ASK THE DOCTOR: Myths about colds
By DR. JIM MITTERANDO
The Patriot Ledger

Q. My 15-year-old grandson tells me his cold will not get worse if he is outdoors on cold days in just a T-shirt. When I was little, my mother bundled me up when I had a cold. I say he looks foolish, to say the least. Who is right?

A. You may be right that he looks foolish simply wearing a T-shirt without a coat on a cold day but his fashion (or lack thereof) does not affect his "cold" illness.

The "common cold" is misleading since the illness has nothing to do with cold weather. Certain viruses that cause the common cold tend to be more active in the winter and school year, which misleads people into associating this illness with climate or temperature. Colds occur in warm, southern climates as well. I see plenty of people with cold infections in the summer time.

Colds are caused by viral infections requiring contact with a sick person. They are not influenced by cold weather nor being improperly dressed.

Many myths still exist about catching colds that are incorrect. Changes in weather and dampness may affect someone's arthritis but will not cause a cold. Going outside with a wet head or getting wet in the rain cannot cause any infection at all. Bundling up will not prevent a cold nor will it help the cold to go away.

In fact, the old adage of "sweating out a fever" is incorrect and overbundling may raise the fever.

People are always looking for the magic cure for a cold but, unfortunately, there is none. Cold medications can relieve certain symptoms - aches, congestion, coughs - but do not cure or even shorten a cold. Vitamin C does not help with a cold. Zinc and echinacea have been disappointing in treating colds with conflicting study results.

The best treatment is to drink lots of fluids and rest. Stress and sleep deprivation can depress the immune system, making people more vulnerable to illness and prolong recovery.

Expectorating (coughing up) mucus was commonly recommended in the past, but is unnecessary. The body naturally clears mucus and debris from the lungs and you do not have to force a cough or blow your nose unless you feel the need.

Guaifenisin - an expectorant found in many cough syrups - does not loosen mucus any better than simply drinking plenty of fluids. In addition, guaifenisin can cause nausea.

The only ingredient you need in a cough syrup is dextromethorphan (DM), which can help suppress an annoying cough. It will not speed the recovery of the cough. Gargling (especially with salt water) was popular in the past for treating sore throats and is no longer necessary. Gargling often causes gagging and does not speed recovery.

Simply keeping the throat moist with frequent sips of liquid or sucking candies will provide some comfort for a sore throat. Medicated lozenges or sprays sometimes can temporarily numb a painful throat, but they taste bad and do nothing to help recovery. I prefer Lifesavers or mints over any medicated lozenge.

It is a myth that high fevers can cause brain damage. "Fever phobia" contributes to fear and misunderstanding regarding fever in children that leads to overuse of Acetaminophen (Tylenol) and Ibuprofen (Advil, Motrin).

Parents often feel helpless because the child feels bad and they want to provide relief. It is important to remember that fever is not an illness but a symptom and never harms a child.
The only reason to lower a youngster's temperature is to make the child more comfortable or to avoid a febrile seizure (in the seizure-prone child). New research has shown that fever may actually aid the immune system in fighting infection. When dealing with a fever, "treat the child, not the thermometer." Fever is only one of many signs of illness. The best indicator of a child's illness is their level of activity and behavior.

Dr. Jim Mitterando is a family doctor at Health Care South/Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.

Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.

Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.

Copyright 2001 The Patriot Ledger