Cold/routine upper respiratory infection -- there are lots of things that people have tried but in general not much has panned out to help treat a cold. Antibiotics do nothing for a cold, but they may throw off your intestinal tract and decrease your ability to absorb nutrients for the next month. Zinc, at a dose of 50 mg three times a day has shown some mild benefit if started immediately on onset of symptoms. This can be found in the vitamin section of any grocery store. It is often found for a higher price in things like Cold EZZ. Vitamin C, Echinacea, and chicken soup have never held up in good scientific studies to decrease the duration of a cold, in fact our friends at UVA did a great study on Echinacea last year which showed no benefit. Rest and hydration are probably the best things you can do.

Flu -this is usually characterized by abrupt onset of fever over 101, body aches, cough. If you have the true flu he won't even be able to think about training. Antibiotics do nothing for the flu. The medication Tamiflu has received a lot of press. The truth of it is that in healthy adults it decreases the duration of the flu by less than 24 hours if started within the first 48 hours of onset. It is generally safe, but it is no miracle. In the elderly, it can be more helpful, but in healthy young adults their own body does the majority of the work. Again, the best thing to do is rest, get good hydration, and wait it out.

Medications -- there are a significant number of medications for symptom relief. Remember, they will not speed up the duration of the illness, they may just help with your symptoms. Decongestants are medications such as Sudafed which dry up your mucus production. Sudafed also raises your heart rate, and your blood pressure. It will give you dry mouth and may affect your reaction time. If you can't get your nose to open up, or the snot to stop flowing, this may be helpful. Expectorants are medications such as guaifenessin (mucinex) of which is designed to loosen the mucus, again little data that it does much good in the long-term. Anti-histamines (Benadryl, Allegra, Claritin..) really have no place in treatment of the above conditions as these are allergy medications. Cough suppressants -- these come in a variety of forms and generally just tried to put you to sleep. None is particularly better than the other, it just seems to be a personal basis. Now, if these medications help you feel better, that is OK, but don't expect them to make things go away. You may wonder then why there are so many medications at your local pharmacy shelf -- it goes back to one of the founding fathers of Western medicine, Sir William Osler, who said “The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.” Doctors are notorious for suggesting these medications also because it gives them something to tell the patient. Patients in general don't like to pay money only to be told there is nothing to do.

Return to activity -- first, never exercise with a fever. That is a must as there have been developments of heart conditions following this. If all has gone well and you shut yourself down for a few days to let your body fight the infection, you should be able to start exercising at half speed four or five days later. Work your way back over the next four to five days to your training schedule. If you try to work through an infection, you'll often just prolong the time in tell you have to shut down. This will mean a longer course of poor training than a few just shut down to begin with. If you feel that anything is getting worse after you start back, slow down. If it is taking more than a week to get over a cold or flu you may need to get in with your physician. Some people will develop a one –two punch where they may start with a viral infection and develop a bacterial infection afterwards. From a prevention standpoint, try to remember that good handwashing and avoiding sick people is one of your best defenses this time of year. These are just some guidelines, but in general remember your body needs energy to fight an infection, and never exercise with a fever.

Until next time…

Matt Marchal, M.D.