Some Frequently Asked Questions, first published in SAGA Magazine (14)
Professor George Lewith
I’ve been reading that scientists now believe Echinacea can help prevent and shorten a cold, but don’t think vitamin C helps. Didn’t they say the opposite last year? What’s your view?
There has been a very consistent debate about vitamin C, some scientists assuring us that high dose vitamin C during acute viral infections is safe and effective and others saying that it doesn’t work. Linus Pauling, who won the Nobel Prize for chemistry, used to swear by it, sometimes taking up to 15 or even 20 grams each day. While the theory suggests that high dose vitamin C should help viral infections as it seems to act as an antioxidant and also has a very direct antiviral and antibacterial effect, the clinical evidence from studies is conflicting, with the balance now favouring those who feel it is of limited value. Echinacea has been a particularly popular remedy for viral infections in Europe, particularly Germany. Folklore had it that it was preventative and could stop colds and flu occurring, but the actual clinical trial evidence suggests that it probably cuts short viral infections by a day or two at the most. Vitamin C has always been a somewhat debatable “cold cure”; the evidence for Echinacea suggests that it doesn’t stop viral infections occurring, but it does seem to shorten the duration of the cold if taken in adequate dose.
I take glucosamine and chondroitin for my arthritis, and a leaflet in the pack says they also make it in a gel. Is this worthwhile and can I use both at once?
There is now a lot of data on both glucosamine and chondroitin, which suggests that probably both independently will help arthritis if taken in an adequate oral dose. The dose for glucosamine is very likely to be between 1.2 and 1.5 grams a day, and for chondroitin it seems to be about 800 milligrams a day although there is some debate and we do not have accurate dosing data. These need to be oral doses and the suggestion is that glucosamine has both an anti-inflammatory effect and quite a powerful effect on sparing joint cartilage. Chondroitin, similarly, seems to have an effect on sparing and possibly improving joint cartilage. The evidence for glucosamine indicates that joint damage is certainly diminished over a 2 or 3 year period (compared to placebo) and it is just possible that there may be some cartilage regeneration. We are not certain whether both together have an additive effect. They do seem to work through different mechanisms so it is quite possible that using both together could help provide added protection against developing arthritis. There are also some negative studies that suggest that these two medications are not particularly helpful. What we do know is that they are safe and the probability is that they have a protective and preventative effect as far as arthritis is concerned, so are very worthwhile taking. We have no evidence that the gels work as well as the oral medication, in fact the theories on the possible immune mechanism of chondroitin imply that it is actually quite important to activate the immune system in the gut, so taking it orally may be a vital element in the medication working. As far as I am aware there is no evidence to suggest that the gel is harmful or has adverse effects, so taking both at once shouldn’t be a problem, but it may be a waste of time and money!
My GP has put me on a statin to lower my cholesterol, but says I’d be wasting money by buying Co-enzyme Q10 supplements to prevent side effects, is she right?
While people argue that statins are life saving, a number of adverse reactions have now begun to emerge as these drugs seem to be used very widely among the over 50s particularly in men. The real danger about blood fats is not just cholesterol, but the low density lipoproteins (LDLs), which trigger an inflammatory response in the arterial wall and cause the arteries to slowly “block off”. It has also been suggested that some of the benefits of statins are not related to their cholesterol lowering activity and they may be working through other mechanisms. One of the disadvantages of statins is that they can cause a muscle inflammation and this results in a raised muscle enzyme called creatinine kinase. People taking statins may feel quite intense muscle aches and this usually correlates with a raise in creatinine kinase indicating muscle inflammation. Statins also deplete Co-enzyme Q10 and this essential nutrient is thought to have a variety of important functions. It helps muscle power, so depleting CoQ10 in heart muscle may in itself be damaging. It could, in theory decrease muscle power in your arms and legs and create weakness and pain. CoQ10 supplements are said to improve mental function and there is some suggestion that statins may slightly impair cognitive function. Recently there has also been a suggestion that taking statins may increase cancer risk, but the mechanism for this is unclear. Many people have tried to market CoQ10 on the basis that it is a supplement that may get rid of some of these unwanted side effects. There is no hard evidence that this is the case and we have no real understanding of whether CoQ10 may interfere with the mechanisms through which statins operate and provide benefit although we have no evidence that it does diminish the effects of statins. If you are having unpleasant adverse reactions from statins, then the best thing to do is discuss this with your doctor; sometimes using a different type of statin can get rid of the adverse reaction. If you wish to use CoQ10 then it seems to be safe and may well be worth a try.
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