Common Cold

The common cold is an upper respiratory infection caused by a virus. In the United States, adults have between 3 and 6 colds a year, and children have as many as 8 to 10.

Signs and Symptoms

• Sneezing and runny nose from nasal congestion
• Sore throat
• Cough
• Hoarseness
• Fever (102 F or lower)
• Headache

Causes

More than 200 different types of viruses cause colds. You can get a cold by touching a person with a cold (for example, by shaking hands with a person with a cold) and then touching your nose or eyes. Colds are also transmitted through the air. Exposure to cold outdoor air and fatigue do not make you more likely to get a cold, although psychological stress may.

Risk Factors

People more likely to get colds include:

• Children and those over 65
• Children who have parents who smoke
• Children who attend day care
• Smokers and those exposed to second hand smoke
• Those exposed to industrial smoke, toxic fumes, or other air pollutants
• People with immune system disorders, like HIV, AIDS, or cancer, or compromised immune function, like those taking steroids for a long time
• People under a fair amount of stress

In addition, colds are more likely during the winter months, but not because of exposure to cold air. This is likely because of the increased contact with others who are sick due to more time spent indoors.

Diagnosis

Most people recognize that they have a cold and treat it themselves without seeing a doctor. If you do see your doctor, the diagnosis will be made based on your symptoms and exam. Tests are not necessary. Colds generally go away on their own after about 7 to 10 days. If you have an underlying lung condition, however, like asthma or emphysema, you should let your doctor know right away when you get a cold.

Preventive Care

Although anyone and everyone can get a cold, there are a few things that you can do that may help improve your immune system and make you less susceptible to getting colds:

• Exercise regularly
• Eat a proper diet rich in fruits and vegetables and low in fat
• Get sufficient rest at all times
• Minimize your stress and your reaction to stress. Consider yoga, tai chi, or other forms of relaxation on an ongoing basis.
• Wash your hands frequently, especially after coming into contact with someone who has a cold.

Treatment Approach

With a cold, the goal of treatment is to improve your symptoms as quickly as possible. With that said, even if you do nothing, they should go away within 10 days. Antibiotics (which are for bacterial infections) and antihistamines (which are for allergies) cannot help cure your cold. There are medications, herbs, supplements, and homeopathic remedies that may make you feel better while you have a cold.

Lifestyle

• Drink a lot of water to help loosen secretions.
• Rest to restore your energy and avoid complications from the cold like bronchitis or pneumonia.
• Eat a diet rich in fresh fruits and vegetables. These foods provide lots of antioxidants (substances that may help boost your immune system), especially vitamins A and C.

Medications

• Decongestants: may help prevent sinus and ear infections. Do not take if you have a heart condition or high blood pressure.
• Nasal sprays: Use only for the recommended amount of time (usually three to five days). You can become reliant on them, and they can make your symptoms worse if used for too long.
• Aspirin and other pain relievers (like acetominophen or ibuprofen) can be used for fever or aches. Take only if necessary. Do not give aspirin to children under 18 because of the risk of Reye's syndrome (a condition of that leads to brain and liver damage).

Nutrition and Dietary Supplements

Because supplements may have side effects or interact with medications, they should be taken only under the supervision of a knowledgeable healthcare provider. Be sure to talk to your physician about any supplements you are taking or considering taking.

Lactobacillus acidophilus
Lactobacillus is a probiotic, which means that it is an organism that actually helps fight, rather than cause, infection. Studies have been quite promising in terms of the ability of lactobacillus supplements or lactobacillus in certain milk and yogurt products to help reduce the likelihood of getting a respiratory infection, like a cold, even in children. Talk to your doctor or pediatrician about possibly trying lactobacillus.

Vitamin C
Despite the popular belief that vitamin C can cure the common cold, the scientific evidence supporting this idea is limited. There have been a few studies suggesting that taking large doses of vitamin C supplements at the onset of cold or flu symptoms, or just after exposure to someone with one of these ailments, can shorten the duration of your cold or ward it off altogether. However, the majority of studies, when looked at collectively, lead researchers to conclude that vitamin C does not prevent or treat the common cold.

If that is the case, however, why do so many stand strongly by the belief that it works? Some experts suggest that vitamin C may only be useful in case of a cold if you have low levels of this nutrient to begin with. Another possibility is that the likelihood of success may be very individual – some improve, while others do not.

If you are amongst the 67% of people who believe that vitamin C is helpful for your colds, there may be power in your conviction. In other words, your experience is important and if vitamin C has worked for you in the past, it is likely to work for you again. Talk to your doctor about any pros and cons with regards to using vitamin C during cold and flu season.

Zinc
Zinc plays an important role in the immune system, which may explain why it seems to be helpful in protecting against infections such as colds. People who are zinc deficient tend to be more susceptible to a variety of infections. Zinc supplementation enhances immune system activity and protects against a range of infections including colds and upper respiratory infections (like bronchitis). Several important studies, but not all, have revealed that zinc lozenges may reduce the intensity of the symptoms associated with a cold, particularly cough, and the length of time that a cold lingers. Similarly, nasal zinc gel seems to shorten the duration of a cold. However, zinc nasal spray does not appear to have the same benefit.

Herbs

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care and only under the supervision of a practitioner knowledgeable in the field of herbal medicine. Be sure to also talk to your physician about any herbs that you are taking or considering taking.

Astragalus (Astragalus membranaceus)
Astragalus has been used traditionally to enhance the immune system, including possibly preventing and treating colds and flus. Some practitioners claim that this herb shortens the duration of colds, although science has not proven this. Astragalus should not be used if you are taking certain medications for HIV or other viruses.

Celery seed (Apium graveolens)
Celery seed is one of the lesser-known herbs in Western herbal medicine. In other parts of the world, however, it has been used for thousands of years for a variety of reasons including by Ayurvedic physicians (practitioners who practice Ayurvedic medicine, an ancient Indian from of health care) to treat colds and flus.

Echinacea (Echinacea purpurea)
One of the most popular herbs in America today is the Native American medicinal plant known as Echinacea (also called coneflower). Echinacea is primarily used to shorten the duration of the common cold and the flu and to alleviate the symptoms associated with them, such as sore throat (pharyngitis), cough, and fever. Although the data in the medical literature goes back and forth somewhat, certain scientific studies do support that Echinacea will have this effect if you start taking it soon after your cold symptoms begin. Science does not support the use of Echinacea before you have a cold or flu, however. In other words, to date, research suggests that this herb does not help prevent colds and flus (despite the popularity of this use), but it does support that it helps treat them if taken early enough.

Eucalyptus (Eucalyptus globulus)
Eucalyptus is commonly used in remedies to treat the common cold and its symptoms, particularly cough. It can be found in many lozenges, cough syrups, and vapor baths throughout the United States and Europe. Herbalists recommend the use of fresh leaves in teas and gargles to soothe sore throats. Ointments containing eucalyptus leaves are also applied to the nose and chest to relieve congestion. Eucalyptus oil helps loosen phlegm, so many herbal practitioners recommend inhaling eucalyptus vapors to help treat coughs and the flu.

Garlic (Allium sativum)
Garlic has been used as both food and medicine in many cultures for thousands of years, dating as far back as the time that the Egyptian pyramids were built. Today, garlic is used for many health related purposes including to try to reduce symptoms from a cold, such as cough. At least one well-designed scientific study supports the use of garlic for preventing and treating colds. The people who participated in this research trial received either garlic supplements or placebo for 12 weeks during "cold season" (between the months of November and February). Those who received the garlic had significantly fewer colds than those who received placebo. Plus, when faced with a cold, the symptoms lasted a much shorter time in those receiving garlic compared to those receiving placebo.

German Chamomile (Matricaria recutita)
Chamomile has been used to treat a variety of symptoms related to colds including chest and nasal congestion as well as sore throats.

Goldenrod (Solidago virgaurea)
Goldenrod is used by herbalists for a wide range of health problems including colds and flus.

Goldenseal (Hydrastis canadensis)
Goldenseal is often combined with echinacea in preparations designed to strengthen the immune system. Many professional herbalists recommend goldenseal in herbal remedies for hay fever (also called allergic rhinitis), colds, and flu. Goldenseal has not been thoroughly investigated in scientific studies, however.

Licorice (Glycyrrhiza glabra)
Licorice root has been used in both Eastern and Western medicine to treat a variety of illnesses including the common cold, cough, and sore throat. It is important to note, however, that people who regularly consume large amounts of licorice (more than 20 g/day) may inadvertently raise blood levels of the hormone aldosterone, which can cause serious side effects including headache, high blood pressure, and heart problems. Use of any licorice product is not recommended for longer than four to six weeks. People with high blood pressure, obesity, diabetes, or kidney, heart, or liver conditions should not use this herb nor should you use it if you are pregnant, breastfeeding, have decreased libido or other sexual dysfunction.

Linden (Tilia spp.)
Linden is used in many cough and cold remedies. Active ingredients in linden help promote sweating, which may be helpful if you have a fever.

Marshmallow (Althea officinalis)
Although science hasn't tested this traditional use, professional herbalists may recommend marshmallow for cold, cough, and sore throat.

Peppermint (Mentha x piperita)
Peppermint is widely used for cold symptoms. This is because peppermint and its main active agent, menthol, are effective decongestants. Menthol also thins mucus and, therefore, works as a good expectorant, meaning that it helps loosen and break up coughs with phlegm. It is soothing and calming for sore throats (pharyngitis) and dry coughs as well.

Siberian ginseng (Eleutherococcus senticosus/Acanthopanax senticosus)
Siberian ginseng may help the body deal with physically and mentally stressful exposures such as viruses that cause the common cold. By strengthening your system, it may, in theory, also help prevent illness. In fact, a 4-week study of healthy people found that those who received Siberian ginseng extract had improvements in a number of measures that reflect the functioning of the immune system. Also, in laboratory studies, an extract of Siberian ginseng slowed the replication of certain viruses, including influenza A (which causes the flu) as well as human rhinovirus and respiratory syncytial virus (both of which cause symptoms of the common cold). It had no effect, however, in test tubes on adenovirus (another cause of the common cold and other respiratory infections). These findings don't guarantee that you will be less likely to develop colds and flus if you take Siberian ginseng, but they do suggest that that is possible. More research to test this idea would be interesting.

Wild yam (Dioscorea villosa)
Although not studied scientifically, wild yam has been used traditionally in the Amazon and in central America to treat a variety of conditions including fever and colds.

Yarrow (Achillea millefolium)
There has been very little research on yarrow's medicinal properties. Clinical experience, however, supports the use of yarrow for colds and fever. It seems to bring down body temperature by promoting perspiration.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of the common cold based on their knowledge and experience. It is important to note, however, that cold symptoms are viewed in homeopathic medicine as the body's natural way of eliminating a virus. For this reason, homeopathic doctors may recommend no treatment at all in the case of a cold. If a remedy is selected, the intention is generally to boost the body's natural immune response. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

• Aconitum — for symptoms including fever, anxiety, and thirst, that start abruptly, often following exposure to a cold climate or draft; most effective during the first 24 hours of the illness
• Allium cepa — for colds with clear watery discharge that burns and/or irritates the nostrils; red, burning eyes; and symptoms that worsen in warm rooms and in the evening
• Arsenicum album — for colds with watery, burning discharge from the eyes and nose, throbbing headache, nasal congestion that is not relieved by sneezing, dry mouth, sensitivity to cold, and a thirst for small sips of fluid
• Belladonna — for colds with sudden onset of high fever, flushed face, watery nasal discharge, sore throat, throbbing headache, earache, and cough that tends to worsen at night; this remedy is most appropriate for individuals who are often agitated and sometimes delirious; these symptoms may cause children to cry
• Bryonia — for chest colds with spastic cough that produces only a small amount of mucus and sharp chest pain that worsens with inhalation and while coughing; a dull headache, little to no nasal discharge, and sneezing may also be present
• Euphrasia — for colds with excessive, non-irritating watery discharge that tends to worsen in the morning and when the person is lying down
• Ferrum phosphoricum — for the early stages of a cold with slight fever, flushed face (redness may be patchy), and fatigue; may also be used in children with nosebleeds or bloody nasal discharge
• Gelsemium — for colds that have gradual onset with watery nasal discharge that causes irritation, a feeling of fullness or tickling in the nose and/or the back of the throat, muscle aches, fatigue, lack of energy, lightheadedness or spaciness, and a headache with pain in the back of the head
• Hepar sulphuricum — for late stages of a cold when nasal discharge turns from watery to thick, yellow, and foul smelling; symptoms tend to worsen in the evening and with cold and wind
• Mercurius — for fluctuating body temperature and thick, yellow nasal discharge with a foul odor; symptoms may also include bad breath and a swollen tongue
• Pulsatilla — for coughs and nasal congestion with thick, yellow-green mucus that does not burn the skin; symptoms tend to worsen in warm, stuffy rooms and when the person is lying on his or her back; this remedy is most appropriate for children (even newborns) and adults who are weepy, have mood swings, and are easily influenced by others

Mind/Body Medicine

A study of a small number of university students suggests that practicing relaxation techniques on a regular basis may help reduce the number of days that you have a cold or the flu. A similar study using relaxation techniques and guided imagery reached the same conclusion for a group of 45 children. Some good stress reduction techniques include meditation, deep relaxation, yoga, tai chi, and breathing exercises.

Other Considerations

Pregnancy
Tell your health care provider if you are pregnant or think you are pregnant. Some medications, herbs, and supplements may be harmful to the fetus and should, therefore, not be taken if you are pregnant or trying to become pregnant.

Special Populations
If you have asthma, emphysema, or any other underlying respiratory disorder, you should talk to your doctor as soon as you develop cold symptoms.

Warnings and Precautions
If your symptoms have not resolved in 7 to 10 days, you should call your doctor. Other reasons to see your physician include high fever (above 102°F), thick, green nasal discharge, or development of a productive cough (cough with phlegm), especially if it is thick and green as well.

Prognosis and Complications

Generally, as stated earlier, colds resolve on their own in 7 to 10 days. Some potential complications from colds include:

• Worsening of a pre-existing respiratory condition, such as asthma or emphysema
• Bronchitis
• Pneumonia
• Ear infection
• Sinusitis

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