Cold FX, the #1 Placebo for Good Canadians

by Jay Smith on January 28, 201217 comments

Here is a short narrative of nationalism as placebo effect: Canada is cold. Canadians get cold. Canadians get colds! Therefore, Canadians need Cold FX!

Claiming to kickstart a winter-battered immune system and to mitigate the effects and frequency of cold and flus, Cold FX frankly appeals to the Canadian-ness of Canadians. Legions of hockey and sports heroes vouch for it, while Cold FX itself boasts about being “proudly Canadian” and emphasizes its bootstraps-pulled roots in Edmonton, Alberta. No wonder the ginseng capsules are the best selling cold product in Canada.

Credit CBC’s Marketplace for revealing how this potent national symbol is actually quite a bit less potent than popularly believed. A recent episode investigates the shoddy science behind Cold FX — but in so doing incidentally reveals much about the relationship between hockey, national mythology, and the placebo effect.

The extent to which these elements are entangled becomes clear when Marketplace host Erica Johnson goes to a hockey arena and gives pop quizzes about Cold  FX to random hockey-watchers. She asks: Has Cold FX been clinically proven to reduce the duration of colds? The severity? The frequency? And is it most effective when taken at the first sign of a cold?

If you answered “yes” to any of those questions, you’re wrong. None of the statements are true, despite the fact that Cold FX’s labels suggest that they are. The study commissioned by Cold FX that is cited in support of these claims, however, showed no appreciable reduction in the severity or duration of cold and flu symptoms in subjects given the product. To boot, subjects were given daily doses, not at the onset of symptoms.

As for reducing the frequency of cold and flu outbreaks, as a University of Alberta scientist tells Marketplace, after having reviewed all studies investigating Cold FX, that the product taken daily (again, not at the onset of cold or flu symptoms) has been shown to prevent the average person from becoming sick once in seventeen cold and flu seasons. Alternatively put, of seventeen people taking the supplement daily, only one person would show a reduction (by one!) in the frequency of cold and flu outbreaks.

Remember that Cold FX is some $60 for a bottle of 150 — twice daily is nearly three hundred dollars a year. Whether this is worth avoiding only one cold in seventeen years is debatable. When hand washing and sanitization, which has been proven to be far more effective (see the up-to-40%-fewer colds reported here) at preventing the spread of the cold and flu, is free (or much cheaper, if you’re going for sanitization), however, the debate is likely not to be a very heated one.

Founded in Edmonton in 1992, Cold FX created an eponymous concoction of ginseng and took the unusual step of commissioning pharmacologically rigorous product testing in order to show the product’s effectiveness. Even though the results were, as mentioned above, mostly inconclusive, having pseudo-scientific backing formed the backbone of Cold FX’s mainstream legitimacy.

That said, a huge part of Cold FX’s current appeal isn’t scientific, but how it’s been successfully twinned to success in sport, and success as a patriotic endeavour. From claiming that “it’s reported that 75% of Canada’s Olympic athletes” use the product (reported by whom?), to its aggressive recruitment of Canadian Olympians as “athlete ambassadors”, Cold FX has strategically positioned itself as a product that permits athletes to succeed as synecdoches for Canadian physical hardiness (or imperviousness to colds/cold).

Endorsements, like that from football team Edmonton Eskimos, more conclusively link sport and a Canada as stereotypical great white north, whose inhabitants are fighting off not just colds but the cold.

Says one TD Forss, head athletic therapist for the Eskimos: “COLD-FX helps the team overcome the difficulties of travel and playing in colder climates. It also enables us to perform at our highest level late in the season, when typically athletes start to feel run down.”

Again, Cold FX allegedly enables Canadians to persevere in a climate that is fundamentally both inhospitable and hostile — enduring a Canadian winter, Cold FX’s marketing implies, is an feat akin to competing in the Olympics. (Just as inversely, success in the Olympics is demonstration of inherent Canadian superiority.) Therefore, enduring a Canadian winter without succumbing either to the cold or a cold requires Cold FX.

Like this, “cold” takes on wholly unscientific valance. Cold begets colds. And Cold FX intervenes when the “effects” of the cold set in.

It is this folk logic that informs not just the hapless hockey fans, who with both shocked and shocking consistency fail their arena-side pop quizzes, but pharmacists who should, by their professional standards, know better.

In the Marketplace episode, they are shown with their faces blotted out. “It works best if you take at the first sign of a cold,” says one pharmacist confidently, in a it-could-be-anywhere pharmacy. Those lines are repeated near-verbatim by a host of other pharmacists similarly lulled into critical stupour by the claims on Cold FX’s blue-and-pink packaging.

Arguably Cold FX’s most prominent “ambassador”, Don Cherry, the still-inexplicably-influential barking head hockey commentator, was first a paid supporter of the product, and then, following Cold FX ’s sale to the pharma giant Valeant, as an unpaid one. (He still takes four capsules a day, he boasts to Johnson.)

When Johnson offers that there is no scientific evidence for the effectiveness of Cold FX, Cherry demonstrates his enduring quotability in declaring: “I’m not interested in what scientists say. Science — so what.”

In a nutshell, this is the reason that Marketplace’s exposé will likely have no effect on Cold FX’s sales. We like to talk about science and proof and rationality, but in the end belief in hockey and maple leaves and the coldness of winter wins out. Cold FX, this “struggling true-blue Canadian company,” in Cherry’s words — producing a product in China, not Alberta — deserves our allegiance.

At least the placebo effect has been scientifically proven.

17 comments

Andrew Loewen on January 29, 2012 at 4:22 pm. #

Thanks for this. The Maple Leaf Echinacea revealed as a pricey scam.

Michael McDougall on January 30, 2012 at 11:33 am. #

My name is Michael McDougall, and as the Senior Manager of Media Relations for COLD-FX, I’d like to provide our perspective on this subject.

COLD-FX’s safety and efficacy are supported by more than 10 clinical trials, conducted at eight universities, and spanning 19 years of research. Published in nine peer-reviewed medical journals, including Pediatrics and The Canadian Medical Association Journal, these trials were conducted with approval from Health Canada and/or the FDA.

Four randomized, double-blind, placebo-controlled clinical trials — the gold standard of clinical evaluation — have evaluated COLD-FX for the prevention of acute upper respiratory tract infections. The results of these trials support COLD-FX’s safety and efficacy in helping reduce the frequency, severity and duration of cold and flu symptoms by boosting the immune system. It was the totality of this evidence that was evaluated by Health Canada in the licensing process, and which resulted in the granting of an NPN (product license for natural health products) to COLD-FX in 2007.

Following are the key results of these 4 clinical trials:

• 26% reduction in the average number of colds and flu
• 56% reduction in the number of recurrent colds and flu
• 31% reduction in the severity of symptoms
• 35% reduction in the duration of symptoms
• 89% reduction in relative risk of colds and flu among institutionalized seniors
• Shown to supplement the effectiveness of the flu shot

For more information, please visit http://cold-fx.ca/health_clinical.htm

Michael McDougall
Senior Manager, Media Relations
Afexa Life Sciences

Andrew Loewen on January 30, 2012 at 5:35 pm. #

Laugh out loud. Apparently Cold FX enterprises is feeling the heat of the simple dissemination of information. Well done, Jay.

Ken on December 18, 2012 at 6:42 am. #

You troll much? Big pharma got a handle on you? I have used this product and it is amazing and it is natural and NOT GMO. The science backs up the product. Get your head out of your ass.

Jay Smith on January 30, 2012 at 6:14 pm. #

Flattery that I am the subject of corporate attention aside, I *am* curious how Afexa responds to the criticisms offered in the Marketplace episodes that Cold FX does *not* affect the severity or duration of upper respiratory infections. Mr. McDougall’s response doesn’t address the criticism, either, that the product’s (meagre) effectiveness is a result of daily use, whereas the “provides immediate relief” label continues to be bandied about. In short, Mr. McDougall, thanks for the response but I’d love to hear how you respond more concretely to the issues here.

Lorelei Loveridge on January 31, 2012 at 6:13 am. #

I think this is a very important revelation and I, too, would like to read the studies. Wonder if these can be dredged up.

Jay Smith on January 31, 2012 at 2:56 pm. #

I’m banging my head to sneak into the medical databases, Lorelei. What I did find was this response http://sciencebasedpharmacy.wordpress.com/2009/02/27/cold-fx/ to the four trials that the Media Relations fellow there mentions. The four trials are in the same order of discussion as on the Cold FX page: http://coldfx.ca/health_clinical.htm. I might be able to get on the databases tonight (i.e. with password) for the dissenting studies.

Michael McDougall on January 31, 2012 at 7:47 am. #

Thanks very much, Ms. Smith, for the invitation to continue the conversation. I’ll do my best to answer all of your questions. If I do miss any, or my answers require further elaboration, I’m happy to continue this thread until all of the issues have been settled. We at Afexa stand behind COLD-FX; we’re disappointed by the conclusions that have been reached, and we’re eager to provide our perspective.

Regarding the “immediate relief” copy on the packaging, it was since these packages were designed that the Natural Health Products Directorate was created, and that we sought a Natural Product Number (NPN—the product license natural health products require in order to be sold in Canada). With the granting of our NPN and the indication that “COLD-FX helps reduce the frequency, severity and duration of cold and flu symptoms by boosting the immune system,” the company was required to change all of our packaging to reflect this more robust indication. We have taken too long to complete this process. Six of the eight formats of COLD-FX have already transitioned to the new packaging, and we have expedited the completion of the brand-wide process. The two outdated packages will have been replaced in our system by this March, with the new packages expected to hit store shelves shortly thereafter.

Regarding the clinical evidence, as I mentioned in my previous post, four double-blind, placebo-controlled clinical trials have been conducted on COLD-FX’s efficacy, and they conclude that COLD-FX provides:

• a 25% reduction in the average number of colds and flu (sorry—26% cited above was a typo)
• a 56% reduction in the number of recurrent colds and flu
• a 31% reduction in the severity of symptoms
• a 35% reduction in the duration of symptoms
• an 89% reduction in relative risk of colds and flu among institutionalized seniors
• additional benefit when taken in combination with a flu shot

Links to the publications’ abstracts can be found here:

• Canadian Medical Association Journal 2005 Oct 25; 173(9):1043-8 http://1.usa.gov/xlFHPu
• Journal of Alternative and Complementary Medicine 2006 Mar; 12(2):153:7 http://1.usa.gov/w4zZPf
• Journal of the American Geriatric Society 2004 Jan; 52(1):13-9 http://1.usa.gov/wtH9Xf
• Influenza Research and Treatment Vol. 2011 (2011), Art ID 759051http://bit.ly/yNP0US

The article contains a link to the company’s webpage summarizing these studies along with the results of the other published trials on the product. That page can also be found here http://cold-fx.ca/health_clinical.htm

The evidence establishing COLD-FX’s efficacy in reducing the frequency, severity, and duration of cold and flu symptoms by boosting the immune system is very strong, and has been reviewed by healthcare professionals, clinical researchers, and the Natural Health Products Directorate at Health Canada who, after thorough review, licensed COLD-FX with an NPN under this medical indication.

Again, I appreciate the invitation to participate in the conversation, and would be happy to provide further comment should anyone have any questions. Thanks very much.

Michael Jackson (from the grave) on February 3, 2012 at 2:34 am. #

word mr. smith.

taking a pill in edmonton’s, let’s say, below 30 degree temps & expecting to not get sick is bogus.

i get sick; when i eat shit, when i don’t sleep & when my feet get cold/soaked & i am chilled to the bone.

embarrassing i have to say this to the cold fx dude above but our surroundings have an impact on our bodies. no pill can control that.

he should go stand out in the rain for a week & keep poppin’ them pills like tic tacs. bet his ass gets a runny nose.

>implying his ass has a nose

Ken on December 18, 2012 at 6:49 am. #

I didn’t realize it rains in 30 below weather? LMAO Have you ever heard of science? I bet you eat realy good to a sickman? Science blows away your verbal stupidity.

Adam on February 28, 2012 at 10:53 am. #

And im 100% sure that the delay in the package change had nothing to do with the appeal of the old message as compared to the new one…. Anything to get your hands on peoples money right?

Michael McDougall on February 28, 2012 at 12:48 pm. #

Hi, Adam,

I appreciate your perspective on the issue, and can understand how you could arrive at that conclusion: we are focused on growing our business and we did take too long to complete the transition of our packaging. As it happens, though, we began the brand-wide transition of our packaging immediately upon receiving our NPN. We were eager to make the change, because we’re of the opinion that the new indication associated with our NPN, that “COLD-FX helps reduce the frequency, severity and duration of cold and flu symptoms by boosting the immune system,” is more robust and more compelling than the language we were using previously. At the same time, we wanted to maintain the familiarity of our packaging for our regular consumers, to simplify their purchase decision. That’s why we implemented the change incrementally across our many formats, rather than all at once.

While we have taken an unacceptable amount of time to finish this process, six of the eight formats of COLD-FX have already transitioned to the new packaging, and we have expedited the completion of the brand-wide process. The two outdated packages will have been replaced in our system by this March, and the new packages are expected to hit store shelves shortly thereafter.

If you have any questions about the product, our packaging, or the company, please be in touch either through this forum or using one of the contact methods listed here: http://cold-fx.ca/contact.htm

Thanks very much.

Ken on December 18, 2012 at 6:50 am. #

So what product do you endorse for the cold and flu season? Hmmmm

Drew on August 9, 2012 at 5:45 am. #

The cold-fx marketing machine is in full on damage control here.

Mr McDougall refers to the Natural Health Products Directorate as if that is some sort of check and balance. Here is what the Center for Science in the Public’s Interest has to say about them: http://www.cspinet.org/new/pdf/feature_herbal_roulette.pdf

Gordon Tippett on August 14, 2013 at 11:04 pm. #

Oh yes. I had a blood test done at the hospital during a medical checkup but I WAS NOT SICK and my immune system count was 45% above normal.

Jenx on September 16, 2013 at 5:41 am. #

Been taking cold fx extra strength morning and night since nov 2012. It’s sept 2013 and I haven’t had a cold yet. Normally I get one every 3 – 4 months. Had strep last summer and was really sick so wanted something to help me stop them before they start. Now I feel a bit of something coming on when my husband and kids have a cold then it just goes away. I believe cold fx works. Wasn’t a believer when I started taking it.

Jim on October 4, 2013 at 10:08 pm. #

If Cold-Fx works by boosting the immune system (a nebulous unproven statement), then won’t it harm people with auto-immune diseases? If you have arthritis, MS, etc. shouldn’t you avoid this stuff like the plague? Or does it just somehow magically boost only the part of the immune system that deals with cold viruses?