It’s that time of year when we are bombarded by flu treatment quackery from “immune-boosting” miracle supplements to junk that “cures” every single virus known to medical science. During this world of the coronavirus pandemic, it seems to be even louder.
This article will attempt to debunk the myths of flu treatments such as “boosting the immune system,” magical supplements, and other nonsense involved with the world of flu treatment pseudoscience.
The one way to prevent the flu, other than hiding in a bubble during the winter (which may be a good thing with the COVID-19 pandemic), is the seasonal flu vaccine. But that’s not a treatment, it prevents the flu.
Immune boosting flu treatment myth
One of the most fundamental facets of the flu treatment quacks has got to be boosting the immune system myth. These charlatans oversimplify the immune system – they do this because the immune system is so complicated, they need to simplify it so that they can sell their worthless products. And, doing this is a fundamental aspect of pseudoscience.
Moreover, these woomeisters try to make it seem your immune system is a pathetic, weak, useless function without their expensive, miracle, magical pseudoscience.
In fact, the immune system is a huge, complex, interrelated structure that contains an almost infinite variety of biomolecules (especially antibodies), cells, tissues, and organs, generally working in efficient harmony. And the immune system is pretty resilient. If the immune system was such a weakling, we would all be dead from pathogens before we made it to our 5th year of life. And there is a reason, why we make it past your 5th year of life, but I’ll get to that.
If these charlatans were actually correct, humans would have died out a few hundred thousand years ago, and birds would be ruling the planet. Birds are cool (and are the only living dinosaurs), but they probably wouldn’t have invented Facebook. Wait.
So, if someone says “this thing is critical to boosting immunity so that you will never get the flu or coronavirus,” your first question must be “which of the thousands of different parts of our immune system is boosted?” They almost never are able to answer that question.
Your second question should probably be “do you have peer-reviewed extraordinary evidence that supports that extraordinary claim?”
And is there any physiologically plausible method to boost or enhance all of this system or even a small part of it? In general, the immune system is an on/off type of network. It’s either working perfectly well, or it isn’t, and we know the precise conditions that might cause the immune system to start working less perfectly.
- There are some chronic conditions, such as stress and malnutrition (I’m not talking about not enough oranges, but a large, long-term calorie and micronutrient deficit), that can reduce the performance of your immune system.
- There are a few chronic diseases that can have an impact on the quality of the immune response, diabetes being one of the more prevalent, but there are many others.
- Some people are born with impaired immune systems. Some may acquire an immune deficiency as a result of certain diseases (HIV/AIDS is the best known). Even some medical treatments, like chemotherapy or immunosuppressive therapies, can weaken or even destroy the immune system. One of the tropes of the immune system pseudoscience is that an infection weakens the immune system; in fact, the sick feeling you have from a cold or other diseases can be a part of the immune response.
- Short-term acute conditions, such as lack of rest and exercise, can temporarily depress the immune system, but that is usually easily reversed.
Almost everyone, short of those with chronic conditions mentioned above, has a well-functioning and highly-effective immune system–there is no way to make it better. And there is little evidence that a normally functioning immune system can be “boosted.” And by evidence, I mean high quality randomized clinical or epidemiological studies published in high-quality peer-reviewed journals.
On the other hand, if you really could boost your immune system, is that even a good idea? How can you even fine-tune a “boost” without figuring out the exact amount necessary to get the effect you want?
In fact, there are reasons why we shouldn’t have a too powerful immune system. For example, overactive immune systems are responsible for allergic conditions such as asthma and eczema. And there’s a type of runaway immune response known as a “cytokine storm” which may be responsible for the high mortality in severe flu pandemics.
Inflammation is normally a healthy response to injury or pathogen invasion, but in some autoimmune diseases, such as rheumatoid arthritis, it can be painful and debilitating.
In addition, an overactive immune system can become misdirected and start attacking the cells of the host body. This immune system error can cause autoimmune diseases such as arthritis and Type 1 diabetes.
So, no, it really is not a good idea to boost your immune system, even if you could (and you can’t). After you ask one of the flu treatment “boosting immunity” quacks whether they actually have any evidence supporting their nonsense, you should ask how do they prevent the serious consequences of a boosted immune system.
Don’t hold your breath – that might be bad for your immune system.
One more thing – there is a scientifically-supported method to boost your immune system. That would be a vaccine. Actually, vaccines don’t “boost” the immune system generally, it induces a very specific response to one antigen, like the flu. Because science-based medicine is very specific!
Flu treatment myths – top 11 hits
Although I don’t want to bore the reader by debunking every single bit of flu treatment quackery on the internet, I thought I’d give you the top 10 with the published science that supports the debunking. Because that’s why you’re here, to see the evidence. Right? Please?
OK, this one is partially true, for a couple of reasons. First, mothers who breastfeed have a significantly lower risk of some cancers. That’s a good thing.
However, the pseudoscience-pushers claim that “you get exposed to something your body starts making antibodies to help protect the baby.” That is not even close to being true.
As I wrote before, breastfeeding helps in passive immunity, preventing certain pathogens from entering the baby through the digestive tract. This is obviously important.
However, it does not confer immunity to pathogens that enter through wounds and the respiratory system, like influenza. The mother does transfer antibodies to the baby in utero, but that lasts for just a few weeks or months until the baby can produce antibodies from its own adaptive immune system.
Any antibodies in the mother’s milk do not pass from the digestive tract into the bloodstream of the baby to cause it to develop an immune response. That’s not how it works.
Fish oil supplements
Although there is some weak evidence that fish oil may or may not have some effect on cardiovascular health, a systematic review (the pinnacle of the hierarchy of scientific research) showed no change to the immune system function as a result of fish oil supplements.
Of course, given how complicated the immune system is, I would reject any claims that fish oil (or any supplement) has on the immune system unless it was in a large, published clinical trial.
Once again, this claim has some evidence supporting it, but not in the way they think. There is some research (another systematic review) that some probiotics may have some effect on the innate immune system of the gut.
This doesn’t mean that it has an effect on the adaptive immune system, which protects us from airborne pathogens like the flu. Or measles.
I’m not sold on the whole gut biome claims that seem to be overhyped, but if you have excess money for these supplements, they might not help, but they don’t do much harm. But they’re going to do nothing for immune system boosting against the flu.
Oscillococcinum is a homeopathic preparation, derived from Muscovy duck liver and heart (yes, you read that right), that is claimed to treat the flu. Because of the dilution, there are simply no molecules of duck guts in the homeopathic pill.
Based on this ridiculous figurative and literal quackery (get it), one would not be surprised by a Cochrane systematic review that concludes, “There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum in the prevention or treatment of influenza and influenza-like illness.”
Homeopathy is pseudoscientific quackery, and it is useless as a flu treatment.
Echinacea has received a substantial marketing effort, based on hype and anecdotes, supporting its use as a supplement to treat colds and flu. However, a systematic review has shown us that it has no effect on colds.
A highly biased, poorly designed study was published in a low impact factor journal that appears to show that echinacea may have an effect on the treatment of the flu.
Unless you want to keep away mythical vampires, this claim again lacks any supporting scientific evidence. There is no robust epidemiological or clinical evidence that garlic has any effect on preventing or treating the flu. And a systematic review (which is at the top of the hierarchy of biomedical research) found no evidence that it improved outcomes with another viral disease, the common cold.
Once again, there is no evidence that ginger is effective as a flu treatment.
A new entrant into the flu treatment quackfest is elderberry. But a review of the research on elderberry treatment finds that there is only weak and limited evidence that it has an effect on the flu.
Let’s not fall for the argument from ignorance and claim it “may” have an effect. The evidence is unconvincing, and other than non-clinical opinion articles published in alternative medicine journals, we just don’t have robust evidence that elderberry is an effective flu treatment.
There is an ongoing trope that we are all deficient in vitamin D which has something to do with the immune system, according to the woomeisters.
In fact, vitamin D may be deficient in some individuals, especially during the winter. However, does that have much to do with our immunity to flu.
Well, a recent meta-review found that “no association was observed between VDD and immunogenic response to influenza vaccination.” Another review of the literature concluded that “the survey of the literature data generates some controversies and doubts about the possible role of vitamin D in the prevention of influenza virus.”
If one is deficient in vitamin D, that is something that should be corrected, easily done with supplements. But is there any evidence that taking large doses will “boost your immune system,” making it an effective treatment for flu? No.
Again, the pseudoscience crowd likes to overstate the value of diet in our overall health. Sure, there is some good evidence that a Mediterranean diet may lower the risk of all cancers and cardiovascular disease. But is it critical to immune system boosting? No evidence.
Here’s an adage that maybe we should all follow – eat food, not too much, mostly plants.
Science-based flu treatment
There are real, science-based treatments for the influenza virus. Anti-viral drugs, especially amantadine, rimantadine, zanamivir (Relenza), and oseltamivir (Tamiflu) have been shown to be effective in reducing the course and improving outcomes from influenza. They weren’t developed by magic, but by targeting very specific properties of the flu virus. This is why an antiviral against one disease may be totally ineffective against another, such as COVID-19.
Just because we do have effective, evidence-based treatments for the flu, it doesn’t mean that they are a better choice than prevention by the flu vaccine. These treatments are expensive, they might have significant adverse effects for some, and they have to be taken almost as soon as symptoms first appear.
But the flu treatment quacks will continue to take your money by selling you supplements and pseudoscientific treatments that will do nothing for the flu. And just to remind everyone, the flu is not some trivial disease that is no worse than the common cold.
Until the coronavirus pandemic of 2020 hit, the flu was one of the most deadly infectious diseases – somewhere between 24-62,000 Americans died from it during the 2019-20 flu season. Worldwide, it kills between 290,000 to 650,000 people annually. Ironically, these numbers might drop significantly because of mitigation efforts to the much more deadly coronavirus.
Let’s sum this up in the fewest possible words – the flu vaccine prevents the flu, so fake (or even real) treatments might be unnecessary.
- Frei R, Akdis M, O’Mahony L. Prebiotics, probiotics, synbiotics, and the immune system: experimental data and clinical evidence. Curr Opin Gastroenterol. 2015 Mar;31(2):153-8. doi: 10.1097/MOG.0000000000000151. Review. PubMed PMID: 25594887.
- Ghasemi Fard S, Wang F, Sinclair AJ, Elliott G, Turchini GM. How does high DHA fish oil affect health? A systematic review of evidence. Crit Rev Food Sci Nutr. 2019;59(11):1684-1727. doi: 10.1080/10408398.2018.1425978. Epub 2018 Mar 1. PubMed PMID: 29494205.
- Gruber-Bzura BM. Vitamin D and Influenza-Prevention or Therapy?. Int J Mol Sci. 2018 Aug 16;19(8). doi: 10.3390/ijms19082419. Review. PubMed PMID: 30115864; PubMed Central PMCID: PMC6121423.
- Jenness R. The composition of human milk. Semin Perinatol. 1979 Jul;3(3):225-39. Review. PubMed PMID: 392766.
- Lee MD, Lin CH, Lei WT, Chang HY, Lee HC, Yeung CY, Chiu NC, Chi H, Liu JM, Hsu RJ, Cheng YJ, Yeh TL, Lin CY. Does Vitamin D Deficiency Affect the Immunogenic Responses to Influenza Vaccination? A Systematic Review and Meta-Analysis. Nutrients. 2018 Mar 26;10(4). doi: 10.3390/nu10040409. Review. PubMed PMID: 29587438; PubMed Central PMCID: PMC5946194.
- Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database Syst Rev. 2014 Nov 11;2014(11):CD006206. doi: 10.1002/14651858.CD006206.pub4. PMID: 25386977; PMCID: PMC6465033.
Liu W, Zhou P, Chen K, Ye Z, Liu F, Li X, He N, Wu Z, Zhang Q, Gong X, Tang Q, Du X, Ying Y, Xu X, Zhang Y, Liu J, Li Y, Shen N, Couban RJ, Ibrahim QI, Guyatt G, Zhai S. Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis. CMAJ. 2020 Jul 6;192(27):E734-E744. doi: 10.1503/cmaj.200647. Epub 2020 Jun 3. PMID: 32493740.
Malosh RE, Martin ET, Heikkinen T, Brooks WA, Whitley RJ, Monto AS. Efficacy and Safety of Oseltamivir in Children: Systematic Review and Individual Patient Data Meta-analysis of Randomized Controlled Trials. Clin Infect Dis. 2018 May 2;66(10):1492-1500. doi: 10.1093/cid/cix1040. PMID: 29186364.
- Mathie RT, Frye J, Fisher P. Homeopathic Oscillococcinum® for preventing and treating influenza and influenza-like illness.Cochrane Database Syst Rev. 2015 Jan 28;1:CD001957. doi: 10.1002/14651858.CD001957.pub6. Review. PubMed PMID: 25629583.
- Porter RS, Bode RF. A Review of the Antiviral Properties of Black Elder (Sambucus nigra L.) Products. Phytother Res. 2017 Apr;31(4):533-554. doi: 10.1002/ptr.5782. Epub 2017 Feb 15. Review. PubMed PMID: 28198157.
- Rauš K, Pleschka S, Klein P, Schoop R, Fisher P. Effect of an Echinacea-Based Hot Drink Versus Oseltamivir in Influenza Treatment: A Randomized, Double-Blind, Double-Dummy, Multicenter, Noninferiority Clinical Trial. Curr Ther Res Clin Exp. 2015 Apr 20;77:66-72. doi: 10.1016/j.curtheres.2015.04.001. eCollection 2015 Dec. PubMed PMID: 26265958; PubMed Central PMCID: PMC4528044.
- Sahoo M, Jena L, Rath SN, Kumar S. Identification of Suitable Natural Inhibitor against Influenza A (H1N1) Neuraminidase Protein by Molecular Docking. Genomics Inform. 2016 Sep;14(3):96-103. doi: 10.5808/GI.2016.14.3.96. Epub 2016 Sep 30. PubMed PMID: 27729839; PubMed Central PMCID: PMC5056903.
- Turner RB, Bauer R, Woelkart K, Hulsey TC, Gangemi JD. An evaluation of Echinacea angustifolia in experimental rhinovirus infections. N Engl J Med. 2005 Jul 28;353(4):341-8. doi: 10.1056/NEJMoa044441. PubMed PMID: 16049208.