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Healthnotes Newswire (December 20, 2007)— Does Vitamin C Cure the Common Cold? By Jane Hart, MD 

At the first sign of a cold, many people reach for the vitamin C in hopes of warding off the illness or easing symptoms. A new study looking at the effects of vitamin C on the development, duration, and severity of a cold, suggests that while vitamin C may not reduce the incidence of colds in a general population, taking vitamin C may, in fact, reduce the duration of a cold and help prevent a cold in certain people.

Does vitamin C shorten a cold?

If you take it before the cold starts. The authors of the study reviewed 30 research trials that included 11,350 people who took 200 mg or more of vitamin C daily at various stages of a cold. Results of the review showed that taking vitamin C before a cold starts may reduce the duration by 8% for adults and 13.6% for children.

Does it reduce risk?

Only at “extremes.” The review also found that vitamin C taken before a cold starts does not reduce the incidence of colds in a general adult population but may reduce the incidence in people exposed to extreme physical or cold (temperature) stress. For example, a group of athletes and soldiers on sub-Arctic exercises who took daily vitamin C reduced cold risk by 50%.

Does it make a cold less severe?

Not if you’re already sick. According to the reviewed trials, vitamin C’s effects on cold severity were inconsistent. A slight benefit was attributed to vitamin C in reducing days absent from school or work, but according to the review no significant effect has been seen in trials to date on the duration or severity of colds when vitamin C is started after symptoms begin.

What do the experts say?

Critics of the current review suggest that 1 to 3 grams of vitamin C is too small an amount and that research is needed on the effects of higher doses. Dr. Harri Hemila, lead author of the study, and his colleague state that, “studies on the therapeutic use of high doses of 4 grams and 8 grams on the day of the onset of respiratory symptoms are tantalizing and deserve further assessment.” Dr. Harri Hemila and his colleague state that “there seems no justification for routine megadose vitamin C supplementation in the normal population.” They add that taking vitamin C preventatively “may be justified in those exposed to severe physical exercise or cold stress or both.”

They also point out that to date none of the trials that looked at using vitamin C after a cold begins have examined the effect of vitamin C on children, even though trials that used vitamin C preventatively have found a substantially greater beneficial effect on duration in children, and they recommend further research in this area.

What’s the bottom line?

While vitamin C has been shown to affect disease resistance in numerous animal studies, we still do not have the full answer on how much vitamin C might help people ward off disease. And since the review looked at 30 studies that used different amounts for different lengths of time, the optimal amount for combating the cold remains to be discovered. For now, a person suffering from cold symptoms should eat a balanced diet that provides a wide variety of vitamins and minerals needed for health, and talk to a doctor about an appropriate amount of supplemental vitamin C to help shorten the duration.

Alan R. Gaby, MD, Healthnotes chief science officer, has concluded from his review of the vitamin C research, that adults who take 500 to 1,000 mg of vitamin per day preventively, and increase to 1,500 to 4,000 mg per day at the first sign of a cold, can reduce the duration and severity of colds by approximately 30%.

(Cochrane Database of Systematic Reviews 2007:3; article number CD000980. doi:10.1002/14651858.cd000980.pub3.)

Healthnotes Newswire (November 29, 2007)—Following reports of serious injuries and deaths in children treated with cold medicines, the health community and industry has waited expectantly for the US Food and Drug Administration to weigh in on the issue. The FDA’s announcement in August of its plans to conduct a hearing prompted many manufacturers to voluntarily remove children’s cold medicines from store shelves. Now, the much-anticipated hearing has led the FDA to conclude that, until more research is conducted that shows safety and efficacy, these medicines should not be given to children under two years old unless instructed by a healthcare provider.

The limited number of available studies on the use of cough and cold medicine in children has not demonstrated effectiveness, according to information presented at the FDA hearing. Some cough and cold products currently on the market have never been tested in children.

Despite the lack of scientific evidence, manufacturers still claim their products’ effectiveness on the label and in the media. Linda A. Suydam, president of the Consumer Healthcare Products Association, said that over-the-counter cold medicines provide “real comfort” to children who suffer from cold symptoms. She stated that harm in children, while rare, is usually attributable to accidental ingestion, “an issue of safekeeping that is best addressed through education.” In other words, it is important to store medicines safely out of children’s reach and to administer them properly. (For more tips on safe administration, see the end of this article.) Suydam said that the Consumer Healthcare Products Association will work with the FDA to ensure sufficient scientific evidence of these products’ efficacy.

Taking care of your ailing child

Natural remedies, such as vitamin C, are an option for parents looking for ways to soothe their children’s cold symptoms. “Taking vitamin C two or three times a day for several days has been shown to shorten the duration of colds and the severity of symptoms in children,” said Alan R. Gaby, MD, chief science editor for Healthnotes. “However, two other cold remedies that are effective in adults—echinacea and zinc lozenges—do not appear to work for children.” The appropriate amount of vitamin C for children varies depending on age and tolerance and should be discussed with a healthcare professional.

This new attention on medications may signal a return to the old-fashioned, common sense remedies many parents grew up with:

• Make sure your child gets plenty of fluids intake in order to maintain water balance and to thin secretions. Avoid sugary drinks in favor of water or a comforting chicken broth.

• Avoid giving sick children sugar and excessively fatty foods, as they are known to dip immune function.

• A warm, humid environment created by a humidifier may provide some comfort while riding out a cold.

• Make sure your sick child gets pleny of rest, especially those with severe symptoms.

Cold medicine dos and don’ts

The FDA made the following recommendations for parents who may continue to administer over-the-counter cold medicines to their children:

• Do not use cough and cold products in children under two years old unless given specific directions to do so by a healthcare provider.

• Read all of the information in the “Drug Facts” box on the product label.

• Do not give children medicine more often or in greater amounts than what is listed on the product label and use only as directed.

• Do not give children medication that is intended for adult use.

• Be aware that using various cough and cold medicines in combination may pose health risks; parents should ask a doctor whether or not it is safe to use products in combination.

• Use appropriate measuring devices such as a dropper or dosing spoon; parents should contact their doctor or pharmacist if they do not understand the dosing directions.

Finally, the FDA reminds parents that medicines used to treat cold symptoms do not cure a cold and that, even without treating symptoms, children will get better with time.

(Sources: FDA Public Health Advisory www.fda.gov/cder/drug/advisory/cough_cold.htm

FDA Hearing Presentation www.fda.gov/ohrms/dockets/ac/07/slides/2007-4323s1-03-Petitioner-Sharfstein.ppt

Consumer Healthcare Products Association Statement www.chpa-info.org/ChpaPortal/PressRoom/NewsReleases/2007/07_20_CHPA_Ad_Comm_Statement.htm)