Viral Upper Respiratory Infections (Colds and Influenza) and Zinc

One famous alternative treatment for colds is the use of zinc in nasal gel or lozenges. Taking zinc supplements might also be useful in some cases.^1-3 There is a significant amount of research to support the use zinc for colds (and, potentially, the flu).

When you take zinc as a lozenge or nasal gel or spray, you are not using it as a nutrient. Instead, certain forms of zinc release ions that are thought to directly inhibit viruses in the nose and throat.

Also, taking zinc in oral supplement form supports the immune system, which can then be more effective in combating the virus causing your cold or flu, or preventing illness altogether.

Read more details about Zinc.

Use of lozenges containing zinc gluconate or zinc acetate have shown somewhat inconsistent but generally positive results for reducing the severity and duration of the common cold. For example, in a double-blind trial, 100 people who were experiencing the early symptoms of a cold were given a lozenge that either contained 13.3 mg of zinc from zinc gluconate or a placebo.⁸ Participants took the lozenges several times daily until their cold symptoms subsided. The results were impressive. Coughing disappeared within 2.2 days in the treated group versus 4 days in the placebo group. Sore throat disappeared after 1 day versus 3 days in the placebo group, nasal drainage in 4 days (versus 7 days), and headache in 2 days (versus 3 days). Positive results have also been seen in double-blind studies of zinc acetate.^9,10,167 Not all studies have shown such positive results.¹¹ However, the overall results appear to be favorable.^12,143

Use of zinc in the nose is somewhat more controversial.¹⁴⁴ In addition to showing inconsistent results in studies, use of zinc nasal gel can cause pain and possibly loss of sense of smell.

In one double-blind, placebo-controlled trial, 213 people with a newly starting cold used one squirt of zinc gluconate gel or placebo gel in each nostril every 4 hours while awake.⁷ The results were significant: treated participants stayed sick an average of 2.3 days, while those receiving placebo were sick for an average of 9 days, a 75% reduction in the duration of symptoms. Somewhat more modest but still significant relative benefits were seen with zinc nasal gel in a double-blind, placebo-controlled study of 80 people with colds.¹⁰³ However, a slightly larger study of a similar zinc gluconate nasal gel found no benefit.¹¹³ Another study—this one involving 77 people—failed to find benefit, even with near constant saturation of the nasal passages with zinc gluconate nasal spray.¹⁴⁴

Zinc products--supplements, lozenges, and nasal gels and sprays--are widely available in drugstores and health food stores.

Based on a significant amount of research on zinc and colds, supplemental zinc and zinc lozenges have the most favorable evidence and the fewest potential side effects. Though zinc nasal gel has also demonstrated impressive results for treating colds, it can cause pain and possibly loss of sense of smell.

With supplemental zinc, more isn't better; once you do have enough zinc, getting extra won't help, and might even hurt (see Side Effects and Warnings).

It has been suggested that the exact formulation of the zinc lozenge plays a significant role in its effectiveness.¹³ According to this view, certain flavoring agents, such as citric acid and tartaric acid, might prevent zinc from inhibiting viruses. In addition, chemical forms of zinc other than zinc gluconate or zinc acetate might be ineffective. Zinc sulfate in particular might not work. Along the same lines, sweeteners such as sorbitol, sucrose, dextrose, and mannitol are said to be fine, while glycine has been discussed in an equivocal manner.

Safety Issues

Zinc taken orally seldom causes any immediate side effects other than occasional stomach upset, usually when it's taken on an empty stomach. Some forms do have an unpleasant metallic taste. Use of zinc nasal gel, however, has been associated with anosmia (loss of sense of smell). ¹ In fact, After receiving over 130 reports of anosmia, the FDA warned consumers and healthcare providers in 2009 to discontinue use of certain Zicam Cold Remedy intranasal zinc-containing products, including Zicam Cold Remedy Nasal Gel, Cold Remedy Nasal Swabs and Cold Remedy Swabs in kids size. ² Furthermore, if the gel is inhaled too deeply, severe pain may occur.

Long-term use of oral zinc at dosages of 100 mg or more daily can cause a number of toxic effects, including severe copper deficiency, impaired immunity, heart problems, and anemia. ^{3 4 5} Zinc at a dose of more than 50 mg daily might reduce levels of HDL ("good") cholesterol. ⁶ In addition, very weak evidence hints that use of zinc supplements might increase risk of prostate cancer in men. ⁷ The US government has issued recommendations regarding "tolerable upper intake levels" (ULs) for zinc. The UL can be thought of as the highest daily intake over a prolonged time known to pose no risks to most members of a healthy population. The ULs for zinc are as follows: ⁸

• Infants

• 0-6 months: 4 mg

• 7-12 months: 5 mg

• Children

• 1-3 years: 7 mg

• 4-8 years: 12 mg

• 9-13 years: 23 mg

• Males and Females

• 14-18 years: 34 mg

• 19 years and older: 40 mg

• Pregnant Women and Nursing Women

• 18 years or younger: 34 mg

• 19 years and older: 40 mg

There are also some interactions between zinc and certain medications to consider:

Use of zinc can interfere with the absorption of the drug penicillamine and also antibiotics in the tetracycline or fluoroquinolone (Cipro, Floxin) families. ^{9 10 11 12 13} The potassium-sparing diuretic amiloride was found to significantly reduce zinc excretion from the body. ¹⁴ This means that if you take zinc supplements at the same time as amiloride, zinc accumulation could occur. This could lead to toxic side effects. However, the potassium-sparing diuretic triamterene does not seem to cause this problem. ¹⁵

Interactions You Should Know About

If you are taking:

• ACE inhibitors ; estrogen-replacement therapy ; oral contraceptives ; thiazide diuretics ; or medications that reduce stomach acid (such as H 2 blockers [ Zantac ] or proton pump inhibitors [ Prilosec ]): You may need to take extra zinc.

• Amiloride : This medication could reduce zinc excretion from the body, leading to zinc accumulation, which could cause toxic side effects. Do not take zinc supplements unless advised by a physician.

• Manganese ; calcium ; copper ; iron ; antacids ; soy ; or antibiotics in the fluoroquinolone (such as, Cipro , Floxin ) or tetracycline families: It may be advisable to separate your doses of zinc and these substances by at least 2 hours.

• Penicillamine : Zinc interferes with penicillamine's absorption so it may be advisable to take zinc and penicillamine at least 2 hours apart.

• Zinc supplements: You should also take extra copper and perhaps magnesium as well because zinc interferes with their absorption. Zinc interferes with iron absorption, too, but you shouldn't take iron supplements unless you know you are deficient.

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