The average American catches two to four colds a year, with U.S. consumers spending billions of dollars annually on remedies to treat and prevent respiratory infections, coughs, sore throats, and stuffy noses. But what works and what doesn't, when it comes to combating the common cold?
In a new analysis of 67 cold-remedy studies, Michael Allan, M.D., director of medicine at the University of Alberta, found strong evidence that zinc can prevent a cold, while OTC pain relievers and decongestants are reliable treatment options. The review, published in the Canadian Medical Association Journal, found probiotics — "good bacteria" in yogurt and other food products — can also block cold infections. But findings were inconclusive on the benefits of ginseng, garlic, homeopathy, Echinacea, or vitamins C or D.
Dr. Allan added, however, that despite the lack of scientific evidence for many cold and flu remedies, many of his patients still swear by some — in part because they believe the treatments are working.
"People have individual reactions to medicines that are not predictable," he said. "There is also, of course, the placebo effect — you think it's going to work [and you feel better]."
Here's what you need to know about the latest word on common cold prevention and treatment strategies, based on Dr Allan's analysis and other studies.
Zinc: Lozenges and other over-the-counter tablets that contain zinc (such as Zicam and Cold-Eeze) have been shown to ease symptoms and shorten the duration of the common cold, and also may help prevent infections from taking hold. Two studies indicated children who took 10-15 milligrams of zinc sulphate daily had fewer colds and absences from school. Although the studies were carried out on children the researchers concluded that: "there is no … reason why zinc could work only in children and not adults." But not all zinc products are safe. In 2009, the Food and Drug Administration warned consumers not to use some zinc-based nasal products, which have been linked to a loss of taste and smell in some people.
Decongestants: OTC decongestants relieve stuffy sinuses by shrinking blood vessels that cause congestion. The most effective ones contain pseudoephedrine (the active ingredient in Sudafed). But FDA restrictions implemented in 2005 limit how much an individual can purchase because the drug can be used to make methamphetamine. That said, it is safe and among the most effective cold remedies. Spray-based decongestants are also effective, but should only be used short term.
Expectorants, antihistamines: Products designed to help you cough up mucus (such as Mucinex) have can ease coughs, but drinking more water or using a humidifier can have the same effect. Combining expectorants with antihistamines, however, can also alleviate cold symptoms, but should not be used in children under 5 years of age, health officials warn. In addition, antihistamines and allergy medicines — such as Claritin, Zyrtec, and Benadryl — can help treat a runny nose or sore throat.
Painkillers: For fever, acetaminophen (Tylenol) and ibuprofen (Advil) can be helpful, as well as anti-inflammatories like naproxen (Aleve). But some individuals with heart disease, asthma, or stomach problems should consult a doctor first about which medication is the safest and most effective to take, Dr. Allan notes. Theraflu contains acetaminophen and other anti-cold ingredients, but can pose a risk of liver damage at high doses or if taken with alcohol or other acetaminophen-containing products.
Probiotics: Dr. Allan said scientific research has shown that probiotics may help prevent colds, perhaps by boosting the body's immune system. But the types and combinations of organisms varied in the studies as did the formulations, making comparisons difficult. Because many foods with probiotics contain other healthy ingredients, there are few downsides to adding them to your diet during cold and flu season.
Echinacea: Studies on the effectiveness of the herb echinacea have had mixed results. Some have suggested it can shorten the length of a cold, perhaps by boosting the immune system, but others have been inconclusive. The ragweed-related herb can also cause side effects in people who suffer hay fever.
Vitamin C: Taking mega-doses ofvitamin C became popular in the 1970s after Nobel laureate Linus Pauling claimed it could prevent and treat the common cold. But studies of the antioxidant have been disappointing. A review by the Cochrane Collaborative — a scientific organization that analyzes multiple studies to reach consensus conclusions — found vitamin C supplements had no effect on common cold incidence but may shorten an infection's duration. But high doses can cause nausea, diarrhea, and stomach cramps. A healthier option: Eat foods loaded with vitamin C, such as citrus fruits, to stay healthy.
Homeopathic remedies: Products such as Defend and Sambucol promise to fight multiple symptoms of a cold, but the National Institutes of Health has concluded there is little to no evidence that such homeopathic remedies are effective. In addition, they are not as stringently regulated as drugs.
Other strategies: The benefits of frequently used remedies such as ginseng, (found in ColdFX), gargling with salt water, or using honey are unclear, Dr. Allan concluded. His team also noted that most colds are caused by viruses, with only about 5 percent due to bacterial infections, so antibiotics won't help, eve though they are often prescribed inappropriately for viral infections.
In addition, health experts say the following strategies can help ward off a cold or ease symptoms:
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- Fastidious handwashing, and the use of alcohol-based hand sanitizers and disinfectants, can help keep cold and flu bugs at bay.
- Avoid close contact with people who have a cold, especially during the first few days when they are most likely to spread the infection.
- Drink lots of fluids — including water, fruit juices, and even warm lemon water with honey — to help loosen congestion and prevent dehydration. Avoid soda, coffee, and alcohol, which can make dehydration worse.
- Use saline nasal drops and sprays to ease stuffiness and congestion. Such products carry few risks, even for children, and don't lead to the rebound effect — a worsening of symptoms when the medication is discontinued — seen in other types of nasal products.
- Chicken soup, or even clear broth, might actually help relieve cold and flu symptoms acting as anti-inflammatory and speeds up the movement of mucus.
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