Do you have a cold … or the flu?
You swear it’s a cold, your friend thinks it’s the flu, and the dozens of meds at the pharmacy promising to make you feel human again claim to target both. So does the difference matter?
Absolutely, says Susan Rehm, MD, medical director of the National Foundation for Infectious Diseases. The influenza virus causes the flu, and since just a few variants of the virus exist, it’s become relatively easy to prevent with a flu shot or treat once you’ve got it.
Colds can be trickier. The rhinovirus is often responsible, but more than 200 other viruses can trigger the common cold—which means anti-viral prescriptions aren’t typically an option. Instead, over-the-counter symptom-relievers and home remedies are your best bet—but you still need to tread carefully. To get the last word on how to treat—and how not to treat—the common cold and flu, we consulted experts from the field. Here are their tips.
It’s the flu if…
“It hits you like a bolt of lightning,” says Steven Lamm, MD, internist and faculty member at New York University School of Medicine and a frequent guest doctor on The View. “You’ll likely run a fever of above 101°F, and you’ll be flat out,” says Dr. Lamm. Chills, fatigue, muscle aches, and tightness of the chest are also characteristic of the flu. You might have a cough, or a runny nose, but you’re less likely to suffer from upper respiratory symptoms than you are with the cold.
What to do
Get thee to the doctor—and fast. “The prescription-only anti-viral meds Tamiflu and Relenza must be taken within 48 hours of the onset of the symptoms,” says Karen Hill, MD, the founder of Internal Medicine and Pediatric Associates in Houston. The treatment will reduce the intensity of symptoms, hasten recovery, and significantly decrease the chances of you developing complications such as pneumonia or bronchitis.
What not to do
Taking several OTC drugs to treat your symptoms can be dangerous, causing you to inadvertently double-dose on any one ingredient, warns Dr. Rehm. “Combination meds sometimes contain acetaminophen without advertising it on the front of the box. If you also take, say, Tylenol, you’re in danger of toxification.”
Antibiotics are another no-no, says Dr. Lamm, because they target bacteria—not viruses. There’s a caveat, though: “When complications develop, like if someone coughs up green phlegm spotted with blood, this signals a bacterial infection, and here antibiotics could be appropriate,” says Dr. Lamm.
It’s a cold if…
“The symptoms are predominantly above the neck,” explains Neil Schachter, MD, author of The Good Doctor’s Guide to Colds and Flu. Runny nose, cough, watery eyes, sore throat, congestion, and sneezing signal a cold, and these unpleasant symptoms often build up over a day or two. “You may feel achy or have fever, but these will be much less severe than with the flu,” says Dr. Schachter.
What to do
To shave a few days off a cold, take daily 250-500mg of vitamin C at the onset of the illness, says Dr. Schachter. “But there’s no definitive evidence that this works, and too huge amounts will irritate your stomach,” he warns—but it’s worth a shot. Zinc lozenges, such as Cold-Eze, taken intensively over 48 hours may potentially also help.
If your symptoms get bad, hit the pharmacy or your local health food store. Antihistamines can dry up your sinuses, or, for a more natural remedy, Hill suggests a saline nasal spray. “Nasal passages are where the virus replicates and enters into your system,” explains Dr. Hill. “By rinsing them out, you’re effectively flushing out some of the virus.”
What not to do
If you have a mild fever—below 100°F—don’t necessarily reach for the fever reducer, advises Dr. Lamm. “Unless you’re in a high-risk category, fever can be your body’s way of fighting off the infection.” Instead, you may just be better off getting rest and drinking plenty of fluids to make sure you don’t get dehydrated from sweating. You should also avoid decongestants, says Dr. Hill. These thicken mucus and reduce the swelling of the nasal passages, making it easier breathe—but they can also lead to a rebound effect: “They work well the first time,” says Dr. Hill, “but with every subsequent use you’ll have to administer more, and you’ll have to medicate more frequently for relief.”
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