The Best Flu Treatment For You

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With this season’s flu showing no signs of diminishing—and reports of spot shortages of antiviral medications and flu shots—more Americans are searching for other ways to protect themselves.

Certain of these "alternative" flu therapies, such as dietary supplements, are even being recommended by some pharmacists, according to news accounts.

More people are also donning surgical or respiratory masks to keep flu germs at bay. And some are getting prescriptions for steroids and antibiotics if they do come down with the virus.

Do any of these strategies actually work? And what should you do if you can't find an antiviral like Tamiflu, or a place to get a flu shot? Here’s what our experts say to do. 

Flu Shot and Antiviral Drugs

Newspapers and TV stations around the U.S. have reported that some consumers are having difficulty finding the flu vaccine and prescription antiviral medications such as oseltamivir (Tamiflu and generic are the most commonly prescribed) and zanamivir (Relenza). These drugs can reduce flu symptoms somewhat and may shorten the course of the flu.

According to the Centers for Disease Control and Prevention (CDC), there have been spot shortages of the vaccine and the antivirals, particularly of generic oseltamivir in capsule and powder form (which is mixed with water for those who have trouble swallowing capsules).

If you haven’t had the vaccine yet (and it’s still wise to get it) and your doctor's office doesn't have it, check the CDC’s Flu Vaccine Finder or the HealthMap Vaccine Finder to see where it’s available in your area. Confirm by phone before you go and be aware, says the CDC, that you may not have a choice about which flu shot you get.

If you have just come down with the flu and your doctor thinks you're a candidate for an antiviral—most otherwise healthy people generally are not—it may take a bit of detective work to find it, says Michael Hochman, M.D., M.P.H., director of the Gehr Center for Health Systems Science at the Keck School of Medicine at USC in Los Angeles.

At his center, the nurses keep up with which pharmacies have antivirals in stock, so ask whether your doctor's office has similar information. Or check pharmacy websites—some are noting availability of antivirals—or call local drugstores. Good to know: If you need powder oseltamivir and it's out of stock, pharmacists now have permission from the CDC to compound it from capsules.

If cost is a concern, know that many health insurers are currently covering Tamiflu as a generic or at the lowest cost "tier" for brand-name drugs. You can also check websites such as GoodRx, where you can download a coupon that will let you purchase oseltamivir at Walmart for just under $52.  

Supplements and Homeopathy

Americans will spend close to $3 billion on dietary supplements touted to help fend off colds and flu—or minimize symptoms—this year alone, according to the Nutrition Business Journal.

Elderberry (which comes in liquid, tablet, gummy, and tea form and is said by some to ease congestion; elderberries are shown at top) and the homeopathic product Oscillococcinum, which is marketed to “temporarily relieve flu-like symptoms,” appear to be in high demand—selling out in some stores.

But whether it’s a botanical such as elderberry or oregano oil, a vitamin or mineral, or a homeopathic remedy like Oscillococcinum, “there’s no good research on any of them,” says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser.

The key word here is “good,” notes Lipman, and while small, preliminary studies have shown some promising possibilities for the flu-symptom-reducing effects of elderberry and oregano oil, larger, longer, and more rigorous studies are needed.

In the case of one vitamin—vitamin D—some research does suggest that supplements may modestly reduce the risk of upper respiratory infection such as a cold or flu. But those results were mainly seen in people who were very deficient in the vitamin.

“The evidence on vitamin D as protection or treatment for flu in people who already have normal levels is pretty weak,” says Lipman, who recommends talking to your doctor if you have concerns about your vitamin D levels.

And, notes Heather Free, Pharm D., a spokesperson for the American Pharmacists Association and a pharmacist in the Washington, D.C., area, supplements are only loosely regulated by the Food and Drug Administration.

"So we do not know exactly what is in the makeup of that product," she explains.

Homeopathic products, which are classified by the FDA as medications and may sit on drugstore shelves next to over-the-counter drugs, are a different matter. In homeopathy, a presumed active ingredient—in Oscillococcinum, it's an extract of wild duck heart and liver—is diluted to the point where it's virtually undetectable.

According to Lipman, there's no good evidence that homeopathy works. The Federal Trade Commission says “homeopathic product claims are not based on modern scientific methods.” And a 2015 research review from the independent Cochrane Collaboration found there are no high-quality studies to show that Oscillococcinum relieves flu symptoms.

Consumer Reports reached out to Boiron, the manufacturers of Oscillococcinum. In an emailed statement, a Boiron representative wrote, "Oscillococcinum has remarkable customer satisfaction (and a money-back guarantee)."

The statement also said: "Oscillococcinum has been shown in two placebo-controlled, double-blind, randomized clinical trials to help reduce the severity and shorten the duration of flu-like symptoms."

What should you do if you've got the flu? Unless you're a candidate for an antiviral, our experts recommend strategies such as rest, getting plenty of fluids, and the use of OTC pain relievers as directed by your doctor. You can also follow the Consumer Reports' day-by-day guide to treating colds and flu. 

Surgical and Respiratory Masks

If you've recently walked into a doctor’s waiting room, or even your local mall, you’ve probably seen people wearing paper masks over their mouths and noses.

“In our office, we now routinely hand out masks to people who come in with flu-like symptoms such as a cough, runny nose, and/or fever,” Lipman says.

While most studies on masks have been done in healthcare settings, some suggest they may help stave off flu in other situations, too.

One University of Michigan study, for example, found that college students living in dorms who wore face masks and practiced good hand hygiene for six weeks had lower rates of flu-like illnesses than those who didn’t.

“The mask may help block the flu virus, which travels through the air in droplets when an infected person coughs or sneezes,” Lipman explains. It may also help prevent you from passing the virus from your hands to your mouth or nose.

If you’re at high risk of flu complications—for example, you’re over age 65 or have a compromised immune system—consider wearing masks whenever you are in a crowded area, such as a full movie theater, Lipman says. And wear one if you're sick and are going to be around other people, or are caring for someone with the flu.

Last, consider a mask if you're going to a doctor's office, or if you're traveling on an airplane, especially if people around you seem sick.

Two types of masks are currently available: surgical masks (available at drugstores and online), designed to block large particles that may carry viruses, and N-95 respirators (available at some hardware, medical supply, and office supply stores and online), which block even smaller particles.

Both appear to work equally well, according to a 2009 study in JAMA. Just make sure you get a tight fit around your mouth and nose. For more advice on masks and the flu, see what the CDC says.  

Steroids and Antibiotics

If you’re running a high fever and feel miserable, you may be tempted to ask your doctor for antibiotics. But these only work for bacterial infections—not viral infections like the flu. And using the medications unnecessarily can contribute to an increase in antibiotic-resistant bacteria and bacterial infections that are hard or impossible to cure, Lipman says.

The flu can sometimes, however, lead to complications that may be appropriate to treat with antibiotics, such as bacterial pneumonia. Secondary infections such as strep throat may be treated with antibiotics, too, says pharmacist Heather Free.

Some doctors may also prescribe steroids such as prednisone to stem symptoms like the cough that can occur due to inflammation from the flu virus.

But this is potentially dangerous, because steroids suppress your immune system—making it harder to fight infection, says William Schaffner, M.D., professor of preventive medicine and infectious diseases at the Vanderbilt University School of Medicine in Nasvhille.

Generally, steroids should be considered for the flu only for people who are admitted to the hospital with severe wheezing due to an underlying problem such as chronic obstructive pulmonary disease or asthma, Lipman adds. Even then, a 2016 Cochrane review found that hospitalized flu patients who received steroids had a greater risk of death compared with those who didn’t get these drugs—mainly from hospital-acquired infections.

"There's no strong evidence that steroids work, and we know steroids have side effects," Hochman says.

So unless you have a bacterial infection or lung problems, avoid antibiotics and steroids for the flu. Instead, follow these treatment steps if you do get sick. "The highest value things you can do are the simple things, like giving your body time to rest and staying home to protect others," Hochman says.  

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