How to tell what it is and the best way to treat it…

Sniffling, sneezing and wiping your eyes? You might assume you have a cold…but not so fast. These symptoms also can come from the flu or allergies…from something that’s similar to an allergy…and even from something else entirely—sinusitis!

Telling these five conditions apart can be tricky—even for doctors and for people who may have developed allergies later in life. According to Murray Grossan, MD, an otolaryngologist and head and neck surgeon with the Tower Ear, Nose and Throat Clinic at Cedars-Sinai Medical Center in Los Angeles, knowing the difference is the key to getting the most effective treatment…


Colds are caused by more than 100 different viruses. Your symptoms will depend on the specific virus you are infected with.

Telltale signs: In addition to common cold symptoms, such as sneezing, a sore throat, congestion and/or a cough, you may also have a low-grade fever, mild body aches and aching, swollen sinuses. Symptoms usually last a week or two.

Dr. Grossan’s favorite cold remedies: Get into bed and rest—and watch a funny movie. Also, have chicken soup and decaffeinated green tea with lemon and honey. Chicken soup and green tea have anti-inflammatory properties that help fight infection and stimulate lazy nasal and bronchial cilia to remove bacteria and viruses. Research shows that laughing promotes healing. If you need help sleeping, try 25 mg to 50 mg of diphenhydramine (Benadryl).

For an immune-boosting herbal cough syrup: Mix one-half teaspoon each of cayenne pepper and freshly grated ginger root…two tablespoons each of honey and apple cider vinegar…and four tablespoons of water. Take one teaspoon every few waking hours.


The flu will make you feel awful.

Telltale signs: Symptoms can be the same as a cold, but you’ll have significant body aches and probably a fever. Also, the flu comes on more suddenly than a cold.

Dr. Grossan’s advice: Get a flu shot. If you still come down with the flu, stay home for at least 24 hours after any fever is gone so you won’t spread the virus. Adults over age 65 and those with any chronic health problem should take an antiviral drug, such as oseltamivir (Tamiflu), to avoid flu complications, including pneumonia. Antivirals work best if taken within 48 hours of starting to feel sick. The more liquids you can drink, the better.


Allergic rhinitis (nasal allergy) is caused by a hypersensitive immune system that identifies an innocuous substance as harmful, then attacks it, causing symptoms.

Telltale signs: Nasal allergies can cause symptoms that are nearly indistinguishable from a cold—congestion, sneezing, red and runny eyes, scratchy throat, etc.—but allergies do not cause the mild fever or achiness of a cold. With seasonal allergies, you get symptoms from exposure to pollen (trees in spring, grass in summer and weeds in fall). Allergies to pet dander, dust, etc., tend to occur year-round.

Helpful: Use a diary to track your symptoms and the times they occur. It will help you distinguish allergies from other conditions.

Dr. Grossan’s advice: Prescription nasal sprays, such as fluticasone propionate (Flonase, also available OTC) or azelastine (Astelin), work for most people with less risk for side effects than antihistamine pills. Also avoid spicy foods, which can worsen nasal allergies. Avoid temperature changes, especially getting chilled.


This condition causes virtually the same symptoms as allergies, but it’s not a true allergy that involves the immune system. Rather, it’s triggered by specific irritants, such as certain odors, smoke and exhaust—or even changes in the weather.

Telltale signs: With nonallergic rhinitis, standard allergy medications fail to relieve symptoms, and allergy tests are negative. Postnasal drip, an irritating flow of mucus down the back of the throat, tends to be worse with nonallergic rhinitis than with seasonal allergies.

Dr. Grossan’s advice: Avoid irritants that you’re sensitive to…and consider using the prescription drug ipratropium bromide (Atrovent), available as a nasal spray. It helps relax and open nasal passages. This drug can cause side effects, including dizziness, so use it only when needed and at the lowest dose possible.


Sinusitis is tough to diagnose because it often occurs in conjunction with colds and allergies. Reason: The excess mucus from congestion provides an optimal breeding ground for bacteria and viruses.

Telltale signs: Congestion with tenderness and a feeling of pressure around the eyes, cheeks or forehead. Also, when you blow your nose, the mucus will usually have a yellow or greenish color. Fever may be present as well. Symptoms can last for several weeks (acute) or even longer (chronic).

Dr. Grossan’s advice: The prescription nasal sprays mentioned under “Allergies” help open the airways. Acetaminophen (Tylenol) or naproxen (Aleve) work for sinus pain. Green tea and humming (see below) will speed your recovery, as will pulsating irrigation. Bromelain (from pineapple) and papain (from papaya) also help reduce pain. (Clear-ease Enzyme Tablets, a product created and sold by Dr. Grossan, contains both bromelain and papain in a formula that is especially well-absorbed.) Antibiotics are not always needed for acute sinusitis—a virus is sometimes the cause.

Natural Remedies for All Sinus Problems!

Nasal cilia (tiny, hairlike strands) help clear mucus from the nasal cavity. Slow-moving cilia can lead to nasal and sinus irritation and congestion. To stimulate cilia…

Hum. It may sound far-fetched, but the vibrations from humming break up and thin accumulated mucus. Patients of mine who hum for a few minutes several times a day tend to get fewer sinus infections.

Keep the nose moist by using a preservative-free saline nasal spray such as Simply Saline, available in drugstores. Avoid daily irrigation with a neti pot—the neti pot can easily get contaminated with bacteria, and irrigation can wash away protective elements in the nose.

Stay warm and drink hot tea. Cold temperatures can slow the movement of nasal cilia, so wear a jacket, hat and scarf to keep warm. Warm your nose when coming indoors from cold outside temperatures before entering an elevator, classroom, office, store, etc. Additionally, avoid cold beverages and drink hot green tea, which contains L-theanine, an amino acid that increases ciliary activity. Drinking lots of fluid also will help thin and clear mucus and speed recovery.