Omid Farhang
In 2012, I wrote two posts about a sore throat. The first described the home remedies I was trying. The second reproduced a long prescription that included ciprofloxacin, a mucolytic, lozenges, vitamin C, herbal cough syrup, and a combination cold tablet.
Two years later, I turned that experience into advice. In a Persian post I wrote that someone with a cold and sore throat “definitely” needed antibiotics.
I was wrong. More importantly, I can now see how I reached the wrong conclusion.
This is personal reflection and general health literacy, not medical advice or a tool for diagnosing your next illness.
Here is the practical takeaway. Before treating an illness, ask:
- What do I know? Separate observed symptoms from assumptions about their cause, and recognize what I cannot determine myself.
- What am I trying to achieve? Treating a cause, shortening an illness, reducing discomfort, and preventing complications are different goals.
- What supports this intervention? Look for evidence of benefit for this condition and this intended outcome—not only tradition, testimonials, or a plausible explanation.
- What are the risks of acting or waiting? Include side effects, interactions, duplicated ingredients, unnecessary treatment, and harmful delay.
- What would change my decision? Know which worsening, persistent, or severe symptoms mean self-care is no longer enough.
The rest of this article shows how my old decisions failed those tests and how the same questions change what I would do now.
The mistake I can now recognize
My old posts reveal a chain of assumptions:
- My throat felt much worse, so I called it a “major infection.”
- I treated infection as if it automatically meant bacterial infection.
- A doctor gave me a long prescription, so I interpreted the number and apparent strength of the products as evidence of thorough treatment.
- I got through the illness, so I treated the prescription as proof of what had worked.
- I later generalized one episode into advice for other people.
None of those steps established that the illness was bacterial, that every item in the prescription was necessary, or that the antibiotic changed the outcome. A self-limited viral illness can improve after someone takes a medicine without improving because of that medicine.
The long list also created an illusion of coverage: something for mucus, something for pain, something for the throat, something herbal, and an antibiotic to attack what I assumed was the cause. It looked comprehensive. But a treatment is not better merely because it is stronger, more familiar, more natural, or accompanied by more products.
That is the argument I missed then: the quality of a health decision depends on the reasoning behind it, not on how impressive the intervention appears.
How the five questions change the decision
These are the questions I wish I had asked in 2012.
1. What do I actually know?
Separate observations from conclusions.
I could observe that my throat hurt, I had cold symptoms, and I felt worse. I could not determine from discomfort alone which organism—if any—was responsible. Even “infection” was an interpretation, not something I had established.
This boundary matters. Cough, runny nose, and hoarseness can point toward a viral sore throat, but symptoms do not always settle the question. The CDC notes that, without clear viral symptoms, examination alone cannot reliably distinguish viral pharyngitis from group A strep; testing may be needed. Health literacy includes knowing what you cannot responsibly diagnose yourself.
2. What outcome am I trying to change?
“Treat the illness” hides several different goals:
- remove or control the cause;
- shorten the illness;
- reduce discomfort;
- prevent a complication; or
- keep hydration, breathing, and other basic functions stable while the body recovers.
A treatment can help with one goal and do nothing for another. A lozenge may soothe a throat without shortening a viral illness. Rest and fluids can support recovery without killing a virus. An antibiotic can treat a susceptible bacterial infection but cannot treat a cold virus.
Once the outcome is explicit, “did it work?” becomes a better question. Did it reduce pain for three hours, or did it alter the course of the disease? Those are not the same claim.
3. What evidence supports this intervention for this outcome?
The common cold makes this concrete. Colds are caused by viruses, and antibiotics do not work against them. Most sore throats are also viral; confirmed strep throat is a different problem with a different treatment.
That is why “antibiotics sometimes treat sore throats” cannot support “my sore throat needs an antibiotic.” The missing work is identifying the condition and connecting the proposed treatment to an outcome demonstrated for that condition.
The same discipline applies to elderberry, propolis, vitamins, probiotics, and anything else described as immune support. A biological explanation can make an idea worth studying; it does not prove a meaningful benefit in people. Testimonials show that someone used a product and later felt better. They do not tell us what would have happened without it.
4. What are the risks of acting—and of waiting?
Doing something and doing nothing both have consequences.
An unnecessary antibiotic offers no benefit against a virus, but it can still cause rash, nausea, diarrhea, allergic reactions, C. difficile infection, and antimicrobial-resistant infection. The CDC’s antibiotic guidance is direct: when antibiotics are not needed, they will not help, and their side effects can still cause harm.
Waiting also has risk when the working assumption is wrong or the illness is becoming serious. The comparison is therefore not “medicine versus no care.” It is the expected benefit and harm of an intervention versus the expected benefit and harm of monitored supportive care or further assessment.
5. What would change my decision?
A reasonable self-care plan needs an exit condition.
For a typical cold, the CDC recommends medical care for trouble or fast breathing, dehydration, fever lasting more than four days, symptoms lasting more than ten days without improvement, symptoms that improve and then return or worsen, or worsening chronic conditions. People at higher risk from flu or COVID-19 should contact a clinician promptly because time-sensitive antiviral treatment may be available.
This is not a complete triage list. The transferable lesson is to decide in advance what worsening, persistence, or new symptom would make the current explanation—and therefore the current plan—insufficient.
Applying the questions to an uncomplicated cold
The five questions produce a more useful answer than “take this”:
- What do I know? I have a cluster of cold-like symptoms, but I may not know the exact virus, and I should not infer “bacterial” from severity, mucus color, or the word infection.
- What is the goal? For most colds, it is comfort, hydration, rest, limiting spread, and watching the trajectory—not eradicating the cause with an antibiotic.
- What supports the intervention? Symptom-relief products may temporarily improve comfort; they do not necessarily shorten the illness. Antibiotics do not treat cold viruses.
- What are the risks? Check active ingredients, interactions, contraindications, and duplication before combining products. A “cold and flu” product may already contain an ingredient found in another tablet.
- What changes the plan? Use persistence, worsening after improvement, breathing trouble, dehydration, relevant risk factors, or other severe and concerning symptoms as reasons to seek assessment.
This is what supportive care means: not passivity, but a plan aligned with the expected course of the illness. It accepts that not every symptom must be forced to zero. It also keeps monitoring and escalation inside the plan.
When less treatment is better—and when it is not
Doing less is rational when an illness is likely self-limited, the proposed treatment does not change its course, the symptoms are manageable, and no warning sign is present.
It becomes dangerous delay when those assumptions stop being true.
That boundary is why “be patient” is incomplete advice. Patience needs observation. A mild, improving picture is different from difficulty breathing, dehydration, confusion, significant bleeding, or deterioration after initial improvement. A person’s age, pregnancy, immune status, chronic illness, and risk of severe flu or COVID-19 can also change the threshold for professional care.
The same reasoning applies to symptom suppression. Relief can be valuable: sleep, hydration, and the ability to function matter. But suppressing a symptom is not automatically the same as treating its cause, preventing a complication, or shortening an illness. The purpose should be explicit before another medicine is added.
What the experience taught me about treatments
My story did not end when the cold ended.
After that period of taking antibiotics without enough understanding or appropriate guidance, I spent years struggling to tolerate milk and other lactose-containing foods, as well as several other foods. I suspect microbiome disruption may have contributed.
That is a plausible explanation, not a proven personal diagnosis. A timeline cannot establish causation, and digestive problems can have many causes. I keep that uncertainty visible because it is part of better reasoning too.
The experience eventually led me to explore prebiotics, probiotics, and postbiotics. The useful lesson was not “probiotics are the answer.” It was that four questions I had once blended together are independent: Is the intervention appropriate for this problem and person? Is it effective for the intended outcome? Does the product have reliable quality? What are its safety risks?
The label “probiotic” cannot answer those questions. The microorganism, strain, dose, storage, intended use, and evidence for that use matter. The NIH Office of Dietary Supplements notes that a higher colony-forming-unit count does not necessarily mean a greater benefit. Evidence for one strain and outcome does not validate every product in the category.
Where herbal products fit
The same four questions clarify the difference between a traditional herbal tea from an uncertain source and a manufactured herbal product.
With some teas I used, I could not verify the plant’s identity, contamination, active-constituent level, or consistency between batches. Better manufacturing controls can improve identity, purity, and dose consistency. That answers part of the quality question.
It does not answer appropriateness or effectiveness. A perfectly manufactured product can be reliably ineffective for the problem at hand. It does not settle safety either: herbal products can have adverse effects and drug interactions. As the FDA explains for dietary supplements, manufacturers—not the FDA—are generally responsible for ensuring safety and truthful labeling before sale; the FDA does not pre-approve supplements for safety and effectiveness.
So “traditional,” “natural,” “standardized,” and “commercial” are not conclusions. They are product descriptions. Elderberry or propolis should face the same questions as anything else: what exact product, for what exact outcome, supported by what evidence, with what risks?
What I would do differently today
I would not begin with the medicine cabinet. I would begin by writing down what I know, what I am assuming, and what outcome I want to change.
I would no longer recommend an antibiotic merely because a sore throat feels severe, call a prescription effective because it is long, or convert one recovery into a general treatment rule. I would check whether multiple products duplicate ingredients. I would make supportive care an active plan with clear reasons to seek assessment.
I would also keep uncertainty where it belongs. I cannot prove that antibiotics caused my later food intolerance. I cannot infer that probiotics are right for everyone because they became part of my own exploration. And I cannot call an herbal product effective merely because its manufacture is more controlled than an unverified tea.
I am leaving the old posts online because they show the difference between collecting remedies and evaluating decisions. The record is uncomfortable, but useful: it reminds me that confidence, familiarity, and the appearance of thorough treatment are poor substitutes for establishing what problem I am actually trying to solve.
The next time I am ill, the useful first action is not to choose a product. It is to run the five questions: what I know, what outcome I want, what evidence supports the intervention, what acting or waiting could cost, and what would tell me to get help.
Continue the series
- How I Decide What to Do When I’m Sick applies the five questions to home monitoring, supportive care, medication, and medical help.
- How to Evaluate a Supplement or Medicine examines evidence, labels, doses, quality, interactions, and duplicate ingredients.