Should I Consult a Doctor If I Have a Cold?

A cold can make a person thoroughly miserable. What's worse than having a stuffy head and drippy nose, along with perhaps a cough, headache, or sore throat?

Lots of things of course, but when you're suffering from a cold it's hard to think about those worse off. All you want is relief, and fast. Should you see a doctor?

Think for a moment what you'd like to accomplish by seeing a doctor. You probably know that colds are caused by viruses, and that an antibiotic will not help a virus. Unless you have an underlying problem that predisposes you to more serious infection, such as asthma or chronic obstructive lung disease (COPD), an antibiotic will not get you well more quickly. Your own body's immune system is what heals a cold.

Since no medication will provide a true cure, what about symptom relief?

There was a time, not that many years ago, when the "good" medicines were available by prescription only. Not any more. Almost every so-called cold medicine is now available over-the-counter, the same medications that were once by prescription.

The biggest problem with treating yourself at home is knowing what medication to use for which symptom. If congestion or stuffiness is your main symptom, a decongestant is what you'll need to open your air passages and relieve sinus pressure. There are no prescription decongestants stronger than over-the-counter pseudoephedrine, which you'll have to ask your pharmacist to obtain. The medicine is available without a prescription, but still kept "behind the counter."

Some people benefit from an expectorant, which simply thins the mucus so that it drains more easily. Again, there is no stronger prescription medication than over-the-counter guaifenesin, found in Mucinex, Robitussin, and similar products.

If a runny nose or post-nasal drainage is the problem, you may want to dry up the mucus using an antihistamine. Diphenhydramine (Benadryl) and chlorpheniramine are inexpensive and effective, but sometimes cause drowsiness. Cetirizine (Zyrtec), a non-sedating antihistamine, is another option. Loratadine (Claritin) works well at drying up an allergic nose but is not as effective for colds. Again, all these medications were prescriptions just a few years ago and are every bit as good as medications a doctor might prescribe.

Over-the-counter pain medications such as acetaminophen and ibuprofen can relieve the sore throat and sinus pain associated with a cold. Doctors will not prescribe anything stronger for your discomfort. Aspirin works, well, too, but is more likely to cause stomach upset and should not be used in children under the age of 18 due to the increased incidence of Reye's syndrome.

Dextromethorphan, found in many OTC cold preparations, is an effective cough suppressant. The only thing stronger is a narcotic, which you would have to obtain from a physician, who would probably suggest you try the OTC dextromethorphan first anyway.

So we've covered congestion, drainage, cough, sore throat, and pain. What's left? Chest symptoms, perhaps, but then that's going beyond a simple head cold. If you have a chest cold you're probably better off consulting your doctor.

Lastly, if a cold persists beyond 10 days or so, it's possible that a secondary infection has set in, for which an antibiotic might be advisable.

But overall, if you're not to sick to work or go to school, you probably do not need to see a doctor. Give your body some time to heal itself.

Copyright 2010 Cynthia J. Koelker, MD