I am sick. Meaning that the end of the world is nigh and the the air around me is filled with expelled virus and the soft moaning and whining of a man with the common cold.
I felt it coming on Wednesday evening and in the interest of being prepared and minimising loss of work time, I decided to preemptively buy some cold medicine. I picked up a box of a commonly known cold and flu medicine that happened to be on special and happily toddled home. It wasn’t until I decided to take one of the nighttime doses to insure a good night’s sleep that I noticed that I had purchased an herbal ‘First Defense’ product.
Echinacea? Vitamin C? Garlic? Where’s my decongestant? My antihistamine? My bloody painkiller? I subjected Dr. O’C to a 20 minute rant about the uselessness of ‘alternative medicines’, questionable labelling tactics and damned hippies.
But I took the useless stuff anyway, having spent hard earned money on it.
I awoke the next morning, fully expecting to be drowning in a sea of mucous and misery. But as my various peripheral sensors came into focus I realized that I didn’t feel that bad. My throat was a bit sore and I didn’t particularly want to get out of bed (of course I never want to get out of bed), but the anticipated congestion, pounding head and general illness just wasn’t there. Could the useless hippy medicine have worked?
Certainly not. I’m a scientist. I teach in a school that’s responsible for training pharmacists, nurses and other medical professionals. These natural remedies are just a way to bilk money out of hapless civilians. The textbook that we use to teach pharmacology to our second year nurses says quite clearly:
Although Echinacea is taken widely to prevent and treat colds, its efficacy is highly questionable. Recent randomised, placebo controlled trials…found it no better than placebo at reducing either the duration or severity of [cold] symptoms.
In my oh so learned opinion, the only effect the echinacea has on preventing or treating colds is a psychosomatic one.
But I did feel OK yesterday. With my attitude about Echinacea, the only psychosomatic effect that it would have would be to make me feel more ill. And I’ve known a fair few scientists who have sworn by echinacea. My former post-doc supervisor, for one; a very smart, if mentally unhinged, woman. So, I decided to be a bit open minded and have a look at the current state of research regarding the efficacy (or lack thereof) of echinacea.
Much of the peer-reviewed literature on Echinacea is either in dodgy complementary medicine journals* or focuses on in vitro experiments showing that Echinacea has little or no effect on various parts of the immune system. However, I found a couple meta-reviews evaluating echinacea’s role in prevention or treatment of the common cold, one of them in The Lancet Infectious Disease – a reasonably reputable scientific journal. The Lancet review, authored by Craig Coleman and his team at The University of Connecticut’s School of Pharmacy, waded through 738 published reports about echinacea and winnowed them down to 14 well-conducted studies that focused on Echinacea and the common cold.
What they found absolutely shocked me. Echinacea use decreased the odds of developing the common cold by 58%** and decreased the duration of the cold by one to four days. I combed through their statistical methods and they seem solid. The studies they chose to evaluate were all in proper scientific journals and undertaken by medical doctors or biomedical scientists. In most cases they were randomised, double-blind, placebo controlled clinical trials. In other words, they were the real deal. Dosage, Echinacea species and duration of treatment varied and in many cases additional supplements (Vitamin C and other herbals) were used, but in general one would have to conclude, gulp, that Echinacea works.
Not all of the studies found that Echinacea reduced the likelihood of getting a cold or the duration of the cold and those that did involved longer term, regular use of the supplement. In fact, there was a sternly worded reply to Coleman’s review questioning much of their methodology. The authors themselves point out that their may be a bias towards publication of studies with positive outcomes; journals aren’t often interested in papers that show that something doesn’t work. It is also important to note that the safety of Echinacea is still a matter of some uncertainty. There are concerns about interactions between Echinacea and other drugs as well as effects on heart rate and blood pressure. There is some evidence that long term use of Echinacea can actually suppress immune function, making the user more susceptible to the common cold and other infectious diseases.
Most importantly, I’m now sick. So I can attest that a single dose of Echinacea, taken out of spite and belligerence, does not prevent the common cold.
*I generally have a very low opinion of complementary medicine. Ironic, then, that I nearly got a moonlighting gig teaching for a local ‘College’ of Alternative Medicine a few months back. Yes, I can be bought. Reasonably cheaply. Contact me for further details.
**The second meta-analysis, compiled by Roland Schoop and colleagues, found a 55% reduction in colds in Echinacea users when compared with placebo groups.