C is for cold – and con?
If something is not scientifically proven to be effective, should you take it anyway if it makes you feel better?
It seems to be flu season at the moment in Malaysia. I think it’s because of all the Raya open houses that people have been having this month – and plenty of opportunities while mingling with hosts who cultivate and transmit all sort of viruses and bacteria. As a result, almost everybody I know has a scratchy throat, a dry cough or a wet nose. Or all three.
An oft-heard piece of advice at this point would be “Go eat lots of vitamin C”. The required daily dose, as recommended by the American National Institute of Health, is 90 mg per day. When people say “lots”, they mean take a few of those 1000mg tablets several times a day.
Recommendations to take thousands of milligrams of the stuff are freely given, with the promise that your cold will soon go away.
But does it work?
The suggestion that vitamin C could help fight the common cold was an idea proposed by the chemist Linus Pauling in the 1970s. By that time, he had won two Nobel prizes and pioneered several breakthroughs in medical research. This spurred a flurry of medical trials over the next 40 years involving over 10,000 participants.
The results? A review of decades’ worth of clinical research in 2007 concluded that if vitamin C is taken daily, there is a slightly shortened cold duration, equivalent to a day or two over a year on average. If taken only after a cold starts, the vitamin C supplements do not make a cold shorter or less severe.
Given this lack of conclusive evidence of its benefits, why does it still get prescribed by friends and family as an effective cure? Why aren’t doctors telling patients, don’t waste your money, just get lots of fluids and rest?
It’s probably partly because there are very few known harmful side effects from taking vitamin C. If a patient believed that wearing a red hat would make his cold heal faster, the doctor may think, as long as it does no harm, you are free to do as you wish.
I saw a similar principle in action when a guest at an open house told a doctor that he had invested in an expensive, shiny new machine that dispensed ionic water and asked him to corroborate the benefits. I had seen this product before being sold for thousands of ringgit and after reading what I could about it, I concluded that it was perhaps not worth even ten.
However, to my surprise, the doctor didn’t warn the questioner off the product. Instead, he replied that he did not know of any scientific study about the product that caused any harm.
At the time, this struck me as being a little irresponsible. I think there should be more made of the scientific method. Scientists shouldn’t be afraid to say: “I’m sorry, there is no scientific evidence that supports the benefits you are suggesting. Save your money, try something else.”
But I kept my mouth shut at that time. After all, for a layman like me, to challenge a medical doctor on his professional opinion would be like, well, challenging a two-time Nobel prize winner about his theories.
Pauling kept believing about the benefits of vitamin C to the very end, claiming it would also cure cancer, and took doses of up to 14,000 mg per day. He eventually passed away in 1994 of prostate cancer at the ripe old age of 94.
It is a measure of his influence that people are still conducting studies on the efficacy of vitamin C. It does help reduce colds for high-performing athletes in extreme conditions, so there clearly is some benefit, but people also talk about how stubborn he was that he stuck to his ideas despite mounting evidence contrary to it.
Yet, I can’t help but admire that his characteristic to not give up was also a hallmark that led him to such diverse scientific breakthroughs earlier in his life.
If you wish to be an adventurer, pioneering into the unknown, that is admirable in itself, and by all means experiment with your body. But I must also say if there is no evidence that something works, then you should be well aware that you’re spending a lot of money for no good reason at all.
Except perhaps to make yourself feel good, which isn’t a small thing in itself.
Despite the lack of clear scientific evidence, there are many people who swear by the efficacy of either vitamin C or ionised water. They say, their colds are shorter and less severe and that the water makes them feel refreshed when they drink it.
It may also be the placebo effect. In fact, a study on the efficacy of vitamin C done in 1975 was rejected by its author on the basis he thought some of the volunteers may have been feeling better because they knew they were being given vitamin C (although subsequent analysis challenges that).
Yet, if the placebo effect is real and the patient feels better, should a doctor step in and dismiss the patient of his misconceptions? By doing this, wouldn’t the patient then feel worse and the doctor be causing harm to him?
What grates me is the inefficiency of the whole situation. Yes, there are companies that package vitimin C into nice tablets which are sold as a convenient way of meeting your dietary requirements. Yet, it may be as efficient as a sugar pill taken with the right frame of mind.
But I think most nutritionists would also say that you can get an adequate dosage of vitamin C if you eat lots of fruits and vegetables as part of a balanced, healthy diet. Is it really more convenient to eat a pill? I think it’s more fun to have an orange or a bowl of strawberries.
So if you don’t want to take the rest and drink lots of water, perhaps the way of getting rid of that Raya flu or cold is to actually just be more careful about what you are eating at the open houses. And wipe your hands clean after every salam.
