1. Backache. Research demonstrates that for most cases of lower back pain, chiropractic or osteopathy works far better than anything medicine has to offer (WDDTY vol 4 no 8).

2. Ear ache. In most cases, time, mullein oil, a woolly hat or a hot water bottle works far better than antibiotics in curing ear ache, according to numerous studies (Alternatives,WDDTY vol 5 no 12).

3. Fever. Fever is your body’s extremely clever method of killing foreign bugs of all varieties and shouldn’t be suppressed. Rather than worrying about the exact degrees, its more important to determine whether the problem is serious say, meningitis. Fevers for ordinary viral and bacterial infections won’t exceed 105 degrees, which isn’t dangerous.

4. Infection. For common or garden infections, first try working with a herbalist, who will prescribe echinacea or berberis, rather than antibiotics.

5. Just in case checkups, particularly if you are over 50. If you have nothing blatantly wrong with you, going to a doctor won’t necessarily protect you but is likely to unleash the entire arsenal of his testing apparatus.

6. Menopause. Unless you are among the very small percentage of women who don’t respond to other measures, holistic measures (diet, homeopathy, herbs) will help you through the change in a safer way than any doctor.

7. Chronic but not life threatening diseases. Eczema, psoriasis, non life threatening asthma all respond better to alternative measures than drugs, which only suppress symptoms (The Guide to Asthma and Eczema; PROOF! vol 1 no 3).

8. Slimming. All a doctor usually has to offer is drugs, and numerous slimming drugs have been found to be life threatening. Allergies are one of the major causes of overweight, as are calorie poor slimming diets (WDDTY vol 6 no 5 and Allergy Handbook).

9. Colds and flu. Unless you are elderly and your immune system is compromised in some way, there is nothing your doctor can give you or your child that will improve a cold or flu. Bed rest, plenty of fluids, lemon and honey drinks and homoeopathy help; antibiotics cannot.

10. Acne. Again, all your doctor has is drugs with horrendous side effects to offer you. Try diet and allergy treatment first (The Allergy Handbook).

That’s the sales pitch for the latest flu vaccine FluMist, approved earlier this year by the US Food and Drug Administration (FDA) for use in people aged 5-49 years. It may seem like a good idea, but FluMist contains live, albeit weakened viruses. Apart from being expensive, it cannot be used by those at highest risk for the worst complications of the flu – the elderly, infants, diabetics, pregnant women, anyone with a lung disease such as asthma, and those whose immune systems are in any way compromised. It is also not recommended for healthcare workers.

Its most common side-effects, according to the manufacturer, include ‘cough, runny nose/ nasal congestion, irritability, headaches, chills, muscle aches and fever > 100° F’ – symptoms nearly identical to the flu. Also, live vaccine can be shed for up to two weeks – for instance, through sneezing or coughing – possibly affecting others around the vaccinated person. Thus, the precautions included in the FluMist pack state that ‘recipients should avoid close contact with immunocompromised individuals for at least 21 days.’ Such individuals include those with eczema, cancer, undiagnosed HIV/AIDS and organ-transplant recipients.

MedImmune, which makes FluMist, recently entered into an agreement with Wal-Mart, the world’s biggest retailer. US consumers can now get a quick blast of FluMist while they shop. The product is not yet licensed in the UK but, as with all medical ‘innovations’, forewarned is forearmed.

Propolis is rich in bioflavonoids that may be responsible for its reputed antiviral properties (J Nat Prod, 1992; 55: 294-302; Microbiologica, 1990; 13: 207). Taking 500 mg once or twice daily can also be used to treat viral infections, sore throat, and the pain and fever associated with colds and flu.

While catching a cold is not the end of the world, it is often inconvenient and unpleasant. It is also, to some extent, avoidable.

* Avoid sugar, especially if you feel you are coming down with something. Sugar lowers immune function almost immediately, and may make the difference between fending off a cold and succumbing to it. Sugar is present in foods you may not suspect, like ketchup and fruit juice.

* Get enough sleep – it will keep you strong and ensure that your body has the strength to fight off any potential invaders.

* Take vitamin C. Not all studies agree, but the weight of the evidence does seem to suggest a protective effect, reducing the incidence of the flu and colds by 28 and 50 per cent, respectively (Deutsche Gesundheitswesen, 1954; 9: 702-6; Int J Tuberc Lung Dis, 1999; 3: 756-61). Those under heavy physical stress will particularly benefit (Int J Sports Med, 1996; 17: 379-83). Aim to take 1000 mg daily.

* Other useful supplements include vitamin A (8-12,000 IU daily), which can reduce the in-cidence and severity of infection and illness; vitamin E (200-400 IU daily), which boosts resistance to infections; and coenzyme Q10 (20-200 mg daily), which can compensate for immune deficiencies due to ageing or disease. Probiotics, though technically not nutrients, do improve immune function (Int J Immunother, 1993; 1X: 23-8). Supplements should contain at least three billion viable bacteria per capsule.

* Exercise improves circulation of immune complexes. Regular moderate exercise can lead to fewer colds and flu (Exerc Immunol Rev, 1997; 3: 32-52; J Gerontol A Biol Sci Med Sci, 2002; 57: M557-62). But don’t overdo it since pushing yourself past your limits may have a paradoxical immune-weakening effect (Int J Sports Med, 1994; 15: S131-41).

* Take garlic regularly as it is antibacterial, antiviral and antifungal. Fresh is best, used either in cooking or added to other ingredients in a juicer. But supplements are also effective (and less smelly). In one recent trial, one capsule per day of a garlic supplement containing stabilised allicin for 12 weeks led to 63 per cent fewer colds and 70 per cent fewer sick days than those taking a placebo (Adv Ther, 2001; 18: 189-93).

* Think twice about the flu vaccine – it does not work (Cochrane Database Syst Rev, 2001; 4: CD001269) and may even weaken your immune system. As much as 30-40 per cent of elderly people don’t respond to it (Hum Immunol, 1994; 40: 202-9) and around one in 12 patients (8 per cent) say it triggers asthma (Lancet, 1998; 351: 326-31). Other adverse effects include optical neuritis and permanent blindness, vasculitis and joint problems, reversible paralysis and myelopathy (see also box below).

* Cover your mouth and wash your hands. Colds/flu are spread chiefly through the air (Eur J Epidemiol, 1987; 3: 327-5). When you cough or sneeze, infectious microbes are expelled at over 120 miles per hour, easily reaching most people in your vicinity. Washing your hands with regular (not antibacterial) soap will also decrease the likelihood of spreading a virus to your nose, mouth or other people.

* Adaptogenic herbs such as Siberian or Asian ginseng, Astragalus, Schisandra and Rhodiola are thought to help keep various systems – including immune function – healthy, and are often recommended to prevent colds/flu. In one trial, people given 100 mg of Asian ginseng plus a flu vaccine had fewer colds/ flu compared with those receiving only the vaccine (Drugs Exp Clin Res, 1996; 22: 65-72).

* Stress. You are twice as likely to catch a cold if you are stressed out (N Engl J Med, 1991; 325: 606-12). Do what you can to de-stress, and consider supplementing with the B-complex vitamins such as B6, B12 and folic acid (Clin Sci, 1984; 66: 241-8). Aim for 25-100 mg as part of a complex.

* Elderberry extract is anti-inflammatory and antiviral. Data suggest that 30-60 mL can shorten the duration of flu in children and in adults (J Altern Complement Med, 1995; 1: 361-9). Combined with St John’s wort and soapwort, it inhibits both the influenza and herpes simplex viruses in the lab (Phytother Res, 1990; 4: 97-100).

Virtually everyone has a theory about colds and flu and, given the glut of information, it may be hard to separate the facts from plain fiction. Yet, there are data that show what makes us vulnerable to these infections, and how to stay well when the weather turns cold.

Susceptibility and stress
Catching the flu is not a random event. Bugs may be getting nastier (see box below), and our poorly ventilated, sometimes crowded, environments may encourage the spread of virulent viruses. But if exposure were the only factor, all of us would get sick every time we were exposed.

In truth, many people in a room may be exposed to a cold or flu virus, but only some become infected. Susceptibility, not exposure, is the key and is likely to be influenced by a number of things.

People who have heart complaints, asthma, chronic kidney disease or diabetes, or who are taking medications (for instance, steroids) are more susceptible to colds and flu. Smokers are also more susceptible to upper respiratory tract infection (URTI; Am J Public Health, 1993; 83: 1277-83).

But predicting susceptibility in an otherwise healthy population is less straightforward. Nutritional status and exercise play a role (see boxes, pp 2 and 3) but, recently, a great deal of study has focused on the role of stress.

The ability of stress to alter immune function, and precipitate and aggravate infectious diseases has long been recognised (J Fla Med Assoc, 1993; 80: 409-11). Today, there is strong evidence that the single biggest risk factor that puts otherwise healthy people at risk of catching a cold may be stress.

In one study, after determining their stress levels by questionnaire, 394 subjects were exposed to common rhinoviruses (the virus causing the common cold). Only 27 per cent of the low-stress group showed clinical symptoms compared with 47 per cent of those at the high end of the scale (N Engl J Med, 1991; 325: 606-12).

In another study, 276 subjects, who had been carefully evaluated for their level of involvement in one or more of a dozen types of social ties – for example, with a spouse or partner, sibling, parent, close friend or fellow worker – were given nasal drops containing rhinoviruses.

Susceptibility to colds was reduced as social support increased. Of those with three or less relationships, 62 per cent came down with a cold compared with only 35 per cent in those with six or more types of social support (J Am Med Assoc, 1997; 277: 1940-4).

A repeat of that study (Health Psychol, 1998; 17: 214-23) evaluated stress more precisely (long term vs short term) as well as the severity of illness, and also measured blood levels of natural-killer (NK) cells, the immune system cells that combat infectious agents. Those stressed for more than a month had lower NK-cell activity and were 2.2 times more likely to develop colds. The biggest risk came with increased job stress.

Stressed children have a greater susceptibility to URTI and show measurable decreases in mucosal immunity (J Psychosom Res, 1997; 43: 271-8). Depression is also strongly related to catching a cold (Epidemiology, 2001; 12: 345-9).

Prescription drugs, like antibiotics, can also increase colds/ flu susceptibility. A substantial number of GPs still prescribe antibiotics for colds/flu, even though these drugs don’t work against viruses (J Am Med Assoc, 1997; 278: 901-4; J Am Med Assoc, 1998; 279: 875-7).

Australian doctors report that flucloxacillin, a semisynthetic penicillin, can cause cholestatic jaundice (Med J Aust, 1989; 151: 701-5), though its relation to the drug may go unrecognised because of a delayed onset (Lancet, 1992; 339: 679). Older patients and those receiving flucloxacillin for more than two weeks are particularly at risk (BMJ, 1993; 306: 233-5).

Newer combination antibiotics such as Septrin – trimethoprim and sulphamethoxazole, or co-trimoxazole – have been linked with skin rashes and blisters (Ind J Derm, 1982; 48: 207-8; Br J Dermatol, 1987; 116: 241-2; Dermatology, 1986; 172: 230-1), and a host of HIV-like symptoms, including anaemia, loss of appetite, nausea, vomiting, numbness, convulsions, chills, fever, swollen glands, and ulcers in the mouth, eyes and urethra.

Overuse of antibiotics also contributes to the emergence of ‘superbugs’, and can deplete the friendly gut bacteria needed to maintain good health and immunity. Clearly, when you take antibiotics, you are risking a trade-off of symptoms which may leave you more unhealthy than you were before.

Over-the-counter madness
If you do succumb to a cold or flu, there are literally hundreds of over-the-counter (OTC) remedies that claim to relieve cold symptoms, but most have been proven useless (J Am Med Assoc, 1993; 269: 2258-63). The most popular varieties use a scattergun approach, mixing several different types of ingredients, often resulting in a variety of side-effects.

For instance:
*Nasal sprays containing phenylephrine hydrochloride, oxymetazoline hydrochloride or xylometazoline hydrochloride may clear the nose initially but, after a few days, their continued use can cause a rebound effect, producing worse nasal congestion than before.

* Oral decongestants stimulate the sympathetic nervous system and can increase blood pressure and pulse – risky for those with hypertension. They can cause heart rhythm disturbances, anxiety and a rebound effect. Perhaps the worst offender is phenylpropanolamine (PPA). In one study, this chemical increased the risk of stroke in women more than threefold (N Engl J Med, 2000; 343: 1826-32). This was the last straw in more than a decade of studies of PPA. The US Food and Drug Administration (FDA) has asked drug companies to stop marketing products containing PPA but, in the UK, it is still widely found in cold remedies.

* Antihistamines may reduce a runny nose and sneezing, but have a minimal effect on other symptoms. They can have a sedating effect and are often added to multisymptom cold remedies because of their ability to counteract the stimulant effect of decongestants.

* Cough suppressants such as guaifenesin (Robitussin) and dextromethorphan (NyQuil or Night Nurse) show no efficacy in suppressing coughs. The latter has been associated with liver damage and is used by teenagers to get a ‘poor man’s high’. Codeine also doesn’t suppress coughs, but can result in constipation.

* Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, paracetamol (acetaminophen) and ibuprofen may in fact increase nasal symptoms. There is also evidence that aspirin decreases the antibody response in rhinovirus infections (J Am Med Assoc, 1975; 231: 1248-51; J Infect Dis, 1990; 162: 1277-82). Furthermore, the influenza virus grows best at 34-35º C, but poorly – if at all – at temperatures greater than 37º C. So reducing fever with NSAIDs may simply prolong the agony of a cold or flu.

To jab or not to jab?
Predicting a flu epidemic is not an exact science, as was elegantly illustrated in 1976 when US officials, spurred on by illness among soldiers at Fort Dix, New Jersey, predicted a swine flu epidemic as lethal as the great flu pandemic of 1918. In the event, rates of flu and pneumonia-related deaths in 1976 were at their lowest in years (MMWR, 1976; 25: 391-2), much to the chagrin of the government, which had spent millions preparing a vaccine.

As flu can be caused by any of hundreds of strains of myxovirus, which mutate more or less constantly, vaccination amounts to a kind of biological Russian roulette. Even if the vaccine is for the right strain of myxovirus, for reasons not yet fully understood, you may not respond by producing anti-bodies to it. One study found that 30-40 per cent of elderly people do not respond to vaccination (Hum Immunol, 1994; 40: 202-9), and even if an immune response occurs, there is doubt as to whether this reduces the incidence of influenza (Vaccine, 1994; 12: 1185-9).

Studies into the efficacy of the flu vaccine show mixed results (Gerontology, 1995; 41: 3-10), and questions remain as to whether the inactivated virus used in the vaccine can truly provide complete protection (Int Arch Allergy Immunol, 1995; 108: 318-20).

Then there are the side-effects. While authorities say these are rare, this is cold comfort if you are among those affected. The ill-fated swine flu vaccine resulted in a rise of Guillain-Barré syndrome, a type of paralysis (Am J Epidemiol, 1979; 110: 105-23). In one UK study, around one in 12 patients said the flu vaccine was a trigger for asthma attacks (Lancet, 1998; 351: 326-31). Optic neuritis and permanent blindness, vasculitis and joint problems, reversible paralysis and myelopathy have also been reported (Am J Ophthalmol, 1997; 124: 703-4; J Rheumatol, 1997; 24: 1198-202; Ned Tijd Geneeskunde, 1995; 139: 2152-4; Muscle Nerve, 1995; 18: 1199-201).

Reviews of the benefits of vaccines in healthy adults have shown that these are negligible, sucessfully reducing the number of virus carriers (as shown by blood tests), but not of those who actually develop the flu (Cochrane Database Syst Rev, 2000; [2]: CD001269; Vaccine, 2000; 18: 957-1030).

Vitamin C, zinc and Echinacea
Research shows that most of us treat colds and flu at home (J Fam Pract, 1998; 47: 366-9). Decades of research have gone into vitamin supplementation and immunity, and many nutrients have proved to be important in shoring up our immune defences (see box below).

The most popular of these are vitamin C and zinc, although opinion varies regarding their true effectiveness. In the 1970s, Linus Pauling’s review of the evidence concluded that large doses of vitamin C prevented colds and alleviated symptoms (Proc Natl Acad Sci USA, 1971; 68: 2678-81).

Since that time, however, the efficacy of vitamin C has been hotly debated. A 1975 analysis by Thomas Chalmers concluded that the case for vitamin C had “questionable validity” (Am J Med, 1975; 58: 532-6), but a recent analysis of the report suggests that his analysis was seriously flawed (J Am Coll Nutr, 1995; 14; 116-23).

It is now generally accepted that a dose of 1-8 g of vitamin C daily can decrease the severity of cold symptoms by an average of 23 per cent and reduce the duration of illness by nearly half (Scand J Infect Dis, 1994; 26: 1-6; Br J Nutr, 1992; 67: 3-16).

More recent reviews of the evidence say that, while vitamin C can alleviate cold symptoms, taking large doses is not preventative (Cochrane Database Syst Rev, 2000; [2]: CD000980). However, some groups may benefit from regular supplementation, such as athletes under heavy physical stress (Int J Sport Med, 1996; 17: 379-83). One review suggests a reduction in cold incidence of up to 50 per cent with regular vitamin C use (Int J Tuberc Lung Dis, 1999; 3: 756-61).

Zinc has long been promoted as a remedy and preventative for colds and flu. In one study, a nasal gel containing zinc significantly shortened the duration of a cold if taken within 24 hours of the onset of symptoms (Ear Nose Throat J, 2000; 79: 778-80, 782).

However, taken as a whole, the evidence for the efficacy of zinc lozenges is inconclusive (Cochrane Database Syst Rev, 2000 [2]: CD001364; J Nutr, 2000; 130 [5S Suppl]: 1512S-5S). The first study of zinc lozenges found a seven-day reduction in colds duration with zinc (Antimicrob Agents Chemother, 1984; 25: 20-4). Such results piqued drug company interest and, by the end of the1980s, five more studies had been carried out. However, only one of these showed zinc to have any effect. But then, in 1996, another study suggested that zinc lozenges were effective against cold symptoms (Ann Intern Med, 1996; 125: 81-8), thus launching zinc back on the road to popularity.

One trial of zinc lozenges (12.8 mg) found that patients taking one every two to three hours early in the course of a cold reduced the duration and severity of their symptoms, especially cough (Ann Intern Med, 2000; 133: 245-52).

But another randomised double-blind trial of 249 children (total daily dose of 50-60 mg) found no difference between zinc lozenges and placebo (J Am Med Assoc, 1998; 279: 1962-7). More recently, a trial of both zinc gluconate and zinc acetate concluded that neither had much effect on cold symptoms (Clin Infect Dis, 2000; 31: 1202-8).

So far, at least 10 double-blind trials have evaluated zinc lozenges for treating the common cold. Half have shown efficacy and half have not, results which may be due to methodological differences. Trials that began therapy shortly after onset of symptoms, used zinc gluconate or glycine-sweetened zinc gluconate and gave multiple daily zinc doses of 13-23 mg per dose found zinc to be effective. Most of the negative trials, on the other hand, varied from this protocol in one way or another.

Echinacea, one of the best-selling OTC herbals, has also shown mixed efficacy. German researchers gave the liquid root extract of either E. purpurea or E. angustifolia, two of the most popular types, or placebo to 302 healthy volunteers in a double-blind randomised trial. Results showed that both types of Echinacea were only slightly more effective than the placebo in preventing colds over a 12-week period, although participants taking the herb reported feeling better than those taking placebo. The authors concluded that, at best, Echinacea may reduce the risk of catching a cold by about 10-20 per cent (Arch Fam Med, 1998; 7: 541-5).

Other studies, however, have shown that Echinacea can relieve symptoms, reducing both the severity and duration of a cold (Arzneim Forsch, 2001; 51: 563-8; Arch Fam Med, 1998; 7: 541-5). One trial in Sweden looked at 246 healthy adults who caught a cold and took an E. purpurea preparation or placebo. The subjects took two tablets three times a day for seven days or until they felt better. The Echinacea preparations were significantly more effective than the placebo (Phytomedicine, 1999; 6: 1-6).

The key to these and other remedies may be to treat at the first signs of cold or flu. A recent review of 13 trials of Echinacea in the treatment and prevention of colds concluded that, while it may not prevent colds, early treatment could be beneficial for relieving symptoms (J Fam Pract, 1999; 48: 628-35). It also noted that Echinacea preparations vary widely in composition.

When colds or flu strikes, we all hope for a magic bullet to make things right, but most of the methods we use are still shots in the dark. Traditional approaches – usually involving rest, liquids and keeping warm – may not be glamorous but, in the end, appear to be effective, less prone to adverse effects and less expensive.

Pat Thomas

The influenza virus, which is an RNA virus, can mutate up to a million times more often than a DNA virus. Only the human immunodeficiency virus (HIV), supposedly another RNA virus, mutates faster.

In addition to ducks, the influenza virus is also able to infect pigs as well as humans. Strains of duck, human and pig viruses can easily swap genetic material. If a host becomes infected with two or more viruses simultaneously, they can rapidly mutate into new and never-before-seen strains. If one virus is extremely communicable while the other is extremely lethal, the mixing and matching of their genes could produce a lethal hybrid. This is what scientists speculate happened in 1918.

New evidence from Australia suggests that the Spanish flu pandemic of 1918 that killed so many healthy people in their prime was a mutation of human and pig strains of influenza. The researchers’ findings are based on a reexamination of gene fragments of the 1918 flu virus, extracted from the preserved tissue of two soldiers who died from it and the lungs of a third victim who was exhumed after 80 years from a grave in the permafrost soil of Alaska (Science, 2001; 293: 1842-5).

As long as we continue to provide environments where viruses from different hosts can easily mix and exchange data (for instance, the Oriental practice of hanging duck cages above pig sties so that the pigs can feed on the avian faeces), viruses will continue to take advantage of this and grow ever more powerful.

However, exercise – like everything else – has a downside. While regular moderate exercise is helpful, bursts of heavy exercise once in a while may be harmful, suppressing immunity for several hours and creating a period of vulnerability when the risk of upper respiratory tract infections is increased (Int J Sports Med, 1994; 15: S131-41). Interestingly, the soldiers most severely affected by the US swine flu outbreak of 1976 were just beginning basic combat training, a time of exceptional exertion (J Infect Dis, 1977; 136 [Suppl]: S363-8).

Vitamin A can reduce the incidence and severity of infectious illnesses (Clin Infect Dis, 1994; 19: 489-99; J Nutr, 1995; 125: 1211-21). The usual dose is 8000-12,000 IU daily

B-complex vitamins such as B6, B12 and folic acid support immune function and are especially useful for stressed individuals (J Am Med Assoc, 1981; 245: 53-8; Clin Sci, 1984; 66: 241-8). Daily doses range from 25-100 mg as part of a complex

Vitamin C is the best-known immune-enhancing nutrient (see main story). Aim for 1000 mg daily

Vitamin E significantly decreases susceptibility to infections. Supplementation can benefit both the healthy and the ill (Arch Immunol Ther Exp, 1987; 35: 207-10; Ann NY Acad Sci, 1989; 570: 283-90). A daily dose should be around 200-400 IU

Ubiquinone (coenzyme Q10) can compensate for immune deficiencies due to ageing or disease (Med Hypoth, 1992; 38: 315-21; Mech Ageing Develop, 1978; 7: 189-97). Daily doses range from 20-200 mg

Zinc gluconate has shown a modest benefit on the duration of cold symptoms whereas zinc acetate did not (Clin Infect Dis, 2000; 31: 1202-8). Daily doses range from 15 mg for prevention to 100 mg during an infection

Selenium if deficient has been associated with lowered immunity. Its role as an antioxidant may be an important factor (Fed Proc, 1979; 38: 2139-42). Try 25-100 mg daily

Probiotics are technically not nutrients, but have a role in improving immune function (Immunopharmacol Immunotoxicol, 1992; 14: 331-40; Int J Immunother, 1993; 1X: 23-8). Supplements should contain at least three billion viable bacteria per capsule.

In France, where homeopathy is firmly established, the two most popular remedies for flu or the common cold are both homeopathic. The top seller is the single remedy ‘Oscillococcinum 200’, while the number two slot is firmly held by a mixture, which sells under the cryptic L.52. Both are available in the UK, and their popularity is due to their long-established reliability in ridding sufferers of symptoms without side effects.

Oscillococcinum, discovered accidentally by Dr Joseph Roy during the 1930s, is prepared from very diluted Barbary duck heart and liver, which were – incorrectly, we now know – thought to contain a bacterium, Oscillococcus, associated with flu-like states. Roy’s spurious bacterial theory has now been found to have foundation in fact; game fowl have been proved to be a prime reservoir for human influenza viruses. This remedy’s extraordinary reliability in treating influenza over almost seven decades has been proved with success rates reported in various population samplings from 80-90 per cent, whenever the remedy was taken within 48 hours of the onset of symptoms. Controlled trials were run and published in France (c. f. Thorsons Enclopaedic Dictionary of Homeopathy by this author, HarperCollins, London 1991) demonstrating effectiveness in controlling fever, cough during day and night, runny nose, muscle and joint stiffness, and shivering. This study was backed up on a larger scale (Br J Clin Pharmacol, March 1989; 27: 329-35).

The competing remedy, L.52, is a combination of 10 common cold and flu remedies: Aconitum nappellus, Arnica montana, (Atropa) Belladonna, Bryonia alba, Cinchona officinalis, Drosera rotundifolia, Eucalyptus globulus, Eupatorium perfoliatum, Gelsemium sempervirens and Polygala senega.

In a scientific trial conducted by researchers (none of whom were homeopaths) at the department of infectious Illnesses at the Felix Houphouet-Boigny Hospital in Marseilles, a high percentage of patients improved significantly in all categories – bronchial congestion, day and nighttime coughing, runny nose, need to resort to antibiotics after treatment, speed of recovery – compared to a group given a placebo (Casanova et al, ‘L.52: A Flu Treatment,’ Dr Ph Lecocq, pub., Metz: Editions Lehning, 1988).

Harald Gaier

Harald Gaier is a registered naturopath, osteopath and homeopath.

Reach for garlic. Fresh and raw garlic (Allium sativum) is best, but if you take supplements, use those made from dried garlic and not the steam-distilled variety (which has little or no beneficial alliicin). In a study involving 146 subjects taking garlic or placebo for 90 days during the cold season, nearly three times as many of those taking placebo caught a cold compared with those taking a daily garlic preparation. In addition, those with a cold taking the garlic appeared to recover more quickly (Adv Ther, 2001; 18: 189-93)

Meditate, don’t medicate. Stress-reducing therapies, such as hypnosis, have been found to improve immune function (J Consult Clin Psychol, 2001; 69: 674-82; Int J Psychophysiol, 2001; 42: 55-71). Meditation and yoga may achieve similar results. Relaxation has proved effective in treating recurrent symptoms of cold and flu in children (J Psychosom Res, 2001; 51: 369-77; J Dev Behav Pediatr, 1996; 17: 311-6)

Try homoeopathy. L52, a combination of 10 homoeopathic remedies taken in drops, has proved successful in treating colds and flu in two large-scale trials in France (Lecocq P, Flu Treatment, Metz: Editions Lehning, 1988). However, the low dilutions are low and, as it contains several known poisonous plants, some homoeopaths recommend other alternatives

Oscillococcinum 200 is prepared from diluted Barbary duck heart and liver. Anecdotal evidence suggests that it is effective for flu if taken within 48 hours of symptom onset. Controlled trials in France (Gaier H, Thorsons Encyclopaedic Dictionary of Homeopathy, London: HarperCollins, 1991) found it effective for controlling fever, cough, runny nose, muscle and joint stiffness, and chills. These findings were supported by others on a larger scale (Br J Clin Pharmacol, 1989; 27: 329-35).

A recent review of Oscillococcinum concludes that it ‘probably’ reduces the duration of illness in patients with flu symptoms, but is unlikely to be a preventative, although the authors acknowledge that data on this remedy are lacking (Cochrane Database Syst Rev, 2000; [2]: CD001957).

You need a doctor’s prescription to get Oscillococcinum in the UK, but Ainsworth’s Homoeopathic Pharmacy (020 7935 5330) produces their own version called Anas barb and operate a mail-order service. Ainsworth’s also produces an anti-cold and flu remedy combining Bacillinum and Influenzinum which is updated every year to cover the latest flu strains.

A German trial comparing homoeopathic Eupatorium perfoliatum D2 with aspirin found that both treatments were equally effective in relieving cold and flu symptoms (Arzneim Forsch, 1981; 31: 732-6)

Stay hydrated with water, herbal teas and even chicken soup (Chest, 2000; 118: 887-8). Consider also herbal teas such as nettle and Echinacea. One study found that Echinacea herbal tea was more effective than a placebo for relieving cold/flu symptoms (J Altern Complement Med, 2000; 6: 327-34)

Steam inhalation may make you feel better (Chest, 1991; 99; 1352-6; J Am Med Assoc, 1990; 264: 989-91), although two large-scale trials concluded it did not relieve cold symptoms (J Am Med Assoc, 1994; 271: 1109-11; 1112-3)

Limit the spread of microbes. Covering your mouth when you cough or sneeze seems obvious, but it’s amazing to see how many people don’t do it. When you cough or sneeze, vapour containing infectious microbes is expelled at over 120 mph, easily reaching most people in your immediate vicinity. In fact, rhinoviruses are spread chiefly by vapour and not by personal contact (Eur J Epidemiol, 1987; 3: 327-35).