Alternative Cold Prevention

Many people tend to sniff at supplements and herbal alternatives to cold prevention. Though herbs have been used medicinally for centuries, a knee-jerk charge against them is that their effectiveness is unproven, and consequently they lack drug-class approvals by the Food and Drug Administration.

The major obstacle is difficult to surmount: You can’t patent a plant. Dr. Bruce Barrett, a researcher and associate professor of family medicine at University of Wisconsin, explains that manufacturers don’t pay to research natural remedies because they can’t protect the investment. “If one company sinks $10 million into research, the rest of the world can just jump on the bandwagon. There are a few exceptions, but in general you can’t patent most herbal medicines very well. Nobody is going to fund a 10,000-person, three-year trial on Echinacea or ginseng, and that’s what we’d really need to provide convincing evidence.”

So the burden of proof usually remains just that—a burden. It’s ironic, since botanicals are the foundation of modern medicine. Barrett notes that between one-quarter and one-third of pharmaceuticals are derived from plants.

If you believe something works, it just might.

“The placebo effect” is a well-known, if not well-understood, phenomenon. Scientists have suggested that when subjects are given a simple sugar pill believing it is helpful medicine, the part of their brain that controls the immune system goes to work.

A fundamental guideline for research credibility is the use of “double-blind” studies, which is when neither the researchers nor the subjects know who is receiving drugs and who is receiving placebos. There’s an inverse relationship between placebo effect and a drug’s perceived effectiveness: As the percentage of subjects who respond to the placebo increases, the perceived value of the drug withers.

So even when the drug is imagined, the results can be very real. “Over and over we find that when people believe in stuff, it works!” laughs Barrett. “I think it’s very reasonable for people who believe in alternatives to use them, provided they are safe and taken in safe doses. Just because there are no trials doesn’t mean they shouldn’t be used.”

The assertion behind many alternatives is that they will bolster the immune system.

Such assertions are difficult to verify, though, because even when we see evidence that a medicine is helping to activate the immune system, we don’t know exactly how it’s done. “For instance, it’s been known for 50 years that vitamin C links with collagen, and that’s why it’s effective in preventing scurvy,” says Barrett. “We know a bit about what it does do, but how that links to prevention against an infectious disease is not well known. I think that’s why there are so many things out there that supposedly affect the immune system. It’s hard to prove or dispute them when we don’t know what we should be measuring.”

The list of natural substances that may help strengthen human defense against the common cold is long. It includes andrographis, astragalus, garlic, ginger, ginseng, goldenseal, lemon, peppermint and several Chinese herbs—any or all of which may be helpful, but none has been adequately tested. A 1999 article in the American Journal of Clinical Nutrition reviewed the health-promoting properties of common herbs and concluded, “The discriminate and proper use of some herbal products is safe and may provide some therapeutic benefits, but the indiscriminate or excessive use of herbs can be unsafe and even dangerous.”

The effectiveness of vitamin C and Echinacea, two of the most popular defenses against colds, is undetermined.

The Cochrane Collaboration is a large, multinational group of experts who systematically review published research and make careful health-care recommendations. While acknowledging that vitamin C may reduce the risk of colds in people exposed to extreme physical stress or cold weather, the group’s latest review of evidence found that vitamin C had “no effect on common cold incidence in the ordinary population.” It’s worth noting, though, that the last time Cochrane reviewed research it had a positive recommendation for vitamin C’s preventive properties. The facts never changed—just the group’s read on the data. Cochrane continues to encourage further study.

Echinacea is Barrett’s expertise, and he’s currently conducting a major trial he hopes will show the effectiveness of this herbal medicine. He cites the humble stats for Echinacea, based on admittedly thin evidence to date. “It looks like the benefit [for cold prevention] would be small even if it’s true: Around 15 percent reduction in incidences of colds in someone who takes it. If the average person gets four colds a year, you’d have to take Echinacea for two years straight, on average, before you’d prevent one cold!”

This doesn’t mean vitamin C or Echinacea is useless against colds—it means the research to date has not been statistically significant enough to be conclusive. Evidence for both treatments continues to swing in and out of favor.

You probably don’t need a doctor to tell you that good health and fitness habits make for a stronger body in every way. Some people are genetically predisposed to have robust immune systems, but most anyone can fortify himself or herself with a better cold defense. Good hygiene, especially proper hand washing, is fundamental to limiting virus transmission. Nutrition clearly plays a role as well: In areas where people are malnourished, cold infections are more frequent and more severe. Regular exercise promotes fewer and less intense bouts with colds. However, evidence shows that people who run marathons are very likely to get a cold soon afterward, which suggests that overexertion can increase susceptibility.

“Alternative Cold Prevention” has been reviewed for accuracy by Dr. Bruce Barrett, associate professor of family medicine at the University of Wisconsin.

Confused by health myths and misinformation? Each week, Rich Maloof talks to leading health experts to bring you the straight facts on a broad range of health topics.

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