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Why complementary medicine is better than Ibuprofen or Paracetamol in the prevention and treatment of respiratory infections (common cold and flu).

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.

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.

Unfortunately, many people just continue doing work and play without rest and use analgesics and other cold formulas 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 the time needed till recovery. In some cases we just may need something to get through an important event so taking analgesics may help, but prevention or a reduction of the duration of symptoms of a respiratory infection is the best way and complementary medicine may just have the answer.

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

The evidence

Paracetamol and Ibuprofen

Paracetamol and Ibuprofen could prolong the symptoms of respiratory infections. A new study found patients were more likely to come back within a month with worsening or new symptoms if they were prescribed Ibuprofen or Ibuprofen with Paracetamol for the symptoms of the common cold. Between 50% and 70% 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)

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.

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 and inhibition of platelet aggregation, and may delay labour and birth. Use of Ibuprofen is therefore contraindicated during the third trimester of pregnancy, including the last few days before expected birth.

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 chronic obstructive respiratory disease. Those with low vitamin D levels were nearly 40% more likely to have had a respiratory infection than those with adequate vitamin D levels. (2)

Other findings support the proposition that vitamin D possesses important pleiotropic actions outside 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 an 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 was conducted with Japanese school children. The children were randomly divided into two groups: one group received daily supplements of 1200iu of vitamin D3, while the other 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% in the vitamin D3-supplemented group, compared with 18.6% in the placebo group. This reduction was even greater for those who had low vitamin D (250HVitD), with a 74% reduction in the incidence of influenza. Also, asthma attacks were significantly reduced in asthmatic children in the vitamin D3-supplemented group. (4)

Vitamin C

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

Correct nutrition is also a necessity so 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)

Thirty-one comparison studies examined the effect of regular vitamin C supplementation on common cold duration (9745 episodes). In adults the duration of colds was reduced by an average of 8% (3% to 12%) and in children by an average of 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 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)

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 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 who 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)

Ginseng

Ginseng found to reduce the likelihood of a repeat cold

A study included 323 adults who were randomly assigned to take either ginseng capsules or placebo capsules filled with rice powder every day for four months. During that time participants kept daily logs of any cold symptoms, including a 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% versus almost 23% in the placebo group). (10)

Pelargonium sidoides

Pelargonium sidoides found to provide relief from acute bronchitis symptoms

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[R] which has been clinically proven to provide relief from acute bronchitis symptoms after seven days (45% of the patients taking Kaloba[R] experienced recovery after seven days compared to 6.4% taking a placebo). Kaloba[R] can also 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[R] also helps to clear excess mucus from the respiratory system during acute sinusitis or acute bronchitis. (11, 12))

Hedera helix (Ivy)

Dried ivy leaf extract found to improve symptoms in patients with bronchitis

Ivy extracts are part of many current cough medicines and studies have found Ivy helps liquefy 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, in his book Herbal Medicine, mentions ivy extract as a treatment for whooping cough symptoms. (13)

A study of 9657 patients (of whom 5181 were children) with bronchitis (acute or chronic bronchial inflammatory disease) were treated with a syrup containing dried ivy leaf extract. After seven days of therapy 95% of the patients showed improvement or healing of their symptoms. The authors of the study concluded that dried ivy leaf extract is effective and well tolerated in patients with bronchitis. (14)

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 their expert advice.

Russell Setright is an accredited Naturopath, Medical Herbalist, Nutritionist, Remedial Therapist and Emergency Medical Technician and an educator in natural medicine, Advanced Life Support, First Aid, Emergency Critical Care and Rescue. Russell is a member of ATMS, AREMT, ACRRM, and the Australian Medical Writers' Association. He was registered in the Northern Territory under the Health Practitioners and Allied Professionals Registration Act in 1986 and was the Editor in Chief of the Journal of Health Sciences, and is naturopathic consultant to Blackmores Ltd. Russell is also the author of the Get Well books.

REFERENCES

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

(2.) Ginde AA, Mansbach JM, Camargo CA. 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;169:4384-390

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

(4.) Urashima M, Segawa T, Okazaki M, Kurihara M, Wada Y, Ida H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr2010; 91(5): 1255-60.

(5.) Hemila H. Vitamin C and the common cold. Br JNutr. 1992; 67(1);3-16.

(6.) Douglas RM, Hemila H, Chalker E, Treacy B. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2007;(3):CD000980

(7.) Hemila H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews. 2013; 1. Art. No.: CD000980. DOI: 10.1002/14651858. CD000980.pub4.

(8.) Shah SA, Sander S, White CM, Rinaldi M, Coleman Cl. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis The Lancet Infectious Diseases. 2007; 7(7): 473-480.

(9.) Vitetta L, Coulson S, Beck SL, Gramotnev H, Du S, Lewis S. The clinical efficacy of a bovine lactoferrin/wheyprotein Ig-rich fraction (Lf/ IgF) for the common cold: A double blind randomized study Complement Ther Med. 2013;21(3):164-171.

(10.) PredyGN, Goel V, Lovlin R, Donner A, Stitt L, Basu TK. Efficacy of an extract of North American ginseng containing poly-furanosylpyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ. 2005; 173(90): 1043-1048 doi: 10.1503/cmaj. 1041470

(11.) Matthys H, Eisebitt R, Seith B, Heger M. Efficacy and safety of an extract of Pelargonium sidoides (EPs 7630) in adults with acute bronchitis: A randomised, double-blind, placebo-controlled trial. Phytomedicine. 2003; 10(S4):7-17.

(12.) Agbabiaka TB, Guo R, Ernst E. Pelargonium sidoides for acute bronchitis: A systematic review and meta-analysis. Phytomedicine. 2008; 15(5): 378-385.

(13.) Weiss RF. Weiss's Herbal Medicine. Stuttgart: Thieme;2001.

(14.) Fazio S, Pouso J, Dolinsky D, Fernandez A, Hernandez M, Clavier G, HeckerM. 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.2009; 16(1): 17-24.
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Author:Setright, Russell
Publication:Journal of the Australian Traditional-Medicine Society
Article Type:Report
Date:Sep 1, 2016
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