Sun November 27, 2011

Not To Be Sneezed At

Sometimes mind over matter is the best defense when it comes to healing. KUNC commentator Dr. Marc Ringel has more.

Should you take Echinacea if you get a cold this winter?  Yes, if you believe in it.

Belief accounts for a significant part of why even the most scientifically grounded treatments work.  It’s called the placebo effect, a fundamental principle of healing.

Until the last century or so, medical practice consisted of a little science and a lot of consoling.  And the consoling healed, especially when mediated by some herb or procedure that both doctor and patient expected would help.

As western medicine has become more scientific and powerful, we have lost sight of just how potent was the healing presence that used to be the first tool in a doctor’s black bag (or stash of talismans).  In recent years though, the placebo effect itself has come under scientific scrutiny.  A multitude of research papers has reported on the objectively measured power of belief in what the doctor orders.

One really interesting study, entitled “Placebo Effects and the Common Cold,” was published this summer in Annals of Family Medicine, well in time to be of use during the cold and flu season that we all know is just around the corner.

The authors recruited 700 participants, ages 12 to 80, who answered “yes” to just one simple question, “Do you think you have a cold?”

Participants were then assigned randomly to one of four groups:  no pills; pills that contained the herb and the subjects knew it; placebo pills that they were told might be Echinacea; and Echinacea pills that they were told might be placebo.  In the last two groups, neither subject nor scientist knew who had gotten the herb and who the sugar pill until statisticians were turned loose on the data.  This is called a double blind design, a feature that lends further credibility to the results.

For follow-up these folks reported daily on the severity of their cold symptoms until they were all better.  Using statistical untangling techniques the scientists were able to separate out how much Echinacea itself lessened patients’ experience of the common cold and how much belief in the healing herb reduced their suffering.

Patients who had said on entry that they believed Echinacea was an effective remedy for the common cold were as likely to benefit from sugar pills as they were from the herb.  The improvement was, you should pardon the pun, nothing to be sneezed at--duration reduced by 2-1/2 days and symptom severity score by 26% when compared to their pill-less or unbelieving fellow subjects.

These findings say something pretty loud and clear about Echinacea:  that the herb itself is probably not very effective, if at all, pharmacologically speaking, but widespread belief in the worth of this natural remedy makes it a great placebo.

In light of these results, what specifically should you do this winter vis-à-vis respiratory infection?  Let me first stray from the topic of Echinacea long enough to urge you to get a flu shot, an objectively valuable medical intervention that protects against the nastiest of upper respiratory infections.

After that, do what you believe will help.  You’d probably do well with doses of those things your ma or grandma used to give you when you were under the weather:  VapoRub, Smith Brothers, Halls, Listerine, chicken soup, honey and vinegar, a hot water bottle, vaporizer, zinc, Vitamin C, maybe Echinacea…and of course, plenty of TLC.

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