By Joan van Wyngaard | B.Pharm, M.Sc (Pharmacology), MBA, PhD
Tonight I ran a masterclass on colds and flu — why you get sick fast, and how to actually stop the virus. And I thought it was worth putting into writing, because there are some things in this space that I feel very strongly about, and some things that I think most people have simply never been told.
Let me start at the beginning.
Cold vs Flu — Know the Difference
Most people are familiar with the difference between a cold and influenza, but it’s worth being clear about it as a starting point, if only because of how differently you need to respond to each. A cold is more gradual, milder, with a runny or blocked nose, mild fatigue, perhaps a low-grade temperature. Influenza hits suddenly and hard — high fever, chills, severe body aches, extreme fatigue, and it can lead to serious complications. Both are caused by viruses. Neither responds to antibiotics.
The Virus is the Problem — So Why Are We Ignoring It?
Here is something that I knew, but never really thought about until a training I attended some years ago completely changed my perspective: you cannot get sick if the virus cannot get into your cells.
Think about how infection actually happens. Someone near you sneezes or coughs. You inhale a droplet, or you touch a contaminated surface and touch your face. The virus contacts the mucosa — the lining of your nose or mouth — and then it attaches to your cell receptors and enters the cell. That is when everything starts.
Once inside, the virus replicates extraordinarily fast. It hijacks your cell’s own machinery, makes thousands of copies of itself, bursts the cell open, and moves on to infect the next cells. The symptoms you experience — the runny nose, the fever, the headache — those are not the virus itself. That is your own immune system fighting back.
And here is the critical point: this process happens very fast. The sooner you intervene, the better your chances of not getting severely ill, or of not staying sick for as long.
Why Antibiotics Don’t Work — And Why That Matters
Viruses are not bacteria. Antibiotics have zero effect on a viral infection. The reason we have so much antibiotic resistance in the world today is partly because so many people with colds and flu receive antibiotics — either because they demand them or because practitioners prescribe them to be safe. People don’t always finish their course, the bacteria get exposed to sub-therapeutic levels, and resistance develops.
The only time antibiotics are appropriate during a cold or flu is if you develop a secondary bacterial infection — which does happen, but it is not the primary illness.
The Problem with Conventional OTC Products
When symptoms start, most people run to the pharmacy looking for something to dry up their nose, bring down their fever, and ease the headache. And there are plenty of products that will do exactly that.
The problem is that none of them do anything about the virus.
I’ll be honest — after I attended a training overseas a number of years ago, I stopped using conventional over-the-counter cold and flu products. Because I realised what they were actually doing: making me feel better while the virus continued to replicate happily from cell to cell. I was staying sick for the full ten days, feeling reasonably comfortable, while achieving nothing in terms of actually fighting the infection.
There’s also a specific concern around fever suppression that I think is critically underappreciated. A low-grade fever is not your enemy — it is an environment that is genuinely uncomfortable for the virus. Elevated temperature helps your immune system fight the infection. When you take a pain reliever to bring the fever down, you are removing one of your own body’s weapons. Think twice before you do that automatically. The exception is a high fever, particularly in young children or vulnerable patients — that does need to be managed. But a mild fever in an otherwise healthy adult? Let it do its job.
Decongestants also carry their own risks — rebound congestion if used for more than three to five days is a real problem. Antihistamines cause sedation. And many people who should not be using these products — those with high blood pressure, stomach ulcers, kidney issues, and many others — are doing so without realising the risks.
So What Actually Works?
There are natural ingredients that have been clinically proven to interfere with the viral process itself — not just manage how you feel. They work in three key ways:
Blocking attachment — preventing the virus from binding to your cell receptors in the first place. If it can’t get in, you can’t get sick. Pelargonium sidoides and Echinacea both have this anti-adhesive mechanism.
Inhibiting replication — stopping the virus from reproducing inside the cell, once it has entered. Pelargonium sidoides, NAC, and quercetin all contribute here.
Boosting the immune response — helping your macrophages and immune cells clear the infected cells faster, without going into overdrive. This is where immune modulation comes in.
Pelargonium sidoides — Our Proudly South African Hero
I want to spend a little time on this plant, because it is South African, and I think we should feel genuinely proud of it.
Pelargonium sidoides is wild-harvested — it grows in the Eastern Cape and in Lesotho. It looks a bit like a sweet potato. Traditionally, it was used for diarrhoea (it is high in tannins) and for respiratory illnesses. It was introduced to Europe in the early 1900s by a British man who believed it had cured his tuberculosis — it became known as Stevens’ Consumption Cure. The Germans eventually took our root to the level of prescription medication by conducting more than 30 clinical trials. It first received approval for chronic bronchitis, and currently holds recognition from the European Medicines Agency for colds and flu.
What makes it remarkable is its complexity. It has more than 50 identified constituents — and to this day, scientists have not been able to identify all of them, nor have they been able to identify a single “active ingredient.” They believe the efficacy comes from the synergy of the whole extract. And that complexity is actually a significant advantage: because the ratios of constituents differ slightly depending on altitude, rainfall, and growing conditions, the virus can never fully adapt to it. Resistance simply cannot develop in the way it does with a single-compound antibiotic or antiviral drug.
The mechanisms of action of Pelargonium sidoides include:
- Anti-adhesive — prevents viruses and bacteria from sticking to cell surfaces
- Broad-spectrum antiviral — tested against influenza, RSV, rhinovirus, coronavirus, and SARS-CoV-2 variants
- Antibacterial — protects the respiratory tract against secondary bacterial infection
- Immunomodulatory — activates macrophages and cytokine production without pushing the immune system into overdrive
- Mucociliary clearance — this one is unique to Pelargonium. It increases the ciliary beat frequency in the respiratory tract, which means the tiny hair-like structures in your airways physically beat faster, helping to sweep viruses and infected mucus out. No other herb does this.
- Anti-inflammatory — reduces pro-inflammatory cytokines, making you feel better without suppressing the immune response
Used alongside an ingredient that thins mucus — like NAC — you get a really powerful combination: thin the mucus AND sweep it out. Because infected mucus sitting in your lungs and airways is just a breeding ground for further infection.
There is also exciting synergy between Pelargonium and both Vitamin D and NAC. And more recently there have been studies showing that Pelargonium actually enhances the effect of Vitamin D — which is a very useful finding for South Africans, many of whom are more Vitamin D deficient than they realise, despite our sunshine.
Something worth noting: I myself submitted six regulatory dossiers for Echinaforce to SAHPRA in 2015. So when I see a CPD article from a doctor claiming there is “very little evidence” for herbals in cold and flu, I react with genuine alarm. That is a significant misrepresentation of the science. Pelargonium sidoides has been tested in more than 30 clinical trials in over 10,000 patients. The evidence is extensive, rigorous, and registered with regulatory authorities across the world.
In practical terms, what does Pelargonium do for you as a patient? It gives you your best chance of not getting sick if you start it early enough. If you do get sick, you won’t get as sick. And you will recover faster — typically three to five days sooner than without treatment. The dosing frequency matters: because the virus replicates so fast, three times a day is the standard therapeutic dose.
Echinacea
Echinaforce is one of the best-studied Echinacea preparations in the world. It has similar antiviral and immunomodulatory effects to Pelargonium, with a particularly strong anti-inflammatory component. Critically, it has EMA-recognised claims for both prevention AND treatment of colds and flu — which means a lower daily dose for prevention is clinically validated.
The delivery format matters. A spray with Echinacea works directly at the point of exposure — the nasal and throat mucosa where the virus first makes contact. When I was working with A.Vogel, we did a lot of sampling with the sore throat spray containing Echinacea, sage, and peppermint. Medical doctors in particular loved it — they would see a sick patient and immediately spray their throat. The Echinacea is antiviral, the sage is antibacterial, and the peppermint gives it a pleasant taste. Many of those doctors genuinely felt it protected them.
More broadly, liquid formats — drops and sprays — are preferable for these products. The absorption is better because the active ingredients don’t have to pass through the liver. They absorb directly from the mucosa into the bloodstream, and they act right at the site of viral entry.
NAC — N-Acetylcysteine
NAC became much more prominent during COVID, and for good reason. From a complementary medicine regulatory perspective in South Africa, we can specifically claim it as a powerful antioxidant. It is a precursor to glutathione — your body’s master antioxidant. It also has mucolytic properties, thinning mucus and making it easier to clear. It is a sulfur donor, well tolerated at standard doses, and synergistic with both Pelargonium and Vitamin C. Standard dose is 600 mg per day, increasing during illness.
MSM — Methylsulfonylmethane
One of my personal favourite ingredients. MSM is organic sulphur — it also increases glutathione levels, and acts as a natural anti-inflammatory and analgesic. In the context of cold and flu, it reduces the inflammation and general discomfort, and helps neutralise the free radicals generated by the infection. Think of it as a natural alternative to reaching for a pain reliever — without the concerns around fever suppression.
Vitamin C — The Absorption Science Nobody Talks About
This one generates a lot of passion, and I understand why — but the science is actually quite clear, and it cuts against what most people believe.
I have had customers tell me that if it is not 1,000 mg, they don’t want it. I have had practitioners ask me for 5-gram preparations. And what I want to say is: the absorption of Vitamin C does not work that way.
The absorption is essentially complete up to around 200 mg per dose. Above 500 mg it drops off significantly. Above 1,000 mg, most of it is simply excreted in your urine. All you are doing at that point is acidifying your urine and — as we saw clearly during the COVID years — increasing the risk of calcium oxalate kidney stones and renal complications in people who overdose long term.
When you are sick, taking 1,000 mg per day in divided doses is reasonable and supported — your body’s demand is genuinely higher. Most standard OTC cold and flu products sit in this range, which is fine. But when you are healthy, 100 mg per day is adequate for most people. Spending money on high-dose Vitamin C as a daily supplement when you are not ill is simply not evidence-based.
Bromelain and Quercetin
Bromelain, derived from pineapple, is a proteolytic enzyme with strong anti-inflammatory effects. It was very popular for some years in South Africa before it was briefly classified as a scheduled substance — which was, frankly, a strange regulatory decision given that it comes from a fruit. It helps thin mucus, reduces inflammation, enhances absorption of other nutrients, and has even been registered as a type of antibiotic in animal feed. A useful synergistic ingredient in any cold and flu regimen, ideally taken on an empty stomach.
Quercetin is a flavonoid — and interestingly, Pelargonium sidoides actually contains some quercetin, which speaks to the complexity of that extract. Quercetin is a powerful antioxidant, acts as a zinc ionophore (helping transport zinc into cells where it can inhibit viral replication), and has direct antiviral activity. A good complementary ingredient.
Homeopathic Remedies
It is worth clarifying for those who may not know: herbals and homeopathics are completely different categories of medicine. Herbals contain active phytochemical constituents at measurable concentrations. Homeopathics are energy medicine — prepared through serial dilution to the point where no original molecules remain, based on the principle that what causes a symptom in large doses can relieve it in extreme dilution. Not everyone believes in the mechanism, and the evidence base is limited.
That said, the biggest upside to homeopathic remedies is their safety profile. They carry minimal risk of drug interactions and are one of the few options that can be used during pregnancy. Nothing is tested in pregnant women — not because herbs are inherently dangerous, but because it is ethically impossible to conduct those trials. For pregnant patients asking what they can take, homeopathic remedies such as the Pegasus range are a reasonable option. Panado remains the conventional choice.
Daily Prevention — What to Take Every Year
Prevention is better than cure, and there are some ingredients with excellent evidence behind them for daily immune support during cold and flu season.
Beta-glucan — derived from yeast or mushrooms. There is a substantial body of clinical evidence showing that beta-glucans activate macrophages and natural killer cells, prime innate immunity, and reduce the incidence of respiratory infections. This is also where Bio-Strath comes in — a fermented yeast supplement containing six different herbs that are fed to Saccharomyces cerevisiae, which absorbs and metabolises them over three months before the yeast is inactivated. The end product contains all 20 amino acids, beta-glucans, and mannans from both the yeast and the herbs. It is marketed significantly for cognitive function in South Africa, but its immune-supporting effects are real and substantial. Importantly, because it is a natural fermented product rather than a fortified supplement, you cannot create deficiencies by taking it long term.
On that note — zinc is commonly recommended for cold and flu, and short-term use is fine. But long-term zinc supplementation without copper can deplete copper levels over time. This is a real issue that is under-discussed. If you are taking zinc daily, make sure your supplement contains copper as well, or cycle it seasonally rather than year-round.
PEA — Palmitoylethanolamide. My secret weapon, and the one I think deserves far more attention in this space than it currently gets.
I started taking PEA for my leg and hip — I have some inherited structural issues, and PEA’s anti-inflammatory and analgesic effects via the PPAR-α pathway are well documented for pain management. That was my only reason.
What I did not expect was that I stopped getting sick.
Not a cold, not a bout of flu, not even the feeling of something coming on — despite being surrounded by sick children and colleagues through a full South African winter. I went back to the literature, and what I found genuinely surprised me. There are six placebo-controlled, double-blind clinical trials on PEA for influenza and the common cold, conducted in the 1970s and involving nearly 4,000 people — before anyone was even looking at PEA for joints or pain. The data shows that people taking PEA were significantly less likely to get sick, and that even when they were serologically confirmed to have been exposed to and infected by the virus, the manifestation rate — actually getting ill — was dramatically lower in the PEA group.
I can attest to this personally. Around me, people got sick. I didn’t. I’m still standing.
PEA is something your body produces naturally — supplementing with it simply ensures there is enough. The daily maintenance dose is 400–600 mg. If I feel something starting, I increase to 400–600 mg three times a day. The longer you take it, the better the effect — it is not an acute-use supplement, it is something that builds.
Vitamin D3 — many South Africans are more deficient than they expect, despite living in a sunny country. Indoor lifestyles, sunscreen use, and the winter months all reduce synthesis significantly. Vitamin D is a fundamental immune regulator, and deficiency is strongly linked to increased susceptibility to respiratory infections. Supplement to maintain adequate levels, particularly through winter.
The Practical Timeline
Sooner is always better. The moment you feel something starting — a scratch in the throat, a first sneeze, that vague sense of not quite being right — that is your window.
- Echinacea spray or drops: up to three to five times a day acutely
- Pelargonium sidoides: three times a day
- PEA: three times a day during illness
- NAC and MSM: daily, increased during illness
- Vitamin C: increase dose while sick, return to maintenance when recovered
And then the foundations, which have not changed and will not change: sleep well, hydrate properly, wash your hands, manage your stress, eat nutritiously, and exercise moderately. We are all exposed to viruses continuously — they are everywhere, mutating constantly. The best you can do is give your own body the best possible chance when that exposure happens.
If you have questions about navigating cold and flu season — which ingredients to use, when, and in what combination — feel free to reach out. My guidance is always ingredient-specific, not product-specific. Good science exists behind several natural options, and understanding why they work is what helps you use them correctly.