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'Is it bullshit?': Cold and flu edition

Cough drops, neti pots, nasal swabs -- are any of these actually helpful?

Cough drops, neti pots, nasal swabs -- are any of these actually helpful? Associated Press

It’s that special time of year when we all shuffle to the nearest pharmacy, breathe through our mouths, stare at shelves upon shelves of cold and flu remedies, read product titles, warnings, and labels, and quietly wonder, “Is this even anything?”

Over-the-counter cold and flu remedies are an industry worth billions of dollars, and it’s hard to pin down what actually works, what does more harm than good, and what's straight-up bullshit. Over the years, medical colleges and researchers have been trying to figure out the same thing. Here’s a roundup of some of the most common over-the-counter remedies.

Cough drops
Listen, we don't want to take away the comfort of mindlessly sucking down an entire bag of these bad boys in a single day. They’re like candy with a gross aftertaste that reminds you it’s supposed to be medicine.

But cough drops, which are mostly sugar and menthol, probably won’t help your cough too much beyond making your throat feel all sweet and minty. You might as well down a bag of peppermints or a spoonful of honey.

In fact, the American College of Chest Physicians has revisited this topic numerous times, and their consensus as of 2017 is that what little evidence exists for the efficacy of cough drops—and pretty much all other over-the-counter cough remedies—is “overall of low quality.” Even codeine, the active ingredient in your more heavy-duty cough syrups, has attracted scrutiny as a “medical myth” that doesn’t hold up in double-blind trials.

Then again, it’s super hard to OD on menthol, so if cough drops make you happy, keep right on sucking. If not, don’t waste your money.

Neti pots
If you’ve never tried it, you’ve probably had a friend or a relative extol its virtues. If you have tried it, a friend or a relative has probably told you it’s going to somehow kill you.

Neti pots are small, teapot-shaped devices designed to flush saline solution in one nostril and out the other, hopefully removing whatever crud has been hanging out in your nasal passages for the past week. There’s no denying they work. There’s something extremely cathartic about blowing your nose and finally coming face to face with your abuser, so to speak.

So why are these gross little teapots so scary to some people? Well, in 2018, a 69-year-old woman from Seattle died after a contracting a rare brain-munching amoeba, and scientists suspected the source of infection to be her neti pot, which she’d begun using a month before. Her tragic mistake appeared to have been filling it with Brita-filtered tap water instead of the totally sterile stuff recommended.

That’s… not great. But does it mean you shouldn’t use a neti pot? Only if it also means you shouldn’t jump into any bodies of fresh water. In 2015, a Minnesota boy died after contracting a similar amoeba from swimming in Lake Minnewaska. All it means is: Be careful. Use only sterile, distilled, or previously boiled water, and keep your device clean and dry.

Echinacea
Hi, welcome to Whole Foods.

Echinacea comes in pills, gummies, tinctures, teas, and more, promising to ease your cold symptoms and boost your immunity. It’s a type of flower, and people on this continent have been using it as medicine for a very long time.

So, will the echinacea gummy cure or prevent your cold? So far, we’re at the scientific equivalent of “meh.” Some studies find little evidence it does anything, others say it has some slight effects, others say there’s no way to tell with all the myriad ways it’s prepared and administered. In short, jury’s still out. It probably won’t hurt, maybe it’ll help, and besides, now you're at Whole Foods! 

Zicam
Hey, those little nasal swabs are back on the shelves! You may be wondering where they’ve been.

Zicam, a self-described homeopathic cold remedy, promises to shorten your cold or flu rather than merely mask the symptoms. It wasn't around for a while after the FDA sent it a big old warning letter in 2009, citing 130 consumer reports dating back to 1999 claiming people who used Zicam then lost their sense of smell.

In 2006, its parent company paid roughly $12 million to settle 340 lawsuits on the subject, but it took the FDA’s nudge to convince the company to yank the product from stores.

Zicam’s back, mostly because subsequent studies on the subject have merely managed to suggest—but not prove—a link between the product and “irreversible” damage to mouse and human nasal tissue. The company’s website says Zicam has “reformulated” all of its products out of an “abundance of caution.”

Other experts maintain you should avoid Zicam not because of the potential risk to your nose, but because there’s little proof it actually works. As a homeopathic drug, it has not been evaluated by the FDA for effectiveness or safety.

Airborne
Once upon a time, Airborne touted itself as a cold preventative and treatment—just the thing you needed if you were going to be trapped on a plane for five hours with a bunch of germy strangers.

No longer, thanks to a report by ABC News in 2006, which found that Airborne’s testing facility, GNG Pharmaceutical Services, was little more than a two-man operation with “no clinic, no scientists, and no doctors.”

Airborne settled a $23 million false advertising lawsuit and admitted no wrongdoing, but nonetheless scaled back its designation from a cure and preventative subtance to an immune system booster. Because it is technically a dietary supplement and not a “drug,” per se, there’s nothing the FDA can do to test whether it actually works.

According to its website, the "crafted blend" consists mostly of vitamin C, zinc, “antioxidants,” and a proprietary mish mash of herbs. There have been some studies that show zinc may or may not be effective in shortening colds (or, you know, may do more harm than good), but research has shown that for most people, taking more Vitamin C than you ordinarily get from your diet won’t keep you from getting sick.

Gargling with salt water
Your mom made you do it, and you hated it, but did it help? Studies say: yeah, probably.

Salt water certainly isn’t going to cure your cold, but it can loosen sludge caked from nasal drip and make your throat feel a little better. A 2005 study in the American Journal of Preventative Medicine also found it was pretty effective at keeping you from getting colds and other infections in the first place.

It certainly doesn’t hurt that it’s extremely low-cost and very unlikely to give you some horrifying side effect.

Bonus Round: Getting your flu shot
The Minnesota Department of Health wouldn’t speak to any of the above, but has been consistent about one treatment in particular: getting a flu vaccine. They’re recommended for everyone six months of age and older.

Contrary to popular belief, you don't actually get the flu from a flu vaccine. Some get a mild fever or achiness after getting the shot, and may just contract another cold or virus circulating around at the time, which can be mistaken for the flu strain the vaccine was supposed to prevent.

If you’re not willing to get the shot for your own health, consider getting it to protect others. So far this season, 16 people have died of influenza in Minnesota alone.