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. But 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.

My favorite cold remedies: Get into bed and rest. 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. If you can watch a funny movie. 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 gingerroot... two tablespoons each of honey and apple cider vinegar...and four tablespoons of water. Take one teaspoon every few waking hours.

The Flu

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.

My 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.


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.

My advice: Prescription nasal sprays, like fluticasone propionate (Flonase) 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.

Non-allergic Rhinitis (Vasomotor Rhinitis)

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.

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. Additionally, avoid cold beverages and drink hot green or black tea-both contain L-theanine, an amino acid that increases ciliary activity. The excess fluid also will help thin and clear mucus, speeding recovery.

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.

My 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).

My advice: The prescription nasal sprays mentioned under "Allergies" help open the airways. Acetaminophen (Tylenol) or naproxen (Aleve) work for sinus pain. Bromelain (from pineapple) and papain (from papaya) also help reduce pain. Antibiotics are not always needed for acute sinusitis–a virus is sometimes the cause.

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