Is there anything else I can take?
We’ve all been there – raw throat, hacking cough, sniffles, and sneezing are the telltale signs of a cold. Throw in a fever, body aches, and chills, and we’re most likely dealing with the flu. Either way, we’re miserable and just want it to go away.
Cold, flu, and respiratory virus season is in full swing, and patients often want to take something to help make their symptoms better.
Colds and flu are caused by viruses, and antibiotics won’t help. Many of my patients have already exhausted a wide array of “conservative” measures, such as over-the-counter medications and their grandmothers’ home remedies, but still find themselves looking for something else.
“Is there anything else I can take” usually is followed by “What do you think about natural herbs or supplements?”
Short answer? Yes! Supplements can be an excellent tool, as long they’re used correctly, and with the right patient.
The fine print on supplements
Before going into the specifics, there are some general things everyone should be aware of. First, the FDA does not regulate supplements as stringently as the foods you eat and the medicine you take, so it’s often hard to know what you’re getting. What does that mean? Supplement manufacturers are not required to prove the safety and effectiveness of their products before putting them on the market. The dosage on the label may not match the dose in the pill. The factory where it was produced may not follow consistent quality standards. The supplement may not have been tested for allergens or toxins, and evidence of its benefit may be lacking. Read the label and look for a standardized extract, which will ensure the supplement contains the same concentration of ingredients from batch to batch in that brand.
So, do your research and check with your doctor before you start taking anything.
A supplement primer
What is a supplement? Generally, there are a few key types of products people think of when they say “supplement.” These can range from substances that our bodies already make; substances such as vitamins and essential nutrients that our bodies really need, but we may not consume enough in our diet or can’t process correctly due to our genetic makeup; and substances like herbs, which may help or change our body chemistry in some way, such as St. John’s wort.
Even with the perfect diet, most Americans can still benefit from some form of a supplement to help keep a proper balance in the body.
Keep in mind that even if a product is naturally occurring, too much of it may not be safe. It is possible to overdose on supplements. So, it’s important to always talk to your doctor about which supplements you are starting so that you can make sure they don’t interact with other medications you’re already taking and perhaps make your condition worse.
Your supplement scorecard
Now that we’ve got that out of the way, what would be best for a patient with a cold or the flu? [A disclaimer here – this information does not in any way substitute for medical advice from your doctor; it’s meant to complement a treatment plan and hopefully start a conversation with your doctor.]
Let’s start with the adage that says, “Drink orange juice and it will make you feel better.” That’s because of vitamin C, or ascorbic acid, that can be found in the orange. Vitamin C is also found in other citrus fruit, strawberries, papayas, and green leafy vegetables like kale and broccoli, to name a few.
Vitamin C benefits are real. Ascorbic acid has been widely studied and found to lessen the duration and severity of the common cold when taken at doses of 200-250mg twice a day. Very high doses (more than 500 mg a day) of vitamin C should be avoided because of possible nausea, heartburn, and diarrhea. It’s worth noting that vitamin C has recently been in the media for its use in high-dose clinical trials in other diseases, but in those cases vitamin C benefits are still being studied.
Another common supplement I recommend is zinc, which has been proven effective in randomized trials dating back to the 1980s. Zinc is an important mineral known to boost immunity because it activates T cells, a type of white blood cell that plays an important role in our immune system (and works great in healing wounds). Most people get enough zinc in their diet (most commonly found in red meat and poultry), but supplements are recommended for patients with poor diets, or who are vegetarians or alcohol abusers. If you have digestive conditions such as Crohn’s disease, you may also be nutritionally deficient.
The zinc I like most comes in lozenge form and can be taken every 3-4 hours until symptoms are gone. It’s best to start taking it as soon as cold symptoms start, with studies showing it most effective when taken within 24 hours of the onset of symptoms. It’s a good idea to take zinc with food because of its unpleasant taste and the possibility of nausea if you take it on an empty stomach. Zinc is safe for most children to take.
Echinacea is a very popular herbal supplement for prevention of respiratory infections. Echinacea is an herb that comes from the coneflower, so avoid taking it if you are allergic to ragweed or marigold because it can make your symptoms worse. Evidence of its effectiveness is mixed, but it has been shown in some studies to improve upper respiratory infections when taken at the first onset of symptoms. Echinacea comes in a variety of forms – tablets, juice, and tea, but it can be quite bitter if taken raw. Patients with active liver/HIV/TB or autoimmune diseases should avoid it, as should anyone taking steroids or immunosuppressants. Patients who take the tablet form can take 400mg up to three times a day.
Elderberry (or Sambucus nigra) has been shown to help reduce the severity and duration of flu and flu-like illnesses. This is another excellent herbal supplement that parents and children alike can take. Be careful to never ingest this raw (most commercially available forms are all precooked), because it can cause severe gastrointestinal problems. Patients with diabetes, those taking “water pills” (diuretics), lithium, digoxin, or cancer chemo agents need to be cautious when taking elderberry. Adult patients can take 2 teaspoons (10ml) of elderberry syrup up to four times a day for 3-5 days. It also comes in a gummy form that kids love.
Finally, garlic is often cited as effective for boosting immunity, although we aren’t sure exactly how it works. Studies indicate garlic can reduce the number of days of illness. It also helps lower cholesterol, so add it to that chicken soup!
Talk before you try
Nothing will cure a cold but time. There is an effective prescription drug (Tamiflu) for flu, but it must be taken soon after the onset of symptoms (usually within the first 48 hours). The key is communication! Talk to your doctor when you are considering “trying something else,” and remember to study the label for standardized extracts.
What can you do to help prevent colds and flu? First, wash your hands often and thoroughly. Drink lots of liquids, take vitamin C, and eat a healthy diet with lots of fresh fruits and vegetables. Try to avoid becoming over-fatigued or stressed out. Get regular exercise, don’t smoke, and consider getting a flu shot. These practices won’t guarantee you don’t get sick this winter, but if you do, you’ll already be in better shape to fight off the bug.