Cold/Flu Products: What Works, What Doesn't

From Airborne to vitamin D, the truth behind preventative measures and treatments.
In 2004, People magazine interviewed Dr. Peter Katona, an associate clinical professor of infectious diseases at the David Geffen School of Medicine at UCLA, about a money-making dietary supplement called Airborne.

The small tablets, then being marketed as a handy cold prevention and treatment remedy, are chock-full of vitamins, herbs and minerals and fizz once placed in water.

Katona gave a frank opinion, calling the over-the-counter supplement a "waste of money." The actor Kevin Costner, on the other hand, gave a brief but glowing review and confessed to stashing them on his private plane.

"Who do you think readers listened to?" says Katona, with a laugh.

In Depth: Cold/Flu Products To Try, And Toss

Katona's assessment was reinforced last December when Airborne agreed to pay up to $30 million to settle a class-action lawsuit. The Federal Trade Commission, which announced the settlement, said Airborne lacked "competent and reliable scientific evidence to support the claims."

Airborne is still on the shelves--with a slightly different marketing claim that it supports the immune system--but that doesn't make the product any more effective.

Though Americans spent $4.6 billion on cough, cold and sore throat remedies in 2008, in fact there are only a handful of scientifically proven preventions and treatments for viruses that cause the cold and flu, and none of them involve excess doses of vitamins. Instead, public health officials and physicians have a more common-sense approach, including avoiding sick people, getting vaccinated for the seasonal and H1N1 flues, managing symptoms with reliable medications like an anti-inflammatory or decongestant, and seeking treatment for the flu within the first 48 hours of flu symptom onset.

Prevention and Treatment Myths
Still, this doesn't stop sufferers from relying on a host of ineffective treatments. Like Dr. Katona, emergency physician Dr. Frank McGeorge often deals with patients who rely on remedies that lack scientific proof until their symptoms worsen and they have to see a health care professional.
McGeorge, a Detroit-Mich.-based spokesman for the American College of Emergency Physicians, says a lot of patients often take vitamins like echinacea, zinc and vitamin C once they get sick. While research on the use of the herb echinacea to treat colds and flues is still ongoing, many studies--including two funded by the government--have found no benefit.

Similarly, there's not enough scientific evidence to demonstrate that zinc and vitamin C are powerful weapons against the cold and flu. On the contrary, both can be harmful in excessive doses. Earlier this year, the Food and Drug Administration warned consumers that the homeopathic cold-treatment nasal spray Zicam, which contains the mineral zinc, had been linked to a loss of smell in more than 100 people since 1999. McGeorge also advises against regularly taking more than 500 milligrams of vitamin C per day. Doing so over a long period of time may be harmful; excess vitamin C can cause severe diarrhea.

"There are very intelligent, well-grounded people who swear by this stuff," says McGeorge, referring to vitamin supplements and homeopathic remedies. "My problem is that people taking these [products] sometimes ignore things that will really help them and instead choose voodoo medicine."

Getting Smart About the Cold and Flu
Instead, McGeorge would prefer patients to practice cold and flu prevention by washing their hands, avoiding sick people, staying healthy and, for the flu, getting vaccinated. This year that means obtaining both the seasonal flu vaccine and the H1N1 vaccine. The second vaccine is particularly important for high-risk patients like pregnant women and young children.
Controlling uncomfortable symptoms of either the cold or flu can be done with over-the-counter medications like ibuprofen, an anti-inflammatory that reduces fever and pain; a decongestant, which relieves swollen tissue in the nose; or an antihistamine, which minimizes sneezing, runny nose and coughing. And staying hydrated, which helps keep mucus moist and easy to clear from the nose, will do more to help the body heal than any alternative or homeopathic remedy.

Dr. Norman Edelman, chief medical officer at the American Lung Association, says an effective cold and flu prevention strategy should also include a healthy diet, exercise and plenty of sleep. Following these guidelines will help support the immune system, though Edelman stresses that minor slip-ups, like missing an hour or two of exercise during the week, won't severely compromise one's natural defenses.

And if you've been unfortunate enough to catch a cold or flu, Edelman has a final recommendation: be considerate of others.

"Cancel that trip to grandma's or don't go to work," he says. "If you're sick and spread it to someone else, that's an impolite thing to do."

Cold/Flu Products To Try, And Toss

Echinacea
Some who use this herb to shorten the duration of a cold or treat its symptoms say that it's effective, and at least one study of 95 people made a similar observation. Yet many studies, including two funded by the government, have found no benefit. The National Center for Complimentary and Alternative Health, a division of the National Institutes of Health, is continuing to study the use of Echinacea in treating upper respiratory infections and in supporting the immune system.

Vitamin C
There is no conclusive evidence to support vitamin C as a cold prevention or treatment remedy, according to the National Institute of Allergy and Infectious Diseases. Several controlled studies have been conducted, but the data on whether or not vitamin C reduces the severity or duration of symptoms is unclear. In fact, taking more than 500 milligrams of vitamin C daily over a long period of time may be harmful; excess vitamin C can cause severe diarrhea.

Consider Vitamin D
If there is a supplement you might consider taking this winter, says Dr. Edelman, it is vitamin D. Recent research has demonstrated an association between vitamin D deficiency and cardiovascular disease and increased risk of the common cold. It's easy to get sufficient levels of vitamin D--which the body processes when it's exposed to the sun's UV-B rays--during the summer months but more difficult throughout winter. Research on the use of vitamin D to protect against the cold is still ongoing; discuss the appropriate dose with your physician.

Tamiflu and Relenza
Practicing prevention doesn't guarantee immunity; for those who do come down with the flu, McGeorge recommends seeing a health care professional within the first 48 hours. That's a critical window of time during which a doctor can prescribe the antiviral medications Tamiflu or Relenza, both of which have been shown to shorten the course of the flu.