Dear Patient, If You Have to Treat a Cold, Know This:

Americans hate being sick. There are too many cold medicines out there to remember by name. But there are really only a handful of different drug classes to consider.

In order to choose any one of them, be clear about what you want to accomplish. It’s actually very simple.

1) Make my cold go away faster: Zink, echinacea, visualization/manifesting, sauna, prayer (may be mostly placebo effect ).

2) Stop my nose from running (including post nasal drip): You’ll want the crud to leave your body as soon as possible, so turning off the drain pipe that your nose has become can increase the risk of stagnant mucous in your sinuses becoming secondarily infected. But intermittent use of a decongestant (pills like pseudoephedrine, diphenhydramine or nasal sprays like Afrin) can help you look healthier than you are for an important Zoom meeting.

3) Make my nose run and relieve the pressure in my sinuses: Lots of fluids, room humidifier/vaporizer, shower steam, nasal steroid spray, guaifenesin (Mucinex) or even nasal lavage (Nettipot), but I personally have reservations about that one.

4) Stop my dry cough: Cough suppressants like dextrometorphan or codeine, humidifier/vaporizer, asthma inhaler if you have one.

5) Help me raise that thick, sticky phlegm: Fluids, humidifier/vaporizer, guaifenesin (Mucinex). Don’t try to suppress a productive cough. Just like with a runny nose, get the crud out of your body!

6) Headache/body aches/fever: Acetaminophen (Tylenol), ibuprofen, naproxen. But be aware that a low grade fever actually helps us clear cold viruses faster.

7) Knowing when to get medical help: Worsening symptoms, a second wave of fever; shortness of breath, wheezing, chest pain, severe sinus pain, clouding of the mind…the list goes on. Most people have had colds before. Is this one just like the others or the worst ever in some way?

8) Lastly: We used to think green phlegm meant bacterial rather than viral infection. But we now know viruses often cause up to three weeks of wet cough or nasal discharge. And be aware that we have antivirals for influenza and Covid, but not for the common cold viruses. (Sadly, we can send people to the moon, but we can’t cure the common cold.)

9 Responses to “Dear Patient, If You Have to Treat a Cold, Know This:”

  1. 2 Alessandra Chaves February 5, 2023 at 9:36 am

    I don’t know if this is true for everyone bit I have found that laying in bed too much when I have a cold makes the symptoms worse. I try to at least to sit during the day and move about the house, it helps with fluids not to get too stagnated.

  2. 3 foggysunset February 5, 2023 at 11:54 am

    Yes! to everything you said. Also: quality sleep is key to getting over a cold quickly, which is where an antihistamine for a night or two can pull double duty, drying you up & knocking you out.

  3. 4 Courtenay A Wells February 13, 2023 at 12:41 pm

    For #8, are you saying that yellow or green mucus can occur with viral infections, too? Do you have references? I checked NLM/ PubMed and did not find anything about mucus color and sinusitis. (Though I did get distracted and learned a lot about sinusitis research and results!) I am very interested because this is one of those symptoms patients ALWAYS use to leverage antibiotics. Thanks.

  4. 7 James Lynch APRN February 18, 2023 at 10:06 am

    We *used* to be able to send people to the moon. Perhaps it is that lack of TANG that is keeping us from curing the common cold? 😏

  5. 8 jensi ahir February 18, 2023 at 2:30 pm

    The medications are good but I personally feel that if the common cold is not that bad then there’s no need for medicines and the person requires rest as well as in India people drink turmeric milk which helps with the cold and cough.

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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