Common Cold pp 275-307 | Cite as

Vitamins and minerals

  • Harri Hemilä
Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)


Taking vitamins and minerals to fight the common cold is popular in western countries and thus it is important to find out whether or not they are effective. A large number of trials have found that regular vitamin C supplementation shortens the duration of colds, and is probably beneficial when administered therapeutically starting soon after the onset of symptoms. Zinc lozenges have reduced the duration of common cold symptoms when the total daily zinc doses were over 70 mg. Consequently, both vitamin C and zinc have the potential to become options for treating the common cold, but more research is needed to determine optimal doses and treatment strategies. The prophylactic effect of vitamins and minerals has also been examined in several trials. Vitamin C has no preventive effect in the general community, but may reduce the incidence of respiratory symptoms in restricted population groups such as people under acute physical stress and people with a particularly low dietary intake of vitamin C. There is no evidence that vitamin E supplementation prevents colds in middle-aged people. Nevertheless, the effects of vitamin E in elderly males have been found to be heterogeneous, and further studies are warranted in elderly people. β-Carotene has been promoted for improving the immune system, but there is no evidence that it is effective against colds. The use of multivitamin and multimineral combinations against respiratory tract infections in elderly people has been studied in a number of trials, but a nearly uniform lack of efficacy has been found. Vitamin D and folic acid have been constituents of multivitamin supplements, and the absence of benefits of these supplements implies that increasing the intake of vitamin D or folic acid in elderly people would not have substantial preventive effects against respiratory infections.


Antimicrob Agent Common Cold Zinc Gluconate Zinc Dose Common Cold Symptom 


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References Links to the full texts or abstracts of the following reference list that are available via the internet can be found at: Some of the publications are located at the publisher’s pages and require permissions to be reached, but several are freely available. The file will be updated so that new controlled trials on the substances discussed in this chapter will be appended at the end of the file.

  1. 1.
    Mäkelä MJ, Puhakka T, Ruuskanen O, Leinonen M, Saikku P, Kimpimäki M, Blomqvist S, Hyypiä T, Arstila P (1998) Viruses and bacteria in the etiology of the common cold. J Clin Microbiol 36:539–542PubMedGoogle Scholar
  2. 2.
    Syrjälä H, Broas M, Suramo I, Ojala A, Lähde S (1998) High resolution computed tomography for the diagnosis of community-acquired pneumonia. Clin Infect Dis 27:358–363PubMedGoogle Scholar
  3. 3.
    Millen AE, Dodd KW, Subar AF (2004) Use of vitamin, mineral, nonvitamin, and nonmineral supplements in the United States: The 1987, 1992, and 2000 National Health Interview Survey results. J Am Diet Assoc 104:942–950PubMedGoogle Scholar
  4. 4.
    Pauling L (1971) The significance of the evidence about ascorbic acid and the common cold. Proc Natl Acad Sci USA 68:2678–2681PubMedGoogle Scholar
  5. 5.
    Pauling L (1971) Ascorbic acid and the common cold. Am J Clin Nutr 24: 1294–1299PubMedGoogle Scholar
  6. 6.
    Cowan DW, Diehl HS, Baker AB (1942) Vitamins for the prevention of colds. JAMA 120:1268–1271Google Scholar
  7. 7.
    Ritzel G (1961) Kritische Beurteilung des Vitamins C als Prophylacticum und Therapeuticum der Erkältungskrankheiten [Critical analysis of the role of vitamin C in the treatment of the common cold]. Helv Med Acta 28:63–68. Translation at: (accessed 29 December 2008)PubMedGoogle Scholar
  8. 8.
    Hess AF (1920) Scurvy: Past and Present. Lippincott, Philadelphia. A digitalized version is available at the Cornell University Library: http://chla.library. (accessed 29 December 2008)Google Scholar
  9. 9.
    Robertson EC (1934) The vitamins and resistance to infection: Vitamin C. Medicine 13:190–206Google Scholar
  10. 10.
    Perla D, Marmorston J (1937) Role of vitamin C in resistance. Parts I and II. Arch Pathol 23:543–575, 683–712Google Scholar
  11. 11.
    Bourne GH (1949) Vitamin C and immunity. Br J Nutr 2:341–347Google Scholar
  12. 12.
    Glazebrook AJ, Thomson S (1942) The administration of vitamin C in a large institution and its effect on general health and resistance to infection. J Hygiene 42:1–19Google Scholar
  13. 13.
    Hemilä H, Louhiala P (2007) Vitamin C may affect lung infections. J R Soc Med 100:495–498PubMedGoogle Scholar
  14. 14.
    Hemilä H (2006) Do vitamins C and E affect respiratory infection? [PhD Thesis]. University of Helsinki, Helsinki, Finland, pp. 11–16, 35–51. Available at: (accessed 29 December 2008)Google Scholar
  15. 15.
    Bartley W, Krebs HA, O’Brien JRP (1953) Vitamin C Requirement of Human Adults. A Report by the Vitamin C Subcommittee of the Accessory Food Factors Committee. Spec Rep Ser Med Res Counc (GB) No. 280. HMSO, London, p. 43Google Scholar
  16. 16.
    Mason SF (1997) The science and humanism of Linus Pauling (1901–1994). Chem Soc Rev 26:29–39Google Scholar
  17. 17.
    Pauling L (1970) Vitamin C and the Common Cold. Freeman, San FranciscoGoogle Scholar
  18. 18.
    Pauling L (1976) Vitamin C, the Common Cold, and the Flu. Freeman, San FranciscoGoogle Scholar
  19. 19.
    Hemilä H (1992) Vitamin C and the common cold. Br J Nutr 67:3–16PubMedGoogle Scholar
  20. 20.
    Himmelstein SA, Robergs RA, Koehler KM, Lewis SL, Qualls CR (1998) Vitamin C supplementation and upper respiratory tract infections in marathon runners. J Exercise Physiology online 1(2;July), Available at: http:/faculty.css. edu/tboone2/asep/jan9.htm (accessed 29 December 2008)Google Scholar
  21. 21.
    van Straten M, Josling P (2002) Preventing the common cold with a vitamin C supplement: A double-blind, placebo-controlled survey. Adv Ther 19:151–159PubMedGoogle Scholar
  22. 22.
    Hemilä H (1997) Vitamin C intake and susceptibility to the common cold. Br J Nutr 77:59–72; discussion: 1997;78:857–866PubMedGoogle Scholar
  23. 23.
    Briggs M (1984) Vitamin C and infectious disease: A review of the literature and the results of a randomized, double-blind, prospective study over 8 years. In: MH Briggs (ed) Recent Vitamin Research. CRC Press, Boca Raton, pp 39–82Google Scholar
  24. 24.
    Hemilä H, Chalker EB, Treacy B, Douglas RM (2007) Vitamin C for preventing and treating the common cold. Cochrane Datablase Syst Rev CD000980Google Scholar
  25. 25.
    Hemilä H (1996) Vitamin C and common cold incidence: A review of studies with subjects under heavy physical stress. Int J Sports Med 17:379–383PubMedGoogle Scholar
  26. 26.
    Hemilä H (2004) Vitamin C supplementation and respiratory infections: A systematic review. Mil Med 169:920–925PubMedGoogle Scholar
  27. 27.
    Peters EM, Goetzsche JM, Grobbelaar B, Noakes TD (1993) Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runners. Am J Clin Nutr 57:170–174PubMedGoogle Scholar
  28. 28.
    Peters EM, Goetzsche JM, Joseph LE, Noakes TD (1996) Vitamin C as effective as combinations of anti-oxidant nutrients in reducing symptoms of upper respiratory tract infection in ultramarathon runners. S Afr J Sports Med 11 (March):23–27Google Scholar
  29. 29.
    Moolla ME (1996) The effect of supplemental anti-oxidants on the incidence and severity of upper respiratory tract infections in ultra-marathon runners MSc Thesis]. University of Cape Town. South AfricaGoogle Scholar
  30. 30.
    Sabiston BH, Radomski MW (1974) Health Problems and Vitamin C in Canadian Northern Military Operations. SCIEM Report no. 74-R-1012. Defence and Civil Institute of Environmental Medicine; Downsview, Ontario, Canada. 10 pp. Available at: (accessed 29 December 2008)Google Scholar
  31. 31.
    Anderson SD, Kippelen P (2008) Airway injury as a mechanism for exercise-induced bronchoconstriction in elite athletes. J Allergy Clin Immunol 122: 225–235; discussion: 2009;123:274–275PubMedGoogle Scholar
  32. 32.
    Schachter EN, Schlesinger A (1982) The attenuation of exercise-induced bron-chospasm by ascorbic acid. Ann Allergy 49:146–151PubMedGoogle Scholar
  33. 33.
    Cohen HA, Neuman I, Nahum H (1997) Blocking effect of vitamin C in exercise-induced asthma. Arch Pediatr Adolesc Med 151:367–370PubMedGoogle Scholar
  34. 34.
    Tecklenburg SL, Mickleborough TD, Fly AD, Bai Y, Stager JM (2007) Ascorbic acid supplementation attenuates exercise-induced bronchoncostriction in patients with asthma. Respir Med 101:1770–1778PubMedGoogle Scholar
  35. 35.
    Charleston SS, Clegg KM (1972) Ascorbic acid and the common cold. Lancet 299:1401–1402Google Scholar
  36. 36.
    Clegg KM, Macdonald JM (1975) L-ascorbic acid and D-isoascorbic acid in a common cold survey. Am J Clin Nutr 28:973–976PubMedGoogle Scholar
  37. 37.
    Elwood PC, Lee HP, Leger AS, Baird IM, Howard AN (1976) A randomized controlled trial of vitamin C in the prevention and amelioration of the common cold. Br J Prev Soc Med 30:193–196PubMedGoogle Scholar
  38. 38.
    Baird IM, Hughes RE, Wilson HK, Davies JE, Howard AN (1979) The effects of ascorbic acid and flavonoids on the occurrence of symptoms normally associated with the common cold. Am J Clin Nutr 32:1686–1690PubMedGoogle Scholar
  39. 39.
    Tyrrell DAJ, Craig JW, Meade TW, White T (1977) A trial of ascorbic acid in the treatment of the common cold. Br J Prev Soc Med 31:189–191PubMedGoogle Scholar
  40. 40.
    Hemilä H (2008) Vitamin C and sex differences in respiratory tract infections. Respir Med 102:625–626PubMedGoogle Scholar
  41. 41.
    Anderson TW, Reid DBW, Beaton GH (1972) Vitamin C and the common cold: A double-blind trial. Can Med Assoc J 107:503–508 corrections: 1973;108;133 and 1973;108:492PubMedGoogle Scholar
  42. 42.
    Anderson TW, Beaton GH, Corey PN, Spero L (1975) Winter illness and vitamin C: The effect of relatively low doses. Can Med Assoc J 112:823–826PubMedGoogle Scholar
  43. 43.
    Ludvigsson J, Hansson LO, Tibbling G (1977) Vitamin C as a preventive medicine against common colds in children. Scand J Infect Dis 9:91–98PubMedGoogle Scholar
  44. 44.
    Hemilä H (1999) Vitamin C supplementation and common cold symptoms: Factors affecting the magnitude of the benefit. Med Hypotheses 52:171–178PubMedGoogle Scholar
  45. 45.
    Coulehan JL, Reisinger KS, Rogers KD, Bradley DW (1974) Vitamin C prophylaxis in a boarding school. N Engl J Med 290:6–10PubMedGoogle Scholar
  46. 46.
    Bancalari A, Seguel C, Neira F, Ruiz I, Calvo C (1984) Valor profilactico de la vitamina C en infecciones respiratorias agudas del escolar [Prophylactic value of vitamin C in acute respiratory infections of schooldren] Rev Med Chil 112: 871–876. Translation at: (accessed 29 December 2008)PubMedGoogle Scholar
  47. 47.
    Karlowski TR, Chalmers TC, Frenkel LD, Kapikian AZ, Lewis TL, Lynch JM (1975) Ascorbic acid for the common cold. JAMA 231:1038–1042PubMedGoogle Scholar
  48. 48.
    Hemilä H (1996) Vitamin C, the placebo effect, and the common cold: A case study of how preconceptions influence the analysis of results. J Clin Epidemiol 49:1079–1084PubMedGoogle Scholar
  49. 49.
    Hemilä H (1997) Vitamin C supplementation and the common cold: Was Linus Pauling right or wrong? Int J Vitam Nutr Res 67:329–335PubMedGoogle Scholar
  50. 50.
    Anderson TW, Suranyi G, Beaton GH (1974) The effect on winter illness of large doses of vitamin C. Can Med Assoc J 111:31–36PubMedGoogle Scholar
  51. 51.
    Padayatty SJ, Sun H, Wang Y, Riordan HD, Hewitt SM, Katz A, Wesley RA, Levine M (2004) Vitamin C pharmacokinetics: Implications for oral and intravenous use. Ann Intern Med 140:533–537PubMedGoogle Scholar
  52. 52.
    Padayatty SJ, Riordan HD, Hewitt SM, Katz A, Hoffer LJ, Levine M (2006) Intravenously administered vitamin C as cancer therapy: Three cases. CMAJ 174:937–942PubMedGoogle Scholar
  53. 53.
    Rivers JM (1987) Safety of high-level vitamin C ingestion. Ann NY Acad Sci 498:445–454PubMedGoogle Scholar
  54. 54.
    Hathcock JN, Azzi A, Blumberg J, Bray T, Dickinson A, Frei B, Jialal I, Johnston CS, Kelly FJ, Kraemer K et al. (2005) Vitamins E and C are safe across a broad range of intakes. Am J Clin Nutr 81:736–745PubMedGoogle Scholar
  55. 55.
    Gotzsche AL (1989). Pernasal vitamin C and the common cold. Lancet 2:1039PubMedGoogle Scholar
  56. 56.
    Thomas WR, Holt PG (1978) Vitamin C and immunity: An assessment of the evidence. Clin Exp Immunol 32:370–379PubMedGoogle Scholar
  57. 57.
    Beisel WR (1982) Single nutrients and immunity: Vitamin C. Am J Clin Nutr 35 (Feb suppl):423–428, 460–461Google Scholar
  58. 58.
    Gross RL, Newberne PM (1980) Role of nutrition in immunologic function: Vitamin C. Physiol Rev 60:255–260, 290–302Google Scholar
  59. 59.
    Jariwalla RJ, Harakeh S (1996) Antiviral and immunomodulatory activities of ascorbic acid. Subcell Biochem 25:215–231Google Scholar
  60. 60.
    Webb AL, Villamor E (2007) Effects of antioxidant and non-antioxidant vitamin supplementation on immune function. Nutr Rev 65:181–217PubMedGoogle Scholar
  61. 61.
    Akaike T, Noguchi Y, Ijiri S, Setoguchi K, Suga M, Zheng YM, Dietzschold B, Maeda H (1996) Pathogenesis of influenza virus-induced pneumonia: Involvement of both nitric oxide and oxygen radicals. Proc Natl Acad Sci USA 93:2448–2453PubMedGoogle Scholar
  62. 62.
    Peterhans E (1997) Oxdants and antioxidants in viral disease. J Nutr 127: 962S–965SPubMedGoogle Scholar
  63. 63.
    Akaike T (2001) Role of free radicals in viral pathogenesis and mutation. Rev Med Virol 11:87–101PubMedGoogle Scholar
  64. 64.
    Snelgrove RJ, Edwards L, Rae AJ, Hussell T (2006) An absence of reactive oxygen species improves the resolution of lung influenza infection. Eur J Immunol 36:1364–1273PubMedGoogle Scholar
  65. 65.
    Castro SM, Guerrero-Plata A, Suarez-Real G, Adegboyega PA, Colasurdo GN, Khan AM, Garofalo RP, Casola A (2006) Antioxidant treatment ameliorates respiratory syncytial virus-induced disease and lung inflammation. Am J Respir Crit Care Med 174:1361–1369PubMedGoogle Scholar
  66. 66.
    Hemilä H (2006) Do vitamins C and affect respiratory infection? [PhD Thesis]. Helsinki, Finland: University of Helsinki; pp. 5–10, 105–131 Available at:http:// (accessed 29 December 2008)Google Scholar
  67. 67.
    Witt EH, Reznick AZ, Viguie CA, Starke-Reed P, Packer L (1992) Exercise, oxidative damage and effects of antioxidant manipulation. J Nutr 122:766–773PubMedGoogle Scholar
  68. 68.
    Packer L (1997) Oxidants, antioxidant nutrients and the athlete. J Sports Sci 15: 353–363PubMedGoogle Scholar
  69. 69.
    Hemilä H (1996) Vitamin C supplementation and common cold symptoms: Problems with inaccurate reviews. Nutrition 12:804–809PubMedGoogle Scholar
  70. 70.
    Chalmers TC (1975) Effects of ascorbic acid on the common cold: An evaluation of the evidence. Am J Med 58:532–536PubMedGoogle Scholar
  71. 71.
    Dykes MHM, Meier P (1975) Ascorbic acid and the common cold: Evaluation of its efficacy and toxicity. JAMA 231:1073–1079PubMedGoogle Scholar
  72. 72.
    Hemilä H, Herman ZS (1995) Vitamin C and the common cold: A retrospective analysis of Chalmers’ review. J Am Coll Nutr 14:116–123PubMedGoogle Scholar
  73. 73.
    Hemilä H (2008) Chalmers’ meta-analysis 1975. Available at: (accessed 29 December 2008)Google Scholar
  74. 74.
    Hemilä H (2008) The Dykes and Meier review 1975. Available at: http://www. (accessed 29 December 2008)Google Scholar
  75. 75.
    Pauling L (1976) Ascorbic acid and the common cold: Evaluation of its efficacy and toxicity. Part I. Med Tribune 17(12): 18–19Google Scholar
  76. 76.
    Pauling L (1976) Ascorbic acid and the common cold. Part II. Med Tribune 17(13):37–38Google Scholar
  77. 77.
    Chalmers TC (1996) Dissent to the preceding article by H. Hemilä. J Clin Epidemiol 49:1085Google Scholar
  78. 78.
    Hemilä H (1996) To the dissent by Thomas Chalmers. J Clin Epidemiol 49: 1087Google Scholar
  79. 79.
    Hemilä H (2008) The most influential trial on vitamin C and the common cold: Karlowski et al. 1975. Available at: (accessed 29 December 2008)Google Scholar
  80. 80.
    Truswell AS (1986) Ascorbic acid. N Engl J Med 315:709Google Scholar
  81. 81.
    Kleijnen J, Riet G, Knipschild PG (1989) Vitamine C en verkoudheid; overzicht van een megadosis literatuur [in Dutch; Vitamin C and the common cold; a review of the megadose literature]. Ned Tijdschr Geneeskd 133:1532–1535PubMedGoogle Scholar
  82. 82.
    Hemilä H (2008) Truswell’s mini-review 1986. Available at: http://www.ltdk. (accessed 29 December 2008)Google Scholar
  83. 83.
    Hemilä H (2008) Kleijnen’s meta-analysis 1989. Available at: http://www.ltdk. (accessed 29 December 2008)Google Scholar
  84. 84.
    Hemilä H (2008) Pauling’s meta-analyses 1971a,b. Available at: http://www. (accessed 29 December 2008)Google Scholar
  85. 85.
    Meydani SN, Wu D, Santos MS, Hayek MG (1995) Antioxidants and immune response in aged persons: Overview of present evidence. Am J Clin Nutr 62: 1462S–1476SPubMedGoogle Scholar
  86. 86.
    Moriguchi S, Muraga M (2000) Vitamin E and immunity. Vitam Horm 59: 305–336PubMedGoogle Scholar
  87. 87.
    Baehner RL, Boxer LA, Allen JM, Davis J (1977) Autoxidation as a basis for altered function by polymorphonuclear leukocytes. Blood 50:327–335PubMedGoogle Scholar
  88. 88.
    Prasad JS (1980) Effect of vitamin E supplementation on leukocyte function. Am J Clin Nutr 33:606–608PubMedGoogle Scholar
  89. 89.
    Eckman JR, Eaton JW, Berger E, Jacob HS (1976) Role of vitamin E in regulating malaria expression. Transact Assoc Am Physicians 89:105–115Google Scholar
  90. 90.
    Taylor DW, Levander OA, Krishna VR, Evans CB, Morris VC, Barta JR (1997) Vitamin E-deficient diets enriched with fish oil suppress lethal Plasmodium yoelii infections in athymic and sicd/bg mice. Infect Immun 65:197–202PubMedGoogle Scholar
  91. 91.
    Garg R, Singh N, Dube A (2004) Intake of nutrient supplements affects multiplication of Leishmania donovani in hamsters. Parasitology 129:685–691PubMedGoogle Scholar
  92. 92.
    Graat JM, Schouten EG, Kok FJ (2002) Effects of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: A randomized controlled trial. JAMA 288:715–721PubMedGoogle Scholar
  93. 93.
    Meydani SN, Leka LS, Fine BC, Dallal GE, Keusch GT, Singh MF, Hamer DH (2004) Vitamin E and respiratory tract infections in elderly nursing home residents: A randomized controlled trial. JAMA 292:828–836; corrections: 2004;292: 1305 and 2007;297: 1882; discussion: 2004;292: 2834PubMedGoogle Scholar
  94. 94.
    Hemilä H (2005) Potential harm of vitamin E supplementation. Am J Clin Nutr 82:1141–1142PubMedGoogle Scholar
  95. 95.
    Hamer DH, Meydani SN (2004) Vitamin E and respiratory tract infections in elderly people. JAMA 292:2834Google Scholar
  96. 96.
    The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study Group (1994) The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330:1029–1035Google Scholar
  97. 97.
    Hemilä H, Kaprio J, Albanes D, Heinonen OP, Virtamo J (2002) Vitamin C, vitamin E, and beta-carotene in relation to common cold incidence in male smokers. Epidemiology 13:32–37PubMedGoogle Scholar
  98. 98.
    Hemilä H, Virtamo J, Albanes D, Kaprio J (2006) The effect of vitamin E on common cold incidence is modified by age, smoking and residential neighborhood. J Am Coll Nutr 25:332–339PubMedGoogle Scholar
  99. 99.
    Hemilä H, Virtamo J, Albanes D, Kaprio J (2004) Vitamin E and beta-carotene supplementation and hospital-treated pneumonia incidence in male smokers. Chest 125:557–565PubMedGoogle Scholar
  100. 100.
    Hemilä H, Virtamo J, Albanes D, Kaprio J (2003) Physical activity and the common cold in men administered vitamin E and β-carotene. Med Sci Sports Exerc 35:1815–1820PubMedGoogle Scholar
  101. 101.
    Hemilä H, Kaprio J, Albanes D, Virtamo J (2006) Physical activity and the risk of pneumonia in men administered vitamin E and β-carotene. Int J Sports Med 27:336–341PubMedGoogle Scholar
  102. 102.
    Bendich A (1989) Carotenoids and the immune response. J Nutr 119:112–115PubMedGoogle Scholar
  103. 103.
    Hughes DA (1999) Effects of carotenoids on human immune function. Proc Nutr Soc 58:713–718PubMedGoogle Scholar
  104. 104.
    Omenn GS (1998) Chemoprevention of lung cancer: The rise and demise of beta-carotene. Annu Rev Public Health 19:73–99PubMedGoogle Scholar
  105. 105.
    Chandra RK (1992) Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 340:1124–1127PubMedGoogle Scholar
  106. 106.
    Carpenter KJ, Roberts S, Sternberg S (2003) Nutrition and immune function: A 1992 report. Lancet 361:2247–2248PubMedGoogle Scholar
  107. 107.
    White C (2004) Three journals raise doubts on validity of Canadian studies. BMJ 328: 67; correction: 2004; 328: 257PubMedGoogle Scholar
  108. 108.
    Smith R (2005) Investigating the previous studies of a fraudulent author. BMJ 331:288–291PubMedGoogle Scholar
  109. 109.
    Chavance M, Herbeth B, Lemoine A, Zhu BP (1993) Does multivitamin supplementation prevent infections in healthy elderly subjects? A controlled trial. Int J Vitam Nutr Res 63:11–16PubMedGoogle Scholar
  110. 110.
    Girodon F, Lombard M, Galan P, Brunet-Lecomte P, Monget AL, Arnaud J, Preziosi P, Hercberg S (1997) Effect of micronutrient supplementation on infection in institutionalized elderly subjects. Ann Nutr Metab 41:98–107PubMedGoogle Scholar
  111. 111.
    Girodon F, Galan P, Monget AL, Boutron-Ruault MC, Brunet-Lecomte P, Preziosi P, Arnaud J, Manuguerra JC, Hercberg S (1999) Impact of trace elements and vitamin supplementation on immunity and infections in institutionalized elderly patients. Arch Intern Med 159:748–754PubMedGoogle Scholar
  112. 112.
    Barringer TA, Kirk JK, Santaniello AC, Foley KL, Michielutte R (2003) Effect of multivitamin and mineral supplement on infection and quality of life. Ann Intern Med 138:365–371PubMedGoogle Scholar
  113. 113.
    Avenell A, Campbell MK, Cook JA, Hannaford PC, Kilonzo MM, McNeill G, Milne AC, Ramsay CR, Seymour DG, Stephen AI et al. (2005) Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): Pragmatic, randomised, double blind, placebo controlled trial. BMJ 331:324–329PubMedGoogle Scholar
  114. 114.
    Liu BA, McGeer A, McArthur MA, Simor AE, Aghdassi E, Davis L, Allard JP (2007) Effect of multivitamin and mineral supplementation on episodes of infection in nursing home residents: A randomized, placebo-controlled study. J Am Geriatr Soc 55:35–42; correction: 2007; 55: 478; discussion: 2007; 55: 1311–1314PubMedGoogle Scholar
  115. 115.
    Fischer Walker C, Black RE (2004) Zinc and the risk for infectious disease. Annu Rev Nutr 24:255–275PubMedGoogle Scholar
  116. 116.
    Aggarwal R, Sentz J, Miller MA (2007) Role of zinc administration in prevention of childhood diarrhea and respiratory illnesses: A meta-analysis. Pediatrics 119:1120–1130PubMedGoogle Scholar
  117. 117.
    Coles CL, Bose A, Moses PD, Mathew L, Agarwal I, Mammen T, Santosham M (2007) Infectious etiology modifies the treatment effect of zinc in severe pneumonia. Am J Clin Nutr 86:397–403PubMedGoogle Scholar
  118. 118.
    Kurugöl Z, Akilli M, Bayram N, Koturoglu G (2006) The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children. Acta Paediatr 95:1175–1181PubMedGoogle Scholar
  119. 119.
    Kurugöl Z, Bayram N, Atik T (2007) Effect of zinc sulfate on common cold in children: Randomized, double blind study. Pediatr Int 49:842–847PubMedGoogle Scholar
  120. 120.
    Eby GA, Davis DR, Halcomb WW (1984) Reduction in duration of common cold by zinc gluconate lozenges in a double-blind study. Antimicrob Agents Chemother 25:20–24PubMedGoogle Scholar
  121. 121.
    Prasad AS (2008) Zinc in human health: Effect of zinc on immune cells. Mol Med 14:353–357PubMedGoogle Scholar
  122. 122.
    Korant BD, Butterworth BE (1976) Inhibition by zinc of rhinovirus protein cleavage: Interaction of zinc with capsid polypeptides. J Virol 18:298–306PubMedGoogle Scholar
  123. 123.
    Geist FC, Bateman JA, Hayden FG (1987) In vitro activity of zinc salts against human rhinoviruses. Antimicrob Agents Chemother 31:622–624PubMedGoogle Scholar
  124. 124.
    Suara RO, Crowe JE (2004) Effect of zinc salts on respiratory syncytial virus replication. Antimicrob Agents Chemother 48:783–790PubMedGoogle Scholar
  125. 125.
    Berg K, Bolt G, Andersen H, Owen TC (2001) Zinc potentiates the antiviral action of human IFN-alpha tenfold. J Interferon Cytokine Res 21:471–474PubMedGoogle Scholar
  126. 126.
    Novick SG, Godfrey JC, Godfrey NJ, Wilder HR (1996) How does zinc modify the common cold? Clinical observations and implications regarding mechanisms of action. Med Hypotheses 46:295–302PubMedGoogle Scholar
  127. 127.
    Novick SG, Godfrey JC, Pollack RL, Wilder HR (1997) Zinc-induced suppression of inflammation in the respiratory tract, caused by infection with human rhinovirus and other irritants. Med Hypotheses 49:347–357PubMedGoogle Scholar
  128. 128.
    Godfrey JC (1988) Zinc for the common cold. Antimicrob Agents Chemother 32:605–606PubMedGoogle Scholar
  129. 129.
    Eby GA (1988) Stability constants of zinc complexes affect common cold treatment results. Antimicrob Agents Chemother 32:606–607PubMedGoogle Scholar
  130. 130.
    Martin RB (1988) pH as a variable in free zinc ion concentration from zinc-containing lozenges. Antimicrob Agents Chemother 32:608–609PubMedGoogle Scholar
  131. 131.
    Eby GA (1997) Zinc ion availability — The determinant of efficacy in zinc lozenge treatment of common colds. J Antimicrob Chemother 40:483–493PubMedGoogle Scholar
  132. 132.
    Bakar NKA, Taylor DM, Williams DR (1999) The chemical speciation of zinc in human saliva: Possible correlation with reduction of the symptoms of the common cold produced by zinc gluconate-containing lozenges. Chem Speciat Bioavail 11:95–101Google Scholar
  133. 133.
    Eby GA (2004) Zinc lozenges: Cold cure or candy? Solution chemistry determinations. Biosci Rep 24:23–39PubMedGoogle Scholar
  134. 134.
    Smith DS, Helzner EC, Nuttall CE, Collins M, Rofman BA, Ginsberg D, Goswick CB, Magner A (1989) Failure of zinc gluconate in treatment of acute upper respiratory tract infections. Antimicrob Agents Chemother 33:646–648PubMedGoogle Scholar
  135. 135.
    Godfrey JC, Conant-Sloane B, Smith DS, Turco JH, Mercer N, Godfrey NJ (1992) Zinc gluconate and the common cold: A controlled clinical study. J Int Med Res 20:234–246PubMedGoogle Scholar
  136. 136.
    Prasad AS, Fitzgerald JT, Bao B, Beck FW, Chandrasekar PH (2008) Duration and severity of symptoms and levels of plasma interleukin-1 receptor antagonist, soluble tumor necrosis factor receptor, and adhesion molecules in patients with common cold treated with zinc acetate. J Infect Dis 197:795–802PubMedGoogle Scholar
  137. 137.
    Petrus EJ, Lawson KA, Bucci LR, Blum K (1998) Randomized, double-masked, placebo-controlled clinical study of the effectiveness of zinc acetate lonzenges on common cold symptoms in allergy-tested subjects. Curr Ther Res 59:595–607Google Scholar
  138. 138.
    Turner RB, Cetnarowski WE (2000) Effect of treatment with zinc gluconate or zinc acetate on experimental and natural colds. Clin Infect Dis 31:1202–1208; discussion in: 2001: 32: 1520PubMedGoogle Scholar
  139. 139.
    Mossad SB, Macknin ML, Medendorp SV, Mason P (1996) Zinc gluconate lozenges for treating the common cold: A randomized, double-blind, placebo-controlled study. Ann Intern Med 125:81–88PubMedGoogle Scholar
  140. 140.
    Prasad AS, Fitzgerald JT, Bao B, Beck FW, Chandrasekar PH (2000) Duration of symptoms and plasma cytokine levels in patients with the common cold treated with zinc acetate; a randomized, double-blind, placebo-controlled trial. Ann Intern Med 133:245–252PubMedGoogle Scholar
  141. 141.
    Douglas RM, Miles HB, Moore BW, Ryan P, Pinnock CB (1987) Failure of effervescent zinc acetate lozenges to alter the course of upper respiratory infection in Australian adults. Antimicrob Agents Chemother 31:1263–1265PubMedGoogle Scholar
  142. 142.
    Macknin ML, Piedmonte M, Calendine C, Janosky J, Wald E (1998) Zinc gluconate lozenges for treating the common cold in children: A randomized controlled trial. JAMA 279:1962–1967PubMedGoogle Scholar
  143. 143.
    Weismann K, Jakobsen JP, Weismann JE, Hammer UM, Nyholm SM, Hansen B, Lomholt KE, Schmidt K (1990) Zinc gluconate lozenges for common cold: A double-blind clinical trial. Dan Med Bull 37:279–281PubMedGoogle Scholar
  144. 144.
    Zarembo JE, Godfrey JC, Godfrey NJ (1992) Zinc(II) in saliva: Determination of concentrations produced by different formulations of zinc gluconate lozenges containing common excipients. J Pharm Sci 81:128–130PubMedGoogle Scholar
  145. 145.
    Al-Nakib W, Higgins PG, Barrow I, Batstone G, Tyrrell DA (1987) Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges. J Antimicrob Chemother 20:893–901PubMedGoogle Scholar
  146. 146.
    Farr BM, Conner EM, Betts RF, Oleske J, Minnefor A, Gwaltney JM (1987) Two randomized controlled trials of zinc gluconate lozenge therapy of experimentally induced rhinovirus colds. Antimicrob Agents Chemother 31:1183–1187PubMedGoogle Scholar
  147. 147.
    Simkin PA (1976) Oral zinc sulphate in rheumatoid arthritis. Lancet 2:539–542PubMedGoogle Scholar
  148. 148.
    Prasad AS, Brewer GJ, Schoomaker EB, Rabbani P (1978) Hypocupremia induced by zinc therapy in adults. JAMA 240:2166–2168PubMedGoogle Scholar
  149. 149.
    Hoffman HN, Phyliky RL, Fleming CR (1988) Zinc-induced copper deficiency. Gastroenterology 94:508–512PubMedGoogle Scholar
  150. 150.
    Samman S, Roberts DC (1987) The effect of zinc supplements on plasma zinc and copper levels and the reported symptoms in healthy volunteers. Med J Aust 146:246–249PubMedGoogle Scholar
  151. 151.
    Jafek BW, Linschoten MR, Murrow BW (2004) Anosmia after intranasal zinc gluconate use. Am J Rhinol 18:137–141PubMedGoogle Scholar
  152. 152.
    Alexander TH, Davidson TM (2006) Intranasal zinc and anosmia: The zinc-induced anosmia syndrome. Laryngoscope 116:217–220; discussion: 2006;116: 1720–1723PubMedGoogle Scholar
  153. 153.
    Jackson JL, Peterson C, Lesho E (1997) A meta-analysis of zinc salts lozenges and the common cold. Arch Intern Med 157:2373–2376PubMedGoogle Scholar
  154. 154.
    Jackson JL, Lesho E, Peterson C (2000) Zinc and the common cold: A meta-analysis revisited. J Nutr 130 (5S Suppl):1512S–1515SPubMedGoogle Scholar
  155. 155.
    Thompson SG (1994) Why sources of heterogeneity in meta-analysis should be investigated. BMJ 309:1351–1355PubMedGoogle Scholar
  156. 156.
    Caruso TJ, Prober CG, Gwaltney JM (2007) Treatment of naturally acquired common colds with zinc: A structured review. Clin Infect Dis 45:569–574PubMedGoogle Scholar
  157. 157.
    Chalmers TC, Smith H, Blackburn B, Silverman B, Schroeder B, Reitman D, Ambroz A (1981) A method for assessing the quality of a randomized control trial. Control Clin Trials 2:31–49PubMedGoogle Scholar
  158. 158.
    Higgins JPT, Green S (eds) (2008) Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. [updated September 2008]. Section 8.3.3. The Cochrane Collaboration. Available at: (accessed 29 December 2008)Google Scholar
  159. 159.
    Balk EM, Bonis PA, Moskowitz H, Schmid CH, Ioannidis JP, Wang C, Lau J (2002) Correlation of quality measures with estimates of treatment effect in meta-analyses of randomized controlled trials. JAMA 287:2973–2982PubMedGoogle Scholar
  160. 160.
    Glasziou P, Chalmers I, Rawlins M, McCulloch P (2007) When are randomised trials unnecessary? Picking signal from noise. BMJ 334:349–351PubMedGoogle Scholar
  161. 161.
    Eby GA (2008) Therapeutic effectiveness of ionic zinc for common colds. Clin Infect Dis 46:483–484PubMedGoogle Scholar
  162. 162.
    Council of Scientific Affairs, American Medical Association (1987) Vitamin preparations as dietary supplements and as therapeutic agents. JAMA 257: 1929–1936Google Scholar
  163. 163.
    Caruso TJ, Gwaltney JM (2005) Treatment of the common cold with Echinacea: A structured review. Clin Infect Dis 40:807–810PubMedGoogle Scholar
  164. 164.
    Hemilä H (2005) Echinacea, vitamin C, the common cold, and blinding. Clin Infect Dis 41:762–763PubMedGoogle Scholar
  165. 165.
    Richards E (1988) The politics of therapeutic evaluation: The vitamin C and cancer controversy. Soc Stud Sci 18:653–701Google Scholar
  166. 166.
    Richards E (1991) Vitamin C and Cancer: Medicine or Politics? St Martins Press, New YorkGoogle Scholar
  167. 167.
    Galloway J (1991) Crusades and rackets. Nature 353:125Google Scholar
  168. 168.
    Segerstråle U (1992) Vitamin C and cancer — Medicine or politics. Science 255: 613–615PubMedGoogle Scholar
  169. 169.
    Huxtable RJ (1992) C for controversy. Trends Pharmacol Sci 13:82–83Google Scholar
  170. 170.
    Goodwin JS, Tangum MR (1998) Battling quackery: Attitudes about micronutrient supplements in American Academic medicine. Arch Intern Med 158: 2187–2191PubMedGoogle Scholar
  171. 171.
    Vandenbroucke JP, de Craen AJM (2001) Alternative medicine: A mirror image for scientific reasoning in conventional medicine. Ann Intern Med 135: 507–513PubMedGoogle Scholar
  172. 172.
    Goodwin JS, Goodwin JM (1981) Failure to recognize efficacious treatments: A history of salicylate therapy in rheumatoid arthritis. Perspect Biol Med 31: 78–92Google Scholar
  173. 173.
    Goodwin JS, Goodwin JM (1984) The tomato effect: Rejection of highly efficacious therapies. JAMA 251:2387–2390PubMedGoogle Scholar
  174. 174.
    Barber B (1961) Resistance by scientists to scientific discovery. Science 134: 596–602PubMedGoogle Scholar
  175. 175.
    Gonzales R, Sande M (1995) What will it take to stop physicians from prescribing antibiotics in acute bronchitis? Lancet 345:665–666PubMedGoogle Scholar

Copyright information

© Birkhäuser Verlag Basel/Switzerland 2009

Authors and Affiliations

  • Harri Hemilä
    • 1
  1. 1.Department of Public HealthUniversity of HelsinkiHelsinkiFinland

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