Published January 30, 2025
As the weather gets colder, more people are coming down with respiratory illnesses like the common cold and bronchitis. It’s important to know what causes these illnesses and how to treat them effectively to stay healthy.
The Viral Nature of Common Respiratory Illnesses
The vast majority of respiratory illnesses are caused by viruses, which generally do not respond to antibiotics. Instead, treatment focuses on supportive care to help the body fight off the infection. For example, acute bronchitis—an inflammation of the bronchial tubes—is primarily viral in origin, with studies showing that 85% to 95% of cases in healthy adults are caused by viruses such as rhinovirus, adenovirus, and influenza A and B (pmc.ncbi.nlm.nih.gov).
The Pitfalls of Overtreatment
Despite the viral nature of most respiratory infections, there is a tendency to overprescribe antibiotics. Again, antibiotics kill bacteria but don’t work against viruses and unfortunately the misuse of antibiotics can lead to several complications.
Antibiotic Resistance: Overuse of antibiotics contributes to the development of resistant bacteria, making future bacterial infections harder to treat.
Disruption of the Microbiome: Our gut microbiome is a complex ecosystem of beneficial bacteria that play a crucial role in our overall health. Taking antibiotics unnecessarily can disrupt this balance, leading to potential health issues. Dr. Marty Makary, in his book “Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health,” discusses how overtreatment and the misuse of antibiotics can harm our health. https://www.bloomsbury.com/us/blind-spots-9781639735327 (this disruption of our gut microbiome is not insignificant can lead to a whole host of issues, research showing that use of antibiotics and life increases the risk of inflammatory bowel disease like Crohn’s disease and colon cancer)
The Role of Corticosteroids
Sometimes steroids are used to help reduce inflammation in a respiratory infection.
You might have discovered already that I am cautious about prescribing corticosteroids, such as prednisone. Although sometimes it can be helpful with children in respiratory distress from croup research indicates that corticosteroid treatment in influenza in adults is associated with increased mortality and hospital-acquired infections. (pubmed.ncbi.nlm.nih.gov). Thus, their use in viral infections like influenza is not recommended. While they may provide short-term relief due to their anti-inflammatory properties, the risks, including immune suppression and increased susceptibility to secondary infections, outweigh the benefits.
Probiotics: Supporting Gut Health
If we absolutely must use an antibiotic, I always recommend using a probiotic as well -to mitigate the negative impacts of antibiotics. When administered in adequate amounts, confer a health benefit on the host. They can help restore the natural balance of bacteria in the gut, especially after antibiotic use. Incorporating probiotic-rich foods like yogurt, kefir, and fermented vegetables into your diet can support gut health during and after illness. Bio-k is also an excellent commercial probiotic that has clinical evidence supporting its use during and after an antibiotic.
When to Seek Medical Attention
While most respiratory illnesses are self-limiting and resolve without medical intervention, it’s crucial to know when to consult a healthcare professional. Adults should seek medical attention if they experience:
Persistent Symptoms: Upper respiratory symptoms lasting more than three weeks or a cough lasting more than a week.
High Fever: A fever exceeding 103°F (39.4°C) or a fever that persists for more than four days.
Shortness of Breath: Difficulty breathing or chest pain or an oxygen saturation of less than 94%.
Underlying Health Conditions: Individuals with chronic health issues, seniors over the age of 65 or weakened immune systems should be more vigilant.
These are not exhaustive, but may indicate a more severe condition, such as pneumonia or a bacterial infection, which could require specific treatments.
Also, viral infections and colds can be treated at home and do not necessarily need the attention of an MD. The above are guidelines. Of course I regularly publish what to do for colds in terms of some simple things that have antiviral properties including good old beet juice. I do recommend beet juice not as a preventative however but to be taken episodically. You can find these recommendations below.
Conclusion
Understanding the viral nature of most respiratory illnesses underscores the importance of appropriate treatment approaches. Avoiding unnecessary antibiotics, being cautious with medications like corticosteroids, and supporting your body’s natural defenses through proper nutrition and rest are key strategies.
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