Sniffles and Sneezes

Is it possible to get through a winter season without a sniffle or sneeze? Most likely not, as we are indoors more than outdoors, sharing the same air with all those who are sick. (Ever notice how an illness spreads through a family, school, work place or facility?) As we move forward in cold and flu season, the mass marketing of products gets going in full-force. There are the old familiars-decongestants, antihistamines, cough syrups and analgesics (pain and fever-reducers)-that have been around for a long time and are regulated as drugs. But there are also all kinds of alternative supplements that are promoted. According to a study published in the New England Journal of Medicine, October 15, 2015, and reported on by Medscape Infectious Diseases on their website, dietary supplements send an estimated 23,005 Americans to the emergency department and result in 2,000 hospitalizations each year. 

 One of the newer cold/flu remedies to hit the market are products made with elderberries. The cooked blue/black berries have been used in teas, liquid extracts and capsules. Information on elderberries shows:  

• There have been some small studies that show the elderberry may relieve flu symptoms, but the evidence is not strong enough to support use of the berry.   
• A few studies have suggested that a product containing the elder flower and other herbs can help treat sinus infections when used with antibiotics, but further research is needed.
• No reliable information is available on the effectiveness of elderberry or elder flower products for other uses.
• The NCCIH warns that uncooked or unripe elderberries are toxic and cause nausea, vomiting, or severe diarrhea. Only the blue/black berries of elder are edible. Furthermore, elder flower can have diuretic effects, so caution must be used if you are also taking drugs that increase urination.

 Other popular “alternate” remedies for colds include zinc, Echinacea and Vitamin C.

•  Zinc for colds comes in lozenges, syrups and sprays. There is not a lot of definitive research about zinc. There is some evidence that taken within 24 hours of the onset of a cold, it may reduce the average length of a cold in healthy people by a day or two. As far as preventing colds, some research has shown that for children, taken in low doses for 5 months in advance of a cold, it may result in fewer colds. (Key word is “may” not “will.”) Zinc is not recommended for persons with chronic illness or asthma.  Nasal zinc has been shown to cause severe, irreversible loss of smell. Side effects of zinc products can include gastrointestinal symptoms. Long-term use can result in copper deficiency. Zinc can interact with some antibiotics and rheumatoid arthritis drugs.
•  There are many formulations of products with Echinacea which has made it difficult to study. Therefore the research has mixed results. Some studies show no benefit at all, while some show a small decrease in severity and duration of symptoms. No studies have demonstrated its ability to prevent colds. It appears to be most effective if taken on the first day of symptoms. Very little research has been done on children. Few side effects have been reported, but it can cause an allergic reaction or a rash.
• Vitamin C believers, nothing will change your mind. Vitamin C for colds has been studied more than the two products listed above. No study has demonstrated that vitamin C will help people prevent colds. Some research shows that if it is taken regularly before the onset of a cold, it may shorten the duration of the cold and the symptoms may be less severe. However, research also shows that taken after the onset of a cold, there is no improvement of symptoms. Overall, Vitamin C is generally safe. High doses may cause digestive symptoms.

(Several sources were reviewed to compile this information: National Institutes of Health, Mayo Clinic, WebMD, The National Center for Complementary and Integrative Medicine-NCCIH and the Center for Science in the Public Interest-CSPI).

 With more than 1 billion colds occurring in Americans each year (NCCIH data), you can be sure that researchers will continue to search for alternatives for treating colds. Right now, there is on-going research about buckwheat honey as a substitute for cold syrups and geranium extract to reduce symptoms of acute bronchitis, acute sinusitis and the common cold. Stay tuned to learn more!

 If you are using a dietary supplement to treat a cold (or other illness) it is very important to let your  health care provider and the pharmacist know. Sometimes it is the interaction between a supplement and a prescribed medication that can cause a serious problem. The main messages about supplements are: Know what you are taking; Know how it might interact with other medications you take; and what are the potential side effects to watch for. If you have had a reaction or side effect from a dietary supplement you have taken, you can report it to the Safety Reporting Portal, http://www.safetyreporting.hhs.gov.

 There are a number of reliable resources for learning about a supplement. National Center for Complementary and Integrative Health (NCCIH), www.nccih.nih.gov; Office of Dietary Supplements (ODS), http://ods.od.nih.gov; Center for Food Safety and Applied Nutrition (CFSAN), http://www.fda.gov/AboutFDA/CentersOffices/OfficeofFoods/CFSAN or the National Library of Medicine’s MedlinePlus, http://www.medlineplus.gov  

 Residents of the Quinnipiack Valley Health District (Bethany, Hamden, North Haven and Woodbridge) without internet access can call QVHD, 203 248-4528, for written information on this topic or a specific supplement.  The information in this column is provided for educational purposes only and is not intended to be construed as medical advice or replace the advice of your health care provider.