What I Recommend My Patients During Cold & Flu Season

It's that time of year when my inbox fills up with "Do I need to be seen?" messages. The answer is usually no—but I get it. Being sick is miserable, and it's hard to know what actually helps versus what's just marketing hype. So here's what I actually recommend.

These are simple, evidence-based interventions that genuinely help:

1. Saline sinus rinse This is my #1 recommendation. It mechanically clears out mucus and irritants. Yes, it feels weird at first. Yes, it works.

2. Over-the-counter pain medications Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can help you feel significantly better by reducing aches, pains, and fevers. People underestimate how much more tolerable being sick becomes when you're a little less achy. If you are taking certain medications or have kidney disease it may be best to avoid ibuprofen and other non-steroidal anti-inflammatory medications (NSAIDs).

3. Drink lots of fluids Any fluid counts. Tea with honey is particularly helpful for sore throat and cough.

4. Cool mist humidifier Adding moisture to the air helps keep your nasal passages and throat from drying out, which makes you more comfortable and helps your body clear mucus more effectively.

5. Nasal steroid spray for congestion If you have significant sinus congestion, adding Flonase (or generic fluticasone) about 10 minutes after your saline rinse can really help.

What to skip:

• Phenylephrine (the decongestant in most over-the-counter cold medicines)—it doesn't actually work

• Afrin—it's habit-forming and can make congestion worse when you stop, especially if used for more than 3 days

What might help but isn't for everyone:

• Pseudoephedrine (the decongestant you have to ask the pharmacist for) does work well, but avoid it if you have high blood pressure

A note on antibiotics:

Most colds and flu are viral, which means antibiotics won't help and can actually cause side effects. The exception is if you develop a secondary bacterial infection like bacterial sinusitis.

When are you contagious?

Generally, stay home until you've been fever-free for 24 hours without medication. You're most contagious in the first 3-5 days of symptoms. If you absolutely have to go out during those first few days and you're coughing or sneezing, please wear a mask. Your coworkers and the person behind you in the grocery store will thank you.

When to call your doctor:

• You're having trouble breathing

• Your fever isn't going away after 3-5 days

• You get better but then get worse again

• You are not improving as expected

About testing:

If you have a high fever, I recommend using a home flu and COVID test within 48 hours of symptoms starting—early treatment may make a real difference, especially for those with risk factors for severe illness. Not every cold symptom needs to be tested, but high fever with cough and runny nose is a good indicator to check.

One more thing:

It's common for a cough to last up to 8 weeks after a respiratory infection. This is normal and doesn't automatically mean you need antibiotics or further treatment.

Good luck, wash your hands, and feel better soon!

And speaking of staying healthy—if you're tired of navigating colds, flu, and everything else without a doctor who actually knows you, we're opening our Primary Care+ membership February 2nd, 2026. [Join the waitlist here]

Important Medical Disclaimer: This information is for general educational purposes only and does not establish a doctor-patient relationship. This content is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified healthcare provider before starting any new medications or treatments, even over-the-counter ones. This advice is intended for adults—always consult your pediatrician about treating children. Even over-the-counter medications can interact with prescription drugs or worsen certain health conditions, so check with your pharmacist or doctor if you have questions about what's safe for your specific situation. If you have a medical emergency, call 911 or go to the nearest emergency room.