Also indexed as: Pharyngitis, Upper Respiratory Infection,
Coughing. Aching Sneezing. Take a few simple actions to knock out
the annoying common cold. According to research or other evidence, the following self-care
steps may be helpful:
- Be sure to rest
- Give your body some down time to help it fight off the cold
- Drink those fluids
- Get plenty of water and other clear fluids to help thin mucus
- Take extra vitamin C
- Studies have shown 1 to 4 grams a day may make your cold shorter
and less severe
- Shorten sick time with echinacea
- At the first signs of a cold, take 3 to 5 ml of this herb as a
juice or tincture every two hours to make your cold less severe
- Use zinc lozenges
- Use lozenges containing zinc gluconate, zinc gluconate-glycine, or
zinc acetate, providing 13 to 25 mg every two hours, to help stop the virus and shorten the
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full common cold article for
more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About the common cold
The common cold is an acute (short-term) viral infection of the upper respiratory tract
that may be spread through the air (by sneezing, for example) or by contact with contaminated
Product ratings for the
What are the symptoms?
The common cold often causes runny nose, sore throat, and malaise (vague discomfort). Sore
throat is sometimes a symptom of a more serious condition distinct from the common cold, such
as strep throat, which may require medical diagnosis and treatment with appropriate antibiotics. Since it is a viral infection, antibiotics are not effective against the
Over the counter products may help to reduce the symptoms associated with the common cold
and sore throats, but they do not speed recovery. Analgesics, such as aspirin (Bayer, Ecotrin, Bufferin), ibuprofen (Motrin, Advil), and acetaminophen (Tylenol), reduce pain due to sore
throats and headaches. Products containing local anesthetics such as benzocaine (Cepacol
Maximum Strength, Spec-T) and phenol (Cepastat) provide temporary relief from sore throat
pain. Topical nasal decongestants such as oxymetazoline (Afrin) and phenylephrine
(NeoSynephrine) may provide relief from nasal congestion, but they should only be used for a
few days. The oral decongestant
pseudoephedrine (Sudafed) may help relieve nasal congestion, while antihistamines such as
diphenhydramine (Benadryl), brompheniramine (Dimetapp), and chlorpheniramine (Chlor-Trimeton) might help dry
excess mucus and reduce sneezing. Guaifenesin
(Robitussin) is an expectorant used to remove mucus in the sinuses, lungs, and ears. The cough
suppressant dextromethorphan (DM) may be
recommended at bedtime to facilitate sleep; however, since expectoration of sputum is
considered a valuable mechanism for expelling infectious organisms and congested secretions, a
cough should not be suppressed during the day. Most products available over the counter to
treat the common cold combine decongestants, antihistamines, analgesics, expectorants, and
Though most symptoms of the common cold are controlled with over the counter products, some
individuals might require prescription strength cough suppressants, such as codeine (Robitussin A-C) and hydrocodone (Vicodin Tuss, Tussionex, Hycodan).
Individuals with sore throats that last for more than a few days should be checked by a
healthcare practicioner as their condition might be caused by a bacterial infection, which
requires oral antibiotics such as amoxicillin
(Amoxil) and cephalexin (Keflex). Some health care practitioners may prescribe oral
antibiotics to prevent a secondary bacterial infection in immune deficient patients.
A warm, humid environment created by a humidifier may provide comfort during the common
cold. Rest is recommended, especially for people with severe symptoms. Increased fluid intake
is necessary in order to maintain water balance and to thin secretions.
Dietary changes that may be helpful
Excessive sugar, dietary fat, and alcohol have been reported to impair immune function, although no specific information is
available on how these foods may affect the course of the common cold.
Vitamins that may be helpful
A review of 21 controlled trials using 1 to 8 grams of vitamin C per day found that “in each of the
twenty-one studies, vitamin C reduced the duration of episodes and the severity of the
symptoms of the common cold by an average of 23%.”1 The optimum amount of
vitamin C to take for cold treatment remains in debate but may be as high as 1 to 3 grams per
day, considerably more than the 120 to 200 mg per day that has been suggested as optimal
intake for healthy adults. A review of 23 controlled trials found that vitamin C
supplementation produces a greater benefit for children than for adults.2 The same
review found that a daily amount of 2 grams or more was superior to a daily amount of 1 gram
at reducing the duration of cold symptoms.
Zinc interferes with viral replication in
test tubes, may interfere with the ability of viruses to enter cells of the body, may help
immune cells to fight a cold, and may relieve cold symptoms when taken as a
supplement.3 In double-blind trials, zinc lozenges have reduced the duration of
colds in adults4 5 but have been ineffective in children.6
Lozenges containing zinc gluconate, zinc gluconate-glycine, and, in most trials, zinc
acetate7 8 have been effective; most other forms of zinc and lozenges
flavored with citric acid,9 tartaric acid, sorbitol, or mannitol have been ineffective.10 Trials
using these other forms of zinc have failed, as have trials that use insufficient amounts of
zinc.11 For the alleviation of cold symptoms, lozenges providing 13 to 25 mg of
zinc (as zinc gluconate, zinc gluconate-glycine, or zinc acetate) are used every two hours
while awake but only for several days. The best effect is obtained when lozenges are used at
the first sign of a cold.
An analysis of the major zinc trials has claimed that evidence for efficacy is “still
lacking.”12 However, despite a lack of statistical significance,
this compilation of data from six double-blind trials found that people assigned to zinc had a
50% decreased risk of still having symptoms after one week compared with those given placebo.
Some trials included in this analysis used formulations containing substances that may
inactivate zinc salts. Other reasons for failure to show statistical significance, according
to a recent analysis of these studies,13 may have been small sample size (not
enough people) or not enough zinc given. Thus, there are plausible reasons why the authors
were unable to show statistical significance, even though positive effects are well supported
in most trials using gluconate, gluconate-glycine, or acetate forms of zinc.
Zinc nasal sprays may be even more effective than zinc lozenges at speeding the resolution
of cold symptoms. A double-blind trial showed a 74% reduction in symptom duration in people
using a zinc nasal spray four times daily, compared with the 42 to 53% reduction reported in
trials using zinc gluconate or zinc acetate lozenges.14 The average duration of
symptoms after the beginning of treatment was 2.3 days in the people receiving zinc, compared
with 9.0 days in those receiving placebo. However, in another double-blind study, zinc nasal
spray was no more effective than a placebo; in both groups the median duration of symptoms was
seven days.15 The beneficial effect of zinc nasal sprays should be weighed against
a potentially serious side effect. At least ten cases have been reported of people with
previously normal sense of smell who experienced severe or complete loss of smell function
after using intranasal zinc gluconate. In some cases the loss of smell was long-lasting or
Propolis is the resinous substance
collected by bees from the leaf buds and bark of trees, especially poplar and conifer trees.
Propolis extracts may be helpful in preventing and shortening the duration of the common cold.
A preliminary clinical trial reported propolis extract (daily dose not given) reduced upper
respiratory infections in children.17 In one small, double-blind trial of propolis
for the common cold, the group taking propolis extract (amount unstated) became free of
symptoms more quickly than the placebo group.18 Most manufacturers recommend 500 mg
of oral propolis products once or twice daily.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
Four different categories of herbs are used to help combat the common cold. First, herbs
that stimulate the immune system to fight the
infection are used during the onset of the
common cold—echinacea and Asian ginseng are two examples. Second, herbs known as
diaphoretics promote a mild fever and sweating both of which are useful for fighting
infection. A fever is a sign that the immune system is working; thus, diaphoretics may also be
immune stimulators—elder, boneset, and
yarrow are three examples. The third category
includes herbs that, based on test tube studies, may directly kill the viruses that cause
colds—goldenseal, myrrh, and usnea are examples. Finally, a fourth category of
herbs are used to alleviate cold symptoms, such as sore throats. These herbs tend to be high
in mucilage and are soothing and anti-inflammatory, or have tannins that are astringent (i.e.,
that constrict boggy tissue, promoting healing)—marshmallow and red raspberry are two examples.
As the following chart shows, many herbs fit into more than one category; goldenseal is one
example, as it has both immune-stimulating and antiviral properties.
||Andrographis, Asian ginseng, astragalus, boneset,
echinacea, eleuthero, garlic,
goldenseal, hyssop, linden,
schisandra, wild indigo
||Boneset, elder flower, hyssop,
|Antiviral (test tube studies only)
||Barberry, elderberry, goldenseal, goldthread, horseradish, myrrh,
Oregon grape, usnea, wild indigo
||Soothe sore throat: blackberry, blueberry, red raspberry (astringents), coltsfoot, mallow, marshmallow, mullein,
red raspberry (mucilage)
Reduce nasal stuffiness: eucalyptus, peppermint
Relieve aches: meadowsweet
Miscellaneous sore throat relief: sage, yarrow
|Note: These actions have not necessarily been proven in clinical trials
in humans and are intended only to clarify distinctions among herbs, not to give
recommendations for use.
Double-blind trials have shown that various echinacea extracts shorten the duration of the
common cold.19 20 Fresh pressed juice of echinacea (E. purpurea) flowers
preserved with alcohol, and tinctures of echinacea (E. pallida) root are the forms
most commonly studied and proven effective. In addition, several double-blind trials have
found that echinacea (E. angustifolia) root tinctures in combination with wild indigo, boneset, and homeopathic arnica reduce symptoms of the
common cold.21 In one double-blind trial, a proprietary formulation of echinacea,
white cedar, and wild indigo, known as Esberitox®, reduced the length and severity of
cold symptoms significantly more than did placebo.22 One double-blind trial found
that echinacea was inffective for treating colds that were induced in research subjects by
instilling a cold virus (rhinovirus) directly into their noses.23 However, the
relevance of this study to the treatment of naturally occurring colds is not clear. Another
double-blind study found that echinacea was not an effective for upper respiratory tract
infections in children aged 2 to 11 years.24
Echinacea is believed to work primarily through immune stimulation. The minimum effective amount of
echinacea tincture or juice appears to be 3 ml three times per day. Higher amounts, such as 3
to 5 ml every two hours, is generally better and is safe, even for children.25
Encapsulated products may also be effective, according to a double-blind trial using the root
of E. pallida.26 Generally, capsules containing 300 to 600 mg are used
three times per day. According to one double-blind trial, employees of a nursing home who
consumed echinacea tea at the onset of a cold or
flu reduced the duration of their symptoms by about two days when compared with people
consuming a placebo tea.27 The participants drank five to six cups of tea on the
first day of their symptoms and decreased this by one cup each day over the next five
Double-blind trials indicate that regular use of echinacea to prevent colds does
not work.28 29 30 Therefore, it is currently recommended to
use echinacea at the onset of a cold, for a total of seven to ten days.
Andrographis contains bitter constituents
that are believed to have immune-stimulating and anti-inflammatory actions.31
Several double-blind trials have found that andrographis may help reduce symptom severity in
people with common colds.32 33 34 35 Though the
earliest clinical trial among these showed modest benefits, later studies have tended to be
more supportive. A combination of a standardized andrographis extract combined with eleuthero, known as Kan jang, has also been shown in a
double-blind trial to reduce symptoms of the common cold.36
In a double-blind study, supplementation with
American ginseng significantly reduced by 27% the number of colds that people experienced
over a four-month period, compared with a placebo.37 The amount used in this study
was 400 mg per day of a freeze-dried extract.
In a double-blind trial, participants took one capsule per day of a placebo or a garlic supplement that contained stabilized allicin
(the amount of garlic per capsule was not specified) for 12 weeks between November and
February. During that time, the garlic group had 63% fewer colds and 70% fewer days ill than
did the placebo group.38
Geranium (Pelargonium sidoides) is an herbal remedy used in Germany, Mexico,
Russia, and other countries for the treatment of
respiratory tract and ear, nose, and throat
infections. In a double-blind study of children with acute tonsillitis/pharyngitis that
was not due to a Streptococcal infection, participants given an extract of geranium had
significantly more rapid resolution of symptoms, compared with those given a
placebo.39 The amount of the geranium extract used in this study was 20 drops three
times per day for six days.
In a double-blind study, a proprietary product containing marshmallow root, licorice root, and elm bark (Throat Coat®) was
effective in providing rapid, temporary relief of sore throat pain in people with acute
pharyngitis.40 Throat Coat® was taken as a tea in the amount of 5 to 8 ounces,
4 to 6 times per day, for two to seven days.
Herbal supplements can help strengthen the immune system and fight infections. Adaptogens,
which include eleuthero, Asian ginseng, astragalus, and schisandra, are thought to help keep various body
systems—including the immune system—functioning optimally. They have not been
systematically evaluated as cold remedies. However, one double-blind trial found that people
who were given 100 mg of Asian ginseng extract in combination with a flu vaccine experienced a lower frequency of colds and
flu compared with people who received only the flu vaccine.41
According to test tube experiments,42 wild indigo stimulates immune function, which might account for its role in
fighting the common cold and flu. In
combination with echinacea, boneset, and homeopathic arnica, as mentioned above, wild indigo
has prevented and reduced symptoms of the common cold in double-blind research. Wild indigo is
traditionally considered a strong antimicrobial agent, though it has not yet been investigated
as an agent against cold viruses.
Boneset is another immune stimulant and diaphoretic that helps fight off minor viral
infections, such as the common cold. In addition,
linden and hyssop may promote a healthy
fever and the immune system’s ability to fight infections. Yarrow is another diaphoretic that has been used for
relief of sore throats, though it has not yet been researched for this purpose.
Goldenseal root contains two alkaloids,
berberine and canadine, with antimicrobial and mild immune-stimulating effects.43
However, due to the small amounts of alkaloids occurring in the root, it is unlikely these
effects would occur outside the test tube. Goldenseal soothes irritated mucous membranes in
the throat,44 making it potentially useful for those experiencing a sore throat
with their cold. Human research on the effectiveness of goldenseal or other
berberine-containing herbs, such as Oregon
grape, barberry, or goldthread (Coptis
chinensis), for people with colds has not been conducted.
Goldenseal root should only be used for short periods of time. Goldenseal root extract, in
capsule or tablet form, is typically taken in amounts of 4 to 6 grams three times per day.
Using goldenseal powder as a tea or tincture may soothe a sore throat. Because goldenseal is
threatened in the wild due to over-harvesting, substitutes such as Oregon grape should be used whenever possible.
Elderberry has shown antiviral activity and
thus may be useful for some people with common colds. Elder flowers are a traditional
diaphoretic remedy for helping to break fevers and promote sweating during a cold. Horseradish has antibiotic properties, which may
account for its usefulness in easing throat and upper respiratory tract infections. The resin
of the herb myrrh has been shown to kill
various microbes and to stimulate macrophages (a type of white blood cell). Usnea has a traditional reputation as an antiseptic
and is sometimes used for people with common colds.
Herbs high in mucilage, such as slippery
elm, mallow (Malvia sylvestris), and
marshmallow, are often helpful for symptomatic relief of coughs and irritated throats. Mullein has expectorant and demulcent properties,
which accounts for this herb’s historical use as a remedy for the respiratory tract,
particularly in cases of irritating coughs with bronchial congestion. Coltsfoot is another herb with high mucilage content
that has been used historically to soothe sore throats. However, it is high in pyrrolizidine
alkaloids—constituents that may damage the liver over time. It is best to either avoid
coltsfoot or look for products that are free of pyrrolizidine alkaloids.
Red raspberry, blackberry, and blueberry leaves contain astringent tannins that are
helpful for soothing sore throats.45
Sage tea may be gargled to soothe a sore throat. All of these remedies are used
traditionally, but they are currently not supported by modern research.
Eucalyptus oil is often used in a steam
inhalation to help clear nasal and sinus congestion. It is said to work similarly to menthol, by acting on receptors in the nasal mucous
membranes, leading to a reduction of nasal stuffiness.46 Peppermint may have a similar action and is a source
of small amounts of menthol.
Meadowsweet has been used historically for
a wide variety of conditions. It is reputed to break fevers and to promote sweating during a
cold or flu. Meadowsweet contains salicylates, which possibly give the herb an aspirin-like
effect, particularly in relieving aches and pains during a common cold. While not as potent as
willow, which has a higher salicin content,
the salicylates in meadowsweet do give it a mild anti-inflammatory effect and the potential to
reduce fevers during a cold or flu. However,
this role is based on historical use and knowledge of the chemistry of meadowsweet’s
constituents; to date, no human studies have been completed with meadowsweet.
Traditional Chinese Medicine practitioners
use Chinese artichoke (Stachys sieboldii), a species similar to wood betony (Stachys betonica), for colds and
flu.47 It is unknown whether wood betony would be useful for people with the common
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
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The information presented in Truestar Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over-the-counter medication is also available. Consult your doctor,
practitioner, and/or pharmacist for any health problem and before using any supplements or
before making any changes in prescribed medications. Information expires September 2015.
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