Our Definitive Guide to Cold and Flu

Share This:

comments

So you’ve come down with a nasty bug that’s been making the rounds. The good news? You probably don’t need to go into the doctor’s office. The bad news? You still feel awful.

If you think you have an upper respiratory infection (URI) — which includes the common cold, sinus infections, chest colds (bronchitis), and the flu (caused by the influenza virus) — there’s a lot you can do at home to feel better faster. You’ll have infections like these many times throughout your life, so learning what helps the most (and the least) is worth your time.

What to Expect with an Upper Respiratory Infection

More than 90 percent of upper respiratory infections are caused by viruses. These infections create different symptoms at each stage. Most colds and flus go away in about a week, although some symptoms (like coughing) can take two or three weeks to go away completely.

Helen (Eleni) Xenos, a One Medical doctor in Chicago, describes the typical progression of the common cold:

  • Day 1: Fatigue, headache, sore or scratchy throat.
  • Day 2: Sore throat worsens, low fever, mild nasal congestion.
  • Day 3: Congestion worsens, sinus and ear pressure become very uncomfortable. It may be difficult to sleep.
  • Day 4: Mucus may turn yellow or green (this is normal). Sore throat improves, but coughing begins.
  • Days 5-7: Energy and congestion improve.
  • 1 week+: Cough usually tapers off after a week, but can take up to 3 weeks to fully resolve.

If your symptoms are much worse than these, such as coughing so hard you throw up, or coughing up bloody mucus, or if you have a fever over 102°F, you might have something more serious going on, like pertussis (whooping cough) or pneumonia.

Read more about when to call your doctor.

If a cold drags on, it can turn into a sinus infection that causes pain around the eyes, nose and/or sinus headaches. Chest colds (bronchitis) cause chest congestion and a hacking cough that drag on for a few weeks. The flu comes with a prominent fever and body aches that usually last a couple of days.

What Helps You Feel Better

Treating the symptoms and supporting your immune system is the best first course of action to get you feeling better faster. Everyone’s experience of a cold is slightly different from the next person’s, and there are so many options in the cold and flu aisle at the drugstore. How do you know which symptom remedies are right for you?

The key is to find what works best for you personally, for your symptoms, whether it’s over-the-counter cold and flu remedies or soothing herbal tea. If, for example, you experience bad sinus pressure when you have an upper respiratory infection, a decongestant like pseudoephedrine or a nasal sinus rinse might be good to have on hand. If it’s coughing that usually makes your life miserable during a head or chest cold, you could try inhaling hot steam from the sink or shower a few times a day to help break things up.

Read about remedies for sore throat, cough, congestion, and more.

Your immune system’s job is to eradicate viral and bacterial infections from your body. It’s very effective as long as you provide it with the proper support. The best way to do that is to rest. Being stressed out or not getting enough sleep releases hormones that suppress your immune system.

In addition, taking one to two grams a day of vitamin C during cold season can lessen the severity and duration of your colds, although it won’t prevent you from catching them in the first place. Taking zinc lozenges during a cold also supports your immune system, but you have to take so many of them (one lozenge every two hours all day long for up to a week) that it isn’t practical for most people. If you do take zinc, take the lozenges on a full stomach to avoid nausea.

Why Antibiotics Won’t Help — and Might Hurt

Almost all URIs are caused by viruses, and at present we don’t have medications that work against them. (One notable exception: There are antiviral medications for the flu. If you start them in the first 24 to 48 hours of symptoms, it might reduce the duration of your illness by about a day.)

As for the small percentage of upper respiratory infections caused by bacteria, most go away on their own — and often just as quickly — even if you don’t take antibiotics. So if there’s a chance antibiotics can help, what’s the harm?

There are many reasons to be conscientious about taking antibiotics (such as breeding resistant superbugs, or making your health care cost more), but there’s another that’s of immediate concern: diarrhea. Antibiotics can wreak havoc in your intestines and upset the normal balance of bacteria — including the bacteria that help you digest food, which can lead to abdominal pain, bloating, gas, and alternating diarrhea and constipation. And taking multiple courses of antibiotics puts you at risk of potentially long-lasting effects on your gut.

Like everything health-related, the decision about whether to take antibiotics for a bacterial infection comes down to weighing the risks and benefits. Your provider will be happy to discuss the decision with you in detail.

Keeping Your Infection to Yourself

Colds and flus are contagious from the time you get them (even before you have symptoms) until around three to five days after your symptoms start. They’re usually not contagious after a week, even if you’re still coughing or congested.

The best way to avoid passing on a URI (or catching one in the first place) is to wash your hands frequently and cover your mouth when you cough or sneeze. It’s also best to take at least a couple of days off work or school while you’re most contagious.

When to Call Your Provider

Occasionally, viral infections can set the stage for more complicated bacterial infections. If you experience any of the following, call your health care provider:

  • High fever (over 102°F)
  • Shortness of breath or wheezing
  • Coughing up bloody mucus
  • Coughing so hard that you throw up
  • Feeling worse after 5 to 7 days of symptoms, especially if you have worsening headache, congestion, or sinus pain
  • If you don’t start to feel better after 10 days of symptoms

Remedies for Cold and Flu Symptoms

Cough and Chest Congestion

  • Antihistamine/decongestant combo (e.g., brompheniramine/pseudoephedrine)
  • Cough suppressant: Dextromethorphan (Delsym)
  • Expectorant (mucus thinner): Guaifenesin (Mucinex, Robitussin)
  • Gentle hot tea (chamomile, licorice root, peppermint, thyme) with or without honey or lemon juice; Traditional Medicinals “Throat Coat” or “Breathe Easy” teas
  • Honey (1 tablespoon of raw honey 1 to 3 times daily). Note: honey is not safe for infants under 12 months.
  • Steam inhalation: Boil 1 inch of water in a pot, remove from the stove, add 5 drops of eucalyptus oil if desired, and inhale slowly for a few minutes twice daily with a towel over your head.

Sore Throat

  • Pain relievers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol). It’s OK to use the maximum dose for 1 or 2 days while your symptoms are at their worst. Follow directions on the packaging.
  • Cooling or numbing medicines: Chloraseptic spray, lozenges, gargle echinacea tincture in water
  • Saltwater gargles throughout the day: 1 tablespoon of salt in a glass of warm water
  • Warm tea with honey, Traditional Medicinals “throat coat” or “breathe easy” teas, “sore throat tea
  • Chicken soup or other clear broth

Nasal Congestion and Sinus Pressure

  • Oral decongestants: Pseudoephedrine (Sudafed) is the most effective choice, but you have to ask for it at the pharmacist counter and show ID. Avoid decongestants if you have poorly controlled high blood pressure.
  • Nasal spray decongestant: Oxymetazoline (Afrin). Don’t use this for more than 3 days, or your congestion will come back even worse.
  • Pain relievers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol). It’s okay to use the maximum dose for 1 or 2 days while your symptoms are at their worst. Follow directions on the packaging.
  • Nasal steroid spray: Flonase, Nasonex, Nasacort
  • Nasal irrigation twice daily with warm salt water (neti pot, NeilMed Sinus Rinse, Nasaline)
  • Steam inhalation: Boil 1 inch of water in a pot, remove from the stove, add 5 drops of eucalyptus oil if desired, and inhale slowly for a few minutes twice daily with a towel over your head.
  • Moist heat compresses over your sinuses for several minutes a few times a day
  • Herbs: Goldenseal, Bi Yan Pian, Sinupret

Runny Nose

  • Oral decongestants: Pseudoephedrine (Sudafed) is the most effective choice, but you have to ask for it at the pharmacist counter and show ID. If you have high blood pressure, avoid  pseudoephedrine or take care to monitor your blood pressure while you take it.
  • Nasal spray decongestant: Oxymetazoline (Afrin) can be used for a short time. Don’t use this for more than 3 days, or your congestion will come back even worse.
  • Antihistamines: Allegra, Zyrtec, Claritin, Benadryl (all available in generic formulas) are all effective. Benadryl (diphenhydramine) will make you sleepy; the others won’t. Antihistamines tend to work better for runny noses from allergies, but they can help a bit, and they come in some of the combination cold/flu products.
  • Saline nasal spray
  • Steam inhalation: Boil 1 inch of water in a pot, remove from the stove, add 5 drops of eucalyptus oil if desired, and inhale slowly for a few minutes twice daily with a towel over your head.

Fever

  • Fever reducers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol)
  • Drink lots of water
  • Take a warm or cool shower
  • Warm tea (chamomile, peppermint)

Headache and Body Aches

  • Pain relievers: Ibuprofen or naproxen (Advil, Motrin, Aleve), acetaminophen (Tylenol). It’s okay to use the maximum dose for 1 or 2 days while your symptoms are at their worst. Follow directions on the packaging.
  • Moist heat compresses or cold packs
  • Rub on Tiger Balm
  • Take a nap
  • Take a warm bath with Epsom salts

Share This:

The One Medical blog is published by One Medical, an innovative primary care practice with offices in Boston, Chicago, Los Angeles, New York, Phoenix, the San Francisco Bay Area, Seattle, and Washington, DC.

Comments