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Hello and welcome to Inside Health. Now,

1:10

the nights are starting to draw in. I think

1:12

I'm starting to get that sense of inevitability that

1:14

some point over the next weeks and months I'm

1:17

going to get hit with the usual bout

1:19

of winter coughs and colds. So

1:21

I'm getting ahead of myself this year. I'm getting prepared.

1:24

I'm stockpiling my medicine cabinet.

1:28

I'm at home at the moment and

1:31

I've got a couple of friends. Resident

1:33

GP, Dr Margaret McCartney is doing a house call.

1:35

Hi Margaret. I'm

1:36

thrilled to be here, James. And

1:38

also Dr Lindsay Broadbent, a virologist

1:40

from the University of Surrey. Hello. Hello,

1:43

James. Lindsay, I'm actually delighted

1:45

that you were able to make it because, you know,

1:48

we were doing some prep for this programme and you were

1:50

sounding this rough.

1:53

So I'm not sure what I have. I've

1:56

been unwell for about 10 days.

1:59

I've done a few covid tests for

2:02

that time all of which have been

2:04

negative if it

2:06

was a viral infection one

2:08

of the commonly circulating ones

2:10

I Would have expected

2:13

to start feeling and sounding

2:15

better by now You're

2:18

not going to believe this but I do feel

2:20

a lot better and sound

2:22

a lot better than I did even yesterday in

2:26

the meantime, I have been Really

2:29

relying on tea with lemon

2:31

and honey Apart from that I

2:33

have been making sure I

2:36

stay warm and keeping my cat

2:38

company You're

2:41

sounding much better now. Yes.

2:44

Thanks for me This

2:46

one of the conundrums this time of year though, isn't it can often

2:49

be quite difficult to know What's

2:51

going on because you've got a runny nose

2:53

or a cough or a cold and it's like that could

2:55

be anything Think

2:57

of those symptoms. What is it a virus

2:59

that's doing to my body? That's making me feel

3:02

like that

3:02

So when we get infected with a with

3:05

a virus particularly a respiratory virus It's

3:07

our immune system that actually causes a

3:10

lot of the symptoms that we experience

3:13

So in fighting that infection

3:15

our body starts to produce more mucus We

3:18

actually lose the cells that line our

3:20

airways that have these little hairs on

3:22

them that help to sweep away all that excess

3:24

Mucus so we can get really clogged

3:27

up really bummed up Which is how we feel

3:29

so congested and then because our immune

3:31

system is producing all of these different

3:34

We call them cytokines and chemokines to kill

3:37

the virus That's how we can end up with fever

3:39

how we can end up with X and pens

3:42

So it is actually our body's response to

3:44

the virus that can actually make us feel really

3:46

really dreadful But a lot of the

3:48

stuff that we get this time is really quite low level

3:50

stuff Isn't it it's enough to make us

3:52

feel grotty without putting our lives at risk? So

3:55

sometimes you still have to go to work or you have

3:58

to get up and get the children somewhere And

4:00

it's one of those things where you don't have the choice of just

4:02

I'm just going to bed and I'll take it as

4:04

Something that might make me feel a little bit better

4:08

that's why people do this and reach

4:11

for the medicine can and

4:13

Go to the box actually Try

4:17

not to spill everything everywhere Organised

4:20

gym

4:24

Well, we'll go through my very organised

4:26

medicine box in a minute But first

4:29

we've been chatting in Cardiff to see what you

4:31

turn to each winter.

4:32

Right, I've got privacy tomorrow straight

4:35

food, fruit spray vitamins

4:37

things like that Vic

4:39

you always got a Vic Anything

4:43

you name it. It's a in my cabinet and

4:45

it's all sorted My mother

4:47

for that. She's got a remedy for everything. She have

4:50

every illness. She got a remedy

4:51

for so It just follows

4:53

down the trees and I've done the line.

4:54

That's one person who's hyper organized

4:57

a couple more a bit like me

4:58

It's not a medicine cabinet. It's a medicine

5:01

tin quality street one actually, but

5:03

it's got I do for fun

5:05

cold and flute in the blip and

5:07

Plenty of stuff for heartburn

5:09

and cough medicine and that's about my

5:11

lot.

5:12

Definitely gonna have them there Just in case

5:15

you never know

5:15

I'll be honest. I don't have a cabinet I have a hessian

5:18

sack that is full of bits. This

5:20

is completely true I think I

5:22

think what ends up being hoarded mostly in mine is

5:24

Alka seltzer I always buy it for the inevitable

5:26

hangover and then end up thinking to myself

5:29

when I have the hangover I don't deserve Alka seltzer and

5:31

to be punished more and then yet

5:33

just have have archaic pouches of suspicious

5:36

fizzy compounds sticking

5:38

in this sack

5:38

I have paracetamol ibuprofen

5:41

loratadine for hay fever other

5:44

than I keep it simple

5:45

Yeah, the only thing I can add is the throat

5:48

lozenges because I get really bust for throat

5:50

stuff Yeah, nothing nothing special and

5:53

then of course some of us don't do

5:55

any prep at all My dad

5:57

was a doctor. So I'm not much of a how

6:00

popular if I don't have to be. So yeah, we

6:02

don't go too much to be really. I

6:04

think if we got the odd pain, paracetamol or

6:07

ibuprofen, that's

6:09

about it really, yeah. We're not really

6:11

ill people, are we?

6:16

So it sounds like we have three big camps

6:18

of people. Who do you most naturally fit

6:20

in with Lindsay?

6:21

Oh, I have a full-on medicine

6:24

drawer in my house. It has everything

6:27

from cough syrup to throat lozenges

6:30

to painkillers.

6:31

You're a walking pharmacy. Yeah. Margaret?

6:35

I have to say I'm perhaps not the most organized. I'm

6:38

usually trying to make sure that some indie paracetamol

6:41

during the winter season, but really I wouldn't go any

6:43

further than that. Do you

6:44

lean on anything else if

6:46

you get ill or do you just ride it out with

6:48

paracetamol? Generally I expect my family

6:50

to bow to my every demand and wish during

6:52

a period of illness. But I'm

6:55

relying if I said I'd take anything because I generally

6:57

almost always wouldn't. Well, because I'm

7:00

trying to be a bit more focused about what

7:02

I buy this winter, I thought I'd

7:04

nip out from work and head to

7:06

the pharmacy. This is Reshma Malvey

7:08

from John Bell and Croydon.

7:10

Hello, my name's Reshma.

7:12

How can I help you? Well, hi Reshma. I'm

7:14

just staring at the dizzying array of cold

7:16

and flu remedies, trying

7:18

to figure out what I should get ready for winter

7:21

because I don't want to have to leave the house if I'm

7:23

feeling really lofty. So I just thought, why don't

7:25

I stop while ahead of time? I'm more prepared than no

7:27

other, this year is my thinking.

7:28

You're absolutely in the right place. So let me help

7:30

you. If we take cold and flu,

7:33

for me most of it will be around choice

7:35

of flavour and hence that's what marketing's

7:37

all about. And the most important thing is choosing

7:39

the right active ingredient for

7:40

the symptoms. I know, I always prefer having

7:43

the lemony sachet in some hot

7:45

water in comparison to swallowing a tablet.

7:47

I don't, I'm sure it's exactly the same stuff on

7:49

the packet, but it's- It's

7:50

the same ingredients as in the capsule

7:53

and so let me ask you, why do you find drinking

7:56

a mug of hot liquid

7:58

versus a

7:59

capsule?

7:59

is better for you. I just enjoy drinking the

8:02

drink. And often that's exactly it.

8:04

It's not complicated. If

8:05

we take cold and slews, one

8:07

of the basic advice that I would give all my customers

8:09

is trying to increase the amount of

8:11

fluid that you're taking in. So warm

8:14

fluid actually helps bring

8:16

some of that warm back inside that comfort.

8:18

So when you've got a mug of one of the

8:20

sachets you've mixed up into warm stuff, it's

8:22

actually making you feel better

8:24

whilst you're getting all the active ingredients to

8:26

help you with your symptoms. So actually it's

8:29

combating it two ways.

8:32

Now coming

8:34

back to my sachets, Lindsay, Margaret,

8:37

let's start with now I don't have the

8:39

branded version of it because I'm a big fan of like the non-branded

8:41

versions of drugs. But these are those cold

8:44

and flu sachets that you stir in with water,

8:46

smell like lemon and

8:49

Margaret, on the front of my packet I can

8:51

read two drugs in this one, paracetamol

8:54

and phenylephrine. What are they and

8:56

what are they supposed to do? Well we know what paracetamol

8:58

is, it's an easy one right? So you know your

9:00

paracetamol

9:01

is you know it reduces fever,

9:03

it's a painkiller and you know phenylephrine

9:06

it's a decongestant or at least it's meant to be a

9:08

decongestant, that's how it's marketed. It's marketed to

9:10

try and un-bong your nose, it works in the blood

9:12

vessels,

9:12

the idea is that it can reduce

9:15

the congestion that's on your nose and make you be able to

9:17

breathe a

9:17

bit easier. At least that's the idea

9:19

behind it. Does it work? Well the

9:22

big issue with all of this stuff, you know

9:24

and I mean all of these remedies that are

9:26

targeted at cold and flu type of winter

9:28

bugs, the big issue is that

9:31

the vast, vast majority of the time you

9:33

will get better no matter what you do or you

9:35

don't do. This is a minor illness that will improve no

9:37

matter what. So

9:39

if you take something for it you can

9:41

very well think oh it's made me feel better, I'm

9:43

getting better with it and yeah you were

9:45

going to get better anyway, the medication didn't actually

9:49

make the difference. So what you need

9:51

to know whether these things are working or not is to compare

9:53

it with placebo groups, in other words inactive medications

9:55

and we know that people taking placebo will often feel a

9:57

bit better themselves anyway. taking

10:00

something within itself can make you feel

10:02

a bit better. The act of taking something

10:04

that reminds you of childhood, you know,

10:06

it's got a strong scent or, you know, a

10:09

flavour and can be comforting, I suppose,

10:11

within itself.

10:11

I've been talking to you a lot about certain things that you've been talking

10:13

about before the

10:14

end of the programme. Yeah, yeah, yeah. So, and the big

10:16

issue with all of those things is, is it

10:18

worth me paying to get this?

10:21

Is this something that's going to do as I think it will

10:23

do? And actually, if you look even at paracetamol, you

10:25

know, one of these most, you know, well used medications

10:27

that we've got, you know, there has been a randomised controlled

10:30

trial done of paracetamol and codes and fluidic illnesses.

10:32

It doesn't find it as beneficial, you

10:34

know, but the act of taking something may well

10:36

make some people feel a bit better. My

10:39

philosophy in general is, it's not advantaging

10:41

you as well, you know, what's the point in taking it?

10:43

So, I suppose I would come from the more sceptical

10:47

of the medical profession, you know,

10:49

in terms of what we take and what we use. Lindsay?

10:52

These treatments we take very often don't make any

10:54

claims about making you better. So,

10:57

if they're not claiming anything, they don't have to prove

10:59

it. So, they don't need

11:01

that clinical evidence to say

11:03

you're going to get better if you take this because

11:06

they're not writing that on the box.

11:07

One of the areas that I really want to get into

11:10

now is when it goes a little bit lower and we end up with a

11:12

nasty cough. And when I was back

11:14

at the pharmacy with Reshma, the

11:17

array of choices was dizzying.

11:20

There's lots of different brands, lots

11:22

of different really complicated sounding ingredients

11:25

on the bottles. Reshma, shall we go

11:27

through some of them and figure out what

11:29

the drugs are actually doing inside the body? Absolutely.

11:32

Shall we start with a dry and tickly? Yes.

11:35

So, if you had a dry cough, you

11:37

may use the words such as, I'm

11:40

coughing but nothing's coming up. I'm

11:42

coughing all the time and

11:44

I can't seem to stop it. I'm coughing predominantly

11:47

at night, it's keeping me awake

11:49

but there's no obstruction.

11:50

Not bringing anything up?

11:51

Not bringing anything up because there's nothing there at

11:53

this point to bring up. Okay, well this

11:56

particular one doesn't sound like it's really got any drugs in it at all.

11:58

Glisceral sucrose sounds like it's a good idea.

11:59

sugary and gloopy to me. Yes,

12:01

and often the base

12:03

of many of the cough mixtures will be just

12:06

that because when you have got

12:08

a cough there's usually irritation towards

12:10

the better back of the throat so by

12:13

coating it with something thick and syrupy you're

12:15

just soothing it. So if it is just

12:17

a dry tickly cough there's nothing much

12:20

more that's coming out but it's just irritating

12:22

something as simple as a glycerol

12:24

syrup is just as effective of treating

12:27

a cough.

12:27

There's a dry one though that does have more ingredients

12:30

in. Nextro... go

12:32

on finish it off for me. Nextro misful fan. Thank

12:34

you.

12:35

So that particular ingredient so if you found

12:37

that actually just having a sugary

12:40

syrup really hasn't quite settled off

12:42

down but actually your cough is

12:44

persistent it's disturbing you throughout the

12:46

day and more so worse at night you

12:49

actually can't even get a good night's sleep but there's

12:51

no phlegm that you're trying to shift and it doesn't

12:53

feel it's congested and ingredients

12:56

such as sex in the phlegm works

12:58

in your brain to stop that trigger

13:01

that's causing that cough so actually

13:03

you do get that better night's sleep that

13:05

cough is not disturbing you and that's you're

13:07

getting your body to allow your surface

13:09

from the cover. Yeah it can cause

13:11

addiction though just say it on the front of the bottle.

13:13

So one of the reasons why ingredients like this

13:15

will only be found through pharmacies is for

13:17

just that reason.

13:17

If we move on to the chesty

13:20

cough so those are going to be the ones that come with a bit of gung

13:23

una that comes up. Where shall

13:25

we start? Because there's actually quite a lot

13:27

of different

13:28

drug names on all of these. Go on you people.

13:30

So I've picked the star shelf with guachenosine.

13:33

Guachenosine is an ingredient

13:36

that is known and research has

13:38

shown that where you've got for example

13:40

guitar and that's just a very sticky

13:42

phlegm that's tangent to your throat and

13:45

ingredients such as

13:45

guachenosine will help loosen

13:48

that stickiness to make it a lot more fluid

13:51

so your lungs when you are coughing

13:52

you're able to bring it and

13:53

clear that much

13:55

more easily. What about these because these are also

13:57

chesty coughs with two completely different drug names

13:59

in there.

13:59

This particular one, it is a chesty

14:02

cough mixture but it has got an added ingredient,

14:04

difinitramine, which is an antistamine.

14:07

Classically used in especially

14:09

products such as cough mixtures to give you

14:12

the drowsy feel. So actually if you're

14:14

not sleeping very well because you're not coughing away,

14:16

it just allows you to get

14:18

a better night's sleep. It's difficult isn't it

14:20

because you kind of walk in, take

14:22

a bottle of chesty cough medicine and actually

14:24

we've found three completely different formulations

14:27

in just the first three with PIP. So it's

14:29

not straight forward even when you think you're just buying

14:32

chesty cough medicine. Absolutely

14:33

and one of the reasons why I always recommend, come

14:35

and speak to your pharmacist through your pharmacy team. They'll

14:38

try to understand what your symptoms are

14:41

and match the right product to you.

14:43

So we're going to go through the evidence

14:46

as to which cough mixtures do or

14:48

don't work in a minute. But Lindsay,

14:51

I've got a challenge for you. My four year old can tell me what

14:53

a cough is but what would a university

14:56

researcher tell me a cough is?

14:58

Coughs are important to help stop

15:00

things going into our lungs which

15:02

is called aspiration. So that mucus,

15:05

we don't want that going into our lungs. Our saliva,

15:07

we don't want that going into our lungs. So

15:10

coughing helps redirect those

15:12

fluids the way they should be going. And

15:14

there are actually little things on the

15:17

surface of ourselves. They're called trip channels

15:19

that can control how much we cough

15:22

and those trip channels are actually increased

15:25

when we're sick. So when we have a respiratory

15:27

virus infection, the number of those

15:29

trip channels increase. So we're more

15:32

likely to cough. So there is

15:34

a huge amount of science behind

15:36

why we cough but we don't really

15:38

know how to prevent that very well.

15:41

We even want to.

15:42

You just described it as like an essential thing.

15:45

Quite. So if you're coughing up mucus,

15:47

you want to cough up that mucus. You do not

15:49

want that to stay in your lungs. And

15:52

I think that's where the debate comes with

15:54

cough syrups. Are they doing anything? Is

15:56

it worth

15:57

their money? But some

15:59

of the chesty cough.

15:59

would argue that the drugs

16:02

are loosening up the mucus to make

16:04

it easier to get out

16:06

of the way. So it's not suppressing what the

16:08

body's doing, it's making it

16:10

easier. There

16:11

are some active ingredients that have

16:14

been shown to thin mucus and

16:17

those kind of cough syrups, if you have a very chesty

16:19

cough and you have a lot of thick

16:21

sticky phlegm, those do

16:24

have a role in helping to thin that mucus,

16:26

making it easier to clear it and swallow

16:28

it. So the length of time you have that mucus,

16:31

the length of time you have that cold or that

16:33

flu isn't going to change, it just

16:35

helps you deal with it a little bit easier.

16:38

Margaret, you have been delving through

16:40

the published evidence around cough mixtures.

16:43

How do you deal with it?

16:44

You need to know what would have happened without

16:46

using the cough mixture to predict whether it actually

16:48

did you any good or not. When you go and look at the evidence,

16:51

you'll find in general they'll only

16:53

produce a very mild benefit on reducing

16:55

cough frequency or severity,

16:58

but quite often they're not compared to doing

17:00

nothing at all. And that's why I

17:02

become quite interested because we really would

17:04

want to know whether this was better than not

17:07

spending your money on something over the counter.

17:08

But you're not saying that they do

17:11

nothing at all?

17:12

So they have small effects which are not

17:15

very long lasting. And of course there are

17:17

some side effects from some of these medications

17:20

as well, not all of them. One called fulcodine,

17:22

which was a medication used in

17:24

a lot of cough mixtures that was withdrawn

17:26

from the UK market early in 2020. Out

17:30

of a concern that actually almost up to

17:32

a year after it had been taken, it could affect

17:34

the way that general anaesthetics work and put

17:36

people in danger of anaepolaxle afterwards.

17:39

So a rare side effect, but one where

17:41

I think the regulators

17:42

for medicine looked at the pros and cons of it and

17:45

decided that it was better off the market than on it.

17:47

Yeah, that's one that's probably worth people checking their

17:49

medicine cabinets at home for, isn't it?

17:51

I think these oral medications have great cultural

17:53

significance to people and they've never been using

17:55

them off and on for their entire lives. And

17:57

I think when they were with

17:58

John from the market, I think that's a good thing.

17:59

I think there were quite a lot of people who felt quite disappointed to

18:02

see their old favourite brands being withdrawn

18:04

but I think it's fair enough because even

18:06

very rare side effects do build up if

18:09

hundreds of thousands of people are using it in the

18:11

population.

18:11

One other thing that I've got in my stockpile

18:14

here are some throat sweets

18:16

left over from last winter still

18:18

in day's age and I was

18:21

amazed by the variety when

18:23

I went to the pharmacy. You've

18:25

got one, two, three, four, five, six, seven

18:28

shelves of it. So

18:29

throat lozenges have a really useful

18:32

place and often, I don't know, you might have been

18:34

caught out that when you're talking to

18:36

somebody and you end up with this coughing

18:38

fit you just need to settle your throat down,

18:40

often because it just may be dry. So

18:43

some of these lozenges can be designed just

18:45

to help moisten and soften the best of the

18:47

throat.

18:47

Are they actually medicines or are they

18:49

just sweets? Could I just get a packet of, you

18:52

know...

18:52

I would call them meditative sweets because

18:55

as much as they are

18:58

sweets because they are made of sugar or

19:00

glucose they have got active ingredients in

19:02

it which does have a purpose that it plays.

19:05

In terms of you've got what I call just basic...

19:07

I shouldn't call this, it's not very good to say

19:10

this on marketing purposes I call it basic

19:12

sweets

19:13

that are flavoured, have a little bit

19:15

of menthol to help you feel

19:16

better. Or eucalyptus sometimes, don't you?

19:18

It's not, I call, specifics.

19:20

So for example if you've got that really itchy

19:23

throat the way you can't even

19:25

swallow because it's so painful you've got lozenges

19:27

that contain anti-inflammatory. Similar

19:30

to, for example, ibuprofen that you may take for

19:32

your headache.

19:33

Once again though, the danger of just assuming

19:35

that everything's the same because

19:37

it really isn't.

19:38

It isn't, no, they've all got their own active

19:41

ingredients that play a vital role

19:43

in terms of some of them will have antiseptics so

19:45

keep the back of the throat clean and clear so

19:47

it doesn't develop anything further.

19:50

Margaret, you've swiped my throat

19:52

sweet. I have,

19:53

I haven't been impressed because they've got sucrose

19:55

and glucose in them and honey in them,

19:58

they're flavours.

19:59

They are sweets with some complicatedly

20:02

named chemicals in them. And there have been randomized

20:04

controlled trials done on them when they've compared them to

20:07

non-medicated sweeties.

20:08

And in general, I think one of the... So active fruit pastels?

20:11

Yeah,

20:11

yeah, yeah. So I think it looks identical

20:13

without the kind of medication in them. So still in the

20:15

same striking colours and with the sugar

20:17

in them as well. And when they do these

20:19

trials, and there have been a few of them done, you'll

20:22

find that the placebo reduces the

20:24

pain

20:25

scores or discomfort scores

20:26

by a little bit. And these might do it by a little bit

20:28

more. But these are maybe one or two

20:31

points on an 11 point scale. So it's

20:33

not making a massive difference overall. So

20:35

you could probably avoid paying for

20:38

them, you know, just by using kind of, you know, other

20:40

non-medicated... I just tried to figure

20:42

out... Has my doctor told me to buy sweets? Right,

20:46

in a minute, we're going to talk about one of my absolute

20:48

favourites. But there's

20:50

one more product that I wanted to talk about.

20:52

It's a nasal spray. The idea is that

20:54

you stick it up your nose and it actually says

20:57

in capital letters on the bottle that it's antiviral.

20:59

And the idea is that for once, we're actually

21:02

targeting the virus rather than the symptoms.

21:05

And there were a few options in the pharmacy.

21:08

So these were designed looking

21:10

at, well, actually, how do you prevent the cold? So this

21:12

is not going to help when you've got the cold. This

21:15

is probably one of the things I'd say if you want to put it

21:17

into your winter cabinet is to have

21:19

a think. Why? The way these

21:21

products are designed is to protect that

21:23

lining.

21:24

It's basically like a coating to stop the virus

21:26

getting any further.

21:26

Yes, that's exactly what it is. So if you

21:29

spray it up the nose, what it's doing is it is

21:31

giving you that protective layer. So

21:33

when you are breathing or you may be exposed to colleagues

21:36

at work who may have a cold, at least you're protecting

21:38

yourself from it.

21:41

Who wants to start?

21:43

Lindsay?

21:45

Well, the claim of antiviral to start

21:47

with, I have issues because antivirals

21:50

are a specific thing. What

21:52

a lot of these nose sprays do

21:54

that claim to help prevent colds

21:56

and flus and stop them in their tracks, they

21:59

claim to... coat the nose so

22:02

that viruses can't get access to

22:04

ourselves.

22:05

The evidence for this is quite limited but

22:08

not to mention there are other routes to viral

22:10

infection so you're squirting this up your nose.

22:13

What happens if a virus gains entry through your

22:15

mouth or through your eyes so we can become infected

22:18

with respiratory viruses through our eyes?

22:21

So the benefits from this are quite

22:23

limited. There are other things

22:25

like nasal rinses that have been shown

22:27

in the lab to reduce

22:30

the viral load which means the number of

22:32

viral particles in our nose but that

22:34

actually might have more benefit for the

22:36

people around us. At that stage

22:38

you're already infected but it may reduce

22:41

how much virus

22:41

we're breathing out.

22:43

Margaret, they often come with the phrase clinically

22:46

proven.

22:47

I think that can mean a variety of things and also

22:49

nothing at all. So

22:51

an interesting one of these products was a

22:53

complaint made to the advertising standards authority

22:56

budget a few years ago and they were very strictly told

22:58

not to be claiming that it could

23:00

lead to the elimination of cold symptoms.

23:02

So I think they were obviously to be quite careful. And

23:05

interestingly as well with these sprees,

23:08

certainly some of them have got a status

23:10

of a class 1 medical device which is

23:12

not one that gets permission to be sold

23:14

on the basis of clinical trials

23:16

instead

23:17

it's sold on the basis of

23:19

self-declaration and this is the same

23:22

category of medical devices that's applied to things like bandages

23:24

and spectacles and glasses, not

23:26

things that we would often think about

23:29

as medicines. And again

23:31

as Lindsay says these things tend to

23:33

be treated or tested in a lab with

23:35

cells and a petri dish not in real life.

23:37

So again there is no good evidence

23:39

that these will provide

23:41

a benefit to you. In

23:43

a minute we're going to talk about one of my absolute favourites.

23:49

I've just loved the smell of it. In a completely

23:52

unscientific survey of the people in Cardiff

23:55

Well let's just say I am not the

23:57

only person. Vaporub?

23:59

Because I like the paper of. I

24:02

swear by the neck on your chest, if you bow out every

24:04

night, you'll go to bed.

24:05

And on the bottom of your feet. That's

24:07

what I do. Put it on the bottom of my feet. And I'm never

24:09

off the exit. So, Sunday's

24:11

going good.

24:17

And whenever... Do you want to smell Margaret's? I

24:19

wouldn't

24:19

actually smell Margaret's, though.

24:21

Oh my gosh. I don't like

24:23

that at all. See, whenever

24:26

I smell that, that takes me back to

24:28

being four years old, being

24:30

sick of my mum rubbing it on my chest. And

24:33

ever since, I've just

24:35

loved the smell of it. And when I'm ill, I

24:38

will turn to the mental

24:40

vapour up. I'm

24:42

not on commission, but God, I love the smell. So

24:44

this is really interesting, what you're saying about your childhood

24:47

and, you know, going back to thinking about when you felt

24:49

sort of loved and warm and insecure. And it is, there's

24:51

so many of these things. And it's not a bad thing.

24:54

It's not a wrong thing. We do want to go to

24:56

a place of security and comfort. Yeah.

24:58

Lindsay, do you want to sniff?

25:00

Yes. I love the smell

25:02

of menthol. And actually,

25:05

menthol is a trigger

25:07

for certain receptors we have on ourselves.

25:09

And it does the same thing that if you

25:12

go outside into really cold weather in

25:14

the middle of winter and you take a big deep

25:16

breath, you know that sensation you

25:18

get that your airways are open?

25:23

Menthol does the same thing. It is tricking our

25:25

bodies into thinking there is cold

25:27

in the air. And while

25:29

it won't help us, it won't relieve

25:32

that congestion. It makes us think

25:35

the congestion is relieved because

25:37

those cellular receptors are responding

25:39

to a cold stimulus.

25:41

Right. We're going to talk philosophy in

25:43

a minute, I think. Margaret, you've

25:45

been again digging through any of the scientific evidence.

25:47

Does menthol do anything for a cold? I mean,

25:49

there have been trials done and interestingly,

25:51

parents will see in some trials anyway,

25:54

that they felt that the changes looked a bit better

25:56

when they had it on. But again, I think it's quite

25:58

difficult to disentangle her.

25:59

placebo effect because as you said it doesn't have a

26:02

distinctive

26:02

end sequence doesn't it? So I

26:04

think it might be quite hard to control for that way. I know how to

26:07

keep you away now I just walked it. I just got

26:09

like a vampire. Yeah. Lindsay

26:12

you made a really interesting point like nobody

26:15

here is really saying that it's going to completely

26:18

clear your nose but what you said is it makes you

26:20

think

26:21

that you have.

26:23

Which is more important?

26:26

I think we could debate the placebo

26:28

effect for hours but

26:30

very often if we think we

26:33

feel better it can help

26:35

us get better. So a lot

26:37

of these things that help

26:39

relieve the symptoms or that help us maybe

26:42

sleep a little better they

26:45

may be psychologically, maybe psychologically

26:47

and physiologically they may

26:49

be helping us but they aren't actually

26:52

doing anything at all to get rid of the virus.

26:54

It feels like a slightly awkward area

26:56

of medicine. If I feel better

26:59

am I?

27:00

Well yeah I mean absolutely if you feel better

27:02

the only person that can say whether you feel better is

27:04

you and there has been some evidence to say

27:06

that if you tell people that this isn't an active drug

27:08

and they feel better with it they'll still feel better with it

27:11

you know. I don't think it's necessarily

27:13

a bad thing to acknowledge that it may not be

27:15

the drug itself that's making you feel better but

27:17

that's fine.

27:18

Where do we end

27:21

all of this? Margaret in terms of these

27:23

drugs we're not saying they're doing nothing

27:25

that they're all just duds

27:28

are we? Equally we're not saying that

27:30

they are magical wonder drugs

27:32

that are going to end your cold overnight.

27:35

Yeah although I think there are definitely some of them that

27:37

really don't behave any better than placebo so

27:40

yeah and there certainly are some that have been shown

27:42

in trials to give people minimum and temporary

27:44

release. From my point of view what I'm really

27:46

interested in is making sure people are not buying

27:49

stuff with over inflated claims

27:51

or promises and that's when I get a bit annoyed

27:53

to be honest with you. You know this is

27:55

a multi-million pound industry and you

27:58

know we're being asked to contribute towards that. And

28:00

really if we knew all the facts and if we had stuff

28:02

that was in plain packaging that said exactly

28:05

what the risk-benefit equation was, I just wonder

28:07

how much of that we would spend. But

28:09

equally, other people can make equally valid choices to me.

28:11

I come from one particular perspective, other

28:14

people will have a different view and that's absolutely

28:16

fine.

28:17

Well, thank you both so much for coming to

28:19

my home. I'm going to chase Margaret out by throwing

28:21

her with the mental paper off. Off

28:25

you go.

28:28

Hi, I'm Kristy Young and

28:30

this is Young Again, my podcast

28:32

for BBC Radio 4, where I get the

28:34

chance to meet some of the world's most

28:37

noteworthy and intriguing people

28:39

and ask them the question, if you

28:42

knew then what you know now, what

28:44

would you tell yourself? I don't regret anything in

28:46

my life. You don't? Not

28:49

me. Oh, if we could only turn back. For

28:51

me, well, I'd probably tell my younger

28:53

self to slow down, not

28:55

to be so judgmental, that

28:57

all that worrying was wasted energy

29:00

and that a perm is always

29:02

a bad idea. This might be the best therapy

29:04

I've had all year, by the way. Okay. You

29:06

never know. Join me for some frank and

29:09

I hope fascinating exchanges. Subscribe

29:11

to Young Again on BBC Scenes.

29:59

from

30:00

Vero, Kentucky.