Thursday, December 23, 2004

Merry [expletive deleted] Christmas from the Common Cold

by Tom Bozzo

Outside Temperature: -8 degrees Fahrenheit (*)
Mood: Stuffy, sniffly

Just a week or two ago, I had been marveling at how long it had been since John was sidelined with any sort of illness. Then his nose started running, and long story short, he's on the mend, I'm about at the peak (or depths, as it were), and Julia sounds snarfy but is still acting like a normal 9-week-old. Suzanne, for now, still seems to be defended by a significant remnant of the butt-kicking and name-taking pregnant woman's immune system and shows no symptoms.

This brings me to a matter of some delicacy. Some of my in-laws have been recommending a homeopathic cold remedy. I like them and know that they only want me to get over the cold quickly, but I just plain don't believe in homeopathic medicine. What's the protocol for breaking this to them?

As for what sets me off about homeopathy, see this page cheerily explaining that (but not how) diluting an active ingredient by a factor of 100 makes the active ingredient twice as potent for a taste, or read Bob Park's Voodoo Science for an earful.

Now, the remedy in question probably wouldn't kill me — after I survived seeing the shelf price at Walgreen's — as it comprises a couple of zinc compounds and a bunch of inactive ingredients to make lozenges. I do recall a period, several years ago, when zinc lozenges were all the rage in cold remedies.

Some particular features of this homeopathic zinc lozenge, apart from its extravagant price, made me think of Gary Becker's recommendation to solve the drug price crisis in part by cutting back on effectiveness research and trusting the public more, and chuckle. Mordantly, as Bob Somerby of the Daily Howler would put it.

Take a real drug, for instance my usual antihistamine, and the active ingredient is clearly listed — loratadine 10 mg.

The lozenges' active ingredients were given as [zinc compound 1] "1X" and "[zinc compound 2] "2X." In homeopathy, a "1X" solution is 1% active ingredient and a "2X" solution is 0.01% active ingredient (i.e., a 1X solution of a 1X solution). My first inclination was to think that the lozenge was 1.01% active ingredients and 98.99% filler, but it then struck me that it could just as easily be a half-and-half mixture of the 1X and 2X solutions and thus be (at least) 99.495% inactive ingredients. You can't tell from the labeling.

Meanwhile, the remedy's manufacturer links a report on a clinical trial that purports to have demonstrated the stuff's improbably high effectiveness. Having skimmed the linked paper, I'm interested in knowing what makes for a good medical study, and how tough it is to slip something past the goalie. But I figure the general public, if they got as far into it as me, would tend to see "clinical trial" and think, "then it must be good."

Placebo effect addendum: A nasal spray form of the remedy in question lists only a 2X concentration of one of the lozenges' active ingredients: no more than 0.01%.


(*) Edina, MN
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