Medical Practice

Dear Patient, If You Have to Treat a Cold, Know This:


Americans hate being sick. There are too many cold medicines out there to remember by name. But there are really only a handful of different drug classes to consider.

In order to choose any one of them, be clear about what you want to accomplish. It’s actually very simple.

1) Make my cold go away faster: Zink, echinacea, visualization/manifesting, sauna, prayer (may be mostly placebo effect ).

2) Stop my nose from running (including post nasal drip): You’ll want the crud to leave your body as soon as possible, so turning off the drain pipe that your nose has become can increase the risk of stagnant mucous in your sinuses becoming secondarily infected. But intermittent use of a decongestant (pills like pseudoephedrine, diphenhydramine or nasal sprays like Afrin) can help you look healthier than you are for an important Zoom meeting.

3) Make my nose run and relieve the pressure in my sinuses: Lots of fluids, room humidifier/vaporizer, shower steam, nasal steroid spray, guaifenesin (Mucinex) or even nasal lavage (Nettipot), but I personally have reservations about that one.

4) Stop my dry cough: Cough suppressants like dextrometorphan or codeine, humidifier/vaporizer, asthma inhaler if you have one.

5) Help me raise that thick, sticky phlegm: Fluids, humidifier/vaporizer, guaifenesin (Mucinex). Don’t try to suppress a productive cough. Just like with a runny nose, get the crud out of your body!

6) Headache/body aches/fever: Acetaminophen (Tylenol), ibuprofen, naproxen. But be aware that a low grade fever actually helps us clear cold viruses faster.

7) Knowing when to get medical help: Worsening symptoms, a second wave of fever; shortness of breath, wheezing, chest pain, severe sinus pain, clouding of the mind…the list goes on. Most people have had colds before. Is this one just like the others or the worst ever in some way?

8) Lastly: We used to think green phlegm meant bacterial rather than viral infection. But we now know viruses often cause up to three weeks of wet cough or nasal discharge. And be aware that we have antivirals for influenza and Covid, but not for the common cold viruses. (Sadly, we can send people to the moon, but we can’t cure the common cold.)

Hans Duvefelt is a family physician, author, and creator of the “A Country Doctor Writes” books.