The “common cold” and the flu have become such a frequent part of our seasonal vocabulary that we rarely take the time to think about the best way to treat their symptoms. Evaluating treatment options is especially important in people with multiple sensitivities such as those who have symptoms of autism spectrum disorders, ADD, and ADHD. The “common cold” was named this way because of its likeness to symptoms of exposure to the cold weather. The “flu” is short for “influenza.” Both the cold and flu are viral respiratory illnesses. The common cold may be bothersome, but the flu can lead to more dangerous and severe illness that can cause death in high risk patients. The average American child will have 6-10 colds per year, the average adult 2-4 episodes per year (Simasek and Blandino, 2007). Flu is less common, but it also has become part of our acceptance of normal expected illnesses. Currently, there is not a cure for the common cold or the flu. Generally, we treat the symptoms of the cold or flu — not the virus itself. It is important to note that it is the symptoms of these viruses and their treatment that differentiate one from another. In order to have a better understanding of the two, I have summarized the differences between the cold and the flu in Table 1.
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Cold and Flu Medications
Treating cold and flu symptoms has become a large OTC (over-the-counter or non-prescription) business. Most drug and grocery stores have a large section dedicated to these products. The number of products available to the public is starting to decrease as the Food and Drug Administration (FDA) recognizes the problems with safety and efficacy of these drugs, especially when given to children. In December 2005, the FDA mandated that OTC decongestants containing phenylpropanolamine become prescription only. Studies showed an increased incidence of stroke in people who took phenylpropanolamine. On October 8, 2020, the FDA released an announcement that manufacturers are voluntarily modifying all cold/flu products to state “do not use in children less than 4 years of age.” Experts reviewing the products think that these products should not be given to children under the age of 6, and extreme care should be given with children under 12-years-old. Many health care professionals believe greater measures should be taken while studies on the safety and effectiveness of these products are being undertaken. One problem noted by the FDA is that children are often overdosed from use of more than one medication at a time. Improper measurement of the dose has also posed safety risks. Understanding the directions and the ingredients and using the measuring cup that comes with the product may reduce the incidence of overdosing. The FDA recommends that parents and caregivers check the active ingredients on the product label. Parents and caregivers should also check the inactive ingredients on the label, as both may affect the well-being of a person with ADD, ADHD, or ASD.
Inactive ingredients such as preservatives, dyes, and other excipients can cause allergic reactions, such as rash, exacerbation of asthma symptoms, anaphylaxis, hyperactivity, and, in some cases, upset stomach and diarrhea. Table 2 lists some of the inactive ingredients that are commonly added to cold, cough, and flu products and the adverse reactions that may occur. If you have a prescription medication for which you would like to know the inactive ingredients, there are several ways to find out.
- First, you can ask your pharmacist to look at the package insert. Under the title “description” at the very top of the insert, there is a list of all the ingredients in a manufactured product.
- Second, check a Physicians’ Desk Reference (PDR). The PDR is a compilation of package inserts printed as a book. Most libraries and large book stores have a copy of the PDR. Unfortunately, only the most current high volume prescription drugs are in the book.
- Third, you can look online. Find the official website of the prescription drug you are checking on. Click on “health care professional” and then go to the prescribing information section, which will bring up a copy of the package insert. The first item listed is the description, and the inactive ingredients are listed there.
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Treating Symptoms
When treating the symptoms of a cold or flu virus, it is best to look at each symptom and treat it accordingly. When you administer multi-symptom relief products, you may be giving unnecessary medications that may have unwanted side effects. One of the concerns brought to the attention of the FDA was that children were being given overdoses when parents/caregivers did not realize the same type of medication was in the multi-symptom product as in the individual symptom product that they were giving. If you buy OTC medications to treat cold and flu symptoms, buy products that have single active ingredients and as few additives as possible.
Remember that colds and flu are viral infections. Therefore, antibiotics are not effective against these viral infections and should not be taken to treat them. When unnecessarily prescribed, antibiotics can cause resistant organisms, yeast overgrowth, and immune suppression. When antibiotics are needed for secondary bacterial infection, probiotics should be used to help maintain a healthy gut. (Editor’s note: probiotics should not be given at the same time as the antibiotic dose, but spaced midway between doses.) The antibiotic Augmentin™ is commonly prescribed for children with ear infections. It has been reported that Augmentin™ should be avoided in patients with autism, Asperger’s, ADD, or ADHD due to a potential adverse neurological effect caused by the clavulanate component of Augmentin™ (Fallon, J 2005).
Table 3 is a list of suggested treatments for common cold and flu symptoms and what considerations should be given to people with a diagnosis of autism, ADD, ADHD, or Asperger’s syndrome.
The best approach in treating the symptoms is to look at each one individually and apply treatments according to each. At the first sign of symptoms (e.g., sore throat for cold), I like to start taking zinc and vitamin C and use an herbal blend drop containing Echinacea, shitake, and noni, which also boosts immunity. Try some of the non-medicine interventions if you have not used them before. Nasal irrigation with saline solution (homemade or purchased) has become a popular alternative to decongestants. Warm liquids to drink, inhale or bathe in are very comforting and therapeutic. A few drops of eucalyptus oil in a bath will help clear a stuffy nose and head.
Recent studies indicate that some patients’ autistic-like symptoms may improve during a fever. Children became calmer and had an improved response to touch and closeness. Although it is unclear why the improvements occur, it is thought to be related to an immune system response (Curran, Newschaffer, et al. 2007). Treating a fever below 101.5 degrees Fahrenheit with medications may not be necessary unless underlying medical issues warrant the use of medicine.
Prevention is always the best medicine for colds and flu. Practicing good hand washing, and eating, drinking and sleeping well, plus a little knowledge about treatment options will go a long way. Remember — with the exception of using prescription antiviral medications — we only treat the symptoms of cold and flu, not the virus.
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References
Bateman, B., Warner, J.O., et al. (2005). The effects of a double blind placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. Arch Dis Child. 90(8):875.
Boch, K. (2007). Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies. New York: Ballantine Books.
Curran, L.K., Newschaffer, C.J., et al. (2007). Behaviors associated with fever in children with autism spectrum disorders. Pediatrics 120 (6): e1386-e1392.
Fallon, J. (2005). Could one of the most widely prescribed antibiotics amoxicillin/clavulanate Augmentin™ be a risk factor for autism? Medical Hypothesis 64:312-315.
Garland, M.L., Hagmeyer K.O. (1998). The role of zinc lozenges in the treatment of common cold symptoms. Ann Pharmacother. 32:63-69.
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Kumar, A., Rawlings, R. et al. (1993). The mystery ingredients: sweeteners, flavorings, dyes, and preservatives in analgesic/antipyretic/antihistamine/decongestant, cough & cold, antidiarrheal and liquid theophylline preparations. Pediatrics 1993;91;927-933.
Kumar, A., Weatherly, M. et al. (1991) Sweeteners, flavoring, and dyes in antibiotic preparations. Pediatrics 87(3): 352-360.
Nagel, J., Fuscaldo, J. et al. (1977). Paraben allergy. JAMA 237(15):1594-5.
Pangborn, J., Baker, S.M. (2005). Autism: Effective Biomedical Treatments. San Diego: Autism Research Institute.
Simasek, M., Blandino, D.A., (2007). Treatment of the common cold. American Family Physician, 75 (4):515-520.
Williamson, J.M., Boettcher, B., et al. (1982). Intracellular cysteine delivery system that protects against toxicity by promoting glutathione synthesis. Proc. Natl. Acad. Sci., USA 79:6246-6249.
From Age of Autism