Estrogen and Cancer

Posted on Posted in Continuing Education, Homestudy, Seminars, Webinars

486321414_XSThe word “estrogen” actually refers to a family of related molecules that stimulate the development and maintenance of female characteristics and sexual reproduction. The most prevalent forms of human estrogen are estradiol and estrone. Both are produced and secreted by the ovaries although estrone is also made in the adrenal glands and other organs. Estriol is a third form of estrogen that is produced by the placenta and is only synthesized in significant amounts during pregnancy.

The breast and the uterus, which play central roles in sexual reproduction, are two of the main targets of estrogen. The estrogens normally promote healthy cell growth in the breast and uterus. Yet, this same propensity to stimulate cell proliferation can also increase the risk of developing breast or uterine cancer.

The apparent connection between breast cancer and estrogen has been noted for over a century, beginning with the publication of a paper in 1896 by Scottish physician George Beatson. The article, which appeared in the British medical journal, The Lancet, reviewed the case of a 34-year-old woman with advanced breast cancer who lived for four years after her ovaries were removed, a treatment now known as ovarian ablation.

Breast cancer risk increases with menstruation at an early age, late age at menopause, later age at first full-term pregnancy, and few or no pregnancies. Research suggests that the reason may be that these situations result in longer lifetime exposure to estrogen, which promotes cell division in breast tissue and possibly unregulated cell growth, leading to mutations.


According to some studies, body fat and menopause appear to be important factors in the estrogen-cancer connection. Obesity has a complex relationship to breast-cancer risk that differs depending upon menopausal status. In one study published in the International Journal of Cancer, which included 176,886 European women between 18 and 80 years of age, researchers found a 65 percent increase in the risk of breast cancer for

After menopause, the adrenal glands continue to produce small amounts of a steroid called androstenedione, which is converted into estrogens by aromatase in fat tissue. Increased levels of this steroid may be the reason why menopause and obesity are associated with higher estrogen levels and increased risk of breast cancer. It is also believed that excess fat may cause the body to produce more estrogen than is necessary for normal cell growth.

In addition, fat cells secrete the pro-inflammatory chemicals, TNF-alpha and IL-6, either of which can act to increase the production of aromatase, which is directly related to increases in estrogen. Obesity is also associated with greater tumor burden in women diagnosed with breast cancer, higher-grade tumors, and poorer prognosis and/or increased mortality. Weight gain and obesity have been identified as the most important risk and prognostic factors for breast cancer in postmenopausal women. Moreover, the association between obesity and cancer has also been established for colorectal and prostate cancer.


Breast Cancer

Posted on Posted in Continuing Education, Homestudy, Webinars

breast_cancer_000014453948Over 60 studies have been published that have examined the relationship between physical activity and breast-cancer risk. Although the majority of studies indicate that physically-active women have a lower risk of developing breast cancer than inactive women, the amount of risk reduction varies widely (from 20 percent to 80 percent). Most evidence suggests that physical activity reduces breast-cancer risk in both premenopausal and postmenopausal women. Women who increase their physical activity after menopause may also experience a reduced risk compared with inactive women.

High levels of moderate to vigorous physical activity during adolescence may be especially protective. For example, a recent prospective study of the activity levels of adolescent girls in relation to their subsequent risk of benign breast disease (a risk factor for later development of breast cancer) found that adolescent girls who — as young women — walked the most were at the lowest risk. The association between adolescent physical activity and breast cancer risk was also examined among women enrolled in the Nurses’ Health Study II. An inverse association was observed between physical activity at ages 14–22 and premenopausal — but not postmenopausal — breast cancer. The association was strongest for women

Awareness may have played a role in the findings of the association between diet intake and breast cancer among Polish women who were ranked according to their level of regular physical activity. The results suggested that a higher intake of vegetables and fruits may be associated with a decreased risk of breast cancer among women who were ranked in either the lowest or highest quartiles of lifetime physical activity. In addition, there was a positive association for sweets and dessert intake among women in the lowest quartile of PA. These findings could be interpreted to suggest that a high intake of antioxidant-rich foods could confer protection in the presence of either a sedentary or extremely active lifestyle. Furthermore, the high intake of sweets in those ranked as least active could be associated with a higher risk for breast cancer.  One additional study found that physical activity performed either before or after cancer diagnosis was related to reduced mortality risk for both breast and colorectal cancer survivors.


The Zika Virus: A New Warm Weather Worry

Posted on Posted in Pain, Seminars, Webinars

mosquito-542156_640It’s odd to think about mosquitoes in the middle of winter. However, in Brazil, it’s not the middle of winter.  The Zika virus, a potentially devastating illness, has captured medical headlines around the world.  Carried by mosquitoes, the Zika virus has been documented in Central and South America, the Caribbean and several southern states.  Apart from causing miserable flu- like symptoms, this unusual and worrisome virus can cause catastrophic birth defects.  In fact, as of January 31, 2016, the Brazilian government has traced over 3,000 birth defects to Zika virus exposure in utero.

Patients with Zika infection may experience high fevers, severe musculo-skeletal pain and profound malaise.  Symptoms are often similar to those caused by another warm weather mosquito-borne culprit, Chikungunya virus.  The word, “Chikungunya,” is a tribal word describing the acute, contorted, bent-over posture of people doubled-over with pain, as the illness strikes.  An intense, maculo-papular rash on the trunk and extremities is often present early on. Encephalitis, myocarditis, and hepatitis can develop.  The most recent outbreak of Chikungunya virus flared up in October, 2013 on the island of St. Martin.

Researchers believe the current outbreak of Zika virus can be traced to large crowds and warm weather at the most recent World Cup events.  The illness has now been confirmed in 24 countries. Nearly 40 cases are being evaluated in the United States, however, all of these cases are apparently related to exposure while traveling.

Zika virus in the expectant mother can result in severe birth defects, neurologic deficits, and even anencephaly in newborns.  The Brazilian government has taken the unprecedented measure of warning women not to get pregnant until the situation is controlled.  This is an extreme policy designed to prevent extreme tragedy.  The best advice for everyone combines current science and common sense:

  • Women who are pregnant or may become pregnant should avoid travel to endemic areas of infection.
  • Be careful around upcoming Mardi Gras and Carnivale celebrations.
  • If travel is essential to these areas, avoid camping, “jungle expeditions,” dense tropical vegetation, standing water, or other obvious exposures to mosquitoes.
  • Minimize outdoor exposures at dawn and dusk.
  • Keep arms and legs covered and use insect repellants properly.
  • If symptoms develop, seek medical attention promptly and give a precise travel history.

For now, staying informed and exercising common sense and good judgment is everyone’s best bet.


Understanding Blood Pressure

Posted on Posted in Continuing Education, Homestudy, Nutrition, Seminars, Webinars

blood-pressure-monitor-350930_640By Dr. Mary O’Brien MD

Blood pressure (BP) is a measurement of the force exerted against the walls of the arteries as the heart pumps blood to all the tissues and organs of the body. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.

BP is measured using an inflatable arm cuff and a pressure gauge. The reading is given in millimeters of mercury (mmHg) and includes two numbers: an upper number (systolic pressure) that reflects the pressure in the arteries when the heart contracts and pumps blood into the arteries [comma deleted] and a lower number (diastolic pressure) that is a measure of the pressure in the arteries as the heart relaxes after contraction (between beats).

When BP readings are found to be consistently elevated, a diagnosis of high blood pressure (hypertension) can be made. Chronic hypertension increases the risk of serious health problems, including heart attack, heart failure, kidney failure, and stroke. These complications are often referred to as end-organ damage because damage to these organs is the end result of long-standing hypertension.       Unfortunately, hypertension may be undetected for many years because it is typically slow to develop — and quite often asymptomatic. It has been estimated that one out of every five U.S. adults with high BP does not know that she has it.

The American Heart Association (AHA) estimates that hypertension affects approximately one in three adults in the United States. However, the prevalence of elevated BP that is either below the cut-off point for hypertension or undetected is much higher. For example, in 2012, 31 percent of all U.S. adults aged 18 years and older were hypertensive, and an additional 31 percent had pre-hypertension (blood pressure that is higher than normal but not yet in the high BP range).

Moreover, among individuals with hypertension, only about half (47 percent) have their condition under control even though seven in 10 hypertensive U.S. adults use medication to treat the condition.  These numbers are consistent with the most recent National Health and Nutrition Examination Survey.

Despite recent advances in the medical treatment of hypertension, and the introduction of public health campaigns designed to increase awareness of this condition, hypertension remains a significant public health problem in the United States. Our home-study course will address the definition, symptoms, causes, risk factors, complications, and treatment options for hypertension. Information about these components can provide the necessary tools to reduce the prevalence of hypertension and related health problems.


Chocolate: Friend or Foe?

Posted on Posted in Continuing Education, Homestudy, Nutrition, Webinars

chocolate-1220655_640By Mary O’Brien, M.D.

Research suggests that chocolate is the most widely craved food. There is a special questionnaire designed with the sole purpose of assessing chocolate cravings. While only 15 percent of men report craving chocolate, approximately 45 percent of women do, and 75 percent of the women indicated that only chocolate would satisfy their food craving. Explanations of why chocolate is desired by so many are numerous and include the possibility that chocolate is addictive, replaces deficient nutrients,  triggers the release of mood-altering chemicals, and  stimulates the pleasure centers in the brain.

The desire for chocolate appears to be increased by visual cues, such as looking at pictures of chocolate  or holding a chocolate bar.  Persons who have been subjected to dietary restriction prior to encountering these cues are more likely to experience cravings combined with feelings of guilt, anxiety, and depression. Findings have demonstrated that exercise is effective in reducing chocolate cravings in persons exposed to chocolate cues.  Exercise, by reducing stress, may also be effective.

While the reasons behind chocolate cravings may be unclear, the fact that chocolate is a highly desired food is certain. This raises the question of whether giving in to the chocolate urge is harmful. One could certainly argue that a daily dose of chocolate could add to an already precarious calorie balance in some people — or that responding to the craving is establishing a habitual pattern that could manifest in other, more deleterious cravings.

However, if unsweetened chocolate is viewed strictly from a nutritional point of view, it can be described as a food consisting of saturated (palmitic and stearic) and monounsaturated (oleic) fats.  Chocolate can also be described as containing starchy and fibrous carbohydrates that have very few simple sugars and few flavonoid antioxidants.  Chocolate has several minerals, including magnesium, calcium, iron, zinc, copper, potassium, and manganese.  Chocolate has vitamins A, B-1, B-2, B-3, C, E , and pantothenic acid.  Chocolate has roughly 150 kilocalories per ounce. Unfortunately, the preferred form of chocolate for most people is not the unsweetened but the sweetened form, in which the amount of fats, sugars, and calories is increased.

Chocolate also contains the stimulants theobromine and caffeine.  Chocolate has the hormone precursors phenylethylamine and tryptophan, which are thought to have mildly anti-depressant effects. These chemicals are present naturally in the cocoa bean from which chocolate is derived. Cocoa products also contain pharmacological substances such as n-acetylethanolamines that have some chemical similarities to cannabis (marijuana), and compounds that stimulate the brain to release an opiate-like substance called anandamide. Despite the scary-sounding nature of these latter two compounds, the pleasurable effects of cocoa and chocolate do not appear to stem from their drug-like effects, but from the hedonic reaction of the mouth to the feel and smell of the combined fat and sugar. For example, when chocolate-cravers were given cocoa capsules they reported no satisfaction at all.

The moral of the chocolate story, like that of many other guilty pleasures in life, is that while a little is possibly acceptable and can even give a boost to physical and emotional health, too much pushes the pendulum in the other direction. The oft-quoted statement in this regard is “moderation in all things,” but perhaps we should also keep in mind the words of William Somerset Maugham: “Excess on occasion is exhilarating. It prevents moderation from acquiring the deadening effect of a habit.”


Obesity and Heart Disease

Posted on Posted in Continuing Education, Homestudy, Nutrition

thick-373064_640By Dr. Mary O’Brien MD

Longitudinal studies clearly indicate that obesity predicts coronary atherosclerosis in men and in women. Hypertension, a leading cause of atherosclerosis, is approximately three times more common in obese individuals than in those who are of normal weight or less than normal weight.

Body mass index (BMI) is one of the most effective ways to measure obesity. Some studies show that a BMI that is between 25 and 30 confers as much as a 70 percent increased risk of coronary heart disease.

However, a high BMI may not entirely predict heart disease risk. In women, a BMI near 30 may still not be of major concern when the increase in fat tissue is distributed over the hips and not the abdomen.  Accumulating evidence indicates that an increased waist circumference, or waist-to-hip ratio (WHR), predicts complications and mortality from obesity.

Weight-reduction seems to be effective in reducing risks of coronary heart disease (CHD) and congestive heart failure (CHF), potentially preventing heart disease in obese patients. Evidence indicates that, for obese patients, a reduction of only five percent to 10 percent of body weight improves lipid profiles, insulin sensitivity, and endothelial function.  Such a reduction also reduces thrombosis and inflammatory markers.

Maintaining a BMI of less than 25 throughout adult life is a good strategy to reduce the risk of heart disease. For most patients with a BMI between 25 and 30, lifestyle changes in diet and exercise are appropriate.

Restricting consumption of fat to less than 30 percent of total calories should be recommended, because low-fat diets also promote weight reduction. Physical training programs can reduce body mass and help bring about gradual weight loss.

Medical therapy may be necessary in patients with a BMI higher than 30. However, the safety of long-term use of anti-obesity medications has not been established. When the BMI falls within the range of 35 to 40 (or above), bariatric surgery may be an option. Unfortunately, less than five percent of patients are able to maintain their reduced weight four years after surgery. Thus, the prevention of obesity with diet and regular physical activity appears to be the most dependable way to maintain cardiovascular health.


Alzheimer’s Disease

Posted on Posted in Brain Science, Continuing Education, Elder Care, Seminars

constant-63613_640By Dr. Mary O’Brien, MD

Alzheimer’s disease is one of the most dreaded health conditions of our time. There is no cure, and current treatments don’t slow down the disease; they can only alleviate symptoms. As well as avoiding Alzheimer’s disease and age-related cognitive decline, many people want to stay as sharp as possible as they age, and, if possible, delay age-related cognitive decline. Yet are there truly preventive strategies to stave off of Alzheimer’s disease or cognitive problems associated with aging?

While there’s no definitive evidence about what can prevent or reduce the risk of Alzheimer’s disease or dementia, scientific studies have offered clues about strategies that might slow down or prevent cognitive decline. The good news is that research on the prevention and treatment of Alzheimer’s disease—which currently affect about 5.3 million Americans—is now a high priority.

In late 2015, the U.S. Congress approved the largest increase to date in federal spending for Alzheimer’s disease research and care-giver support in the 2016 federal budget—a $350 million increase over 2015. The increase in federal spending came in response to reports and studies documenting the needs and opportunities that lie ahead for Alzheimer’s disease research. By 2050, Medicare spending on Alzheimer’s disease is expected to quadruple to $589 billion annually, but one treatment delaying the onset of the disease could save Medicare $345 billion in the first 10 years of its use, according to a report from the Alzheimer’s Association.

Over the past 30 years, many advances have been made in understanding Alzheimer’s disease and dementia. We now understand the biology of Alzheimer’s disease as never before. The brains of people with Alzheimer’s disease are filled with amyloid plaques—composed of deposits of a toxic protein fragment called beta-amyloid. The brains of Alzheimer’s disease patients also have an abundance of neurofibrillary tangles or abnormal collections of twisted protein threads found inside nerve cells, composed chiefly of a protein called tau.  In Alzheimer’s disease, the amyloid plaques and neurofibrillary tangles damage the brain’s neurons, interfering with their ability to function and communicate with one another. As a result, Alzheimer’s disease causes the brain to shrink and atrophy.

Scientists are now emphasizing research on the development of Alzheimer’s disease and on the symptoms and signs of early Alzheimer’s disease, which is termed mild cognitive impairment. The hope is that learning more about mild cognitive impairment can help identify patients at increased risk for the disease and for disease progression.

The symptoms of mild Alzheimer’s disease include:

  • Memory loss and confusion about once familiar things or places.
  • Difficulty accomplishing daily tasks, especially handling money and paying bills.
  • Poor judgment that leads to bad decisions.
  • Mood and personality changes, such as increased anxiety and aggression.

The symptoms of moderate Alzheimer’s are more serious, and include:

  • Increasing memory loss and confusion, and shortened attention span.
  • Irritability and Inappropriate outbursts of anger.
  • Difficulty with language (in reading and writing) and difficulty in working with numbers.
  • Trouble recognizing friends and family members.
  • Difficulty organizing, planning, and thinking logically.
  • Restlessness, agitation, anxiety, tearfulness, and wandering.
  • Repetitive movements and statements and sometimes muscle twitches.
  • Paranoia, delusions, and hallucinations.
  • Loss of control over impulses.

Age and genetics are the strongest risk factors for dementia and Alzheimer’s disease. However, other risk factors have been linked to Alzheimer’s disease. Research has shown that people with heart disease, stroke, and high blood pressure may be more likely to develop Alzheimer’s disease and to have more severe diseases.  Studies also show that patients with metabolic syndrome, Type 2 diabetes, and sleep apnea are at increased risk for mild cognitive impairment and Alzheimer’s disease. Whether or not successful treatment of hypertension, heart disease, diabetes and sleep apnea can affect cognitive decline is open to question, but is under study. One large trial funded by the National Institutes of Health (NIH) has compared intensive glucose-lowering treatment with standard treatment for Type 2 diabetes, but there were no significant differences between the two groups.

Hormones such as estrogen and progesterone also have effects on the brain. Yet studies on whether menopausal hormone therapy is protective against cognitive decline or Alzheimer’s disease have been conflicting.  Research is continuing on estrogen and progesterone as well as other hormonal therapies that could be preventive, including testosterone, growth hormone-releasing hormone and DHEA (dehydroepiandrosterone).

Many studies have also investigated whether vitamins and dietary supplements can protect against cognitive decline and Alzheimer’s disease. Epidemiological and laboratory studies have suggested that antioxidants from food and supplements can lower the risk of Alzheimer’s disease by preventing oxidative damage from free radicals. Vitamin E, vitamin C, B vitamins, and coenzyme Q10 have been tested as treatments to slow down or prevent Alzheimer’s disease, but none have proved effective. Researchers are also investigating the effect of resveratrol—a compound found in red grapes and red wine.

Research has also revealed that healthy habits can have an important influence on the risk for Alzheimer’s disease and cognitive decline. Studies show that exercise can stimulate the brain and help to make new neuronal connections within the brain that are vital to healthy cognition. Daily aerobic exercise, for instance, can enhance recall and executive function. Research has also found that a diet rich in vegetables is associated with a reduced risk for cognitive decline, and a Mediterranean diet significantly lowers the risk for mild cognitive impairment and Alzheimer’s disease.

Keeping your mind active throughout life may also reduce the risk of Alzheimer’s disease. Large observational and epidemiological studies have associated cognitive health with the maintenance of social relationships at work, volunteering or by living with someone. Mentally stimulating activities such as reading books and magazines, playing game and going to lectures may also keep the mind sharp. Recent large studies have found that people who spend a lot of time in intellectually stimulating activities are significantly less likely to be diagnosed with Alzheimer’s disease.

For healthy people, formal cognitive training sessions also seems to have benefits for the brain. Studies on memory, reasoning, and processing speed training—all aimed at improving mental skills—show that this training can improve cognitive skills for up to 10 years. Other studies are now investigating whether the combination of exercise and cognitive training can delay or prevent age-related cognitive problems.

  1. National Institute on Aging. Alzheimer’s Disease: Unraveling the mystery.
  2. National Institute on Aging. Alzheimer’s Disease Progress Report: Intensifying the Research Effort.
  3. Preventing Alzheimer’s Disease: What Do We Know?
  4. Alzheimer’s Association. Historic Alzheimer’s funding increase signed into law, answering Alzheimer’s Association call for action.


Menopause and the “Change”

Posted on Posted in Continuing Education, Elder Care, Homestudy, Psychology

flower-428368_640Menopause, long surrounded by misconception and myth, is actually just one of the major transitions in a woman’s life. Most women go through menopause, whether it is secondary to surgery, a specific medical condition, or as part of the natural course of a woman’s life.

Many women dread the thought of menopause—the night sweats, the hot flashes, the weight gain, the mood changes. However, though menopause may mean a few more graying hairs and wrinkles, it is decidedly not a ticket to emotional problems or physical old age. Many women, in fact, find perimenopause and menopause only mildly problematic, and others discover that their symptoms can often be controlled or alleviated.

Though menopause has often been regarded as a medical illness, it is more accurately described as a life change—one that is often accompanied by a complex set of physical and emotional responses. There are health risks that increase after a woman reaches menopause, such as the risk for heart disease and cancer, but these can be cut drastically by preventive medication, diet, or lifestyle.

Menopause can also be a time of new freedom, new beginnings, and second chances. It’s often a time when women begin to reevaluate their lives. Some may decide to embark on bold new paths in their work or personal lives, while others may rededicate themselves to the lives they have already built.

There are many kinds of treatment available to help with perimenopausal and menopausal symptoms, from hormone replacement therapy to nutritional supplements. Physicians can discuss options with their patients, and together they can decide what course would suit them best. An increasing amount of research is available on this phase of life, and better drugs and treatment for menopausal symptoms continue to be discovered.

At one time, menopause was simply referred to as “the change,” a time of life to be dreaded. With an average life expectancy of 79 years of age, most women have at least one third and probably more of their lives ahead of them by the time they reach menopause. And those remaining years are free of menstrual periods, the possibility of pregnancy, and, in most cases, childcare responsibilities.

The “change” can actually be a positive time in a woman’s life. It’s a time when a woman and her partner can recreate their life together, or she can pursue new dreams, and decide how she wants to spend the second half of her life. On the job front, too, it is an ideal time to look at what has been accomplished, and evaluate whether making any changes is desirable. It’s a time to think about where a woman‘s journey in life has taken her, and decide how she wants to spend the years ahead.


Flu Vaccines and How They Work

Posted on Posted in Continuing Education, Elder Care, Seminars, Webinars

Flu SHot, Vaccination

By Dr. Mary O’Brien MD

Composed of two type A viruses and one type B virus, seasonal flu vaccines change annually to reflect the viral types and strains that international surveillance and scientific analysis predict will circulate during a given year. Each vaccine’s protective potential is determined by individual health status and by similarities among the viruses contained in the vaccine and those in circulation. A vaccine that closely matches circulating viruses protects most people from serious flu-related illness.
Even a vaccine that is not a close match affords a degree of protection. Flu vaccines do not protect against flu-like illnesses, which are caused by non-influenza viruses. Also, seasonal flu vaccine does not provide protection against type C influenza.
Seasonal flu vaccine is available in two forms: injected and intranasal routes. Injected vaccine is made from inactivated viruses while the intranasal is an live-attenuated virus.

Live-attenuated influenza vaccine (LAIV) is a flu vaccine in the form of a nasal spray. LAIV is made from live, weakened viruses that do not cause the flu. The Center for Disease Control has approved LAIV for use in people between two years and 49 years of age who are healthy and who are not pregnant. LAIV is also an approved option for people who live with or care for those at high risk for contracting flu. It is not recommended for caregivers of people whose severely compromised immune systems require a protected environment. These healthy individuals should get the flu shot.

Flu vaccinations may be given at the same time that other vaccines are administered. Although vaccination is advisable as soon as seasonal vaccines become available, being vaccinated later in the flu season, like December, still confers benefit in most years. One dose of vaccine a year is sufficient for most people. Children under nine years of age who are being vaccinated against flu for the first time or who were initially vaccinated with a single dose during the previous flu season should receive two doses of vaccine at least four weeks apart.

Side effects associated with flu shots are generally mild, appear shortly after the injection, and persist for a day or two. They include soreness: redness; and swelling at the injection site; low-grade fever; sore or red eyes; and aches. LAIV can cause headache and runny nose. Adults may also develop sore throat or a cough, and children may wheeze, vomit, and have muscle aches or fever.

Symptoms of rare, serious reactions include:

  • high fever
  • behavioral changes
  • breathing difficulties
  • hoarseness or wheezing
  • hives
  • paleness
  • weakness
  • rapid heartbeat
  • dizziness

Although flu-related morbidity and mortality vary from year to year, the CDC estimates that between five and 20 percent of Americans contract flu in a given year and that 200,000 are hospitalized for treatment of flu-related complications. Approximately 36,000 deaths a year result from flu-related causes in the United States. Always check with your doctor before getting a flu vaccination. Also, many local pharmacies offer flu vaccinations in the store to fit your schedule.


The Case of the Common Cold

Posted on Posted in Continuing Education, Elder Care, Homestudy, Nutrition

The most prevalent of all human illnesses, the common cold, is a minor infection of the upper respiratory tract. It mainly involves the nose and throat but can extend to the sinuses, ears, and bronchial tubes. As a general rule, cold symptoms are milder than flu symptoms and most people recover in seven to ten days. Some signs of the common cold are:cold-treatment

  • low grade fever
  • sore throat
  • coughing and/or sneezing
  • nasal congestion or runny nose
  • slight muscle aches
  • mild headaches
  • watery eyes

Cold symptoms generally emerge between one and three days after a cold virus enters the body and resolve in a week — with or without medication. One cold in four lasts up to 14 days; this most often occurs in children, the elderly, and people who are in poor health. Smokers often have more severe, extended cold symptoms than nonsmokers.

Fewer than 5 percent of colds lead to such complications as bronchitis, middle-ear infection, or sinusitis accompanied by a prolonged cough, but between 5 and 15 percent of children who have colds develop acute ear infection when bacteria or viruses infiltrate the space behind the eardrum. A cold can produce wheezing, even in children who do not have asthma, and symptoms of asthma, bronchitis, and emphysema can be exacerbated for many weeks. Symptoms that persist for more than two weeks or that recur might be more allergy than infection related.

Post-infectious cough, which usually produces phlegm, may disrupt sleep and persist for weeks or months following a cold. This complication has been associated with asthma-like symptoms and can be treated with asthma medications prescribed by a physician. Medical attention is indicated if symptoms progress to:

  • sinusitis
  • ear pain
  • high fever
  • a cough that worsens as other symptoms abate
  • a flare-up of asthma or of another chronic lung problem
  • significantly swollen glands
  • strep throat
  • bronchiolitis
  • pneumonia
  • croup

Beginning in late August or early September, the incidence of infection rises gradually for a few weeks and remains elevated until declining in March or April. Seasonal variations in susceptibility may be related to cold weather or to months when school is in session―times when people spend more hours indoors and chances of interpersonal transmission are enhanced. Changes in relative humidity may also have an effect. Cold temperatures dry the lining of nasal passages and increase vulnerability to infection by common cold-causing viruses that thrive in such weather.

Over the course of a lifetime, a person has been estimated to spend the equivalent of five years suffering from the common cold. One-fifth of that time, cold symptoms are severe enough to require bed rest. Women get more colds than men―especially women between 20 and 30 years of age―and adults over 60 years of age get less than one cold a year on average.

Learn more about the common cold and influenza through our homestudy courses.