Beyond the flu shot: A closer look at the “alternatives”

Once again, it’s influenza season. The vaccine clinics are open, and the hysterical posts about the vaccine’s danger are appearing in social media. There’s familiarity to all of this, but also a big new change – at least in Canada, where I am. Pharmacists can now administer the vaccine. And it’s completely free to anyone in Ontario (where I am), so the barriers to obtaining the vaccine are pretty much eliminated. There’s no longer a need to drag your kids to their family doctor or line up at a public health clinic. Anyone can walk into a pharmacy, show their health card, and walk out minutes later, vaccinated.  It’s another enabling change that may help improve immunization rates, as uptake rates in the population remain modest.

This year’s flu season is (as of week 47) fairly quiet. Google Flu trends suggests a fairly typical picture, nothing like what we saw in 2009/10, the year of H1N1. My city’s influenza tracker reports only a dozen cases so far this season. Many of us will get our flu shot, continue with our lives, and not think about the flu until next season’s announcements. That’s the hope, anyway. Influenza can kill, and in its more virulent forms, is devastatingly deadly. The worst case scenario (so far) is almost unimaginable today. In 1918/19 an influenza pandemic killed 50 million people worldwide (5% of the population). So among public health professionals, that worry about the next wave is always present. Much has been written at this blog <plug>nicely compiled in the SBM ebook,</plug> on the efficacy and safety of the flu vaccine. In short, the vaccine is effective for both individual and population-level protection, but only modestly so, and its effectiveness varies based on its match with circulating strains. And despite widespread use for decades, there are frustrating limitations with the current vaccine beyond efficacy, including the need to repeat the shot annually. Someone said something about “going to battle with the army you have”. (I thought it was Crislip but he was quoting Rumsfeld.) The quote is apt. It’s not a perfect vaccine, but it does offer protection – if not directly to you, then indirectly to those at greater risk of infection. Hospitals and health facilities have been criticized for demanding health professionals either get the vaccine or wear a mask – and the arguments against vaccination are losing. But even the strongest advocates of influenza vaccine will acknowledge its limitations, which perhaps contributes to the understandable perception that there is more that could be done- beyond reasonable and effective precautions like handwashing and hygiene.

Whether it’s the confusion of colds with the flu, the known limitations of the vaccine, or the ubiquity of upper respiratory infections, there is no end to the products, therapies, and nostrums touted as influenza preventatives or treatments. And half of the population may be using them. In this realm, where evidence is mostly absent, pretty much anything goes. I was reminded of this by physician Yoni Freedhoff who noted that he was handed a coupon for “Flu Shield” after he and his family received the vaccine at his local pharmacy. These products are marketed like an extended warranty offer: Why stop at the vaccine? Buy the supplement for extra protection. At least extended warranties can occasionally be useful, unlike Flu Shield. Locally, the alternative-to-medicine purveyors are competing with public health endeavors by touting a monthly “homeopathic flu injection” while subtly discouraging the vaccine that actually provide immunization. Many of these products have been examined in detail in this blog, so I’ve compiled a list of the most actively promoted. I’ve categorized them loosely based on their plausibility and known efficacy data:

Possibly effective

Oseltamivir (Tamiflu): This is a drug, not a supplement, but worth mentioning as one of the few products that might work. There is published data to suggest oseltamivir is modestly effective for the prevention and treatment of influenza. However, given the lack of complete transparency with the oseltamivir clinical trials, it’s not possible to make any definitive conclusions about its effectiveness. Given any positive data would likely have been published already, my sense is that oseltamivir’s modest efficacy may be still overstated.

Unlikely to be effective

Vitamin D: While there’s evidence that some may be deficient in vitamin D, especially in the winter, supplementation doesn’t appear to have any effect at preventing infection.

Elderberry: There’s some promising data with elderberry suggesting it can reduce flu-like symptoms, but these findings it needs to be confirmed in larger trials. We’ve seen this pattern with just about every herbal remedy: Promising preliminary data, followed by less impressive data when better trials are done. It would be nice to see further studies to evaluate its effectiveness.

Zinc: Sold as lozenges for the treatment of colds, the effects are inconsistent. There’s no evidence showing efficacy for treating influenza. Zinc nasal sprays, such as Zicam, have been associated with permanent loss of the ability to smell.

Garlic: There is some preliminary data examining garlic’s effectiveness for preventing colds, but it’s inconsistent and the positive effects may not be real. There’s no evidence demonstrating any effectiveness of garlic for preventing or treating influenza. As preventatives go however, I’m supportive of any that also enhance my meals.

Ginseng: There are a number of forms of ginseng that have been studied for their immunostimulant effects. One of the more popular brands is Cold-fX. To the manufacturer’s credit, there have been some trials on Cold-fX examining its ability to help prevent colds and influenza. The data don’t suggest the effects, if any exist, are that meaningful. Whether it has any meaningful effects at influenza protection hasn’t been specifically studied.

Probably useless

Echinacea: Despite the hype and the marketing there is no persuasive evidence that Echinacea does anything to prevent or treat influenza. It’s one of the better-studied herbs for respiratory infections and is demonstrably ineffective. As Steven Novella noted, “The market for Echinacea endures, largely on a sea of anecdotes and marketing spin that is incongruous with the evidence.” If you think it works, you might feel better, but there’s no meaningful or measurable actual effects.

Wheatgrass: True modern-day snake oil, this is touted as an “immune booster” but isn’t any better than any other food.

Megavitamins: Sometimes called “orthomolecular” treatments, this is based on the idea that if vitamins in our diet are good, then massive doses of vitamin supplements must be better. The most commonly touted is vitamin c, but there’s no shortage of others. It’s the same idea behind the belief that vitamin infusions are a good idea. In the absence of a deficiency, there’s no convincing evidence that megavitamins have any beneficial effects for prevention or treatment.

Oil of Oregano: This is the herbal cure-all without demonstrable evidence of efficacy.

Definitively useless

Vicks Vaporub: Commonly used for symptom relief (it was around for the big pandemic of 1918/19), there’s no evidence it is effective for prevention or treatment. Even data showing it has any meaningful effects is poor. The active ingredient is camphor, a tissue irritant. There’s an urban myth that putting it on your feet will treat a cough, but that’s all it is – a myth.

Onion: Cutting up an onion and putting it beside your bed or around your house. Because onions suck up viruses, apparently.

Engystol, Pascoleucyn, and Gripp-Heel: These are homeopathic products. Like all other homeopathic preparations, there are no medicinal ingredients and are quite literally placebos, without demonstrable evidence of efficacy to prevent or treat influenza. Quite frighteningly, some that are approved as oral supplements (in Canada, at least) are marketed by the manufacturers (PDF) and administered by naturopaths as injections. Yes, they’re injecting oral products. Hopefully that water is sterile.

Oscillococcinum (Oscillio): The heart and liver of a Muscovy duck, fermented, then diluted to nothingness so the final product is 100% pure homeopathic placebo. Useless for both prevention and treatment.

Wet socks: This naturopathic strategy involves putting on a pair of cold, wet socks, covering them with dry socks, and then going to sleep. Apparently it will “‘rev up’ the immune system”, demonstrating the limits of the naturopathic understanding of immunity.

Pouring oil in your ear: Despite the claims, trying to heat a lymph node in your neck won’t have any impact your illness.

Despite all the limitations of the current flu vaccine, it still represents the most effective means of protecting yourself and the community from influenza. Despite the myriad of complementary and alternative remedies touted to prevent or treat influenza, there’s no convincing evidence for most treatments. This list isn’t exhaustive – if I’ve missed any popular ones, please let me know in the comments.

Posted in: Herbs & Supplements, Homeopathy, Vaccines

Leave a Comment (83) ↓

83 thoughts on “Beyond the flu shot: A closer look at the “alternatives”

  1. windriven says:

    Now if only we could develop a vaccine to prevent credulity…

  2. irenegoodnight says:

    I never thought the Vapo-Rub (I buy store brand) would cure or even shorten our colds, but it sure makes everyone feel pampered and important–increased well being? My kids–and hubby still, plead for a chest rub before bed when they have colds. Vapo Rub covered by a warm towel or hot water bottle, a hot toddy (or tea/cocoa for the kids) can help with a good night’s sleep. I’ve wondered if it isn’t just a type of aromatherapy–placebo effect–from the smell of the camphor?

    Anyway, do you think it would do any good to nail this “thesis” to the door of Walgreen’s (who sells every one of these remedies–and more)?

  3. Salty Dog says:

    Scott: I always appreciate your thoughtful and we’ll researched articles. How about using some of your energy and influence to convince your colleagues (or better yet the regulatory bodies) that selling these products is unethical and only makes it more difficult for those of us that are science-based to deliver quality care to our patients.

  4. Alia says:

    How I envy you, Canadians. I had to go the doctor’s, have an overall check-up (even though I was well at the time and I tolerate the vaccine very well, I’ve had it every year for like, 10+ years) and pay an equivalent of USD25 for it (yes, that much, it includes the cost of the doctor’s visit to). My former head teacher used to provide the vaccine to all interested teachers, it was administered at school and we only paid for the vaccine itself, the doctor’s consultation was provided free of charge. But then the head teacher changed and so now I have to do it on my own.
    Anyway, the flu shot seems to work for me, I get the usual winter-time colds (just getting over one at the moment), but no flu ever since I started vaccinating.

    1. MTDoc says:

      Just a piece of information about vaccine cost to clinics. Two years ago the vaccine cost my former clinic $15 per dose. The additional $10 covered the services associated with its administration and any doses which went unused or not paid for. Patients are routinely advised to get this particular immunization at public health or the pharmacy because their overhead is either less or it’s subsidized by the taxpayer. While strongly urging patients to get their “flu shot”, unless it’s a patient receiving regular care, its cheaper for everyone for them to get it elsewhere. Private clinic overhead is often misunderstood, but involves substantial cost, the same way you would never go to an ER just for a flu shot. Still, I liked the old days when it was our pleasure to provide all our patients with affordable, quality care.

  5. Birdy says:

    While I’m glad to see Ontario’s pharmacists can now administer the flu vaccine, that’s not the case in all of Canada. Here in PEI, we still have to go to a clinic and get them from RNs or family doctor and there is a fee (which is waived for certain high risk groups) that ranges from $7-$15 per person. It’s an inconvenience and can be a burden for poorer families. I’m hoping to see our pharmacists’ scope expanded in the future. They only just got the ability to extend prescriptions last year. Unfortunately our province is slow to change so I don’t expect to see this in the near future.

  6. Leeann says:

    I looked at the “homeopathic flu” link, 6 shots “covered by most insurance plans.” Really?

  7. TwistBarbie says:

    With regards to the homeopathic oral doses as injections, I know the ones from Heel are sterile in polyamps. They are the same preparations sold as injectables in other countries, but I guess health Canada finally did something right with regards to CAM by forcing these to be sold as oral. Still useless of course, but at least they aren’t likely to cause an infection (unless the ND injecting them is as uneducated about proper injection procedure as they area about other crucial aspects of their trade). My boss’s son is graduating pharmacy this year and I’ve heard him tell people vitamin C has in fact been shown to work well for colds and the flu. No idea where he picked that one up, I haven’t seen anything besides “may possibly shorten duration by 0.3 days” or things to that effect.

    1. WilliamLawrenceUtridge says:

      Vitamin C does “work” for colds and flu; in high doses it’s a natural antihistamine. So it doesn’t make the cold or flu shorter, but it does help with some of the symptoms like congestion.

      So while the doctors and researchers are correct in that you don’t get better any faster (i.e. you don’t clear the virus any quicker), patients are “correct”, with ironic quotes, in that they feel better while sick, and they seem to get better quicker (i.e. their symptoms seem to disappear earlier).

      Slightly different definitions lead to different interpretations.

      1. TwistBarbie says:

        Hmmm ok. I wasn’t aware of that, but looking at the Natural Medicine Database it says “there is some evidence that vitamin C may also have weak antihistamine properties.” So thank you! I learned something! Far from the “reduces duration by 20%!” that I heard a pharmacist tell someone the other day!

        1. WilliamLawrenceUtridge says:

          Ya, at best you could possibly say “taken in huge doses that are impossible to reach through food, vitamin C makes the symptoms of rhinoviruses and influenza 20% less, thus giving the appearance of a cure”.

          But that’s less sexy.

          1. TwistBarbie says:

            Well, if it’s just about “feeling” better i’ll stick to my old standby: Hot chamomile tea with milk, honey and 2oz of brandy, or my Dimetapp-tinis :)

  8. Greg says:

    I’ve read that Oil of Wild Oregano is useful for treating a variety of respiratory ailments including flu, so I am wondering if you overlooked it or is it completely useless?

    1. windriven says:


      Actually Scott mentioned that:

      “Oil of Oregano: This is the herbal cure-all without demonstrable evidence of efficacy.”

      Are you thinking that the wild is better than the tame? I’m told that homeopathic manufacturers only use the tame because the wild goes crazy during succussing and sometimes breaks the machinery.

      1. Greg says:

        Everything I’ve read mentions the wild variety as being most desirable as well as a high carvacrol content (> 80%).

        Anecdotally, in 2007 our dog came down with pneumonia and was close to dying, according to our vet. She stayed in the clinic overnight for 2 nights and was released to us with a 2 week’s worth of medication. In conjunction with the medication I gave her 1 capsule daily (basically a dropper-full) of high-quality Oil of Wild Oregano for about 3 weeks. On her return visit to the vet, a month later, her lungs were totally clear. Our vet was amazed – he told us it usually takes about six months for the lungs to be completely clear of pneumonia.

        My wife who’s asthmatic, uses it whenever she gets a cold. Prior to using it, colds almost always affected her lungs too and she would end having to get prescription medication to get well. Since she has been using Oil of Wild Oregano, only once has a cold become so bad that she had to see a doctor.

        I’m not saying it can be used to cure anything but the wild variety definitely seems to have some medicinal effects.

        1. Greg says:

          Forgot to mention, I read Scott’s blog on Oil of Oregano. Oreganol P73 is not a particularly good brand – their Super Strength formula is great but the regular is not as good as products from Hedd Wynn, Joy Of Mountains, Natural Factors and New Roots, all of which are over 80% carvacrol.

        2. windriven says:

          Let’s say, just for a moment, that carvacrol promotes clearing lungs of fluid. What is the correct dosage? At what purity? What is the LD(50)? The lists pure carvacol as:

          “GHS Classification
          Acute toxicity

          Oral(Category 4)
          Skin corrosion(Category 1B)
          Serious eye damage(Category 1)”

          But its “natural” right? So it can’t hurt anything, right?

          1. windriven says:

            Should have said The MSDS lists pure carvacol…

          2. Greg says:

            I sense some hostility in your reply. However to answer your question, because it’s natural it can’t hurt anything, just like the thousands of species of poisonous mushrooms won’t hurt you, nor the deadly venom of insects, snakes and lizards won’t hurt you…

            1. Greg says:

              I should have written “…nor will the deadly venom of insects, snakes and lizards hurt you…”

              Sucks that you can’t edit your posts.

            2. windriven says:

              Hostility is too strong a word. Sarcasm is probably closer. I think it was probably the comparative analysis of brands that sent me over the edge.

              You advocate an 80% carvacrol for treating pulmonary congestion. But purified carvacrol has serious enough properties to be listed on its Material Safety Data Sheet.

              So I wonder how you know with certainty the concentration of the drug that you purchase, how you know how to dose it, what are the manifestations of an overdose or allergic reaction and what would you do about one.

              1. Greg says:

                Sorry I don’t understand what you want. As I stated earlier, the experiences about which I have written were anecdotal, so I can’t give you any quantitative measurements at this time or speak to allergic reactions, etc. It’s not like I am advocating this to anyone else. So far as the concentration of the products is concerned, I don’t have access to a lab, so I can only go by the manufacturers’ claims.

              2. windriven says:

                “Sorry I don’t understand what you want”

                I am confused by your willingness to use a drug with uncertain dosing, uncertain side effects and quite limited – if interesting – science supporting it.

                I also find it a little dissembling to plead anecdote on the one hand while discussing the virtues of various brands on the other.

              3. Greg says:

                You must have missed the part where I mentioned I am going by what I have read regarding the concentration of carvacrol. Though you might, I certainly don’t consider it a drug. All I wrote was that it seems to have medicinal properties, it’s beyond my control if that somehow offends you. Personally I detest your nitpicking and I wonder why you’re being so adversarial.

              4. windriven says:

                “Though you might, I certainly don’t consider it a drug. All I wrote was that it seems to have medicinal properties,”

                A compound used for its medicinal properties is, by definition, a drug. It doesn’t matter what you or I consider it to be.

                ” I wonder why you’re being so adversarial.”

                Because supplements are the gateway drugs of woo. Flaccid thinking, shruggy response to lack of data, equanimity about science versus superstition provoke that response.

                This thread started with you questioning why oil of oregano wasn’t covered by Scott. I pointed out that it was. You responded that what Scott covered wasn’t the right brand of oil of oregano. About that time I figured you to be shruggy masking your shrugginess behind the claim of anecdote. Bull crap. You went out of your way to try to justify the use of oil of oregano.

              5. Greg says:

                Whatever. Too bad you didn’t bother to comprehend what I wrote and take it for face value, which is how it was offered. I don’t have an agenda, but obviously you do and it seems to have clouded your thinking and perhaps jaded your outlook. I sure hope this is not the attitude you display to your friends and family – if it is, I feel for them. Dealing with a personality such as yours on a daily basis would be very difficult.

              6. WilliamLawrenceUtridge says:

                Herbal supplements like oil of oregano have been called “drugs of uncertain potency, of uncertain purity, of uncertain pharmacokinetics and uncertain effectiveness”. If oil of oregano can have an effect on the body, it can have side effects as well (aside from tasting like pizza every time you burp), and you simply don’t know what they are. It’s possible that it may well act as a bactericide or viricide, even inside the body. But how? Does it interfere with RNA synthesis perhaps? Your body makes a ton of RNA, is it interfering with that? Is it mutagenic in high doses?

                It’s possible it works extremely well, its extracts definitely have biological effects, it may be one day developed into a drug just like willowbark was. And just like willowbark, it may be found to have side effects as well (that can be spun into main effects, like they were with the anti-clotting effects of aspirin). Any herb that may have effects can be made into a standardized, often improved version in drug form. Notice how very few people chew willowbark these days, but lots take aspirin.

            3. windriven says:

              ” Too bad you didn’t bother to comprehend what I wrote and take it for face value, which is how it was offered.”

              Oh, I comprehend it just fine. But take it for (sic) face value seems to mean ‘accept it uncritically.’ Sorry, no can do. These pages are littered with anecdotes and cherry-picked data and appeals to dubious authority from sometimes well-meaning people who just don’t have a clue.

              This is a forum about science based medicine, not about what worked for aunt Sally when she went through the change. When you lay something half-baked out on the table here don’t be surprised when someone jumps on it.

              If you were serious about critical thinking you would take it as a great opportunity. I, for instance, will be eternally grateful to Karlwithakay who, sadly, we don’t see much of anymore. Karl once jumped on a rather libertarian proposition I forwarded and exposed a serious flaw. It caused me to reevaluate libertarianism in general and its place in my own ethics and philosophy. Good on him.

              ” Dealing with a personality such as yours on a daily basis would be very difficult.”

              Let’s both give thanks that you don’t have to. :-)

              1. Greg says:

                “When you lay something half-baked out on the table here don’t be surprised when someone jumps on it.” That’s fine but you could at least be civilized about it – this is an open forum and anyone can comment. In general I find people, like you, on this forum are antagonistic towards anyone who offers a different view or opinion that diverges from the mainstream. You also love to jump to conclusions, which in and of itself is at odds with a scientific mindset. You don’t win people over by being antagonistic, so I guess it’s hardly surprising that there is so much dissension on these forums, given the penchant to argue and harangue people who post comments with which you disagree.

              2. windriven says:

                “but you could at least be civilized about it”

                Oh puleeze. I asked some straightforward questions about a drug that you are giving to your wife and dog. I may have been a little sarcastic about it in an effort to get you to think a little critically about what you were saying and doing. I’ve reviewed everything that I’ve written to you in this thread and I can’t find anything that could be reasonably characterized as uncivilized.

                “this is an open forum and anyone can comment.”

                Yes, you did. Then I did. Each of us several times:

                You: author didn’t mention X.
                Me: actually, he did.
                You: but it wasn’t the right brand of X. That one doesn’t have enough essence of X.
                Me: pure essence of X can have some nasty side effects. Have you thought about this?
                You: you’re being mean to me.
                Me: not mean, just a little snarky, Sparky.
                You: I’m not advocating X, just telling a little story about it.
                Me: You don’t know what you’re doing using X and you wouldn’t have pushed the conversation this far if you weren’t selling the usefulness of X as a therapy.
                You: I’m using X based on information I got from some unnamed source. It must be right! Besides, its not a drug. I hate you! (slams door)
                Me: Yes, it is a drug and I’m not inclined to let you dribble out nonsense about a drug you don’t remotely understand.
                You: Whatevs. But you’re stupid and should just accept whatever I say and move on. You’re a real a-hole, you know.
                Me: I haven’t said these things to be an a-hole (but I’m working up to it :-) ) but to try to explain that in science forums claims need to be accompanied by proof.
                You: You are too an a-hole … a huge one and nobody likes you.
                Me: Let’s review our conversation. I’m not claiming not to be an a-hole, only that I have not been one to you in this thread. I appreciate your concern about the status of my relationships and about my ability to influence people. But I’m perfectly happy to let my words speak for themselves and let the chips fall where they may. Moreover, my friends like me in spite of my many failings and the feelings of my not-friends toward me aren’t of much interest.

                “it’s hardly surprising that there is so much dissension on these forums”

                Merriam-Webster: dissension: disagreement that causes the people in a group to argue about something that is important to them.

                Finally you and I agree. It is hardly surprising.

              3. Greg says:

                “Me: You don’t know what you’re doing using X and you wouldn’t have pushed the conversation this far if you weren’t selling the usefulness of X as a therapy.” An assumption.

                “You: I’m using X based on information I got from some unnamed source. It must be right! Besides, its not a drug. I hate you! (slams door)” Another assumption.

                “You: Whatevs. But you’re stupid and should just accept whatever I say and move on. You’re a real a-hole, you know.” more assumptions

                For what it’s worth, I don’t believe you are an a-hole, but I do believe you could have been more civilized. You could have started out by asking what I knew of it, instead you started with scientific queries about which you already knew the answers. If I had the wherewithal I would do a study of it, whereas you’re just willing to sit back and do nothing but criticize – not very helpful or scientific. Don’t you think there’s value in getting some firsthand experience, instead of always relying on other people’s research or lack thereof? As you should well know, humans are extremely fallible.

                But for the sake of the argument, what critical thinking skills am I to apply? The fact that there aren’t any studies available doesn’t necessarily indicate Oil of Wild Oregano hasn’t any beneficial effects. It just means no one has studied it as yet. Do you think it would be possible to crowd-fund a study?

              4. Greg says:

                I checked the article, which I saved – The Wild Oregano Oil Miracle Article by Dr. Zoltan P. Rona, MD, MSc, – and I was wrong about the carvacrol content recommendation – anything over 70% is good, though I do believe I read another article that mentioned 80% as being better.

              5. windriven says:

                “The fact that there aren’t any studies available doesn’t necessarily indicate Oil of Wild Oregano hasn’t any beneficial effects.”

                No, it certainly doesn’t. But the scientific approach is to expect proof of benefit as well as an understanding of risk before using a drug.

                There are all sorts of people who recommend all sorts of treatments for all sorts of conditions. You will see them discussed in these pages every week. You will see comments by them in these pages every week.

                Claims and anecdotes don’t mean much until they are supported by careful scientific study. The first of many reasons for this is confirmation bias: we are likely to see that which we expect to see.

                Perhaps oil of oregano is harmless. I hope so. Perhaps oil of oregano does some good. I hope so. By some estimates up to half of the pharmacopeia arose from pharmacognosy. But this isn’t the Dr. Oz show. So we wait for good evidence of efficacy and safety. Especially safety. What you personally take is, IMHO, your business. What you suggest to others – even when that is couched as an anecdote – is another matter.

                Finally – and really, we’ve about exhausted this thread – when something is billed as:

                “The Wild Oregano Oil Miracle Article by Dr. Zoltan P. Rona, MD, MSc, ”

                don’t walk, run the other way.

                I’m going to save us both the aggravation of pointing out why the three items you claimed to be assumptions of mine are demonstrably not. The weekend is upon us.

                But this did make me feel a little bad:

                ” If I had the wherewithal I would do a study of it, whereas you’re just willing to sit back and do nothing but criticize – not very helpful or scientific. ”

                I frankly had pegged you for an herbalist or naturopath trying to sell a bill of goods. If in fact you are simply someone trying to understand science and medicine and ways to use those tools to better your life and the lives of those around you, you’ve found a good place in SBM. If you want to learn about oil of oregano, go to Pubmed and enter carvacrol in the search window. You’ll find 800-odd listings. Much of the work seems to be very preliminary, most are from obscure journals and some are obviously woo. You aren’t going to find any smoking guns there – at least I didn’t in a quick review. But you will see some serious work by serious people who are interested in learning if oil of oregano has any value as a drug and if so what dangers it might pose.

              6. WilliamLawrenceUtridge says:

                Here is the article by Dr. Rona. Looks like it’s quackery, or at least unsupported by anything meaningful. It is promoted as a cure-all, it’s promoted for vague symptom-based illnesses with no known infectious etiology like chronic fatigue syndrome and fibromyalgia, it “boosts the immune system”, a meaningless statement that if true would be a source of tremendous concern for those with allergies and autoimmunity concerns.

                It may work as an antiparasitic, bacterial or viral compound, but if that’s the case – it clearly hasn’t been reliably tested as part of a controlled series of clinical trials. If that’s the case, then you are essentially taking it for granted that it doesn’t have serious adverse effects. You may be right, but historically this is a risky bet. St. John’s Wort for instance, interferes with HIV medications and causes photosensitivity, a problem not appreciated until scientific testing occurred. Hell, even grapefruit poses concerns for people taking medications.

              7. Greg says:

                Ok – thanks, I’ll have a look through the PubMed studies.

  9. Harriet Hall says:

    Just want to add a reminder that there is a high-dose flu vaccine for those of us over 65 who tend not to have as good an immune response to the regular vaccine as younger folks.

    1. egstras says:

      “Just want to add a reminder that there is a high-dose flu vaccine for those of us over 65 who tend not to have as good an immune response to the regular vaccine as younger folks.”

      Had that one this year — felt sort of crappy for the next couple of days, but nothing major.

  10. Regan says:

    I had enough trouble scheduling one doctors visit for my toddler to get the flu vaccine. I can’t imagine trying to do 6, so hopefully homeopathy is shooting itself in the foot there. ( My husband and I both work at places that the nurses chase you down and stick you with it provide it for free.)

  11. Rick L, RN says:

    Dr. Hall is there support that the high dose vaccine is more effective than the tradational? I seem to recall the research was still out on this. Thanks.

  12. Renate says:

    If you eat enough garlic, people may try to keep you at a distance, which might prevent them from giving you the flu.

  13. Forcefield says:

    Far fewer colds since I changed my diet several years ago and got rid of the so-called “SAD” (Standard American Diet). Perhaps one cold in the past three years. I was typically running 2-3 per year before that. Of course, this is highly anecdotal and it could just be pure luck or some other confounder. But I do think that restoring myself to a more healthy physiology through diet – as measured by a panel of lipids, blood pressure readings, weight and glucose-insulin biomarkers – could be the (real) answer. Maybe. I’m willing to entertain skepticism (including my own).

    1. MTDoc says:

      I too used to get 2or 3 colds a year, but then I stopped treating sick kids. Seriously, the problem was not so much the sick kid I was seeing, as it was his six siblings who were fascinated by the doctor and wanted to get as close to the great man as possible. Washing hands is important, but not enough when trapped in a small room with half a dozen coughing , if admiring, children. Where I was at the time it was a cultural thing.

      1. Forefield says:

        In today’s society, which is globalized and highly mixed, I would suspect you would be exposed to rhinovirus, coxsackievirus, adenovirus, etc. with great frequency even if you weren’t looking after little ones in ER (or wherever you practiced).

    2. WilliamLawrenceUtridge says:

      Exercise can have a beneficial effect as well, increasing the activity of the nonspecific immune cells. The analogy I saw was someone coming into your house once a week to straighten up. Sure, it didn’t ensure your house was spotless 24/7, but it means that when it came time to clean up properly, there was a lot less to do.

      1. Forcefield says:

        I suspect you are right, although exercise leads to temporary immunosuppression followed by immune “enhancement”. Still, in my case, I believe diet has been much more potent, and specifically getting off the SAD. I view exercise as a useful adjunct but I can’t do enough intense exercise to really make a difference (despite exercising for 5+ days per week).

  14. RobRN says:

    The onion flu protection urban legend surfaced here recently (in an ambulatory health care organization!) and, to my surprise, there were more than a few who attested to the method. Oxidation causes the slice of onion to darken – Just like it makes a slice of apple turn brown.

  15. NorrisL says:

    In August of 2002, our Winter, my wife and I both came down with the worst flu either of us ever had. But our only concern was Charlotte. She was 8 weeks old at the time and whenever I “came to” enough to have a rational thought, all I could think of was, if Charlotte gets this, she is dead. She didn’t get it, nor did her older brother Daniel. We all get vaccinated every year now!

  16. NorrisL says:


    As a vet I can assure you that I have treated dogs with pneumonia on numerous occasions and they often recover in 4-6 weeks and sometimes less! On the odd occasion you may strike a longer term case but that would be the very odd occasion.

    1. Greg says:

      Well, you would know better than I would – I was just relating what our vet told us at the time. I can only surmise that given the severity of our dog’s illness, the vet did not expect her to be fully recovered with a month.

  17. Calli Arcale says:

    I always thought with garlic that you were supposed to eat whole cloves, at which point your breath would be so redolent that nobody would come close enough to infect you. :-D

  18. WBailey says:

    What about Zanamivir? I heard tamiflu has significant amount of resistance floating around whereas zanamivir doesn’t. Worthless anecdote: I was prescribed it prophylactically when traveling during the h1n1 pandemic and didn’t get the flu. The delivery method was interesting.

  19. Donna B. says:

    For entertainment purposes only, I offer this gem I came across on my FB feed explaining why the flu vaccine is ineffective:

    “The flu vaccine only works on the Influenza type A and B strains. However, research shows that 80% of flu symptoms are related to viruses other than Influenza such as rotovirus, coronavirus, rhinovirus or even some bacteria.”

    Well, duh. The chicken pox vaccine isn’t going to help prevent whooping cough, so why bother getting the flu vaccine??? And yes, I commented pointing out the idiocy of the statement. I have too many FB friends anyway.

    Source of the quote above:

    1. oderb says:

      While you may believe that your FB feed has entertainment value, you miss an important – and obvious – point.

      If influenza only accounts for 20% of people with flu symptoms, and if the vaccine is say 50% effective, then that means that the vaccine will only prevent about 10% of the flu that goes around every season.
      And that doesn’t count the majority of people who don’t get sick at all.

      Why aren’t people told that the vaccine will help much less than 10% of people who get it?

      I suspect many fewer people would get vaccinated if they knew these numbers.

      1. MTDoc says:

        It could be that that precise group are the ones that die a rather unpleasant death. I learned early that most people with COPD would not survive influenza no matter what treatment they received. A moderately severe case of influenza compromises at least 50% of your pulmonary function. A really healthy person can survive that with proper supportive treatment. But if you have already lost 50% of your lung function you are SOL. I’ve watched too many people die, signed hundreds of death certificates, and still no one understands what we are talking about when we try to tell them that influenza is not the “flu”.

      2. mousethatroared says:

        Your statistics seem a bit fuzzy, but even if they are correct I say “Ha! a lot better than Vegas odds, baby.” and not being dreadfully ill is a lot higher on my priority list than getting $15 of quarters from the slots.

      3. Donna B. says:

        oderb, I don’t think I’m the one missing the point.

        You, as well as the chiropractor I quoted, somehow think that a vaccine for specific strains of the flu virus should also relieve symptoms of illnesses caused by other agents that may have similar symptoms. That’s rather silly.

      4. Andrey Pavlov says:

        @ oderb:
        Your statistics are incredibly wrong. You don’t seem to have an understanding of how to actually use statistics.

        If the vaccine prevents 50% of flu cases, then it prevents 50% of flu cases. You don’t take have of the incidence of flu-like illness that is actually flu and say that is how much flu is prevented. That makes no sense whatsoever.

        I mean, think about your own sentence for a minute:

        If influenza only accounts for 20% of people with flu symptoms, and if the vaccine is say 50% effective, then that means that the vaccine will only prevent about 10% of the flu that goes around every season.

        Influenza accounts for 20% of people with flu-like illness. If half of that is prevented then 10% of flu like illness will be prevented. Not flu. Do you not see the distinction? And understand why it matters? It is still 50% of flu prevented, not 10%. The key difference here is that most flu-like illness is reasonably benign. The flu itself is much, much less benign. Preventing 50% of it is still a good thing.

        But seriously, take a minute and just think your own sentence through and realize that you are speaking from a point of pre-determined conclusion and bias against the vaccine rather than actually thinking through the reality of the disease and the vaccine.

    2. lizditz says:

      A chiropractor, why am I not surprised?

    3. WilliamLawrenceUtridge says:

      There’s an element of truth there, though it’s more accurately the case that laypeople can’t tell the difference between influenza and rhinoviruses. Influenza causes fever, body aches, chills, etc. It’s quite unpleasant. People think a set of sniffles is the flu (or a stomach ache), so there is umbrage when the flu vaccine doesn’t prevent sniffles and tummy aches – because people don’t realize this isn’t the flu.

      Where that statement really goes wrong is when it says “…80% of flu symptoms are related to viruses other than influenza…” Well, if they’re viruses other than influenza, they aren’t flu symptoms, are they? They’re probably rhinoviruses, which we also lack a vaccine for (but fortunately is far, far less dangerous than influenza).

  20. oderb says:

    I’m wondering why Vitamin D was dismissed as unlikely to be effective on the basis of just one study.

    Two positive studies are cited in this article. Why weren’t they mentioned?

    (I’m not endorsing the Vitamin D council commentary on influenza, just the two cited studies.)

    1. Chris says:

      Possibly because of this study he linked to in the sentence about Vitamin D:

  21. mousethatroared says:

    I don’t know if it’s the flu, but there is some very nasty flu acting virus going around my son’s school. Two of his friends have been out of school over a week. Two more weeks of school before break when, hopefully, the risk of school borne contagion will be lower. I guess I’m kinda hoping it IS the flu since we’ve gotten the flu shot and I’m keeping my fingers crossed that it was a good pick this year.

  22. lizditz says:

    Re Vicks VapoRub and other similar products (aromatics in petroleum jelly) — it’s probably safe to use on school age children, in moderation, as a placebo showing that the caregiver is aware of the child’s discomfort and wishes to alleviate it. Strongly related to putting an adhesive bandage over an injury not visible to the naked eye.

    1. CC says:

      The main thing I remember from Vicks VapoRub when it was rubbed on me as a kid was that the smell cleared my sinuses and crossed my eyes. That was some strong smelling stuff!

      I imagine eating horseradish would have the same cold-or-flu treatment benefit.

      1. Nashira says:

        Horseradish, Chinese hot mustard, or exceptionally spicy kung pao chicken from our favorite place, were my family’s usual go-tos. Mmmm fire!

  23. charles grashow says:

    At first glance, world-renowned Israeli virologist Dr. Madeleine Mumcuoglu does not seem like the sort of person you expect to come up with what could turn out to be a cure for one of humanity’s biggest threats today – the avian flu.

    She seems comfortable and grandmotherly, not the type you usually associate with the frontline of research into a potential pandemic. On the other hand, however, Mumcuoglu is clearly a very determined woman who has turned a lifetime of research into the health benefits of elderberry, an old folk remedy for influenza, into a clinically proven treatment for regular flu. Now, new in-vitro tests have proved that her remedy, the elderberry-based Sambucol, also appears to be effective against avian flu.

    Last week, Retroscreen Virology, a leading British medical research institute associated to Queen Mary College, University of London, announced that Sambucol was at least 99% effective against the avian flu virus, H5N1, and in cell cultures significantly neutralized the infectivity of the virus.

    “I think that Sambucol has a great role to play – it really can save lives,” Mumcuoglu told ISRAEL21c. “To my knowledge, it’s the only product that can cut the flu in half, before complications have a chance of setting in. If we do have a cure for chicken flu, this is a really positive thing for Israel.”

    1. WilliamLawrenceUtridge says:

      One must note that this is in vitro work; petri dishes and test tubes. Much like cancer, it’s easy to kill viruses in glass dishes. Whether elderberry extracts will work in humans is a totally different question; it must survive in the blood, or passage through the gut, including deactivation through the first-pass effect of the liver. It must reach the infected tissues in sufficient dosage to kill the virus. It must be more toxic to the virus than it is to the surrounding tissues. It must have minimal side effects (and anything that is a strong viricide in human tissues is likely to have side effects).

      Petri dish studies are a starting point for investigating drugs that may eventually cure human diseases. Only greedy quacks, idiot reporters and loons pretend that killing something in a petri dish is the last stop in an herbal extract becoming a proven treatment. Maybe exercise a bit of critical thought next time instead of just assuming this was a slam-dunk. A search of pubmed shows that sambucol has essentially no studies demonstrating that it works. Dr. Mumcuoglu has a lot of work to do before her claims can be considered credible.

  24. Andrés says:

    Closer look at vitamin D? Really?

    You are aware that Rees et alter didn’t test any infection for influenza A in laboratory, aren’t you? As I already said vitamin D is not expected to have any effect on influenza B and rhinoviruses at least. If it is common knowledge that influenza prevalence is between 10%-20% (lower for influenza A) of all the influenza like illnesses I am at a loss about your unjustified confident statement “Unlikely to be effective” based on a trial not assessing influenza A infection. Supporting evidence is quite stronger. This blog is called Science Based Medicine. I think that the Science part obliges to higher standards than this.

    1. WilliamLawrenceUtridge says:

      Feel free to start your own blog, where you can tout the virtues of vitamin D supplementation and justify your ongoing irrational refusal to vaccinate yourself against influenza, without challenge.

      1. Andrés says:


        From Face Mask Use and Control of Respiratory Virus Transmission in Households (my bolds):

        We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but <50% of participants wore masks most of the time.

        I am curious. Do your wear a mask everywhere? You know, you wanted to do what you could in order not to infect anyone and you can’t count on getting the flu shot alone because its effectiveness depends on it being a good match.

        1. WilliamLawrenceUtridge says:

          I don’t wear a mask everywhere. I get vaccinated every year. And that study pretty much showed that wearing a mask is not a very effective way of preventing infection, which is characteristic.

          The influenza vaccine, when well-matched, is an effective preventive measure. I’m still confused why you discount it so. If you are so concerned about influenza, I’m not sure why you don’t get vaccinated.

  25. Sawyer says:

    You really should stop citing you own comments as evidence. It gives the false impression that a Science Based Medicine contributor supports your view, and upon clicking the link I find it’s quite the opposite. I doubt this is purposeful but it’s very annoying.

    It also reveals how some of your viewpoints do not change when subjected to new evidence. You previously bemoaned western medicine for not pursuing RCTs for non-patent molecules. What kind of study did Dr. Crislip cite in this post? How could this have happened?

  26. Andrés says:

    @Sawyer: Maybe I am a little dumb today. Please clarify to me where “I already said” is misleading anyone.

    Sawyer said:

    You previously bemoaned western medicine for not pursuing RCTs for non-patent molecules.

    I also said:

    At least it is not going to be the case for vitamin D.

    Perhaps it wasn’t clear my meaning. I tried to say “Thankfully it is not going to be the case for vitamin D”.

    Sawyer said:

    What kind of study did Dr. Crislip cite in this post?

    You are aware that this post is by Scott Gavura, aren’t you? The paper by Rees et alter that I am commenting upon is precisely the one linked by Scott Gavura on this post.

  27. Tara says:

    Can anyone give me good sources of science based data on Essential Oils? Where I live they are practically a religion and I know many many people who base their illness prevention and treatment on OnGuard or other oils.
    Even more frightening, in my role as a mother to a 6 year old Type 1 diabetic I come in to contact with a lot of people who believe that if you rub Cinnamon oil over where a person’s pancreas is, it will help regulate their blood sugars. I need a good place to point to when these claims come up.

    1. WilliamLawrenceUtridge says:

      Tara, essential oils smell nice. Some are topical irritants. They aren’t medicine, or if they are, they will have side effects listed prominently (and will be prescribed by a doctor). Use them to make your house, hands or bathroom smell nice, don’t pretend they have medical uses. Try looking them up on pubmed, specifically using the “systematic reviews” filter to try to find the latest research that synthesizes primary studies to draw larger conclusions.

      In addition to weblinks to give people, you could ask them a couple questions. For instance, how does the cinnamon oil move through the skin to reach the pancreas? How does it survive processing by the liver, filtration by the kidneys, and modulation by the immune system to have an effect on the pancreas? Since type I diabetes is due to the death of pancreatic cells, what biological effect is the oil allegedly having, is it causing the B-islet cells to regrow? In which case, you would see measurable increases in insulin in your child (not to mention – taking insulin would then cause hypoglycemia, and you would be able to see this in your child’s symptoms).

      Nobody will have an answer for you, because cinnamon oil applied to the skin doesn’t do squat.

      1. Tara says:

        Thanks for the help! It has been hard to come up with a coherent answer that people can hear over the sound of my head exploding.

        Also, thanks to all the SBM family. I have both Type I diabetes and cancer in my little immediate family and I love having this site as a resource to recommend for the people around us who so lovingly provide the most ridiculous advice.

        We’ve been told asparagus, red algae, vitamin C, alkaline diets, raw food diets, colon cleanses, dealing with unresolved emotional issues, and every other kind of woo you can think of will cure my husband’s cancer. I love having the facts on all those individual brands of nonsense right at my fingertips. Happy Holidays!

        1. WilliamLawrenceUtridge says:

          In general, as a rule of thumb, what works is already used. Anything else is speculative, and likely nonsense. If it’s not already licensed, or in a clinical trial, it’s likely a waste of time and energy.

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