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Cough! The health products you don’t need

Selection of health products

We Brits spend about £3bn a year on over-the-counter pharmacy products, yet our snapshot research found popular products making claims that our experts don’t think are backed up by sufficient evidence.

I’ve got a cough and cold but what to do? There’s a bewildering array of products on the shelves at my local pharmacy, but what’s actually scientifically proven to work, and should I just keep my money in my wallet?

We bought popular health remedies from chemists, and our expert panel examined the claims made on them. They found no compelling evidence that convinced them any of these products were needed.

Where’s the cough medicine evidence?

For example, our experts examined the published evidence for cough medicines Benylin Tickly Coughs, Benylin Chesty Coughs (both Non-Drowsy) and Covonia Herbal Mucus Cough Syrup, and concluded there’s ‘no robust evidence’ that they do what’s said on the bottle.

And you may be getting more than you bargained for with Benylin Tickly Coughs. Sugar is its main ingredient, with 7.7g (a generous 1.5 teaspoons) in every 10ml dose. If you had an adult’s maximum dose for a week, you’d have eaten the same amount of sugar as in five Mars bars.

So how do these products pass the regulator’s tests? Cough medicines are licensed medicines and the regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), told us the licence-holder is legally required to show them the evidence that they work.

We asked the manufacturers to share the research behind their claims so that our experts could ensure they’d seen all the relevant evidence. The companies declined, saying they had satisfied the regulator who had thoroughly reviewed their clinical evidence.

Companies don’t have to share the evidence they’ve supplied to the MHRA. But what are we to do if we aren’t allowed to see this? How can we know if the science behind what we’re buying is robust enough for us to trust their claims?

Seven Seas, Rescue Remedy and Adios

What else did we find? Well, Seven Seas Jointcare tablets claim to ‘look after your joints’, but our experts concluded that there’s no evidence that its active ingredients can do this.

Our panel said the trials behind Adios, which claims to be a natural way to speed up weight loss, are not robust enough to prove that it’s actually an effective slimming aid. And Bach Rescue Remedy is apparently no more effective at relieving stress than a placebo, according to independent tests.

These products aren’t cheap: Seven Seas Jointcare Be Active is £12.45 for 30 tablets (not even a month’s supply). Adios costs £10.69 for 100 tablets (about a month’s worth).

You can check out these examples and more in our gallery of ten health products we think you don’t need, but make sure to share the ones you think need to be examined.

Health products on a shelf

In the end, manufacturers need to be more transparent so that we can scrutinise what’s really behind their products and make a truly informed decision when we’re after a health remedy.

Comments
Guest
Argus says:
15 October 2012

How much money is in Pharma?

There’s your answer. If all these products can get to market and sold in their million because the marketing tells us they are good for us, then we are going to believe it.

Companies like Which and the regulators are clearly letting us down.

Personally I never take remedies, hardcore post-op pills are the only thing that work for me

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Guest

I hardly think Which? can be accused of letting us down. Over the decades Which? has persistently examined product claims, particularly in the medicine sector, and recommended stricter approval regimes. The drug industry needs a whole coven of Which?s on its case full time.

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Guest

Some cough remedies warn against taking with alcohol because this can make you rather drowsy. Taken with a little cooking whisky they can help provide a good night’s sleep. 🙂

Always read the label and follow instructions, of course.

Guest
Sophie Gilbert says:
16 October 2012

More doctors need to tell people not to waste their money on cough medicine, like mine did a long time ago. Instead, as per her “prescription”, take a hot drink with honey in it, or a teaspoonful of honey by itself. Along the lines of Wavechange’s suggestion, a hot toddy (I take mine with cooking brandy, honey and a splash of lemon juice) just before going to bed will help the throat a little, help towards a good night’s sleep, add to the hot liquid intake, and it’s not bad for the soul either.

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Guest

There was a W.C. Fields film in which an odious child was sent out to get some cough remedy with “ippicac”. Hence I always take “honey, lemon and glycerine linctus with Ipecacuanha” – available from most chemists and supermarkets at a very modest price. W.C. would have added a tincture of the grainy spirit to his potion – after all, he famously remarked that he always took a bottle of whisky with him in case he saw a snake; he also took a snake.

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Guest

It depends – I do not use patent medicines usually – For instance the last time I had flu was seventeen years ago – but to ease the symptoms – I used Gee’s Linctus – worked well – still have 3/4 of the bottle – In fact Gees has worked well for me for some 60 years. Rather like the last time I had a migrainy headache – went to doctors who gave me a 400 pack of Ibuprofen – two tablets worked – at present use they will last me 200 years.

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Guest

Proper drowsy Benylin isn’t so easy to get hold of these days, seems to be a bit ‘under the counter’ in some chemists and you have to pass an interview to get hold of it. But chased down with a large scotch at bedtime it’s a pretty good anaesthetic.

I wouldn’t take much notice of the sugar content, you’d have to be a pretty dedicated user to get fat on this stuff.

Guest
hoppingpinkrabbit says:
18 October 2012

Its not the fat you got to worry about, its your teeth!

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Guest

I used Bach’s rescue remedy (using a dropper, rather than the spray pictured here) before a second driving test and, as effective as a placebo or not, it got me through a driving test.

Sometimes our brains need to think something is benefiting us for it to actually happen. Now I’m no psychologist, but I was definitely less nervous during the second test. Whether that was because I was less stressed thinking it was doing something to me, we’ll never know.

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Guest

In tests placebos have been shown to make a real physical change to our bodies – it seems a belief that something will help really does work. In fact, I remember reading about a test where two placebo sugar pills are more effective than one sugar pill… So it’s not to say placebos are a bad thing. It’s just when these ‘placebos’ are a heavy weight on our wallets…

Guest
Barry Coleman says:
19 December 2015

I would imagine that a heavier load on our wallets would produce a greater placebo effect. Wouldn’t it? It seems to work well in all sorts of other places. E.g. fashion clothing, cars, houses, pedigree dogs, yachts and so on. Pay more, if you can, and feel good!

Guest

Rescue remedy works on animals who are not aware of what they are taking so I believe this to be a good indicator that it works. It has helped me many times unlike some other herbal remedies.

Guest
Dot. says:
16 October 2012

when my daughter was pregnant with her 1st child 14 years ago, she got very agitated by a scan when the person doing it spoke out loud and said she couldn`t find a heart beat and then” if the baby`s head went any lower it would drop out by itself”. She was only 20 weeks pregnant at the time. She got back to work in a right state, her boss rang the hospital to complain and asked to speak to the consultant. She did and he recommended Rescue Remedy so as my daughters blood pressure didn`t get out of hand. It worked. It also worked on me and 2 of my colleagues when we had to give evidence in a criminal trial recently when we were a bit stressed. So don`t always believe these so called tests. I also swear by Echinacea capsules for preventing colds and I haven`t had a cold for 5 years instead of the 2 a year I used to get. No “evidence” they work either so they say but I know they do

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Guest

Thanks for sharing, Dot. Clinicians used to rely on lotions and potions which were dreamt up in a dark room somewhere – it was called witchcraft. Some patients enjoy dabbling with these mysterious potions – they are magical because they have no evidence to explain how they might work, and that is what underpins their placebo effect. So…as long as you understand that and want to play Dungeons and Dragons, then keep on taking these “remedies” but keep them for yourself only. Here’s a question for you: what would you have done if your daughter’s blood pressure had gone higher and threatened the pregnancy? Would your nearest and dearest have said – ah yes, mum’s decision to use this crackpot potion was sound, especially as there is no evidence to show it works. Does that sentence sound right to you? and I can tell you for sure that in a court of law the consultant who advised you to do so would not have a leg to stand on. First rule of medicine – first do no harm….remember that the next time you offer your potion to someone else.

Guest

I have worked for A Nelson & Co who sell Bach Flower Remedies. They came under immense pressure from the industry & practitioners for proof. A dentist chair trail was conducted where the patient was giving either a placebo or a Bach Flower Remedy. The results proved to be inconclusive and were not recognises by the BMA. During this time Nelsons were fighting a five year legal battle with Healing Herbs over the use of the name “Bach” which they subsequently lost and had to pay many millions of pounds in legal costs.

Losing the court battle Nelsons had to impose a massive price increase across their range of products to pay the costs. A bottle of Rescue Remedy went up from £1.29 to £3.79 which affected sales massively. As with all medicines the cost of the product is minimal with a bottle of Flower Remedy costing less than 2p to manufacture and produce.

[This comment has been slightly edited. Thanks, mods.]

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Guest

Thanks for telling us how little it costs to make a bottle of Flower Remedy. That’s another reason to avoid anyone wasting their money.

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Guest

I think it would be wise for Which? to discuss their concerns about these products with MHRA, the regulator that has approved them.

I am not surprised that the companies failed to provide evidence of efficacy to Which? but I do think this should be available to the public. Perhaps MHRA could help here.

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Guest

@wavechange
I’ve taken it up with the MHRA. Watch out for the blog!

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Guest

Thanks David. I look forward to hearing what they have to say.

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Guest

I Beg to differ with Which,re Vitamin C.LINUS PAULING got the Nobel Prize for Medicine twice for his work with it which proved efficaceous in cancer and there are other recorded cases; recently research published showed it did reduce colds; but personally ECHINACEA, which also gets a bad press is a life saver – though I often wonder who finances the studies which say herbal and Vit C etc. are no good – big Pharma>

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Guest

Small correction. Linus Pauling never got a Nobel prize for medicine. He got the prize for chemistry (in 1954) and the Peace Prize (in 1962). Sadly, in old age, he went decidedly eccentric (a hazard for Nobel prizewinners) and started to advocate high dose vitamin C as a panacea. There was no good evidence at the time that it helped anything and there still isn’t.

And echinacea cures your cold in only seven days when otherwise it would have taken a week, You don’t have to believe me. Look at the web site of the National Center for Complementary and Alternative medicine, Despite their strong bias in favour of alt med. they don’t claim that it is effective.

And before you accuse me of being in the pay of Big Pharma, take a look at http://www.dcscience.net/?p=5538

Guest
Dave in Newport says:
18 October 2012

I felt this piece could have been covered in a single sentence….
‘We asked a panel of mainstream medical experts….who said …because there was no evidence…..none listed were of any or little benefit ’
In the same issue of the magazine there were reader surveys of on-line shopping and money pit motors which were based on user experiences to base the worthiness of these products. Given that many herbal and traditional medication hasn’t had robust testing, wouldn’t this have been better.

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Guest

I’m afraid it wouldn’t have been better. It is easy to see whether mechanical gadgets work but it is surprisingly hard to tell whether a medicine works, In any case your argument is only partly right. Some things have been tested quite a lot -like glucosamine and echinacea. And those that have been tested well have been found not to work.

Others, as you say have not been tested well. Perhaps you should be asking why the manufacturers are selling them despite inadequate testing. Vast amounts of money are made by selling these nostrums, One can’t help wondering why some of that money is not used for testing. Perhaps the manufacturer has a suspicion that the tests would be failed?

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Guest

Well, in most cases there were studies but – in our experts’ opinions – they didn’t support the claims. For example, Rescue Remedy has independent studies – but they show it to be no more effective then placebo. It is up to the companies to prove that remedies work before they go on the shelves, and it is up to the regulator to check that the evidence is adequate. We shouldn’t have to do the regulator’s job, surely?

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Guest

If there are so many remedies on the market that do no better than a placebo, why are the products allowed to be put on sale before any regulator seems to take action against them. Why doesn’t the regulator get more involved before these products hit the shelves? Or is that just too simple ?

And as a recent Watchdog episode highlighted pain relief tablets being marketed for specific parts of the body when in fact its the same formula ( things like period pain and migraine have the exact same PL number ). Heaven forbid some poor woman suffering from both at the same time, could be duped into taking one tablet from each box. Surely any competent regulator could be able to foresee this and pull the products before allowing them onto the shelves.

Even as a lay person its obvious to me that with the same PL number (and I don’t even know what PL stands for, as I can’t be bothered to look it up on the web – I don’t need to know) they shouldn’t be marketing them in the way they are.

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Guest

@william
I thing that part of the answer is that things like Benylin have been around for a long time, before the regulators existed. A lot of old stuff got given the benefit of the doubt. That was OK as an interim measure, but the MHRA documents on cough suppressants contain some pure gobbledygook. I’m trying to find out what the MHRA really thinks, and why it continues to endorse things which, for all practical purposes, don’t work. The results will appear on dcscience.net whenever I get the information (getting information from the MHRA can be a slow process).

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Guest

WILLIAM – you are of the same frame of kind a myself. I dont know what PL stands for but I know that there are two points – sort of – with a space in between, when there is pain a sort of electric thingy goes to them,it is the same for whatever pain. There is no pain killer anywhere which will tell the pill “this is for period pain” pain is pain to the body and a pill sorts out the pain not the cause. I spoke at length this weekend with a student of Biomedical Science – so it is still the same, the bodies haven’t changed since I was young! The Ad people should be stopped from saying that – there are trying people to buy a pack for each type of pain – not one for the pain in the ar*e these ads are. It’;s a con job and the ad regulator ought to stop it. There will be a lot of people who are ignorant – not ignorant per se – but of the facts about pain.

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Guest

Interesting – Flowers Remedies and Bachs rescue remedies have been used very successfully to treat dogs adopted from our kennels for various problems for years – and they WORK – Now not one of the dogs understands what a placebo actually is – but the symptoms are relieved. So I am a sceptic.

Plus why should I take the trouble to make up a complex concoction when I can buy or stock a ready made concoction that is equally as effective and very very convenient.???

Gees Linctus certainly relieves my rare coughs.

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Guest

@richard
Sorry, but “it works on animals” is one of the oldest excuses used by peddlers of quack medicines. Of course the animal doesn’t know, The placebo effect (and the get-better-anyway effect) work not on the animals but on their owners. If you’ve paid for a treatment, and you want the dog to get better, it’s human nature to attribute the improvement to the treatment. In those cases where it’s been tested, this turns not to be true. All you are seeing is an improvement that would have happened anyway.

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Guest

Sorry totally DISAGREE – the dogs improve – it is not the placebo effect – some of the remedies have been used for many years with great success. Owners of my breed of dog DO NOT WASTE MONEY.; Plus the use of such medication is to ease the symptoms – not eradicate the disease. and we have 100s of owner/adopters who happily disagree with you.. I’d sooner spend a little to remove the problem NOW than wait three or four months for the symptoms to “die away naturally”

Rather like Gees Linctus – I could wait three weeks for the cough to go away – I sooner have a couple of teaspoons to stop the symptoms instantly.

I really don’t mind if you prefer to suffer – I don’t.

Guest
Roger Bellingham says:
22 October 2012

Re Benylin. The real test is whether it works. I have used it for many years and found that it does. Did any on the experts actually try it when they were suffering from a cough? If not, how did they know that it doesn’t do what it says on the bottle? OK, maybe honey and lemon and a paracetamol would be just as good, but Benylin is less hassle.

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Guest

For those that don;t know the PL number stands for, and you’ll like this, Marketing Authorisation number. Hands up who thought is was Product Licence number. (It used to be that but they changed it, crazy people). See

http://www.mhra.gov.uk/Howweregulate/Medicines/Licensingofmedicines/index.htm

So if its a Marketing number why have Nurofen been allowed to market the same pill for different pains

See http://www.nurofen.co.uk/products.php#specific

Surely the body that gives out these PL numbers should be consulted by an company that wants to change the marketing, I mean packaging, of existing products. And then things like this con would stop. If they don’t want to get involved with Marketing then they can always rename the PL number back to what it was.

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Guest

I think it is the regulators role to ensure that something that may do you harm is not sold to you without prescription, and to prevent clearly misleading claims. But it is up to you to be savvy about what you buy. Companies want your money and will try all ways to get it – branded painkillers v generic for example. I generally resist taking anything unless it is essential; blood pressure pills for example – I bought a BP monitor to check my state over several weeks before conceding they were probably needed. An exception is Vick’s First Defence – at the first sign of a cold I use it in a desperate attempt to ward it off; it doesn’t seem capable of doing any harm. To my surprise, most (but accept it has been a small sample sizze) colds have stopped developing – but they may have done anyway. I usually accompany it with whisky lemon and honey in hot water which may not cure your cold but makes you feel better. I suspect many don’t visit the docs unless absolutely necessary – which leads to trying witchcraft potions.

Guest
Andrew Rosenthal says:
25 October 2012

As a consumer of cough medicines, I welcome this report, however rather than just discredit treatments available, I would far rather your “experts” actually make a recommendation of something that works. It is one thing to say there is no evidence for certain elixirs and potions, but without offering alternatives I find it rather unhelpful.

Personally I have found the Benylin Tickly cough treatment does sooth a tickly cough – even if it turns out there is no evidence to say why it should work – however if there is a better “scientifically proven” treatment, then I (and I suspect many of your other readers) would like to know.

I look forward to something more constructive then just a headline grabbing story.

Your
Andrew Rosenthal

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Guest

@Andrew Rosenthal

I’m sorry to say that there no effective treatment seems to exist. When the classical cough suppressants, things like pholcodine, dextromethorphan, were tested properly it was found that they were essentially ineffective (as is honey). Perhaps the article should have made this more clear. As a pharmacologist, I can only apologise for this failure. But cough certainly isn’t the only common ailment for which no effective pill exists.

All I can say in mitigation is that real medical research has been going on for less than 100 years. It has turned out to be very complicated. Come back in another 100 years and I’m sure more problems will have been solved,

Guest
Roger Rowland says:
28 October 2012

Personally, I was hugely disappointed by this article. The comments of the experts were very brief and just as “unscientific” as some of the product claims. “The company provided no evidence of effectiveness”, “effectiveness is unproven”, “we found no studies showing all the benefits claimed”, “the research isn’t robust”, etc. etc. Every schoolboy knows that “absence of evidence is not evidence of absence” and there is much empirical “evidence” to warrant some more serious look at the effectiveness of these products in the real people that spend real money becuase they find them helpful. Your implication is that these people are just mindless sheep throwing money away to the evil big pharma companies. Popular position perhaps, some nice soundbites and headlines maybe, but serious scientific opinion – I think not. There is so much to criticise about this article that it’s difficult to know where to start. However, one example is Boots Cold & Flu Relief, in which one of the experts argued that 400mg of paracetomol is less than the “more usual” 500mg – so why is this a problem? What research shows that 500mg is good and 400mg is useless? If some exists, it should have been quoted – if it doesn’t exist, then what value this “opinion”?

Very unhappy with this piece – could have been so much more useful.

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Guest

I believe that people are wasting money, based on what I have read over the years and from speaking to friends and family in the medical profession. If these products were both useful and represented good value for money, GPs might be able to prescribe them on the NHS.

Guest
Roger Rowland says:
28 October 2012

@wavechange – yes, I believe that too. I’m bemoaning the way that the article was presented to supposedly expose this. Experts should, in my opinion, sound like experts – if you look at Ben Goldacre’s writings, you can see a big difference here.

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Guest

@Roger Rowland

It was a fairly short article. To review all the evidence would have taken an entire issue. However you can do it yourself, through Cochrane reviews and some other reliable sources.

You are quite right when you say “absence of evidence is not evidence of absence”, but it doesn’t help the argument much. Are you saying that people should be able to make any claim they want if there is no evidence that the claim is true? In any case, for at least some of the ingredients there is evidence that they don’t work to any useful extent.

That shows, incidentally, that anecdotal evidence is just unreliable. When you’ve spent money on a potion, and your cold gets better, it’s human nature to attribute the the recovery to the potion, when in fact it would have got better anyway. It’s alarmingly easy to fool yourself and the purveyors of cold cures make a fortune from that.

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Guest

Roger

I take your point and would be very happy to have much more depth, especially since I’m accustomed to reading complex scientific papers and reviews. However, Which? writes for the general public rather than for those who have a particular interest in a topic and their articles provide sufficient information to encourage us to find out more.

I would like articles to be kept simple, with more depth available on the Which? website.

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Guest

Regarding evidence – if a company makes a claim for a product it is their responsibility to support that claim with robust evidence (which properly conducted trials can provide), not for someone else to disprove it . Regarding Boots tablets, perhaps the thought behind the comment was that paracetamol was the only useful ingredient, and you’d be better off buying 500mg generic paracetamol rather than a doubtful, and more expensive, concoction. However, if you believe the claims made for these products, if they don’t do you any harm, and if you are prepared to pay the high prices most cost, then ignore the advice and try them – and if your symptoms disappear that’s great.

Guest
Roger Rowland says:
28 October 2012

Well you sort of understood my point – why wouldn’t a chart of dosage vs. effectiveness of paracetomol based on research have been informative? Then once we know what doses are proven to be helpful, we can make our own cost comparisons. FWIW I don’t believe *anything* claimed, even for prescription-only drugs, but would much rather see the evidence for/against than have to read another set of opinions.

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Guest

I wonder what would happen to chemists shops if they did not have these profitable “remedies” to sell?

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Guest

Thank you for this excellent piece. I have long been amazed at how gullible some people are with regard to supplements and remedies. My local shopping centre has several shops selling Chinese medicine and herbal remedies. I hope you will cover more of these bogus products in future. I was recently badly bruised and about 8 friends recommended arnica. I can find no evidence that it works, and the doctor told me not to bother when I queried it. One person even said it must work because it was sold in Boots!

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Guest

A current Conversation on the things people take on holiday suggests that 20% of people pack supplements when they go on holiday.

https://conversation.which.co.uk/transport-travel/holiday-home-comforts-world-travel-market/

No doubt some of them will also pack some of the ‘health’ products we are discussing.

Guest
Dave Crew says:
17 November 2012

I’ve always found the best remedy for a chesty cough is a generic cough syrup called Simple Linctus. It’s not expensive, pleasant to take, can be bought anywhere and is effective after just a few swigs.

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Guest

First sign of a cold I take 1000mg of Vitamin C. Haven’t had a humdinger for over 20 years now. Also works for cold sores if taken quick enough. Only need to take it for a few days. Also take it for a few days when flying or someone splutters over you in the supermarket.
It is the only health supplement I need.

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Guest

Have a look at what David C. has to say about vitamin C on the previous page.

I don’t remember having cold sores and I can’t remember when I last had a bad cold. I have not taken vitamin C, other than what is in the food I eat.

Guest
David Hawkins says:
4 December 2012

I’ve got cold and a very irritating cough right now but the article seems to be warning that nothing can help at all. If this is true, why not say so up front. If on the other hand some remedies (commercial or home-made) can be useful, it would be really helpful to identify them. There seems to be no positive advice at all from Which? in recent years.

Guest
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Guest
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Guest
Simon says:
3 June 2014

“Which”, as with so many others, relies too heavily on chemical analysis and laboratory “proof” of a remedy. There is absolutely no respect for people who find benefit in products such as Rescue Remedy, for example.

You appear not to understand people at all! Different things work for different people and different situations.

I have had acupuncture for various problems, and it worked wonderfully for some, but not at all for others. I had a knee problem many years ago: the drugs made no difference, nor even the surgery or physiotherapy (I expected these to help). I came across a magnetic product, and that worked wonders – and has done ever since. Pychological? How could it be? I was fairly open minded about all of it, but only one worked.

People don’t live in laboratories, “Which”, so try to be more open minded and respectful.