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The Common Cold, No Cure in Sight

Armen Hareyan's picture

Treatment for Common Cold

What's the best treatment for a cold? Some say rest and lots of liquids, others say to feed a cold and starve a fever. But what if you have a cold with a fever? Does medication help?

Cold remedies have proliferated like the viruses that cause them since the days of Hippocrates who noticed colds are more common in winter. To date, there is no cure for the common cold, but that has not stopped people from hawking one thing or another as a sure fire treatment. Herbs, vitamins, heat, minerals and more have been proposed to relieve or cure colds.

To understand the whys and wherefores of cold treatment, it's important to understand what a cold is and is not. The nose, throat and sinuses can be infected by viruses or bacteria. Colds are caused by one of a couple hundred strains of virus that can infect the lining of the respiratory tract.

Typically, a cold begins with a sense of scratchiness in the throat and irritation in the nose. There is often a runny nose and stuffiness in the first day and there may be some pressure in the cheeks or eyes from early sinus irritation as the body begins to react to the infection. The ears might feel clogged or uncomfortable. As the immune system reacts to the virus, we feel achy or tired and may start to get a low fever. By the second day, we often feel much worse, with much more nasal congestion and drainage, a cough and more sinus pressure and ear congestion and possibly higher fever. The symptoms begin to subside a bit by the third or fourth day, and we are left with stuffy nose, sinus pressure, ear fullness or pain, possibly low fever, fatigue, sore throat and a cough. By the tenth to fourteenth day, if we have not developed a secondary infection, we get well.

The viruses that cause colds make us more susceptible to infection from bacteria that are already in our noses and throats or that we contract from the environment. Other risk factors, such as, smoking, asthma and other respiratory diseases, diabetes and so on also reduce our ability to resist these secondary infections. Signs we have a secondary infection include worsening of symptoms or persistence beyond two weeks.

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Nothing will kill the cold virus except our immune systems, but it takes about two weeks before our respiratory tract gets back to normal. Most traditional cold remedies are not designed to cure a cold, just to make us feel a little better. Decongestants shrink swollen membranes and reduce drainage. Pain medications like Tylenol, Advil and Aleve help to reduce the aches and pressure we might feel. Antihistamines dry the drainage, perhaps too much. Dextromethorphan might help with coughing, but that is in dispute. Some studies show tea and cocoa do a better job as cough suppressants than dextromethorphan which can cause drowsiness.

Zinc, vitamin C and Echinacea have been touted as treatments to stop colds in the early stages, but, to date studies done have failed to support those claims. It's possible that having a strong belief in the efficacy of such things is what actually helps. If so, it's reasonable to try them. Singing and dancing have been shown to increase antibodies that fight colds, but a positive attitude also helps.

As in so much of medicine, prevention is much better than treatment. We don't really "catch" colds; we give them to ourselves. Unless someone coughs or sneezes directly at us, a person with a cold will not spread it to us. Doctors see dozens of patients with colds during the season and rarely catch their patients' colds.

Cold air, drafts, chills, wet hair and so on do not cause colds. The usual way the virus gains entry to our systems is by touching our nose, mouth or eyes with our fingers. When we touch other people's hands or things they have touched, we get the virus on our own hands, then we inoculate ourselves.

The "secret" to cold prevention, then, is clean hands and never touching our mouth, nose or eyes unless we have sanitized our hands first. Studies in day care settings and in schools have proven that attention to hand washing reduces the incidence of colds. To be effective, hands should be rubbed vigorously with soap and water for thirty seconds. Alternatively, alcohol gel hand sanitizers kill cold viruses in a second and are just as effective as vigorous hand washing.

If, despite our best efforts, we do catch a cold, several things can help: extra rest helps our immune system fight the infection and more fluids keep the drainage thin. Treating symptoms might help us to feel better, but people with other medical conditions should ask their doctors if decongestants, antihistamines or cough suppressants are acceptable for them. Nasal decongestant sprays are fine for a few days, but after 5 days, they can cause rebound congestion that is harder to treat and may cause addiction to the spray. Smoking increases the chance of a secondary infection. If symptoms are getting progressively worse or are not gone in two weeks, it's time to call the doctor.

With a good diet, reasonable rest, and attention to keeping our hands clean, we might go the entire winter without a single cold.