The Best and Worst Ways to Treat Your Cold

Treating a cold with antibiotics and over-the-counter meds? You're just wasting your money.

February 4, 2014


You get a cold. You head to the pharmacy or natural foods store and load up on over-the-counter meds or herbal supplements. You might even head to your MD, who will load you down with antibiotics and prescription cough medicines. Then you head home to chase those pills with orange juice and lots of sleep.


Sound familiar? If that's your routine for treating a cold, here's a news flash: It isn't working, and all you're doing is emptying your wallet on expensive blister packs of meds that probably aren't doing you a darn bit of good.

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That's the suggestion of a new study published in the Canadian Medical Association Journal that analyzed roughly 80 randomized control trials (considered the gold standard of medical research) of various methods for preventing and treating colds, ranging from vitamin C and zinc supplements to vapor rubs and synthetic decongestants. What they found was that very few of the over-the-counter medications—and even most of the prescription meds—handed out to treat the common cold are effective, while the most effective medications are staring you right in the face. 

We turned to the study's coauthor, Bruce Arroll, PhD, Elaine Gurr chair of general practice and primary health care in the department of general practice and primary health care at the University of Auckland, for some clarification on what the study found.


What works:

The absolute BEST ways to prevent a cold, according to 67 high-quality trials, are the easiest and cheapest…

• Washing your hands!

• Using hand sanitizers

• Staying home from work when you're sick

• Wearing gloves and a mask if you can't avoid other sick people

Taking zinc was also found to be a good preventative measure, based on studies of children who took a daily supplement of 10 to 15 milligrams (mg) of zinc. They missed far fewer days of school and had significantly fewer colds than the non–zinc-supplementing control group.

What might work:

Probiotics. Studies on probiotics and upper respiratory tract infections show inconsistent results, but one strain of probiotics that does seem to work is Lactobacillus casei, a strain found in a fermented drink called Yakult and in Dannon's DanActive yogurt.

Exercise. Though the one trial of exercise as protection against a cold showed conflicting results, it did show that overweight and obese post-menopausal women who exercised saw a decrease in the number of colds they got. The women exercised 45 minutes per day, 5 days a week.

Garlic. The authors called the evidence for garlic "promising," but just one trial exists on its effectiveness, and that study wasn't very well done.

Gargling with plain water. Don't worry about adding salt; gargling with plain water three times a day (about half an ounce for 15 seconds, repeated three times) seemed to work pretty well at preventing upper respiratory tract infections in a trial of 387 adults, just 30 of whom got sick during the trial. 

What's a total waste of money:

There were very few strong trials of the following cold treatments, and those that did exist generally concluded that these aren't any more effective than a placebo at preventing a cold:

• Echinacea

• Vitamin C

• Vitamin D (There are lots of benefits to taking vitamin D for other reasons, but don't expect it to help prevent colds.)

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What works:

Acetaminophen and ibuprofen. Inflamed nasal passages and airways trigger most of your misery when you have a cold, so popping an anti-inflamatory, such as Tylenol or Advil, is a quick, effective way to get some relief, says Arroll. The research suggests the two are even more effective when taken together, alternating one after the other every few hours.  

Honey. Trials, which did focus solely on children, found highly consistent benefits for kids who took 2.5 to 10 mg of honey before bed. It controlled their coughs and helped them sleep better than over-the-counter cough medicines.

Decongestants. They don't make a huge difference, but decongestants will give you a small amount of relief from a cold-induced stuffy nose, the research suggests. Look for products that contain phenylephrine as the active decongesting ingredient.

Zinc. There does seem to be some evidence that taking zinc once you get sick will help you feel better faster. After you get sick, Arroll suggests taking a 23-mg zinc gluconate supplement every two hours.

What might work:

Vapor rubs. These rubs, which contain menthol, camphor, and eucalyptus oil, seem to work well at relieving congestion in kids, but their efficacy in adults is questionable. One study found them to be no more effective than petroleum jelly (a placebo) at relieving congestion in adults, but vapor rubs do seem to help adults get to sleep more easily.

What's a total waste of money:

Antibiotics. Repeat after us: Colds are caused by viruses, NOT BACTERIA, thus ANTIBIOTICS DON'T WORK for the common cold! And taking them unnecessarily puts you at risk for developing a resistance to them, which could trigger more severe, untreatable infections later on. Research has shown that antibiotics don't even do anything to alleviate cold symptoms, but 80 percent of people who take them DO report unpleasant side effects.

Over-the-counter cough medicines. Ironically, few studies have found any benefit for adults from taking medicines containing guaifenesin and dextromethorphan, the two main ingredients in cough suppressants.

Nasal irrigation. Whether inhaled as a spray or used in a neti pot, saline nasal sprays don't seem to help treat a cold either. You might experience some benefit, but studies just haven't found either to be very effective.

Other common cold treatments whose efficacy hasn't been borne out by science include:

• Echinacea

• Vitamin C

• Chinese medicinal herbs

• Ginseng

The bottom line, says Arroll, is that in the absence of a true cure for the common cold, you really just have to deal with being uncomfortable for a few days. Otherwise you're just inflicting unpleasant side effects on yourself from drugs that aren't really helping. "People like to do something," he says, so taking some acetaminophen or ibuprofen, taking some honey before bedtime, and maybe using Vicks Vaporub are the best steps to take. But most important: "Keep away from people and work, and wash your hands or use hand sanitizers."