Sniffles, sneezes and sore throats, part 2: what to do

My last article discussed when to come to the doctor and when or if antibiotics might be warranted when you are faced with the common cold. By in large, these infections will resolve no matter what you do, with time, rest and a little TLC. But there are some remedies — including prescription-based, over the counter and herbal — that have been touted to reduce the symptoms or the duration of the common cold. In today’s article, we are going to look at which remedies have been shown to be helpful based on evidence-supported trials, which may help (and won’t hurt) and those which have been shown not to help and even some that can be downright harmful.

In the past 10 years, the recommendations have changed for children under 6 years old. It is now recommended that you should not administer any over the counter (OTC) cold or flu medications to children who are age 5 and younger. This includes antihistamines, decongestants and cough medications of all kinds. The reason is that cold medications are in the top 20 substances that can lead to overdose and death in children under age 5. In addition, it has been shown in large randomized controlled trials that cough syrups, decongestants and antihistamines are ineffective in young children in reducing symptoms, helping with sleep or reducing the length of time of the illness, so the huge take home point is to avoid all OTC cough and cold medications for children under 6.

What can you do for your usually joyful child who is now coughing heavily, nose is completely plugged and is generally listless and miserable? Liquid Tylenol (acetaminophen) or Ibuprofen at weight-appropriate doses is still best for fever and body aches. Saline nasal drops and bulb suction for babies and saline nasal spray for older children can thin mucus secretions and open-up the nose. For nasal congestion, there is good evidence that cromolyn nasal spray and ipratropium nasal spray (by prescription) can help with congestion, sneezing and rhinorrhea, and is safe in children.

There are several complementary and alternative medications (CAM) that have shown good potential for helping with the common cold. Zinc lozenges have evidence in children over age 6 and adults to reduce the severity and length of virus. It is no longer recommended to use zinc nasal spray and the FDA now has a warning that the spray can cause permanent loss of smell.

The data on vitamin C, echinacea, vitamin D and probiotics have had mixed results. As a rule, supplementing with extra vitamin D, C and probiotics certainly won’t hurt, and some studies have shown mild improvement in symptoms and length of illness.

Mom’s recipe of chicken soup really does help, as well as other warm liquids. Honey and lemon in warm tea or water helps with cough. There is some evidence that Buckwheat honey is superior to regular honey in reducing cough and soothing sore throat. Other studies have shown that vapor rub (Vicks) helps with cough and stuffy nose. It can cause a little localized skin irritation in some children but otherwise is safe to use on all age groups.

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In terms of herbal medications, the new kids on the block are Pelargonium sidoides or South African Geranium extract (Umcka Coldcare) has helped with cold symptoms as well as Andrographis paniculate (Kalmcold). Both of these have good evidence for reducing cold symptoms in children as well as adults.

For adults, an antihistamine/decongestant combination is more effective than an antihistamine or decongestant alone. In terms of complementary and alternative medications, the above recommendations can apply to adults as well as children. If you would like more information, check out https://familydoctor.org for the latest information on treatment of symptoms of upper respiratory infections.

But again, I will emphasize that prevention is still the best medicine. Try to make sure that your children are washing their hands frequently, not drinking from the same cup after family members or friends, and covering their cough.

Although a flu shot will not prevent the common cold, a flu shot is recommended now for everyone over the age of 6 months and will prevent the more serious influenza infection. At Ilanka, flu shots are free. Individuals either qualify for free vaccine, or, if covered under Medicaid, Medicare, Tricare or Prudential, insurance will be billed with no out-of-pocket expense.

Ilanka will also be providing on-site flu shots clinics again this year at the school (for teachers and school employees), forest service, fish and game and at Sunset View, as well as at the Elder’s Mug-Up in October. So get ready to see your friendly, neighborhood nurse at your place of employment or come on in and we will get you protected against flu this season.

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