November 26, 2004
Consumers Search for a Hefty Dose of Flu-Fighting Alternatives
Nov. 26--One winter about 20 years ago, as Barbara Dively prepared to pay for an armful of pills, lozenges, and other flu provisions at her Plymouth Meeting drugstore, the pharmacist brushed it all aside.
"You only need one thing," he told her. It was something Dively had never heard of, but which has been the sole flu remedy in her family medicine chest ever since: Oscillococcinum, Oscillo for short, a best-seller in France and an increasingly popular brand here.
As the flu season rolls in and the vaccine shortage continues, over-the-counter Oscillo is just one of many possible flu-fighting alternatives being explored by consumers. Possibilities include echinacea and zinc, garlic and Vitamin C, and a legion of other substances whose fans are many and passionate.
It's a confusing morass of products and therapies, many considered mainstream in other parts of the world but as yet unproven by Western scientific standards. Federal regulators don't vouch for their effectiveness, either.
Still, the appetite grows. For flu and many other illnesses, more and more Americans want to treat themselves -- and do it with remedies that replace or augment conventional Western ones.
Oscillo, which one independent analysis found short-circuited the flu by just a few hours, is a homeopathic remedy. Like Dolicoccil, Airborne and Hyland's, other flu treatments derived from duck organs, it is part of a therapeutic system developed in the late 1700s by Samuel Hahnemann.
It was for Hahnemann, a German physician lionized by his followers and vilified by established medical interests, that the Homeopathic Medical College of Pennsylvania was renamed in 1869.
(For more than four decades, Hahnemann University Hospital in Philadelphia and its medical school, now part of Drexel University College of Medicine, have been allopathic -- traditional -- institutions.)
Homeopathy uses small doses of plant, animal or mineral substances to stimulate self-healing. It is based on the principle of similars -- like cures like -- which means that a substance that can cause certain symptoms in a healthy person can cure similar symptoms in an unhealthy person.
In the case of Oscillo, the Muscovy duck's heart and liver are thought to be reservoirs for the flu virus.
Although many conventional doctors still find Hahnemann's notions implausible, homeopathy had a prominent place in 19th-century health care and is now part of the renewed interest -- among doctors, as well as consumers -- in complementary and alternative medicine (CAM). Also in that category are herbal remedies, diet supplements, acupuncture, chiropractic, massage and yoga, traditional Chinese medicine, and natural therapies.
The federal Centers for Disease Control and Prevention reported earlier this year that 36 percent of 31,000 Americans surveyed said they had used some form of CAM during the previous year. Most sought relief from back and neck problems, colds, joint pain or depression -- and most used conventional treatments, too.
CAM spending is estimated at $36 billion to $47 billion a year, which sends CAM critics such as Stephen Barrett into orbit.
The retired Allentown psychiatrist, who runs the Web site Quackwatch.org, calls alternative medicine for flu and all else "quack nonsense.""There are some heavy-duty claims that are fraudulent as hell," he said, "and I don't believe any of it."
The U.S. Food and Drug Administration treats over-the-counter vitamins, minerals and herbs as foods, not drugs, and does not vouch for their efficacy or quality. If a product's claims are proved false or misleading, however, or the product is deemed unsafe, the agency can pull it from the market -- as it did earlier this month with Double Deers Formula brand Expellin Extract (Concentrated) and Cardioflex, herbal supplements from China.
Homeopathic remedies are regulated as drugs, but held to a lesser standard than conventional medicines.
Dively, who in 20 years has gone from student to teacher of homeopathy, responds serenely to the naysayers. "Once you have a few of these healing experiences," she said, "you don't really care what other people think."
Although Dively, her husband, John, and three grown children have used conventional medicines, they prefer homeopathy for just about everything -- arnica for swollen ankles, ruta for blown-out knees, tarantula cubensis for spider bites, bryonia for arthritis and anas barbariae, Oscillo's active ingredient, at the first sign of flu.
The Divelys swear by them all, although there appear to be no scientific studies of any of them except Oscillo.
The independent Cochrane Collaboration, which evaluates the evidence behind health claims, reviewed seven studies of Oscillo and concluded that it cannot prevent flu but that it can slightly shorten its duration -- by 0.28 days or 6.7 hours. The nonprofit Cochrane called the data "promising" but said most of the studies were too small and the evidence too weak to support Oscillo as a "first-line treatment" of flu.
Boiron, Oscillo's French manufacturer, with U.S. corporate headquarters in Newtown Square, said studies show that 63 percent of patients who took its product at the outset had fewer chills and headaches, lower fever, and less stiffness and pain within 48 hours.
Boiron does not claim that Oscillo prevents flu, said spokeswoman Alissa Gould, who estimated that U.S. sales of Oscillo, the company's flagship product, would hit $15.4 million this year, a 27 percent hike over last year.
The back-and-forth over Oscillo is typical of the debate over alternative remedies, which mainstream medical researchers are beginning to study more closely.
Among them is Philippe Szapary, an internist and assistant professor of medicine at the University of Pennsylvania, who is looking at dietary supplements and cardiovascular disease.
Some alternative treatments do work, Szapary said, such as ginkgo biloba for blocked leg arteries and fish oil for heart disease in certain high-risk groups. But the field is very complex for researchers, to say nothing of consumers, who must evaluate a universe of confusing information to decide what works.
"It's mind-boggling," he said.
Some popular alternative remedies for cold, flu and upper-respiratory infection:
--Echinacea: Most studies report positive results in early treatment of cold and flu. But there are three different commonly used species of the plant, each available in many forms, and the studies so far have not been very well designed. Overall, the results have been convincing enough that the German government has endorsed the use of Echinacea purpurea as soon as symptoms begin. Be aware that the herb is not recommended for long-term use and that it failed to help children with respiratory infections in one very large, well-designed trial.
--Zinc: As a lozenge or nasal gel, zinc may act directly in the throat or nose to reduce the duration of the common cold. Be aware that high doses of zinc can have adverse effects and there have been unconfirmed reports of loss of smell resulting from zinc nasal gel.
--Garlic: There is evidence that regular use of garlic may help prevent colds. Be aware that there are more than 200 chemicals in garlic and some may interfere with other medications.
--Vitamin C: Although not firmly established by clinical trials, Vitamin C's antioxidant activity may help boost immune function and may make some people feel better. Be aware that there are no conclusive data on large doses of Vitamin C preventing colds or reducing the severity or duration of symptoms and that Vitamin C may affect other drugs you are taking.
Sources: www.consumerlab.com, www.cochrane.org and www.webmd.com
FOR MORE INFORMATION:
www.consumerlab.com: independent test results, health and product information.
http://nccam.nih.gov: National Center for Complementary and Alternative Medicine at the National Institutes of Health, for information on complementary and alternative medicine and research.
www.quackwatch.org: health-related frauds and fads.
www.cochrane.org: science-based reviews of clinical trials.
www.cfsan.fda.gov or 1-888-723-3366: Center for Food Safety and Applied Nutrition at the U.S. Food and Drug Administration, for information on supplement safety and labeling.
To see more of The Philadelphia Inquirer, or to subscribe to the newspaper, go to http://www.philly.com.
(c) 2004, The Philadelphia Inquirer. Distributed by Knight Ridder/Tribune Business News. For information on republishing this content, contact us at (800) 661-2511 (U.S.), (213) 237-4914 (worldwide), fax (213) 237-6515, or e-mail [email protected]