Russell Setright Naturopath

Why Complementary Medicine is better than Ibuprofen or Paracetamol in the prevention, and treatment of respiratory infections (common cold and Flu)

Russell Setright

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Most people at one time or another will catch a common cold or flu. Many different types of viruses cause these infections and it is these viruses that infect the nose, throat and upper respiratory tract causing pain, congestion and fever.

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Common sense tells us that keeping warm and avoiding sudden temperature changes, such as, leaving a warm home or office for the cold outdoors will reduce the chances of catching a cold or flu. Always don warm clothing when moving from a warm to a cold environment as these sudden changes in temperature lower resistance to infection without adequate protection.

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Unfortunately, many people just continue doing work and play without rest and use analgesics and other cold formula to just “push on through”. Although these may ease the aches and pains associated with respiratory infections they don’t reduce your spreading the cold to others and in fact may worsen the symptoms and increase time needed till recovery. Although in some cases we just may need something to get through an important event taking analgesics may help, but prevention and a reduction of the duration and symptoms of a respiratory infection is the best way and complementary medicine may just have the answer.

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There are many herbs, vitamins and minerals that have a positive effect in reducing the incidence, duration and symptoms of respiratory infection and following is factual information on the most commonly used.

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The evidence

Paracetamol and Ibuprofen

Paracetamol and or Ibuprofen could prolong the symptoms of respiratory infections

A new study found patients were more likely to come back within a month with worsening symptoms or new symptoms if they were prescribed ibuprofen or ibuprofen with paracetamol for the symptoms of the common cold. Between 50 per cent and 70 per cent of participants in this study who were prescribed ibuprofen or ibuprofen with paracetamol had elongation and worsening of the symptoms that required returning to their doctor.(1)

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Health Department Warning

Call the Poisons Information Centre on 13 11 26 (Australia) if a child, young person or adult has taken more paracetamol or ibuprofen than is recommended. Paracetamol is often taken by people who intend to harm themselves (suicide attempts). Paracetamol in large doses can cause severe liver damage

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Use in the elderly

Ibuprofen should not be taken by adults over the age of 65 without careful consideration of co-morbidities and co-medications because of an increased risk of adverse effects, in particular heart failure, gastro-intestinal ulceration and renal impairment.

Use in pregnancy

Category C: Ibuprofen inhibits prostaglandin synthesis and, when given during the latter part of pregnancy, may cause closure of the foetal ductus arteriosus, foetal renal impairment, inhibition of platelet aggregation and may delay labour and birth. Use of ibuprofen is thus contraindicated during the third trimester of pregnancy, including the last few days before expected birth

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Vitamin D3

Low vitamin D status is associated with higher rate of respiratory infections

A large study of 18,883 people reported strong association between low blood levels of vitamin D (25OHVitD) and increased respiratory infections. Those with the lowest blood vitamin D levels reported having significantly more recent colds or flu and the risks were even higher for those with chronic respiratory disorders, including asthma and COPD. Those with low vitamin D levels were

nearly 40 per cent more likely to have had a respiratory infection than those with adequate vitamin D levels (2).

Other findings support the concept of vitamin D possessing important pleiotropic actions outside of calcium homeostasis and bone metabolism. In children, an association of nutritional rickets with respiratory compromise has long been recognized. Epidemiologic studies clearly demonstrate the link between vitamin D deficiency and the increased incidence of respiratory infections (3)

Vitamin D3 supplements found to reduce the incidence of influenza in School children

A recent randomised double-blind, placebo-controlled trial among School Children in Japan was conducted. The Children were randomly divided into two groups: One group received daily supplements of 1200iu daily of vitamin D3, while the other group received a placebo. The children were then assessed for the incidence of influenza over the 2008 to 2009 winter period.

The study found that the incidence of influenza was 10.8 per cent in the vitamin D3 supplemented group, compared with 18.6 per cent in the placebo group; this reduction was even greater for those who had low vitamin D (25OHVitD), with a 74 per cent reduction in the incidence of influenza.

Also, asthma attacks were significantly reduced in asthmatic children in the vitamin D3 supplemented group(4)

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Vitamin C

Vitamin C reduces the symptoms and duration of respiratory infections (common cold)

Correct nutrition is also a necessity, we should always endeavour to include plenty of fresh fruit and vegetables in the daily diet as these are a good source of vitamin C.

Studies and clinical trials have shown that supplementing with vitamin C and vitamin E can help strengthen the immune system reducing the incidence and symptoms of colds and flu (5)

Vitamin C supplementation can start with bottle fed babies. Blackcurrant and rose hip formulas high in vitamin C are readily available. These fruit juice formulas should be included in baby’s daily feeding routine. Children over two years of age can either have a crushed Children's Chewable Vitamin C tablet added to their food or chew one tablet twice daily and adults should take between 1,000 mg and 2,000mg daily. In six trials with participants exposed to short periods of extreme physical or cold stress or both (including marathon runners and skiers) vitamin C reduced the common cold risk by half. (6)

In thirty-one comparisons studies that examined the effect of regular vitamin C supplementation on common cold duration (9745 episodes). In adults the duration of colds was reduced by 8% (3% to 12%) and in children by 14% (7% to 21%). In children, 1 to 2 g/day vitamin C shortened colds by 18%. The severity of colds was also reduced by regular vitamin C administration(7)

Echinacea

Echinacea found to reduce the incidence   and the duration of respiratory infections

Echinacea is one of the most commonly used herbal products, but controversy exists about its benefit in the prevention and treatment of the common cold. A meta-analysis evaluating the effect of echinacea on the incidence and duration of the common cold was undertaken. The meta-analysis included   14 studies were where Incidence of the common cold was reported

The results found that Echinacea decreased the odds of developing the common cold by 58% and the duration of a cold by 1·4 days. The authors concluded that published evidence supports echinacea's benefit in decreasing the incidence and duration of the common cold.(8)

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Lactoferrin

Lactoferrin found to reduce the incidence of the common cold

Lactoferrin is a compound that is naturally produced in the body by immune cells and it is particularly prevalent in secretions of the upper airways, eyes and stomach.  Bovine lactoferrin supplementation has been shown to boost the activity of certain immune cells. One study found that the total number of cold-associated symptoms reported by participants that received a Lactoferrin/whey compound (Lf/IgF) was significantly less than those in the placebo group. Also, total days sick with a cold and cold severity were reduced over the clinical trial period for Lf/IgF over placebo, but the trend was not significant(9)

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Ginseng

The study included 323 adults who were randomly assigned to take either the ginseng capsules or placebo capsules filled with rice powder every day for 4 months. During that time, participants kept daily logs of any cold symptoms -- including runny nose, congestion, sore throat and headache.

In general, adults in both groups had a similar likelihood of developing one cold during the study period. But less than half as many in the ginseng group had a repeat cold -- 10 percent, versus almost 23 percent in the placebo group(10)

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Pelargonium sidoides

For centuries, the herb Pelargonium sidoides has been traditionally used in South Africa for the treatment of respiratory diseases. The common name for this herb is umckaloabo which is derived from the Zulu language and means “heavy cough”. Today specialised farms using ecological cultivation methods produce P. sidoides.

This herb is now available in the product  Kaloba® which has been clinically proven to provide relief of acute bronchitis symptoms after 7 days (45% of the patients taking Kaloba® experienced recovery after 7 days compared to 6.4% taking a placebo), it also can help speed up recovery.

Preliminary evidence suggests that P. sidoides may assist in acute bronchitis and acute sinusitis by preventing the reproduction of various respiratory viruses and inhibiting the adhesion of certain bacteria to respiratory cells. Kaloba® also helps to clear excess mucus from the respiratory system during acute sinusitis or acute bronchitis.(11)(12)

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Hedera helix (Ivy)

Ivy extracts are part of many current cough medicines and studies have found Ivy helps liquify and clear mucus from the airways and relax and calm convulsive coughing.

 In the past, the leaves and berries were taken orally as an expectorant to treat cough and bronchitis and Professor Weiss MD in his book Herbal Medicine, mentions Ivy extract as a treatment for whooping cough symptoms.

A study of 9657 patients (5181 children) with bronchitis (acute or chronic bronchial inflammatory disease) were treated with a syrup containing dried ivy leaf extract. After 7 days of therapy, 95% of the patients showed improvement or healing of their symptoms. The authors of the study concluded, that the dried ivy leaf extract is effective and well tolerated in patients with bronchitis(13)

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The information given by Naturopath Russell Setright in this article is for general educational purposes only and not for the treatment of any disease or condition. Always see your Healthcare Practitioner for any suspected disease accident or condition and follow there expert advice.

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Zinc Lozenges

According to a meta-analysis of three randomized controlled trials zinc acetate lozenges may increase the rate of recovery from the common cold three fold. On the fifth day, 70% of the zinc lozenge patients had recovered compared with 27% of the placebo patients.

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The dose of zinc in the three studies was between 80 to 92 mg/day. Such doses are substantially higher than the recommended daily zinc intake in the USA, which is 11 mg/day for men and 8 mg/day for women. However, in certain other controlled studies, unrelated to the common cold, zinc has been administered in doses of 100 to 150 mg/day to patients for months with few adverse effects. Furthermore, 150 mg/day zinc is a standard treatment for Wilson's disease that requires treatment for the rest of a patient's life. Therefore, it seems highly unlikely that 80-92 mg/day of zinc for one to two weeks, starting very soon after the onset of the first cold symptoms, might lead to long-term adverse effects. None of the three analyzed zinc lozenge studies observed serious adverse effects of zinc.

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Even though there is strong evidence that properly formulated zinc acetate lozenges can increase the rate of recovery from the common cold by 3 fold, many zinc lozenges on the market appear to have either too low doses of zinc or they contain substances that bind zinc ions, such as citric acid. Therefore, the findings of this meta-analysis should not be directly extrapolated to the wide variety of zinc lozenges on the current market.(14)

 

References;

1. P. Little, M. Moore, et al. Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. BMJ, 2013; 347 (oct25 2)

2.      Adit A. Ginde, MD, MPH; Jonathan M. et al.  Association Between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey. Arch.  Intern.  Med. 2009;169(4):384-390

3.   Walker VP, Modlin RL.  The vitamin D connection to pediatric infections and immune function. Pediatr Res. 2009 May;65(5 Pt 2):106R-113R.

4.  Urashima U, et al. “Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren” American Journal of Clinical Nutrition, March 10, 2010.

5. Hemila, H. “Vitamin C and the Common Cold” Br. J. Nutrition” 67(1);316, January, 1992

6. Hemilä H, et al. Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2007

7. Harri Hemilä1, et al. Vitamin C for preventing and treating the common cold Editorial Group: Cochrane Acute Respiratory Infections Group, Published Online: 31 JAN 2013

8. Sachin A Shah PharmD a c, Stephen Sander PharmD et al. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis The Lancet Infectious Diseases, Volume 7, Issue 7, Pages 473 - 480, July 2007

9.  Luis Vitettaemail, Samantha Coulson et al, The clinical efficacy of a bovine lactoferrin/whey protein Ig-rich fraction (Lf/IgF) for the common cold: A double blind randomized study, Complementary Therapies in Medicine Volume 21, Issue 3 , Pages 164-171, June 2013

10. Gerald N, et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ October 25, 2005 vol. 173 no. 9 doi: 10.1503/cmaj.1041470

11. Heinrich Matthys, et al. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis: A randomised, double-blind, placebo-controlled trial  Phytomedicine Volume 10, Supplement 4, 2003, Pages 7-17

12. Taofikat B. Agbabiaka, et al. Pelargonium sidoides for acute bronchitis: A systematic review and meta-analysis,  Phytomedicine Volume 15, Issue 5, 15 May 2008, Pages 378–385

13. S. Fazio et al, Tolerance, safety and efficacy of Hedera helix 1 extract in inflammatory bronchial diseases under clinical practice conditions: A prospective, open, multicentre postmarketing study in 9657 patients Phytomedicine Volume 16, Issue 1, January 2009, Pages 17–24

14. ​Harri Hemilä, James T. Fitzgerald, Edward J. Petrus, Ananda Prasad. Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients: An Individual Patient Data Meta-Analysis. Open Forum Infectious Diseases, 2017; 4 (2) DOI: 10.1093/ofid/ofx059