2008-10-10 / Columnists

Health & Harmony

Cough and Cold Remedies
By Dr. Nancy Gahles

DR. NANCY GAHLES DR. NANCY GAHLES The season is upon us for sniffling, sneezing and coughing. At the first sign of distress, we look for a product that will immediately reduce our symptoms and decrease the duration of suffering. Main street drug stores carry the usual product line of over-the-counter preparations, a dizzying array to choose from to be sure. Apart from the selection process based on our symptoms, there is the selection process for infants, children and adults. And then there is the advice of health experts, consumer advocate groups and the FDA to take into consideration.

A recent report from REUTERS revealed that the cautions and advisories from last January are still being voiced today. In January, the FDA recommended against the use of some over-the-counter cough and cold products because of their risk of strokes and seizures. They cautioned against their use for children up to 2 years of age after voluntary recall of some 14 products. The offending ingredient is Phenylpropanolamine. Write it down on a piece of paper and put it in your wallet next to your CVS or Duane Reade card. When reaching for products such as Dimetapp, Nyquil, Robitussin, Triaminic, Alka Seltzer Plus Children's Cold medicine, Johnson & Johnson's Tylenol and Pediacare among many other allergy and flu medicines…reach for that piece of paper and check for this ingredient. It is the one that you want to avoid purchasing.

There are two reasons why the experts are urging the FDA to ban sales of these products. One such concern is well put by Dr. Wayne Snodgrass of the University of Texas Medical Branch, "Cough and cold medicines…have not been proven to be effective and they have clear risks. It is time for them to be reevaluated." According to the Reuters report, an FDA panel of outside experts last year said they should not be allowed to be given to children under 6 years of age because these drugs were allowed on the market under rules for over-the-counter products that do not require data showing safety and efficacy. The data was taken from adult studies and extrapolated to pediatric populations. The battle cry of responsible pediatricians in this regard is always that children are not little adults. They are wholly different and drugs need to be tested on the pediatric population who will be using them to ensure safety.

The second reason why there is a call to ban these drugs is that the misuse of the products by consumers is causing the adverse reactions to take place. The industry claims that most of the events are due to accidental ingestion by children or being given the wrong dose. Linda Suydam, head of the Consumer Healthcare Products Association, said that companies are taking action to study individual ingredients, educate parents and change packaging so to improve proper dosage guidelines.

The problem remains that if the over-the-counter drugs are ineffective and they pose risks due to lack of studies to substantiate their safety, what is a parent to do? We all know that there is no cure for the common cold and we also know that the common cold is one of the worst sufferings that can take a week or more to subside.

Adults want instant relief for themselves and for their children. Over the last year, since the recalls, I have had patients tell me that they DO give their children the banned over-thecounter products because they have nothing else to do. EVEN when they know they are ineffective AND dangerous, they will use them out of desperation. One notable voiced this same fact. At an Art exhibit last winter, I was speaking with the actress Jane Seymour. We were talking about her children and the recent recall. I mentioned to her that, luckily, we have alternatives that we can use that are safe and effective, and that we don't have to act out of fear in the middle of the night and put our children in harm's way. She replied, "Oh, that's just what I did. I acted out of desperation."

All this preamble is to make these points. NEVER act out of desperation. NEVER act out of fear. NEVER act out of weakness. The most regrettable decisions arise in these situations.

Forewarned is forearmed. We are forewarned when we know that fall and winter bring on colds and coughs. We are forewarned when we are consciously aware of our predispositions to same. We are forewarned when we know which situations tend to cause us to be susceptible to colds and coughs.

We are forearmed when we know that simple strategies like getting enough sleep and rest will reduce likelihood of catching a cold. We are forearmed when we dress for the weather understanding that getting chilled is a causative factor. We are forewarned when we eat properly for the season and do not tax our immune systems with too much of the sugars and alcohol or too little of the fresh fruits and veggies. We are forewarned when we know that there are safe, effective alternatives to preventing a cold and to treating colds and coughs. Recent studies have shown that honey is most effective in reducing coughs. That means that when you are desperate in the middle of the night you can make a hot cup of herbal tea with honey to soothe the irritated mucous membranes. I advocate education and patient responsibility. We live in the world of information networks. People love to look up their symptoms and get a diagnosis from WebMD. In the same way, one can Google complementary and alternative treatments for coughs and colds. I am a devotee of homeopathic medicine for both prevention and treatment and so I belong to the National Center for Homeopathy whose website provides a place where you can go to type in the symptoms and find a remedy. www.nationalcen t erforhomeopathy.org. Of course, action belies the education to use it. Again, there are books and home study courses where one can learn the modality that suits you and your family's needs. As I tell my children, it's a wonder how well you do on a test when you do the homework!

My battle cry is EDUCATE yourself. Don't be a victim. We have too much at stake to bury our heads in the sand of ignorance and lay blame on the drug companies when something happens. The Internet is replete with sources of education. Be your own best advocate. Feel free to contact me at askDrNancy @aol.com with specific questions.

(Source: REUTERS, Susan Heavey, Beltsville, MD).

May The Blessings Be!

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