This week, I have a cold. Or at least what certainly behaves like one complete with coughing, a sore throat, postnasal drip and that general feeling that my upper respiratory tract has decided to become the center of attention.
No fever, thankfully.
My husband has it too. So does my daughter.
The three of us have spent a great deal of time together recently dealing with grief together as a family. We’ve been under an extraordinary amount of stress, with disrupted sleep, shapeshifting schedules, and not taking care of ourselves.
Then all three of us got sick.
The obvious explanation is also probably the biggest one… we’ve been together. Respiratory viruses spread between people, and stress does not magically create a cold virus.
But as a pharmacist, another question immediately came to mind: Does severe stress change our ability to fight off an infection once we’re exposed? 
Stress and Colds Are Very Connected
One of my favorite studies on this subject is an older but fascinating experiment published in the New England Journal of Medicine. Researchers assessed psychological stress in hundreds of healthy volunteers and then deliberately exposed them to respiratory viruses. (and yes, people volunteered for this!)
As stress levels increased, so did the likelihood of infection and developing a nasty cold. The incidence of colds ranged from roughly 27 percent among people at the lower end of the stress scale to about 47 percent among those at the higher end.
The researchers accounted for factors such as age, sex, season, allergies, whether or not you smoke, exercise habits and even baseline antibodies which surprised me. The stress correlation remained after all that was accounted for.
That doesn’t mean stress “causes” a cold. You still need exposure to a virus. But it suggests that the condition of the host – meaning you – influences what happens after your body sees the bug.
Simply put, “stress weakens your immune system.”
But even that’s too simplistic. 
Stress changes immune function in surprisingly specific ways. During prolonged stress, cortisol and adrenaline signaling can alter the activity of T cells, natural killer (NK) cells and macrophages – immune cells involved in recognizing viruses, coordinating immune responses and clearing infected cells.
Stress can also shift the balance of inflammatory messengers called cytokines, including interleukins, which help immune cells communicate. Meanwhile, helper T cells (CD4+ cells) help orchestrate the antiviral response by directing other immune cells where they’re needed.
In other words, stress doesn’t simply “turn down” immunity. It can rearrange the immune response—increasing certain inflammatory signals while making some antiviral defenses less efficient. That’s why I think saying stress dysregulates immunity is more accurate than saying it merely “weakens” it.
Cortisol Isn’t the Bad Guy
Cortisol gets blamed for practically everything these days. I’ve blamed it on things too where appropriate.
You’ll see advertisements promising to “lower cortisol” as though cortisol were some toxic substance we should eliminate. Please don’t fall for that.
You need some cortisol. And cortisone. It’s a balance. The body is an orchestra.
Cortisol is not entirely awful, it’s an essential hormone involved in blood pressure, blood sugar, inflammation, energy availability and your response to danger. If a bear walked into your kitchen, you’d be extremely grateful for your stress-response system!
The problem is prolonged activation of cortisol… of your stress-response system (without adequate time to recover).
Major emotional stress and chronic activation can affect sleep, appetite, digestion, blood sugar, inflammation and behavior. You may eat differently. You may skip meals, or want to. You may drink less water than you should. Exercise disappears. Sleep becomes fragmented or you wake up earlier than you used to.
And sleep deserves special mention because immune function and sleep are closely connected.
So when someone says, “I finally got through the crisis and then I got sick,” there’s a physiological reason for that.
The Drip May Be Driving the Cough
One of my most annoying symptoms right now is postnasal drip. It’s not coming from my chest. I can tell. I bet you can tell when you have a cough too. If not, let me explain how you can tell.
Your nose and sinuses continuously make mucus. Normally you barely notice it. But when those tissues become irritated or inflamed, suddenly you notice every drop.
Mucus draining down the back of the throat can irritate tissues and trigger coughing. That’s why treating only the cough with a cough syrup doesn’t help. It misses the source of the problem.
If your constantly clearing your throat, and you’re also experiencing a mild cough, it’s possibly… probably a post-nasal drip type of cough. And if you treat the drip with an antihistamine, the cough reflex stops or at least quiets.
I’ve been using Claritin (loratadine) once daily and Flonase (fluticasone nasal spray).
Here’s an important distinction.
Claritin is an antihistamine. It’s particularly useful when histamine is contributing to runny nose, sneezing or allergy symptoms.
Flonase is a corticosteroid nasal spray that reduces inflammation inside the nose. It’s FDA-labeled for allergy symptoms including nasal congestion, runny nose and sneezing. It isn’t technically a “cold medicine,” so don’t assume every stuffy nose needs it. But when nasal inflammation or allergies are contributing to the misery, it can be useful.
Saline is another beautifully boring remedy that I think is underrated. A saline nasal spray or properly prepared nasal rinse can loosen mucus and wash away irritants. If you’re doing actual nasal irrigation with a neti pot or squeeze bottle, don’t use ordinary tap water. Use distilled, sterile or appropriately treated water.
Sometimes simple medicine is good medicine.
What I’ve Been Using
My throat has been sore enough that I’ve been occasionally reaching for Cepacol numbing lozenges. And taking a spoonful of honey (more below). Also, we need to mention those old-fashioned warm salt-water gargles.
I like gargling because it costs practically nothing, has very little downside for most people and can be soothing to irritated throat tissue. A simple ratio is ½ teaspoon of salt dissolved in 8 ounces (1 cup) of warm water. Gargle it for several seconds and spit it out—don’t swallow it.
Honey is another option worth remembering. It can calm coughing. You can add it to some warm tea and that will help your throat. Honey should never be given to a baby under one year old because of the risk of infant botulism.
Here’s an article you might like, The Best Honey for Allergies: Raw Unfiltered vs. Pasteurized Comparison.
Here’s an article to share 6 Incredible Fast-Acting Sore Throat Remedies.
For chest and airway symptoms, I also happen to have QVAR (beclomethasone), a prescription inhaled corticosteroid that was prescribed for me previously.
Let me clarify something important because inhalers get lumped together: QVAR is not a rescue inhaler and it does not immediately open constricted airways the way a bronchodilator such as albuterol does. It reduces airway inflammation and is used as a controller medication.
If you’re wheezing or having difficulty breathing, don’t simply borrow someone’s steroid inhaler and hope for the best. That’s doctor territory.
And if your cough is keeping you awake, there are conventional OTC choices too. Dextromethorphan is a cough suppressant found in many products. Guaifenesin is an expectorant that can help loosen mucus.
Read labels carefully because combination cold products are notorious for making people accidentally double up on ingredients.
As a pharmacist, I’d rather see you choose a medication for the symptom you actually have than swallow six ingredients because they’re packaged in a brightly colored box labeled “Cold & Flu Everything.”
What About Vitamin C, Zinc and Herbs?
Naturally, this is where my supplement cabinet gets involved.
I’ve been taking my own vitamin C formula with DHQ, along with Immune Script at night and Mito B during the daytime. (FYI, my precious Mito B gave me a noticeable flush one day! That’s because it has genuine niacin which opens up your blood vessels). A niacin flush isn’t necessarily dangerous in an otherwise appropriate dose, but the warmth, redness, tingling and prickly sensation can certainly be startling. It happens from the vasodilation that occurs.
Let’s just say that during an already difficult month, I didn’t particularly need a vitamin adding special effects.
I still think vitamin C is reasonable nutritional support, but let’s keep our claims grounded. Research doesn’t show that taking vitamin C after a cold begins magically stops it. Regular vitamin C supplementation may modestly shorten the duration or severity of colds in some people, but it isn’t a cure.
Zinc has somewhat better evidence when used early. Oral zinc lozenges may shorten a cold when started close to the onset of symptoms. Don’t use intranasal zinc products because some of them have been associated with loss of smell. Zinc can also cause nausea, and excessive long-term zinc can contribute to copper deficiency. If you want a gentle low-dose form that won’t tilt your copper out of ratio, switch to my Chelated Zinc.
Then there’s echinacea. I like herbal medicine, but liking an herb doesn’t mean I give it a scientific participation trophy. Research on echinacea is inconsistent, partly because preparations vary tremendously. Some studies suggest modest benefit, others don’t. I consider it an option rather than a cold cure.
Elderberry gets plenty of attention too. I use the berries to make tea. Evidence isn’t strong enough for me to tell you it prevents or cures a cold or flu. If you enjoy elderberry products, fine, I like it too, just don’t let syrup replace appropriate testing or medical care if your really sick. There are commercial preps of this everywhere. If you want to try your hand at making an herbal tea that also supports your thyroid (and immune system), try Mullein Elderberry Tea.
And please remember: “natural” and “drug-free” don’t mean interaction-free. Plant medicine can affect medications, allergies and medical conditions.
Essential Oils: Comfort Versus Cure
Essential oils deserve their own little reality check.
Peppermint, eucalyptus and similar aromatic oils can create a wonderful sensation of easier breathing. That cooling sensation can make a congested person feel better.
But feeling as though the nasal passages are more open and actually eliminating a respiratory virus are two very different things.
There isn’t strong evidence that eucalyptus, oregano oil or other essential oils cure the common cold.
I think aromatherapy is perfectly reasonable for comfort if you tolerate it. A diffuser, steamy shower or appropriately diluted topical product may feel wonderful.
Just don’t put concentrated essential oils directly inside your nose, don’t swallow them casually, and be particularly careful around children and pets. Essential oils are highly concentrated chemicals even though they came from plants.
Sometimes symptom relief is a perfectly worthy goal. We don’t have to call something antiviral to appreciate it.
When Home Remedies Are Enough
Most uncomplicated colds improve on their own.
Rest. Hydrate. Gargle. Use saline. Drink warm fluids. Take appropriate OTC medications if you need them. Give your immune system some decent food and as much sleep as life will allow.
But there comes a point where DIY medicine should end.
According to the CDC, medical attention is warranted for trouble breathing or rapid breathing, dehydration, fever lasting longer than four days, symptoms lasting more than 10 days without improvement, or symptoms that improve and then return or worsen. There’s more at the CDC’s WEBSITE.
I’d add that significant chest pain, blue or gray lips, confusion, severe weakness, coughing up blood, low oxygen readings or anything that simply feels seriously wrong deserves prompt evaluation.
Also call sooner if you have underlying lung or heart disease, are immunocompromised, or are at higher risk for complications.
A lingering cough can also have causes that aren’t infectious at all. Allergies, asthma, reflux, medication side effects and postnasal drainage are common possibilities.
That’s why a cough that refuses to leave deserves another look rather than another bottle of cough syrup.
Your Immune System Needs Recovery, Not Perfection
Perhaps this is the part I’ve been thinking about most.
When life becomes overwhelming, people sometimes feel guilty because they’re not exercising enough, eating perfectly, sleeping eight hours or remembering every supplement.
I don’t think that’s particularly helpful.
During periods of major stress, your goal may simply be to give your body small opportunities to recover.
Drink the water.
Eat a little protein. Some carbs too, they’ll make you feel better.
Make the soup. And hot tea.
Go outside for ten minutes if the weather isn’t humid or uncomfortable.
Take a nap if you can.
Turn off your phone a little earlier.
Accept help.
And if you catch a cold anyway, it doesn’t mean you failed at taking care of yourself.
My family has been together constantly through a very difficult period, so it’s hardly shocking that one respiratory bug managed to make the rounds. Shared exposure probably explains a lot of it.
But science also reminds us that the brain, nervous system, endocrine system and immune system aren’t separate little departments operating behind closed doors. They’re talking to one another all day long.
What happens emotionally can have physical consequences. And what happens physically can affect how we feel emotionally. For now, I’m treating the symptoms, listening to my body and giving it a little extra room to recover. If you liked this article, please share it.
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Suzy Cohen, RPh, has been a licensed pharmacist for over 30 years, blending conventional medicine with natural approaches to help people feel better and live healthier. She is the founder of Script Essentials, a supplement company known for targeted, custom-formulated products, some with patented innovations.
With a special focus on thyroid health, functional medicine, and drug-induced nutrient depletion (what she calls “drug muggers”), Suzy is the author of several books including Thyroid Healthy, Drug Muggers, and Diabetes Without Drugs. She also writes a nationally syndicated health column and shares practical, easy-to-understand guidance with readers around the world.
