Don't Reach for the DayQuil Until You Read This

If you haven't gotten sick yet, brace yourself – cold and flu season is upon us.

Recently, my medical researcher caught a particularly nasty cold. She found herself at the drugstore, desperate to find something to bring her relief and allow her to come back to work.

"Doc, I felt so overwhelmed. There are so many new products out there," she told me. "I wasn't sure what I should take – or what would be safe to take."

Even with all the research we do for our readers, the explosion of cold medicine options is enough to leave anyone confused (especially if your mind's already cloudy from exhaustion).

Adults typically get two or three colds each year, usually in the winter and spring. If you're older, you also face more serious risk of complications, including pneumonia. That's why we wanted to give you the most up-to-date research on what works... what doesn't... and how to stay healthy this season.

Cold Versus Flu

The first step is knowing whether you have a cold or the flu. That's because if it is the flu and you're 65 or older, you're at a higher risk of complications like pneumonia or hospitalization. If you suspect it's the flu, get tested for it at your doctor's office right away. The sooner you can take antiviral medication for the flu, the better.

And of course, we also urge you to get a flu shot and hopefully avoid it altogether.

The Cleveland Clinic has put together a concise list to help you figure out if you're fighting the flu or a cold and how to combat each one. Here's what it boils down to:

Flu: Use the acronym "FACTS" – Fever, Aches, Chills, Tiredness, and Sudden onset. Sudden onset is one of the key differences between the flu and a common cold. The flu usually lasts three to seven days when treated with two to four days of bed rest, liquids, and over-the-counter flu medications.

Cold: You can feel a cold "coming on" for a while before you really get sick. It typically lasts from one to three weeks. Symptoms include a runny rose, congestion, sneezing, sore throat, and coughing. You can treat it with over-the-counter cold medicine and vitamin C.

Note that in either case, if your doctor offers you antibiotics, tell him "no, thanks." Antibiotics work on bacteria. But the flu and the cold are both viruses, so antibiotics are useless.

Over-the-counter medications are the only real option for colds. If it's the flu, you can get a prescription antiviral medicine. But doctors typically reserve them for people at high risk of complications, like pregnant women, those with compromised immune systems, and folks over 65.

If you stick to over-the-counter medications, you'll likely see three main ingredients: vitamin C, zinc, and elderberry.

Vitamin C. This is one supplement I recommend without reservation. Vitamin C has many good benefits. It's an antioxidant. That means it combats damaging inflammation and regulates blood flow. It's also a booster for our immune systems.

A 2000 study from Cochrane Library, one of the most prestigious database systems, evaluated 30 trials involving vitamin C and the common cold. It found regularly taking vitamin C cut the duration and severity of symptoms.

And a review in the journal Nutrients in 2017 looked at more recent research. The authors saw that six to eight grams of vitamin C per day shortens the duration of a cold, if you start taking it as soon as you feel sick. The problem here is... that's a lot of vitamin C – about 6,000 milligrams. The average supplement only contains about 500 milligrams... so you'd have to munch down 12 or more tablets.

Personally, I don't think you need to knock back that much. If I feel a tickle in my throat, I go on a vitamin C blitz. I take 3,000 to 4,000 milligrams a day for a couple of days to knock out the virus. Remember, you can get vitamin C through foods like citrus fruits, peppers, and broccoli. It's not enough to fight off a cold, but it's a good way to bump up your immune system.

Zinc. Taking zinc for colds has fallen in and out of favor in the medical community over the past 30 years. While some studies show that zinc shortens the common cold by about three days, it can come with some side effects, like nausea and stomach cramps.

Too much zinc also leads to problems like copper deficiency and a reduction in good cholesterol ("HDL"). Just 40 milligrams a day is the average recommended value – zinc supplements often contain about 30 milligrams. And avoid any zinc nasal sprays – some folks lost their sense of smell permanently after using these medications. One popular spray, Zicam, no longer contains zinc – and without zinc we're not sure why you would bother.

A Finnish review in 2011 looked at trials that used zinc lozenges. The author concluded that higher doses of zinc (75 milligrams or more) did shorten the duration of colds. And the most troubling side effect – copper deficiency – only happened when folks took the zinc for six weeks or longer.

Zinc works because the group of viruses that cause the common cold (rhinoviruses) attach to the lining of our noses and throats with a certain receptor. Zinc also binds to this same receptor, meaning the virus can't spread. I still take zinc when I feel a cold coming on, but I always make sure to take it with my vitamin C.

Elderberry. I do have some reservations about elderberry as a way to combat colds. First of all, there's little hard science out there that supports its many health claims. A handful of studies suggest taking elderberry syrup can shorten the amount of time you feel sick from the flu (by up to four days). A small 2011 study from Germany found elderberry syrup – when super concentrated – killed several types of bacteria and the influenza virus.

My concern is that no one has identified a mechanism of action – the studies are all small and don't cover the actual cause. That said, some elderberry syrup during a cold or the flu probably won't hurt. It doesn't interact with any typical medications (though you should check with your doctor), and it might boost your immune system the way vitamin C and zinc do.

An important note on these and other over-the counter drugs – they won't "cure" anything. They simply manage your symptoms. In some cases, they may shorten the duration of your cold or flu. You may feel well enough to return to work, but remember... you're still recovering.

In a recent issue of Retirement Millionaire, I told subscribers three big risks that come along with all those drugs and what you need to keep in mind before you grab some cold medicine.

If you're not already a Retirement Millionaire subscriber, you can get started today, right here. (If you're a subscriber, you can read all about the risks here.)

What We're Reading...

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
January 21, 2020