Let’s get one thing straight! There is nothing common about the “common cold.” Whoever came up with that name should be spanked. It implies a bunch of falsehoods. The word “common” is a misnomer. It tells you nothing about the nature of an upper respiratory tract infection. Some colds last a couple of days and are gone with barely any symptoms. Others can persist for weeks or longer and knock you out! Medical experts have been repeating this chestnut for decades: “More than 200 different viruses are known to cause the symptoms of the common cold” (NIH Research Matters, April 13, 2009). That’s not very helpful!
What Causes the “Common Cold”:
When we are told that well over 200 different viruses cause common cold symptoms, that is not very helpful information. Imagine if the mayor of a medium-sized city reported to the city council members that over 200 different things led to a huge budget deficit. The council members would want to know precisely what “things” created the problems so they could begin to deal with the causes of the deficit.
Attributing symptoms such as sneezing, sore throat, stuffy and runny nose, fever, coughing and post-nasal drip to one of 200+ different viruses is virtually meaningless information. It tells you nothing about the particular virus causing your symptoms and it offers no useful information about potential treatments.
Not all colds behave the same way. Some viruses provoke long-lasting nasal congestion that may lead to sinusitis. Others hit the lungs, leaving victims coughing for many weeks. What works for one “cold” may not work for another.
Researches who test vitamin C or zinc for the “common cold” have no idea what viruses they are treating. To say that ascorbic acid is useless or that zinc is great is not helpful. That’s because vitamin C might work well against certain cold viruses but not others. Ditto for zinc, chicken soup or astragalus root.
Which Viruses Cause Common Cold Symptoms?
Ask the experts and they will tell you that rhinoviruses cause anywhere from 10 to 40 percent of colds. That would be like saying water purification led to 10 to 40 percent of the city’s budget deficit. The council members would want to know was it 10% or 40% and what parts of the water purification system were responsible.
There are over 160 rhinoviruses divided into three different groups (A, B and C). Other viruses responsible for the common cold include coronaviruses. We have already met this family! Remember COVID-19 is a coronavirus. The CDC cites types 229E, NL63, OC43 and HKU1 as all causing cold symptoms. Then there is RSV (respiratory syncytial virus) and parainfluenza virus. And lets not forget enteroviruses, influenza viruses and adenoviruses. Sometimes cold-like symptoms are triggered by bacteria such as Chlamydia pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae or Mycoplasma pneumoniae.
Here’s the bottom line. Most of the time doctors have no idea what is causing your upper or lower respiratory tract infection. If it’s the middle of flu season and everyone is coming down with similar symptoms, they may blame your misery on Influenza A (N1N1)pdm09 or Influenza B Yamagata lineage. But most of the time patients and doctors are clueless about the particular virus causing common cold symptoms .
What “Common Cold” Products Actually Work?
Masks Against Viruses:
It’s that time of year! Cold and flu season has arrived. Most people have stopped worrying about exposure to the SARS-CoV-2 virus. They are shopping, going to sporting events, dining out and gathering with friends and family. Most people have stopped wearing masks for a variety of reasons. We have been astonished at the anti-science stance of many visitors to this website. They insist that masks are worthless and/or cause harm. Here are just a few examples:
“Wearing a mask outside is utter stupidity. A breeze blows the virus away. Sunlight kills the virus. Overall, mask- wearing causes the body to retain CO2, that has serious effects on people. My question is: Do the benefits of mask wearing outweigh to detrimental effects?”
I wonder how Ed would feel if the surgeon showed up in the operating room without a mask on.
Hope offers this:
“Masks were created long ago, but not for virus protection. The N95 mask was used by workers on wood machine chippers. The regular blue mask was made as a splash guard for surgeons and medical staff. This entire nonsense was all designed by psychopaths to receive millions for PPE [personal protective equipment]. Masks never stop the spread nor do they block any of the viruses people catch.”
We have dozens, if not hundreds, of comments from people who adamantly reject masks as a protective strategy against viral infections. No matter what the evidence reveals, these folks will reject face mask.
That said, here is a review in the prestigious journal PNAS (Proceedings of the National Academy of Science) Jan. 11, 2021. The conclusions:
“Our review of the literature offers evidence in favor of widespread mask use as source control to reduce community transmission: Nonmedical masks use materials that obstruct particles of the necessary size; people are most infectious in the initial period postinfection, where it is common to have few or no symptoms; nonmedical masks have been effective in reducing transmission of respiratory viruses; and places and time periods where mask usage is required or widespread have shown substantially lower community transmission.”
Infectious disease epidemiologists and researchers writing in Scientific American, Dec. 23, 2022) offer this:
“When it comes to individual decisions, masks are among the most low-cost and most effective steps that can be taken to broadly reduce transmission of a multitude of viruses.
“Similarly, one of the largest pre-COVID-19 randomized studies of mask-wearing, conducted with over a thousand University of Michigan residence hall students in 2006 to 2007, found that symptomatic respiratory illness was reduced among mask-wearers.
“More recently, researchers measured the amount of virus present in exhaled breath from people with respiratory symptoms to study how well masks blocked the release of virus particles. Those who were randomly selected to wear a mask had lower levels of respiratory shedding for influenza, rhinovirus—which causes the common cold—and non-SARS coronaviruses, than those with no mask.
“Our preliminary work in a community with frequent mask-wearing behavior has found that the rate of non-COVID respiratory illness in families fell by 50% during 2020 and 2021 compared with earlier years.”
A recent review found that masks reduce the spread of airborne respiratory viruses (JAMA Network Open, Oct. 31, 2023).
The authors concluded:
“…masking with the highest-quality masks that can be made widely available should play an important role in controlling whatever pandemic caused by a respiratory pathogen awaits us.”
Although people in many parts of Asia often have been wearing masks during cold and flu season, the American culture discourages this behavior. That is especially true now due to the politicalization of COVID-19. One other thought: Most people wear cheap masks that do not fit well. Unless the mask is comparable to an N95 and creates a snug fit, it may do little, if anything, to prevent the spread of upper respiratory tract viral infections.
Cold Remedies to Treat the Symptoms of the Common Cold:
While the rest of us suffer during cold season, drug companies and pharmacy chains are licking their chops. There’s gold in sneezes, sore throats and coughs.
There has been such a proliferation of complicated cold remedies on drug store shelves it is hardly any wonder the American public is confused. You can choose between Multi-Symptom Hot Liquid Packets, a Flu and Body Aches Formula or Cough and Head Congestion Relief.
Although the names make it seem as if each product is targeted for a specific set of symptoms, in reality the ingredients in most products are remarkably similar.
When I was writing the first edition of The People’s Pharmacy 50 years ago, I complained about multi-symptom medications:
“Most cold remedies contain a whole sinkload of ingredients. Undoubtedly, there will be a decongestant, an antihistamine, a pain-reliever, and then just about anything…There is almost no medical justification for products which contain so many different compounds all rolled up into one, and there is reason to believe that there could be a negative effect.”
I went on to criticize the decongestant phenylephrine because in oral formulations it is ineffective. Fast Forward 5 decades:
Phenylephrine (PE) is a key ingredient in a great many OTC cold and cough medicines. It’s found in Sudafed PE, Theraflu Severe Cold Relief, Advil Sinus Congestion and Pain and Mucinex Sinus Max, among other products.
Americans spend roughly $1.8 billion on hundreds of products containing PE. That’s why many people were shocked in September 2023 when the Food and Drug Administration admitted that oral phenylephrine is not effective in relieving nasal congestion.
This is not new news for most health professionals. Pharmacists even petitioned the FDA to take oral PE out of OTC cold remedies long ago. Given that the agency has now admitted that the ingredient is not effective orally, it may eventually disappear.
The two pharmacists who started the ball rolling, Drs. Hatton and Hendeles, wrote a commentary in The New York Times (September 29, 2023):
“How can an ineffective drug discovered nearly 100 years ago and marketed since the 1930s still be on the market, despite decades of drug experts like us prodding the F.D.A. to do something? It boggles the mind, and worse than that, this is only the tip of the iceberg. This decongestant is like many drugs on the market that don’t really provide relief.”
The inside scoop on phenylephrine is available at this link.
Dextromethorphan (DM) in Cough Remedies:
These same pharmacists go on to point out that other ingredients in many cough and cold medicines don’t actually work as expected. Dextromethorphan (DM) is supposed to suppress coughs. Although the FDA approved it in 1958, the drug remains controversial.
The Medical Letter on Drugs and Therapeutics (Dec. 17, 2018) notes that:
“Dextromethorphan has not been shown to be effective or safe in young children. Dextromethorphan can cause confusion, excitement, irritability, nervousness, and, in high doses, nausea, vomiting, and headache.”
In one study, researchers compared buckwheat honey to honey-flavored DM or no treatment for children with coughs due to colds (Archives of Pediatric & Adolescent Medicine, Dec. 2007). Honey worked best to control cough symptoms, while DM was not better than placebo.
Antihistamines: Helpful or Harmful?
Antihistamines are a mainstay of most cold remedies. Check labels and you are likely to find names such as chlorpheniramine, brompheniramine, doxylamine and diphenhydramine.
But are antihistamines helpful against the common cold? Health experts have testified to Congress that such compounds “cause cold sufferers more harm than good and should be banned from the products.” And medical consultants for Consumers Union believe that “antihistamines have no place in cold remedies.”
While antihistamines can make adults drowsy, they can sometimes stimulate children. A well-meaning parent decides to give little Johnny some medicine to stop the sniffles and cough so he can get some sleep. But this intervention could boomerang, especially if there is also a decongestant in the formula. The cough could be calmed but the child may be wide awake for hours because of drug-induced insomnia.
Long-acting multi-symptom preparations also pose a risk for some people. The 12-hour relief that is advertised can occasionally turn into unrelenting side effects. High blood pressure, anxiety or sleeplessness can be complications of decongestants such as pseudoephedrine or phenylephrine. Men with enlarged prostates can end up in great distress if they unwittingly swallow a decongestant.
The ubiquitous pain reliever/fever reducer in cold and cough remedies seems illogical to us. For one thing, colds rarely cause pain. Reducing a mild to moderate fever may actually be counterproductive, as this short-circuits the body’s immune reaction to the invading viruses.
Home and Herbal Remedies for Common Cold Symptoms:
So what should a cold or flu victim do when the throat gets scratchy or a cough starts to take its toll? We have become big fans of home remedies and alternative treatments. Chicken soup, ginger, vitamin C, zinc lozenges and onion syrup are among our favorite remedies.
Generations of grandmothers have relied on chicken soup with lots of garlic and thyme. In China, chicken soup might be fortified with astragalus root, which could help boost the immune response (Archives of Pharmacal Research, June 2022). Some people take the extract in a capsule, but then they are missing the comfort of chicken soup.
The recipe for ginger tea requires a half-inch piece of fresh ginger. Grind it into a paste and put it in a mug. Pour boiling water over it, and let it stand a few minutes. Then pour off the clear liquid into a clean cup, sweeten it to taste and take it morning and night for two days.
Here are just a few stories from visitors to this website.
“I have had the symptoms of a cold for about 6 months with post nasal drip causing phlegm and coughing at night. Last night I made some ginger tea which I drank before bed.”
“I did not cough once during the night and woke up with a clear nose and throat and I could breath without the rattle of excess phlegm in my throat. I am having some more tonight.”
Fluf offers a slight change on the recipe:
“I have a bad cold. I have been using ginger tea made with grated fresh ginger, with a little apple cider vinegar.
“I heat a cup of water in the microwave, take a teaspoon of the grated ginger WITHOUT STRAINING, add one teaspoon of apple cider vinegar, a pinch or turmeric and a little ground black pepper, anti-inflammatory.
“Drink as hot as possible. My upper respiratory symptoms are gone within 5 minutes of finishing the drink. I think that the raw ginger pieces are the best remedy; fiery hot all the way down to the stomach, but that is part of feeling better. Stay warm until your cold is over.”
Adrian has a different version:
“I have a variation of the ginger tea. It’s in the form of ginger soup.
“Wash ginger and strip off the skin. Crush ginger with the side of the knife.
“Boil ginger in water. Once boiling, lower the temperature and add chopped green onion.
“Add 2-3 egg whites and mix until egg is cooked.
“I take this ‘soup’ when I get sick and it helps remedy the symptoms. Most of the time it also cures the cold. My family has been doing this for sick members and I will pass on the tradition to my young’uns when I have them.”
Sally adds garlic:
“I made the tea with garlic and maple syrup and my cough immediately disappeared!”
Another favorite old-time remedy for coughs and colds is onion syrup. Many readers have fond memories of this approach, and some are still using for their kids and grandkids.
AM offers this testimonial:
“My grandmother (who would have been 99 at the end of the month) used to make onion syrup for us when we were children. I remember onion and sugar but thought there was something else in it. Nope, that’s it!
“I just made it for my 5-year-old son who was never sick before starting school and now got a bad cough.
“Onion syrup still works like a charm. I switched it up a bit and added raw local honey and it seems like that works just as well as sugar.”
“My grandmother, Mami M., used to make a version of this many years ago. I think it worked great. I was almost never sick with my Mami around to dose me with her home remedies as needed (all except the castor oil and that was my biological mother’s favorite weapon).
“The honey & onion syrup she made not only worked well, but tasted nice. She used to also use a drop or two of “Agua Ardiente” (Crystal)…if the honey onion syrup did not fix ya, the alcohol for sure did (you had to get better in self defense or more would follow!).”
Here is Sally’s recipe:
“When my kids were babies and got croup I made onion syrup on the stove, cut a few onions in half and cover with water, bring to a boil, then simmer real low & slow with enough water just to cover (a couple of hours); sweeten with a little sugar or honey (depending on child’s age).
“Nothing worked better, croup gone in a day or so.”
“Golden milk” made with turmeric is popular in India and Indonesia. Along with ginger, peppermint and licorice, traditional practitioners in these regions have used turmeric for thousands of years (Drugs in Context, June 14, 2023). Although scientists have not conducted extensive randomized controlled trials on these botanicals, patients experience subjective benefit. You may find the Golden Milk preparation from Gaia Herbs helpful. Gaia Herbs exercises excellent quality control over all the ingredients. Just stir a teaspoonful of the powder into a warm cup of milk, dairy or non-dairy.
One reader wrote:
“Turmeric milk is an old old Ayurvedic remedy for cough and colds. Ayurvedic treatment has been practiced in India for thousands of years.”
No matter which way you treat a cold–drug store formula or old-fashioned remedy–know when to consult a doctor. Symptoms such as severe sore throat or hacking cough, swollen glands, dark green or yellow mucus, serious sinus pain, or debilitating aches and pains require medical attention. Such signs could signal type A influenza and there is a treatment for that. Antiviral drugs can shorten the severity and duration of the flu if taken promptly.
If you would like to get more details on cold remedies you may wish to consult our Guide to Coughs, Colds & the Flu. You will learn more about zinc, vitamin D, Astragalus root, Andrographis, thyme and Echinacea. What’s more, you will get Grandma Graedon’s famous Chicken Soup Recipe! Here is a link to the download.
Share your own favorite cold and cough remedy below in the comment section.