The top five cold remedies that do not work

A cure for the cold, from ThadGuy.com

One of my daughters caught a cold last week, and now she's given it to me. We’re giving ourselves the best treatment known to science: rest. But to judge from the products offered at our pharmacies, you’d think there were dozens of options to treat a cold. In local pharmacies and in the medicines aisle at my local grocery store, I’ve found row after row of colorful packages, claiming to relieve cold symptoms, shorten the duration of the common cold,” and more. 

Some of these medications actually do treat symptoms, but none of them cure a cold. But mixed among them—sometimes side-by-side with real medicines—I found several products that don’t work at all. 

How can a drug manufacturer get away with this? Simple: the products that don’t work are either supplements or homeopathic products. The manufacturers of both these types of “medicines” have successfully lobbied Congress to pass laws that exempt them from FDA regulation. Supposedly they aren’t allowed to make direct claims to cure or treat disease, but unless you read the wording on their packages very carefully, you’d never notice. (Note to older adults: bring your reading glasses to the pharmacy section!) 

Most important for consumers: if a treatment says it’s homeopathic, then its ingredients do not have to be shown effective. “Homeopathic” simply means that the ingredients are listed on the Homeopathic Pharmacopoeia, a list maintained by homeopaths themselves. And if it contains supplements or vitamins, they too are exempted from regulation by the FDA, under a law known as DSHEA. 

So next time you go searching for something to take for your cold, or for your child’s cold, here are the top 5 cold remedies you should not buy:

1. Zicam is a zinc-based remedy. Zinc is tricky, because there is some evidence to suggest that taking zinc right at the onset of a cold might shorten its duration a little bit, from 7 days to 6. But as Dr. Terence Davidson from UC San Diego explained, if you look at the more rigorous studies, the effect vanishes. Zinc turns out to have some worrisome side effects, too. Zicam's nasal spray and gel versions were linked to a serious loss of the sense of smell (anosmia), which led the FDA to issue a warning letter in 2009. Zicam responded by withdrawing the product for a time, but their website now says “A clinical link between the Zicam® products and anosmia was not established.“ Strictly speaking, this is correct, but there have been published reports suggesting a link, such as this one from 2009.*

Zicam’s website makes the misleading claim that “All of our Zicam® products are regulated by the FDA.” This is a common ploy of homeopathic drugmakers, claiming the FDA regulates them because the FDA could step in (as they've already done with Zicam) if consumers are being harmed. Unlike real drugs, though, Zicam has not been evaluated by the FDA for effectiveness or safety.

2. Airborne. You can find this in the cold remedy section many pharmacies (I did), but Airborne doesn’t cure anything. It’s a cleverly marketed vitamin supplement with no scientific support for any health benefits. How do they get away with it? Actually, Airborne paid $23 million back in 2008 to settle a class-action lawsuit over its advertising. They had been calling Airborne a “miracle cold buster.” According to the Center for Science in the Public Interest’s David Schardt, 

“Airborne is basically an overpriced, run-of-the-mill vitamin pill that’s been cleverly, but deceptively, marketed.”

After the lawsuit, Airborne modified their packaging, which now claims only that it “helps support your immune system.” This is one of those vague claims that supplement makers love, because it doesn't really mean anything. Airborne's products also now include a disclaimer that

 “These products are not intended to diagnose, treat, cure, or prevent any disease.”  

So what the heck are they doing in the “cold medicines” section of the store?

3. Coldcalm is a homeopathic preparation sold by Boiron, one of the world’s largest manufacturers of homeopathic remedies (including Oscillococcinum, an almost laughably ineffective flu remedy). It claims on the package to relieve cold symptoms. What’s in it? A dog’s breakfast of homeopathic ingredients, including belladonna, about which NIH says, 

“Belladonna is UNSAFE when taken by mouth. It contains chemicals that can be toxic.” 

Another ingredient is pulsatilla, which “is highly toxic, and produces cardiogenic toxins and oxytoxins which slow the heart in humans.” Neither belladonna nor pulsatilla relieves cold symptoms.

Being homeopathic, these ingredients are highly dilute, but I think I’ll pass on Coldcalm.

4. Umcka. Umcka is another homeopathic preparation that claims to “shorten the duration of common cold” and “reduce severity of cold symptoms.” Sounds pretty good—if only it were true. Umcka’s active ingredient is a plant extract called pelargonium sidoides, an African geranium. Interestingly, there have been a few experiments on this extract, some of which showed a small positive effect. However, a review of these studies reported that their quality was “very low," that all of them were conducted by Umcka itself, and that all of them were conducted in the same region of Russia. And remember: homeopathic preparations are so dilute that they contain little, and sometimes none, of the active ingredient.

5. Antibiotics. Okay, these are real medicine, and you can’t buy them over the counter at your pharmacy. But Americans take them in huge quantities to treat the common cold. The problem is, antibiotics don’t work for colds.

When my daughter told her friends she had a cold, they wanted to know why she didn’t go to the doctor. Of course, doctors can’t do anything about a cold, and going to a doctor’s office just puts other patients at risk. My daughter knows this. But her friends were astonished to hear that we never take her to the doctor for a cold. It turns out that most of them had been to doctors many times for colds, often coming away with a prescription for antibiotics. 

Antibiotics treat bacterial infections, not viruses. Taking antibiotics unnecessarily can be bad for you: besides wiping out your gut flora, it increases the risk that bacteria will develop drug resistance. Perhaps if we changed the name to "antibacterials," doctors would stop prescribing them for viruses.

I found Zicam, Airborne, Umcka, and Coldcalm for sale at Walgreens and Walmart. CVS and RiteAid don’t carry Umcka (good for them!) but do sell the others.

When you get a cold, you develop immunity to it and you won’t catch it again.We keep getting colds because they're caused by more than 100 different viruses, most of them nasty little buggers that continually circulate in our population. Each time you catch a cold, you’re getting a brand new one. The only consolation is that once you’re over it, you won’t get that one again.

So if you get a cold this winter, save your money. Stay home, rest and drink plenty of fluids. And I have it on good authority that there is one treatment for the common cold that’s inexpensive, widely available, and really, really works: chicken soup.

*In response to my inquiry, Zicam's manufacturer, Matrixx Initiatives, sent me some additional information. They pointed out that subsequent studies have not supported a link between Zicam and anosmia (loss of the sense of smell), and also that they permanently discontinued Zicam intranasal gel products ("Cold Remedy Nasal Gel and Cold Remedy Gel Swabs) in 2009, "despite the absence of any credible scientific data pointing to a potential link." They also argue that "the efficacy of zinc-based formulations is primarily a function of bioavailable dose" and that "Zicam products are formulated to ensure availability of the zinc." Arguing in favor of Zicam's benefits, they pointed to several studies that I'd already read, and I remain unconvinced and, as I pointed out above, Matrixx does not have to prove efficacy to the FDA because they are selling Zicam as a homeopathic preparation, which allows them to avoid FDA regulation.

Strychnine for your child's cold - courtesy of your friendly homeopath

I was in the pharmacy section of my local grocery store last week, looking for children's ibuprofen, when I stumbled upon Children's ColdCalm, a homeopathic product from Boiron.

This stuff isn't cheap - it's $12.49 at RiteAid, and the price is similar at my local grocery stores (Giant Foods and Whole Foods). If you follow the instructions, you'll give half the package (40 pills) to your child in the first 12 hours.

Not only is it expensive, but it doesn't work - or at least there's no evidence that it does. Boiron is selling parents sugar pills and telling them that it will cure their children of colds. Here's what the package says, right on the front: "Multi-Symptom Cold Relief, Sneezing, Runny Nose, Nasal Congestion, Minor Sore Throat."

Since it's in the "Colds" section of the pharmacy, most parents probably assume this is just like any other medicine. But it's not. It's a homeopathic drug.

The manufacturer, Boiron, makes very specifc claims on their website. Here's a partial list of ColdCalm's ingredients with their claimed benefits:

Belladonna 6C HPUS * Relieves colds with a sudden onset

Eupatorium perfoliatum 3C HPUS * Relieves sinus pain

Gelsemium sempervirens 6C HPUS * Relieves headaches associated with colds

Kali bichromicum 6C HPUS * Relieves nasal discharge

Nux vomica 3C HPUS * Relieves sneezing attacks

Phytolacca decandra 6C HPUS * Relieves sore throat associated with colds

Pulsatilla 6C HPUS * Relieves colds with a loss of taste and smell

What the heck are these? Belladonna sounds familiar - oh yes, that because it's an extremely toxic plant, also called Deadly Nightshade, one of the most poisonous plants in the Western hemisphere.

And "nux vomica": that sounds suspicious. Maybe that's because it is actually strychnine! Yes, that's right, strychnine, once used as rat poison, which is fatal to adults in doses as small as 30 milligrams. I wonder how much Boiron recommends that we give to children?

According to the American Cancer Society:

"Strychnos nux-vomica has not been proven effective for the treatment of any illness. Since the seeds contain strychnine, which is poisonous to humans, conventional medical practitioners do not recommend it as a medicine. Some research has shown that the level of poison in nux vomica preparations may depend greatly on how the seeds are processed."

Need I say more? Pulsutilla, another ingredient in ColdCalm, is a poisonous plant that produces toxins that slow the heart and can cause convulsions.

Is this how they want to cure my child's cold?

But wait, these are homeopathic medicines, which means they've been diluted down to nothing. So perhaps there's so little strychnine in the pills that it won't hurt your child, at least not too much. In ColdCalm, though, the dilutions aren't as tiny as the ones used in typical homeopathic preparations: 3C is one part in 1 million, so there might be some strychnine left in these tablets. We really don't know. A huge problem here is that none of these claims have been tested, so no one (including Boiron) knows what strychnine at these dilutions does to a child. Nor can they say precisely how much strychnine is in each tablet.

You might have noticed the abbreviation HPUS in that ingredient list: this refers to the Homeopathic Pharmacopoeia, a list of homeopathic drugs. HPUS drugs cannot be regulated by the FDA. Yes, you read that right. Homeopathic drugs are approved automatically as long as the homeopaths themselves list them in their "pharmacopoeia." No evidence of efficacy is required. We have Congress to thank for this - specifically, the Food, Drug and Cosmetics Act of 1938, which granted a special exception to homeopathic drugs. The Act was authored primarily by a Senator who believed in homeopathy.

I wrote about Boiron's ridiculous Oscillococcinum flu "cure" last year, but I didn't realize they have a whole line of bogus treatments for colds and flu. And Boiron isn't some small mom-and-pop operation: it's a huge multi-national company selling nothing but homeopathic products, making huge profits selling treatments that don't work.

So parents, if you see "homeopathic" on that package in the pharmacy, you might want to look a little harder at what they're selling you.