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Treating The Common Cold

For the last week I have had a cold. I usually get one each winter. I have two kids in school and they bring home a lot of viruses. I also work in a hospital, which tends (for some reason) to have lots of sick people. Although this year I think I caught my cold while traveling.  I’m almost over it now, but it’s certainly a miserable interlude to my normal routine.

One thing we can say for certain about the common cold — it’s common. It is therefore no surprise that there are lots of cold remedies, folk remedies, pharmaceuticals, and “alternative” treatments. Finding a “cure for the common cold” has also become a journalistic cliche — reporters will jump on any chance to claim that some new research may one day lead to a cure for the common cold. Just about any research into viruses, no matter how basic or preliminary, seems to get tagged with this headline. (It’s right up there with every fossil being a “missing link.”)

But despite the commonality of the cold, the overall success of modern medicine, and the many attempts to treat or prevent the cold — there are very few treatments that are actually of any benefit. The only certain treatment is tincture of time. Most colds will get better on their own in about a week. This also creates the impression that any treatment works — no matter what you do, your symptoms are likely to improve. It is also very common to get a mild cold that lasts just a day or so. Many people my feel a cold “coming on” but then it never manifests. This is likely because there was already some partial immunity, so the infection was wiped out quickly by the immune system. But this can also create the impression that whatever treatment was taken at the onset of symptoms worked really well, and even prevented the cold altogether.

What Works

There is a short list of treatments that do seem to have some benefit. Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, and naproxen, can reduce many of the symptoms of a cold – sore throat, inflamed mucosa, aches, and fever. Acetaminophen may help with the pain and fever, but it is not anti-inflammatory and so will not work as well. NSAIDs basically take the edge off, and may make it easier to sleep. Read more »

*This blog post was originally published at Science-Based Medicine*

Health And The Value Of Open-Mindedness

Three recent sto­ries lead me to my open­ing topic for the year: The value of open-mindedness. This char­ac­ter­is­tic — a state of recep­tive­ness to new ideas — affects how we per­ceive and process infor­ma­tion. It’s a qual­ity I look for in my doc­tors, and which I admire espe­cially in older people.

Piece #1 — On the brain’s matu­rity, flex­i­bil­ity and “cog­ni­tive fitness”

For the first piece, I’ll note a Dec 31 op-ed piece that appeared in the New York Times: This Year, Change Your Mind, by Dr. Oliver Sacks, the neu­rol­o­gist and author. In this thought­ful essay, he con­sid­ers the adult brain’s “mys­te­ri­ous and extra­or­di­nary” power to adapt and grow: “I have seen hun­dreds of patients with var­i­ous deficits — strokes, Parkinson’s and even demen­tia — learn to do things in new ways, whether con­sciously or uncon­sciously, to work around those deficits.”

With appro­pri­ate and very-real respect, I ques­tion Sacks’ objec­tiv­ity on this sub­ject — he’s referred some of the most out­stand­ing (i.e. excep­tional) neu­ro­log­i­cal cases in the world. And so it may be that his care­ful reports are per­fectly valid but not rep­re­sen­ta­tive; for most of us, the adult brain’s capac­ity to estab­lish new cir­cuitry for lan­guage learn­ing or music appre­ci­a­tion may be lim­ited. What his sto­ries do show is that unimag­in­ably strange things hap­pen in our brains, at least occa­sion­ally. And maybe we should just accept that and take notes (as he does so care­fully), and keep an open mind. Read more »

*This blog post was originally published at Medical Lessons*

Echinacea For Colds: Does It Really Work?

Does echinacea, the popular natural cold remedy, really work?

It depends on what you mean by “work.” Results [recently] reported in the Annals of Internal Medicine found that echinacea may reduce the length of a week-long cold by 7 to 10 hours and make symptoms a little less onerous. That can’t be characterized as a major effect, so many people may figure that the trouble and expense of echinacea just isn’t worth it (fortunately, side effects from echinacea don’t seem to be much of an issue.)

But others may decide that some benefit is better than none, and these results do fit with others that have left the door slightly ajar for echinacea having some effect as a cold remedy — a modest effect, but an effect, nonetheless.

A summary for patients published by the Annals summed up the situation nicely:

People who take echinacea to treat colds may experience a decrease in the length and severity of their cold symptoms but to such a small degree that they may not care about the difference. Although many studies of echinacea have been performed, researchers still disagree about its benefits in treating the common cold. This study is unlikely to change minds about whether to take this remedy.

Have you tried echinacea as a cold remedy? Has it worked? How do research findings, pro and con, affect your opinion of so-called alternative medicines?

Many of the echinacea studies, especially early on, were sponsored by companies making or selling the product. This study was supported by a grant from the National Center for Complementary and Alternative Medicine, which is part of the National Institutes of Health.

- Peter Wehrwein, Editor, Harvard Health Letter

*This blog post was originally published at Harvard Health Blog*

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