We are often told that the common cold is something that must simply be endured. “Just wait it out” is what friends and family will tell you. Doctors will recommend conservative therapies to treat cold symptoms, such as rest and hydration. While this is a good place to start, many people are left to their own devices on how to get through the day. As a result, everyone has their own “cold remedies” along with numerous books and websites devoted to the topic. Many are selling something but few have any evidence of their effectiveness. Lately, medical literature has been focusing on research that reviews “at-home” cold remedies and provides real scientific evidence of their benefit (or lack thereof). Below we review the good and the bad when it comes to getting over that pesky cold.
The Good
1) Nasal decongestants
Oral medications such as pseudoephedrine or phenylephrine (i.e. Sudafed TM) have been shown to reduce nasal swelling in the short term and improve airflow. A Cochrane Review, which collects and reviews the best available medical evidence, revealed a benefit when compared to placebo for topical and oral nasal decongestants.
2) Mucolytics
This is a class of medications that includes Guafenisin (i.e. Mucinex TM) and works to thin secretions and helps the body get rid of mucus. These drugs have been shown by some studies to be effective in reducing symptoms, including cough. It is recommended for symptomatic relief of upper airway congestion caused by thick mucus.
3) Nasal steroid sprays
These medications such as fluticasone and mometasone (i.e. Flonase TM or Nasonex TM) have been shown to be effective in reducing inflammation of nasal mucosa and improving symptoms. Evidence for their use in generalized upper respiratory viral syndrome is mixed, but they have shown to decrease symptoms and swelling of the nasal mucosa especially in viral rhinosinusitis.
The Bad
1) Antibiotics
Logically, it makes sense that antibiotics would not help the common cold given that it is caused by a virus. Antibiotics are used to treat bacterial infections and thus should not be used. A recent Cochrane review showed no difference between antibiotics and a placebo pill in changing the symptoms or duration of upper respiratory infections. Moreover, inappropriate antibiotic use leads to the development of drug resistant bacteria which are a cause of severe and life-threatening infections.
2) Oral prednisone or other oral steroids
Steroids are used to treat many things and can improve certain long term breathing issues. Unfortunately, their use to treat the common cold is to be avoided. Studies have shown they have no impact on symptoms or disease course when compared to placebo. They also have several short term side effects including increasing blood sugars, irritability and psychotic reactions. Recent studies have also reported possible increased risk of blood clots and sepsis. There is even a very rare side effect of breakdown in the bone of the hip that has been documented numerous times.
3) Long-term use of short acting nasal decongestants
Short acting nasal sprays such as oxymetazoline or phenylephrine (i.e. Afrin TM or Neo-Synephrin TM) have shown benefit in improving symptoms short term, but avoid using these beyond the recommended three days. A condition where the nasal tissues become addicted to the medicine is possible and results in “rebound congestion.” Long term use of topical sprays can actually damage the nasal tissues and result in worsening nasal congestion.
Need help?
It can be difficult to figure out what is a cold versus something else like the flu or a bacterial sinus infection. SmartDocMD solves this problem with our proprietary A.I. derived health care platform. Simply click here, and take our online patient interview. You will tell us about your cold symptoms along with other pertinent details that will help us figure out what is wrong. The A.I. system is able to discern the difference between a common cold, flu, or sinus infection and will direct you to getting help in the most efficient way possible. This is all provided to you for free. If you want further diagnosis and treatment by a doctor, we can help with that too. For more information on the differences between a cold and sinus infection, check out this recent blog post.