstores.
 Zinc. The cold-fighting reputation of zinc has had its ups and downs. That's because many
zinc studies — both those that find the mineral beneficial and those that do not — are flawed.
The highest quality randomized trials generally show no benefit. In studies with positive results,
zinc seemed most effective taken as a lozenge or nasal spray in the form of zinc acetate within
48 hours of the onset of symptoms. Taking zinc with food may reduce side effects, including a
bad taste and nausea. Intranasal zinc may result in permanent damage to the sense of smell.

Common cold
ARTICLE SECTIONS
 Definition  Preparing for your
 appointment
Symptoms  Treatments and drugs
 Causes  Lifestyle and home remedies
 Risk factors  Alternative medicine

  Prevention
Complications

Definition

The common cold is a viral infection of your upper respiratory tract — your nose and throat. A common
cold is usually harmless, although it may not feel that way. If it's not a runny nose, sore throat and
cough, it's the watery eyes, sneezing and congestion — or maybe all of the above. In fact, because any
one of more than 200 viruses can cause a common cold, symptoms tend to vary greatly.

Most adults are likely to have a common cold two to four times a year. Children, especially
preschoolers, may have a common cold as many as six to 10 times annually.

Most people recover from a common cold in about a week or two. If symptoms don't improve, see your
doctor.

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Symptoms
Symptoms

Symptoms of a common cold usually appear about one to three days after exposure to a cold virus.
Signs and symptoms of a common cold may include:

 Runny or stuffy nose

 Itchy or sore throat
 Cough
 Congestion
 Slight body aches or a mild headache
 Sneezing
 Watery eyes
 Low-grade fever (up to 102 F, or 39 C)
 Mild fatigue

The discharge from your nose may become thicker and yellow or green in color as a common cold runs
its course. What makes a cold different from other viral infections is that you generally won't have a high
fever. You're also unlikely to experience significant fatigue from a common cold.

When to see a doctor

For adults — Seek medical attention if you have:

 Fever of 102 F (39 C) or higher

 High fever accompanied by achiness and fatigue
 Fever accompanied by sweating, chills and a cough with colored phlegm
 Significantly swollen glands
 Severe sinus pain

For children — In general, children are sicker with a common cold than adults are and often develop
complications, such as ear infections. Your child doesn't need to see the doctor for a routine common
cold. But seek medical attention right away if your child has any of the following signs or symptoms:

 Fever of 103 F (39.5 C) or higher, chills or sweating

 Fever that lasts more than three days
  Vomiting or abdominal pain
 Unusual sleepiness
 Severe headache
 Difficulty breathing
 Persistent crying
 Ear pain
 Persistent cough

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Causes
Causes

Although more than 200 viruses can cause a common cold, the rhinovirus is the most common culprit,
and it's highly contagious.

A cold virus enters your body through your mouth or nose. The virus can spread through droplets in the
air when someone who is sick coughs, sneezes or talks. But it also spreads by hand-to-hand contact
with someone who has a cold or by using shared objects, such as utensils, towels, toys or telephones.
Touch your eyes, nose or mouth after such contact or exposure, and you're likely to "catch" a cold.

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Risk factors
Risk factors

Cold viruses are almost always present in the environment. But the following factors can increase your
chances of getting a cold:

Age. Infants and preschool children are especially susceptible to common colds because they haven't
yet developed resistance to most of the viruses that cause them. But an immature immune system isn't
the only thing that makes kids vulnerable. They also tend to spend lots of time with other children and
frequently aren't careful about washing their hands and covering their coughs and sneezes. Colds in
newborns can be problematic if they interfere with nursing or breathing through the nose.

Immunity. As you age, you develop immunity to many of the viruses that cause common colds. You'll
have colds less frequently than you did as a child. However, you can still come down with a cold when
you are exposed to cold viruses, have an allergic reaction that affects your nasal passages or have a
weakened immune system. All of these factors increase your risk of a cold.

Time of year. Both children and adults are more susceptible to colds in fall and winter. That's because
children are in school, and most people are spending a lot of time indoors. In places where there is no
winter season, colds are more frequent in the rainy season.

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Complications
Complications

 Acute ear infection (otitis media). Ear infection occurs when bacteria or viruses infiltrate the
space behind the eardrum. It's a frequent complication of common colds in children. Typical
signs and symptoms include earaches and, in some cases, a green or yellow discharge from the
 nose or the return of a fever following a common cold. Children who are too young to verbalize
their distress may simply cry or sleep restlessly. Ear pulling is not a reliable sign.

 Wheezing. A cold can trigger wheezing in children with asthma.

 Sinusitis. In adults or children, a common cold that doesn't resolve may lead to sinusitis —
inflammation and infection of the sinuses.
 Other secondary infections. These include strep throat (streptococcal pharyngitis),
pneumonia, bronchitis in adults and croup in children. These infections need to be treated by a
doctor.

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Preparing for your appointment
Preparing for your appointment

If you have a cold, you're likely to start by first seeing your family doctor, a general practitioner or your
child's pediatrician.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea
to be well prepared for your appointment. Here's some information to help you get ready for your
appointment, and what to expect from your doctor.

What you can do

 Write down the symptoms you're experiencing, including any that may seem unrelated to the
reason for which you scheduled the appointment.

 Write down key personal information, including any major stresses or recent life changes.
 Make a list of all medications, as well as any vitamins or supplements and over-the-counter
(OTC) cold remedies that you're taking.
 Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your
time together. List your questions from most important to least important in case time runs out. For
common cold, some basic questions to ask your doctor include:

 What is likely causing my symptoms or condition?

 Other than the most likely cause, what are other possible causes for my symptoms or
condition?
 What kinds of tests do I need?
 Is my condition likely temporary or chronic?
 What is the best course of action?
 What are the alternatives to the primary approach that you're suggesting?
 I have these other health conditions. How can I best manage them together?
 Are there any restrictions that I need to follow?
 Should I see a specialist? What will that cost, and will my insurance cover seeing a
specialist?
 Is there a generic alternative to the medicine you're prescribing me?
 Are there any brochures or other printed material that I can take home with me? What Web
sites do you recommend?
 What will determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions
during your appointment at any time that you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more
time later to cover other points you want to address. Your doctor may ask:
  When did you first begin experiencing symptoms?
 Have your symptoms been continuous, or occasional?
 How severe are your symptoms?
 What, if anything, seems to improve your symptoms?
 What, if anything, appears to worsen your symptoms?

What you can do in the meantime

While you're waiting for your appointment, you may consider taking OTC pain medications and
decongestants to ease symptoms. Get plenty of rest and drink lots of fluids.

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Treatments and drugs
Treatments and drugs

There's no cure for the common cold. Antibiotics are of no use against cold viruses. Over-the-counter
cold preparations won't cure a common cold or make it go away any sooner, and most have side
effects. Here's a look at the pros and cons of some common cold remedies.

 Pain relievers. For fever, sore throat and headache, many people turn to acetaminophen
(Tylenol, others) or other mild pain relievers. Keep in mind that acetaminophen can cause liver
damage, especially if taken frequently or in larger than recommended doses. Be especially
careful when giving acetaminophen to children because the dosing guidelines can be confusing.
For instance, the infant-drop formulation is much more concentrated than the syrup commonly
used in older children. Never give aspirin to children. It has been associated with Reye's
syndrome — a rare but potentially fatal illness.

 Decongestant nasal sprays. Adults shouldn't use decongestant drops or sprays for more
than a few days because prolonged use can cause chronic inflammation of mucous membranes.
And children shouldn't use decongestant drops or sprays at all. There's little evidence that they
work in young children, and they may cause side effects.
 Cough syrups. In winter, nonprescription cough syrups practically fly off the drugstore
shelves. But the American College of Chest Physicians strongly discourages the use of these
medications because they're not effective at treating the underlying cause of cough due to colds.
Some contain ingredients that may alleviate coughing, but the amounts are too small to do much
good and may actually be harmful for children. In fact, the college recommends against using
OTC cough syrups or cold medicines for anyone younger than age 14. The Food and Drug
Administration (FDA) strongly recommends against giving OTC cough and cold medicines to
children younger than age 2. Meantime, under an agreement announced by manufacturers in
late 2008, several brands of OTC cold and cough medications began carrying a warning that
these products should not be used in children under 4. For young children, an accidental
overdose could be fatal. Coughs associated with a cold usually last less than two to three weeks.
If a cough lingers longer than that, see your doctor.

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Lifestyle and home remedies
Lifestyle and home remedies

You may not be able to cure your common cold, but you can make yourself as comfortable as possible.
These tips may help:

 Drink lots of fluids. Water, juice, tea and warm soup are all good choices. They help replace
fluids lost during mucus production or fever. Avoid alcohol and caffeine, which can cause
dehydration, and cigarette smoke, which can aggravate your symptoms.
  Try chicken soup. Generations of parents have spooned chicken soup into their sick
children. Now scientists have put chicken soup to the test, discovering that it does seem to help
relieve cold and flu symptoms in two ways. First, it acts as an anti-inflammatory by inhibiting the
movement of neutrophils — immune system cells that help the body's response to inflammation.
Second, it temporarily speeds up the movement of mucus through the nose, helping relieve
congestion and limiting the time viruses are in contact with the nasal lining.
 Get some rest. If possible, stay home from work if you have a fever or a bad cough, or are
drowsy from medications. This will give you a chance to rest as well as reduce the chances that
you'll infect others. Wear a mask when you have a cold if you live or work with someone with a
chronic disease or compromised immune system.
 Adjust your room's temperature and humidity. Keep your room warm, but not overheated.
If the air is dry, a cool-mist humidifier or vaporizer can moisten the air and help ease congestion
and coughing. Be sure to keep the humidifier clean to prevent the growth of bacteria and molds.
 Soothe your throat. Gargling with warm salt water several times a day or drinking warm
lemon water with honey may help soothe a sore throat and relieve a cough.
 Use saline nasal drops. To help relieve nasal congestion, try saline nasal drops. You can
buy these drops over-the-counter, and they're effective, safe and nonirritating, even for children.
To use in babies, put several drops into one nostril, then immediately bulb suction that nostril.
Repeat the process in the opposite nostril. Doing this before feeding your baby can improve your
child's ability to nurse or take a bottle, and before bedtime it may improve sleep.

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Alternative medicine
Alternative medicine

Alternative therapies probably won't cure your cold, but they may help make you more comfortable by
easing your symptoms.

Echinacea. Whether taking preparations of the herb echinacea protects you from getting a cold or
relieves cold symptoms continues to be debated. While no studies have shown that taking echinacea
can prevent you from getting a cold, there is some evidence that it can modestly relieve cold symptoms
or shorten the duration of a cold. Echinacea seems most effective when taken soon after cold symptoms
are first experienced.

Vitamin C. There's no evidence that taking large doses of vitamin C reduces your risk of catching cold.
However, there is some evidence that high doses of vitamin C — up to 6 grams a day — may have a
small effect in reducing the duration of cold symptoms.

Zinc. There's evidence that zinc nasal sprays or lozenges taken at the beginning of a cold may help
reduce symptoms. While some studies also suggest zinc nasal sprays can be helpful, many users
experienced permanent loss of smell and therefore the use of these sprays is discouraged.

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Prevention
Prevention

No vaccine has been developed for the common cold, which can be caused by many different viruses.
But you can take some common-sense precautions to slow the spread of cold viruses:

 Wash your hands. Clean your hands thoroughly and often, and teach your children the
importance of hand washing. Carry a bottle of alcohol-based hand rub containing at least 60
percent alcohol for times when soap and water aren't available. These gels kill most germs, and
are safe for older children to use themselves.
  Scrub your stuff. Keep kitchen and bathroom countertops clean, especially when someone
in your family has a common cold. Wash children's toys after play.
 Use tissues. Always sneeze and cough into tissues. Discard used tissues right away, and
then wash your hands carefully. Teach children to sneeze or cough into the bend of their elbow
when they don't have a tissue. That way they cover their mouth without using their hands.
 Don't share. Don't share drinking glasses or utensils with other family members. Use your
own glass or disposable cups when you or someone else is sick. Label the cup or glass with the
name of the person with the cold.
 Steer clear of colds. Avoid close, prolonged contact with anyone who has a cold.
 Choose your child care center wisely. Look for a child care setting with good hygiene
practices and clear policies about keeping sick children at home. The number of children in the
center directly relates to the number of colds to which your child will be exposed.

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Cold symptoms: Does drinking milk increase

phlegm?

I've heard that you shouldn't drink milk when you have a cold
because it increases phlegm. Is this true?
- No name given / Nebraska

Mayo Clinic infectious disease specialist James Steckelberg, M.D., and colleagues answer
select questions from readers.
Answer

Phlegm is the thick, sticky mucus that drips down the back of your throat when you have a cold.
Although drinking milk may make phlegm thicker and more irritating to your throat than it would normally
be, milk doesn't cause your body to make more phlegm. In fact, frozen dairy products can soothe a sore
throat and provide calories when you otherwise may not eat.