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Because I’ve typed this out for two or three people in the past 24 hours plus shared it with someone in person, here’s what you need to know about some of the big causes of coughs.

1. Pertussis: ANY cough which goes on for more than 3-4 weeks is suspicious for pertussis. Moreso if it involves sudden horrible bouts of coughing in someone who otherwise feels fine, especially a couple weeks after a “cold”.

What I wrote in 2004 when I had pertussis:

(This was a year where they claimed there were 25,000 cases reported, but we suspect there were between 10 and 150 actual cases for every one that got officially recognized by the health departments/CDRC.)

2. Asthma: Chronic low grade coughs not really related to illness (sometimes illness comes because the lungs are already compromised, instead of the other way around), especially in young people, are often related to asthma. There are lots of medications for asthma, but for non-life-threatening asthma that hangs around making people cough, the place to start is magnesium. Read more about it here:

Magnesium for asthma: is a brief, informal summary. The short of it? Try magnesium if you have asthma, it won’t hurt and might get you off of asthma meds if it works.

3. If you have figured out the underlying issue causing a cough (for example, virus, bacteria, asthma, whatever) you’ll want to find ways of easing it.

My lowest tech approach starts here, with cocoa, honey, and cherry juice. All of which have actual research and scientific rationale, plus they help. They really help.

Antibiotics can help if a cough is caused by a bacteria AND the problem is bacteria actively producing things which irritate the lungs. They cannot help viruses and while they will shorten the contagious period for pertussis, see the above article for why they’re not a cure-all.

Reflux can cause a chronic cough–treatments vary, hubby takes the generic of prilosec.

Robitussin/Mucinex both are supposed to help thin the secretions. Spicy foods, hot liquids and merely drinking a lot of water can do as well for most people. Skip the drug and go for the hot foods (Thai soups are a family favorite) and chicken soup for a similar effect. Take the mucinex if you can’t deal with soup or spice.

Plain ol’ mentholyptus cough drops can be a big help short term. They also help nausea for some people. Essential oil preparations may help.

For children, a barking cough at night is often croup. First step is to take your phone and your child outside into the cool night air, and do your best to cheer them up. If that doesn’t help their breathing quickly, or they start getting pale or turning blue, call 911 immediately. For kids prone to croup, talk to your doctor about keeping a supply of steroids, a nebulizer and if necessary, oxygen and an oximeter on hand. When Shiny was at her worst with croup, we went from going to the ER every month or two, to almost no ER visits at all, because with the steroids on hand I could just treat her when the telltale symptoms appeared. It never got bad enough to use the oxygen at home. The difference between a croup cough and pertussis cough is that croup cough starts with the barky whoopy cough and they don’t get much of a break–it is a short illness, albeit terrifying. With pertussis, the cough gets worse over the course of weeks, and a kid may appear “fine” in between turning blue coughing. The fever tends to be higher with a viral croup as well. Croup hits like a ton of bricks and is done, pertussis sits around throwing bricks at you and mocking you for three solid months. With croup, keeping a child calm and happy and giving them cool air to breath is the fastest way to stop the immediate problem, but it often gets bad again when you go inside, so it is worth treating medically for most parents (vs. sitting in the cold all night.) Steroids work within hours to bring the breathing under control, and a single d0se may work for 3 days, by which time the body has usually fought off the underlying problem.  Epinephrine or albuterol will open the passages immediately, the two together take a bout of croup from potentially deadly to merely annoying within a very short time.

There are many, many causes of cough–I’m only covering the ones that seem to come up all the time for my circle of friends.

Rule of thumb is if the cough is productive and the chest is congested, work harder on thinning the secretions and reducing inflammation than on suppressing the cough. Suppressing the cough at night should be done cautiously, and with the least means possible. Cocoa is good because it does not eliminate the ability to cough, it just gives you more control, which means you can sleep longer.

If the cough is not productive, suppress all you want. Start with cocoa and cherry, consider basic cough drops, I generally skip dextromethorphan (the “DM” of Robitussin DM) but I do like Benzonatate, which has the side effect of actually relieving some of the chest pain. Opiates (codeine and others) can be effective but have a LOT of potential side effects (headache, constipation) that make them particularly not fun.

Published in Health Home Remedies


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