Friday, January 11, 2013

Cold comfort

I know that if I put a technical scientific term in the title it would be enough to put most readers off, but in response to my jocular "cold treatment" article recently, I received advice from some readers about how to prevent or cure colds.  One was to stuff garlic up my nose, another rub Vick's ointment on my chest, or put cut onions around the house to attract the bugs and so on.  I totally reject these primitive folk cures as having no value whatsoever.  Note that people choose things that smell strong and bad, but that have no proven curative basis.  What they do have is a placebo effect, because you think it will work it seems to help.  It may be real, but it is pure self-delusion.
I was a Professor of Pharmacology, the science of the study of drugs and their effects on human beings.  Actually I was a biochemist who got waylaid into this area, so I am not a clinical or classical pharmacologist (I don't really know the  pharmacopaeia), but I do have some insight.  There are two subdivisions of pharmacology that we are interested in today pharmacokinetics and pharmacodynamics.  The former term, with the ending "kinetics," obviously has something to do with speed, it is the study of how fast a drug distributes about the body; the latter term with the ending "dynamics" has to do with how much of a drug can get to the target site in the body where it is needed to act.  Clearly if the drug you take orally never gets from the digestive system into the blood stream it won't work on a site elsewhere in the body and if not enough of it gets to the target it won't work either.  One major aspect of drug design is to overcome these barriers. 
Someone once asked me how do drugs know where to go to have their effect, and of course the answer is they don't "know," that is teleological.  Drugs simply distribute around the body either systemically (i.e. taken it by mouth or injection) or locally (e.g. by patches absorbing thru the skin or thru nasal ingestion).  They only work or function at the sites where they interact with a specific target, such as an infectious bacteria, a virus or a particular product of these invaders (such as a protein or surface membrane) that distinguishes it from other natural components.
A few years ago there was a major media splash that a young student had come up with a combination of three drugs that killed HIV in a  test tube and could cure AIDS.  One of the drugs was urea, which prompted a leading expert to say that "if i pissed into any tube I could kill any infective agent."  The fact is that at high concentrations any active drug will kill viruses and bacteria, the problem is drug delivery, getting the right drug to the right target in the body in a reasonable time and with an effective concentration.  Killing infectious agents in a test tube is only the very first step to being able to produce an active drug.
I had a friend who was a Professor who believed in Linus Pauling's theory that vitamin C could prevent colds.  He took 1 gram a day, that is a huge amount.  But, since he still got colds he doubled the dose and took 2 grams a day.  Soon he got very ill, his teeth began to crumble (vitamin c removes calcium) and his gums decayed.  He had fainting fits and dizziness.  He was diagnosed as having vitamin c poisoning, and after he stopped taking vitamin c he largely recovered.  Too much of anything is not good.  By the way, double blind studies proved that vitamin c is totally ineffective against colds.
For a cold I take certain specific drugs (no endorsement is intended), for example to stop a running nose and sneezing I take Coldex, that dries the mucous membrane, for a cough I take Oxocatin syrup that is anti-tussive (that stops the trigger to cough) but is also expectorant (that clears out the mucous from the lungs), I also take Strep Care lozenges for sore throat.  In addition I have found that Mucolit lozenges or tables help to clear mucous in the throat and I spray Flixonase that dries out the nasal passages and helps me sleep.  Now all of these are scientifically tested drugs, approved by the FDA in the US (after double-blind studies), and accepted around the world and legally prescribed by medical doctors.  There are many other combinations of drugs that can work, such as Actifed syrup and codeine (which I used to take and which sent me to sleep) and anti-histamine dugs that reduce mucous membrane irritation (this is not intended as medical advice, consult your doctor).  
However, note that none of these drugs actually cures the cold, they each have a different chemical structure and work on a distinct site in the body, but none of them is an anti-viral agent.  The cold is due to rhinovirus infection, a virus that attacks the mucal membranes, causing mucous over-production leading to coughing and sneezing and irritation (no actual rhinocerous-virus!).  We don't have many drugs against viruses (such as HIV) but we do have drugs against many bacteria (such as penicillins), but since the cold is due to a viral agent these anti-bacterial drugs won't work, unless there is a secondary infection that might lead to a fever. 
Finally I want to say that scientific medicine studies all folk remedies, extracts the active ingredient from the whole mess (such as aspirin was discovered from the bark of the willow tree) and then it is about 1,000 fold more effective and that is what one should use.  Believing that onions attract viruses, or that magnets reduce arthritis, or that garlic up the nose cures anything is simply primitive.  Get real! 


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