Winter Health Special, Part 2


In the last post Dr Anastasia Boulais spoke about what you can do every day to help yourself survive and enjoy winter. This time she’ll answer some questions which she most frequently gets in the clinic.

Do I have a cold or a flu?

While we frequently use these terms interchangeably they are quite different clinically.

A common cold can be caused by a variety of different viruses which attack your upper respiratory tract and result in an unpleasant collection of symptoms: runny nose, congested sinuses, sore throat, headache, cough, and occasionally low grade fever. Most people can carry on with their life and may only need to take a couple of days off work, although cough and runny nose may last for as long as 2-3 weeks.

A flu, or influenza, is caused by a particular family of viruses and is much more than a bad cold. The flu makes people quite sick with high fevers, sometimes debilitating muscle and joint pains, sore throat, cough, fatigue and lack of appetite. It can keep you in bed for days and I generally suggest that people take 5-7 days off work. It can be associated with complications such as pneumonia and dehydration, especially if you are pregnant, a smoker, or have a pre-existing chronic medical condition.

Why does everybody keep telling me to drink fluids?

When you are sick you lose a lot of fluids through sweating, respiratory secretions (that’s your phlegm and snot), and by the virtue of not eating and drinking as much. Dehydration can make your feel quite unwell, worsening your headache and making you feel downright miserable. A good guide to your hydration status is the colour and volume of your urine: we are looking for light yellow and large quantity.

Water, ginger and lemon tea, chicken soup are all valid options for rehydration. Cider and lemonade are not.

Can my doctor give me antibiotics just in case?

Whether you have a cold or a flu, antibiotics are not helpful. If you want to know the extent of the antibiotic resistance problem we’ll be facing in the next 50 years google “antibiotic apocalypse”. Why did your doctor give you antibiotics for your sniffly nose or cough last time? Maybe they thought you had a nasty bacterial sinusitis or pneumonia. Or maybe they said no to antibiotics 10 times that day and they were too tired of arguing with yet another patient. Yes, we are human too and sometimes we, regretfully, take the path of least resistance. Can we guarantee you are not going to develop complications? No. But if we give “just in case” antibiotics to everyone who has a cold we can guarantee there won’t be antibiotics left to treat your children’s wound infection or pneumonia in the future.


Do any of these work: zinc, vitamin C, echinacea, garlic?

You could spend hundreds of dollars on the multitudes of cold and flu remedies available now at the pharmacies or natural health stores, however for most of them the jury is still out. This may not be because they don’t work at all, we just don’t have sufficient evidence to recommend them routinely for everyone and none of them are a magic bullet.

The ever-popular Vitamin C has not been found to be helpful for prevention or treatment of colds in general population, however it does seem to reduce the number of colds in people under short term physical stress, such as marathon runners.

Zinc lozenges have been found to shorten the duration of colds if taken in the first 24 hours of the illness at a dose of >75mg daily in a Cochrane review. However, daily just-in-case zinc is not helpful and it can give you nausea and bad taste in your mouth.

Echinacea, ginseng and garlic supplements have all been tested but so far the evidence has come up blank on their cold and flu fighting efficacy.

I would say use your common sense. In spite of the optimistic promises of the “immune-boosting” properties of yet another supplement it is unlikely that you are going to get a miracle. As with every other nutrient, it is much better to get your zinc, garlic and vitamin C through your diet (see our previous newsletter), and save your hard-earned dollars on proper nutrition through winter.



What’s the deal with Vitamin D?

One of the few promising areas in the cold and flu research is the role of vitamin D. Some studies have shown that low levels of vitamin D in the blood increases the risk of catching the flu. In addition, among patients who develop the flu those who have higher blood vitamin D level end up recovering quicker. So it’s a good reason to make sure you get plenty of sunshine via sensible sun exposure in summer prior to the flu season.

What about supplements? There have been a couple of promising studies in some patient groups showing that supplementing with Vitamin D in the flu season can reduce the chance of catching it as well as speed up your recovery. The doses used were between 1200 IU and 2000 IU daily. Some medical practitioners report having a great success with high dose “vitamin D hammer” for those who caught the flu virus: 10,000 IU three times daily for 2-3 days. However, we are still far away from firm recommendations on Vitamin D and more research is needed