Zinc and the common cold explained

(frequently zinc acetate or zinc gluconate lozenges) are a group of dietary supplements that are commonly used in an attempt to treat the .[1] Evidence of any benefit is weak, but it seems zinc may not prevent colds, but possibly reduce their length while not reducing the severity of the symptoms. Adverse effects with zinc supplements by mouth include bad taste and nausea.[2] The intranasal use of zinc-containing nasal sprays has been associated with the loss of the sense of smell; consequently, in June 2009, the United States Food and Drug Administration (USFDA) warned consumers to stop using intranasal zinc.

The human rhinovirus – the most common viral pathogen in humans – is the predominant cause of the common cold.[3] The hypothesized mechanism of action by which zinc reduces the severity and/or duration of cold symptoms is the suppression of nasal inflammation and the direct inhibition of rhinoviral receptor binding and rhinoviral replication in the nasal mucosa.

Effectiveness

Evidence around the effect of zinc on the common cold is weak, and insufficient to provide a basis for clinic decision making. What evidence there is, suggests zinc might not help prevent colds, does not make them less severe, but might reduce their length.[4]

Interactions

Some lozenge formulations do not contain enough zinc to effectively reduce the lengths of colds; some of them contain ingredients that bind zinc, like citric acid, which prevent the zinc from working.[5]

Safety

There have been several cases of people using zinc nasal sprays and suffering a loss of sense of smell. In 2009 the US Food and Drug Administration issued a warning that people should not use nasal sprays containing zinc.

Excessive zinc intake may result in an unpleasant taste and/or nausea.[6]

Mechanism of action

The hypothesized mechanism of action by which zinc reduces the severity and/or duration of cold symptoms is the suppression of nasal inflammation and the direct inhibition of rhinoviral receptor binding and rhinoviral replication in the nasal mucosa. Zinc has been known for many years to have an effect on cold viruses in the laboratory.[7] In the arteriviridae and coronaviridae families of virus that also cause the common cold, in vitro studies found that zinc ionophores block the replication of those viruses in cell culture.[8]

Notes and References

  1. Web site: Zinc – Fact Sheet for Health Professionals . Office of Dietary Supplements, US National Institutes of Health . February 11, 2016. January 7, 2018.
  2. Science M, Johnstone J, Roth DE, Guyatt G, Loeb M . Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials . CMAJ . 184 . 10 . E551-61 . July 2012 . 22566526 . 3394849 . 10.1503/cmaj.111990 .
  3. Web site: Common Cold and Runny Nose. United States Centers for Disease Control and Prevention. January 7, 2018. September 26, 2017.
  4. Nault D, Machingo TA, Shipper AG, Antiporta DA, Hamel C, Nourouzpour S, Konstantinidis M, Phillips E, Lipski EA, Wieland LS . Zinc for prevention and treatment of the common cold . Cochrane Database Syst Rev . 5 . 5 . CD014914 . May 2024 . 38719213 . 10.1002/14651858.CD014914.pub2 . Systematic review.
  5. Hemilä H, Petrus EJ, Fitzgerald JT, Prasad A . Zinc acetate lozenges for treating the common cold: an individual patient data meta-analysis . British Journal of Clinical Pharmacology . 82 . 5 . 1393–1398 . November 2016 . 27378206 . 5061795 . 10.1111/bcp.13057 .
  6. Singh M, Das RR . Singh M . Zinc for the common cold . The Cochrane Database of Systematic Reviews . 6 . CD001364 . June 2013 . 23775705 . 10.1002/14651858.CD001364.pub4 .
  7. Web site: Zinc 'can cut length of common cold'. May 8, 2012. NHS Choices. January 7, 2018. June 12, 2017. https://web.archive.org/web/20170612131640/http://www.nhs.uk/news/2012/05may/Pages/Zinc-shortens-common-cold.aspx. dead.
  8. te Velthuis . Aartjan J. W. . van den Worm . Sjoerd H. E. . Sims . Amy C. . Baric . Ralph S. . Snijder . Eric J. . van Hemert . Martijn J. . Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture . PLOS Pathogens . 4 November 2010 . 6 . 11 . e1001176 . 10.1371/journal.ppat.1001176 . 21079686 . 2973827 . free .

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