Is it a springtime allergy or cold?

April 19th, 2019
A photo of people with kleenix's to their noses.
Is it a cold? Or an allergy? Photo: Getty Images

You feel rotten. You think you have a fever. There’s a headache, maybe a cough. It’s that time of year when you can’t tell if you have a cold, strep, the flu or allergies.

So let’s sort them out with a little help from Dr. Ian Tullberg, medical director for all 17 urgent care clinics operated by UCHealth Medical Group.

Colds

“Colds will give you a runny nose, sometimes a sore throat, a cough and even eye drainage. You can get a fever but usually not body aches. You probably can go about your day and feel crummy but still function.”

Colds are lurking out there all year round, though they are more prevalent in winter.

Most colds can be treated with over-the-counter medications, “but if you have symptoms for more than two weeks, you maybe should seek some relief. There are symptomatic remedies we can offer,” Tullberg said. “There is nothing you can take to make the illness go away any faster; however, some studies show that the use of zinc can help slightly shorten cold symptoms.” Patients should know that there is a toxicity associated with zinc, however.

What about vitamins?

“Vitamin C has been shown not to do a thing. So it’s a waste of money,” he added.

If a cold leads to getting bronchitis (aka, a chest cold) or pneumonia, it’s because the cold has lowered your immune system and made you susceptible to those ailments. The virus itself does not turn into pneumonia, he explained.

Allergies

It can be difficult to tell allergies from the common cold, Tullberg said.

“Usually the inside of the nose is more dusky pink rather than the red of a cold,” he said. Then there’s the watery drainage and itchy eyes and “many patients say it does not feel like it’s an illness.”

Perhaps surprisingly, “you will never get a fever with allergies. Like teething, it’s an old wives’ tale,” he said. If you get a fever, likely the allergies have made you susceptible to some sort of infection.

That doesn’t mean allergies should be dismissed as a minor affliction.

They can be accompanied by “a significant sinus infection, or your nose is blocked and you feel lots of pressure on your face. You can feel absolutely awful. Most people who have severe allergies know they suffer from it and recognize the signs.”

With any of these afflictions, a patient should seek help when “something feels different or odd. We’ve all been sick before, but if this one is different, maybe you should get professional help.

“Difficulty in breathing is the underlying commonality. If we get to the point where it’s compromising your breathing or your fever is 105, then yes, you need to be seen. Less than that, you don’t need to be seen, but you can be seen and we can help with your symptoms,” he said.

And urgent care is probably the best place to go with these illnesses.

“In Colorado Springs, we are about 170 primary care physicians short to treat our population, so access can be difficult,” Tullberg said. “You can try, but if you can’t get help quickly, then urgent care can fill that need.”

That doesn’t mean the emergency room.

“Do not go to the ER for any of these things,” Tullberg said. “These are urgent care issues – if you need to go to the ER, we will send you there.”

Flu

Flu season isn’t quite over, so that’s one possibility.

“Last year, we saw it run well into May and some speculate that we might do it again this year,” Tullberg said.

How do you know it’s the flu? Because it’s mainly a respiratory illness, it’s often accompanied by a cough, chills, fever (of 100.4 or greater), plus significant body aches and possibly even nausea and vomiting.

Tullberg has another test: “I typically ask my patients, ‘Do you feel like you were just hit by a truck?’ If they say yes, then it leads more that direction.”

In most cases, there is no specific treatment and the illness has to just run its course, he said. For patients ages 5 to 65, that means over-the-counter pain relievers and such. But if a patient is younger or older than that, they are considered high risk and probably should see a physician. Younger than age 2 is considered very high risk. People with specific health conditions also may be considered high risk.

A lot has been written about a product called Tamiflu. It can help but comes with lots of caveats, Tullberg said.

A photo of Dr. Ian tullberg
Dr. Ian Tullberg

“You need to start it within 48 hours (of onset) to be most effective. Many providers don’t like Tamiflu because it only shortens the overall duration of the flu by about half a day. But you may be less contagious, if you are around others who are high-risk.

“It can prevent hospitalization for more serious side effects, such as pneumonia, which is the leading cause of death from the flu. And although Tamiflu has its upside, it also can cause nausea and vomiting.”

Most providers will give you the option, but you should know the risks, he said.

In most cases, if you get the flu, the best bet is to just ride out the illness.

“The worst is usually the first few days of feeling awful, then a few days of not feeling well, then a few more of recovery – usually about a week long total.

But seek help if your fever is in the 105 range or you have difficulty breathing, he said.

Sore throat

When most people get an exceptionally sore throat, they say they have “strep throat,” but it’s more likely they have viral pharyngitis, Tullbeg said. And it can happen in the spring as well as winter.

“We see people coming in and saying they’ve had strep throat before and they think they have it again. But most of the time they are incorrect.”

Strep throat usually affects children agers 3 to 15. Anyone older likely has viral pharyngitis, and particularly if they’re older than 40, he added.

Symptoms of either can include fever, pus in the back of throat, and enlarged lymph nodes in the neck. Strep typically is not associated with a cough, but viral pharyngitis can include a cough.

As for treatment, strep calls for an antibiotic if the patient tests positive, he said. As for viral pharyngitis, “the vast majority of patients think they want an antibiotic, but because it’s viral, antibiotics won’t work. There are some other treatments we can offer that help relieve some symptoms, though,” he said.

Do these throat issues require medical attention?

“Probably you should see a physician if have a fever with a very sore throat,” Tullberg said. “We can help you feel better, even if it’s not the treatment you think you need.”

 

About the author

Linda DuVal is a freelance writer based in Colorado Springs who writes articles for UCHealth.