Cold Medicines: They May Be Worthless Or They May Be Harmful
Scripps Howard News Service
The common cold is common, all right.
Most adults get three to five annually; most children get six. Every year in the United States, colds cause 262 million days of restricted activity, more than 22 million lost school days and more than 26 million lost work days.
Many of us just tough it out – “Most colds are minor nuisances and last about a week,” says Dr. Lewis Kuller, chairman of the epidemiology department at the University of Pittsburgh’s Graduate School of Public Health – but many others pop pill after pill to get relief.
We swallow $2.4 billion worth a year. Aspirin, which has been available in tablet form since 1899, is the No. 1 over-the-counter analgesic, with 42 percent of the market.
Acetaminophen (the active ingredient in Tylenol and Panadol) has about 36 percent and ibuprofen (the active ingredient in Advil, Motrin and Nuprin) 21 percent.
Now, a Johns Hopkins University study suggests these medicines might do cold victims more harm than good.
Fifty-six college students volunteered to be infected with rhinovirus 2, one of the almost 200 cold-causing viruses.
Subjects who took aspirin or acetaminophen produced fewer antibodies and had a weaker immune response and increased nasal swelling and blockage. Those who took ibuprofen showed the same pattern, although milder. The study was published in the Journal of Infectious Diseases.
The analgesics pose other risks. Aspirin has been linked to gastric bleeding, hearing impairment in heavy users and the potentially fatal neurological disorder Reye’s syndrome in children.
An acetaminophen overdose can cause delayed liver damage and it appears chronic overuse can damage the kidneys. Ibuprofen also can cause kidney failure, especially in people with such ailments as high blood pressure, heart disease and pre-existing kidney problems. Vanderbilt University researchers say it doubles the risk of ulcers.
Kuller and other health authorities don’t dismiss the medicines as worthless or urge adorning their packages with a skull and crossbones, but they do say people should use common sense.
Americans tend to take medicine for everything, which often engenders improper or even futile use, says Ed Krenzelok, director of Pittsburgh Poison Center.
Say, for instance, your cold has stuffed up your nose. “Aspirin, acetaminophen or ibuprofen aren’t going to do a darn thing for that,” he says. They relieve pain and reduce fever, so if you have neither symptom, “there’s little reason to use them.”
In some cold victims, “there is definitely a perceived benefit from taking aspirin or, especially in children, acetaminophen because they can’t take aspirin because of the danger of Reye’s syndrome,” says Dr. Frederick Ruben, an infectious-disease specialist. “In others, it seems to make no difference at all.”
However, he says, “I sure as heck would not endorse ibuprofen for common colds any more than I would be against people taking aspirin if it made them feel better. I categorize it as a stronger medication with more potential side effects than aspirin.”
Many people develop symptoms from the medicines themselves, says Krenzelok, who has a doctorate in pharmacology. The chief side effect of antihistamines is drowsiness. Some cold medications contain ingredients that constrict blood vessels, which can raise blood pressure to levels dangerous to hypertensives.
He says the poison center gets frequent calls about adults who have taken medicines that have worsened a problem.
Concerned about possible interactions, many doctors now recommend that people use cold products that contain just one or two drugs instead of multi-content medicines. Krenzelok endorses that stand .
“How often is it you have a horrible cough, nasal congestion and a headache in one little package? In my experience, it isn’t that frequent.”
The recommendation appeals to Ruben, “but if someone has taken a multi-content product that works for them, I don’t have any problem with that.” He does, though, warn that those products have the potential for side effects and that people who take them should be “very cautious.”
Kuller is the least worried about side effects, interaction and worsening existing health problems. He knows of no data that suggests taking small quantities of aspirin is “any great hazard” and says the link between acetaminophen and kidney disease usually has been in very heavy users.
Colds, simply, are minor illnesses, he says. “Most people will get over these things themselves. If they take a little aspirin or antihistamine, it’s not going to hurt. It’s very rare that people have reactions.”
Unless, of course, they don’t follow the manufacturer’s instructions.
Says Krenzelok: “People have the thought that because it’s non-prescription it’s non-toxic, and people use them almost with a complacency – `If it says on the bottle to take one or two, I can take three or four.’ That occasionally gets people into problems.”
So what should you do when you get a cold? A number of things.
— “Drink plenty of liquids” is old but sound advice. You need more fluids to replace those lost through nasal secretions, but leave the booze in the bottle. Alcohol is a dehydrating agent.
— Wash your hands after blowing your nose to lessen the chance of infecting others.
— “Take out some Kleenex. The cold will disappear by itself,” says Kuller. In children, however, “we worry about streptococcal infection and rheumatic fever. Children with sore throats and high fevers should be seen by a pediatrician or family doctor. In adults with pulmonary or heart disease, a respiratory infection can be a cause of considerable concern.”
— Remember that cold medicines don’t kill the virus. They alleviate symptoms. Therefore, says Ruben, “If your symptoms are relieved by a medication, feel free to use it.”
— Krenzelok says to ask your pharmacist – he calls them “the most under-utilized health-care professionals” – for advice and buy only what you need to relieve your symptoms. “It’s generally cheaper that way.”
— Above all, he says, be patient and allow the medicines to work.
What about home remedies such as hot baths and facial compresses, hot lemonade, tea with honey and lemon, eucalyptus chest rubs and the ever-popular chicken soup, often lovingly called “Jewish penicillin”?
The experts agree – use any that sound good to you. Says Kuller with a chuckle, “They work about as well as some of the drugs.”
A QUIZ ON COLDS
The best way to cure a cold is not to get one. Take this true-false quiz to see how much you know about how colds are contracted and transmitted:
1. Colds are transmitted easily by hand-to-hand contact.
2. As you age, your chance of catching a cold decreases, as does the severity of the ones you do get.
3. People who live or work with school-age children are more likely to catch colds.
4. Colds are spread easily in poorly ventilated places.
5. There is a link between colds and diet.
6. Family members shouldn’t worry about spreading cold viruses among themselves.
7. Emotional stress increases your likelihood of catching colds.
8. Turning up the heat reduces the possibility of catching a cold.
9. Smokers generally experience more severe symptoms than non-smokers.
10. You can catch colds by not dressing appropriately for cold weather.
1. True. Hand-to-hand contact followed by self-contamination seems to be the most common means. Some cold viruses can survive for several hours on the hands, in cloth handkerchiefs and on hard, non-porous substances such as counters, dishes, drinking glasses, doorknobs and telephones. Non-afflicted people get the virus on their fingers and infect themselves by rubbing their eyes or touching or wiping their noses.
2. True. But people 65 and older and people with chronic heart or respiratory problems, diabetes, asthma or weakened immune systems are high-risk candidates for flu.
3. True. Young school-age children are the most susceptible to and the prime spreaders of cold viruses. Usually, as children and parents age, the frequency of colds drops. Teachers and day-care workers are at greater risk because they’re exposed to so many children’s viruses.
4. True. Transmission is faster in rooms with closed windows, crowded classrooms and public transportation.
5. True. Some studies indicate a diet rich in fiber, several minerals and vitamins A, B, C and E bolsters the body’s immune system.
6. False. In a home, it’s more likely family members who aren’t immune to a particular virus will catch it from a sick member.
7. True. Stress and excessive fatigue increase the risk of many illnesses, including colds.
8. False. Cold viruses are most effective in dry air, and turning up the heat reduces the relative humidity of a room. That dries nasal mucus, which opens cracks that allow viruses to infect exposed cells.
9. True. Especially coughing. Some studies also show the children of smoking parents are more susceptible to all respiratory illnesses.
10. False. Exposure to cold weather, sitting in a draft and getting chilled or overheated don’t cause you to “catch your death of cold.”
Scripps-Howard News Service.