Doctors have abbreviations for anything that causes coughing, sneezing, sore throat, congestion and/or runny nose: URTI (upper respiratory tract infection) or the shorter version URI (upper respiratory infection). These names are as bad or worse than the term “common cold.” Whether you call it a URTI or a common cold, the name tells you absolutely nothing about what you have come down with or what you should do about it. 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!
In this article we are going to compare home and herbal remedies to over-the-counter drugstore treatments. Americans spend billions of dollars on multi-symptom medications containing antihistamines, decongestants, pain relievers, cough suppressants and fever reducers. How well do those “modern” approaches work compared to ancient healing traditions?
What Causes the “Common Cold”:
We are told that well over 200 different viruses cause common cold symptoms. That is not very helpful information. Imagine what you would do if your car stopped running. You might have it hauled to the dealer or a repair shop. How would you react if you were told that there were over 200 “things” that could be responsible for your car not running. Your would want to know precisely what things needed to be repaired so you could drive again.
Automobile mechanics are far more successful at diagnosing a car’s problems and fixing them than physicians are at diagnosing the cause of the common cold. Attributing symptoms such as sneezing, sore throat, stuffy and runny nose, fever, coughing and post-nasal drip to one of 200+ different viruses is not very helpful 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. Doctors call that LRTI (lower respiratory tract infection) or bronchitis.
What works for one “cold” may not work for another. I have always been disappointed when health care providers reflexly dismiss home and herbal remedies as ineffective. Researchers 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 very helpful either. That’s because vitamin C might work well against certain kinds of 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 a dead battery is responsible for anywhere from 10% to 40% of car failures. What about a bad alternator, broken ignition switch, clogged fuel filter or a bad starter motor? Unless there is a proper diagnosis, the mechanic won’t be able to fix your car.
There are over 160 rhinoviruses divided into three different groups (A, B and C). Other viruses responsible for the cold symptoms include coronaviruses. We have already met this family! Remember COVID-19 is a coronavirus.
The CDC states that coronaviruses 229E, NL63, OC43 and HKU1:
“…usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most
people get infected with one or more of these viruses at some point in their lives.”
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 (“walking pneumonia”).
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 cold symptoms .
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:
Phenylephrine (PE) is a key ingredient in a great many OTC cold and cough medicines. It has been found in Sudafed PE, Theraflu Severe Cold Relief, Advil Sinus Congestion and Pain and Mucinex Sinus Max, among other products.
Americans spend billions 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.
The Food and Drug Administration moves very slowly, though. The agency announced on November 8, 2024 that it would like to remove the oral decongestant phenylephrine (PE) from over-the-counter cold, cough and allergy products. How long did it take?
Fifty years ago I wrote that Consumer Reports had found that oral phenylephrine was ineffective in controlled clinical trials. No data since then contradicted that observation.
In 2007, during a meeting at the FDA, it was noted that “PE is not more effective than placebo.” This was in reference to the oral form of phenylephrine.
An FDA overview of the data presented at that meeting reports (Nov. 4, 2024):
“Data from a small, single-dose oral bioavailability study conducted in 14 subjects showed that active parent PE represents less than 1 percent of the total PE…in the plasma after a single 10 mg oral dose of PE.”
So, in 2007 the FDA was aware that very little phenylephrine gets to the nose. When the same active ingredient is sprayed in the nose, it has a direct effect and starts constricting blood vessels almost immediately.
There is a drawback to using topical nasal sprays such as phenylephrine or oxymetazoline (found in Afrin, Vicks Sinex or Mucinex Sinus-Max nasal spray). Although they work well to open nasal passages, such products often come with a warning.
Afrin, for example, cautions:
“Do not use for more than 3 days…Frequent or prolonged use may cause nasal congestion to recur or worsen.”
Despite evidence that PE did not ease congestion, products containing this ingredient remained on the market. Most are still there today.
Old News Is Now New News:
All this controversy around PE is not new news for most health professionals. Pharmacists even petitioned the FDA to take oral PE out of OTC cold remedies long ago. Sadly, though, most pharmacies have continued to sell cold, cough and allergy remedies containing this ingredient for decades. I suspect that drug companies will fight the FDA tooth and nail to keep PE on the market. Reformulating famous brands can be a challenging and expensive process.
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 paradoxically 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. The cough might be calmed but the child may be wide awake for hours because of drug-induced insomnia.
Decongestants?
As mentioned, topical decongestants (vasoconstrictors) can only be used for two or three days. After that, rebound congestion can pose a real challenge. Read some of the comments at the end of this article to find out what that can be like:
Can You Overcome an Afrin Addiction?
The oral decongestant pseudoephedrine (Sudafed Sinus Congestion 12-Hour Relief Caplets) works. But you won’t find this product on the shelf. It can only be purchased from behind the pharmacy counter. It also comes with these instructions:
“Ask a doctor before use if you have
- heart disease
- high blood pressure
- thyroid disease
- diabetes
- trouble urinating due to an enlarged prostate gland”
You are told to “Stop use and ask a doctor if”
- “nervousness, dizziness, or sleeplessness occur”
Pain Relievers?
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.
Please do not take my word for this. Take a few minutes to listen to our podcast with Dr. Roger Seheult. He is a pulmonologist who co-founded MedCram and one of the best communicators we have ever interviewed. If you want to know why lowering your mild to moderate fever could be handicapping your immune response, listen to Dr. Seheult. He will also tell you about the scientific evidence for steam inhalation, sunshine, vitamin C and zinc. Here is a link to that podcast. You can listen to the streaming audio by clicking on the white arrow inside the green circle under the photo of a very sick woman. You can download the mp3 file to your computer or electronic device by clicking on the link at the bottom of the show notes.
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.
Chicken Soup:
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.
Ginger Tea:
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.
Arthur wrote:
“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 of 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!”
Onion Syrup:
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 it 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.”
Marguerite recalls:
“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:
“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.
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. Many visitors to this website insist that masks are worthless and/or cause harm. Here is just one example:
Hope offers this opinion:
“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.”
I wonder how Hope would feel if a surgeon and the attending assistants performed knee replacement surgery without wearing masks.
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 reject face masks.
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 wear masks during cold and flu season, the American culture frowns upon this behavior. 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.
Learn More:
If you would like to get more details on a variety of natural cold remedies, you may wish to consult our eGuide 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. If you think family and friends might benefit from some of suggestions, please share this article with them. There are icons at the top of the article to make that process easier. And if you believe our in-depth articles have value, please encourage your acquaintances to sign up for our newsletter at this link. Thank you for supporting our work.
