To Dose Or Not To Dose?

October 31, 2006 9:29 AM

A twist on the question "is it better to let a cold run its course or is it better to medicate?". There have already been AskMeFi threads to this regard but I repeat the question because of something a doctor told me: if you dry up the runny nose/postnasal drainage, you prevent the mucus from going into your upper respiratory tract, thereby precluding the chest-clearing cough. Is this sound medicine? I've gone through four Kleenex just typing this question.
posted by the sobsister to Health & Fitness (12 answers total)

A cold is a virus, and OTC medications don't affect the progress of a virus. In other words, the cold is going to run its course no matter what you do. The purpose of over-the-counter medications is to make you feel better while it happens.

What that doctor said sounds wrong to me, by the way. What drains out the back of your nasal area doesn't go into your lungs; it gets swallowed.
posted by Steven C. Den Beste at 9:41 AM on October 31, 2006

I don't know, the typical course of a cold for me is sore throat then runny nose, leading to mucus in the lungs and hacking cough with a (secondary) infection requiring antibiotics, so, yes, it might help.

I am a smoker though, which means that my lungs can't clear mucus as efficiently as non-smokers'.
posted by claudius at 9:55 AM on October 31, 2006

I don't think most colds don't have chest congestion. If you have chest congestion you may have something else.
posted by dgeiser13 at 10:02 AM on October 31, 2006

I don't know, the typical course of a cold for me is sore throat then runny nose, leading to mucus in the lungs and hacking cough with a (secondary) infection requiring antibiotics, so, yes, it might help.

That's exactly how it works for me as well (having just come back from the doctor with a Z-pack for the respiratory infection). The only way I can avoid it is medicating the shit out of it when it first comes up, and hoping for the best.
posted by mckenney at 10:05 AM on October 31, 2006

A cold is not life-threatening, assuming you are otherwise healthy. You can choose to treat the symptoms or not; whichever you choose won't make a major difference in your overall life.

Cold remedies generally do a pretty good job, for me, of keeping symptoms in check. If I have a choice between being sick for seven days, but with mostly suppressed symptoms, versus being sick for four days, but with nasty symptoms, I'll medicate every time. I'm not sure that's the actual choice.... I don't know that you stay sick for longer if you take the OTC remedies. But even if I grant the supposition that it's true, I'd still take the medicines.

I know I'll be well two weeks later, with no lasting effects, so why not make myself less miserable?
posted by Malor at 10:13 AM on October 31, 2006

Postnasal drip is definitely associated with developing a cough, yes. So, if you don't want to cough, clear up the postnasal drip with meds. If I'm reading your question right, then yes, this is sound medicine. Or at least, it matches what they told me in pharmacy school.
posted by selfmedicating at 10:41 AM on October 31, 2006

If you dry up congestion in the upper resiratory tract (that is, from the throat upwards) you'd be preventing the throat-clearing cough, and also the painful sore throat that post-nasal drip can cause. You're just relieving symptoms, but relieving symptoms is the best you can do with a cold.
posted by wryly at 11:16 AM on October 31, 2006

You can feel better, and be better, in 3 to 5 minutes, without any side effects, using a hair dryer to cure your cold.
posted by paulsc at 1:03 PM on October 31, 2006

Cold meds are just to make you comfortable. Last winter I tried Zicam and that did seem to make the cold shorter.

The doctor told me at one point that the key is to drain, not to dry. Drying tends to lead to secondary stuff (I'm prone to sinus infections). He recommended using a saline nasal spray 3-5 times a day.
posted by Mrs. Smith at 1:58 PM on October 31, 2006

"I don't think most colds don't have chest congestion. If you have chest congestion you may have something else."

The typical pattern for me is to get the cold followed by the chest congestion, followed by bronchitis and being sick for weeks. This is common in asthmatics. So anything that can be done to avoid the chest problems is worth doing, IMHO (but IANAD).
posted by litlnemo at 2:20 PM on October 31, 2006

I'm not a doctor, but I've found that using decongestants and drinking lots of water early on in a cold seems to prevent me from developing the post-cold cough that most people seem to get. Assuming that the cough is caused by enough post-nasal drippage, and you can stop the post-nasal drippage by using decongestants, I don't see any reason to let the mucus run it's course and potentially cause an annoying weeks-long cough. Dry up the mucus, keep your sinuses moist with saline spray & drinking lots of fluids, and you will probably feel better in a few days.

I don't know about you, but once I get "the cough", I get the cough for several ANNOYING weeks.
posted by catfood at 2:21 PM on October 31, 2006

I am another "drain, not dry" person. I now only take expectorants (preferably time-release guaifenesen like Mucinex), plus ibuprofen and saline spray. I gave in this time after a really bad night and rinsed out with weak warm salt water a la the neti pot, and that was incredibly gross and made me feel so much better that I might actually buy the little pot instead of using my rigged squeeze bottle.

I will take a half or quarter dose of liquid decongestant (which, for me, is plenty) if I need to attend a lecture, wedding, funeral, or movie, because nobody wants to listen to me honk and gurgle, but I try to avoid it if I can.
posted by Lyn Never at 6:18 AM on November 1, 2006