The cold facts about colds and flu

Many products sold on drug store shelves don't help. But some simple steps can.

Consumer Reports magazine: January 2013

Photo: Alisson Sieffer

Here’s a news Flash: There’s still no cure for the common cold, which can be caused by any of more than 200 viruses. But that didn’t keep Americans from spending $4.2 billion on nonprescription cough and cold remedies in 2011, according to the Consumer Healthcare Products Association. Some may make you feel better; others won’t. This guide should help you cope with the discontents of winter.

First, to minimize the chance of catching the flu, most people at least 6 months old should get vaccinated every year (flu viruses change annually, and so does the vaccine). An exception: people allergic to eggs, since the vaccine is grown in eggs. Wash your hands often, and get plenty of sleep. (See the vaccines we recommend for adults and kids. If you do get sick:

For a cold. Rest, drink liquids, gargle with warm salt water, and use a neti pot to flush the nose with distilled saltwater; suck on nonmedicated lozenges or swallow a bit of honey (don’t give lozenges to young kids or honey to babies under 1 year old); and take a bath or shower to let warm, moist air loosen phlegm. Try over-the-counter painkillers such as acetaminophen (Tylenol and generic) or ibuprofen (Advil and generic) for aches and pains. Echinacea, vitamin C, or zinc lozenges might shorten the duration of a cold, but they won’t keep you from getting sick. And although earlier research hinted that vitamin D might aid against respiratory infections, a well-designed clinical trial published in October in the Journal of the American Medical Association found that vitamin D won’t help adults ward off or recover faster from the common cold.

Skip most remedies aimed specifically at colds. See the table below for details.

For the flu. Rest and drink fluids. Use over-the-counter painkillers, and consider taking elderberry fruit extract and n-acetyl cysteine, which some research has shown might relieve flulike symptoms. Children younger than 5, adults 65 and older, pregnant women, and people with suppressed immune systems should see a doctor immediately if they have flu symptoms. A prescription antiviral drug such as oseltamivir (Tamiflu) may shorten the duration of the illness by a day or so if started within 48 hours of symptoms. Consult a doctor also if you develop trouble breathing or if an existing problem such as diabetes or asthma grows worse. Most other people shouldn’t need to see a doctor. Antibiotics won’t help a flu or cold: They treat bacterial infections, not viruses.

Meds to try, and to avoid

Research hasn’t established that cold medicines actually work. If you try them, avoid multisymptom remedies, whose mix of ingredients can raise the risk of side effects and overdoses, especially if you take them with other drugs. Instead, choose over-the-counter meds by active ingredients and buy single-symptom formulas.

For a drippy nose, try nasal sprays or drops with oxymetazoline (Afrin, Neo-Synephrine Nighttime) or antihistamines such as chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benadryl Allergy). Generic versions of those products work the same and are likely to cost less. Note that using the drops or sprays for more than a few days can cause symptoms to come back, or “rebound.”

Inhaling camphor or menthol vapors creates a sense of improved airflow, but there’s little objective evidence of a benefit, says the American Pharmacists Association.

How to tell the difference between a cold and the flu









Sore or scratchy throat, then runny or stuffy nose, sneezing; finally a cough; fatigue.

Low or none

Mild to moderate

A week to 10 days, but cough can linger for weeks more.



Chills, dry cough, headache, muscle aches, stuffy nose, extreme tiredness, weakness.

100° F or higher

More severe

One to two weeks, but weakness and fatigue may last for weeks more.



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