Starve a cold, feed a fever? Or is it feed a cold, starve a fever?

/ July 9, 2014/ Cold & Flu, Cough, Nasal Congestion, Nasal Irrigation/ 6 comments

Starve a cold, feed a fever? Or is it feed a cold, starve a fever?

David B Engler MD, FACAAI, FAAAI Board Certified Pediatric & Adult Allergist and Immunologist www.allergyhouston.com About the author: Dr. David B Engler is a Phi Beta Kappa graduate of the University of Texas at Austin and a graduate of Baylor College of Medicine. He trained in allergy at The University of Texas Medical Branch. Dr. Engler has served two terms on the Board of Regents at the American College of Allergy, Asthma and Immunology and has published several manuscripts on allergy and allergy testing in national peer-reviewed journals. He has also served as the Chairman of the Section of Allergy and Asthma for the Texas Medical Association.

As we head into cold and flu season, many of us will catch a viral infection that will give us symptoms of a common cold: runny and/or stuffy nose, sore throat, cough, headache, and yellow mucus. So if we’re infected, we should take an antibiotic, right? Wrong! Antibiotics don’t work on viruses, and viruses cause colds. A review of sinus infections from the New England Journal of Medicine (2004;351:902-910) stated that using antibiotics is usually not recommended until the mucus has been discolored for at least 7 or 10 days. Many of the patients we treat for allergy to multiple antibiotics develop those allergies when their antibiotic is changed over and over again. It gets changed because they take the first antibiotic when the “cold” first appears. Amazingly, the antibiotic does nothing to treat the virus, which runs it course. The patient, not feeling any better, asks for another antibiotic. And sometimes another. For years, the line about chicken soup was, “Will it help?” “Well, it couldn’t hurt”. Scientific evidence suggests that chicken soup actually does help. It contains the amino acid, cysteine, which has been shown to thin out thick mucus secretions and help relieve congestion. Hydrating by drinking Gatorade, water or any non-caffeinated beverage helps further. What about “feed a cold, starve a fever”. It’s actually not a bad idea. A fever without cold symptoms may be the flu (influenza), another viral infection often manifest by nausea and vomiting. Starving the fever by withholding food is reasonable if one is nauseated, but make sure you drink plenty of fluids. Gatorade is a good choice here, too. What else works when you have a cold? Rinsing your nose out with a salt-water solution a couple times a day. Some people prefer a Neti Pot, and others like the NeilMed squeeze bottle. Whichever you use, mix the salt with distilled water, not tap water. I’m sure the city makes clean drinking water, but I’m not as confident in the old pipes it runs through. And Mucinex works by increasing the water content in the mucus, so that the mucus thins out and you can cough it up or blow it out. For a stuffy nose, you may want to consider a decongestant spray such as Afrin. But don’t use Afrin more than 5 days in a row or you may become physically dependent on it (addicted).

And remember, unless you have an immune deficiency; skip the antibiotics until the mucus is yellow or green for at least a week.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.

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