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Treating the Common Cough: Time to Think Natural

by Peter W. Crownfield, executive editor

If you've ever taken medicated syrup or drops for an irritating cough and then waited, and waited, only to find that the cough resolved on its own time, this article is for you. Yes, that means virtually everyone. Guidelines published in January by the American College of Chest Physicians (ACCP) state that over-the-counter cough medications are ineffective in treating the underlying causes of cough.1


"With over-the-counter cough medicines under fire, the message seems clear: It's time to consider natural alternatives."


According to Dr. Richard Irwin, chair of the ACCP cough guidelines committee, over-the-counter cough syrups generally do not contain enough medicine to be effective, or they contain drugs that have not been proven to be effective for treating the common cough.2 "In most cases, a cough that is unrelated to chronic lung conditions, environmental influences, or other specific factors will resolve on its own."3

The ACCP guidelines address cough in both the adult and pediatric populations. In fact, they strongly recommend against the use of over-the-counter cough and cold medications by children ages 14 and younger. "Cough is very common in children. However, cough and cold medications are not useful in children and can actually be harmful," said Dr. Irwin.


"An October 2005 study suggests North American ginseng extract can be a safe and effective natural remedy for treating colds and cold-related symptoms, including cough."


Adding to the evidence against cough medicines, a recent review in Respiratory Phyisology & Neurobiology attributes the perceived "benefit" of cough medicines to nothing more than the placebo effect.4 The review authors also speculate that it may not be coincidental that most cough medicines are formulated as sweet syrups, rather than as tablets or capsules. In other words, people may take them because they taste good, not because they help get rid of their coughs.

But wait, there's more: While cough expectorants and suppressants have little or no effectiveness in treating cough, they are potentially effective in causing cavities, suggests a report published in the January/February issue of General Dentistry,5 the peer-reviewed journal of the American Academy of General Dentistry. The report revealed that many syrupy medications, including those commonly used for combating cough, are characterized by low pH levels, high acidity and sugar, which can cause erosion to the outer layers of the teeth. The report also noted that medicine administered before bedtime, when the flow of saliva decreases, can increase dental damage.

All of the above adds up to a fair amount of depressing news about cough medicine, and it comes straight from the allopathic community. The bottom line: Medical manage ment of cough doesn't seem to be all that effective, and might carry health risks. What can you do? Let's take a minute and consider some simple natural methods of treating'that bothersome cough:

  1. An October 2005 study suggests that North American ginseng extract can be a safe and effective natural remedy for treating colds and cold-related symptoms, including cough. According to the researchers, ginseng "appears to be an attractive natural prophylactic treatment for upper respiratory tract infections."6
  2. Zinc may relieve cough and other cold symptoms, according to a study published in the Annals of Internal Medicine.7 Subjects recruited within 24 hours of developing symptoms of the common cold were administered a single zinc lozenge (12.8 mg zinc acetate) or placebo every two to three hours while symptoms were present. Duration of cough in the zinc group was 3.1 days per person compared with 6.3 days in the placebo group.

"According to a recent study in the Annals of Internal Medicine, subjects given zinc lozenges suffered from cough for just over three days, compared with more than six days for those taking placebo."


  1. Dr. Edward Schulman, an American Thoracic Society representative on the ACCP cough guidelines committee (the ATS endorsed the guidelines), recommends drinking plenty of fluids and eating chicken soup to help get rid of the common cough. According to Schulman, cold-related coughs generally last less than three weeks.2
  2. Andrea Candee, author of Gentle Healing for Baby and Child A Parent's Guide, says the anti-inflammatory properties of onion and honey can help relax coughing spasms and soothe irritated tissue. Both are antimicrobial as well.8 Thyme also can be combined with honey to make a natural cough syrup, says Candee. Thyme has antimicrobial properties and is a natural expectorant.8

Other nonpharmaceutical options are out there – some with research to back them; others whose merits are based on clinical observation and/or sheer experience. The point is that the majority of people have taken cough syrup and/or cough drops at least once; how many have tried natural cough remedies? With the release of the ACCP guidelines, the message seems clear: When it comes to treating the common cough, it's time to think natural.


References
  1. Diagnosis and management of cough: executive summary. ACCP evidence-based clinical practice guidelines. Chest January 2006;129(supplement): 1S-23S.
  2. Doctors discourage the use of cough medicines. Over-the-counter versions do little to relieve symptoms, experts say. MSNBC.com, Jan. 9, 2006.
  3. New guidelines challenge OTC cough syrup use. Harvardvanguard.org, posted Jan. 11, 2006.
  4. Eccles R. Mechanisms of the placebo effect of sweet cough syrups. Respiratory Physiology & Neurobiology 2005.
  5. Medications and Cough Syrups May Cause Cavities. Sciencedaily.com, posted Jan. 11, 2006. Source: Academy of General Dentistry.
  6. Predy GN, Goel V, Lovlin R, et al. Efficacy of an extract of North American ginseng containing polyfuranosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. Canadian Medical Association Journal, Oct. 25, 2005;173(9):1043-48.
  7. Prasad AS, Fitzgerald JT, Beck FWJ, et al. Duration of symptoms and plasma cytokine levels in patients with the common cold treated with zinc acetate. Annals of Internal Medicine 2000;122:245-52.
  8. Q & A: Is there a home remedy for coughs so I can avoid the chemicals and alcohol found in over-the-counter cough syrups? Naturalfamilyonline.com, accessed Feb. 6, 2006.
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