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How Not To Be Miserable During Sore Throat Season

THE THROAT—TECHNICALLY the pharynx—is the piping that starts behind your nose and runs behind your mouth, down to where your esophagus and trachea split. It moves food to your stomach and transports clean air to your lungs. The throat "absorbs a lot of damage" that would otherwise hurt your lungs, says Phillip C. Song, M.D., the director of the division of laryngology at Mass Eye and Ear. Plus, it sits at the top of the esophagus, which leads to the cauldron of acid that is your stomach. No wonder it gets sore so often.

YOUR THROAT IS coated with a layer of mucus, explains Douglas J. Van Daele, M.D., at the University of Iowa's Carver College of Medicine. When it dries out or thickens, or its composition changes, a sore throat happens. OTCs can handle a lot, but see a doc if you have a fever, difficulty breathing or swallowing, or soreness lasting a couple weeks.

Viral Infection

Up to four in five sore throats are caused by viruses, like those behind colds, Covid, and the flu, which screw with mucus production.

How You'll Know: The sore throat comes with other symptoms you'd expect from those viruses.

Treatment: Hydrate, take your preferred OTC meds, and wait out the virus. (And prevent the next one with up-to-date vaxes.) If you're really run down, test for the flu or Covid to see if you need meds. And by the way, strep throat is an infection, too, but it's a bacterial one. It'll require antibiotics.

Irritants From Outside

Allergens like mold, pollen, and dust, if you're sensitive to them, can inflame the throat and affect mucus production. Post-nasal drip from the allergic reaction can cause you to constantly, and irritatingly, clear your throat.

How You'll Know: The sore throat is chronic and flares up when you've been exposed to allergens.

Treatment: A two-stage attack. Start with an antihistamine and a nasal steroid. If those don't work, enlist an allergist.

Irritants From Inside

Acid reflux can, believe it or not, make it all the way up the esophagus to your throat, mess with the mucus coating, and irritate the tissue.

How You'll Know: Most of the time, you'll notice heartburn, a sour or bitter taste, or subtle bloating and burping. If needed, a doctor can confirm this cause with a small camera that, yes, goes through your nose.

Treatment: OTC reflux meds. According to Dr. Song, a reflux-related sore throat usually takes longer to resolve than the two-week course the box recommends.

Note: Meds you take for other conditions may also cause a sore throat. These include ACE inhibitors, decongestants, and prostate meds. Don't stop taking them. Just know that they may bother your throat.

How to Soothe a Sore Throat

THE MOST IMPORTANT thing to do is hydrate, which goes a long way toward keeping your mucus in good shape. Beyond that? "This is a place where a lot of home remedies are really pretty good," says Dr. Van Daele.

USEFUL

Salt water: Gargling, and also nasal rinses.

Humidifier: Cool-mist humidifiers are best.

MAYBE USEFUL

Tea: Great for hydration as long as it's not caffeinated, which dries you out.

Cough drops: Quick ingredient rundown: Sugar is bad. Zinc is good. Menthol can potentially be irritating, according to Dr. Van Daele.

PROBABLY NOT USEFUL

Hydrogen peroxide: Gargling it might help, but there are a lot of ways to do it wrong and get no benefit.

What Else Goes Wrong Sleep Apnea

Shallow or interrupted breathing while sleeping isn't strictly a throat problem, but throat muscles relaxing and blocking airways can be part of it. Worth noting: The CPAP machine used to treat some forms of sleep apnea can dry you out and cause soreness.

Laryngitis

"Losing your voice" is a result of inflammation of the larynx (a neighbor to the pharynx). Sore throats often go with it. There are a lot of potential causes beyond karaoke night. If you have unexplained hoarseness for more than four weeks, it's time to go to a doctor—that means something else is going on, such as a viral infection or vocal-cord--specific issues like nodules and scarring.

Cancer

Cancers of the larynx and pharynx are very treatable, usually with surgery and/or radiation, if caught before they spread. The top two risk factors: drinking and smoking. The third notable one is human papillomavirus (HPV), which is more commonly associated with cervical cancer. HPV-related cancers happen—usually in the tonsils and the back of the tongue—even to people who don't drink or smoke. They're on the rise in younger men. Luckily, the HPV vaccine is effective at preventing them. Ideally, get it before age 26 (though you can get it up to age 45). Make sure your doctor and dentist keep an eye out, especially if you're 46 or older.

Wait! Please Explain the Tonsils

THERE ARE A few kinds of tonsils, but the ones you're thinking of are the palatine tonsils visible on either side of the back of your mouth. They help your immune system learn what bugs to defend against, which is also why they may be prone to infection and inflammation. The tonsils are largest when you're young and your immune system is developing, and that's one reason they're usually taken out during adolescence if there's trouble. Adults who suffer frequent infections (which will give you a chronically sore throat) can have them removed, too, but the recovery is more arduous.

This story appears in the November/December 2024 issue of Men's Health.

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What Does Your Sore Throat Really Mean? What The Doctors Say

It's that time of year again – no, not the countdown to Christmas, but the season of sore throats. The symptoms are all too familiar: painful swallowing, swollen glands, a scratchy cough and unquenchable thirst, and you know as the day goes on they're only going to get worse."Sore throats are particularly common in the UK during winter months," explains Dr Deepali Misra-Sharp, GP Partner at Lordswood Medical Group in Birmingham. "As temperatures drop, people tend to spend more time indoors in close proximity, increasing the spread of viruses.

"Research indicates our immune systems may not be as robust in colder weather, partly due to reduced vitamin D levels from less sunlight exposure. This reduced immune efficiency can make it easier for pathogens to establish infections, including those causing sore throats."Though typically not severe, sore throats can be incredibly painful – this, Dr Misra-Sharp says, is because the throat is packed with nerve endings, making it highly sensitive."When inflamed due to infection or irritation, even simple activities like talking, swallowing, and yawning can trigger intense discomfort," she adds.

But with so many different symptoms around, it can be difficult to tell what's causing your sore throat – and whether or not you should be worried, with the emergence of a new Covid strain, the XEC variant, also characterised by a sore throat." It's crucial to differentiate between viral and bacterial infections, as the treatment approach for each is different," says Phil Day, superintendent pharmacist at online provider Pharmacy2U. So what does your sore throat really mean – and how can you treat it?

Sometimes rest is the only solution for a sore throat

Simple sore throat

Look for: Pain when swallowing, dry throat, mild fever"

Most sore throats can be caused by viral infections like the common cold or flu," explains pharmacist Phil Day, so there's no need to worry. Symptoms include pain when swallowing, a dry, scratchy throat, mild fever, runny nose and fatigue. These usually clear up within a week on their own, but there are plenty of non-prescription treatments if you need a helping hand."

Relief options include staying hydrated, throat lozenges, and over-the-counter pain relievers like paracetamol or ibuprofen," says Dr Misra-Sharp. These will alleviate pain and discomfort for several hours at a time, and can be taken at home, saving you the time and hassle of booking to see your GP.

Strep throat

Look for: Sudden throat pain, swollen glands, white streaks on tonsils

If your symptoms are more severe, you may have strep throat – a bacteria infection caused by streptococcus bacteria. Symptoms, says Phil Day, "include a sudden onset of sharp throat pain, difficulty swallowing, swollen glands and white streaks or spots on the tonsils. Strep throat can also cause a high fever and general fatigue, and also potentially tonsillitis."

Dr Misra-Sharp adds: "You may also experience fever, headache and body aches." Unlike a simple sore throat, strep throat won't go away on its own – it requires antibiotics to clear it up and prevent complications such as rheumatic fever, so book an appointment with your GP.

Relief options for a simple sore throat include staying hydrated, throat lozenges, and over-the-counter pain relievers like paracetamol or ibuprofen

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Tonsillitis

Look for: Swollen tonsils, fever, pain when swallowing

Characterised by red and swollen tonsils, a fever and pain when swallowing, tonsillitis is an infection of the tonsils, which are the round, fleshy tissues at the back of your throat. Some people develop white spots on their tonsils, too, and Phil Day adds: "It may also cause bad breath, swollen lymph nodes and even ear pain."

Confusingly, tonsillitis can be either bacterial or viral – so if you suspect this, go and see your GP, especially if your symptoms are severe." Viral tonsillitis is generally managed with supportive care, much like treating a sore throat – rest, hydration and over-the-counter treatments," says Phil. "However, bacterial tonsillitis, particularly when caused by strep bacteria, requires antibiotic treatment."

Laryngitis

Look for: Painful throat, hoarse voice or voice loss"

This condition, often from a viral infection or strain on the vocal cords, leads to inflammation of the voice box, causing hoarseness or voice loss along with sore throat," explains Dr Misra-Sharp – so if you've got a husky voice, this is the likely cause. Laryngitis can also be triggered by overuse of the voice or exposure to irritants like smoke. It typically clears up on its own in a week or two, but it can be painful and uncomfortable in the meantime."

Resting your voice, staying hydrated and using steam inhalation – by leaning over a bowl of boiling water, covering your head and shoulders in a towel, and breathing the steam in and out through your mouth – can help ease symptoms," says Dr Misra-Sharp.

Tonsillitis can be either bacterial or viral – so go and see a GP if you suspect it

Pixabay

Pharyngitis

Look for: Painful throat, runny nose, lasting fever and headache

Similar to a typical sore throat, pharyngitis is inflammation of the back of the throat, called the pharynx, but may be more persistent. It typically results in a painful throat, fever, runny nose, cough, headache and a hoarse voice, and symptoms usually last three to five days. This can be caused by either bacteria or viruses – so if you've got a sore throat you can't seem to shift, it's worth getting checked out in case you need a prescription.

Glandular fever

Look for: Extreme fatigue, fever, painful throat that lasts for weeks

Sometimes called the "kissing disease" and also known as "mono", glandular fever is an infection that's spread through saliva – and mostly affects teenagers and young adults aged up to 24." Caused by the Epstein-Barr virus, it presents with extreme fatigue, fever, swollen lymph nodes and a sore throat lasting for weeks," explains Dr Misra-Sharp. "Conditions like [this] involve significant inflammation, which can release inflammatory substances that affect the whole body, leading to fatigue, headaches, and general malaise." Sufferers are infectious for up to seven weeks before symptoms develop and may be infectious for several months after being unwell. Complications can include liver conditions, kidney problems and, occasionally, long-lasting chronic fatigue. Glandular fever will go away on its own, but requires a blood test so it's worth getting a proper diagnosis from your GP. "Treatment usually includes hydration, rest and over-the-counter pain relief," says Dr Misra-Sharp.

XEC Covid variant

Look for: Persistent cough, fatigue, loss of taste or smell

Responsible for the recent surge in Covid cases, the XEC strain of coronavirus is highly-contagious and has been detected in 27 countries across Europe, Asia and North America. According to the most recent data from the UK Health Security Agency, it's responsible for a rise in hospital admissions, currently 4.5 per 100,000 people. "The XEC variant of Covid-19 has added another layer of complexity to the sore throat diagnosis," explains Phil Day. "In many cases, a sore throat is one of the initial symptoms. "However, unlike typical sore throats, sufferers also experience a dry, persistent cough, fatigue, fever and loss of taste or smell – the latter is quite unique to Covid, so keep an eye out for it. While most mild cases can be managed with rest and over-the-counter remedies, it's best to do a Covid test and follow NHS guidelines for isolation, treatment and care. And, if in doubt, get checked out. Dr Misra-Sharp says: "If you have any concerns about any sore throat, especially with persistent or severe symptoms, please consider seeing a GP."

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