Combating Colds

Everyone swears by a different remedy -- chicken soup, a miracle drug, megadoses of vitamins -- but what really works?

The bane of travelers and an unwelcome winter guest, the common cold is one of medicine's ubiquitous yet elusive targets. The National Institutes of Health estimate that there may be as many as one billion cases of the cold in the U.S. each year -- two to four for the average adult. And the billions of dollars we spend on tablets, sprays, lozenges, syrups and other nostrums mostly just keep symptoms at bay.

Unwilling to pull up the covers and surrender, we went in search of the best available battle plan against colds. It's a difficult problem. Unfortunately, a single protective cold shot (akin to an annual flu shot) that fights all of the 200 cold-causing viruses is virtually impossible to formulate.

Antibiotics are useless against viral maladies. The picture gets even more complex on the prevention and naturopathic fronts. Rigorous studies show only equivocal benefits from such common remedies as vitamin C or zinc, although there is abundant anecdotal evidence that indicates otherwise. For some people, "home remedies do seem to work," says Cristina Cassetti, a program officer for influenza and related respiratory viruses at the NIH. The brightest proven advance in recent years is the zinc gel spray Zicam, which ear, nose and throat specialists themselves widely use. It doesn't cure a cold, but clinical trials have shown that Zicam can reduce a cold's symptoms and shorten its duration.

Prevention

Let's start with prevention. Mainstream and alternative medicine experts agree: The single best, proven way to ward off colds is to wash your hands frequently, especially after interacting with other people or spending time in crowded places. In addition, doctors say it's usually fine to experiment with some of the common home preventives. The difficult part is that dosages and preparations vary so widely that it's hard to find a consensus on exactly what to take and when. However, even if vitamins and supplements don't work, they are not likely to harm you in common doses (say, 1,000 mg of vitamin C daily or about 13 mg of zinc every two hours or 15 to 20 drops of tincture of echinacea 2 to 5 times a day). Dr. Betty McElroy, the medical director of the Heritage Center School, a residential school in Provo, Utah, says colds nearly disappeared there after she started giving the kids one fruit-flavored Cold-Eeze lozenge, containing 13.3 mg of zinc gluconate glycine, per day (with parents' blessings), increasing to four per day at the first sign of cold symptoms. "I was impressed," McElroy says.

Immune-Boosting Strategies

Other immune-boosting strategies include combinations of herbs and vitamins, such as the Quantum Cold & Flu Formula elixir (available in health-food stores) or the fizzy Airborne tablet (800-590-9794). Internist Shari Midoneck, an associate professor of clinical medicine at the Weill Medical College of Cornell University, and her husband, Mark Pochapin, a gastroenterologist, believe that the dietary supplement Culturelle (culturelle.com) -- a probiotic containing Lactobacillus GG, which replenishes healthy bacteria in the colon -- is a good immune stimulant that routinely nips their own colds in the bud. In fact, they're currently conducting their own study on it.

Dr. Andrea Darby-Stewart, a physician in the department of family medicine at the Mayo Clinic in Scottsdale, Arizona, advises her patients to take only name-brand naturopathic preparations by reputable manufacturers, like Centrum. She also cautions that echinacea can interfere with some blood-pressure medications, and vitamin C can worsen kidney stones. Consult with your doctor before taking any dietary supplements.

Aside from using Zicam, the primary advice for treating a cold remains bed rest and plenty of fluids. Remember this the next time you're tempted to tough it out and go to the office: You may end up missing more work when your simple cold turns into sinusitis or bronchitis. (Besides, your colleagues don't want your germs.) Antihistamines provide relief from runny noses and sneezing but dry out mucus membranes and cause drowsiness. Decongestants are better because they clear congested areas. The ancient chicken-soup remedy does, in fact, appear to inhibit inflammatory-cell migration to the nose and head, thus making you feel better. Don't forget that if you believe you're taking something that will help, it very well might (the placebo effect). And you can never overestimate the dollop of love served with chicken soup, says Cassetti, because "psychological factors can have dramatic effects on outcomes."

* Excerpted from the January 2004 issue of Town and Country.