Thursday, June 18, 2009

The Sad Story of Zicam

Nationwide, the Zicam cold remedy nasal gel was ordered to be pulled off the shelves on Tuesday, June 16th. The charge was simply that using the nasal gel could lead to anosmia, or a permanent loss of smell. Indeed, 130 people had reported a loss of smell after using Zicam. As a rather randomly-chosen Dr. Charles Lee points out, anosmia goes much further than merely not being able to appreciate a rose or a home cooked meal. “People without the sense of smell may not be able to detect life dangerous situations, such as gas leaks or something burning in the house,” he says.

But why did the Zicam nasal gel cause anosmia? The answer is actually quite simple. Zinc is the culprit. In this case, it takes the form of zinc gluconate. Zinc has been known in the past to cause loss of smell when used intranasally. (One of my brilliant colleagues wrote about this very issue, first back in 2006, then again two years later.) Worse, studies using intranasal zinc gluconate to treat the common cold did not show an appreciable difference in the duration or severity of symptoms. They did show a risk of potentially irreversible anosmia.

Another issue: how did this product get placed on the shelves in the first place? Usually, it’s the Food and Drug Administration that dictates whether or not a drug is able to be put on the shelf. But Zicam got past this by stating that the active ingredient was homeopathic zinc gluconate. The FDA does not regulate homeopathic remedies, and so was not beholden to restrict the sale of Zicam. But in this case, the matter was all semantics. Specifically, the active ingredient was zincum gluconicum 1X. This is a homeopathic way of saying “a 10% solution of zinc gluconate.” Usually, homeopathic remedies are very dilute…dilute to the point where some of the most powerful remedies don’t have a single molecule of the original substance in them. (How and why these remedies work is an issue for another post.) But if not dilute enough, these remedies can exhibit properties of their original substance – precisely because they contain that substance. And a 10% solution of zinc gluconate certainly qualifies.

This is one of those instances where something that seems harmless or beneficial may end up being quite harmful. Many people are drawn to alternative medicine precisely because they feel it is less harmful than drugs – and in many instances they are right. But this is not always the case. Are herbs safe to use? Not if they’re herbs like foxglove (from which we get the highly regulated heart medication digitalis) or poison hemlock (which Socrates drank to commit government-ordered suicide). Similarly, are nutrients safe? Usually, yes, but as we now know, not if it’s zinc applied to the inside of the nose.

Another disturbing aspect of the Zicam issue is that blame is being wrongly placed on the whole practice of homeopathy. As I mentioned above, it was not the homeopathic quality of zinc that caused the cases of anosmia. It was the zinc itself. An article by the Associated Press about this issue misrepresents homeopathy as a whole. Dr. Jerry Avorn, an expert in pharmaceutical safety at Harvard dismisses homeopathy as having only alcohol as the active ingredient, saying “the therapeutic effect is no greater or lesser than a martini.” The article’s author also discovered that some homeopathic remedies are composed of more than 10% alcohol, when the American Academy of Pediatrics dictates no medicine contain more than 5% alcohol. All three entities might be surprised to know that a homeopathic dose usually consists of a pellet or two or a drop or two of the remedy in the mouth – hardly enough to give either adult or child an alcohol “buzz-on,” as Dr. Avorn claims.

It’s a sad issue. Zicam willfully deceived both the FDA and the public in an effort to get its product out to consumers wanting to treat their colds effectively. Thousands of consumers bought Zicam’s products, thinking that since it was homeopathic, natural, herbal, and/or non-pharmaceutical, it was safe. And as a result, scores of people have permanently lost one of their vital senses.

But what can we take from this? Some people might consider this evidence of the “snake oil” nature of alternative medicine. It isn’t. It’s evidence of greed taking precedence over the health of the public, and greed is not limited to alternative medicine. It may also be an indication that alternative medicine should be regulated more, although I have great doubts about the ability of the FDA to effectively regulate this profession. It is possible to view this as a societal need for qualified health care professionals who are thoroughly trained in the realm of natural medicine – and naturopathic doctors are precisely those health care professionals.

If you are prone to cold and the flu, it’s definitely a good idea to see if you can deal with issues from a natural perspective, with the help of a naturopathic doctor. Check my website out for more information about naturopathic medicine, and what it might be able to do for you. And be well.


Do you have health issues that aren't being adequately addressed by conventional medicine? Naturopathic care may be the answer you're looking for. Visit my website for more information about naturopathic medicine, and begin your journey toward optimal health!

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