What to do when you have a cold or flu?

The Common Cold or Upper respiratory infection (URI)

How to know you have it and how to treat it

The Common Cold also called an Upper Respiratory Infection (URI) is one of the most common reasons patients go to the doctor in the cold months although they can occur even in the summer.  This illness is caused by a virus and is easily transmitted from person to person through oral and nasal secretions.

  • Runny or Stuffy Nose
  • Cough
  • Fatigue 
  • Headache or Sinus Pressure
  • Low grade fever ( usually less than 101) can occur but not common
  • Sore throat 

How to differentiate between a Cold/URI and other illnesses:

How to differentiate between a Cold/URI and other illnesses:
  1. Cold or URI - A cold or upper respiratory infection is usually characterized by symptoms such as a runny or stuffy nose scratchy or sore throat and sometimes a cough. Usually there is no fever or body aches.
  2. The Flu - An upper respiratory infection differs from the flu in that the flu is often accompanied by a high grade fever and severe body aches
  3. Strep throat – It is possible to get a sore throat with a URI but you will rarely ever get a runny or stuffy nose with a strep throat. If the nose is runny or stuffy you most likely have a URI. On the other hand a fever of 101 or greater is more likely seen with strep than with a URI
  4. Sinus infection – People frequently mistake a cold for a sinus infection. To clear up a few myths, a cold that does not go away in a week is NOT a sinus infection. Green mucous also does NOT indicate an infection. Dark or green mucous simply means the mucous is older but is does not help distinguish a cold from a sinus infection. Sinus infections are secondary infections that occur when the sinuses have been filled with fluid which is unable to drain properly for an extended period of time. Typically when someone has had congestion from a cold or allergies for a couple of weeks they may start to develop a fever or worsening pain around the eyes and should see their doctor to see if they have an infection. You can read more about sinus infections in my blog post HERE


Since URI's (Colds) are caused by viruses antibiotics never play any role in treating them. This includes the antibiotic commonly known as Z-pak which is often mistakenly prescribed for the common cold. Antibiotics only work against bacterial infections. No matter how desperate you are to have the symptoms go away, using antibiotics will not help at all and may make things worse.

Things that do help:

  • Sleep – people who sleep 8 hours or more generally get better sooner than those who don't
  • Increased fluid intake – Fluids help to thin secretions and bring up phlegm and also prevent dehydration.

Over the Counter Medications that may give some relief:

Nearly all cold remedies have some combination of these ingredients. There are no magic remedies out there.

  • Decongestants – Should be used for stuffy or runny nose. The only active ingredient that works well for this is pseudoephedrine which can be found in Sudafed, Tylenol cold and sinus and many other remedies. These products do not require a prescription but are now kept behind the counter
  • Decongestant Nasal Sprays - These can offer quick relief but should only be used for a short time since prolonged use can result in dependency. The only effective active ingredient is Oxymetazoline and this can be found in Afrin and store brand nasal decongestant sprays
  • Nasal saline spray or irrigation – This loosens nasal secretions, improving drainage and can reduce the risk of sinus infection. 
  • Pain/Fever Relief – There are four commonly used ingredients for this Aspirin, Acetaminophen (found in Tylenol and other products), Ibuprofen (found in Advil, Motrin and other products), and Naproxyn Sodium (found in Aleve)
  • Antihistamines – More commonly used for allergies, these will help dry up membranes a little even if you have cold. It also makes you drowsy so you can sleep. Examples are Diphenhydramine (Benadryl)
  • Cough Suppressants – The only over the counter ingredient that is useful for suppressing coughs is Dextromethorphan (found in Robitussin DM and others)

All OTC remedies have some combination of the above ingredients in them. Ignore the claims and hype on the package and just buy the remedy that has the ingredients you need in it.  

Things that may work, probably don't work, or definitely don't work:

  • Antibiotics – These never work and it doesn't matter how much you “can't afford to be sick”
  • Expectorants – The main ingredient that is promoted for this is Guaifenesin. Although is good evidence that it is effective in treating congestion for chronic respiratory illnesses the evidence for its effectiveness in acute respiratory conditions like the common cold is mixed. The best way to loosen mucous is to drink fluids and use a vaporizer or humidifier
  • Vitamin CDoes not reduce the risk of contracting a cold but may slightly reduce the severity of symptoms
  • Zinc products – Oral zinc lozenges may reduce the duration of the common cold when started within 24 hours of initial symptoms and taken for a time period of less than 2 weeks. Intranasal zinc has been linked to a severe side effect (anosmia or loss of smell) and should not be used. 
  • Homeopathic remedies - These products are made using homeopathic theory. Homeopathic theory suggests "like cures like" and dilution increases potency. However, scientific evidence contradicts its principles. Dilutions often render remedies chemically indistinguishable from water, challenging claims of efficacy. Lack of scientific rationale and inconsistent outcomes undermine homeopathy's credibility, highlighting its reliance on placebo effects.  These preparations have no proven ingredients in them to begin with and are so diluted that there is often not a single molecule of the original ingredient left in them. You are essentially getting water. All products labeled as homeopathic are ineffective beyond their placebo effect.
  • Echinacea – Evidence is inconclusive with some studies showing a small benefit and other studies showing no benefit at all.
  • "Immune Boosters" - Any herbal remedies or supplements that claim to boost immunity are likely ineffective. The term "Boosts Immunity" is a product of their marketing dept not the medical community. 


The bottom line is that there is no magic cure for the common cold no matter what you hear or read. Colds have to run their course and take 7-14 days to resolve on the average. Your best bet is to take care of your body so your immune system can do its job.