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SPECIAL REPORT
Clobber that cold
The best remedies for the ubiquitous virus don't come in a
bottle. Plus, how to tell if it's something worse than a cold.
uring these winter months, that
villain, the common cold, is
working overtime. Adults get
two to four colds a year on average­
children get even more-and those achy,
sneezy, stuffy symptoms are responsible
for up to 40 percent of lost workdays.
A cold can be caused by one of more
than 200 viruses, so your body may fight
off one virus but still be vulnerable to
another. No pill can wipe out the illness,
but there are several measures you can
take to feel better while your immune
system tries to vanquish the invader.
Will Grandma's chicken soup do the
trick? Should you try squirting zinc in
your nose? We looked at the latest evi­
dence to see which steps are most likely
to ease symptoms-and least likely to
cause you additional trouble.
help thin nasal secretions and loosen
phlegm. Try warm water with honey
and lemon to soothe the throat. And
Grandma was right: Chicken soup really
can help. Research suggests that it may
prevent the excessive buildup of neutro­
phils, virus-fighting cells that trigger the
inflammatory responses that make cold
sufferers feel so rotten.
Rinse your nose. Flushing your
nostrils with saltwater is surprisingly
effective at easing nasal congestion
and may prevent subsequent bacterial
infections, research suggests. You can
buy over-the-counter saline sprays, but
a 2007 clinical trial found that nasal
irrigation kits may work better. One type
of those is a neti pot, which has a small
spout that uses gravity to deliver saline
into the nostrils. Try flushing your nose
morning and night, and make sure to
DEFINITELY TRY
clean the device daily.
Self-care measures
Gargle. Use half a teaspoon of salt
Rest. Give in to the urge to take it easy,
dissolved in a glass of warm water to
espeCially in the first couple of days
relieve painful swelling in your throat.
Suck on lozenges. That helps ease
when your body needs to channel its
energy into fighting the virus. That's
a dry, irritated throat and reduces the
also when you're most contagious, so \ tickling sensation that causes you to
it's considerate to take yourself out of cough. Look for nonmedicated cold
public circulation. It may also help to
lozenges made with glycerin, or use
elevate your head when lying down to
sugarless hard candy.
Take honey. It has antioxidant and
ease the post-nasal dripping that causes
you to cough.
antiviral properties and might soothe
Drink. Warm fluids in particular can
irritated membranes in the back of the
D
worked better at alleviating coughs in
children than an over-the-counter cough
suppressant. Adults and kids ages 12 and
up should take 2 teaspoons; younger
children need less. Don't give honey to
infants younger than one.
Boost humidity. Warm, moist air
from a bath, shower, or kettle can loosen
phlegm and soothe the throat. Indoor
heating dries the air, so in the winter
keep your thermostat set low-no higher
than 68 0 F (20 0 C)-and consider using
a humidifier to maintain a humidity
level between 30 and 50 percent.
CONSIDER WITH CAUTION
OTe remedies
The abundance of cold medicines in
drugstore aisles is more a testament
to the power of marketing than to the
efficacy ofthe drugs. In many cases, they
simply don't work well enough to justify
the risks. "Bottom line is, you should
take as little as possible for a cold;'
says David Blandino, M.D., a clinical
associate professor of family medicine
at the University of Pittsburgh School of
Medicine. "Don't reach for medication
unless a symptom is making you truly
miserable or keeping you up at night:'
If you do need a drug, avoid multisymptom remedies, which tend to
contain extra ingredients that you don't
need and increase the risk ofoverdoses or
side effects. Indeed, a multicenter study
published in 2005 found that more than
one-third of the accidental overdoses of
acetaminophen (Tylenol and generic)
occurred when people combined two
remedies that each contained the drugfor example, a cold medicine such as
DayQuil Cold and Flu Relief plus a pain
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as Tylenol.
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JANUARY 2010
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Consumer Reports on Health
Instead of combination remedies,
pick single-ingredient products that
target your specific symptoms, and take
them only when necessary.
Stuffy nose. Nasal drops or sprays
containing oxymetazoline (Afrin, Neo­
synephrine Nighttime, and generic)
work faster and cause fewer side effects
and potential interactions than oral
decongestants. But oxymetazoline can
cause rebound congestion if used for
longer than about three days. So if the
stuffiness hasn't eased by then, ask your
pharmacist for pseudoephedrine pills
(Sudafed and generic), which are non­
prescription but kept "behind the coun­
ter" to prevent people from using them
to make illegal drugs. Pseudoephedrine
is more effective than phenylephrine,
another over-the-counter decongestant.
Check with your doctor before taking
either medication if you suffer from
anxiety or have diabetes, heart disease,
hypertension, or hyperthyroidism.
Runny, drippy nose. Older anti­
histamines such as chlorpheniramine
(Chlor- Trimeton and generic) and
diphenhydramine (Benadryl Allergy and
generic) may help somewhat, but they
can also cause drowsiness, dry eyes and
mouth, and urinary retention. And you
should avoid them if you have narrow­
angle glaucoma or an enlarged prostate.
Don't bother with newer antihistamines
such as loratadine (Claritin and generic),
since they appear to work only for
allergies. The prescription nasal spray
ipratropium (Atrovent and generic) can
help ease a runny nose due to a cold or
allergies, but it's costlier than the other
drugs ($40 a month or more).
Cough. Since most cold-related
coughs are due to postnasal drip, your
best bet is to try one of the older antihjs­
tamines mentioned earlier-especially
if the cough interferes with your sleep.
Symptom check: Is it a cold or the flu?
People often confuse the cold and the Au, because the symptoms can overlap and
be eased by the same selkare meosures and over-the-counter medications. But it's
important to distinguish between the two, for several reosons. First, people who
could become seriously ill from the flU-including young children, adults age 65 and
older, and people with chronic illnesses or weakened immunity-may need a pre­
scription antiviral drug, which can shorten the duration and severity of the illness if
started within 48 hours of the first symptoms. And it's especially important for people
with the Au to limit contact with others, since it can cause severe illness or death in
vulnerable people. The table below can help you determine whether your symptoms
indicate the common cold or a potentially more serious case of the Au.
ONSET
SYMPTOMS
Gradual
Sudden
Sore or scratchy throat. progressing to
sneezing. arunny or stuffed nose. and
finally. acough.
Chills. dry cough. headache. muscle aches.
stuffed nose, sore throat. extreme tiredness.
FEVER
SEVERITY
DURATION
Low or none.
1000 F(380 C) or higher.
Less severe.
More severe.
A week to 10 days. though the cough can
linger for several weeks after you've
recovered.
One to two weeks.
Evidence for the cough-suppressing
ingredient dextromethorphan (Delsym,
Robitussin, and generic) is mixed,
and it may be particularly ineffective
when combined with the expectorant
guaifenesin, since the two ingredients
basically work at cross-purposes. What's
more, it can cause side effects, espeCially
in children.
DON'T EXPECT TOO MUCH
Herbs and supplements
Even the most optimistic interpreta­
tions of the research on complementary
therapies for the common cold don't
provide much impetus for using them.
Here's the rundown on three popular
alternative treatments.
Echinacea. In the lab, this herb
appears to stimulate the immune system
and fight inflammation, but its track
record against colds in the real world is
spotty. That may be because studies of
the herb vary in methodology and even
in what type of echinacea is used. A 2006
Cochrane review of 16 clinical trials
found some evidence that the species
Echinacea purpurea might help in the
early treatment of colds, but it found no
evidence that other forms of the herb are
effective. In a 2004 survey of CONSUMER
REPORTS readers, only 14 percent of the
people who used echinacea for colds said
that it helped them feel much better; 57
percent said it helped only a little or not
at all. Avoid echinacea if you're allergic
to chrysanthemums, daisies, ragweed,
or sunflowers.
Vitamin C. Some studies have found
a modest reduction in symptoms among
people who took very high doses of the
vitamin after the onset of a cold. But
the levels tested in those studies-1 to 8
grams daily-can cause intestinal upset
and diarrhea in some people. And other
studies have found no benefit at all to
popping vitamin C.
Zinc. This mineral inhibits the growth
of viruses in test tubes, and a clinical
trial published in the 1980s suggested
that zinc lozenges could shorten a cold.
But about half of the trials since then
have found no benefit. Avoid nasal
zinc preparations such as Zicam, which
can cause headaches, nose or throat
irritation, and a loss of smell that may
be permanent. _
www.ConsumerReportsonHealth.org
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JANUARY 2010
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