Archive for February, 2011

Every Cold and Flu Treatment That Has Been Recommended to me in the Past Two Months (And What the Evidence Says)

Hey everyone, I’ve been out of the blogging routine for way too long now, so I’m going to try to get back into the swing of things by writing about all of the cold and flu remedies that I’ve been told to try in the past couple of months. I’ve been sick since midway through December. First I had a cold, and just when I was getting over that I caught a nasty cough virus that’s been floating around Winnipeg this winter, and now I have a cold again as well as remnants of that damn cough combined with the return of my asthma. Party! And when you’re coughing and your voice is all nasally people tend to tell you what you need to do to get better.

The following are all of the remedies (alternative and mainstream) that have been recommended to me, as well as the best non-propagandaish information I could find on each:

Vitamin C

  • Rose to popularity as a treatment for the common cold in the 1970s after this book by Linus Pauling was published.
    • The Cochrane Collaboration is an organization that looks at the body of evidence for a given health care intervention and publishes reviews based on what the results of multiple trials say when considered as a whole. Here‘s the Vitamin C review. In a nutshell:
      • Regular ingestion of vitamin C had no effect on common cold incidence in the ordinary population.
      • It had a modest, but consistent effect in reducing the duration and severity of common cold symptoms.
    • If vitamin C doesn’t reduce my likelihood of coming down with a cold then I wouldn’t bother with taking a daily supplement, since it’s pretty easy to find foods that contain more than enough vitamin C, however it seems to me that it may be worth it to take 0.2g of Vitamin C per day to reduce the length of a cold.
    • Here‘s a podcast episode on the subject.
  • It is also frequently recommended as a way to “boost your immune system”
    • I’ll link to a few articles explaining why the idea that you can boost your immune system is little more than a marketing gimmick, but I’ll try to summarize: if your immune system is working normally it can’t be boosted, but exposure to illnesses (ex. vaccination) will improve your chances of not getting sick. I really think you should read the articles though: One, Two and Three.

Oil of Oregano

  • A few different people recommended Oil of Oregano to me, but nobody really had a clear description of what it’s supposed to do, or what illnesses it’s supposed to treat. There are all kinds of claims made about it but the evidence is lacking. Here‘s a good summary from Science-Based Pharmacy:
    “There is no published evidence to demonstrate that that oil of oregano is effective for any medical condition or illness. There is some very limited evidence to suggest that it might be useful for parasite infections – but given the evidence consists of only one study with 14 patients, and no placebo comparison, we really have no idea if the oregano oil was effective. The bottom line is that despite all the marketing, press, and sales, there is no research that exists to demonstrate that oil of oregano does anything useful in or on our bodies.”

Echinacea

  • A recent study (published in December, 2010) concluded that “illness duration and severity were not statistically significant with echinacea compared with placebo. These results do not support the ability of this dose of the echinacea formulation to substantively change the course of the common cold.”
  • Here‘s an assessment of the evidence for Echinacea by Steve Novella of the Skeptics’ Guide podcast. It’s from 2007, so it was written before that most recent study was published.
  • I should mention that I found both of these links on Skeptic North’s article, Coughs, colds and the “appealing but mistaken concept of boosting the immune system”

Garlic

  • I think this may have been the first time that somebody recommended garlic to me as a cold remedy, but basically it was just recommended that I eat a ton of garlic. I love garlic, so I have no problem incorporating it into my diet, especially when I’m going to be home sick from work for a few days and nobody has to smell me. But will it treat my cold?
  • There is a Cochrane review on the use of garlic for treating the common cold, but there was only one study that fulfilled the criteria for the review and it was a small one (146 participants). The study found that people who took garlic every day for 3 months had fewer colds, but it would take a larger trial to confirm these findings. There were other studies claiming that garlic is helpful in preventing the cold, but they were poor quality so they didn’t meet the Cochrane review standards.
  • I wouldn’t take or recommend garlic based on such poor evidence, although I wouldn’t advise against adding it to spaghetti sauce either.

Cold-fX

  • I have a friend who swears by Cold-fX, which means that for the past couple of months every time I converse with her and I sniffle or cough she tries pushing it on me. I know she means well, but I’m skeptical of any product that makes vague claims like “strengthens the immune system.” To me, that’s meaningless. It’s also fairly pricey, so it’s not worth it to me to spend money on something that has poor supporting evidence.
  • Science-based Pharmacy has an article looking at the evidence related to Cold-fX.
  • My Cold-fX loving friend always tells me “when I take it my colds don’t last as long,” but that’s not something that convinces me because: a) colds don’t always last the same length, b) personal testimonials aren’t helpful because there’s no way of knowing whether an individual would have gotten better without the treatment (this is why trials need large numbers and placebo groups), and c) who keeps track of how long their cold is anyways? People recover from colds whether or not they use a treatment, but without proper trials it’s impossible to say for sure whether something like Cold-fX has an effect.

Buckleys/NyQuil/any cough syrup

  • Personally, cough syrup did nothing for me. Buckleys provided 5 seconds of cooling in my throat before I had to start coughing again. All it did was put me to sleep, which was definitely welcome. But it made me doubtful that cough syrup does anything to alleviate symptoms.
  • I always thought of cough syrups as being efficacious just because they’re pretty mainstream medicine (not that that is a good argument for any treatment), but even Wikipedia has this to say: “There however is no good evidence for or against the use of these medications in those with a cough. Even though they are used by 10% of American children weekly, they are not recommended in children 6 years of age or younger due to lack of evidence showing effect, and concerns of harm.
  • The Cochrane review on “over-the-counter medications for acute cough” concludes: “There is no good evidence for or against the effectiveness of OTC medicines in acute cough. The results of this review have to be interpreted with caution due to differences in study characteristics and quality. Studies often showed conflicting results with uncertainty regarding clinical relevance. Higher quality evidence is needed to determine the effectiveness of self-care treatments for acute cough.”

Neti Pot

  • I actually can’t talk about the Neti Pot without gagging. The thought of sticking something up my nose and pouring a saline solution through my sinuses to wash snot out into my sink is so off-putting to me that I’ll probably never try it.
  • Neti Pots are an example of an alternative medicine practice that has been validated (to an extent), although evidence has shown that using it on a regular basis can increase your risk of sinus infections.

It’s funny that when you’re sick everyone around you puts on their doctor hat – all of a sudden they’re all medical authorities. I have this compulsion too, I recommended my “treatments” of Advil for the sore throat and NyQuil to get some sleep – who knows if that combo is even safe! I think it’s hard to see someone suffering from any kind of illness and not want to help, so we offer up treatments in the hopes that it will make them feel better. Unfortunately this probably does more to line the pockets of drug and supplement companies, who play on peoples’ beliefs in certain treatments in spite of the poor evidence for their efficacy, than it does to soothe the symptoms of a virus.


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