So you have a cold or flu and feel miserable.

It is that time of year. Your nose is runny, your throat is sore, you are coughing, sneezing and are achy all over. Your appetite is poor, and you are tired and irritable. What to do?

First off, don’t pick up the phone or go into your doctor to ask for an antibiotic.

Not only do antibiotics not work for colds and flu, they have side effects and might increase the presence of drug-resistant bacteria.

Antiviral therapy for influenza — not the stomach flu — can shorten the course of the illness by a day or two if started in the first 48 hours of the illness.

But get a flu shot to prevent getting it in the first place.

There is a surprising lack of evidence on over-the-counter cold remedies containing decongestants and antihistamines.

These might provide some relief in older children and adults, but side effects can limit their usefulness.

Avoid if pregnant or in children under 5, as they are one of the 10 leading causes of death in this age group.

An ounce of prevention is worth a pound of cure, so before you get a cold or flu, consider the following which have been shown to reduce risk and severity of illness:

Eat a nutritious diet with foods rich in vitamin C — fruits and vegetables — and zinc — meat, nuts, cereals, seafood and pumpkin seeds;

Don’t smoke and avoid secondhand smoke;

Maintain regular exercise and movement;

Maintain supportive social relations;

Reduce stressors and foster positive emotions;

Wash your hands frequently and try to reduce your exposure to people with colds;

and get the flu shot annually.

A surprising line of research has shown the effects of mind-body therapies such as stress management, relaxation and meditation on reducing upper respiratory infections.

I have been struck throughout the years when treating people with colds and flu with how many, if asked, report significant stress in their lives preceding the illness.

The infection seems to be a barometer of stress levels and emotional depletion or resilience.

Some other common-sense approaches are to get the rest your body needs and drink lots of fluids. Orange juice is a great choice.

One underutilized therapy is nasal irrigation, which helps reduce mucus, relieves obstruction of the sinuses, helps quench postnasal drip-induced cough and can rinse out inflammatory cells. The salt solution is about half a teaspoon in 6 ounces of water or about the taste of tears. It can be instilled through a bulb syringe, a neti pot, spray bottle or by snuffling it from a cup.

A personal favorite of mine is vitamin C at around 3,000 milligrams daily in divided doses during a cold and in lower doses, 200-500 milligrams, for prevention. Vitamin C-rich foods are a good choice. Vitamin C is safe, cheap and readily available.

Zinc also is useful for immune support, though don’t use nasal zinc preparations as they have been reported to cause loss of sense of smell. Keep your vitamin D level up, as it supports immunity as well.

Probiotics prevent or improve cold symptoms. I have found them to be particularly useful in those with recurrent sinus problems and who have been on multiple rounds of antibiotics.

Some other home remedies are:

Echinacea: 900-1800 milligrams daily for three to four days at onset of cold;

Andrographis: 300 milligrams four times a day for three to four days at onset of cold;

Elderberry extract: 1 tablespoon four times a day at onset of influenza;

Chicken soup;

Hot toddy;

Warm lemon juice and honey;

Saunas or hot showers;

Expectorants like guaifenesin;

Pain relievers like acetaminophen, ibuprofen, naprosyn or aspirin but no aspirin in children;


Herbal teas such as peppermint, eucalyptus, camomile;

Aromatherapy inhaling hot steam with oils such as lavender, peppermint, pine, thyme, tea tree or eucalyptus and
Rest. You deserve it. You’ve earned it. You need it.

Dr. Sierpina is the W.D. and Laura Nell Nicholson Family Professor of Integrative Medicine at the University of Texas Medical Branch