Kate And Annie on Immunity. Can You Really Knock a cold on the head? And what is an appropriate amount of butter?

In this episode, pharmacist Kate Thomas is joined by Annie McCubbin from the Why Smart Women podcast to unpack the myths, marketing and medicine behind cold and flu season.

Together, they explore what the evidence really says about popular cold and flu remedies, including vitamin C, zinc, echinacea, andrographis, pseudoephedrine and phenylephrine.

They discuss:

• Can you actually shorten a cold?
 • Do “immune boosters” work, and do we even want a boosted immune system?
 • The role of stress, sleep and lifestyle in immune function
 • Why symptom relief still has value, even when it doesn’t cure the virus
 • The TGA warning on andrographis-containing products
 • Which cold and flu tablets are worth your money and which aren’t
 • Why spreading your virus around the office, gym, or Sydney tram is not a public service

Most importantly, Kate and Annie discuss one of the least popular but most useful pieces of health advice:

Lower your expectations.

A practical, evidence-based conversation for anyone who’s ever stood in the cold and flu aisle, wondering what actually works.

Oh, and how much butter is appropriate on a piece of toast?

Whether you are in perimenopause, approaching menopause, or simply trying to understand your hormones, I've got you.

Read more about this episode at Medication Clarity Clinic, Kate's own medication education and telehealth consulting site: https://medicationclarity.com.au

Follow Kate for more no-nonsense health education at @prescribeorpass on Instagram, Tiktok and Facebook. 

Transcript

SPEAKER_00 0:00

You're listening to On the Moons, where we have conversations about hormones, midlife, and the moments that make us wonder is it just me? I'm Kate. I'm a 48-year-old pharmacist and newly minted perimenopausal oversharer. This is where we talk openly about the changes we aren't prepared for, so we never have to feel alone in them again. I acknowledge the Camaragle people of the Eora Nation, the traditional custodians of the land which I am recording today. I pay my respects to elders past and present, and I extend that respect to all Aboriginal and Torres Strait Islander peoples listening. Always was, always will be, Aboriginal land.

SPEAKER_01 0:44

Well, hello listeners. This is a combinatorial episode of Why Smart Women and On the Moans. And we're going to call it Why Are Smart Women on the Moans. What do you think, Kate?

SPEAKER_00 0:56

I'm just so impressed you use the word combinator. Combinatorial. Combinatorial. I'm going to use that. Is it a real word? Who cares? It is now. I said deproving before. I think that's a real word.

SPEAKER_01 1:08

She did. She did. She did use the word deproving. It's a it's um the opposite of improving.

SPEAKER_00 1:14

Of improving, obviously.

SPEAKER_01 1:16

Deteriorating. Yes, I know there are other actual English words for that meaning. I like that.

SPEAKER_00 1:21

But I like deprove.

SPEAKER_01 1:22

Yeah. So this is the combinatorial episode because Kate and I, um, Annie McCub and Kate Thomas are very aligned on our um sort of disapproval of people that um make claims about supplements and other things which we think um is ingenuine. Is that right? Ingenuine? Ungenuine. Ingenuine. I'm trying to think of a d degenuine.

SPEAKER_00 1:51

Ingenuous. Disingenuous, I think, is the actual word. But if we're trying to come up with English words, I thought you were going to say that we are so aligned in the amount of butter we think is appropriate on a piece of toast.

SPEAKER_01 2:03

Yeah, we just had um we in fact just had some brunch. Tell us 10, is that brunch? Yeah, that's brunch. And um we we had to sort of order triple butter and and we discussed the the the fact that uh we only order the toast in order to have something to put the butter on. That's socially acceptable.

SPEAKER_00 2:21

And your your sister's child? My sister's child, she she's six, and my sister caught her eating butter straight out of the tub with a spoon. And my sister was confused because she was proud and also disgusted at the same time. I get that. But we um Annie and I were just discussing how those little those little cubes of butter, they're not cubes, are they? They're little slabs of butter that you get. Yeah, it's aadequate. They're to be applied like tiles to your toast.

SPEAKER_01 2:50

Yeah, yeah, it's wildly inadequate. Not to be spread. And I can't believe it when I look at someone and they've got a gigantic slab of toast that's like a brick. Right. And then they've got that tiny thing and they're doing this sort of smearing accent. Scraping. Scraping, and I'm like, what is the point of that? No point. And also, I like a lot of jam.

SPEAKER_00 3:07

Yes, you do actually.

SPEAKER_01 3:09

You like a lot of jam. Yeah, I like a lot of jam and I like a lot of cheese. Um, anyway, that's that's our breakfast. Beside the point. That's beside the point.

SPEAKER_00 3:16

So, what are we going to talk about today? Well, I wanted to have a talk about because we're coming into flu season. I mean, we're probably well into flu season now. Oh, I know.

SPEAKER_01 3:25

Are you going to talk about things that are meant to boost the immune system?

SPEAKER_00 3:29

Immune boosting. Oh my goodness.

SPEAKER_01 3:34

God almighty.

SPEAKER_00 3:35

And I know that all of your clever listeners will have had their flu vaccine. I've had mine. And your COVID boosters.

SPEAKER_01 3:43

I haven't had my COVID booster. You can, yeah. Well, I had COVID in July. Am I still covered from that bout?

SPEAKER_00 3:53

Uh, I think they say six months since your infection. So I would go ahead and get your I get it constantly, COVID. Well, go and get a booster.

SPEAKER_01 4:02

It's attracted to me. You are attracted to. I am attracted, but it travels through the community and then it goes beep, beep, beep, there's Annie.

SPEAKER_00 4:09

Annie jumps in, go and get a go and get your COVID booster. Oh, well. But in the pharmacy, there's been a lot of people walking in saying things like ArmorGuard. Oh, well, I I do want to talk about Armor Force. Armor Force. Armor Force, but um, a lot of people coming in saying, I think I'm coming down with something. I need I need something to knock it on the head. And I appreciate, I appreciate the thinking behind that. Like as if you could like it Yeah, like it's like a weed. And maybe if you can spray it before it spreads, it'll stop spreading, but your immune system doesn't really work that way. And I knock it on the head is an interesting um bit of terminology, isn't it? It is. I mean, I understand what they mean. They're trying to get ahead of it so that it doesn't take hold.

SPEAKER_01 4:57

I know what people say to me. They say as soon as you okay, as soon as you get um the slightest hint of something to take zinc and vitamin C. So there's evidence for that, is there?

SPEAKER_00 5:10

There is uh some evidence for zinc lozenges. The thing about zinc is that it matters the way you take it. So a zinc lozenge is the most effective way because it actually sits in it it almost acts locally in your uh throat, but if you swallow it, it's not nearly as effective. And vitamin C is pretty much like if you're eating a balanced diet, you don't need a vitamin C supplement.

SPEAKER_01 5:40

Yeah, who who was the um Linus Pauling, wasn't it? Was it? Wasn't it that came that won the Nobel Prize? Is that Linus Pauling? For and then then started banging on about uh while you talk, I'm just going to look that up if that's correct. I think that he was, unless that's an actor, and I could have got confused, but there is a Nobel Prize winner who then lost the plot and began saying that vitamin C would cure everything.

SPEAKER_00 6:07

Oh well, vitamin C, high-dose vitamin C is pretty all the rage for cancer treatment at the moment as well.

SPEAKER_01 6:14

You're not making it up. I'm not. So uh he suggested in the early 1970s that the optimum daily intake may be about 2,000 milligrams of vitamin C, and that everyone should get 250 milligrams a day, and that he um believed that it would cure everything, including cancer. Amazing. And that but he was a Nobel Prize winner and then he lost the plot.

SPEAKER_00 6:40

Was he a mo uh did he win the Nobel Prize for literature though? Or was it for something scientific?

SPEAKER_01 6:47

No, he was actually a he was a chemist. Oh, okay. I don't know what happened. It was it's a very strange, self-taught chemist. He deproved. He deproved. He hang on, teaching the course the work. The genius of Pauling's work rests not in the single discovery. He won the Nobel Prize in chemistry for his entire body of work, not just a single accomplishment. Okay. Pauling is probably best known for working out the nature of the chemical bond, yet he also discovered, among other things, the cause of sickle cell anemia.

SPEAKER_00 7:17

Oh, so he was actually really smart, and then he lost the plot. Well, I mean, vitamin C is important. I just think that the notion the notion that you can meaningfully reduce the severity or longevity of an illness by taking vitamin C, I think, is is pretty weak. Um certainly zinc lozenges, I think that What would a zinc lozenger do in your throat? Explain to me. I don't know that I fully know. It's something to do with getting into the local cells and stopping the virus replicating. So what if you took it? And because you you breathe like through and and breath goes well, you breathe. So respiratory illnesses, obviously, you breathe them in, they're airborne illnesses, and they have to get into your body through breathing, which goes through your throat. So the idea is that if you suck a zinc lozenge and there's zinc in the back of your throat, it stops the viral cells from multiplying sort of here. I'm pointing too much.

SPEAKER_01 8:12

Why can't I take it prophylactically? Why can't I just take one all the time?

SPEAKER_00 8:16

Well, I'm sure you could, but uh overdosing on zinc isn't easy either. I mean you get nausea and diarrhea and all right.

SPEAKER_01 8:24

So I want to ask you another question. So I got um what did I get? Thing flu, para, parainfluenza. Oh para influenza. And then when I asked my doctor, or she's a neurologist, my friend who's a neurologist, she's also a doctor. Of course she's a doctor. Anyway, she said you probably got it from the gym. When you go to the gym, make sure it's on surfaces. It's on surfaces. I don't know. Is it on surfaces or is it airborne? I'm really confused.

SPEAKER_00 8:51

The air touches surfaces, so it can be in the air, settle on a surface. You can pick it up with your hands. And then touch your mouth. And then be in and around your face and breathe it in.

SPEAKER_01 9:02

Oh, okay. I thought I had to actually the virus is on the dumbbell, and then I pick up the dumbbell, and the virus is on my fingers, and then I touch my mouth. Yeah, then you touch your face. But I thought, but are you saying could I walk past somebody with the virus and they could breathe on it? Cough it on you, yeah. Breathe it out on you. I know they're everywhere. It makes me so paranoid.

SPEAKER_00 9:22

But don't be paranoid because but don't be, because that's what your immune system is for. It's literally the point of it is to protect you. And it does a really, really good job all the time. The thing that people need to, I think, just double down on if they don't want to get unwell with a viral illness is to remember that the absolutely best thing to do is to be immunized. Yep. And then do really basic, boring things that don't get sold to you in shiny containers with beige writing, which is get enough sleep. Make sure you're eating a good diet. Exercise. Keep, you know, keep as fit and well as you can. Wash your hands. Yeah. Like wash your hands. And then if you are immunocompromised or you actually, you know, you really, really don't want to inhale something, wear a mask. Yeah, exactly. And also if you have if you have a cold, like so n if you have a viral illness. Yeah, don't go out. Don't go out. Stop spreading it. Stop spreading it around.

SPEAKER_01 10:22

Stop spreading it, motherfuckers.

SPEAKER_00 10:23

Yeah, don't. And if you absolutely have to go out because, say, you've got to go to your wear a mask.

SPEAKER_01 10:28

Yeah, no, people are awful.

SPEAKER_00 10:29

And these are just really standard things. Don't send your children to school if they're unwell. Don't hero yourself and go to work. No, don't soldier on. Do not soldier on. Don't soldier on. And um, and then symptom relief is is is really valuable as well. So pseudoephedrine is the only thing that is an actual decongestant. So all of those cold and flu tablets that have phenylephrine, the ones that you don't have to show your license for, they don't work. There's no evidence that shows that phenolephrin is a decongestant in that dose. They don't work. So if you want a decongestant that works, you have to hand your license over and get pseudoephedrine. And then Okay, hang on.

SPEAKER_01 11:07

So okay, so I've got a whatever, I've got a virus and I want to feel better. What you're saying is taking phenylephrin is useless. Is useless.

SPEAKER_00 11:17

And what is that in? That's in cold and flu medication that you can buy at the pharmacy without having to hand over your license. So Codril, Codrill is just an example of a brand. Yeah. Codril have Codril, cold and flu with phenylephrine. It's called PE, I think, on the box. PE, phenylephrine. And what is it meant to do? It's meant to be a di well, it's got a combination of paracetamol, which we know is um brings down your fever and for your aches and pains and general analgesia. Yeah. And then it's got this phenyphrin, which they're suggesting is a decongestant. But it it it So that when we say decongestant, we're talking about drying things up. Yeah, drying up your sneezing and your drippy nose and your Yeah, yeah, yeah. Whereas the caudrile that you have to, the caudral cold and flu tablets that you have to hand your license over for contains pseudoephedrine. And pseudoephedrine's amazing at drying up your to dry it up. Well, yeah, because symptom relief is important. I mean, it's doing nothing to stop the s actual spread of the vi you know, it's not killing the virus in you, but it is making you feel better in the same way that VIX Vapor Rub isn't killing the virus. But if you like the smell of it and it's helping you breathe a little bit easier, then fill your boots.

SPEAKER_01 12:35

Right.

SPEAKER_00 12:36

Because symptom control, like actually feeling symptomatically better is is important.

SPEAKER_01 12:41

What what can I ask you about because I I see these terrible sort of overarching um sort of hyperbolic statements um from like um things like Lorna, not Lorna Jane, who's the other one? I've had a mental block. Lululemon. Yeah. Um about um 99% of all illnesses are caused by stress, de-stress, do some exercise, right? Which of course is ridiculous. Ridiculous. It's absolutely ridiculous. And I've been complained to them about that because it's stupid. It is. Um but do you what to what degree do you think, from your experience, that say chronic stress does affect our capacity to fight illnesses?

SPEAKER_00 13:29

I think that they've got more and more research being done into this area, and it is really complicated because it's a great grab for wellness, isn't it?

SPEAKER_01 13:42

You know, it's a great grab. Yeah, it's great.

SPEAKER_00 13:44

So cortisol retreat. High cortisol, you're in cortisol stress or cortisol overload or whatever it is. You've got adrenal fatigue. You've got adrenal fatigue as if they get weary. Um and you know, so I think that I think people think stress is stress is different to different people. Get it out, Kate. People experience stress differently to other people, and they are looking at that chronic stress, and I'm now using inverted commas with my fingers. Your nails are nice, by the way, aren't they?

SPEAKER_01 14:18

They're really pretty.

SPEAKER_00 14:19

I mean, the there's really no getting around the fact that influenza is caused by the influenza virus. So I suppose you could be what they're saying is that they're stressed and therefore your immunity is low and therefore your well I don't know, do we? I don't know. And it doesn't, that sentence to me doesn't make uh it doesn't make sense. So people who have lower immunity, so people who are on chemotherapy have lower immunity. Have a lower immunity. Yeah. And we have medication that we can actually give to people on chemotherapy. Um they're called um so GCSF. Uh Phil Grestum is one of them. And it's an injection, and they actually give it to people after they've had chemotherapy to raise the level of the immune cells from the bone marrow. So that actually is genuine immune boosting medication. So it's not an immune gummy, and it's not as you know, it's not a zinc lozenge.

SPEAKER_01 15:13

Get it off the chemist next to the next to the um St. John's Water.

SPEAKER_00 15:18

No, that's right. And and to your point before, which was Armor Force. So Armor Force is probably a hot seller at this moment.

SPEAKER_01 15:25

It would be.

SPEAKER_00 15:26

But there's the TGA has uh warnings out against one of the ingredients in Armor Force, which is Andrographis. And they found in 2025 there was something like 250 reports to the TGA of anaphylaxis to Andrographus in people who had previously taken it and been completely fine. And there was even one reported death.

SPEAKER_01 15:50

So they are they've got a So how okay, so the TGA for our overseas listeners um is the Australian Therapeutics Goods Administration, and the American equivalent is the FDA. FDA. And the problem with um all of our, well, all of the supplements, you know, and like Armour Force, which has a massive, as soon as there's the slightest nip in the air in Australia, Armor Force is just front and centre, and there's all these really fucking irritating posters everywhere of like a mother and a daughter, and they've got a beanie on, and they've got scarves and they're outside and they're near some sort of slippery dip and swing arrangement, and there's autumn leaves, and they're really happy and like it's idyllic and happy and rustic and autumnal. And of course, on the on the bottom of it says boost your immune system, take whatever it is, it might be Armaphors, it'll be something else and the Echinacea. And of course, the promise is that you can be outside with your child and the autumnal, glorious falling leaves, and you're going to be okay because you're taking an immune-boosting supplement, but you're not, are you?

SPEAKER_00 17:01

Well, a better I think a a better visual would be somebody on the tram trying to get from uh Winyard Station to Central Station, packed in like a sardine with your face up against someone's armpit. Um, that would be a much better visual for me than being outside in the glorious fresh air. Nobody else around me. But um Yeah, so you know, this trying to boost your immune system. It's not like it's not like Wi-Fi. Like you actually can't, you can't get a booster. I mean, you can, it's GCSF and you get it.

SPEAKER_01 17:39

We've just spoken about so we don't want to boost the immune system, correct? No, because if why don't we? Tell me.

SPEAKER_00 17:43

Well, if you had a boosted immune system all the time, then you would have an autoimmune disease. Exactly. So I think everybody just needs to settle down, settle down. Everybody just needs to rein it in a tiny bit and go, okay, if I if I think I'm coming down with something, then get good sleep, stay home. Look, I'm gonna say that grandma's out there were onto something when they said chicken soup because that's good nutrition, that's good fluids, um war, you know, warm fluids are very soothing, and as we've just said, symptom relief is is is very valuable to people. And I think just lower your expectations. So if you could just lower your expectations for three to five days, then you're gonna be fine.

SPEAKER_01 18:24

See, with that parainfluenza, if I may talk about myself at length, please do. Thank you. Um, I got that, and then I had I became very, very ill with asthma. Because you do suffer. I do suffer from it, and it went on and on and on and on and on and on and on and on, and then I had to take everything, um, including um I took prednisolone, which is a steroid, which solves it. And may I say, I had five glorious days where my arthritic fingers didn't hurt. Yes. And I would love to stay on that permanently, but you're not allowed to. You're not allowed to.

SPEAKER_00 19:02

Um, what does it do? That is just to tell our listeners, yeah. I don't know if you've heard of neurofin or non-steroidal anti-inflammatories. Um, neurofin, pomstan, those kind of things are Voltarin, so Diclofinac. They're they all come under the heading of non-steroidal anti-inflammatories. What does that mean? Well, the the reason I bring that up is because of the term non-steroidal. What you've had there is a steroid, which is a steroidal anti-inflammatory.

unknown 19:29

Yeah.

SPEAKER_00 19:29

Yeah. So that's how it works. It actually is bringing down the inflammation, which is why your arthritis felt amazing. It's just amazing. You can't. People on, again, these poor people having chemotherapy do often take long, protracted courses of steroids, either um prednisolone or dexamethasone. Their fingers must feel nice. Their fingers feel nice, but they require careful weaning because you can get horrible rebound. They they do, paradoxically, they do uh lower your immune system over time. So if you are on them chronically, low-dose steroids chronically, you do have to be careful. And you get fluid retention and they can raise your blood pressure. So they're not easy. But a short course, a short burst, which is what you had, it absolutely perfect.

SPEAKER_01 20:20

Yeah, it was just it was five days. And I know because my doctor at the time, because I really trust him and and um I really like him, and he said you don't want to, at the same time as reducing the inflammation, which of course the you know, everything gets inflamed with asthma, he said it does reduce your immune system. Yeah. So that's that's the that's the buy, not the payoff, the payoff, the buyout, no, no, the balance balance or something. Anyway, anyway, it fixed the asthma. Yeah. Uh my as soon as I stopped taking it, my arthritis roared back into life and the swelling came back. That's right. But just for a minute there, it was just so beautiful.

SPEAKER_00 21:00

And I think also to remember that inflammation is actually your body trying to fix the problem. Yeah. So whereas we think it's great to reduce the inflammation, actually, the inflammation is what your body is doing. Yes. It's just that in your case with a chronic chronic arthritis, you you your body's overdoing it. And that's why.

SPEAKER_01 21:22

My body is a tryhard. That's right, exactly. You're a tryhard. My body is try-hard. Also, with asthma, of course, it's a tryhard, isn't it?

SPEAKER_00 21:28

Yeah, it's an over-expression. You're basically a over.

SPEAKER_01 21:33

I'm an over over I'm just an over-achiever health-wise.

SPEAKER_00 21:37

Right? Don't you reckon? Don't you reckon? Yeah. I feel like it's never good to be an over-achiever. In anything. Is it in health, it's always good to be average.

SPEAKER_01 21:46

Yeah, it's true, isn't it?

SPEAKER_00 21:47

Yeah. Just aim for aim for the middle, everybody.

SPEAKER_01 21:50

Aim for that middle ground, right?

SPEAKER_00 21:51

So yeah, I would say to people, just just go and do the boring basic things well. Don't worry about trying to boost your immune system. Just and and also especially don't worry about trying to boost your immune system if you're not already doing the boring things well. So if you're not getting eight hours worth of good quality sleep and you're eating fast food all the time, and you're smoking and and drinking heavily. Drinking heavily.

SPEAKER_01 22:13

Well, I guess I didn't say just drinking because I'm not sure. Drinking heavily wine, I had to put the heavily just to give myself right and out. Yeah, and me.

SPEAKER_00 22:22

Well, you've you've got to be.

SPEAKER_01 22:23

And my own behaviour. Yeah, I've met you.

SPEAKER_00 22:25

But so don't don't try and hack something. There's no you've done the basic things. And then and then even then, just maybe give yourself a bit of grace and say, I'm not well this week. Yeah, and that's okay. My expectations aren't.

SPEAKER_01 22:41

See, as soon as I get a virus, I do go into a sort of um semi, it's not even semi, it's full panic. It's because we don't like to be still. Well, I it's not I don't like to be still, and I don't want to develop um I don't want to have asthma. Oh, yes, that's what happens to me.

SPEAKER_00 22:58

I go, I'm gonna get asthma from this. So for me, it's just because I don't like to sit still. I don't like being still. I don't like anything that makes me less than able to.

SPEAKER_01 23:07

No. No, that's right. Do you know I did the high rocks? Yes, I was gonna ask you about your high rocks. Yeah, I did my high rocks. I did my high rocks uh, I think the weekend before last year. So good. I know, I know. And um, it's just that level of suggestibility that I have. You know, the day before, I think I was saying to you, I might have even said it on the podcast, somebody said, Can you believe middle-aged women are doing the high rocks? I'm like, I know, idiots. And then they said, Would you like to do one? And the next day a 20-year-old said, Do you want to do it?

SPEAKER_00 23:34

I went, Yep. Yeah, yeah, sure. Pushing on an open door.

unknown 23:38

Right.

SPEAKER_00 23:39

Right. And I loved it. I've just come to you with a proposal, and you're pretty much the same. You were like, Absolutely. Yeah, I'm up. I'm up.

SPEAKER_01 23:45

I'm up for things. I'm up for things. I love that about you. We're not going to tell you what our proposal is. We're going to keep our powder dry. That's it.

SPEAKER_00 23:52

It's very exciting.

SPEAKER_01 23:53

Everybody excited. It's an exciting project that we're on to, isn't it?

SPEAKER_00 23:57

It is.

SPEAKER_01 23:57

So on that note, shall we bid our um your beloved listeners farewell? Um, and wherever you are in the world, we hope you stay safe, stay well, keep your critical thinking hats on, don't take an immune boosting vitamin because it won't work, and see you later. Bye. Bye.