“The Pharmacist”: Sniff, sniff, cough – which promises relief from a cold

It's just a cold.

“The Pharmacist”: Sniff, sniff, cough – which promises relief from a cold

It's just a cold. Completely banal. But every time I'm amazed at how bad something so banal can make you feel, even if there's no fever involved. And since the pandemic, a new uneasiness has emerged: What if it's Corona? Do I have to cancel my visit to Grandma? Is it possible that I won't be able to get back on my feet because I'll get Long Covid?

Even if the Corona self-test is negative, you may be lying there, in a bad mood and knowing: There are no medications against cold viruses. No means that would harm these viruses and make us healthy. But with the need to feel better, the urge to take grows. Even among experts, by the way. A few years ago, the Stada company, manufacturer of the cold medicine Grippostad, reported the results of a survey among 300 professionals: According to this, 43 percent of all doctors, pharmacists and pharmaceutical technical assistants (PTAs) take medication to combat the symptoms. Specifically, it is 60 percent for pharmacists, followed by PTAs at 44 percent. For doctors it is one in three. From these numbers you can also see that those who earn from the medicines also rate them more positively for themselves.

The survey mentioned does not say exactly what the experts are taking. It would be pure speculation as to whether they are mostly so-called combination remedies, i.e. special cold remedies such as Wick Medinait or Grippostad, which contain a bit of everything. Typically this is a painkiller such as paracetamol for the pounding head and possible body aches, a so-called decongestant (which is a kind of cold spray that you can swallow) to make breathing easier, and possibly other ingredients such as caffeine for daytime fatigue or doxylamine (an over-the-counter medication). Sleeping pills and antihistamines) for rest at night.

Although such remedies are popular, they are controversial for several reasons. Firstly, because it always remains unclear which of the drugs causes any side effects - this is a fundamental consideration when it comes to combination preparations. Secondly, because of the decongestants. What they actually bring is poorly documented, says the Cochrane Collaboration, the temple of evidence-based medicine, after intensive study evaluation.

Personally, I think that a nasal spray clears the nose better anyway. I would therefore rather take an ibuprofen and nasal spray and maybe drink coffee with it, than a combination medication like this. And if so, I would always take one with ibuprofen or ASA (acetylsalicyclic acid). Paracetamol lacks the anti-inflammatory component, which you can only benefit from when you have a bad cold, because inflammatory processes also play a role.

For me, the biggest problem with such cold remedies is also their greatest strength: they relieve the symptoms, but of course they can't do anything against the virus. And sure, it's a great thing to feel better while you slowly get better again. But then it's incredibly difficult not to fall into the "Why, it's working again!" trap. Even with ibuprofen, I find it really difficult to take it easy and give my body the rest it needs to recover when I actually don't feel that bad. But going to work sick is unhealthy in every way. And while before the pandemic it was still a matter of type whether you wanted to get through a banal infection with or without such fitness boosters, today it is the case: colleagues who show up in the office or store coughing are annoying.

I'm still sure that there will always be a good reason to leave the house with a cold or to show your colors on a Zoom call - and then such remedies simply bring you forward. What I really want to get out of this column is that inhaling is totally underestimated, in my opinion, especially when you have a cold. To inhale, all you need is boiling hot water and a towel to keep the water vapor from escaping so you can inhale it. The steam does not work against viruses, but it moistens the stressed mucous membranes and stimulates blood circulation. This makes it easier to get rid of secretions. In addition, the immune system works best in well-moisturized mucous membranes.

If you add essential oils to the water, the whole thing works even better - such as eucalyptus, mountain pine, peppermint or spruce needle oil, such as those found in inhalation additives from the pharmacy. These oils contain natural substances such as cineole, which has antibacterial and expectorant effects, but can irritate the eyes. So close your eyes or use a plastic inhaler with a nose-mouth attachment.

You read again and again that you can also inhale with saline solution by boiling nine grams of salt in a liter of water and then inhaling the vapor. You can do that too, but the salt has no additional benefit because according to the laws of physics it stays in the pot and you only breathe in the water vapor. Saline solutions only make sense with an electric inhaler, a so-called nebulizer, which you can also rent in many pharmacies (you then only buy the attachments, for hygiene reasons). Inhalation devices can produce significantly finer mist than the one that the water vapor from the pot condenses into. That's why the moisture reaches the bronchi in this way; with the "pot method" it only makes it to the larynx.

However, this is completely sufficient, especially for a cold, which is why nebulizers are more suitable for patients with bronchitis or with permanent lung diseases such as cystic fibrosis. Even if after an infection you still feel like there is still mucus in your bronchi, regular inhalation with a nebulizer can really make a difference.

Personally, I prefer to inhale with chamomile. For convenience, I throw two tea bags into the bowl and off we go. A chamomile extract from a bottle would be ideal because it contains more essential oils and other chamomile ingredients. Chamomile has an anti-inflammatory effect. To ensure that the beneficial vapors really reach their destination, I take a nasal spray before inhaling, especially since the improved blood circulation in the mucous membranes thanks to the vapor makes breathing even more difficult.

After the steam bath, your nose is clear for many hours and you have the good feeling that you have done something to make the infection go away. That being said, there is no better way to avoid potential complications of a cold. So if you're prone to sinus infections and the like, regular inhalation is mandatory (I'll say something about sinus infections in the next column, in 14 days).

So bring water to the boil, pour it into a bowl or pot, head over it, towel over it. Hold out for ten minutes: breathe in through your nose and out through your mouth. Best twice a day. It's boring, I know. But there is music and podcasts. For example, I can give you the one from stern medicine editor Dr. Anika Geisler recommend “The Diagnosis” – these are exciting, entertaining medical puzzles, you get a lot of expert knowledge. And if you are a woman aged around 40, please listen to my podcast, "MENO AN MICH" from BRIGITTE magazine, which is about midlife and menopause. A listener recently wrote to me saying that she would have been spared her divorce if MENO AN MICH had existed ten years ago. So it might be worth it.