Cough is one of the most common symptoms of viral upper respiratory infections, like the flu and common cold. Here at BCA, we treat coughs all the time, especially during winter and spring.This particular year, we have seen a higher than average number of cases in our clinic. This could be, in part, because “most of the circulating H3N2 flu viruses this season are different from the vaccine virus,” or, in other words, this year’s vaccine was did not include what has become the most prevalent flu strain of the current season. What we have been seeing clinically is a cough that lingers for three or more weeks, long after other symptoms are resolved.

Aside from cold and flu, other causes of acute cough include whooping cough, pneumonia, and inhaling an irritant.

Cough is a protective mechanism for the airways and lungs. Cough receptors are located in the pharynx, trachea and bronchioles and are activated by foreign materials. Coughing removes the foreign material from the respiratory tract before it reaches the lungs. Once the cough is stimulated, air is expelled at over 100 mph!

Knowing that a cough is a protective mechanism for the lungs and airways, you may be wondering if you should suppress the cough. The answer is no-if the cough is productive. If you are coughing up mucus, that’s a good thing. In this phase, it is important to drink lots of fluids to help to loosen the phlegm.

We strongly recommend acupuncture during the productive phase of a cough (as long as you don’t have a fever). Our treatment will focus on resolving phlegm, shortening the duration of the illness, and strengthening the body. We also often prescribe herbs for productive cough.

If the cough is unproductive (whether or not it is preceded by a productive cough), the goal is to soothe and suppress the cough. In most of these situations, dry coughs occur because the back of your throat (or pharynx) becomes irritated or inflamed, but may also arise from deeper in the chest. We also recommend acupuncture and herbs during this phase to help relax the airways via the nervous system, and reduce inflammation.

My favorite home remedy is fresh lemon juice and raw honey.  Raw honey is high in nutrients and enzymes which kill bacteria and viruses. The vitamin C and antioxidants found in fresh lemons boost the immune system, speeding healing. Mix the juice of one lemon with 2 to 3 tablespoons of honey, heat to the temperature of hot tea, and drink twice a day. This will soothe an irritated throat and reduce the stimulation leading to cough. Pineapple juice is helpful for productive and nonproductive cough. Pineapples contain bromelain, an enzyme with anti-inflammatory properties. It fights infections and kills bacteria and helps to loosen phlegm The juice from fresh pineapples can suppress coughs five times more effectively than cough syrup, according to a 2010 study. If there is mucous in the sinuses, postnasal drip may irritate the airways. Acupuncture is helpful for draining the sinuses (see our article here), and we also like saline sinus rinses like this one.

An occasional cough is normal. But a cough that persists may signal an underlying problem. A cough is considered “acute” if it lasts less than three weeks; “subacute” between 3-8 weeks, and “chronic” if it lasts longer than eight weeks. After 6-8 weeks, we refer people back to their primary care practitioner and/or specialist to rule out any more serious underlying cause of the cough.