A cold can make a person feel completely miserable. What’s worse than having a stuffy head and a runny nose, along with perhaps a cough, headache, or sore throat?
Many things, of course, but when you are suffering from a cold it is difficult to think about the ones that are worse. All you want is relief and speed. Should you see a doctor?
Think for a moment about what you would like to accomplish by seeing a doctor. You probably know that colds are caused by viruses and that an antibiotic will not help a virus. Unless you have an underlying problem that predisposes you to a more serious infection, such as asthma or chronic obstructive pulmonary disease (COPD), an antibiotic will not cure you more quickly. Your own body’s immune system is what cures a cold.
Since no medication will provide a true cure, what about symptom relief?
There was a time, not many years ago, when “good” drugs were available only by prescription. No longer. Almost all so-called cold medications are now available without a prescription, the same medications that were once prescribed.
The biggest problem with treating yourself at home is knowing which medicine to use for each symptom. If congestion or stuffiness is your main symptom, what you will need is a decongestant to open your airways and relieve pressure from your sinuses. There are no stronger prescription decongestants than over-the-counter pseudoephedrine, which you will have to ask your pharmacist to obtain. The drug is available without a prescription, but it is still kept “behind the counter.”
Some people benefit from an expectorant, which simply thins the mucus to make it drain more easily. Again, there is no stronger prescription drug than OTC guaifenesin, found in Mucinex, Robitussin, and similar products.
If the problem is a runny nose or postnasal discharge, you may want to blot up the mucus with an antihistamine. Diphenhydramine (Benadryl) and chlorpheniramine are inexpensive and effective, but they sometimes cause drowsiness. Cetirizine (Zyrtec), a non-sedating antihistamine, is another option. Loratadine (Claritin) works well for drying an allergic nose, but is not as effective for colds. Again, all of these drugs were prescribed only a few years ago and are as good as drugs prescribed by a doctor.
Over-the-counter pain relievers, such as acetaminophen and ibuprofen, can relieve a sore throat and sinus pain associated with a cold. Doctors will not prescribe anything stronger for your discomfort. Aspirin works well too, but is more likely to cause an upset stomach and should not be used in children under the age of 18 due to the higher incidence of Reye’s syndrome.
Dextromethorphan, found in many over-the-counter cold preparations, is an effective cough suppressant. The only thing stronger is a narcotic, which you would have to get from a doctor, who will probably suggest you try the over-the-counter dextromethorphan first.
So we’ve covered congestion, drainage, coughing, sore throat, and pain. What’s left? Chest symptoms, perhaps, but that goes beyond just a cold. If you have a chest cold, it’s probably best to see your doctor.
Finally, if a cold persists for more than approximately 10 days, a secondary infection may have occurred, for which an antibiotic might be advisable.
But in general, if you are not too sick to work or go to school, you probably don’t need to see a doctor. Give your body some time to heal.
Copyright 2010 Cynthia J. Koelker, MD
