Medicine For People!

February 2020: Zinc Acetate for COVID-19 and the Common Cold

Life Extension Zinc Lozenges

Zinc Acetate for COVID-19 and the Common Cold

• Only Certain Zinc Lozenges Work
• More Remedies for the Common Cold
• What Doesn’t Work
• Colds and Children

The title of this newsletter has been changed to reflect that a physician at the George Washington School of Medicine has reported on four consecutive patients with COVID-19 who were given zinc lozenges for symptomatic COVID-19 with positive results.   Hundreds of other medical journal articles report on the mechanisms of and potential benefit of zinc for this illness.  The remainder of this newsletter is as it originally appeared.

They say we doctors can't cure the common cold, but we haven't stopped trying.

The secret remedy I am sharing today is the zinc acetate lozenge. Read on and you'll learn what we know about that and other effective remedies, and about some older remedies that don't work.

Only Certain Zinc Lozenges Work

Most zinc lozenges and tablets don't work because they don't release zinc in its charged form, which is what we call ionized. However, zinc acetate releases this most effective form of zinc, killing cold viruses and supercharging our own immune system. [1] It can reduce the duration of a cold by about 1/3.

The ones that work are those developed by George Eby and now sold through LifeExtension as “Enhanced Zinc Lozenges.”

They are about the size of a blueberry, the shape of a thickened hockey puck, and dissolve about as easily as a small rock.  When I use them, I put a tiny dish by my bed to put the partially dissolved tablet in after I've sucked on it for a while. These lozenges really dry out your throat, and that's about the time I take them out. Once the dryness goes away, I pick it up and start again.  For me, they are often effective in preventing the cold from developing in the first place, because I keep them on hand and pull the trigger quickly if I think I need them.

There are dozens of ineffective brands of zinc lozenge in the market.Your best bet is to buy these specific zinc lozenges now so you will be ready and, hopefully, not need anything else.

More Remedies for the Common Cold

Naproxen (Aleve) and ibuprofen will help take away the sore throat and aches and pains.

Decongestants and antihistamines will slow down your runny nose. They don't help cough.

Over the years I have probably prescribed gallons of codeine-containing cough medicine. I don't doubt that it makes people feel better.  My academic colleagues now tell me that it is no better than a sugar pill when it comes to relieving cough.  What does work is prescription ipratropium nasal spray (currently about $25).  Scroll to the bottom for the side effects.  Don't bother trying to pronounce it—just ask your doctor for a prescription so you and your bedmate can get some sleep.

What Doesn't Work 

While rinsing your nose with saline helps sinus infections, it's not so great for a cold.Snorting saline into your nostrils doesn't hold up too well in the double-blind tests, nor does n-acetylcysteine, echinacea or garlic.

Important Note! Double-blind studies have their limitations, so if you do have a pet remedy that works well for you, don't stop.

Antivirals, at least the ones we have now, don't work for common colds.

Antibiotics don't work for colds, sinus infections, viral sore throats, or bronchitis.All they do is mess up your normal helpful bacteria, so don't!

Colds and Children

The guidelines are a little different for children.

Do:

Give children two years of age or older acetylcysteine if needed for cough.  It's available without prescription. It is also called NAC, n-acetylcysteine and n-acetyl-L-cysteine.

If your children are old enough to sniff saline into their nose, that can help a stuffy or runny nose.  Use 1/4 teaspoon salt to 8 ounces of water.

Honey can cause infection in children under the age of one, but is recommended over the age of two—to be safe—at a dose of ½ teaspoon up to the age of five years, a teaspoon up to the age of 11 years, and 2 teaspoons up to the age of 18.Once daily is all it takes.

A bedtime application to the neck and chest of an ointment including camphor, menthol, and eucalyptus oil helps.  I am generally not hankering to go back and live childhood over again, but I would go back for this.

Don't:

Don't use ipratropium for cough in children under the age of five.  Over 5 years, yes, it can help runny nose but not congestion. Neither codeine nor dextromethorphan helps cough in children. Don't push fluids; it seems to make things worse.

The Last Word

Get yourself the specific zinc lozenges noted above. I have been using and recommending these since the late 1980s under several brand names.  Different manufacturers do not always get them right.  For now, this is the only brand I know of that is effective.   And no, I don't own stock in the company.

Appendix

The only side effect of ipratropium I have ever observed is dry mouth. The World Health Organization carries it on its list of the safest and most effective essential medications.  Nonetheless, as with anything including milk or peanuts,  ipratropium makes some people wish they hadn't taken it. Sometimes it makes cough worse, interferes with bladder function, makes glaucoma worse, or causes minor problems. But not very often.

Acknowledgments

George Eby, a city planner in Austin, Texas discovered the value of zinc for the common cold and published his research in the early 1980s. Subsequent trials of zinc produced mixed results until researchers accepted that only highly ionized zinc salts were effective.

For the rest of the information in this newsletter I relied on an article by Doctors DeGeorge, Ring and Dalrymple of the Department of Family Medicine at the University of Virginia, published in the American Family Physician of September 1, 2019. To my surprise, they let me know that highly ionized zinc as described above is now generally recognized as effective.

Technical Endnote

[1] Med Hypotheses. 2010 Mar;74(3):482-92. doi: 10.1016/j.mehy.2009.10.017. Epub 2009 Nov 10.

Zinc lozenges as cure for the common cold--a review and hypothesis.Eby GA 3rd

Abstract

A 7-day reduction in duration of common colds was shown by Eby et al. in 1984 using 23mg zinc gluconate throat lozenges. Over the following 25 years, 14 double-blind, placebo-controlled, randomized clinical trials produced widely differing results with about one-half showing success and the remainder showing failure. Positively charged, ionic zinc (iZn), but not bound zinc, is strongly astringent, antirhinoviral, increases interferon-gamma (IFN-gamma) 10-fold, inhibits intercellular adhesion molecule-1 (ICAM-1) and inhibits the release of vasoactive ingredients from mast cell granules. Solution equilibrium chemistry analytical techniques showed lozenge iZn fraction varying from 0% to 100% of total lozenge zinc between trials, with zinc acetate (ZA) releasing 100% iZn, zinc gluconate (ZG) releasing 72% iZn and other zinc compounds releasing much less or none at physiologic pH 7.4. Since only iZn has in vitro benefits, iZn variations are hypothesized to have produced the widely varying clinical results. In support of the iZn hypothesis, lozenge iZn and total daily iZn in trials were found highly correlated with reductions in common cold durations with statistical significance for mean duration (P<0.001) and median duration (P<0.004), while total zinc (iZn plus bound) showed no correlation with changes in duration. Duration reductions (mean 0 days, median 0.43 days) for multi-ligand ZG and ZA lozenges differed significantly from duration reductions (mean 3.37 days, median 2.9 days) for single ligand ZA and ZG lozenges (P<0.001) showing that additive ligands as flavor-masks damaged or eliminated efficacy. Five of 6 trials with lozenges whose zinc compositions had a first stability constant of 1.7 or less succeeded, while only 2 of 9 trials of lozenges with higher stability succeeded (P<0.02). From the strong, multiple statistical relationships found, it is inferred that iZn is the active ingredient in zinc lozenges for colds, as it is in vitro against rhinoviruses, and that solution chemistry analytical techniques used at physiological pH are correct means for lozenge iZn analysis. Zinc lozenges slowly dissolving in the mouth over a 20-30 min period releasing adequate iZn (18 mg) used each 2h are hypothesized to shorten common colds by 6-7 days, which is a cure for the common cold. Due to inadequate lozenge iZn very few of more than 40 different brands of zinc lozenges on the US market are expected to have any effect on the duration or severity of common colds.

 

Thanks to my editor, Jill Buhler Rienstra.

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Medicine for People! is published by Douwe Rienstra, MD at Port Townsend, Washington.