Kaloba Cold Cure: How the MHRA condones quackery

The newspapers today were delighting in reporting that a new cold treatment was being made available to us in Britian. Kaloba is an extract of the geranium Pelargonium sidoides, and has been “used by Zulus for hundreds of years”.

The Telegraph tells us that “extracts are particularly good at reducing the amount of phlegm.” Remarkably, the paper tells us that,

Research by the Cochrane Review showed it to be “effective in resolving all symptoms including headaches and nasal discharge in adults when taken for an extended time period.

The Daily Mail tells us that,

A herbal medicine used by African tribes to counter colds and flu has been given the go-ahead for use in Britain.

For hundreds of years, Zulus have taken extracts from the geranium plant to stop coughs and sneezes.

They say it is particularly effective at cutting phlegm.

To the Daily Mail’s credit they do point out that licensing the pills in the UK does not require the manufacturers to produce evidence of efficacy. They say,

However, because it is a herbal remedy the manufacturers, who claim it can activate the body’s anti-viral defences, do not have to prove it is effective.

Indeed, the MHRA have issued their own assessment and say that,

This registration is based exclusively upon the longstanding use of the extract from the roots of Pelargonium sidoides as a traditional herbal medicine and not upon data generated from clinical trials. There is no requirement under the Traditional Herbal Registration scheme to prove scientifically that the product works.

There are a number of odd things here that are worth noting. Firstly, the MHRA does not look at the use of this stuff within Zulu tribes to assess whether there has been sufficient ‘traditional use’ to determine whether it should be granted a license. They actually looked at evidence of usage within the EU – not amongst Zulus, but principally amongst Germans where this herbal remedy has been on sale for some time.

The second is whether there is any evidence at all for the effectiveness of Kalabo. The Telegraph were remarkably selective in quoting the Cochrane review about this plant. Far from being “effective in resolving all symptoms” as reported, the Cochrane review actually concluded that “There is limited evidence for the effectiveness of P. sidoides in the treatment of ARIs. (acute respiratory tract infections)”. From the trials reviewed, there was a lot of heterogeneity of outcomes (read ‘confusion’) and that the ‘significant’ results came from an unpublished trial. So, it may be effective. But the evidence is too confusing to draw firm conclusions.

But the manufacturers Schwabe Pharmaceuticals and their sales outlet Boots will undoubtedly be welcoming the MHRA’s decision to let this stuff loose on us and the misleading and (mainly) uncritical reporting by the nations finest newspapers are undoubtedly providing a good sales launch.

On this theme…

30 Comments on Kaloba Cold Cure: How the MHRA condones quackery

  1. I’m of the impression that the directive 2004/24/EC means that the MHRA don’t have much choice in the matter. I may be wrong, but I thought that the Traditional Herbal Medicines Registration Scheme was basically an instrument to aid trade in the EU – i.e., the EU has ‘legalised’ unproven herbal remedies that have traditional use (again, I think it is a reqirement of the directive that the remedy must have traditional use in the EU rather than in the place of origin) in order that they may be sold in all EU countries. Good for industry. Good for consumer choice. Not so good for consumer protection. You can buy a greater number of products, but the trade-off is that you are considerably less certain of the benefits.

    You are right to point out what a shit state of affairs it is, but possibly a bit harsh on the MHRA – as far as I can tell they are “only obeying orders”. EU directives on herbal products and vitamin pills (not to mention homeopathics) are basically meant to ‘harmonise’ legislation in member states and assist trade. Everything else seems to be secondary to businesses being allowed to trade freely cross borders.

    “A significant number of medicinal products, despite their long tradition, do not fulfil the requirements of a well-established medicinal use with recognised efficacy and an acceptable level of safety and are not eligible for
    a marketing authorisation. To maintain these products on the market, the Member States have enacted differing procedures and provisions. The differences that currently exist between the provisions laid down in the Member States may hinder trade [etc…]”
    From: Directive 2004/24/EC

    PS – excuse the loser-length post, I just find EU directives very interesting.

    PPS – you’re right about the Telegraph and the Mail’s pieces on Kaloba and having scanned Google News just now I can tell you that the Metro’s coverage was pretty awful too. They are cherry picking from the same Cochrane review and their angle is that Pelargonium is going to “stem the overprescription of antibiotics”, which are (apparently) “ineffective against viral versions [of colds and influenza]”. Which is funny, because I’d never heard about these bacterial cold and influenza bugs. Presumably what they actually mean is that instead of prescribing one useless placebo, doctors are now free to prescribe another?

  2. The operative point is that it ‘works’ if taken over a period of time. Snce colds are self limiting this obviously is going to happen regardless of what you do or take. IOW there is no evidence of its effectiveness if that is the measure of it.

  3. Of the many scientists who have criticized homeopathy, is there not one who will sue for defamation for being called a pseudo-scientist?

  4. Hmm, think you’re a little negative here. Herbal remedies have been around a lot longer than drugs, in fact as far as I know all drugs are, in fact artifical copies of the active constituents of the herbs!

  5. Amongst other trials:

    Efficacy of a Pelargonium Sidoides Preparation in Patients With the Common Cold: A Randomized, Double Blind, Placebo-Controlled Clinical Trial .
    EXPLORE: The Journal of Science and Healing , Volume 3 , Issue 6 , Pages 573 – 584
    V . Lizogub , D . Riley , M . Heger

    Conclusions:

    EPs represents an effective treatment of the common cold. It significantly reduces the severity of symptoms and shortens the duration of the common cold compared with placebo. The herbal drug is well tolerated.

  6. Anonymous – by posting this trial, you are doing what all quacks do – cherry pick studies. You pick the most favourable evidence and do not discuss it in its wider context. This trial was indeed reviewed in the Cochrane review I mentioned in my post, along with other less favourable reviews. To therefore, highlight this one trial is misleading as it ignores less favourable evidence.

  7. I hate to break it to you but it isn’t just ‘quacks’ that like to cherry pick research. The vaults of pharmaceutical companies are stuffed with research that fails to support the efficacy of many of our favourite drugs, which they choose not to publish. ‘Science’ and ‘quackery’ are not nearly as different as you think.

  8. If you qualified what you said by saying “pharmaceutical companies and quacks are not too different” then I might agree with you. But quackery and ‘science’ is not equivalent. Both distort the scientific method for profit. Science and reason is what allows us to see that they do this.

  9. What everyone seems to have forgotten to discuss here is whether this stuff actually works. Well, the only reason I stumbled across this page is because I am currently trying this product and
    I am so impressed (and a little shocked) by the outcome that I decided to find out more about it. My cold symptoms have been dramatically reduced, in comparison with my wife who gave me the damn thing in the first place who is still suffering with normal level symptoms. For once a cold remedy that actually works.

  10. Remarkabale stuff Tom. Your cold got better after a few days, and someone else’s cold took a little longer. This must be the health breakthrough of the century.

  11. I am please there is some positive review for this product. My family have been using it for at least a year. We have three children and since giving them Kaloba at the beginning of an illness they have had a recovery time of about 24 hours….before this they would often be unwell for 4-5 days. My husband and I often use it at the onset of cold symptoms and the symptoms go within 24 hours also. Haven't had any flu since using Kaloba!!

  12. Children get over their sniffles! More miracles! And you escaped flu! Thankfully, a much rarer infection.

    The power of self delusion is amazing and what this blog is all about.

  13. Certainly it is safer to reject something which seems quacky.No one shall think you are a moron.But remember… aspirin derives from weeping willows and digitalis from flowers of the same name.
    I have used it myself and recommended its use with excellent and remarkably quick results so, I will go on prescribing it.

  14. I too have just used the product after looking for something for my daughter (2) who has had sooo many colds since starting daycare at 8months. This time round her sypmtoms were reduced and took less time to recover. Usually her colds end up with sinus infections and therefore antibiotics. This time we did not need them. For myself, when I get a cold it usually drops into my chest and this has not happened this time round. People may chose to doubt the results of this product and you could even play devils advocate about it being mind over matter. But that doesn't explain the difference in my daughter, she is not old enough to think herself better and yes her cold this time round could have been not as bad as all of the others but honestly from talking to the mums of others at daycare who are usually the same as Grace. There is a dramatic difference. So it may not be a cure but it certainly makes life easier in a natural kind of way.

  15. I came across this page searching for info on kaloba after seeing an annoying advert for it on tv earlier. And it seems exactly what I thought, make it look like a true medicine with adverts and packaging but no truth behind it. If you believe it works then keep on using it, it's your money and you can choose to put whatever you like into your body.
    But anecdotal evidence of "It works for me and my family" does not qualify that the product really works. It's like me claiming a regime of massaging mustard into my feet helps with colds because I got less this year than last, and they lasted a lesser amount of time. The cold virus fluctuates way too much in strength and severity from year to year and person to person. Hence why there is no cure.

  16. There will always be those who will pontificate against natural remedies and those who do the same with pharma drugs. If it works for you it works, talk about it around you and people will make up their own minds if they want to try it. I'm in the natural camp, and have long given up trying to convince the naysayers in favour of natural. When people are desperate enough they'll try it then they'll see. Don't slate natural, everyone will assume you have shares in some big company as there's no reason to contest what nature can do. Live and let live.

  17. I’m lying here with what feels like flu and found this page since my girlfriend’s just bought me this shit instead of lemsip as I’d asked. Damn, if she wasn’t being so sweet to me otherwise and I didn’t love her so dearly I’d be reprimanding her this…

  18. I’ve never heard of this stuff before but it was given to me as a sort of gift. Now I’ve tried it but I don’t see any difference in how speedy my cold recovery is. I think it’s just expensive nonsense. The way that most of these herbal medicines are said to have been used by some exotic tribe and contain exotic herbs are convincing to some but that makes it sound even less convincing to me.

  19. Im probably leaving this a couple of years to late but i just read this blog and cannot believe how rude some people are! Especialy over something as silly as a natural cold remedie…….Le canard whatever, u have a real chip on ur shoulder what have these people ever done to u! You say ur glad to here lizziepops has given up trying to convince people that kaloba works but why r u trying soo hard to convince people that it doesn’t! At least we r trying to help people out by sharing that we have found something that works for us in the hope that other people will benefit from this wonderful stuff. And for those that say its expensive stop being so tight! If u feel crap isn’t it worth a fiver! It does work…. A couple of minutes after swallowing kaloba u feel all ur sinuses bubbling and feel a bit like there cracking but in a good way! If that makes sense, and then all ur sinuses clear and ur ears unblock it truly is amazing! Well it works for me anyway hope it does for u to 🙂

  20. I have taken Kaloba at the first signs of a cold for about two years now and can honestly say that it works. Take it as soon as you feel the symptoms coming on and it stops the cold from progressing. This article and the subsiquent comments are hilarious. Take it or don’t take it – the fact that you have a choice is what’s important.

    • Very often I have what feels like a cold coming on. I take nothing and it goes away.

      You are an easy target for scam artists.

      • Since I have been taking Kaloba I have had far less colds, no doubt..
        Why the sarcasm? Dont take it if you dont want to

  21. It is the pharmaceutical companies that cherry pick their trial results.Many times they do not publish and in fact hide trial results and only put forward the trials they wish to to get their drugs approved.At least with natural medicines it is extremely rare that they do any serious harms.Aspirin alone kills at least a thousand times more people per year than all the people killed from natural medicines in a decade.In fact prescription drugs kill over 116,000 people in the U.S per year and Natural medicines have killed 7 people over an 11 year period in the U.S- that’s why we have to be so careful of man- made synthetic drugs which the body fights against instead of working with as is the case of natural medicines.Every drug has side effects,many severe-some deadly- this is proof that the body sees them as foreigners and fights them.

    • It is interesting you bring up Aspirin. This drug is often touted as a success of the herbal approach to medicine. Aspirin has been used for thousands of years in the form of leaves from the Willow tree. It is a real natural medicine. What science has been able to do is to work out which bit of the leaf actually has the desired effects – acetylsalicylic acid. When you take a tablet you know exactly which active ingredient you are taking, exactly how much of it you are taking and the risks etc are clearly researched and laid out for people. If you were to swallow a bunch of willow leaves, you would not know how much acetylsalicylic acid you were ingesting (it varies) and you would not know what other chemicals in the leaves were also having an effect. There would be no label on the bottle and no indication of what risks you were taking. Proponents of ‘natural medicine’ think we are better off just scoffing concoctions of leaves without these warnings. Letting people take unknown drugs from plants, in unknown quantities, with unknown benefits (if any) and unknown risks.

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