When Nick Rous feels a cold coming on, he starts taking vitamin C and lots of garlic. When people around him come down with the flu, he reaches for echinacea and a homeopathic remedy, Oscillococcinum.
As a last resort, Rous, 30, says he turns to Tylenol and the nasal spray Afrin. "But I try to avoid that stuff as much as possible," says the saxophone player, who lives in San Francisco. "They just treat symptoms, but I feel like it's more productive to do things that boost your immune system and your strength."
Like Rous, many Americans are putting their faith in old standbys, such as vitamin C and zinc, and in relative newcomers.
Homeopathic remedies such as Oscillococcinum and combination products such as Airborne are apparently especially appealing.
In 2006, sales of homeopathic immune boosters grew 13%, according to data collected by the Nutrition Business Journal; Airborne's sales jumped nearly 50%, according to company figures. Although sales of formerly popular alternatives such as zinc and echinacea are lagging somewhat (sales dropped more than 6% and 16%, respectively, in 2006, according to the Nutrition Business Journal), they're still among the top sellers for cold and flu - and both, along with vitamin C, are common ingredients in many patented blends.
"People will go out and spend a whole lot of money on these different products, and unfortunately there's not that much that's been shown to be effective," said Dr. Ian Paul, a pediatrician at Penn State College of Medicine who has studied alternative remedies for coughs in particular (his research has so far shown that honey works better than cough syrup for kids).
In the absence of a cure for the common cold or flu, what most people are seeking is a little relief.
With alternative remedies, as with over-the-counter remedies, said Paul, that relief often comes from the belief that the treatment is working. "There's such a large placebo effect with a lot of these things," he said.
Andrew Shao, vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, a trade association, agreed. "To say that things like vitamin C and zinc don't work wouldn't be totally accurate, because clearly for some people they do."
The research may be equivocal, Shao added, "but you hear people all the time saying, 'Well, I swear by it, it works for me.' "
There are, of course, better ways to treat or prevent a cold or the flu. A healthy diet with plenty of fruits and vegetables helps keep the immune system strong. Getting enough rest is critical for prevention and recovery. Exercise has been shown to reduce cold and flu infections, and so, of course, has frequent hand-washing.
And nothing is more effective at preventing the flu, Paul pointed out, than getting the flu vaccine.
Elderberries may make delicious, if uncommon, jams and pies -- but the jury's still out on whether they can cure the flu.
The number of proprietary elderberry products on the market has slowly grown in recent years, particularly in Europe. The berries contain high levels of vitamin C and flavonoids, plant pigment compounds that have shown antimicrobial activity in the lab. In the 1990s, Israeli researchers produced findings suggesting that the plant fought germs in humans too.
In one study, published in the Journal of Alternative and Complementary Medicine in 1995, people living in an Israeli commune during a flu outbreak in 1993 were given either four tablespoons of a proprietary elderberry extract, Sambucol, or the same amount of a placebo syrup daily for three days. Both groups came down with the flu -- but those who took the elderberry product recovered within two days, while the others recovered in six.
In 1999, the researchers tested the product during a flu outbreak in Norway. This time, the elderberry-treated group recovered in half the time it took the placebo group to recover: three to four days compared with seven to eight. The results were published in the Journal of International Medical Research in 2004.
In the U.S., Sambucol is sold in stores by supplement maker Nature's Way. A number of copycat elderberry products are appearing on shelves, claiming that elderberry coats flu viruses to stop them from infecting cells. But there's no evidence to back this up, and only Sambucol's patented formula has been put to the test.
Though Sambucol touts itself as an immune booster (the company's promotional materials suggest taking it daily), it's only been studied in outbreaks, and there's no evidence that it can prevent flu infection.
If cold symptoms alone don't make one's head spin, the sheer number of zinc options on the market -- lozenges, swabs, sprays and tablets containing various salts of the mineral -- surely will.