When You’ve Got A Cold: What To Take And When To Be Seen
Many patients come to the office with “the common cold” and feel a little lost on what to do about it. One of the most common things I get asked is, “When am I supposed to come into the office and get checked, and when should I just stay home?” The second thing I get asked is, “What am I supposed to take for my symptoms.” I’ve listed some answers below for both the Western medicine approach and the natural medicine approach.
Western Medicine Approach- Symptoms be damned:
One thing you’ll notice with the natural medicine approach is the ability to knock symptoms out quickly is often lacking because it usually targets improving the immune response as opposed to directly affecting symptoms. I’ve listed some over-the-counter medications that can dramatically help your symptoms when they’re severe:
MUCINEX (guaifenesin): this helps break up the mucus so it thins out, making it easier and less painful to cough up, and also less globbed up in your sinuses so it’ll drain out easier. Typical doses are about 400 mg every 4 hours, or the extended release of 1200 mg every 12 hours.
SUDAFED (pseudoephedrine): a God-send for that cold that produces more congestion than you ever thought possible. Be aware the only kind that actually seems to work is the stuff you have to ask the pharmacist for and show your ID (people make meth out of this now so it’s regulated). It will also cause most people to feel a little jittery so just take this during the day so it doesn’t disturb your sleep. Typical doses are 30-60 mg every 6 hours, or extended release 60-120 mg every 12 hours
MOTRIN (ibuprofen): This will take care of the body aches, headache, throat pain, or whatever other pain you’re experiencing during that pesky cold, and it also works well for keeping fevers down. Typical doses are 200-400 mg every 4-6 hours. Prescription doses range from 600-800 mg every 8 hours, but you need clearance from your doctor before taking that high of a dose.
ZYRTEC (certrizine) OR BENADRYL (diphenhydramine): I know most people take this for allergies, but it works in a different way to decrease the amount of mucus produced. Consider adding this to the sudafed during those times the sudafed just isn’t cutting it. Zyrtec is a 24 hour antihistamine that doesn’t make you quite as drowsy as bendaryl, typical dose is 10 mg once daily (take it at night) for certrizine and 25-50 mg of benadryl every 6 hours. Benadryl will make you quite drowsy and can be a great sleep aid when the cold seems to be keeping you up at night. Again, pick either Zyrtec OR Benadryl depending on what suits your needs best
DELSYM (dextromethorphan): This is a cough suppressant that works quite well, especially for that dry hacking cough. Keep in mind if you have a persistent dry hacking cough, you may have reactive airway disease caused from a virus (otherwise known as asthma!). See your doctor to find out if an inhaler might help. A typical dose of dextromethorphan is 10 mls every 12 hours.
Natural Medicine Approach:
Neil Med Sinus Rinse: Yes, this is the thing where you flush saline up one nostril and out the other. Many people hate this, which is understandable, but if you can handle it, the effects are wonderful. It can actually be oddly satisfying to see all the snot coming out. If you’re comfortable taking mucinex (the stuff than thins mucus) as listed above, it can help to thin the mucus so it’s easier to flush out. This can be done several times daily as needed.
Elderberry Syrup: thank you to my sister for bringing this to my attention, I was skeptical at first, but I didn’t give it credence until I actually tried it for the first time a few months ago. Since these articles aren’t about anecdotal evidence, I’ll spare you the details of how it kept me from getting sick and made my daughters cold almost nothing. This particular supplement has more evidence than most other supplements out of there on it’s symptom reducing effects. Many studies show it’s ability to not only treat influenza, but also to reduce the severity and duration of the common cold by about 56% (1,2,3,4). Learn how to make it yourself here.
Camphor: Camphor is FDA-approved as chest rub to help reduce coughing in concentrations less than 11%. Over the counter it’s found in Vick’s Vaporub. It can also be found in Doterra’s Deep Blue essential oil blend, and Young Living’s Raven essential oil blend. It’s funny to me that both companies market a different blend (Doterra’s Breathe, and Young Living’s R.C.) as their remedy for cough and cold-like symptoms which don’t contain camphor, but both contain eucalyptus and menthol which subjectively seem to make people feel better. There is no solid evidence that they actually have anti-cough/nasal clearing effects (5), but eucalyptus and peppermint (among a few other ingredients) may have some antibacterial properties against common pathogens that cause bronchitis and pneumonia (6).
Honey: A double-blind randomized control study done in 2013 showed that patients who took 20.8 mg of honey mixed with 2.9 mg of instant coffee every 8 hours for one week was superior at treating post-infectious cough syndrome (that lingering cough that lasts for weeks after the infection has gone away), than 13.3 mg of prednisolone (oral steroid) taken every 8 hours for 1 week (7). Honey has anti-inflammatory properties and coffee contains caffeine which is a bronchodilator which may explain its effects. A few other studies show that honey may be as effective as dextromethorphan (Delsym) at relieving cough in children 2 years and older (8,9,10). I couldn’t find dosing on this unfortunately, but honey is relatively safe in kids over the age of one and worth trying if you want a more natural approach to suppressing your cough.
Schedule an appointment/talk to a triage nurse if you have:
Trouble breathing and especially if you have a history of respiratory problems like asthma or COPD
A decreased immune system and require close monitoring (such as being on chemotherapy, if you have HIV or cancer etc)
A fever greater than 104 that is not coming down with ibuprofen or tylenol.
A history of frequent pneumonia
Been sick without any improvement for longer than 14 days. Viruses take an average of 14 days for your body to fight, and unless you suffer from the above issues, antibiotics unlikely will be prescribed before this.
If something just doesn’t feel right, call your doctor’s office and speak with a triage nurse to better figure out if you need to be seen.
Long story short, if you’re healthy without underlying medical issues, give the virus at least 2 weeks before you go in asking for antibiotics. We are trying to prevent superbugs by only prescribing antibiotics when its truly necessary. Antibiotics aren’t without their risks as well, they disrupt the normal good bacteria in the stomach and it can take weeks for your tummy to get back to normal, so trust your doc when he or she says to hold off on antibiotics until it’s absolutely necessary.
Stay healthy!!