I was recently sent a sample of Sambucol, a well known Elderberry supplement which is supposed to prevent coughs and colds and which I have used successfully in the past to prevent myself and my children getting a cold.
Before posting here though, I wanted to check it out and see whether there was good evidence to support its use. Elderberry has been used for centuries to treat wounds when applied to the skin. It is also taken orally to treat respiratory illnesses such as colds and flu.
The thinking is that the chemicals in elderberries may help to reduce swelling in mucous membranes and relieve nasal congestion. Some people believe that elderberry may have anti inflammatory, antiviral, and anti influenza properties.
Elderberries contain 87 per cent of the daily value in vitamin C as well as large amounts of vitamin A, potassium, iron, vitamin B6, fibre and betacarotene. Elderberries also have diuretic and detoxifying properties.
So what is the evidence for the efficacy of elderberries? A 2012 study in the USA and published in the journal Phytochemistry showed that in lab tests elderberry extract does indeed inhibit Human Influenza A (HINI) infection.
Mass Spectrometry coupled with Direct Binding Assay was used to identify the anti-viral components of Sambucus Nigra or Black Elderberry as it is commonly known. The study showed that the H1N1 inhibition of elderberry flavonoids compared favourably to the known anti influenza activities of both Tamiflu and Amantadine.
Sambucol used to be available as a throat spray which I used to use regularly if I felt a cold coming on. Or even when I knew I was going to be in a crowded place where someone was likely to be infected. It worked fantastically well for me and while I was using it I barely got a cold during the winter season.
Sadly the company who make Sambucocl have discontinued the throat spray so I am going to have to get used to taking a spoonful a day. I will keep you posted as to how I get on throughout the coming winter months!
Last year 52 year old airline pilot Camilla Jago was shocked when she suffered excruciating chest pain which radiated out to her arms. She knew she was having a heart attack because as a pilot she is trained to recognize the symptoms. What she didn’t know was this was no ordinary heart attack but a condition called SCAD (Spontaneous Coronary Artery Dissection).
SCAD is different to a normal heart attack because it is not caused by furring up of the arteries but is a result of one or more inner layers of the artery tearing away from the outer layer. The torn flap of arterial wall creates a haemotoma or blockage in the blood flow to the heart leading to angina, heart attack or sudden cardiac arrest.
The strange thing is that 80% of people who suffer SCAD are women-particularly during or soon after pregnancy. This is why experts at Leicester Royal Infirmary believe it is linked to female hormones or extreme physical exertion. Dr Abi Al Husseini is lead researcher on SCAD and believes that it may also be related to an underlying connective tissue problem.
The big problem is that most doctors have never heard of it and so may never have treated it. Often women who have had SCAD are given medication or worse interventional treatment such as a stent, because their only knowledge is based on a normal heart attack. In the case of SCAD this is not the treatment these women need. Sometimes, particularly when there is good flow in the affected artery the best treatment is to leave it to heal by itself.
“We know you don’t treat these patients the same way as someone who has had a heart attack” explains Dr Al Hussaini. “They are women, they are young and fertile and have a healthy lifestyle. They only need a stent if the flow of blood is not good”.
“We do know that the pathology, prognosis and management are different for SCAD. The way we rehabilitate patients who have had SCAD is probably also different. those who have had more conservative management of SCAD tend to do a lot better because the artery has healed on its own. They simply go on aspirin for a year and if the heart function is OK they do not need any other treatment” she adds.
Luckily for Camilla she was treated at Brighton Hospital where the registrar had heard of SCAD and stopped the cardiologist from inserting a stent. It was there she was put in touch with the SCAD support group which was set up by other women who had suffered this type of heart attack. There is now a growing database of patients at Leicester who are currently liaising with the Mayo Clinic in the US to discover more about the causes of SCAD so that treatment can improve.
A new study published in the Annals of Internal Medicine brings good news to people with chronic neck pain. The large scale investigation by researchers at the University of York found that the use of Alexander Technique or acupuncture can significantly relieve this debilitating type of pain.
Chronic neck pain is extremely difficult to treat, and previous research has shown that very few interventions provide genuine long term benefits. However, it now seems that the Alexander Technique or acupuncture can reduce pain and associated disability over a twelve month period compared with normal care.
The research was conducted at the Department of Health Sciences at York and recruited 517 patients from a variety of GP practices in Leeds, Manchester, Sheffield and York. The patients were randomised to three groups. One was offered Alexander Technique lessons along with usual care, another received up to twelve sessions of acupuncture lasting 50 minutes as well as usual care, and the third had usual care alone. In all three groups usual care included prescribed medication, GP visits, physiotherapy and visits to other healthcare professionals.
After twelve months, pain was reduced by 32% for those having acupuncture and 31% for those learning the Alexander Technique. The reductions were found to be statistically significant and better still, patients were more able to cope or reduce their pain levels without resorting to medication.
Dr Hugh MacPherson, a Senior Research Fellow in the Department of Health Sciences at York, said: “Our key finding is that there are significant reductions in neck pain associated with Alexander Technique lessons and acupuncture at 12 months. For the first time we now have clear evidence that these two interventions provide longer-term benefits for chronic neck pain.”
Thomas Jefferson famously said “If people let the government decide what foods they eat and what medicines they take their bodies will soon be in as sorry a state as are the souls who live under tyranny”. It’s a good quote to start a book with and one which rings true in Dr Malcolm Kendrick’s new book, Doctoring Data. I thought The Great Cholesterol Con was a cracker but this time has taken his scalpel to the world of medical research and properly dissected it for our inspection.
Kendrick is by his own admission a sceptic on all things medical but sceptics can be a force for good in guiding us through the mire of health messages we are bombarded with on a daily basis.
Take just a few he mentions – Will sausages give you cancer? What should you avoid eating? Sugar, fat, salt or all three? Should you have a smear test? A mammogram? What about statins? The sheer volume of information and statistics is enough to bamboozle the more mathematically challenged among us.
Kendrick has ruthlessly dissected the statistics for us and shows how drug trials are hyped and data manipulated to make minute risk seem enormous. He explains succinctly the difference between absolute and relative risk. He sheds light on the difference between “observational” studies and randomised controlled trials where statistics actually mean something. He illustrates the importance of language when describing the results of clinical trials.
For example, loud warning bells should sound when a study claims that treatment X would save 50,000 lives a year. “In medical research we have to be a little more scientific” he explains. “A more pertinent question would be “How much longer does this intervention allow people to live?”
He debunks long held and deep rooted notions about subjects like screening which is seen as “a good thing” by asking what do we really know about the risks and benefits?
For example did you know that there has never been a randomized controlled study on the benefits of cervical cancer screening done anywhere-ever? So why does nobody challenge it? Kendrick does and argues that the public needs well balanced information rather than propaganda to make informed choices.
Of course in the world of medical research, those in positions of power do not take kindly to anyone who dares to question the established order. That does not stop Kendrick criticizing the pharmaceutical companies who have vested interests in ensuring their drug gets to market.
By the time you finish this book you could feel hard pressed to know who to trust. A good start has got to be sceptics like Kendrick who refuse to simply accept current dogma and go digging for the truth.
Why do people who have strokes feel fatigue? Well on Friday I went back to Queen Square for more tests to try and discover exactly that. I was met at the door of No 33 by the lovely Anna who took me to the special room where the testing takes place. First off she asked me how tired I felt on a scale of 1-10 at that precise moment. I felt slightly ashamed to say I was totally knackered. I had had no lunch and had traipsed round the shops for over an hour. Not only that but I had been fighting off a virus which had been trying to take hold for more than two weeks. So I guess I should not have been surprised I didn’t feel 100%. Anna explained what I was going to do and that it required a lot of concentration. The idea was to measure strength and whether I could tell how much energy I needed to perform a task. In typical high tech fashion that I am getting used to at these sessions, I had to hold my forefinger against a slightly Heath Robinson contraption involving a piece of metal and a pencil. The metal was linked up to Ann’s computer to record measurements. Anna would then press the end of the pencil twice against my finger and record on the computer how hard she had pressed and how accurately I guessed the pressure of the pencil was on my finger. Next she pressed the pencil and handed the pencil to me to press at at exactly the same pressure (I told you the test was high tech!) I could see why you needed concentration as it’s vital to remember exactly how it felt when she pressed the pencil into my forefinger so as to try and match the pressure as accurately as possible. The whole test took around an hour. As ever we had a good laugh about the strange set up and the fact that of course I couldn’t be told whether I had got the answers right or not! All that data will now be put into the study which hopefully will help answer the question why so many stroke survivors suffer fatigue.