Reality on a Stick

When I was growing up, the accepted means of battling the common cold was chicken noodle soup
and sleep, and perhaps some vitamin C if your house happened to be stocked.

Then about 15 or 20 years ago, herbal supplements came into fashion and echinacea joined the A list of do-it-yourself remedies. For many people, echinacea and vitamin C are still the combination of choice. What became clearer over time, however, was that any recommended treatments had to be implemented at the first sign of a cold, and even then they were only mildly effective. We all know this from experience: there is no stopping a cold once you’ve been infected. The cold just has to run its course so to speak. This website sums up the average American’s view quite nicely:

Cold and flu season will soon be upon us, the time when those who use medicinal herbs stock up on the two most popular non-pharmaceutical cold remedies — vitamin C and echinacea. Both are effective cold treatments, but neither work all that well for prevention, and they’re far from the whole story.

In 2005, I returned to the U.S. for a visit and was blown away by the sudden, widespread adoption of Airborne as the answer to the common cold. It didn’t sound as though the drug had received the support of the scientific community, but how can you argue with such enthusiastic testimonials? Just about anyone you talked to swore by the stuff! About six months later, I started to see scathing criticisms of the ambiguous claims and pseudo-science employed by Airborne’s manufacturer. After checking out the active ingredients, I finally got the whole picture: Airborne is simply an herb and vitamin cocktail meant to boost your immune system as a cold or flu is coming on. Indeed, that was all it’s manufacturers ever claimed that it was. The entry for Airborne at Wikipedia reads:

Although it is recommended that Airborne be taken “at the first sign of a cold symptom, or before entering crowded environments, like airplanes and offices,” the package explicitly states that Airborne is “not intended to diagnose, treat, cure, or prevent any disease.”

Then came a whole lot of confusing talk about the risks and benefits of high doses of Vitamin C
–which also happens to be a major ingredient in Airborne. It seems that many doctors and researchers found high levels of Vitamin C to be responsible for unpleasant, and unnecessary, side-effects. What’s more, recent studies raise more suspicion as to whether Vitamin C plays a significant role in treating common colds at all.

So why all the controversy? Chris Rock said it best:

The money’s in the medicine.
That’s how you get paid, on the comeback.

Put simply, too many people and too many companies are raking in the dough while we run around trying to figure out the most comfortable way to let a cold run its course. It’s a 17 billion dollar a year industry, and that kind of money can pay for research saying just about anything you like.

Which leaves us with echinacea as the only unscathed supplement in our bag of tricks. An abstract of the most recent research on the topic reads as follows:

Echinacea decreased the odds of developing the common cold by 58% (OR 0.42; 95% CI 0.25-0.71; Q statistic p<0.001) and the duration of a cold by 1.4 days (WMD -1.44, -2.24 to -0.64; p=0.01). Similarly, significant reductions were maintained in subgroup analyses limited to Echinaguard/Echinacin use, concomitant supplement use, method of cold exposure, Jadad scores less than 3, or use of a fixed-effects model. Published evidence supports echinacea’s benefit in decreasing the incidence and duration of the common cold.

So the verdict looks something like this: Echinacea is the only currently recommended supplement that has received wide support by the scientific community as a treatment for the common cold. Its effects are mild, but unmistakable. Vitamin C seems to be a less certain quantity in the battle against our nemesis viral infection. As a result, in the absence of a definitive study on the total effects of high-dose Vitamin C treatments, they ought to be ruled out, as should Airborne due to its high Vitamin C content.

Your comments welcome.

(Disclaimer: I am not a doctor, and this post does not contain medical advice:-)

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