So, you have a cold. What are the best ways to find relief?
A popular decongestant was pulled from some U.S. shelves this week
There are dozens of cold and cough medicines on the market, and many home remedies claiming to help — like a bowl of chicken soup.
But what actually works?
This week, CVS Health, a large pharmacy chain in the U.S., pulled some oral cold and cough medicines containing a popular decongestant from pharmacy shelves. The move comes after a panel of experts reviewed research and concluded phenylephrine is no better at relieving congestion than a placebo.
Phenylephrine is found in popular cold and sinus remedies like Sudafed and Dayquil.
Products containing the decongestant are still available in Canadian and some U.S. pharmacies. A Health Canada spokesperson says they are reviewing "all available information," including the advice from the U.S. Food and Drug Administration's advisory panel of experts.
One Canadian doctor says he expects it's only a matter of time before oral products with phenylephrine as the main ingredient start disappearing in Canada, too.
"Don't worry about it, because it wasn't doing much at all," Dr. Peter Lin, a family physician in Toronto and CBC Radio's house doctor, told Dr. Brian Goldman, host of The Dose podcast.
Before trying anything, doctors say it's important to remember that the common cold virus just needs to run its course.
"A lot of us just think we can medicate away the symptoms that we have. But sometimes you need to give your body a rest in order to be able to heal properly," said Dr. Melissa Lem, a Vancouver-based family doctor and clinical assistant professor at the University of British Columbia.
She says there's not much harm in trying some of the common remedies to treat a cold, like an herbal supplement. But it's important to know what the research shows about its effectiveness.
But if you're looking to lessen some of the symptoms of a cold, here's what doctors say can help to treat symptoms.
Try to avoid viruses
Lin says making sure you get the latest COVID-19 booster and the flu shot — and for seniors, the RSV vaccine — can all help to protect someone from catching a virus in the first place.
Lem recommends the following measures to try and avoid viruses:
- Sanitize your hands frequently
- Wear a mask
- Ventilate indoor spaces
"If we use the layered approach, we will have an OK time getting across the cold and flu season," Lin said.
Some medications can help
Lin and Lem say they still get patients coming to their office during the cold and flu season asking for antibiotics. But in most cases, patients are dealing with the common cold, and antibiotics won't help their symptoms, according to Lem.
Antibiotics are used to treat bacterial infections and to stop bacteria from multiplying, according to Health Canada.
Lem says the average cold lasts up to 10 days. But when those symptoms hit, Lin says people often turn to over-the-counter products in hopes of feeling better as soon as possible.
He adds that for most adults, over-the-counter cold and cough medicine won't cause harm if taken correctly, but they don't necessarily always help, either. He points to the recent decision from the FDA panel of experts about phenylephrine.
"That's why they have to do trials, to show is there a benefit or no benefit," he said.
However, some over-the-counter cold and cough medicine may help symptoms, Lin says. Medicine containing cough suppressants can help address a dry cough, and products containing acetaminophen or ibuprofen can help lower fevers.
Cold medicine with an anti-inflammatory can take away any minor pain, he adds. But Lin emphasizes it's hard to know definitively if people would have gotten better on their own or if the medicine helped.
He also reminds parents to not use cold and cough medicine to treat symptoms in kids.
"The Canadian Pediatric Society was pretty clear that we should be avoiding these things."
Home remedies
Chicken soup is a common suggestion to help those get better — and there is some research to show that it may actually help.
A peer-reviewed study published in 2000 found that chicken soup — when it includes vegetables — "may contain a number of substances with beneficial medicinal activity."
The study's authors from the University of Nebraska Medical Center also noted that a "mild anti-inflammatory effect" could be a reason why chicken soup helps address upper respiratory tract infections.
The steam from the hot liquid "may open up congested noses and throats" — but it will not cure your cold, say doctors with New York City's Mount Sinai health system.
"I think soups, fluids, that kind of thing are fantastic and they are a nice alternative to spending money on drugstore remedies that may not have the best evidence," Lem said.
She's also a fan of honey in a warm liquid for anyone over a year old to help soothe a sore throat. Gargling with warm water and salt can also help, Lin says.
Lin and Lem add that nasal rinses can help get rid of backup in the nasal sinuses. "I'm a big fan of neti pots and sinus irrigation because sometimes you just can't get the gunk out without flushing it with fluid," Lem said.
She adds that it's important when using a nasal rinse to boil your water or use saline to avoid getting a rare fungal infection.
Lin also recommends leaning over hot water in a cup or using a humidifier to keep the throat moist. He says when someone has a stuffy nose, they'll breathe through their mouth, which can dry out the throat.
"That's why the humidifier is helpful."
What about vitamins?
Vitamins and herbal remedies, such as vitamin C and zinc, are often suggested to help get over a cold or avoid one altogether.
Lem says the evidence on their effectiveness "is really conflicting." Research into zinc for treating the common cold has shown mixed results, according to one meta analysis.
Authors of a meta-analysis on vitamin C found that taking the vitamin every day over a longer period of time didn't prevent colds or show consistent benefits if you take it after you've already developed symptoms. However they did find that it slightly shortened the amount of time people were sick by about 10 per cent.
While Lem says taking these vitamins won't cause harm if taken appropriately, "I would say the main drawback would be spending your money on things that don't work."
Lem does caution that when taken in higher-than-recommended daily amounts, vitamin C can be harmful and can increase the risk of kidney stones.
Is it a cold or something else?
Lem says the symptoms of COVID-19 and respiratory syncytial virus (RSV) can vary "so much depending on your age, underlying conditions and immune response." She says that can make it really difficult to tell if you have symptoms caused by either of these or another virus.
Early signs of a cold can include:
- Sore throat
- Red eyes
- Runny nose
Other symptoms could be headache, stuffy nose, watering eyes, hacking cough, chills and muscle aches, according to the Canadian Centre for Occupational Health and Safety.
RSV can cause similar symptoms to a cold, Lem says, but in some people it can cause wheezing or shortness of breath.
Health experts say people who feel sick should take a COVID-19 test to see if they test positive.
If you're still unsure of what virus you may have, Alberta Health Services has a list of the most frequent symptoms for common viruses. If you are getting sicker, have new or worse trouble breathing, have a new or high fever or a new rash, HealthLink BC recommends people seek immediate medical help.
When to seek help
It's important to know when cold symptoms become serious, Lem says.
She recommends a person see a doctor or visits their local emergency room as soon as possible if they're experiencing:
- Shortness of breath
- Dehydration
- Severe lethargy
- Trouble waking up
- Confusion
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