Long before the first apothecary opened in this country, Native Americans knew the secret of crushing a common purple flower, called echinacea, to treat everything from snakebites to stuffy noses.
Today millions of Americans turn to natural remedies, from echinacea to Vitamin C to elderberry, to treat winter ailments such as the cold or flu.
In 2002, for example, consumers spent roughly $800 million on these products to boost their immune systems and to treat illnesses, according to the Nutrition Business Journal, which tracks the industry.
But even the most ardent supporters of natural healing say consumers need to be well informed if they want to benefit from vitamins and herbal treatments.
"In my mind, this is the recommended way to stay healthy," says Brian T. Sanderoff, a holistic pharmacist in Owings Mills. "But people have to be educated. I don't know if a 17-year-old kid behind the counter at a GNC is the best person to give you advice."
Sorting through scientific evidence to support health claims of natural remedies is no simple matter. And in many cases, scientific studies have never been conducted.
In the United States, vitamins and herbs are considered dietary supplements. That means manufacturers don't have to test them as they would if they were prescription or over-the-counter drugs.
And while manufacturers list supplement ingredients on the bottle, because there is no testing or federal oversight, consumers have no way of knowing whether what's advertised on the bottle is contained inside.
As a result, Consumers Union, the nonprofit advocacy group that publishes Consumer Reports magazine, four years ago launched a program to test ingredients of widely used nutritional supplements. The group also looks for inaccuracies in labeling claims.
"These substances are not as well regulated as we believe they should be," says Tunde Akinleye, a Consumers Union chemist.
This month, Consumers Union published its test results on 19 brands of echinacea. A review of scientific literature concluded that the herbal remedy doesn't prevent colds, but it is useful in shortening the duration of a cold if taken within the first few hours of feeling under the weather.
Of the products tested, though, three brands contained less than the labeled amount of an active ingredient and two brands had either little or none of the echinacea plants reported on the bottle, Consumers Union says. Worse, only three brands contained important health warnings on the label.
Consumers Union's top picks: Spring Valley echinacea, sold at Wal-Mart, Origin echinacea, available at Target, and Sundown echinacea, sold at various stores.
Sharon Montes, who heads the University of Maryland's Integrative Medicine Practice at Kernan Hospital, sends her patients to Sanderoff and his partner, Raymond L. Hinish, in Owings Mills, because she knows they have quality products that are properly labeled.
The pharmacists operate Your Prescription for Health (www.illness isoptional.com), one of the region's only holistic pharmacies.
"I try to start where the patient is," says Montes, regarding natural healing. "If they hear the word echinacea and freak out, then I know that we don't go there."
Still, she's convinced vitamins and herbal remedies offer healing properties that can't be found in over-the-counter or prescription drugs. Popular cold remedies such as Tylenol Cold or Advil, for example, treat symptoms but don't stimulate the body's immune system to fight viruses, which cause colds.
"In this country, there's a pattern of treating the symptoms," she says. "Then people are back out there, pushing and pushing. They don't give their bodies time to rest and heal. ... I'm focusing on ways to let the body heal itself."
Go on the offensive
While everyone is different, Montes offers a general formula for fighting winter's cold season:
* Vitamin C: Even though clinical studies show megadoses of Vitamin C aren't absorbed by the body's tissue, Montes suggests boosting Vitamin C intake when trying to fight a viral infection. She advises people to take between 500 and 1,000 milligrams daily, increasng that to as much as 3,000 milligrams daily when fighting a cold. Sanderoff says the body naturally uses more Vitamin C when fighting a virus.
* Echinacea: Montes and Sanderoff recommend tincture forms of echinacea, which means the active ingredient has been extracted from the plant into an alcohol base. This is used to rev up the immune system at the first sign of a cold.
* Zinc lozenges: Consumers Union reports that in the laboratory zinc inhibits the reproduction of rhinovirus, a cause of colds. Montes suggests limiting daily dosages to 30 to 45 milligrams for women and 30 to 60 milligrams for men. Montes says zinc lozenges are especially good for viral sore throats.
* Elderberry: There's less scientific research on elderberry's effect on humans, Montes says, but it is known to support the immune system and to stimulate the body's ability to fight viruses. She recommends people take a teaspoon, four times daily, when fighting a cold.
* Olive leaf: This herbal supplement works to fight both bacterial and viral infections. Montes suggests two capsules four times daily while fighting an illness.
Natural ways to fight a cold
In 2002, Americans spent roughly $800 million on vitamins and herbal remedies to boost their immune systems. Here are the top five dietary supplements, with the amount of money spent on them by consumers:
1. Vitamin C, $214 million
2. Echinacea, $179 million
3. Vitamin A / Beta Carotene, $67 million
4. Zinc, $58 million
5. Combination herbs, $18 million
Source: Nutrition Business Journal
Some can't take it
The herbal remedy echinacea is popular for treating the common cold. Yet many brands do not carry adequate warning labels. Don't use echinacea products if you fall into the following categories:
* Autoimmune disease: Don't use if you suffer from disorders such as Type 1 diabetes, rheumatoid arthritis or multiple sclerosis. The supplement could further stimulate improper immune-system responses.
* Suppressed immune systems: Don't use if you suffer from AIDS or are taking drugs to suppress your immune system such as after an organ transplant.
* Allergies: Avoid echinacea if you are allergic to flowers in the aster family, such as daisies, sunflowers or weeds, including ragweed.
* Pregnancy or breast-feeding: Avoid if pregnant or nursing a baby, says the American College of Obstetricians and Gynecologists.
* Children: Don't bother giving echinacea to children. A study, in the Journal of American Medical Association, found that it isn't effective in young children.
Source: Consumers Union