You don’t have to look at a calendar to know that it’s cold season.
Just listen to the hacking coughs, sneezes and the hoarse, husky voices that have dropped an octave in recent weeks as upper-respiratory infections take a toll in offices, schools and homes.
The common cold is the most frequent illness known to man. But for sufferers, it can feel uncommonly bad to have blocked nasal passages, watery eyes and head-snapping sneezes.
And in an era of heart transplants, in vitro fertilization and human genome mapping, there’s still no treatment for this malady, which accounts for approximately 500 million infections annually in the United States.
And the costs? An estimated $40 billion each year, according to a 2003 economic analysis by the University of Michigan for both direct and indirect costs for medical treatment and lost work time. As the researchers noted, that’s a higher economic burden than some more-serious conditions impose.
Colds are the annoying ailment that won’t kill you but may make you want to cut off your nose to breathe again. They often make adults feel like sniffly children, yearning for their mother’s comfort.
No wonder we shell out an estimated $250 million annually for “remedies” that don’t actually kill the viruses that cause colds and often don’t relieve symptoms any better than a placebo.
This eagerness to be rid of cold symptoms can sometimes exact a human toll: In January, the federal Centers for Disease Control and Prevention linked infant deaths to overuse of cold remedies and advised parents and caregivers not to give children 2 and younger cold medicines without a doctor’s approval.
Colds remain wrapped in lore that seems to leave people as foggy as if they had taken a swig of antihistamines. “Feed a cold, starve a fever” is the age-old advice (with no basis in science). For more on remedies, see accompanying story.
Many still mistakenly think that antibiotics, which kill bacteria but not viruses, can cure colds. And they are often annoyed when their doctors won’t prescribe them.
Cold sufferers complain that their flu shots didn’t protect them against the common cold. (The shots are not intended for that purpose. Influenza is caused by different viruses.) Nor can most people tell the difference between the flu and a cold.
Both cause respiratory symptoms, but influenza is a far more severe infection that comes with a fever, headache and muscle aches as well as a gut-wrenching cough. And unlike the common cold, influenza can be treated with antiviral medicines, provided they are started shortly after symptoms appear.
Remedies: What works, what doesn’t
Here’s a guide to help you make sense of the huge array of treatments available when a cold sidelines you or your family.-The Washington Post
Proven effective
Topical decongestants: Afrin, Neo-Synephrine, Vicks Sinex – all oxymetazoline
Verdict: “Nose shrinkers” are what doctors call these sprays because they reduce swollen nasal passages. “Don’t use them for more than three to four days because you become dependent on them,” says J. Owen Hendley, professor of pediatrics at the University of Virginia. If you do become dependent, expect to get a stuffy nose equal to or worse than the original cold symptoms when you quit.
Analgesics: Advil (ibuprofen), aspirin (acetylsalicylic acid), Tylenol (acetaminophen)
Verdict: They can “make you feel a little better even if you don’t have a fever,” Hendley says, by relieving headaches and the discomfort that comes with a cold.
Antihistamines (Part 1): Benadryl (diphenhydramine), Clistin (carbinoxamine), Tavist (clemastine), Chlor-Trimeton (chlorpheniramine), Dimetane (brompheniramine).
Verdict: These drugs dry out secretions, but they make you very sleepy, experts say. So if you use them, take them before going to bed. And stick with these older, original antihistamines. Newer antihistamines – Claritin and Zyrtec, for example – have no proven effectiveness against cold-related symptoms, according to the American College of Chest Physicians.
Antihistamines (Part 2): Andehist;
Bromfed; Dimetapp Cold and Allergy Elixir; Lodrane – all brompheniramine and timed-release pseudoephedrine
Verdict: The ACCP says there’s strong evidence that this combination has benefit in treating coughs associated with the common cold.
Oral decongestants: Dimetapp; Drixoral; PediaRelief; Sudafed; Triaminic – all pseudophedrine.
Verdict: These products may help you breathe better. Effects are very modest. If you have high blood pressure or heart problems, check with your doctor before using.
Inconclusive
Mucus thinners and expectorants: Mucinex (guaifenesin)
Verdict: Used for a couple of decades, this foul-tasting liquid is a common ingredient in nonprescription cough syrups. More recently, it has been formulated into a pill, making it easier to swallow. There’s little evidence that it can thin mucus, says Hendley, but “it’s worthwhile trying.”
Saline sprays: Breathe Right Moisturizing Saline Spray; Simply Saline – all purified water and sodium chloride
Verdict: There are no definitive studies of these products’ effectiveness, but rinsing the nose with saline helps wash away mucus, which could help relieve blocked nasal passages. “It’s completely safe,” says Ronal Turner, professor of pediatrics at the University of Virginia School of Medicine. “So if it makes you feel better, fine.”
Ineffective
Combination drugs: Dayquil; Nyquil; Theraflu – all various ingredients including: acetaminophen, chlorpheniramine, dextromethorphan, doxylamine, diphenhydramine, guaifenesin
Verdict: The ACCP says to skip the combination medicines – advice echoed by other experts to prevent overdosing and getting ingredients you don’t need. “They promise to do everything,” notes Turner, “but you can get into some trouble.” Better, he says, to find single-ingredient products.
Cough suppressants: Robitussin DM; Delsym; Vicks 44E; Buckley’s – all dextromethorphan
Verdict: There’s so little evidence for effectiveness in treating cold-related coughs that the ACCP strongly discourages the use of these popular medications, especially for children 14 years and younger.
Echinacea
Verdict: This popular herb is widely used for both treatment and prevention of colds. But the studies examining its effects have often been flawed. In 2005, the National Center for Complementary and Alternative Medicine found that it did little to prevent or shorten colds. “We really don’t see any clinically signficant effects,” says Turner. Experts say save your money.
Vitamin C (ascorbic acid)
Verdict: A 2004 Cochrane Review of 29 studies involving more than 11,000 people found no evidence to justify giving megadoses of vitamin C to prevent colds in the general population. Taking up to 4 grams of vitamin C at the start of a cold also did not show any benefits.
Antiviral tissues: Kleenex (virucidals)
Verdict: Purportedly kills the two leading cold viruses, two types of influenza viruses and respiratory syncitial virus within 15 minutes of their being in the tissue. But there’s no evidence that killing viruses in tissues helps to reduce, treat or prevent colds. “It only takes one virus particle to infect you,” Hendley notes.
Zinc lozenges: Cold-Eze (zinc)
Verdict: “There have been an awful lot of studies done on zinc,” but results have been inconsistent and so modest that they are not clinically significant, Turner says.
Homeopathic zinc solutions: Zicam Cold Remedy (minuscule amounts of zinc)
Verdict: In 2006, the maker of Zicam agreed to pay $12 million to settle 340 lawsuits brought by consumers who claimed the product’s nasal gel damaged or destroyed their sense of smell. The company said the agreement was not an admission of liability but an effort to end most of the litigation over the homeopathic remedy.
