[Naughty Nurse]

Can cold and flu remedies actually harm an athlete's performance?

First, though, we should mention the situations in which athletes should put their workouts on hold. Whenever you have a fever greater than 100 degrees, extreme fatigue, shortness of breath or wheezing, or a rapid/irregular heartbeat, it's best to abstain from training. The risk of making things worse, combined with the likelihood of completing a poor workout which won't really help you attain your training goals, make it wise to rest until such symptoms resolve themselves.

The over-the-counter drugs used for the relief of symptoms of colds and the flu can be divided into five categories. These include antihistamines, decongestants, fever reducers (anti-pyretics) and pain relievers (analgesics), cough preparations, and combinations of the above ('shotguns') (see numbered points below). Read product labels carefully and ask your doctor and chemist questions concerning the specific relief you might get from each product.

Don't expect a quicker recovery.

Bear in mind, however, that dosing yourself with medication will not ensure a quicker recovery from your illness. In research carried out at Johns Hopkins University, a group of about 100 children suffering from 'colds' was subdivided into three sub-groups.

The first sub-group was given an antihistamine / decongestant combi-nation, the second a placebo, and the third nothing at all. All three groups recovered in about the same time, with more than half of the kids in all three sub-groups feeling better in two days ('Effectiveness of an Antihistamine-Decongestant Combination for Young Children with the Common Cold: A Randomised, Controlled Clinical Trial,' Journal of Pediatrics, Vol. 118, pp. 125-130, 1991). This study was carried out with children, not adult athletes, but the results should still give you something to think about the next time you're standing in front of a pharmacy wall stocked with scores of expensive cold elixirs.

Instead of relying on medications to ease symptoms and enhance recovery, an increasing number of athletes with colds or the flu are doing well simply by drinking large volumes of fluids and getting extra amounts of rest. As we'll discuss later, these simple steps can go a long way towards relieving much of your discomfort and can in certain cases remove the need to ingest a medication which might have some negative side effects.

Here's a rundown

Let's consider each category of medication and describe how it might influence your athletic performances. We'll also mention which medicines are banned from use during competitions. If you are concerned about a particular medication, consult the official web page of the International Olympic Committee (IOC).

(1) Antihistamines are designed to relieve the sneezing, itching, watery eyes, and runny noses associated with colds and allergic reactions. Depending on the antihistamine, drowsiness can be a major side effect. That can be a problem, of course when judgement and alertness are mandatory, as when you get up early to drive to a race or when you must cycle through a difficult course during a bike race or triathlon. Fortunately, some of the newer prescription-strength antihistamines are less likely to cause sedation. These newer drugs are not without problems, however; they tend to be expensive, and they can take a long time to 'clear' themselves from your system.

Other problems with antihistamines include excessive drying of the mucous membranes in your mouth, eyes, and nose, which can actually make you more uncomfortable than you were before you took the medication. Blurring of vision may also be a problem for a few athletes. Although antihistamines are sometimes associated with sluggishness, they generally do not directly affect aerobic performance or muscle strength and endurance.

Pure antihistamines are usually not banned by athletic bodies, but they are frequently combined in medications with decongestants which are tightly restricted (see below).

(2) Decongestants are supposed to relieve nasal and sinus congestion. Since decongestants generally have a mild stimulant effect, tremor, insomnia, and a feeling of being 'hyper' are relatively common problems associated with their use. As they increase alertness, decongestants can also elevate heart rate and blood pressure, a potential problem for those athletes with underlying blood-pressure difficulties.

The decongestant nose sprays can also produce what is called a 'rebound effect,' in which the nasal passages actually become more congested than usual as the medication wears off. As a result, larger and more frequent doses of the medication are subsequently needed, producing an even greater 'rebound' and a potentially 'vicious circle' in which more decongestant actually leads to greater congestion. In general, decongestant usage should be limited to no more than a few days at a time.

Many decongestants are listed as banned substances by the IOC. Specifically, decongestants containing sympathomimetic amines (which are classified as stimulants by the IOC), including pseudoephedrine, norpseu-doephedrine, and phenylpro-panolamine, are prohibited by the IOC. The reasoning behind this ban is that the amphetamine-like effects of these decongestants can increase heart rates and enhance explosive muscular contractions, leading to potentially heightened performances in cycling, swimming, running, or ice-skating events lasting less than 10 minutes or so. At the other extreme, it is doubtful that decongestant ingestion would help athletes in events lasting several hours (for example, a triathlon or marathon). In fact, the upswing in heart rate associated with the use of decongestants might make exercise seem more intense than usual at typical race speeds.