| | | | Other Names | | | Colds, Chills, Common Cold, Common Cold Virus, Human Rhinovirus, Human
Rhinoviruses, Rhinovirus, Acute Nasopharyngitis, Nasopharyngitis, Coryza,
Head Cold, Head Colds.
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| | | The common cold is an acute (short-term) viral infection of the upper
respiratory tract that may be spread through the air, for example, by
sneezing, or by contact with contaminated objects.
Chills and
colds, though generally trivial, may serve as a prelude to serious
disease. The 'common cold' is caused by a virus, transmitted by sneezing
or coughing between members of families, schools, or people working
together. It may be precipitated by breathing in damp and chilly air,
though some people - particularly the elderly - are at greater risk.
Symptoms Nasal catarrh with a frontal headache is common, while
inflammation of the sinuses, sometimes spreading to the middle ear
with mild fever, may occur. Rarely lasting more than a few days, it may be
followed by tonsillitis or laryngitis, while secondary
respiratory infections such as bronchitis, or even pneumonia, may
occur in predisposed individuals. Although mild, a cold often causes a
short period of immuno-depression, which may lead to more serious diseases
such as measles, whooping cough, influenza and tuberculosis.
Treatment
A couple of days bed rest provides relief for the
sufferer, while also reducing the exposure of others to his infection.
Vaccines seem ineffectual in the prevention of colds. Prompt medical
advice should be sought in cases of prolonged or severe secondary
infections.
What are the symptoms of the common cold? The common
cold often causes runny nose, sore throat, and malaise (vague discomfort).
Sore throat is sometimes a symptom of a more serious condition distinct
from the common cold, such as strep throat, which may require medical
diagnosis and treatment with appropriate antibiotics. Since it is a viral
infection, antibiotics are not effective against the common
cold.
Conventional treatment options: A warm, humid environment
increases comfort during the common cold. For people with severe symptoms,
rest is recommended. Nasal decongestants (e.g., pseudoephedrine,
phenylephrine) may provide temporary relief, but rebound congestion often
occurs. It is important to drink plenty of fluids in order to maintain
water balance and easily flowing secretions. If a cough is severe or
painful, cough suppressants (e.g., dextromethorphan) may be recommended,
particularly as a way of facilitating sleep. Otherwise, expectoration of
sputum is considered a valuable mechanism for expelling infectious
organisms and congested secretions, and therefore it should not be
suppressed.
Dietary changes that may be helpful: Excessive sugar,
dietary fat, and alcohol have been reported to impair immune function,
although no specific information is available on how these foods may
affect the course of the common cold.
Nutritional supplements that
may be helpful: A review of 21 controlled trials using 1 to 8 grams of
vitamin C per day found that "in each of the twenty-one studies, vitamin C
reduced the duration of episodes and the severity of the symptoms of the
common cold by an average of 23%."1 The optimum amount of vitamin C to
take for cold treatment remains in debate but may be as high as 1 to 3
grams per day, considerably more than the 120 to 200 mg per day that has
been suggested as optimal intake for healthy adults. A review of 23
controlled trials found that vitamin C supplementation produces a greater
benefit for children than for adults.2 The same review found that a daily
amount of 2 grams or more was superior to a daily amount of 1 gram at
reducing the duration of cold symptoms.
Zinc interferes with viral
replication in test tubes, may interfere with the ability of viruses to
enter cells of the body, may help immune cells to fight a cold, and may
relieve cold symptoms when taken as a supplement.3 In double-blind trials,
zinc lozenges have reduced the duration of colds in adults4 5 but have
been ineffective in children.6 Lozenges containing zinc gluconate, zinc
gluconate-glycine, and, in most trials, zinc acetate7 8 have been
effective; most other forms of zinc and lozenges flavored with citric
acid,9 tartaric acid, sorbitol, or mannitol have been ineffective.10
Trials using these other forms of zinc have failed, as have trials that
use insufficient amounts of zinc.11 For the alleviation of cold symptoms,
lozenges providing 13 to 25 mg of zinc gluconate, zinc gluconate-glycine,
or zinc acetate are used every two hours while awake but only for several
days. The best effect is obtained when lozenges are used at the first sign
of a cold.
An analysis of the major zinc trials has claimed that
evidence for efficacy is "still lacking."12 However, despite a lack of
statistical significance, this compilation of data from six double-blind
trials found that people assigned to zinc had a 50% decreased risk of
still having symptoms after one week compared with those given placebo.
Some trials included in this analysis used formulations containing
substances that may inactivate zinc salts. Other reasons for failure to
show statistical significance, according to a recent analysis of these
studies,13 may have been small sample size (not enough people) or not
enough zinc given. Thus, there are plausible reasons why the authors were
unable to show statistical significance, even though positive effects are
well supported in most trials using gluconate, gluconate-glycine, or
acetate forms of zinc.
Zinc nasal sprays may be even more effective
than zinc lozenges at speeding the resolution of cold symptoms. A
double-blind trial showed a 74% reduction in symptom duration in people
using a zinc nasal spray four times daily, compared with the 42 to 53%
reduction reported in trials using zinc gluconate or zinc acetate
lozenges.14 The average duration of symptoms after the beginning of
treatment was 2.3 days in the people receiving zinc, compared with 9.0
days in those receiving placebo.
Propolis is the resinous substance
collected by bees from the leaf buds and bark of trees, especially poplar
and conifer trees. Propolis extracts may be helpful in preventing and
shortening the duration of the common cold. A preliminary clinical trial
reported propolis extract (daily dose not given) reduced upper respiratory
infections in children.15 In one small, double-blind trial of propolis for
the common cold, the group taking propolis extract (amount unstated)
became free of symptoms more quickly than the placebo group.16 Most
manufacturers recommend 500 mg of oral propolis products once or twice
daily.
Are there any side effects or interactions? Refer to the
individual supplement for information about any side effects or
interactions.
Herbs that may be helpful: Four different categories
of herbs are used to help combat the common cold. First, herbs that
stimulate the immune system to fight the infection are used during the
onset of the common cold-echinacea and Asian ginseng are two examples.
Second, herbs known as diaphoretics promote a mild fever and sweating both
of which are useful for fighting infection. A fever is a sign that the
immune system is working; thus, diaphoretics may also be immune
stimulators-elder, boneset, and yarrow are three examples. The third
category includes herbs that, based on test tube studies, may directly
kill the viruses that cause colds-goldenseal, myrrh, and usnea are
examples. Finally, a fourth category of herbs are used to alleviate cold
symptoms, such as sore throats. These herbs tend to be high in mucilage
and are soothing and anti-inflammatory, or have tannins that are
astringent (i.e., that constrict boggy tissue, promoting
healing)-marshmallow and red raspberry are two
examples.
Double-blind trials have shown that various echinacea
extracts shorten the duration of the common cold.17 18 Fresh pressed juice
of echinacea (E. purpurea) flowers preserved with alcohol, and tinctures
of echinacea (E. pallida) root are the forms most commonly studied and
proven effective. In addition, several double-blind trials have found that
echinacea (E. angustifolia) root tinctures in combination with wild
indigo, boneset, and homeopathic arnica reduce symptoms of the common
cold.19 In one double-blind trial, a proprietary formulation of echinacea,
white cedar, and wild indigo, known as Esberitoxr, reduced the length and
severity of cold symptoms significantly more than did placebo.20 There is
only one, as yet unpublished, study that has found echinacea to be
ineffective for the common cold.21
Echinacea is believed to work
primarily through immune stimulation. The minimum effective amount of
echinacea tincture or juice appears to be 3 ml three times per day. Higher
amounts, such as 3 to 5 ml every two hours, is generally better and is
safe, even for children.22 Encapsulated products may also be effective,
according to a double-blind trial using the root of E. pallida.23
Generally, capsules containing 300 to 600 mg are used three times per day.
According to one double-blind trial, employees of a nursing home who
consumed echinacea tea at the onset of a cold or flu reduced the duration
of their symptoms by about two days when compared with people consuming a
placebo tea.24 The participants drank five to six cups of tea on the first
day of their symptoms and decreased this by one cup each day over the next
five days.
Double-blind trials indicate that regular use of
echinacea to prevent colds does not work.25 26 27 Therefore, it is
currently recommended to use echinacea at the onset of a cold, for a total
of 7 to 10 days.
Andrographis contains bitter constituents that are
believed to have immune-stimulating and anti-inflammatory actions.28
Several double-blind trials have found that andrographis may help reduce
symptom severity in people with common colds.29 30 31 32 Though the
earliest clinical trial among these showed modest benefits, later studies
have tended to be more supportive. A combination of a standardized
andrographis extract combined with eleuthero, known as Kan jang, has also
been shown in a double-blind trial to reduce symptoms of the common
cold.33
Herbal supplements can help strengthen the immune system
and fight infections. Adaptogens, which include eleuthero, Asian ginseng,
astragalus, and schisandra, are thought to help keep various body
systems-including the immune system-functioning optimally. They have not
been systematically evaluated as cold remedies. However, one double-blind
trial found that people who were given 100 mg of Asian ginseng extract in
combination with a flu vaccine experienced a lower frequency of colds and
flu compared with people who received only the flu
vaccine.34
According to test tube experiments,35 wild indigo
stimulates immune function, which might account for its role in fighting
the common cold and flu. In combination with echinacea, boneset, and
homeopathic arnica, as mentioned above, wild indigo has prevented and
reduced symptoms of the common cold in double-blind research. Wild indigo
is traditionally considered a strong antimicrobial agent, though it has
not yet been investigated as an agent against cold viruses.
Boneset
is another immune stimulant and diaphoretic that helps fight off minor
viral infections, such as the common cold. In addition, linden and hyssop
may promote a healthy fever and the immune system's ability to fight
infections. Yarrow is another diaphoretic that has been used for relief of
sore throats, though it has not yet been researched for this
purpose.
Goldenseal root contains two alkaloids, berberine and
canadine, with antimicrobial and mild immune-stimulating effects.36
However, due to the small amounts of alkaloids occurring in the root, it
is unlikely these effects would occur outside the test tube. Goldenseal
soothes irritated mucous membranes in the throat,37 making it potentially
useful for those experiencing a sore throat with their cold. Human
research on the effectiveness of goldenseal or other berberine-containing
herbs, such as Oregon grape, barberry, or goldthread (Coptis chinensis),
for people with colds has not been conducted.
Goldenseal root
should only be used for short periods of time. Goldenseal root extract, in
capsule or tablet form, is typically taken in amounts of 4 to 6 grams
three times per day. Using goldenseal powder as a tea or tincture may
soothe a sore throat. Because goldenseal is threatened in the wild due to
over-harvesting, substitutes such as Oregon grape should be used whenever
possible.
Elderberry has shown antiviral activity and thus may be
useful for some people with common colds. Elder flowers are a traditional
diaphoretic remedy for helping to break fevers and promote sweating during
a cold. Horseradish has antibiotic properties, which may account for its
usefulness in easing throat and upper respiratory tract infections. The
resin of the herb myrrh has been shown to kill various microbes and to
stimulate macrophages (a type of white blood cell). Usnea has a
traditional reputation as an antiseptic and is sometimes used for people
with common colds.
Herbs high in mucilage, such as slippery elm,
mallow (Malvia sylvestris), and marshmallow, are often helpful for
symptomatic relief of coughs and irritated throats. Mullein has
expectorant and demulcent properties, which accounts for this herb's
historical use as a remedy for the respiratory tract, particularly in
cases of irritating coughs with bronchial congestion. Coltsfoot is another
herb with high mucilage content that has been used historically to soothe
sore throats. However, it is high in pyrrolizidine alkaloids-constituents
that may damage the liver over time. It is best to either avoid coltsfoot
or look for products that are free of pyrrolizidine alkaloids.
Red
raspberry, blackberry, and blueberry leaves contain astringent tannins
that are helpful for soothing sore throats.38 Sage tea may be gargled to
soothe a sore throat. All of these remedies are used traditionally, but
they are currently not supported by modern research.
Eucalyptus oil
is often used in a steam inhalation to help clear nasal and sinus
congestion. It is said to work similarly to menthol, by acting on
receptors in the nasal mucous membranes, leading to a reduction of nasal
stuffiness.39 Peppermint may have a similar action and is a source of
small amounts of menthol.
Meadowsweet has been used historically
for a wide variety of conditions. It is reputed to break fevers and to
promote sweating during a cold or flu. Meadowsweet contains salicylates,
which possibly give the herb an aspirin-like effect, particularly in
relieving aches and pains during a common cold. While not as potent as
willow, which has a higher salicin content, the salicylates in meadowsweet
do give it a mild anti-inflammatory effect and the potential to reduce
fevers during a cold or flu. However, this role is based on historical use
and knowledge of the chemistry of meadowsweet's constituents; to date, no
human studies have been completed with meadowsweet.
Traditional
Chinese Medicine practitioners use Chinese artichoke (Stachys sieboldii),
a species similar to wood betony (Stachys betonica), for colds and flu.40
It is unknown whether wood betony would be useful for people with the
common cold.
Are there any side effects or interactions? Refer to
the individual herb for information about any side effects or
interactions.
References:
1. Hemil„ H. Does vitamin C
alleviate the symptoms of the common cold?-a review of current evidence.
Scand J Infect Dis 1994;26:1-6.
2. Hemil„ H. Vitamin C
supplementation and common cold symptoms: factors affecting the magnitude
of the benefit. Med Hypotheses 1999;52:171-8.
3. Macknin ML. Zinc
lozenges for the common cold. Cleveland Clin J Med 1999;66:27-32
[review].
4. Eby G, Davis DR, Halcomb WW. Reduction in duration of
common colds by zinc gluconate lozenges in a double-blind study.
Antimicrobial Agents Chemotherapy 1984;25:20-4.
5. Al-Nakib W,
Higgins PG, Barrow I, et al. Prophylaxis and treatment of rhinovirus colds
with zinc gluconate lozenges. J Antimicrobial Chemotherapy
1987;20:893-901.
6. Macknin ML, Piedmonte M, Calendine C, et al.
Zinc gluconate lozenges for treating the common cold in children. A
randomized controlled trial. JAMA 1998;279:1962-7.
7. Petrus EJ,
Lawson KA, Bucci LR, Blum K. Randomized, double-masked, placebo-controlled
clinical study of the effectiveness of zinc acetate lozenges on common
cold symptoms in allergy-tested subjects. Curr Ther Res
1998;59:595-607.
8. Prasad AS, Fitzgerald JT, Bao B, et al.
Duration of symptoms and plasma cytokine levels in patients with the
common cold treated with zinc acetate. A randomized, double-blind,
placebo-controlled trial. Ann Intern Med 2000;133:245-52.
9. Eby G.
Where's the bias? Ann Intern Med 1998;128:75 [letter].
10. Garland
ML, Hagmeyer KO. The role of zinc lozenges in treatment of the common
cold. Ann Pharmacolther 1998;32:63-9 [review].
11. Weismann K,
Jakobsen JP, Weismann JE, et al. Zinc gluconate lozenges for common cold.
A double-blind clinical trial. Dan Med Bull 1990;37:279-81.
12.
Jackson JL, Peterson C, Lesho E. A meta-analysis of zinc salts lozenges
and the common cold. Arch Intern Med 1997;157:2373-6.
13. Macknin
ML. Zinc lozenges for the common cold. Cleveland Clin J Med 1999;66:27-32
[review].
14. Hirt M, Nobel S, Barron E. Zinc nasal gel for the
treatment of common cold symptoms: a double-blind, placebo-controlled
trial. Ear Nose Throat J 2000;79:778-80.
15. Crisan I, Zaharia CN,
Popovici F, et al. Natural propolis extract NIVCRISOL in the treatment of
acute and chronic rhinopharyngitis in children. Rom J Virol
1995;46:115-33.
16. Szmeja Z, Kulczynski B, Sosnowski Z, Konopacki
K. Therapeutic value of flavonoids in Rhinovirus infections. Otolaryngol
Pol 1989;43(3):180-4 [in Polish].
17. Brown D. Echinacea root fails
to prevent upper respiratory tract infections. Healthnotes Rev Compl
Integr Med 1999;6:6-7 [review].
18. Hoheisel O, Sandberg M, Bertram
S, et al. Echinagard treatment shorteds the course of the common cold: A
double-blind, placebo-controlled clinical trial. Eur J Clin Res
1997;9:261-8.
19. Melchart D, Linde K, Worku F, et al.
Immunomodulation with echinacea-a systematic review of controlled clinical
trials. Phytomedicine 1994;1:245-54 [review].
20. Henneicke-von
Zepelin H, Hentschel C, Schnitker J, et al. Efficacy and safety of a fixed
combination phytomedicine in the treatment of the common cold (acute viral
respiratory tract infection): results of a randomised, double blind,
placebo controlled, multicentre study. Curr Med Res Opin
1999;15:214-27.
21. Galea S, Thacker K. Double-blind prospective
trial investigating the effectiveness of a commonly prescribed herbal
remedy in altering duration, severity and symptoms of the common cold.
Unpublished, 1996.
22. Schilcher H. Phytotherapy in Paediatrics:
Handbook for Physicians and Pharmacists. Stuttgart: Medpharm Scientific
Publishers, 1997, 43-5.
23. Dorn M, Knick E, Lewith G.
Placebo-controlled, double-blind study of Echinacea pallidae radix in
upper respiratory tract infections. Compl Ther Med 1997;5:40-2.
24.
Lindenmuth GF, Lindenmuth EB. The efficacy of echinacea compound herbal
tea preparation on the severity and duration of upper respiratory and flu
symptoms: a randomized, double-blind placebo-controlled study. J Altern
Comp Med 2000;6:327-34.
25. Melchart D, Walther E, Linde K, et al.
Echinacea root extracts for the prevention of upper respiratory tract
infections: a double-blind, placebo-controlled randomized trial. Arch Fam
Med 1998;7:541-5.
26. Grimm W, Mueller HH. A randomized controlled
clinical trial of the effect of fluid extract of Echinacea purpurea on the
incidence and severity of colds and respiratory infections. Am J Med
1999;106:138-43.
27. Brikenborn RM, Shah DV, Degenring FH.
Echinaforce and other Echinacea fresh plant preparations in the treatment
of the common cold: A randomized, placebo-controlled, double-blind
clinical trial. Phytomedicine 1999;6:1-5.
28. Bone K. Clinical
Applications of Ayurvedic and Chinese Herbs: Monographs for the Western
Herbal Practitioner. Queensland, Australia: Phytotherapy Press, 1996,
96-100.
29. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al.
Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in
adults. J Med Assoc Thai 1991;74:437-42.
30. Melchior J, Palm S,
Wikman G. Controlled clinical study of standardized Andrographis
paniculata extract in common cold-a pilot trial. Phytomedicine
1996;3:314-8.
31. Hancke J, Burgos R, Caceres D, Wikman G. A
double-blind study with a new monodrug Kan Jang: Decrease of symptoms and
improvement in recovery from common colds. Phytother Res
1995;9:559-62.
32. C ceres DD, Hancke JL, Burgos RA, et al. Use of
visual analogue scale measurements (VAS) to assess the effectiveness of
standardized Andrographis paniculata extract SHA-10 in reducing the
symptoms of common cold. A randomized double blind-placebo study.
Phytomedicine 1999;6:217-23.
33. Melchior J, Spasov AA, Ostrovskij
OV, et al. Double-blind, placebo-controlled pilot and phase III study of
activity of standardized Andrographis paniculata Herba Ness extract fixed
combination (Kan jang) in the treatment of uncomplicated upper-respiratory
tract infection. Phytomedicine 2000;7:341-50.
34. Scaglione F,
Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized
ginseng extract G 115 for potentiating vaccination against common cold
and/or influenza syndrome. Drugs Exptl Clin Res 1996;22:65-72.
35.
Beuscher N, Kopanski L. Stimulation of immunity by the contents of
Baptisia tinctoria. Planta Med 1985;5:381-4.
36. Murray MT. The
Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995,
162-72.
37. Bradley PR, ed. British Herbal Compendium, Vol. 1.
Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992,
119-20.
38. Schilcher H. Phytotherapy in Paediatrics. Stuttgart,
Germany: Medpharm Scientific Publishers, 1997, 126-7.
39. Schulz V,
Hansel R, Tyler VE. Rational Phytotherapy, 3rd ed. Berlin: Springer
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40. Li SC, Smith FP, Stuart GA. Chinese
Medicinal Herbs. San Francisco: Georgetown Press, 1973:422.
Source:
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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