Common Cold
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Common Cold:

Decongestants (if congested), zinc throat lozenges, echinacea, and mildly hot salt water gargle each probably help a little, although the research doesn't suggest a major benefit from any of them.  Echinacea is the least likely to be of any benefit. Vitamin C is harmless short-term and may have a slight benefit as well, especially if taken on a routine basis, i.e., before infection starts.  Yogurt or regular probiotic capsules might also help a little.  Sage, the kitchen spice, is a traditional Middle Eastern remedy with no research, but it has been found that people that eat more sage have less lung cancer.  If it helps prevent lung cancer, maybe its good for colds, too.  Hand washing and regular tissues use help reduce the spread of colds.  I try to do all of the preceding when I get a cold, but I still get them and suffer through them.  I especially like the zinc lozenges and salt water gargle.  Don't forget chicken soup.  Air ionizers might be a good idea.  An anti-viral spray has been shown of modest value, but it is still in development. Vitamin E might even help.  Throat Coat Tea helped sore throats in one study.

Decongestant nasal spray is probably a little helpful, although should be used sparingly.  I favor a single squirt of the generic 12-hour Afrin-type in the congested nostril(s), instead of the two suggested on the label.  Try not to over-use since your sinuses can become dependent on the decongestant.  Research benefit is established only for the first usage (Evid Based Nurs. 2005 Jan;8(1):12).  Don't forget chicken soup.  Unfortunately, no controlled studies are available for the time-honored remedy.  I still make it sometimes when I get a cold.

Human rhinoviruses are the leading cause of the common cold, responsible for at least 50% of all colds. Because there are over 100 rhinoviral serotypes, little immunological protection occurs from prior rhinovirus exposure.  In addition to this, a variety of other viruses also cause colds, e.g. coxsackievirus, coronavirus, Ebstein-Barr virus, and metapneumovirus.  Viral colds can cause otitis media and can aggravate asthma, chronic obstructive pulmonary disease, and sinusitis and can cause relapses in herpes infections and multiple sclerosis.

Low cost zinc gluconate lozenge combination which also contains vitamin C, echinacea, and elderberry for $7.79 for 90 lozenges are available from However, I found still cheaper ones from Optimum on the internet.  Ginseng may help prevent some colds.

Human Metapneumovirus (hMPV) 2nd after RSV: hMPV caused about 12% of lower respiratory illnesses that were characterized by wheezing, croup, or pneumonia. It also seemed to be responsible for about 15% of common colds and about one third of complicated inner ear infections. RSV appears November to March, hMPV December to April, Reinfection with hMPV does occur, but of the 3 of 49 cases of recurrence, the second occurrence was as a cold, not as a severe respiratory problem. The severity of hMPV and rhinovirus infections "are about the same, Infants seem to build up immune protection and by age three "it is hard to find coinfection. hMPV infection rates ranging from 0.9% to 2.9% in healthy and frail elderly adults during one year. But the virus accounted for 10% of hospitalizations.

Air ionisers wipe out hospital infections: New Scientist 1/3/03 British research found actinobacter infections in newborn nursery fell to zero in year with ionizers. Article says effect against influenza.

Broad-spectrum Antibiotics Heaviest by Internists, East & South: Broad-spectrum antibiotics (quinolones, amoxicillin/clavulanate, second- and third-generation cephalosporins, and azithromycin and clarithromycin) are commonly prescribed for the treatment of acute respiratory tract infections (ARTIs), especially by internists and physicians in the Northeast and South. 63% of all acute respiratory tract infections treated with these. Blacks, no insurance, and HMO patients least likely to receive. ARTIs in adults seen by physicians for the common cold and nonspecific upper respiratory tract infections (URTIs) (24%), acute sinusitis (24%), acute bronchitis (23%), otitis media (5%), pharyngitis, laryngitis, and tracheitis (11%), or more than 1 of the above diagnoses (13%). Antibiotics were prescribed to 63% of patients with an ARTI, ranging from 46% of patients with the common cold or nonspecific URTIs to 69% of patients with acute sinusitis. Broad-spectrum agents were chosen in 54% of patients prescribed an antibiotic. JAMA 2/19/03.

Vitamin C and Alcohol Abstinence: Study found alcohol abstinence, low dietary vitamin C, and especially low number of types of social ties associated with greater susceptibility to rhinovirus colds in 276 volunteers innoculated with virus. JAMA 10/15/97 278:1231-2. Vit C effective at reducing the increased susceptibility to colds after marathon runs. Int J Sports Med 3/97. 18 Suppl 1:S69-77.

Asthma: Rhinovirus Colds Often Trigger Asthma Exacerbations: In a study of asthma exacerbations in children with a panel of PCR assays for common and newly discovered respiratory viruses, respiratory viruses was associated with asthma exacerbations (63.1% in patients vs 23.4% in controls; odds ratio, 5.6). Rhinovirus was by far the most prevalent virus (60%  patients vs 18.2%  contros) and the only virus significantly associated with exacerbations (odds ratio, 6.8). However, in children without clinically manifested viral respiratory tract illness, the prevalence of rhinovirus infection was similar in case patients (29.2%) versus control subjects (23.4%, P > .05). Prevalence of viral respiratory tract infections in children with asthma. Khetsuriani N, et al. CDC. J Allergy Clin Immunol 2007 Feb;119(2):314-21.


"Airborne" Cold Remedy: No Independent or Published Research: A new, heavily promoted cold remedy with endorsements by paid Hollywood stars including Kevin Costner, is expensive yet has no independent research to support its effectiveness. Each tablet contains a combination of sodium 230 mg, vitamin A 5,000 I.U., vitamin C 1,000 mg, vitamin E 30 I.U., magnesium 40 mg, zinc 8 mg, selenium 15 mcg, manganese 3 mg, potassium 75 mg, herbal extracts (lonicera, forsythia, schizonepeta, ginger, Chinese vitex, isatis root, echinacea) 350 mg, and amino acids glutamine, and lysine (50 mg). The only study is one funded by the manufacturer and done by a company which reports only to the manufacturer.  That reportedly double-blind study claimed to find 79% improving on Airborne vs. 21% on placebo over the five day study.  Such a wonderful result makes one question the honesty of the research.  Also, one study by a research-team-for-hire is hardly enough. Vitamin C, zinc, and echinacea have all been reported in multiple studies to be of some marginal value. At 70 cents per tablet, the treatment (6-7 tablets per day) costs about $25 per cold.

Andrographis paniculata No Help: It has been widely used for the prevention and treatment of common cold especially in Asia and Scandinavia. It is readily available on the internet for prices in the range of $12 for 120 tablets. Ed: The are dozens of herbal remedies, but few have favorable research evidence. In a review by Carr RR, et al. of Ohio State University, researchers found six clinical trials examining the use of herbal medicines and nine trials of other CAM therapies. Echinacea did not reduce the duration and severity of URTI. Andrographis paniculata or echinacea decreased nasal secretions (p < 0.01) but not URTI symptoms. A combination of echinacea, propolis, and ascorbic acid decreased the number of URTI episodes, the duration of symptoms, and the number of days of illness (p < 0.001). Echinacea was associated with a higher frequency of rash compared with placebo (p = 0.008). Neither ascorbic acid nor homeopathy was effective. The efficacy of zinc was not clear, and zinc may be associated with adverse effects in children. Osteopathic manipulation decreased episodes of acute otitis media (p = 0.04) and the need for tympanostomy tube insertion (p = 0.03) in children with recurrent acute otitis media. Am J Health Syst Pharm 2006 Jan 1;63(1):33-9.

Antibiotics No Benefit for Colored Nasal Discharge with Runny Nose: A meta-analysis of data from 7 double blind randomized placebo controlled trials comparing antibiotics with placebo for acute purulent rhinitis (duration less than 10 days of watery colored discharge during a cold) found the risk of benefit for persistent purulent rhinitis at five to eight days with antibiotics was minimal, i.e., 1.18 (95% confidence interval 1.05 to 1.33). The numbers needed to treat ranged from 7 to 15 when the pooled relative risk was applied to the range of control event rates. The relative risk for adverse effects with antibiotics was 1.46 (1.10 to 1.94). The numbers needed to harm for adverse effects ranged from 12 to 78. Antibiotics are probably effective for acute purulent rhinitis. They can cause harm, usually in the form of gastrointestinal effects. Most patients will get better without antibiotics, supporting the current "no antibiotic as first line" advice. Are antibiotics effective for acute purulent rhinitis? Systematic review and meta-analysis of placebo controlled randomised trials. Arroll B, et al. University of Auckland. . BMJ 2006 Aug 5;333(7562):279.

Baptisiae-Thujae-Echinacea Might Help: In a manufacturer's DB PC study of 91 adults with common colds using an extract of a mixture of Baptisiae tinctoriae radix, Echinaceae pallidae/purpureae radix and Thujae, occidentalis herba (SB-TOX), 19.2 mg of SB-TOX three times daily for 3-12 days reduced time to relevant improvement in cold symptoms (measured as the time until less than 30 tissues per day were used) from 1.1 days for placebo to 0.52 days (p = 0.0175). No adverse events were reported. A randomized, double-blind, placebo-controlled, clinical dose-response trial of an extract of Baptisia, Echinacea and Thuja for the treatment of patients with common cold. Naser B, et al. Salzgitter, Germany. . Phytomed 2005 Nov;12(10):715-22.

Cold-fX Claimed Helpful in Tiny Study: COLD-fX is a proprietary extract of the roots of North American ginseng. In a very small DB PC study, almost certainly funded by the manufacturer, 2 capsules/day COLD-fX (200 mg/ capsule) for 4 months were given to 23 adults 65 or older with 22 more receiving placebo. There was no difference in acute respiratory symptoms during the first 2 months. During the last 2 months fewer subjects in the COLD-fX group 32% reported ARI compared to the placebo group 62%. Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. McElhaney JE, et al. University of Connecticut, Farmington, CT. J Altern Comp Med 2006 Mar;12(2):153-7. Ed: In the very low quality study, the researchers simply discarded the results of the first two months post hoc and make claims vastly inflated compared to the findings of the study.  The Canadian corporation sponsoring the study is notorious for such reports.

Cooling of Feet Caused 9% Increase in Colds: There is a common folklore that chilling of the body surface causes the development of common cold symptoms, but previous clinical research has failed to demonstrate any effect of cold exposure on susceptibility to infection with common cold viruses. 180 healthy adults were randomized to receive either a foot chill or control procedure. 13/90 who were chilled reported they were suffering from a cold in the 4/5 days after the procedure vs. 5/90 controls (P=0.047). Those who reported that they developed a cold (n=18) reported that they suffered from significantly more colds each year (P=0.007) compared to those subjects who did not develop a cold (n=162). Acute cooling of the feet and the onset of common cold symptoms. Johnson C, et al. Cardiff University, UK. Fam Pract 2005 Dec;22(6):608-13.

Diphenhydramine (Benadryl), Dextromethorphan Don't Help Child URI Cough: In a DB PC study of 100 children with acute URIs and troublesome nighttime cough, neither medication did any better than controls. Pediatrics. 2004;114:e85-e90 

Decongestants Alpha Adrenergic Help: Both oral and nasal forms have proven effective in natural and experimental cold models. Prolonged use can lead to a rebound effect. Antihistamines also help decrease symptoms. Intranasal ipratropium bromide spray, an anticholinergic, also helps reduce drainage and sneezing with two sprays three to four times daily. Side effects include nasal dryness, occasional nosebleeds, and headache. Interferon alfa-2b helps only if take before symptoms develop. Zinc might help. Mast cell stabilisers are being researched. Cold treatments are overused. Steam inhalation doesn’t help. Guaifenesin marginal antitussive effect but decreases sputum thickness and quantity. Sherif Mossad, Cleveld Clinic, BMJ 7/4/98, 317:33-6.

Echinacea No Help in Adult Stuy: In a 14-day DB PC study of 128 adults beginning treatment within 24 hours of developing symptoms of a common cold, echinacea three times a day was of no benefit in reducing symptoms. Any beneficial trends were very slight. Echinacea purpurea therapy for the treatment of the common cold: a randomized, double-blind, placebo-controlled clinical trial. Yale SH, Liu K. Marshfield Clinic. Arch Intern Med. 2004 Jun 14;164(11):1237-41.

Echinacea Possible Small Benefit in Adult Study: In a DB PC study of 48 adults medically infected with rhinovirus type 39 (RV-39), echinacea, 2.5 mL 3 times per day, for 7 days before and 7 days after intranasal inoculation found 92% of echinacea recipients infected vs. 95% of placebo. Colds developed in 58% of echinacea recipients vs. 82% of placebo (P=.114). Echinacea purpurea for prevention of experimental rhinovirus colds. Sperber SJ, Shah LP, et al. Hackensack University. Clin Infect Dis. 2004 May 15;38(10):1367-71.

Echinacea No Help to Children with Colds: In a large DB PC study of 407 children and 707 colds, Univ. of Washington researchers found no benefit from echinacea but an increase in rashes in the echinacea group. Children started echinacea as soon as they had two cold symptoms. Over 80% of children had at least one cold over the 4 months of the study and the average duration was 9 days. There was a very slight trend for the placebo to do better. Efficacy and safety of echinacea in treating upper respiratory tract infections in children: a randomized controlled trial. Taylor JA, Weber W, Standish L, Quinn H, Goesling J, McGann M, Calabrese C. JAMA. 2003 Dec 3;290(21):2824-30

Echinacea Herbal Remedy Helped Respiratory Infections in Kids: An herbal preparation of 50 mg/mL of echinacea, 50 mg/mL of propolis, and 10 mg/mL of vitamin C was used in the DB PC study of 430 children. Of the 328 who did not drop out in the first week, twice-daily doses of 5.0 mL (age, 1-3 years), or 7.5 mL (age, 4-5 years) were used. Doses were given four times daily during episodes of acute illness. The herbal-preparation group showed a significant decrease in the number of illness episodes (138 vs. 308; 55% reduction). The total number of illness days was lower with the herbal-preparation: 2.6 days vs. 6.2 das; P < .001, as was mean duration of individual episodes (1.6 days vs. 2.9 days; P < .001). Herman A. Cohen, Petach Tikva, Israel, Arch Pediatr Adolesc Med. 2004;158:217-221, 222-224

Echinacea No Benefit: DB PC 148 U Wisc. Started Echinacea 1st day of cold six times then tid for up to nine more days. Actually, placebo did non-significantly better. Ann Intern Med 2002 Dec 17;137(12):939-46

Echinacea Helps in DB: Cologne 880 adults DB PC 6.0 vs 9.0 days to symptom resolution. Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial. Schulten B, Bulitta M, Ballering-Bruhl B, Koster U, Schafer M. Arzneimittelforschung. 2001;51(7):563-8

Echinacea Tea Helped in DB: 95 students 90 days study 5-6 cups per day for up to five days at first symptoms of a cold or flu. p<.001 favoring rx. DB PC. The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebo-controlled study. Lindenmuth GF, Lindenmuth EB J Altern Complement Med. 2000 Aug;6(4):327-34; The purple coneflower has been used as an herbal medicine for centuries, customarily as a treatment for the common cold, coughs, bronchitis, upper respiratory infections, and some inflammatory conditions.

Echinacea Only Trend in Favor in DB: MUSC study with rhinovirus 23 inoculated in DB PC study into over 100 healthy college students who had taken echinacea 300 tid or placebo for 14 days as preventative. No significant difference tho mild trends favoring echinacea: Infection occurred in 44 and 57% and illness occurred in 36 and 43% of the echinacea- and placebo-treated. Similar trend favoring echinacea in intensity of symptoms. Antimicrob Agents Chemother. 2000 Jun;44(6):1708-9

Echinacea Review Says Unclear if Works: Twelve clinical studies published from 1961-1997 concluded that echinacea was efficacious for treating the common cold, but the results are unclear due to inherent flaws in study design. Five trials were published since 1997; two showed that echinacea lacked efficacy for treating and preventing URTI symptoms, and three concluded that it was effective in reducing the frequency, duration, and severity of common cold symptoms.  Pharmacotherapy. 2000 Jun;20(6):690-7

Echinacea Review Favors Treatment: German review found 8 prevention and 8 treatment studies with common cold. Echinacea for preventing and treating the common cold. Melchart D, Linde K, Fischer P, Kaesmayr J. Cochrane Database Syst Rev. 2000;(2):CD000530. Says majority of studies find significant benefit.

Echinacea No Benefit: DB PC 109 pt with frequent colds took 4 ml bid 8 weeks. Am J Med. 1999 Feb;106(2):138-43

Echinacea Brand Said Better than Others in DB: Phytomedicine. 1999 Mar;6(1):1-6. Sweden. Probably funded by manufacturer of Echinaforce. No data in abstract.

Exercisers Got Fewer Colds: In a study of 115 overweight and obese, sedentary, postmenopausal women, those assigned to 45 minutes of moderate-intensity exercise 5 days per week for 12 months had fewer colds than those assigned to once-weekly, 45-minute stretching sessions (P = .02). Risk of upper respiratory tract infections overall did not differ (P = .16), yet may have been biased by differential proportions of influenza vaccinations in the intervention and control groups. Moderate-intensity exercise reduces the incidence of colds among postmenopausal women. Chubak J, et al. Fred Hutchinson Cancer Research Center, Seattle, Wash. Am J Medicine 2006 Nov;119(11):937-42.

Gargling Machine TID Helps Prevent: Workers in foundry assigned to use gargling machine tid for 3 months and who did use it had fewer colds than those assigned to control group. A questionnaire survey to evaluate the efficiency of gargling. Yasuhara T, Itoh K. Sangyo Eiseigaku Zasshi 1996 Sep;38(5):217-22; Also: Nose rinsing, gargling and steam baths. Ned Tijdschr Geneeskd. 1974 Aug 10;118(32):1227-9. Dutch. No abstract available. No other studies on gargling on PubMed 12/27/02

Gargling: Nasal Sinus Spray Some Benefit: In a randomized study of 200 adults with acute viral rhinosinusitis, those who used an atomized nasal douche did better than patients using nasal lavages with isotonic sodium chloride solution. Treatments were 4 times per day for 15 days. Only atomized nasal douches were able to normalize mucociliary transport time to a physiological level (P<.001). Authors suggest the use of the compressor-micronizer chamber system (Rinoflow Nasal Wash & Sinus System) as a routine adjuvant to every treatment of acute rhinopathies. Atomized nasal douche vs nasal lavage in acute viral rhinitis. Passali D, et al. University of Siena, Italy. . Arch Otolaryng Head Neck Surg 2005 Sep;131(9):788-90.

Garlic Claimed to Help Prevent in DB: 63% decrease in colds with garlic supplement over 90 days in winter in DB PC study of 146 in East Sussex. Days sick from colds decreased 70% from 5.01 vs 1.52 days per person because of faster recovery in garlic group. Peter Josling, Garlic Center (sic=Same as Herbal Health Center below), 10/3/01, Adv Ther 2001 Jul-Aug;18(4):189-93 (Herbal and vitamin remedies seem to do much better in studies done by or funded by herbal manufacturers.)

Ginseng Appeared to Help: In what appears to be a manufacturer's DB PC study (and therefore quite unreliable), 323 adults with a history of at least 2 colds in the previous year took 2 capsules of North American ginseng extract or a placebo for a period of 4 months. The mean number of colds per person was lower for ginseng (0.68 v. 0.93). The proportion of subjects with 2 or more Jackson-verified colds during the 4-month period (10.0% v. 22.8%) was significantly lower, as were the total symptom score (77.5 v. 112.3) and the total number of days cold symptoms were reported (10.8 v. 16.5 days) for all colds. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. Predy GN, et al. Capital Health, Edmonton, Alta. CMAJ 2005 Oct 25;173(9):1043-8. Ed: Canadian herbal funded studies have a very poor track record.  Some of these companies are on the stock exchange.  

Ginsana Ginseng Claimed Effective Preventing Colds in DB: Italian DB PC in three doctor offices of 227 patients for 12 weeks with number of colds measured weeks 4-12 with a 65% decrease. Drugs Exp Clin Res. 1996;22(2):65-72

Heated, humidified air for the common cold.

Singh M.

Post Graduate Institute of Medical Education and Research, Pediatrics, Advanced Pediatrics Centre, Sector 12, Chandigarh, India 160012. [email protected]

BACKGROUND: Heated, humidified air has long been used by common cold sufferers. The theoretical basis is that steam may help congested mucus drain better and heat may destroy cold virus as it does in vitro. OBJECTIVES: To assess the effects of inhaling heated water vapour (steam), in the treatment of the common cold by comparing symptoms, viral shedding and nasal resistance. SEARCH STRATEGY: In this updated review we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library issue 4, 2005); MEDLINE (2003 to December Week 2 2005); EMBASE (July 2003 to September 2005); and Current Contents (current five years). SELECTION CRITERIA: Randomized controlled trials (RCTs) using heated water vapor in patients with the common cold or volunteers with experimentally induced common cold. DATA COLLECTION AND ANALYSIS: All the articles retrieved were initially subjected to a review for inclusion or exclusion criteria. Review articles, editorials and abstracts with inadequate outcome descriptions were excluded. Studies selected for inclusion were subjected to a methodological assessment. MAIN RESULTS: Six trials were included. Three found benefits of steam for symptom relief with the common cold (odds ratio (OR) 95% confidence interval (CI) 0.31; 0.16 to 0.60; relative risk (RR) 0.56; 95% CI 0.4 to 0.79). Results on symptom indices were equivocal. No studies demonstrated an exacerbation of clinical symptom scores. One USA study demonstrated worsened nasal resistance, while an earlier Israeli one showed improvement. One study examined viral shedding and antibody titres in nasal washings: there was no change of either between treatment and placebo groups. Minor side effects (including discomfort or irritation of the nose) were reported in some studies. AUTHORS' CONCLUSIONS: Steam inhalation are not recommended in the routine treatment of common cold symptoms until more double-blind RCT trials are conducted. Cochrane Database 2006 Jul 19;3:CD001728.

Hochu-ekki-to Japanese Herbal Cold Medicine Inhibits rhinovirus infection in human tracheal epithelial cells. Yamaya M, et al. Tohoku University, Sendai, Japan. British Journal of Pharmacology, 19 February 2007.

Interferon Combo 33-73% Benefit : Virus damage to the nasal lining is minimal, and the symptoms of a cold are due to the body's inflammatory response to the infection, histamine causes sneezing, kinin causes sore throat, headache due to interleukin. U. Va. Interferon Q12Hr x 3 doses with chlorpheniramine and ibuprofen. DB 150 volunteers. J Infectious Disease 7/8/02

Saline Nasal Spray Helped: In a 20-week crossover study of 108 healthy military conscripts, during the 10 weeks of using a daily normal saline nasal spray, the soldiers had 42% fewer days with nasal secretions or blocked noses (6.4 vs. 11) and 30% fewer colds (0.7 vs. 1.0). A daily nasal spray with saline prevents symptoms of rhinitis. Tano L, Tano K. Boden, Sweden. Acta Otolaryngol. 2004 Nov;124(9):1059-62.

Pelargonium Sidiodes Helped Bacterial Sore Throat in One DB: A Kiev DB PC study of 143 children with non-A strep throats found 20 drops tid of Pelargonium extract EPs 7630 from the roots of a South African geranium plant decreased symptoms better than placebo (-7.0 vs. -5.1 symptoms points) and shortened duration by two days according to researchers. Efficacy of extract of Pelargonium sidoides in children with acute non-group A beta-hemolytic streptococcus tonsillopharyngitis: a randomized, double-blind, placebo-controlled trial. Bereznoy VV, Riley DS, Wassmer G, Heger M. Altern Ther Health Med. 2003 Sep-Oct;9(5):68-79. Ed: Nature's Way is promoting Pelargonium to treat viral upper respiratory infections (colds) but both published studies are on bacterial infections. I did see a lab study showing Pelargonium has some effectiveness against Aspergillus fungus, but no research on the issue of anti-viral efficacy. Nature's Way refers to an unpublished study in which it says acute throat pain was relieved two days sooner in children. A 4 oz. bottle costs $13 from one source.

Pelargonium Helped Bronchitis in DB: A German DB PC study of 468 patients with acute bronchitis given 30 days of EPs 7630 Pelargonium extract tid for seven days found Bronchitis Severity Scores decreased by 5.9 vs. 3.2 with placebo. Of the placebo group, 43% were still unable to work vs. 16% of Pelargonium group. Work disability shortened by two days. Side-effects were non-significantly higher with Pelargonium. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis. A randomised, double-blind, placebo-controlled trial. Matthys H, Eisebitt R, Seith B, Heger M. Phytomedicine. 2003;10 Suppl 4:7-17

Phenylpropanolamine in cold remedies Increases Risk of hemorrhagic stroke: PPA exposure significantly increased the risk, and the risk was much higher in women. In women, linear trends were also found in recency, duration, and dosage of PPA exposure. Yoon BW, et al. Seoul National University, Korea. . Neurology 2007 Jan 9;68(2):146-9. Ed: This was removed from stores by the FDA in 2005.

Probiotic-Multivitamin-Mineral Supplement Slight Benefit Against Common Cold: In a 3-5 month DB PC study of 477 healthy adults, those assigned to take daily the probiotic multivitamin and mineral supplement had 13.6% fewer viral respiratory tract infections (p = 0.07), a relative reduction of 19% in the total symptom score (p = 0.12), 25% in influenza symptoms (p = 0.09), and 54% in the number of days with fever (p = 0.03). The duration of infections was not affected. Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Winkler P, et al. Federal Research Center for Nutrition and Food, Kiel, Germany. Int J Clin Pharmacol Ther. 2005 Jul;43(7):318-26. 

Ruprintrivir Spray Helps in DB: 202 healthy adults were infected with rhinovirus and placed in two DB PC studies of a new anti-viral nasal spray, receiving 2 or 5 sprays per day for 5 days. Ruprintrivirus selectively inhibits Human Rhinovirus 3C protease.  The duration of the cold was decreased from 3.3 days to 2.2 days. The 5 a day treatment worked a little better. Univ. Virginia. Phase II, randomized, double-blind, placebo-controlled studies of ruprintrivir nasal spray 2-percent suspension for prevention and treatment of experimentally induced rhinovirus colds in healthy volunteers. Hayden FG, Turner RB, Gwaltney JM, Chi-Burris K, Gersten M, Hsyu P, Patick AK, Smith GJ 3rd, Zalman LS. Antimicrob Agents Chemother. 2003 Dec;47(12):3907-16

Sage Tea, Leaf Traditional Remedy for Colds: Promoted by various herbal websites, as a natural antibiotic, sore throats, flu symptoms, stimulate hormone production, menopausal symptoms, reducing hot flushes, produce natural estrogen, combat mouth ulcers, reducing breast milk, relieve muscles spasms. Traditional use seems especially colds. No research. Of course, herbal websites mention dozens of different herbs as being good for colds.

Sage: Pharnyngitis Helped in Imperfect Study: In a manufacturer's 3-day DB PC phase II/III study 0f 286 patients with viral sore throats, a spray containing a Salvia officinalis fluid extract 15 % spray containing 140 microl sage extract per dose was superior to placebo for reduction of the throat pain intensity score but 5% and 30% sprays were not.  The results do not appear convincing and only the results for the first two hours were mentioned in the abstract. Efficacy and tolerability of a spray with salvia officinalis in the treatment of acute pharyngitis - a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Hubbert M, et al. Sidroga GmbH, Bad Sackingen, Germany. . Eur K Med Res 2006 Jan 31;11(1):20-6. 

Sesame Oil Slight Benefit for Cough: In a DB PC study of 107 children ( ages 2-12) with cough secondary to common cold, 5 ml (1 teaspoon) of sesame oil by mouth at bed time at day 1, the effect size for cough frequency and cough strength were +0.26 (95%CI -0.64,+0.12) and +0.15 (95%CI -0.53, +0.23), respectively. SO decreased cough symptoms more than placebo but these were not statistically significant. The effect size decreased from days 1 to 3. Sesame oil use in ameliorating cough in children: a randomised controlled trial. Saab BR, et al. American University of Beirut. . Complem Ther Med 2006 Jun;14(2):92-9.

Schefflera heptaphylla Chinese Cold Tea Has Antiviral triterpenoids: Li Y, et al. Jinan University, Guangzhou, China. Schefflera heptaphylla (L.) Frodin is a principal ingredient of an herbal tea formulation widely used for the treatment of common cold in southern China.  Phytother Res 2007 Mar 14. Ed: There are at least 14 studies of 12 different Chinese traditional herbs for the common cold. None of the evidence is good enough to recommend any treatment. Cochrane Database Syst Rev 2007 Jan 24;(1):CD001953.

Throat Coat Tea Some Benefit for Pain: In a manufacturer's DB PC study of just 60 adults, 5-8 oz of Throat Coat tea four to six times daily for 2 to 7 days reduced the intensity of throat pain when swallowing at 5 min (p = 0.007), 10 min (p = 0.005), 15 minutes (p = 0.01), 20 minutes (p = 0.05), and 30 minutes (p = 0.04) after completion of the first dose. Throat Coat was significantly superior to placebo and provided a rapid, temporary relief of sore throat pain in patients with pharyngitis.

Vitamin C 500 mg Helped Prevent But Not Treat Common Cold: In a 5-year DB PC study of 305 Japanese adults with atrophic gastritis, the number of common colds (per 1000 person-months) was 21.3 for vitamin C 50 mg/d vs. 17.1 for vitamin C 500 mg/d. After adjustment for several factors, the relative risks was 0.34 for the high-dose group. No apparent reduction was seen for the severity and duration of the common cold. Effect of vitamin C on common cold: randomized controlled trial. Sasazuki S, et al. National Cancer Center, Tokyo, Japan. European Journal of Clinical Nutrition 24 August 2005. 

Vitamin C: Only Prophylaxis Mildly Helpful in Meta-Analysis: In a review of all studies to date, only the 23 studies of participants taking vitamin C routinely before infection showed no benefit at preventing the colds, but a 8% (adult)-14% (children) decrease in the duration of the colds. Vitamin C for preventing and treating the common cold. Douglas RM, et al. Australian National University, Canberra. PLoS Med. 2005 Jun;2(6):e168 (free access).

Vitamin C Not Very Helpful: Analysis of six largest studies with high dose (1 g or more) found no benefit. Subgroup of British male school children showed mild benefit in four studies. Br J Nutr 11/97, 78:859-61

Vitamin C Said to Help 23% in Meta-Analysis: A review suggests vitamin C decreases the duration and severity by an average of 23%. Best done thought at least 1 g/day. Hemila, Scand J Infect Dis 26:1-6, ’94

Vitamin C Claimed to Help Prevent in DB: Vitamin C twice a day to 168 volunteers for 60 days from November to February found a 26% decrease in colds and 52% decrease "virally challenged" days. The author claims his vitamin C preparation much preferred by participants over previous vitamin C preparations they had tried (sic). P Josling, Herbal Health Center, Adv Ther 2002 May-Jun;19(3):151-9

Vitamin C No Value During Cold: DB PC 400 adults starting Vit C 1 g/d or 3 g/d, or 3 g/d plus supplement, or placebo. 149 got 184 colds. No differences, although the placebo was non-significantly better! Med J Aust 2001 Oct 1;175(7):359-62

Vitamin E Minor Benefit for Colds in Elderly: In a 1-year DB PC study of 617 elderly, vitamin E 200 IU/day had no significant effect on incidence or number of days with infection for all, upper, or lower respiratory tract infections. However, slightly fewer acquired 1 or more respiratory tract infections (60% vs 68%; risk ratio [RR], 0.88; and 65% vs 74%; RR, 0.88), or upper respiratory tract infections (44% vs 52%; RR, 0.84; and 50% vs 62%; RR, 0.81). When common colds were analyzed in a post hoc subgroup analysis, the vitamin E group had a lower incidence of common cold (0.67 vs 0.81 per person-year; RR, 0.83). Vitamin E had no significant effect on antibiotic use. Vitamin E and respiratory tract infections in elderly nursing home residents: a randomized controlled trial. Meydani SN, Leka LS, Fine BC, Dallal GE, Keusch GT, Singh MF, Hamer DH. Tufts University. JAMA. 2004 Aug 18;292(7):828-36. Ed: These are very minimal benefits at best.

Vitamins: Multivit-Mineral, Vit E 200, Not Help URIs: 652 patient DB PC 441 days average >60yos Netherlands. 68% got average 2.5 URIs. Multivit RR 0.95, Vit E RR 1.21. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial. Graat JM, Schouten EG, Kok FJ. JAMA 2002 Aug 14;288(6):715-21

Vitamins: Multivits Cut Sick Days, Colds, Infections But Studies Questioned: Three studies by Ranjit Chandra of Memorial Univ in Newfoundland involving 900 adults over 50 found half as many sick days, half as many days with colds or flu (11 vs 24/yr), and 14% fewer infections. Nutr Action 3/02. Lancet 340:1124 ’92; Nutr Research 22:5 ’02; Am J Clin Nutr 60:437 ’94. A 1994. These studies have been questioned as to the honesty of the data.

Yogurt Shortened Colds by 22%: In a DB PC study of 479 adults during two winter/spring periods (3 and 5 month) supplemented daily with vitamins plus minerals with or without probiotic lactobacilli and bifidobacteria, the intake of the probiotic had no effect on the incidence of common cold infections, but significantly shortened duration of episodes by almost 2 days (7.0 vs. 8.9 days, p=0.045), reduced the severity of symptoms and led to larger increases in cytotoxic T plus T suppressor cell counts and in T helper cell counts. Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial. de Vrese M, et al. Federal Research Centre of Nutrition and Food, Kiel, Germany. Vaccine 2006 Jun 6.

Yogurt: Upper Respiratory Infections: Lactobacillus Milk Decreases Upper Respiratory Infections in Children: In a Finnish study of 571 children, they were given either normal milk or milk with an added strain of Lactobacillus - a type of bacteria which can be found naturally in the gut. Children drank at least 200 ml of their milk every day. Children given Lactobacillus had on average a day less absence from day care. There was also a 17% reduction in those suffering more serious respiratory tract infections and were prescribed fewer antibiotics. There was no difference in allergic or abdominal pain symptoms. Brit Med J 6/2/01

Yogurt: Winter Infections in Elderly Reduced 20%: In a randomized study of 360 elderly with half given live-culture yogurt for 3 weeks found no difference in the number of infections, but a 20% decrease in the number of sick days (7.0 vs. 8.7). Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study. Turchet P, Laurenzano M, Auboiron S, Antoine JM. J Nutr Health Aging. 2003;7(2):75-7. 

Probiotic (Yogurt Type) Bacteria Reduced Cold Symptoms by Over 20%: In a 3-month DB PC study of 479 healthy adults during winter/spring months, that receiving Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 (5x10(7)cfu/tablet) had a lower total symptom score, the duration of common cold episodes, and days with fever: 79.3 vs. 102.5 points (P=0.056), 7.0 vs. 8.9 days (P=0.045), 0.24 vs. 1.0 days (P=0.017). The intake of probiotic bacteria during at least 3 months significantly shortened common cold episodes by almost 2 days and reduced the severity of symptoms. Effect of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 on common cold episodes: A double blind, randomized, controlled trial. de Vrese M, et al. Federal Research Centre of Nutrition and Food,  Kiel, Germany. Clin Nutr. 2005 Aug;24(4):481-491

Zinc Orally Helped: In a 7-month DB PC study of 200 healthy children, oral zinc sulphate (15 mg of zinc) daily with the dose was increased to two times per day (30 mg of zinc) at the onset of cold, until symptoms resolved resulted in fewer colds than placebo (1.2 vs 1.7 colds per child; p=0.003). The mean cold-related school absence was 0.9 d per child in the zinc group versus 1.3 d in the placebo group (p=0.04). The zinc group had shorter mean duration of cold symptoms and decreased total severity scores for cold symptoms (p<0.0001). Adverse effects were mild and similar in both groups. The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children. Kurugol Z, et al. Ege University, Izmir, Turkey. . Acta Pediatric 2006 Oct;95(10):1175-81.

Zinc Lozenges Helps Colds Review Says: 7 DB studies of treatment starting within 24-48 hours and sucking a lozenge every 2 hours while awake with at least 13.3 mg zinc/lozenge. Some bad taste and nausea. Can Fam Physician 5/98, 44:1037-42

Zinc Lozenges Review Says Maybe: 8 DB studies, 4 found effective. Benefit appears maximal if started immediately. Citric acid or tartaric acid may reduce efficacy due to chelation. Studies are with zinc gluconate. Ann Pharmacother 1/98, 32:63-9

Zinc: Review Says Depends on the Zinc Lozenges: Says lozenges that released Zn++ ions shorten colds but ones that released negatively charged zinc species at physiologic pH lengthened colds. Claims high zinc ion availability zinc acetate lozenges beneficial. J Antimicrob Chemother 10/97, 40:483-93.

Zinc Review Says No Clear Benefit: 2 of the 8 DB studies eliminated due to inoculation design. No evidence from analysis of six remaining that reduce duration. Arch Int Med 11/10/97

Zinc Lozenges No Benefit: Study of 249 school children treated with 10 mg lozenges 5-6 times per day within 24 hours of cold. Placebo did just as well. Zinc caused bad taste, nausea, mouth discomfort, and diarrhea. JAMA 6/98 279:1999-2000.

Zinc: Destroys Sense of Smell If Squirted Into Nose: Commercial preparations of intranasal zinc gluconate gel are marketed as a remedy for the common cold. Seventeen patients presenting with anosmia after the use of intranasal zinc gluconate are described. Intranasal zinc and anosmia: the zinc-induced anosmia syndrome. Alexander TH, et al.  University of California, San Diego. Laryngoscope 2006 Feb;116(2):217-20.

Thomas E. Radecki, M.D., J.D.