Daniel Marsula, Post-Gazette Click illustration for larger image.

During the cold and flu season, Dr. Woodson Merrell is never without his own personal arsenal for combating illness. Indeed, it's a veritable international peacekeeping force of Western and Eastern medicines.

There's Esberitox -- a German formulation of echinacea and other herbs in tablet form. There are the Chinese herbs yin chiao and gan mao ling, also in tablet form. He also likes to have a 3 percent solution of hydrogen peroxide on hand to dilute for gargling during the early stages of a sore throat because he says it kills infection.

"Three or four times a year I feel a cold coming on," he says, but after treating it with his toolkit, "I feel minor symptoms and then they go away."

		Fighting cold viruses Some other "outside the box" tips to keep cold viruses at bay from Columbia's Dr. Woodson Merrell: Handwashing is a must. Be careful when handling paper money, which changes hands many times a day, as well as door handles and phones. Wear glasses. Contact lens wearers might want to switch to glasses during cold and flu season as they have to touch their eyes -- a route for viruses to enter the body -- when inserting and removing lenses. Drink tea. It contains antioxidants and polyphenols that help boost the immune system. More studies are available on green tea, but black tea's benefits are promising, too. Garlic is a potent immune system booster. Add a few cloves to prepared salad dressing every day. Eat six daily servings of dark leafy greens, yellow-orange and red colored vegetables and fruits. Mushrooms -- especially maitake, reishi and shitaki -- contain immune boosters. Avoid sugar. Too much can depress the immune system.

On the other hand, he's no fan of standard drug store decongestants for easing cold symptoms, which are so drying "it's like having dried blocks of concrete in your sinuses," he said. Instead, he suggests Western herbs with a "mucilaginous" effect that gently decongest the mucus lining, or essential oils such as those found in Vicks Vapo Rub.

Dr. Merrell is hardly on the fringes of the medical establishment. An internationally known expert in integrative medicine -- which combines alternative and conventional methods of health care -- he is an assistant clinical professor of medicine at Columbia University's College of Physicians and Surgeons, and executive director of the Continuum Center for Health and Healing at Beth Israel Medical Center in New York. Herbal remedies are widely used and considered effective in Europe and Asia, he noted.

Yet his enthusiasm for alternative therapies to fight colds and other illnesses is still dismissed by many in the medical profession, who cite the lack of studies proving they work. But the dearth of hard evidence, he counters, is at least in part a consequence of the fact that most herbal and other natural remedies can't be patented, so drug companies have no economic incentive to fund expensive clinical trials.

Still, the few studies done in this country on popular herbal cold remedies have not been promising. A study in 2003 failed to find any benefit for children taking echinacea, and last summer the New England Journal of Medicine published a study disputing its effectiveness for adults, though critics complained about that study's methodology.

Locally, doctors are divided over herbal remedies' effectiveness.

"I don't recommend echinacea, zinc or high doses of vitamin C. I tell my patients to wash their hands and avoid people who have colds," says Dr. Edward Wrenn, a Forest Hills physician, who says he has yet to find convincing data that alternative remedies work.

"To my knowledge, there's no scientifically corroborated proof that these things are consistently effective in preventing colds," adds Dr. Richard Green of Allergy and Asthma Associates, Downtown.

But Dr. Green keeps the door open a little, citing anecdotal evidence that some approaches -- such as taking zinc for colds -- may be helpful, though "I don't think people have any idea what doses to take of these things."

He noted that people with auto-immune disorders and those taking immunosuppressant drugs should not use herbs because of the risk of dangerous interactions. But he doesn't discourage the average healthy person from trying them.

"As long as they don't overdo it, I don't see any harm in trying these things out."

Lots of users

Consumers are doing just that, in droves. The National Health Interview Survey by the Centers for Disease Control & Prevention in 2002 found that 36 percent of adults use some form of complementary and alternative medicine. An August 2005 Consumer Reports survey of 34,000 respondents found that half had tried alternative therapies during the past two years.

While relatively few cold sufferers are opting for the exotic-sounding Chinese herbs favored by Dr. Merrell and sold in health food stores, millions have bought Airborne, a best-selling effervescent tablet containing vitamin C, antioxidant herbs and minerals that is available at Wal-Mart, CVS and other pharmacies.

Airborne has not undergone any independent study (one paid for by the company showed good results), but it's nonetheless the No. 1-selling cold remedy in the country, promoted by Oprah Winfrey and Kevin Costner. Radio commentator Rush Limbaugh is a paid endorser of Zicam, a zinc formulation for battling colds.

Is it all hype?

Dr. Andrew Weil, perhaps the best-known proponent of alternative medicine therapies nationally and the author of 10 books on the subject, says no. His weapon of choice in battling colds is Astragalus, "which is well researched for colds and flu and is cheap and easy to get. I take it at the first sign of a cold."

He's also a big fan of garlic's immune-boosting powers, as is Dr. Sharon Plank at the Center for Integrative Medicine at the University of Pittsburgh Medical Center.

"Two crushed cloves in a salad every day will help keep you incredibly healthy through the winter," she said. When she feels a cold coming on, she drinks a concoction of hot water with ginger, cayenne pepper, lemon and honey.

Dr. Plank says medical journals are reporting evidence of the power of herbs to combat illness, "but many doctors just don't seek out that information. They're overworked and they don't have time to learn this new stuff on their own."

But Dr. Stephen Barrett, a retired psychiatrist and longtime opponent of alternative medicine who runs the web site Quackwatch.org, calls these claims about the value of Chinese herbs, garlic and other natural remedies "preposterous."

"Garlic is an anticoagulant," he said. "But where are the studies that show it prevents or alleviates cold symptoms?" Dr. Merrell and others, he said, "speak in glittering generalities that have no meaning. The amount of information about herbs is not large, and the average doctor doesn't know much about most of them," he said.

Still, Dr. Merrell says that's changing. At Columbia, courses on complementary medicine are standard for every medical student. Currently, 26 medical schools in this country offer courses in alternative or integrative medicine, and more health insurers are covering such therapies as acupuncture and chiropractic care.

And he contends that the New England Journal of Medicine's study on echinacea last summer was flawed, given that there are nine different varieties of the herb and more than 200 cold viruses during any given season.

Echinacea by itself may not be effective, Dr. Merrell acknowledged, but he said he's had great results when it is combined with other herbs, such as those found in Esberitox, which uses the herbs baptisia and thuja along with two types of echinacea.

But he cautioned that consumers need to be vigilant, because the largely unregulated supplements industry has varying degrees of quality control.

For the confused consumer, Dr. Merrell recommends one Web site, ConsumerLab.com, which conducts independent tests of popular supplements and publishes its results. Tests of 11 Echinacea products, for example, resulted in a high failure rate, with one containing excessive levels of lead and four with smaller amounts of key echinacea plant chemicals than they claimed on their labels.

"If you're taking these things a couple of times a day, you need to check with your primary care practitioner before you even use them," he said. And while the information about these remedies are out there, "there's also a lot of misinformation out on the Web, so you must be careful."