Walk into any chemist's shop
and you'll be bombarded by an array of pills
and potions in bright, shiny packages that claim to treat
almost every imaginable ailment,
from runny noses, to spots, from coughs to aching muscles.
But these remedies don't come cheap.
We now spend £2.5 billion a year
on a whole range of products - from painkillers to multivitamins,
indigestion remedies to cough syrups.
How much do we really know about what we're buying?
I'm on a mission to find out the truth about some of Britain's
top selling over-the-counter medicines.
We've got perfectly safe other remedies here,
without any risk of side effects.
I've never ever done this before ...
I'll be discovering what really happens when you take them.
It's Christmas in my tummy.
You don't often imagine or visualise what's
happening to medicines in your body.
Investigating the common complaints they're designed to treat.
How much snot are we making a day? Half a cup. Quite a large volume. Yeah, it's not pleasant.
And turning myself into a human guinea pig.
Argh...
C'mon, hurry up!
This leg now feels like it's on fire.
To uncover the surprising truth about which medicines really work...
This is the kind of stuff my mum always swore by as a kid.
..and which are just a waste of our hard-earned cash.
HE COUGHS
It's like tear gas.
Over-the-counter medicines have never been more accessible or
more convenient.
You can buy them everywhere from your corner shop to the supermarket
and you don't need a prescription.
But as a doctor, I want to find out
whether these common cures are all they're cracked up to be.
First, I'm looking at Britain's biggest-selling
over-the-counter remedy, oral painkillers.
Last year, we forked out over £350 million on these.
But how much do we really know about the pills we're popping?
There are loads of different kinds of painkiller,
many of which claim to be able to treat different
kinds of pain. Some of them treat period pains, others treat muscle aches, others treat headaches.
I'm a doctor, and I'm bamboozled -
is it really possible for a painkiller to target
a specific body part?
To understand how a painkiller works,
I'm tracking its journey from my mouth, to
the place in my body where it's absorbed, using this - a pill cam.
Any time I see one of these I'm more and more amazed.
It's got a camera at both ends, it's got batteries and lights.
It's essentially like having a miniature film crew,
but a hell of a lot easier to swallow.
The camera shows the incredible internal
journey from my mouth, down my oesophagus to my stomach.
So now we'll chase it with the pill.
'Within a few seconds, the pill has caught up with it.'
There we go.
You don't often visualise what's happening to medicines
once you put them in your body
but this is a great display
of the pill just sitting in the stomach.
But the pill's not working yet. This is just stage one
of its journey, where it gets crushed and mushed.
If I poke myself...
..you can really mash the tablet up further.
It looks like a little snow globe. It's Christmas in my tummy!
It might look pretty, but the painkiller won't actually
start working until it reaches the bloodstream.
So the journey from my mouth to my stomach was really quick,
just a few seconds.
But now the pill's being held there for a little while
and now small amounts of the liquid
with the pill dissolved in it are squirted into my small intestines
and that's where it's going to get absorbed in the bloodstream.
Once in your bloodstream, it flows all over your body.
You end up with as much drug in your big toe as you do in your head.
There is no way of sending
that drug to a particular bit of your body and yet
on the packets - these ones are for headaches,
these ones are for joint pain and these are for periods.
What's more, if you look closely at the packaging you'll notice something.
They all have an identical product licence number and this means
that these three very different packets
contain exactly the same ibuprofen pills,
with exactly the same ingredients.
And so it's not just the annoyance that you're being made to
buy three packets when one would do. There is a safety issue.
If you had your period at the same time as a sore knee
and then you got a headache, you might end up taking
the maximal dose of each one
and that would be three times what you're allowed.
Now, this isn't a case of the manufacturers being
untruthful, these pills will help any pain, but it is clever marketing
and a way to tempt you to buy each particular product.
Remember, always read the small print and that will tell you
what you can safely take, and when.
Oral painkillers aren't the only source of relief we Brits turn to.
Exercise is now one of the nation's most common past-times, so the
use of topical painkillers to treat muscle strain is on the rise too.
Last year, we rubbed £83 million worth onto our aching muscles.
I'm interested in two of the most popular types.
They don't contain any drugs like ibuprofen, instead they claim to
have a heating effect or a cooling effect which relieves muscle pain.
These treatments are obviously hot. They say heat all over them,
they're red and they've got flames in the fonts and on the packet.
These are obviously cold -
they say freeze and cold all over them
and this one has an icicle on it.
And yet the list of conditions that these products claim to treat
is identical - essentially aching muscles.
So how do we decide which to use - the hot ones or the cold ones?
I used to use heat, heat-based products like Deep Heat,
but more recently I've been told that cold is better
so I do use an ice pack every now and then.
Most of the time I use Deep Heat, or things like that,
or muscle rub, to take away pain or to ease it a little bit.
Generally I only have one at a time just so it's a little bit cheaper.
So at the minute I've got a hot cream.
What are you going to buy next time? A cold tube.
Yeah, I'll try the cold treatment next time.
I'm a trained doctor, and even I'm confused about which one to buy.
So to help me decide, I'm going
to do a pretty extreme experiment to find out just how heat
and cold affect the human body after exercise.
I've come to Beat The Bog, a gruelling five-mile obstacle
race over sodden Kentish farmland.
400 runners here are going to be wading, climbing and running
through a muddy hell and I'll be joining them to get some answers.
Only one thing is for certain,
that my muscles are going to be aching.
I'm interested in a very particular sort of muscle pain called
delayed onset muscle soreness, or DOMS for short.
That's the pain deep in your muscles that often gets
worse in the days after exercise.
And what I want to know is, can hot or cold treatments help reduce it?
So, I've recruited some runners to take part in our test
and split them into three teams.
Thank you for taking part.
At the end of the race we're going to do three different treatments.
We've got a nice hot bath for 15 minutes, a really cold bath
for 15 minutes, and no treatment at all as a control group.
'The theory is that by changing the temperature of our deep muscles
'shortly after exercise, we can reduce some of the pain we feel.
'And there are two schools of thought
'on which treatment works best.'
I'm going to relieve the suspense. The hot team is going to get red.
And that is you guys.
Yes! Hooray!
'You could jump into a nice warm tub to heat them up
'or plunge into an ice bath, like Andy Murray, to cool them down.'
I'll put the cold team out of their misery and it's you
guys. Cos this is what the top performers do now!
How long are we going to be in the tubs for?
I'm afraid to say you're going to be in the water for 15 minutes.
Ouch!
'We've chosen 15 minutes because that should be long enough to
'change the temperature of your muscles
'by up to a degree or two.'
You guys can chill out,
put your feet up, you just can't get in either of the tubs.
'But first, five miles of hell on earth.'
Three...two...one!
KLAXON BLARES
This course is going to push the runners to the absolute limit
and exercise those muscles they didn't even know they had.
I'm going catch up with them in just a couple of places.
I think that counts as my ice bath.
'Eurgh, the things I do for science!
'And just when I thought it couldn't get any worse...
'..electric shock therapy.'
Aargh!
C'mon, hurry up.
Now there's a sight for sore eyes - the finish line.
I'm pleased that's over.
I'm tired, I'm aching, I was even stung by a nettle -
but tomorrow morning is when the real agony begins.
And that's what I want to find out now.
Are hot or cold treatments going to help prevent that?
So it's a frosty 15 minutes in a freezing ice bath for those
that drew the short straw.
The first bit is going to be the worst
but once you're in it will be lovely!
You want to sit down so your thighs are in.
Oh, my word! Oh!
LAUGHTER AND SHRIEKING
I'm all right now, I've settled.
Yeah, it's lovely once you're in, isn't it?
You do actually start feeling all right.
Are you getting in?
Er, I've got a verruca, so I can't!
'For the lucky few, it's a 15-minute soak in warm water.'
Would you guys rather be in the cold tub? No! No!
'And how are the control group doing?'
It's not proving too difficult for you guys! No!
We think we're coping quite well, actually. Quite relaxing.
'We'll be monitoring the runners over the next three days to discover
'whether heating or cooling their muscles works
'better at reducing their long-term pain.'
So I think our results are going to be really interesting
but will they help me make a decision about which
over-the-counter treatments I should get - hot or cold?
'I'll be finding out later, when muggins here puts them to the test.'
This leg now feels like it is on fire.
That's a lot of hot cream.
Muscle pain is one thing, but I suspect us Brits
are far more likely to overindulge in food
than we are in exercise, so indigestion is now a common problem.
40% of adults in the UK suffer with indigestion
and last year we spent £120 million trying to treat it.
Indigestion to me feels like burning, bloating,
kind of don't feel well at all.
What do you think causes indigestion?
It can be a number of things, eating too fast, or eating the wrong things.
What are your symptoms?
A kind of tightness, not in the stomach, in the chest area.
So what is indigestion?
Your stomach is a muscular bag that prepares your food for digestion.
It sits about here and importantly it should be full of acid.
But this acid is incredibly strong.
While your stomach can deal with it,
other parts of your body can't, and indigestion occurs when this acid
escapes from your stomach to somewhere it isn't supposed to be.
That is the delicate lining of your food pipe or oesophagus,
and it starts to inflame it and make it very painful.
To help combat the pain we're stocking up our medicine cabinets
with a whole range of pricey remedies.
But if we knew which types of food caused indigestion
we could avoid swallowing that cost.
I really love food, in fact I'm a total glutton, and I'm
certainly no stranger to that awful feeling of lying in bed with
indigestion pain, bitterly regretting an evening of over indulgence.
Luckily, indigestion can be quite a fun thing to study
and with that in mind, I've invited four guests over for dinner to see
what they know about indigestion and how to treat it.
DOORBELL RINGS
Hello, hello. Hello. Hi. Come on in.
Thank you.
'I want to know
'if my diners can identify which foods are the most likely to
'cause indigestion by asking them to score each course out of ten.'
Do any of you suffer from indigestion?
No, I have a steel stomach. I can eat anything. I actually do.
Do you? Yes, yes, I do.
'For starters, a tomato and basil salad
'drizzled with balsamic vinegar.'
Dinner is served.
All right, I've got to keep cooking. See you in a second.
What do you reckon, guys? It's beautiful.
I think it's slightly acidic,
so it could lead to indigestion.
The vinegar is obviously very sharp but mixed with the tomato,
that's very acidic - two acidic things together.
I give the starter a six because the vinegar is
quite acidic and maybe the tomatoes will give us a bit of heartburn.
I'm a massive fan of really spicy food.
And that is making my eyes water!
'Next up, the main - a spicy chicken jalfrezi.'
That's for anyone who wants a bit of extra spice.
Ooh. Oh, this looks nice. Thank you.
I'm going to give the score for the main course an eight
as I believe it'll give a lot of
people indigestion.
This to me isn't as acidic or is going to give indigestion as bad as tomatoes.
Are you serious?
Yeah, seriously.
'Finally, dessert - apple crumble served with vanilla ice cream.'
I think of all the meals we've had this is the most neutral.
I'm going to give apple crumble and vanilla ice cream a zero,
because there is zero chance it'll give me acid indigestion.
Cheers. Cheers! Cheers!
Time to tally up the scores.
David - you reckoned the starter had the greatest capacity to cause
indigestion. In fact, the acid in your stomach
is many, many tens of times more powerful
than the acid in the vinegar and the tomato,
so the tomato juice should dilute the stomach acid.
You all, actually, on average, rated the main course as
the thing most likely to cause indigestion.
All it does is it attaches to your pain nerves
and sends a message to your brain that's the same as if your mouth
was on fire and in fact spiciness shouldn't have any effect on it whatsoever.
You all rated the pudding as the dish least likely to cause
indigestion. In fact, the thing that is most likely to give people
acid indigestion is very high calorie, fatty foods and
the spice content is pretty much irrelevant and the acidity content is reasonably irrelevant as well.
The reason high calorie foods packed with fat and sugar cause indigestion
is because they stimulate your stomach to produce more acid.
This applies to alcohol too, so it's best to avoid this
if you do suffer.
Now we know what causes indigestion,
let's find out how effective the over-the-counter medicines are.
First, the chalk-based antacid tablets which claim to treat
mild indigestion.
David, do you ever take these kind of large chalky pills?
I do. And you do get relief from them. I do, yes.
So pills like this, the chalky ones,
are the quickest to work of all the over-the-counter medicines because
they immediately neutralise the acids, they start working instantly.
They're very safe, they're very bland,
they contain substances a lot like chalk.
Chalk-based antacids work by helping to reduce
high levels of acidity in your stomach.
But what really hurts is acid reflux.
This is what the remedies called alginates claim to treat,
so, next, I want to see how they work.
I have made a kind of model stomach here.
This is a conical flask,
representing the anatomy and contents of your stomach
and it's full of hydrochloric acid
which is the acid that's in your stomach.
This is about same amount of alginate
that a lot of people use to
treat heartburn or acid reflux.
And I'm going to pour it into the stomach.
'Alginates work by forming a protective
'barrier between the acid in your stomach and the oesophagus,
'so that the acid can't reflux back up.'
OK, so I think our fake stomach and alginate mix is ready.
I'll be honest, I've never, ever done this before.
So you can see how it should work.
The alginates have blocked the opening
from the stomach to the oesophagus and they should form...
this is the raft the packs all talk about.
So we should be able to turn this upside down.
And...not have anything leak.
What do you think, shall we give it a go?
See if it'll go completely upside down.
That's pretty good, isn't it?
I mean, even if you shake it, OK,
you wouldn't want to stand on your head,
but that raft is working very effectively
to stop the acid going from the stomach up into the oesophagus.
So the two most popular types of indigestion remedies do
alleviate the symptoms.
But if you find yourself reaching for them often, you should
see your GP as it could be a sign of an underlying health problem.
I've set up a fairly extreme demonstration
to look at the effects of heat and ice on the deep muscles.
I want to find out which works best to relieve the pain
we feel after we exercise.
At the end of a punishing five-mile obstacle
course, I plunged one team into icy water, one had a nice warm bath,
and the other control group just put their feet up.
A sports physiologist has been running the numbers for me.
It's been a couple of weeks since the race.
I felt dreadful for days afterwards,
deep pain in my muscles.
That seems to be what we've seen in the results we got.
You can see everyone felt bad
after the race, as you'd expect.
Right.
But differences emerged once the teams got in to the water.
Then we see this quite dramatic reduction in pain with the hot
and cold treatment groups compared
to the guys who were lounging around on the grass.
That's because they're having this sensation of hot or cold water,
and it's acting as a distraction.
If you bite your tongue then stamp on your foot, you forget
about the fact you've bitten your tongue. Completely.
Then the pain goes back up at 24 hours,
and the groups are pretty similar there.
Not until 72 hours, so three days later,
that you see that very big difference
between the guys who lounged on the grass
and the guys who had the treatment.
The cold and hot seem to have both worked here. How have they worked?
Cold water immersion actually reduces inflammation.
It can actually reduce the pain.
So less blood flow goes to the muscles and therefore you don't
get that inflammatory response that is so painful?
Yeah. The opposite happens with the hot trial, in that it's increasing
blood flow to the muscle, allowing by-products that cause
the pain to be taken away from the muscle and be expired or excreted.
It's almost as if the blood's rinsing or flushing the muscle.
Essentially, yeah.
'What's most surprising to me is that there's barely
'any difference in effectiveness between hot and cold water.'
The evidence suggests that cold water may be slightly better
but we're talking about an improvement in recovery
of maybe 1%, 2%, 3%.
For Andy Murray or Mo Farah or someone that needs to train really
hard and recover really quickly that does make a big difference.
That's what we're talking about in elite sport.
But for the average person,
it doesn't really make much of a difference.
This is great news for me, I was never going to start having ice baths.
But knowing that a long soak in water of any temperature
will reduce my pain, that's fabulous.
So, I've discovered that both hot and cold baths can reduce
long-term pain by changing the temperature of our deep muscles.
And, they can also help in the short term by distracting us.
Next, I want to look at the topical painkillers,
especially the ones that talk about heating or cooling to relieve pain.
How exactly do they work?
I'm going to smell great for the rest of the day!
'First, the cold cream.'
So it immediately is feeling cold.
Why is that? These cooling creams have things like alcohol in them.
As it evaporates, it will be cooling the skin.
'My skin feels cold but I won't know if it's changing the temperature
'of my muscles without sticking a thermometer deep into my leg.'
The temperature is 32.5 degrees inside your muscle there.
That's a normal resting muscle temperature.
So that temperature is about the same as you would expect
if I hadn't put any cream on? Yes.
Shall we try the hot cream?
This I used to use when I was playing sport at school.
That's a lot of hot cream!
But we're going to get a proper result with this!
Yeah, you'll get a result!
Now it feels, as the cream is warming up, I'm starting to feel...
You should start to feel a burning sensation.
Yeah, this leg now, it feels like it's on fire.
'The question is - is it heating my muscle?'
32.4, 32.5. So it's exactly the same temperature as the other leg.
I would swear this leg was on fire, the other leg was freezing cold.
And it would be very persuasive, I think, if you put the creams on,
you would feel like they were deeply affecting your muscles.
Interestingly, they produce this effect without changing
the temperature in the muscles.
Even though it isn't obviously having any deep effect,
the power of the distraction is very real,
so, as a short-term solution,
I think these things are quite effective.
Really what we're just seeing is a distraction,
it's making you feel like it's hot or cold
but it's not actually physically changing the temperature
like it would if we were in a hot or cold bath.
I can't help noticing, though,
that some of these products use words like "deep" and "penetrating".
Now, I know they aren't changing the temperature of my muscles,
so what do the manufacturers mean by those words?
Well, they say that all the claims on their packaging are approved
by the Medicines and Healthcare Products Regulatory Agency.
None of the gels claim to heat or cool the muscles,
but they are a convenient way to manage pain at any time.
The makers of Deep Freeze say the word "deep" is used
because "the gel provides relief from pain in the deeper tissues".
The truth is, if you want reduced pain in the days after exercise,
a bath, either hot or cold, will be much more effective,
it'll be free, and you won't smell like a chemist shop.
Next - a medicine market that we spend over £100 million a year on.
One in five of us will pick up a cough this winter,
so it's no surprise that over-the-counter cough remedies
are big business.
Personally, I've always been pretty sceptical about over-the-counter cough medicines
because to me they don't seem to address the reason we're coughing, the virus.
But, if you think about it, if they did stop us coughing
we'd spread less virus around and we'd all get them less often.
And that can only be a good thing.
So what I want to know is what's in them and do they actually work?
I'm meeting a cough expert to find out.
So what's going on here? I thought we were going to study cough.
Well, Chris, I've got some ingredients here
which we're going to make you cough with.
Cough's about an irritation in your throat and what we're
going use is some chilli and vodka to irritate your throat.
At the back of our throats we all have cough receptors that
react to things like cold viruses and irritants -
they're what trigger the cough reflex.
In order to demonstrate this, Alyn's devised a coughing cocktail
made with vodka and chilli.
So take it off and just take a deep breath over the mixture.
HE COUGHS
It's like tear gas!
It's...
So, what is going on there? Why does that make me cough?
So the hot stuff in the chilli, the capsicum, is going in
and irritating the receptors on the end of the nerves
and that gives you that horrible tickle that you've experienced
and makes you cough.
The theory behind over-the-counter cough syrups is that
they coat the back of the throat, topping the irritant.
But would a home-made syrup work just as well at suppressing a cough?
I'm going to make some here and we can test it. Go ahead.
I'm just putting some hot water in there so we can dissolve our honey.
'I'm using honey and lemon to make a strong tasting, gloopy syrup,
'similar to over-the counter ones.'
This is the kind of stuff my mum always swore by as a kid.
I really enjoyed it but since going to medical school,
I've been quite scornful of this kind of home remedy.
'The syrup's ready, now I just need the cough.'
This is basically a pepper spray right into my lungs.
Chilli pepper. Right!
BUZZING
HE COUGHS
It's like inhaling a curry.
OK, so now we want to try the syrup.
I'm never going to hear the end of this at home, if this works!
OK. OK, so we'll do it again. Say when. Now.
BUZZING
That is remarkable. It's a bloody miracle!
But it's still all going into my lungs. Yeah.
Gosh, Mum, I'm really sorry!
That's absolutely fantastic. I'm really amazed.
The interesting thing is it's kind of the arrogance of doctors, that
we almost don't want to say honey and lemon is very effective.
We don't have a scientific, or very good scientific explanation for this.
We don't know about this very complicated area of the body.
All right, well, I'm persuaded.
What about the over-the-counter preps?
Right, well, let's have a look at those.
'Many cough medicines use this principle of syrupy sweetness
'to relieve cough.
'But is it worth buying cough syrups with extra drugs in them
'which might help with other symptoms?'
We've got three things here which have some of the most common
ingredients in cough medicines.
We have the same sort of liquid. It's syrupy and has
strong flavours in it.
So it has that benefit which we've just demonstrated.
But in addition, some of them have drugs in.
What's the drug in this?
That's got guaifenesin in.
Yeah, I've heard of this. OK.
And it's supposed to be an expectorant,
but it in fact - I can't find any really good evidence that it
works by producing more mucus at all.
What's this one?
That's, the drug is called dextromethorphan,
and that's perhaps the commonest drug that is around.
There is a limited amount of evidence that it has a small
additional effect. What about the white powder?
That's a drug called pseudoephedrine, which does dry
out secretions, so I would only use that if I had a runny nose as well.
There's no evidence that that particularly diminishes cough?
No, absolutely no evidence on cough for that one.
And very little for guaifenesin, but the best evidence,
and that's not all that brilliant, is for dextromethorphan.
So it's not just that the evidence these are any better
than honey and lemon is quite limited, they're also drugs.
Whenever I take pseudoephedrine, I feel anxious,
I get a racing heart, guaifenesin makes
people feel nauseated.
We've got perfectly safe other remedies here which we've
just demonstrated in you
and they are effective and very cheap
and without any risk of side effects.
I guess the thing I really want to know is what do you do?
I make my own cough linctus, a little bit of honey,
bit of boiling water, squeeze of lemon.
It's not an evidence-based, randomised trial
but it's dirt cheap and it works in my house.
In my view, the evidence seems pretty limited that over-the-counter
medicines are any better than a home-made honey and lemon syrup.
And, because it's not medicated, you can drink as many cups as you like.
Now, the medicated syrups do work in the same way
but you can only take them a few times a day
and some people will report these side effects.
Now, we've heard what our cough expert said - he agreed -
but for me the final arbiter in discussions like this is
often the NHS website
and, sure enough, they say the evidence for medicated
cough syrups is limited and they recommend
a honey and lemon drink just like my mum.
And after all that, what did the manufacturers say in their defence?
Well, all cough medicines and the claims made about them,
are approved by the MHRA.
And the risks and side effects are clearly
explained on the patient leaflet inside.
A cough is one thing, but when you've got a full-blown cold or even
flu you can end up with a whole range of different symptoms.
And last year, we spent £347 million trying to beat them.
Increasingly, we reach for the convenience of all-in-one remedies
that treat more than one symptom,
but are we in danger of over-medicating?
To understand more about the symptoms we suffer
and how best to treat them, I've come to Flu Camp.
I'm standing in a high security medical research facility
and at the moment it's in environmental quarantine lockdown.
And that's because the patients in these rooms
are suffering from a highly contagious virus.
But it's not a virus they just caught in the outside world,
it was given to them by the doctors that work here.
We have volunteers who come in, we infect them with virus,
so we know exact point at which they've been infected
and then we monitor them.
This state-of-the-art research facility
was set up to develop cold and flu treatments.
Volunteers are safely infected with common cold and flu viruses
and remain in isolation for up to two-and-a-half weeks
so their every symptom can be recorded.
Starting to get symptoms, sore throat, sneezing,
something's definitely starting to happen.
How are you feeling?
The last two days have been the worst.
Bunged up, sore throat, achy.
If I was trying to do a full day's work
you'd notice the symptoms even more.
I'm definitely ill,
I've got a stuffy nose, one blocked nostril, one runny nostril.
We each get given tissues.
He have to be very meticulous about our mucous collection.
How much snot are we making per day? If we're really snotty.
We can produce over 50g, so half a cup, basically.
Quite a large volume. Yeah, it's not pleasant.
But not everyone suffers in the same way.
How are you feeling?
Feeling fine. Yeah, absolutely great at the moment. Really?
That's not what I was expecting.
It's not what I was expecting.
I haven't got any symptoms at the moment.
No sore throat, no blocked nose. I feel great, to be honest.
'So how come this guy's feeling fine?'
From an individual to an individual basis there is definite variability.
To just give you an example.
If you take the swine flu pandemic from 2009/10, 60-70% of people
would have had very mild symptoms,
they probably put down to a cold,
and then, of course, there was the group where people did die.
I mean, that's amazing.
We can have one virus and between different patients,
some people die
and some people may never even have had symptoms that they noticed
enough to remember. Yes, absolutely.
So if none of us have all-in-one symptoms, how can
we have an all-in-one medicine?
I'm meeting a pharmacist to help me answer that question.
We've got all these different varieties.
Cold and flu max, night and day, powders, capsules, liquids.
What are the ingredients in those products?
The ingredients in these products tend to boil down to three
different medicines. Paracetamol for pain or fever,
ibuprofen, which does a similar thing, and a decongestant.
Different people have different experiences of being ill.
If you're not congested, there's no reason to take something with a decongestant in.
Essentially, you'll get the benefits only if you've got the symptoms.
Otherwise you're just exposing yourself to unnecessary side effects.
If we are going to treat symptoms, we should think about those first
and then think about what drug or medicine
we use to treat the symptom.
I don't know about you, but when I get a cold often it's the headache
that really affects me.
Paracetamol works for me, so that's what I tend to use.
Won't be same for everyone.
It may be convenient to grab an all-in-one remedy.
But, unless you're suffering with all of the symptoms, you might be
better off buying those that target specific symptoms to avoid
taking medicine you don't really need.
And, if you're in any doubt about what to take,
speak to your pharmacist - they might be able to help.
Now, many people think they can avoid all these nasty colds and
viruses by stocking up on products they hope will keep them healthy.
Last year, we paid out £352 million
on vitamin pills and supplements, and it's a growing market.
Although we often buy them in the chemists,
these are foods, not medicines, and are regulated by UK food laws.
I take vitamin C and multivitamins every day.
I think I just take them because I don't think I eat enough fruit and veg
and I feel they're going to give me what I need.
I had cupboards full of vitamins, pots of them.
So I binned all of them and now take one multivitamin.
Hoping it addresses the lot.
One in three people in Britain take vitamin supplements.
That's tens of millions of people popping pills every day
in the hope of improving their health.
But are they doing any real good or can we get everything
we need from the food that we eat?
I've come to meet what I think is a fairly typical British family,
to take a close look at their diet.
Is there anything more fun than rummaging through other people's fridges?!
Potatoes, carrots, coconut water, lovely fresh turkey breasts.
There's loads of goodness in there, but then
we get to the top of the fridge, and it all falls to pieces!
Two packs of chocolate-covered carbohydrate.
Well, it's got the green banner. So that's OK! So it's good.
Like most families, the Jais eat fairly healthily
most of the time, but they still like their treats.
Monday to Thursday,
it's real food. We don't worry about fat contents
and stuff like that, we just eat food.
You mean rather than eating processed stuff.
Rather than eating processed stuff and junk and stuff.
And then on Fridays, they have, like, take out.
Oh, really? Yeah.
'Is this diet giving them all the vitamins they need?
'I've asked the Jais to keep a food diary over the following week
'and I'll be back later to find out.'
We want to get a really accurate look,
so we need you to be completely honest. OK.
Alongside vitamins, one of the biggest sellers
on the market are fish oil supplements that contain omega-3.
And perhaps that's not surprising, because, as a nation,
we just don't eat enough oily fish.
In fact, less than a third of us
eat the recommended one portion a week.
There's loads of stuff in oily fish that's good for you.
And one of the main things is a type of fat called an omega-3 oil
and the interesting thing about omega-3 oils is you can't
make them, you have to eat them,
and they're vital for every cell in your body.
And it's been shown that when you eat them in the form of oily fish
it can help prevent everything from dementia to heart disease.
Do we know which fish will give us the richest source of omega-3?
Fish here! Get your omega-3s for heart and brain!
I've come to ask the people of Norwich.
Salmon has the most. OK, fresh salmon.
Well, the tuna. You think the fresh tuna? Yeah, I do.
Probably them fish fingers, they probably put loads of it in!
To get as many omega-3s as you would have in a piece of salmon,
you'd need to eat 50 fish fingers.
That's all right - good sandwich, that would be!
I think it goes fish fingers, cod, tuna, salmon.
What about tinned tuna and salmon? Tinned salmon's got more
and tinned tuna not so much.
You're exactly right! Salmon has the most, along with the tuna,
and tinned salmon is almost as good as fresh salmon.
Tinned tuna doesn't have much in it.
Cod has some. So for each portion of salmon that you ate,
you'd need to eat five or six portions of cod.
Wow!
So, if eating oily fish is so good for you it would seem obvious
that taking a fish oil supplement would also be good for you.
Well, at the moment, the best evidence shows that
the strongest benefit is from eating the fish itself -
the fish contains a lot more than just the oil.
While fish oil supplements may provide
a benefit for some people,
they can be harmful in others, like pregnant women.
So it's best to check the detailed information on the NHS website
before you take them.
'For the past week, the Jai family have been keeping food diaries
'to see if they're getting all the vitamins they need from their diet.'
How did you find the week with the food diaries?
Concentrates the brain, having to fill out a food diary.
In my mind, I think I eat fantastically,
but when it's on paper in black and white it says a different story.
'I've brought along a vitamin expert to analyse the results.'
So, first of all, Sue, how did the Jai family do, compared to a typical British family?
Fairly well.
I looked at how the two children
compared with children in the UK, other children,
and you with women and men.
And, really, you weren't far different, which is good news.
That's comforting. Yeah.
Let's start with you, Delaney.
Selenium and iodine, that's all really that Delaney's missing.
Selenium's a thing a lot of people are worried about being a bit deficient in.
How do we make sure that we're not deficient in it?
It's found in quite a number of foods,
but the easiest way is to have to odd Brazil nut.
So selenium not too difficult to deal with.
How do people make sure they're getting enough iodine?
I guess the easiest way is to use iodised salt.
You can buy that in supermarkets.
'Brother Dan could do with a bit more calcium.'
Do you know any foods that calcium's in?
Cheese. Cheese is really good.
Milk, yoghurt, cheese, as you said.
So dairy products are a good source, so that's fairly easy.
Mum and Dad, you guys have a bit more yellow.
Terry's a little bit low on iron.
The iron is a problem, actually, because you need iron.
If you had more green veg you would get some iron there.
Right.
Some meat would be helpful. Couple of times a week.
Because if you don't have enough iron you'll end up with iron
deficiency anaemia, so that'll make you feel tired.
Ron, how did you think you were doing?
I thought I was doing well, but obviously the numbers say different.
'Dad Ron isn't eating enough fruit and veg.'
You were getting barely over one portion a day on average.
I was having a little bit of coleslaw
and tomato on the side, but obviously I wasn't having enough.
Would the addition of more fruit and veg, meat, fish, a bit of dairy,
would that sort out the problem? And some nuts. Nuts, pulses.
So what we think of as a "good" diet.
So, should the Jais be paying for costly vitamin supplements
if they can get everything they need by eating a balanced diet?
The Jai family are fairly typical, they're not
getting their five a day and their diets are deficient in a few vitamins
and a few minerals, so it would seem like a really obvious
solution for them to buy an over-the-counter multivitamin supplement.
In fact, the majority of large, independent studies
have shown that for healthy adults, there is
no clear benefit in taking a multivitamin
and, in some cases, they may even be harmful.
There's no question that vitamin supplementation is useful
in certain conditions and age groups, but for most of us
the best bet is to eat a healthy and varied diet.
As a doctor, I thought I knew most things
about over-the-counter medicines.
But I've already turned up some real surprises.
We lead such busy lives, it seems it's often more convenient
to pop a pill rather than rustle up a home remedy or eat our five a day.
But with a bit more time and thought, there's no doubt
we could save ourselves some money and improve our health.
Finally, I want to take a look at two different skin conditions
and the remedies we use to treat them.
Last year, us Brits spent over £80 million
treating fungal infections like athlete's foot.
This itchy, irritating skin disease
affects up to 25% of the population,
but how can we avoid footing the cost?
First we need to understand how infection occurs.
So I've come to meet Haringey women's football team.
This is a great honour coming in the girls' changing room.
Has anyone had athlete's foot?
I know I have. When I dried my feet, they were quite sore
between my toes, and that's when I knew I had athlete's foot.
What's your foot routine like in the changing room?
I get changed, I always change my socks.
I put talcum powder on my toes,
just cos my feet are quite sweaty.
I admit that one!
Karla, are you known in the team as "Sweaty Foot Karla?"
No! But I might be!
Everyone has bacteria and fungi living on their skin,
but when they multiply, problems can start.
Fungi thrive in warm, dark, humid environments
like sweaty trainers,
showers and communal changing areas just like this.
So are Carla and the rest of the team
infected with athlete's foot now?
I've brought along a little camera so we can have a closer look.
I'm looking for flaky, dry skin, and an itchy red rash
that develops in the spaces between the toes.
Dry, no cracks.
High five, exactly.
While Karla... Sweaty Foot Karla!
The front of your foot is almost in the perfect shape
of an expensive stiletto.
Now you're offering!
I must say, your feet do not feel sweaty.
The ladies' feet look fine, but that's with the naked eye.
Who's got ticklish feet?
Karen.
So I'm taking some swabs to the lab to be tested and I'll be back later
with some surprising results.
This is just about the worst plate we got off anyone's foot.
Do you want to hear whose foot it was?
Another skin condition that causes distress to many is acne.
As many as 80% of 11 to 30-year-olds suffer from it,
and last year, we spent £70 million on treating it.
Like almost everyone, I had spots as a teenager,
and for about five years I spent vast quantities of my parents' money
on over-the-counter spot treatments.
Between me and my two brothers, the whole bathroom was full
of different ointments, treatments, lotions and potions.
But did these things do any good
or have I spent my parents' whole retirement fund for nothing?
It's important to know more about what causes acne
so I'm meeting up with a dermatologist.
Dev, I'm a bit confused about acne, it's not really my area.
I know it's to do with hormones.
There's inflammation, bacteria involved,
some people say diet. What's going on, why do we get it?
These are common questions
and I think the best way to answer these would be to look at how
normal skin functions, and then we can tease out how acne develops.
So we've got three different stages of acne here
with our lovely volunteers.
Melanie, do you want to step up
and we'll have a look at your skin to kick off with.
So Melanie's got almost flawless skin.
Is there any bit of it that you notice or that bothers you.
I get quite a lot of blocked pores around my nose area.
That's where I get most problems, I think.
We've got a special derm cam
which is going to magnify the skin ten times.
Let's have a look with the cam.
I must say, they do look very dramatic.
This is common. Blackheads are simply the openings of pores,
which are grease glands in the skin,
so this is the hair coming up,
and attached to the hair is a grease gland,
and this is producing grease, or sebum,
and it travels up through this channel
and comes onto the skin,
and this is normal flow of grease on to the skin.
We need that because skin needs needs to remain supple
and well moisturised. OK.
So, Melanie's skin is quite normal.
Next up is Sam.
So Sam's got slightly more noticeable acne.
You've got very much the same kind of spottiness
I had when I was a teenager for five or six years.
I'm just going to have a look on your cheek.
So there's redness.
What's going on there?
As acne develops, you produce more and more grease,
and that's been forced out.
Also, this top layer of the skin
becomes abnormal and doesn't allow the grease out
as well as you'd hope, so now you've got a blockage,
and this just seals up like this.
Does cleaning affect this? Is Sam not cleaning enough?
Bacteria are already here.
It's coming from within, rather than from the surface.
If you overwash, you may dry out the skin more,
and that stimulates the grease glands to produce more grease,
so you might actually not be doing yourself any favours.
I think the advice should be twice daily washing with soap and water
and that's all you need to be doing.
The main cause of acne is hormonal changes
which is why it's most prevalent in teenagers like Sam,
but for our next sufferer, Julie, it's persisted into adulthood.
Julie, you've had acne for ten years,
you even keep a blog about it.
Can we have a look at your skin with the derm scope? Sure.
There aren't many blackheads,
not many kind of active spots,
but there is this pocking and scarring.
What have you done to the spots over the years? Did you squeeze?
Yes. Like most teenagers, when you see a white head,
your immediate reaction is that the spot's ready
and you want to squeeze it,
and that's what I've known to leave the scarring on my face.
Dev, is this true that the squeezing leads to the scarring?
The minute you apply pressure down here to squeeze that,
this may happen in the skin.
It forms a column, and as a scar forms, it contracts,
and leads to this indentation of the skin,
so we must try and stop this from happening
by adequate treatment early on.
So seeking early treatment for acne is clearly vital.
But do the dozens of products being sold over the counter
actually do any good?
Some are just simply soaps, which just cleans the skin,
and some have active ingredients.
The two best ingredients that have evidence for treating mild acne
are benzoyl peroxide and also salicylic acid,
which gently exfoliates the top layer of the skin
and has the effect of opening up the pores to allow the grease to flow.
But if you're using these for many months
and you're seeing no improvement, then really you should have
prescribed medication by your GP
to try and reduce the chance of you having scarring.
So the over-the-counter remedies can help
but you need to be patient,
as many take as long as six weeks to start working.
If symptoms persist or are particularly severe,
the best advice is to see your GP.
Now, back to the irritating issue of athlete's foot.
Treatments for this and other fungal infections
are a multimillion pound business.
So are there other ways to avoid paying out
for costly over-the-counter remedies?
It's been two weeks since I met Haringey women's football team
and searched their feet for signs of athlete's foot.
They all looked fine, but to be sure, I took some swabs
and sent them to be cultured in a lab.
Now I'm back with some pretty terrifying results.
So, guys, we've got your results,
and we've brought Marc,
who has the lucky job of analysing your foot fungus.
So shall we start by looking... There's quite a variety of results.
We're going to project them on the wall.
Eugh! That's disgusting.
Is this perhaps slightly more disgusting than you were expecting?
Yeah. Not great.
This is like the whole mushroom farm!
This is just about the worst plate we got off anyone's foot.
So whose foot do you think this is?
I'm not going to do it!
The only thing we can say is this is not Sweaty Karla's foot.
But this wasn't the only slide showing signs of athlete's foot.
This is a better selection of what we saw
and it's very interesting to see
that in fact 75% of the plates we took, you all had dermatophytes,
which is the main cause of athlete's foot.
The astonishing fact is that these slides represent all of us.
Everyone carries these bugs
and when they get out of control, this is what it can lead to.
This is actually a particularly savage example
of athlete's foot.
So how can we stop the fungi from multiplying
and turning into full-blown athlete's foot?
Because these bugs are everywhere, you can't really avoid getting them.
You can boil your shoes and sterilise your socks
but you'll quickly pick them up again.
It's about making your feet bad homes for the fungi.
The best thing is really good hygiene.
Clean between your toes, make sure it's dry,
give your feet enough time to get the air through.
They won't grow in that environment.
Prevention is always better than cure,
but if you do get athlete's foot,
do the over-the-counter remedies work?
This is your standard over-the-counter medicine,
and what we did here was we grew dermatophytes on a plate
with their food source.
This is where we put the formulation
and it's killed it completely, so they're very effective.
They get into the fungal cell wall and basically explode the organism,
so it has gone.
They will work as long as you use them correctly.
No matter how obsessive you are, you cannot avoid these fungi.
They're on the changing room floor, they're in your shoes
and they're on the pitch, but what you can avoid
is spending loads of money on anti-fungal over-the-counter medication.
By practising good foot hygiene, you deprive the fungi of food
and water, and you make your feet an inhospitable place
for fungi to survive.
I've reached the end of a fascinating journey to uncover
the truth about the everyday remedies
we have in our medicine cabinets.
I started out a bit professionally sceptical,
but when I reflect on what I do when I'm ill,
I realise I do use over-the-counter medicines.
The important thing, though, when you go to the chemist's,
is do it with your eyes open.
Do your research - the detail's in the small print.
These products may be convenient
but make sure you really know what's in them.
Before you buy any medicine, cut through the marketing.
Ask yourself, would a home remedy work better?
Are there any side effects?
You'll save money and end up getting more effective treatment.