How to Differentiate Between a Cold, Flu and Allergies

Mother Nature has been doing her best to give North Texans a case of whiplash this winter by alternating weeks (and days) of cool and warm temperatures over the past few months. More time spent indoors due to lower temperatures means more togetherness, which also often leads to the spread of bacteria and viruses.

When you first start noticing a sore throat, congestion and a runny nose, how do you know what you’re dealing with? We reached out to Todd Richwine, D.O., family medicine specialist and physician on the medical staffs at Texas Health Southwest Fort Worth and Texas Health Family Care – Clearfork, a Texas Health Physicians Group practice, for advice on how to recognize the telltale signs of a cold, the flu and allergies.

“Typically, the flu has a sudden onset and you’ll experience high or at least moderate fever and frequent body or muscle aches. Chills, fatigue and headaches are common,” he explains. “Colds typically come on slowly, meaning there is a gradual progression of symptoms and people go from wondering if they are getting sick to progressing to where they know they are. I often hear patients say they felt normal and then were suddenly sick with the flu, while it is a very gradual progression with the common cold.

“With colds, fever is rare (at least above 100 degrees), aches are mild and chills are uncommon. There typically is more congestion, sneezing and sore throat with a cold, and headaches are rare.”

We kicked off this year’s blog with a rundown of five common winter illnesses, which included the common cold and the flu, along with pneumonia, RSV and strep. And while these tend to trend upward in the colder months, allergies can be a problem in North Texas year-round.

Richwine says allergies may share some of the same symptoms with colds and the flu, but there are some marked differences.

“Allergies typically cause a lot of the upper respiratory symptoms like a cold, such as sneezing and congestion, but you’ll also have runny or itchy eyes and itchy skin. Those with allergies may feel tired, but typically don’t describe themselves as feeling sick. Colds and flu typically run their course within five to 10 days, where allergy symptoms can last as long as the person is exposed to what they are allergic to, often weeks to months.”

According to the Consumer Healthcare Products Association, Americans spent $34 billion on over-the-counter medicine in 2016. And while consumers have access to everything from pain relievers and antihistamines to nasal sprays and cough drops, there are differing opinions as to how effective OTC medications really are.

“Over-the-counter medicines are very helpful with allergies, both the oral antihistamines like Claritin and Allegra and the nasal steroid sprays like Flonase and Nasonex,” Richwine explains. “They typically are much less helpful for the flu or a cold. Ibuprofen or Tylenol products can address aches and fever, and decongestants and mucolytics can help some of the congestion symptoms for colds. Beyond that, most other OTCs haven’t been found to help a lot.

“The best ‘medicine’ hasn’t really changed much, which is to cover coughs and wash your hands frequently to not spread your illness to others, get lots of fluids and plenty of rest, and allow yourself the time to get well.”

Sometimes it’s difficult to know when to make an appointment to see your physician, especially if you’re not sure what you have. Is it worth the time, money and risk that you might pick up something entirely different while sitting in the waiting room?

Richwine has a few tips for knowing when to head to the doctor.

“Most people have been either sick with the flu or a cold at some point, so if they feel like they or their loved one feel worse than they would expect, I would encourage them to see their provider,” he says. “Shortness of breath could be an indication they have a complication from the flu, like pneumonia. Other things to watch for in adults are pain or pressure in the chest or abdomen, confusion, and severe or persistent vomiting. Those that are high risk, such as those with chronic respiratory issues or who have their immune system suppressed from medications or disease, should see their provider. I would also recommend that caregivers of those who are chronically ill see their providers if they have flu-like symptoms.

“In children, you want to watch out for fast or troubled breathing, bluish skin color, not eating or drinking well, not waking up or interacting well, a fever with a rash or, in the case of infants, being so irritable that he or she doesn’t want to be held. If a child or adult gets better for 24 to 48 hours, then starts getting sick again, that is a good indication for them to see their providers as well.”

Thankfully March marks the end of flu season, but that doesn’t mean sporadic cases may not linger for a while. And while the flu walloped almost the entire country this season, Richwine says he still recommends getting the flu vaccine.

“Unfortunately, there were a lot of news reports recently about the flu vaccine ‘not being good,’ which then led to a lot of people not getting the vaccine this year and they might not get it in the future,” he says. “Most physicians in practice believe that even those who get the flu with a flu shot tend to have more mild symptoms, are at much less risk for the severe symptoms, and in general do better than those who do not get the vaccine. A lot of people also don’t understand that you can get Flu A and Flu B during the same year, as they are different viruses, so there may be a reason to get a flu shot even if you have already had the flu.

“The most important thing to remember is not to panic or become overly worried, as both the flu and the common cold are very common and most people will get better on their own without any long-term complications.”

In need of a primary care physician? Head to TexasHealth.org/provider to find the closest physician near you this cold and flu season, and every season. 

2 Comments

  • marie valentino says:

    These links are always so informative. thank you

  • Patricia Gay says:

    3/17/18
    Many thanks for the above very helpful info & clues for determining differences between cold, flu, & allergies & remedies for each, as well as when to head to Dr. Thanks for taking the time & effort to help many of us confused about similarities/differences.
    Gratefully,

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