Bob Martin says he hasn't caught a cold in years, not since he discovered Echinacea and Goldenseal. For the past decade, the 60-year-old teacher from Placitas, N.M., has taken the herbal supplements in megadoses three times a day at the first sign of a sniffle. Now he only gets sick if he doesn't dose himself in time, he says.
"It's been years since I've had a cold," says Martin. "I take the herbs, climb under the blanket and I'm fine the next day. They nip it in the bud."
Martin is not alone in his faith in herbal remedies, which he also takes for toothaches, earaches, and other ailments. According to the Nutrition Business Journal, Americans spent $1.5 billion on cold and flu supplements and other "immunity boosters" in 2007, and the market is growing at twice the rate as that of the standard, over-the-counter, cough-and-cold-remedy market.
But do these alternative treatments actually work?
Martin and plenty of other consumers answer a resounding "yes," but experts say that, overall, there's little evidence-based scientific literature on the subject. In fact, the makers of Airborne, the ubiquitous "effervescent health formula," settled a class-action lawsuit to the tune of $23.3 million in 2008. The charge? The Center for Science in the Public Interest, which helped litigate the suit, and the Federal Trade Commission, which filed a separate complaint against the manufacturer, said the company made false and unsubstantiated claims when it said its product could fight germs or prevent colds.
"Only a very, very small number of compounds have undergone peer review," says Frank Esper, M.D., member of the division of pediatric infectious diseases at Rainbow Babies and Children's Hospital, in Cleveland. "What you see is anecdotal."
And the ones that have undergone peer review generally come back with mixed reviews. The evidence is often not strong, and it can be conflicting. "But there is some good evidence that some of these things can be effective," says David Leopold, M.D., director of integrative medical education at the Scripps Center for Integrative Medicine and a faculty member with the Scripps Natural Supplement Conference, in La Jolla, California.
Herbal remedies don't seem to prevent colds, but they may help curb symptoms or shorten their duration, he says. "The things I talk about will reduce duration 24 or 36 hours, which is significant if you're out doing things," Dr. Leopold says. "They also seem to decrease severity of symptomology."
Here's what's known about the efficacy of some of the most well-known alternative cold remedies, in alphabetical order:
The herb Echinacea purpurea is one of the best known and widely available herbal cold treatments. Study results are mixed, but its effectiveness may vary depending on the preparation. Two studies funded by the National Center for Complementary and Alternative Medicine found no benefit from echinacea in a juice formulation or in an unrefined combination of root and herb. However, David Leopold, MD, recommends mixing 15 to 20 drops of an echinacea tincture with warm water four or five times a day (or as directed on the bottle). "It tends to be a little more potent than pills," says Dr. Leopold, who is the director of integrative medical education at the Scripps Center for Integrative Medicine and a faculty member with the Scripps Natural Supplement Conference, in La Jolla, Calif.
There may be even less evidence for the efficacy of goldenseal, an herb that Bob Martin, a 60-year-old teacher from Placitas, N.M., swears by. He takes it and echinacea three times a day at the first sign of a cold. He only gets sick if he doesn’t dose himself in time. "Goldenseal hasn't been studied as much but I don't think that there's any inherent problem to using it as long as somebody doesn't have an allergy to it," Dr. Leopold says.
Although this Asian herb is taken mainly to boost energy, stamina, and overall health, researchers have begun to examine its efficacy in fighting the common cold. A 2005 study conducted by Canadian researchers found that taking ginseng every day reduced the severity and duration of cold symptoms, and appeared to prevent colds as well.
Long popular with the holistic crowd, daily rinsing is believed to fend off cough, sniffles, and sore throat. A well-publicized study recently found that children who rinsed with a saline nasal wash six times a day had an improvement in cold symptoms and fewer recurrences. In the study, 401 children ages 6 to 10 were randomly assigned to standard medication or to nasal wash with modified seawater solution (Physiomer) plus standard medication. However, it may be counterproductive to rinse every day when you’re healthy. A 2009 study published in Annals of Allergy, Asthma and Immunology found that daily rinsing can deplete the nose of protective mucus, and actually increase your risk of getting a cold and other infections.
Though less well-known than some other herbal cold remedies, extracts derived from this plant have been shown to decrease the symptoms of acute bronchitis. One study, published in the journal Phytomedicine in 2003, examined 468 adults with acute bronchitis lasting less than two days who were given either placebo or an extract of the roots of Pelargonium sidoides; those in the latter group were told to take 30 drops three times a day for a week. The treated patients saw quicker resolution of symptoms including pain during cough and fever, and were able to return to work in an average of 4.7 days (compared to 6.3 days for placebo).
Vitamin C may be the most studied of the available alternative remedies. Again, study results have been mixed, but experts seem to more strongly support vitamin C than other remedies. Even the purported benefits of Airborne may have more to do with its vitamin content than other ingredients. "There's nothing intrinsically wrong or right with the product," says Steve Gardner, litigation director for the Center for Science in the Public Interest. "It's an extraordinarily expensive vitamin-C delivery system. If there's any benefit, it may be from the vitamin C, which for some people might reduce the severity or duration of a cold, but won’t prevent one." The recommended everyday intake is 75 milligrams per day for adult women and 90 milligrams per day for adult men. Dr. Leopold recommends that people with colds take a gram or so of vitamin C several times a day, depending on what other medical conditions they may have.
A 1996 study found that zinc lozenges reduced the duration of the common cold from 7.6 days to 4.4 days. Other studies have been mixed but doctors do sometimes recommend the supplement. However, there may be some risk to Zicam Cold Remedy products. In 2006, the manufacturer of the zinc spray paid $12 million to settle 340 lawsuits from consumers who claimed to have lost their sense of smell after using the product. And in June 2009, the FDA warned consumers to stop using three Zicam products due to the risk of a loss of the sense of smell.
The good news is that, in general, most of these compounds won't hurt you, says Dr. Campbell (although it can't hurt to check with your doctor). And there may be another upside to herbal supplements. "I believe that most of the over-the-counter products just mask symptoms, which is great to get you through the day," Dr. Leopold says. "But a lot of the oral supplements are working more with the body, maybe stimulating the immune system and also helping the body to heal." "I don't recommend that any of my patients take any of this stuff every day, but as soon as they have a little runny nose and a scratchy throat, they should hit it hard," he adds. "Err on the side of caution."