Neal’s Natural Cold Management Recommendations

We’re heading full steam into cough and cold seasons with warnings from the CDC that America will have a horrible fall.

Let’s hope they’re talking about diseases and not democracy.

I’m hopeful for this cough, cold, and flu season. Most of us here in NY will be wearing masks and schools are mostly virtual: a good combo for a mild season.

The rest of ya’ll probably won’t be so lucky.

On the other side of that, it is 2020. The whole COVID/social unrest/economic crisis/toilet paper shortage/Kobe and Chadwick/political stuff should be enough of a gut check for us all. Do not put your guard down for a second!

We need to go into cold and flu seasons like Wellness Warriors ready for battle.

I’ve written about Natural Cold Remedies and the misinformation around Boosting Your Immune System, so check those out for a deeper dive on the subject of fall wellness. Today, I want to give you my specific recommendations for cold management.

A little semi-related nudge: the second big allergy season is starting, too. Start taking your natural allergy remedies like Allergy Support now. Those with mismanaged allergies are more likely to get upper respiratory tract infections, so get control today!

Please remember that I’m a pharmacist but not necessarily YOUR pharmacist. Make sure you speak to your healthcare professional, especially if the symptoms are more serious or the cold has shifted into something that requires a higher level of care.

Do I Have A Cold?

Upper respiratory tract infections normally all begin the same. Most people start paying attention when they have a scratchy or sore throat. 

If you get frequent colds because you own a pharmacy and have 4 small children, you learn to see some signs a day or so before that. A general “weird” feeling, disrupted sleep, and achiness can tip you off early.

The cold progresses to a runny and/or stuffy nose, fever, headache, and a general body ache. The immune system is wonderful, isn’t it? 

If you get REAL lucky, the post nasal drip causes an irritating dry cough, and the cold eventually settles in your chest, making a productive, yucky cough that can make your rib muscles hurt.

With all that joy, why work so hard to stop the fun?

Here are the three steps I tell my patients to take when a cold shows up, bags in hand, ready to move in. It’s important to note that we have to start early. If you’re on day 3 or 4 of your cold and are stuffed up, skip to Step 3.

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Step 1 – Zinc Lozenges

Finally, a good reason to use Zinc Lozenges! I know everyone has a HUGE supply of it as the whole country bought it based on a COVID meme, so you’ll be stocked up.

Zinc lozenges DEFINITELY help for cold, but not for COVID.

Zinc, when applied topically to the upper respiratory tract, will surround the cold virus as it is replicating and prevents it from ‘sticking’ to the back of the throat. The virus then slides down into the Sarlacc pit of your digestive tract, never to be seen again. 

You have to barrage that upper respiratory tract, though. Zinc must be applied all day, not just once and done.

Zinc has to be taken within the first 24-72 hours to work best. 

Here’s how to use zinc lozenges for cold symptom support:

  • Dissolve 1 lozenge slowly. Don’t chomp down and chew – you have to let it dissolve and coat the back of the throat. 
  • Don’t drink/eat for 15 minutes after to allow the zinc that’s now in your mouth to make its way with your saliva.
  • Do this 6 times a day for at least 48 hours, but no more than 72 hours.

The downside? You’re sucking on a metallic mineral. Taste can change temporarily, but a few unlucky folks have had their taste buds changed for much longer, if not permanently. It’s not without risks, but those risks are super low.

Some will confuse zinc lozenges for zinc capsules or tablets. Those are very different, and orally absorbed zinc (vs topically applied via lozenge) won’t have any impact on your cold. (If you do buy zinc, look for true chelates, like we discussed with our Magnesium article. Skip the zinc capsules, use zinc lozenges, and use them correctly for some great results.

Step 2 – High Dose Echinacea

For a while there, there would be a new article talking about how echinacea doesn’t do anything for the common cold. 

This is only partially true, as is the case with most studies around supplementation. When you study garbage products at mediocre doses, you get garbage study results. 

There’s a positive study of echinacea when the extract of the root is used at a VERY high dose for just a couple days. Dosing the alkylamides at about 50mg daily for 2-3 days has been shown to reduce the severity of cold symptoms. 

Yes, most echinacea products do not contain those compounds (at least in a measurable amount), so they’re generally a waste of money. Daily use of echinacea isn’t recommended by me.

So if after 2-3 days of zinc lozenges you’re not getting the results you hope for, it’s time to bring in the big guns. Quick Defense by Gaia herbs contains that high dose of alkylamides, so that’s my go-to next.

Here’s how to use Quick Defense for cold symptom support:

  • Take 2 capsules five times a day starting no later than 48 hours after cold symptoms start.
  • Take with a glass of water.
  • Don’t take for longer than 2 days 

Some things are meant to be. Despite following step 1 and step 2, that cold may still come. Next is managing the symptoms. We have 2 really great natural options that are paired with some more traditional treatments to get through the misery of the next few days.

Step 3 – Symptom Squashing Solutions

The dirty secret of the drug store is that despite there being a wall full of cold remedies, there are really only 3 or 4 levers we can pull.

Expectorants will loosen phlegm and help clear chest congestion.

Cough Suppressants work by changing your “cough threshold.” 

When sick, you cough easier than normal as every little thing is making you bark, unproductively, like a dog. 

Cough suppressants reset you to a more normal. The myth is that they stop you from coughing productively, but that is untrue. They just make your cough less annoying.

Antihistamines have a property that has a drying effect, so it’s very useful for that post-nasal drip most of us suffer from. 

Our cough during a cold oftentimes isn’t from our chest, but from our sinuses.

Decongestants will work directly or indirectly to, well, decongest stuff. Most of these constrict leaky blood vessels in the sinuses, but for those with cardiovascular risks, you can use neti-pots and saline sprays to decongest without taking heavy-duty stuff.

Analgesics help with the achy pains and fever associated with being sick. 

We have a few options here, and this is what I normally recommend after a quick review of everyone’s history:

3a – Sinus Blaster

Our unique combination of cayenne, garlic, horseradish, and more works to break up sinus congestion using the aromatic properties of those foods.

  • Take 1 dropperful by mouth and swallow.
  • No food or drink for 15-20 minutes after.
  • Use up to 4 times a day.
  • Take it straight up, or mix it with some water. It’s best straight.

Some people tell me they get better so they don’t have to take that… let’s say “unique”… tasting mix.

3b – Bronchial Syrup

If someone’s looking for an herbal blend to support respiratory symptoms like cough or post-nasal drip, there’s nothing like Wild Cherry Bark or Osha Root. Bronchial Syrup has a really cool blend of respiratory-supporting herbs.

If you have severe congestion or any of those ingredients are contraindicated, I’ll push people towards Mucinex. 

Here’s a protip: Mucinex has become a brand name and doesn’t represent one individual product, but a myriad of them. What you are looking for is guaifenesin extended-release in at least a 600mg dose, taken twice daily. I’ll encourage 1200mg (extra strength) often. 

Don’t be fooled by the knock-offs – many guaifenesin tablets now exist that are not extended-release. The liquid Robitussin products aren’t any better. In fact, you’ll have to drink a gallon of that to equal the power of the tablets!

3c – Spray and Rinse As Needed

If the congestion is severe, don’t be afraid to use saline nasal sprays or a neti-pot. We have a cool saline spray called Xlear, which contains xylitol. Xylitol prevents mucus and boogers from sticking. If you’re REAL brave, try the Xlear with pepper extract.

3d – Use Tylenol, Not Aspirin

When it comes to selecting an analgesic, I have a lot of people who want to go au naturale. A few thoughts on this…

White willow bark and other herbs with analgesic properties are actually aspirin-like or aspirin derivatives. I’m of the opinion that aspirin should only be used as an antiplatelet medicine, as that’s its best indication. Aspirin carries too many liabilities to recommend for more than that.

Turmeric may prove useful here, as well as Boswellia or any of the others. As I discussed on my podcast Inflammation: The Silent Killer they are working on the same pathways as NSAIDs like ibuprofen. It may be smart to just use those since it’s just a short period of time and you need relief asap without spending the big buckaroos.

Tylenol is avoided because of “liver”, as many people say. An organ is no reason to avoid an effective and safe option. Tylenol when used wrong can be a problem, like if you have cirrhosis, chronic alcoholism, or take more than the recommended amount of 4000mg daily. Experts recommend that older patients (over 65) and those who use Tylenol regularly limit to 3000mg a day. 

Regardless, it’s safe for almost all of us and will have no ill effect on our liver, so long as we take no more than the limits.

Most of us are very cautious, taking only a few tablets total daily. My recommendation: if you’re going to use these, use them correctly. Here’s a brief summary:

  • Ibuprofen doses shouldn’t exceed 800mg at a time (4 of the OTC version) and acetaminophen shouldn’t exceed 1000mg at a time (2 of the 500mg “extra strength” form). 
  • Take them no more than 4 times a day.
  • You can use both if symptoms are severe, but they should alternate from each other. Ibuprofen, wait a few hours, acetaminophen, wait a few hours Ibuprofen again, etc.
  • Speak with an expert about any analgesic – herbal or traditional.

While I’m at it, let me just say this again: speak to an expert, as all interventions – traditional or natural – aren’t without risk.

In Case Of Cold, Break Glass

An ounce of prevention to prevent the pound of cure, ya know? Wash your hands, stay away from small children, get your rest, exercise, and nutrition, and you’ll be slightly less likely to catch a cold.

The best prevention, though, is to have these things in the house before you get sick. Sort of like a plunger – have one before you need it.

Grab a few items to have in the house and follow my advice above to have the most uneventful cold and cough season in years.

Just trying to keep it real…

Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth

Dr. Neal Smoller, Holistic Pharmacist

About Neal Smoller

Dr. Neal Smoller, PharmD, is a licensed pharmacist: and owner of Village Apothecary, an independent pharmacy in the most famous small town in America—Woodstock, NY. He’s also the host of the popular wellness podcast, The Big Mouth Pharmacist.”


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