Feature Article: Symptoms — To Treat or Not to Treat?

Fever. Chills. Coughing. Sneezing. Headache. Stuffy nose.

Being sick is no fun. All you want is to feel better, or make your loved one feel better. Often, the first stop is the medicine cabinet or the “cough and cold” aisle of the local pharmacy. But is that really the best thing to do?

The instinct to treat the symptoms of illness makes sense. Over-the-counter medicines may make people feel better, but the reality is that, often, these medicines are just making the work of the immune system more difficult. This is because most symptoms are actually caused by the immune system’s response to an infection. Read on to find out what causes several of the common symptoms people experience when they are sick, and what to consider before opening the cap on that medicine bottle.

Symptoms and their causes

Check out what causes many of the symptoms people may experience when feeling sick:

• Fever — The immune system turns up the body’s internal thermostat for two reasons when a person is ill. First, the cells of the immune system work better at the elevated temperatures associated with fever. Second, the pathogens typically do not reproduce as efficiently at higher temperatures. Download this Q&A sheet about fevers or listen to this podcast for more information.
• Chills — Sometimes, when a person has a fever, or right before they get a fever, they experience chills or shivering. The cause is rapid contracting and relaxing of small muscles to increase the body’s temperature.
• Runny nose, stuffy nose, sinus pressure, sinus headache — One of the body’s important infection-fighting tools is mucus, a thick, sticky substance that contains glycoproteins. It can coat pathogens, inhibiting them from attaching to cells and gaining entry into cells. Unfortunately, excess mucus caused during an infection can also cause several of the symptoms that make people uncomfortable. If mucus accumulates in the sinuses, it can lead to sinus pressure and headaches. Mucus that is expelled through the nose or mouth can contain large amounts of bacteria or viruses. For this reason, people should dispose of used tissues and wash hands in an effort to decrease the spread of infection to others.
• Coughing and sneezing — Both of these are physical ways for the body to remove or expel something, such as a pathogen, dust or excess mucus, from a person’s airways. This is part of the innate immune response.
• Vomiting — Another innate immune system response, vomiting is a way for the body to rid itself of something noxious in the stomach, such as when someone has eaten contaminated food or consumed too much alcohol. Severe vomiting can lead to dehydration, particularly if accompanied by diarrhea, so if you are concerned, as with any of these symptoms, contact a healthcare provider.
• Diarrhea — Another symptom induced by the innate immune system, diarrhea provides a way for the body to rid itself of toxins, which are harmful proteins, or pathogens that are in the intestines.

So, what to do?

This depends, to some extent, on who the patient is. Infants, people with chronic conditions for which they are being treated, and older adults may require medical guidance before receiving any medications. For example, infants younger than 2 months of age who have a fever need to be evaluated by a medical provider promptly as they may have an “as-yet-undetected” immune deficiency and could quickly take a turn for the worse. Likewise, individuals being treated with medications for chronic conditions may be advised against taking some or all over-the-counter medications because of the potential for interference of the drugs with one another.

However, generally speaking, for otherwise healthy older children and adults, symptoms of illness can be monitored for their severity and progression. If symptoms are mild and the person does not seem too uncomfortable, medications are probably not necessary. However, if the symptoms continue to worsen, are prolonged, or if the person is uncomfortable, you might want to offer medication or contact your healthcare provider for guidance.

Certain symptoms are considered a medical emergency at any time and immediate medical care should be sought. Some of these include difficulty breathing, turning blue, becoming unresponsive, or losing consciousness; however, you should always consult a healthcare provider if you are unsure.

For more information about how the immune system works, its different components, and what happens when it is not working properly, check out the popular section of the Vaccine Education Center’s website about the human immune system.