- The Washington Times - Sunday, December 3, 2000

A good portion of the cold-remedies aisle has been given over to alternative treatments gone mainstream, such as echinacea and zinc.

As with more traditional over-the-counter medications, evidence that these products help reduce the duration of colds or lessen symptoms is mostly subjective, says Linda Lambert, cold and flu program director at the National Institute of Allergy and Infectious Disease.

"The [effectiveness] of the majority of alternative remedies is anecdotal," she says. "They may work for some and not for others. We need to do additional clinical studies."

Echinacea is a medicinal plant used by American Indians that is thought to stimulate the immune system and prevent upper-respiratory infections. Marketers of the herb suggest taking it at the first sign of a cold to help lessen symptoms.

Ruth Kava, director of nutrition for the American Council on Science and Health, a science-based consumer advocacy group, agrees that herbal remedies have been used for thousands of years. However, she is concerned about their interaction with today's prescriptions.

Echinacea, she points out, should not be taken in conjunction with anything that is taxing to the liver, such as anabolic steroids or metho-trexate, a common cancer drug.

"We are in a situation where our population is getting older and is using a myriad of drugs," Ms. Kava says. "That ups the chances of interactions if [they are] taking any herbal remedies. People need to talk to their physicians and pharmacists about what they are taking."

Zinc lozenges became a popular cold remedy after the Cleveland Clinic published research four years ago that stated zinc could help reduce cold effects by 42 percent.

In a study of 100 people who had had cold symptoms for less than 24 hours, half took Cold-Eeze brand lozenges every two hours, and half took a placebo. The zinc users reported cold symptoms lasting an average of 4.4 days, compared with the placebo-users' 7.6 days.

The theory behind zinc usage is that the mineral might get into some of the sites in the body where the cold virus attacks, thereby making the virus less severe, according to the book "Smart Choices in Alternative Medicine."

A more recent study, published last August in the Annals of Internal Medicine, also found zinc users had a shorter illness. Doctors at three Detroit hospitals studied the effects of zinc on 25 patients who were in the first 24 hours of cold symptoms. The zinc group had colds lasting about four days, compared to eight days for the 23 placebo users.

"We found that treatment with zinc lozenges was associated with a decrease in the average duration and severity of the common cold," wrote Dr. Ananda Prasad, the study's lead author. "Five previous trials failed to show a beneficial side effect of zinc, perhaps because inadequate doses or inappropriate formulations of zinc were used."

Taking large (more than 12 milligrams the amount in most zinc lozenges) doses of zinc for more than three days can result in a deficiency of copper, a rare condition that can disrupt normal growth and metabolism, Ms. Kava says.

Another alternative cold remedy, vitamin C, has been touted for decades as a way to prevent colds.

"There is no question, in large doses [500 to 1,000 milligrams], vitamin C has a mild anti-inflammatory effect," says Dr. Owen Hendley, a professor of pediatrics at the University of Virginia and a longtime cold researcher. "But it is not as strong as ibuprofen. And as for killing the virus, the evidence is nonexistent."

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