Skip to main content
Intended for healthcare professionals
Free access
Research article
First published online February 1, 2012

A Combination of High-Dose Vitamin C plus Zinc for the Common Cold

S Maggini [email protected], S Beveridge, and M SuterView all authors and affiliations
All Articles
https://doi.org/10.1177/147323001204000104

Abstract

Vitamin C and zinc play important roles in nutrition, immune defence and maintenance of health. Intake of both is often inadequate, even in affluent populations. The common cold continues to place a great burden on society in terms of suffering and economic loss. After an overview of the literature on the effects of the separate administration of either vitamin C or zinc against the common cold, this article presents data from two preliminary, double-blind, randomized, placebo-controlled trials, conducted with a combination of 1000 mg vitamin C plus 10 mg zinc in patients with the common cold. In both studies, a nonsignificant reduction of rhinorrhoea duration (range 9 – 27%) was seen. In pooled analyses of both studies (n = 94), vitamin C plus zinc was significantly more efficient than placebo at reducing rhinorrhoea over 5 days of treatment. Furthermore, symptom relief was quicker and the product was well tolerated. In view of the burden associated with the common cold, supplementation with vitamin C plus zinc may represent an efficacious measure, with a good safety profile, against this infectious viral disease.

References

1. Carr AC, Frei B: Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr 1999; 69: 1086–1107.
Crossref
PubMed
ISI
Google Scholar
2. Maggini S, Wenzlaff S, Hornig D: Essential role of vitamin C and zinc in child immunity and health. J Int Med Res 2010; 38: 386–414.
Crossref
PubMed
ISI
Google Scholar
3. Wintergerst ES, Maggini S, Hornig DH: Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Ann Nutr Metab 2006; 50: 85–94.
Crossref
PubMed
ISI
Google Scholar
4. Stefanidou M, Maravelias C, Dona A, et al: Zinc: A multipurpose trace element. Arch Toxicol 2006; 80: 1–9.
Crossref
PubMed
ISI
Google Scholar
5. Plum LM, Rink L, Haase H: The essential toxin: impact of zinc on human health. Int J Environ Res Public Health 2010; 7: 1342–1365.
Crossref
PubMed
ISI
Google Scholar
6. Field CJ, Johnson IR, Schley PD: Nutrients and their role in host resistance to infection. J Leukoc Biol 2002; 71: 16–32.
PubMed
ISI
Google Scholar
7. Erickson KL, Medina EA, Hubbard NE: Micronutrients and innate immunity. J Infect Dis 2000; 182 (suppl 1): S5–S10.
Crossref
PubMed
ISI
Google Scholar
8. Anderson R, Smit MJ, Joone GK, et al. Vitamin C and cellular immune functions. Protection against hypochlorous acid-mediated inactivation of glyceraldehyde-3-phosphate dehydrogenase and ATP generation in human leukocytes as a possible mechanism of ascorbate-mediated immunostimulation. Ann N Y Acad Sci 1990; 587: 34–48.
Crossref
PubMed
ISI
Google Scholar
9. Bhaskaram P: Micronutrient malnutrition, infection, and immunity: an overview. Nutr Rev 2002; 60: S40–S45.
Crossref
PubMed
ISI
Google Scholar
10. Panush RS, Delafuente JC, Katz P, et al: Modulation of certain immunologic responses by vitamin C. III. Potentiation of in vitro and in vivo lymphocyte responses. Int J Vitam Nutr Res Suppl 1982; 23: 35–47.
PubMed
Google Scholar
11. Ströhle A, Hahn A: Vitamin C and immune function. Med Monatsschr Pharm 2009; 32: 49–54 [in German, English abstract].
PubMed
Google Scholar
12. Kennes B, Dumont I, Brohee D, et al. Effect of vitamin C supplements on cell-mediated immunity in old people. Gerontology 1983; 29: 305–310.
Crossref
PubMed
ISI
Google Scholar
13. Keen CL, Gershwin ME: Zinc deficiency and immune function. Annu Rev Nutr 1990; 10: 415–431.
Crossref
PubMed
ISI
Google Scholar
14. Salgueiro MJ, Zubillaga M, Lysionek A, et al: Zinc status and immune system relationship: A review. Biol Trace Elem Res 2000; 76: 193–205.
Crossref
PubMed
ISI
Google Scholar
15. Tapiero H, Tew KD: Trace elements in human physiology and pathology: zinc and metallothioneins. Biomed Pharmacother 2003; 57: 399–411.
Crossref
PubMed
ISI
Google Scholar
16. Dardenne M, Bach J-F: Rationale for the mechanism of zinc interaction in the immune system. In: Nutrient Modulation of the Immune Response (Cunningham-Rundles S ed). New York: Marcel Dekker Inc., 1993; pp 501–509.
Google Scholar
17. Prasad AS: Zinc: an overview. Nutrition 1995; 11 (1 suppl): 93–99.
PubMed
ISI
Google Scholar
18. Knight JA: Review: Free radicals, antioxidants, and the immune system. Ann Clin Lab Sci 2000; 30: 145–158.
PubMed
ISI
Google Scholar
19. Meydani SN, Wu D, Santos MS, et al: Antioxidants and immune response in aged persons: overview of present evidence. Am J Clin Nutr 1995; 62 (6 suppl): 1462S–1476S.
Crossref
PubMed
ISI
Google Scholar
20. Deruelle F, Baron B: Vitamin C: is supplementation necessary for optimal health? J Altern Complement Med 2008; 14: 1291–1298.
Crossref
PubMed
ISI
Google Scholar
21. Hemilä H, Douglas RM: Vitamin C and acute respiratory infections. Int J Tuberc Lung Dis 1999; 3: 756–761.
PubMed
ISI
Google Scholar
22. Ströhle A, Wolters M, Hahn A: Micronutrients at the interface between inflammation and infection ascorbic acid and calciferol. Part 1: general overview with a focus on ascorbic acid. Inflamm Allergy Drug Targets 2011; 10: 54–63.
Crossref
PubMed
Google Scholar
23. Fabris N, Mocchegiani E: Zinc, human diseases and aging. Aging (Milano) 1995; 7: 77–93.
PubMed
Google Scholar
24. Fendrick AM, Monto AS, Nightengale B, et al: The economic burden of non-influenza-related viral respiratory tract infection in the United States. Arch Intern Med 2003; 163: 487–494.
Crossref
PubMed
Google Scholar
25. Heikkinen T, Järvinen A: The common cold. Lancet 2003; 361: 51–59.
Crossref
PubMed
ISI
Google Scholar
26. Singh M, Das RR: Zinc for the common cold. Cochrane Database Syst Rev 2011; 2: CD001364.
Google Scholar
27. Lorber B: The common cold. J Gen Intern Med 1996; 11: 229–236.
Crossref
PubMed
ISI
Google Scholar
28. Mayo Clinic Staff: Common cold. Prevention. Rochester: Mayo Clinic Foundation for Medical Education and Research (available at: www.mayoclinic.com/health/common-cold/DS00056/DSECTION=prevention).
Google Scholar
29. Kallner AB, Hartmann D, Hornig DH: On the requirements of ascorbic acid in man: steady-state turnover and body pool in smokers. Am J Clin Nutr 1981; 34: 1347–1355.
Crossref
PubMed
ISI
Google Scholar
30. Huttunen R, Heikkinen T, Syrjänen J: Smoking and the outcome of infection. J Intern Med 2011; 269: 258–269.
Crossref
PubMed
ISI
Google Scholar
31. Nuorti JP, Butler JC, Farley MM, et al: Cigarette smoking and invasive pneumococcal disease. N Engl J Med 2000; 342: 681–689.
Crossref
PubMed
ISI
Google Scholar
32. Shah SA, Sander S, White CM, et al: Evaluation of echinacea for the prevention and treatment of the common cold: A meta-analysis. Lancet Infect Dis 2007; 7: 473–480.
Crossref
PubMed
ISI
Google Scholar
33. De Vecchi E, Drago L: Propolis’ antimicrobial activity: what's new? Infez Med 2007; 15: 7–15 [in Italian, English abstract].
PubMed
Google Scholar
34. McElhaney JE, Goel V, Toane B, et al: Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: A randomized, double-blinded, placebo controlled trial. J Altern Complement Med 2006; 12: 153–157.
Crossref
PubMed
ISI
Google Scholar
35. Scaglione F, Cattaneo G, Alessandria M, et al: Efficacy and safety of the standardised Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold [corrected]. Drugs Exp Clin Res 1996; 22: 65–72.
PubMed
Google Scholar
36. Talbott S, Talbott J: Effect of beta 1,3/1,6 glucan on upper respiratory tract infection symptoms and mood state in marathon athletes. J Sports Sci Med 2009; 8: 509–515.
PubMed
ISI
Google Scholar
37. Talbott S, Talbott J: Beta 1,3/1,6 glucan decreases upper respiratory tract infection symptoms and improves psychological well-being in moderate to highly-stressed subjects. Agro Food Industry Hi-Tech 2010; 21: 21–24.
Google Scholar
38. Meydani SN, Han SN, Wu D: Vitamin E and immune response in the aged: molecular mechanisms and clinical implications. Immunol Rev 2005; 205: 269–284.
Crossref
PubMed
ISI
Google Scholar
39. Anderson TW, Beaton GH, Corey P, et al: Winter illness and vitamin C: the effect of relatively low doses. Can Med Assoc J 1975; 112: 823–826.
PubMed
ISI
Google Scholar
40. Jaffe GM: Vitamin C. New York: Marcel Dekker, 1984; pp 199–244.
Google Scholar
41. Hume R, Weyers E: Changes in leucocyte ascorbic acid during the common cold. Scott Med J 1973; 18: 3–7.
Crossref
PubMed
ISI
Google Scholar
42. Chalmers TC: Effects of ascorbic acid on the common cold. An evaluation of the evidence. Am J Med 1975; 58: 532–536.
Crossref
PubMed
ISI
Google Scholar
43. Hemilä H, Herman ZS: Vitamin C and the common cold: A retrospective analysis of Chalmers’ review. J Am Coll Nutr 1995; 14: 116–123.
Crossref
PubMed
ISI
Google Scholar
44. Hemilä H: Vitamin C supplementation and common cold symptoms: problems with inaccurate reviews. Nutrition 1996; 12: 804–809.
Crossref
PubMed
ISI
Google Scholar
45. Hemilä H: Does vitamin C alleviate the symptoms of the common cold? A review of current evidence. Scand J Infect Dis 1994; 26: 1–6.
Crossref
PubMed
Google Scholar
46. Hemilä H: Vitamin C supplementation and common cold symptoms: factors affecting the magnitude of the benefit. Med Hypotheses 1999; 52: 171–178.
Crossref
PubMed
ISI
Google Scholar
47. Douglas RM, Hemilä H, Chalker E, et al: Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 2007; 3: CD000980.
Google Scholar
48. Gorton HC, Jarvis K: The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manipulative Physiol Ther 1999; 22: 530–533.
Crossref
PubMed
ISI
Google Scholar
49. Anderson TW, Suranyi G, Beaton GH: The effect on winter illness of large doses of vitamin C. Can Med Assoc J 1974; 111: 31–36.
PubMed
ISI
Google Scholar
50. Heimer KA, Hart AM, Martin LG, et al: Examining the evidence for the use of vitamin C in the prophylaxis and treatment of the common cold. J Am Acad Nurse Pract 2009; 21: 295–300.
Crossref
PubMed
Google Scholar
51. Korant BD, Kauer JC, Butterworth BE: Zinc ions inhibit replication of rhinoviruses. Nature 1974; 248: 588–590.
Crossref
PubMed
ISI
Google Scholar
52. Jackson JL, Lesho E, Peterson C: Zinc and the common cold: A meta-analysis revisited. J Nutr 2000; 130 (5S suppl): 1512S–1515S.
Crossref
PubMed
ISI
Google Scholar
53. Marshall I: Zinc for the common cold. Cochrane Database Syst Rev 2000; 2: CD001364.
Google Scholar
54. Hemilä H: Zinc lozenges may shorten the duration of colds: A systematic review. Open Respir Med J 2011; 5: 51–58.
Crossref
PubMed
Google Scholar
55. Kurugöl Z, Akilli M, Bayram N, et al: The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children. Acta Paediatr 2006; 95: 1175–1181.
Crossref
PubMed
ISI
Google Scholar
56. Vakili R, Vahedian M, Khodaei G, et al: Effects of zinc supplementation in occurrence and duration of common cold in school aged children during cold season: A double-blind placebo-controlled trial. Iran J Pediatr 2009; 19: 376–380.
ISI
Google Scholar
57. Turner RB, Cetnarowski WE: Effect of treatment with zinc gluconate or zinc acetate on experimental and natural colds. Clin Infect Dis 2000; 31: 1202–1208.
Crossref
PubMed
ISI
Google Scholar
58. EFSA (European Food Safety Authority): Tolerable Upper Intake Levels for Vitamins and Minerals. Scientific Committee on Food and Scientific Panel on Dietetic Products, Nutrition and Allergies 2006 Parma: EFSA (available at: http://www.efsa.europa.eu/en/ndatopics/docs/ndatolerableuil.pdf).
Google Scholar
59. Institute of Medicine: Vitamin C. In: Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium and Carotenoids: A Report of the Panel on Micronutrients, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes; Food and Nutrition Board, Institute of Medicine. Washington, DC: National Academic Press, 2000; pp 95–185.
Google Scholar
60. Institute of Medicine: Zinc. In: Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc: A Report of the Panel on Micronutrients, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes; Food and Nutrition Board, Institute of Medicine. Washington, DC: National Academy Press, 2001; pp 442–501.
Google Scholar
61. Maggini S: Vitamins and minerals: contribution to immune function and health. In: Dietary Components and Immune Function (Watson RR, Zibadi S, Preedy VR eds). New York: Springer Science+Business Media LLC, 2010; pp 227–252.
Crossref
Google Scholar
62. World Health Organization (WHO): The Global Burden of Disease. 2004 Update. Geneva: WHO, 2008.
Google Scholar
63. Khanna M, Kumar P, Choudhary K, et al. Emerging influenza virus: A global threat. J Biosci 2008; 33: 475–482.
Crossref
PubMed
ISI
Google Scholar
64. Maines TR, Szretter KJ, Perrone L, et al: Pathogenesis of emerging avian influenza viruses in mammals and the host innate immune response. Immunol Rev 2008; 225: 68–84.
Crossref
PubMed
ISI
Google Scholar
65. Kuiken T, Taubenberger JK: Pathology of human influenza revisited. Vaccine 2008; 26 (suppl 4): D59–D66.
Crossref
PubMed
ISI
Google Scholar
66. Michaelis M, Doerr HW, Cinatl J Jr: Of chickens and men: avian influenza in humans. Curr Mol Med 2009; 9: 131–151.
Crossref
PubMed
ISI
Google Scholar
67. Pappaioanou M: Highly pathogenic H5N1 avian influenza virus: cause of the next pandemic? Comp Immunol Microbiol Infect Dis 2009; 32: 287–300.
Crossref
PubMed
ISI
Google Scholar
68. Chowell G, Bertozzi SM, Colchero MA, et al: Severe respiratory disease concurrent with the circulation of H1N1 influenza. N Engl J Med 2009; 361: 674–679.
Crossref
PubMed
ISI
Google Scholar
69. Perez-Padilla R, de la Rosa-Zamboni D, de Leon S Ponce, et al: Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 2009; 361: 680–689.
Crossref
PubMed
ISI
Google Scholar
70. Desselberger U: Emerging and re-emerging infectious diseases. J Infect 2000; 40: 3–15.
Crossref
PubMed
ISI
Google Scholar
71. Daszak P, Cunningham AA, Hyatt AD: Emerging infectious diseases of wildlife—threats to biodiversity and human health. Science 2000; 287: 443–449.
Crossref
PubMed
ISI
Google Scholar
72. Binder S, Levitt AM, Sacks JJ, et al: Emerging infectious diseases: public health issues for the 21st century. Science 1999; 284: 1311–1313.
Crossref
PubMed
ISI
Google Scholar
73. Albers R, Antoine JM, Sicard R Bourdet, et al: Markers to measure immunomodulation in human nutrition intervention studies. Br J Nutr 2005; 94: 452–481.
Crossref
PubMed
ISI
Google Scholar
74. Delves PJ, Roitt IM: The immune system. Second of two parts. N Engl J Med 2000; 343: 108–117.
Crossref
PubMed
ISI
Google Scholar
75. Delves PJ, Roitt IM: The immune system. First of two parts. N Engl J Med 2000; 343: 37–49.
Crossref
PubMed
ISI
Google Scholar
76. Parkin J, Cohen B: An overview of the immune system. Lancet 2001; 357: 1777–1789.
Crossref
PubMed
ISI
Google Scholar

Cite article

Cite article

Cite article

OR

Download to reference manager

If you have citation software installed, you can download article citation data to the citation manager of your choice

Share options

Share

Share this article

Share with email
EMAIL ARTICLE LINK
Share on social media

Share access to this article

Sharing links are not relevant where the article is open access and not available if you do not have a subscription.

For more information view the Sage Journals article sharing page.

Information, rights and permissions

Information

Published In

Volume 40, Issue 1
Pages: 28 - 42
Article first published online: February 1, 2012
Issue published: February 2012

Keywords

  1. Vitamin C
  2. Zinc
  3. Micronutrients
  4. Common cold
  5. Respiratory infections
  6. Immune system

Rights and permissions

© 2012 SAGE Publications.
Request permissions for this article.
PubMed: 22429343

Authors

Affiliations

S Maggini
Bayer Consumer Care Ltd, Basel, Switzerland
[email protected]
View all articles by this author
S Beveridge
Bayer Consumer Care Ltd, Basel, Switzerland
View all articles by this author
M Sutera
Basel, Switzerland
View all articles by this author

Notes

Author's address for correspondence Dr Silvia Maggini Bayer Consumer Care Ltd, Peter-Merian-Strasse 84, Postbox 4002, Basel, Switzerland. E-mail: [email protected]
a
M Suter is a retired employee of Roche Consumer Health, Basel, Switzerland.

Metrics and citations

Metrics

Journals metrics

This article was published in Journal of International Medical Research.

VIEW ALL JOURNAL METRICS

Article usage*

Total views and downloads: 82708

*Article usage tracking started in December 2016

Altmetric

See the impact this article is making through the number of times it’s been read, and the Altmetric Score.
Learn more about the Altmetric Scores


Articles citing this one

Receive email alerts when this article is cited

Web of Science: 31 view articles Opens in new tab

Crossref: 39

  1. Bone Formation and Maintenance in Oral Surgery: The Decisive Role of t...
    Go to citation Crossref Google Scholar
  2. Nutrient synergy: definition, evidence, and future directions
    Go to citation Crossref Google Scholar
  3. The Effect of Vitamin C and N-Acetylcysteine on Tendon-to-Bone Healing...
    Go to citation Crossref Google ScholarPub Med
  4. COVID-19 Therapeutics: Use, Mechanism of Action, and Toxicity (Xenobio...
    Go to citation Crossref Google Scholar
  5. Vitamin C
    Go to citation Crossref Google Scholar
  6. Immunonutrition and (its impact on) health. Micronutrients and debilit...
    Go to citation Crossref Google Scholar
  7. Communicable Illness Mitigation Strategies for Traveling Elite Sportin...
    Go to citation Crossref Google ScholarPub Med
  8. Immunity-enhancing Micronutrients and Community Pharmacists: An Opport...
    Go to citation Crossref Google Scholar
  9. Supply of Antioxidants vs. Recruit Firefighters’ Cellular Immune Statu...
    Go to citation Crossref Google Scholar
  10. Healthy eating – a modifiable contributor to optimize healthy living i...
    Go to citation Crossref Google Scholar
  11. Vitamin C
    Go to citation Crossref Google Scholar
  12. Vitamin C
    Go to citation Crossref Google Scholar
  13. Pharmacist’s recommendations of over-the-counter treatments for the co...
    Go to citation Crossref Google Scholar
  14. Influence of SARS-CoV-2 acute respiratory viral disease on pregnancy a...
    Go to citation Crossref Google Scholar
  15. Foods as First Defense Against COVID-19
    Go to citation Crossref Google Scholar
  16. Analysis of ascorbic acid content (vitamin C) of purslane (Portulaca o...
    Go to citation Crossref Google Scholar
  17. Effect of Vitamin C Supplements on Respiratory Tract Infections: A Sys...
    Go to citation Crossref Google Scholar
  18. The efficacy of a compounded micronutrient supplement on the incidence...
    Go to citation Crossref Google Scholar
  19. The Effect of a Multivitamin and Mineral Supplement on Immune Function...
    Go to citation Crossref Google Scholar
  20. Zinc Supplementation Reduces Common Cold Duration among Healthy Adults...
    Go to citation Crossref Google Scholar
  21. Individual risk management strategy and potential therapeutic options ...
    Go to citation Crossref Google Scholar
  22. Association of Comorbidities with Coronavirus Disease 2019: A Review
    Go to citation Crossref Google Scholar
  23. Diet composition has a differential effect on immune tolerance in inse...
    Go to citation Crossref Google Scholar
  24. Clinical Effect of Intravenous Vitamin C on Viral Myocarditis in Child...
    Go to citation Crossref Google Scholar
  25. Immune Function and Micronutrient Requirements Change over the Life Co...
    Go to citation Crossref Google Scholar
  26. Potential common factors associated with predisposition to common cold...
    Go to citation Crossref Google Scholar
  27. Antioxidant treatment with vitamin C attenuated rotator cuff degenerat...
    Go to citation Crossref Google Scholar
  28. Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, ...
    Go to citation Crossref Google Scholar
  29. Combination of anti-tuberculosis drugs with vitamin C or NAC against d...
    Go to citation Crossref Google Scholar
  30. Crystal Structure of Feline Infectious Peritonitis Virus Main Protease...
    Go to citation Crossref Google Scholar
  31. The Medicinal Value and the Numerous Sources of Vitamin C - A Review
    Go to citation Crossref Google Scholar
  32. Micronutrients and Ginseng for Immune Support in Older Adults
    Go to citation Crossref Google Scholar
  33. The Common Cold: Potential for Future Prevention or Cure
    Go to citation Crossref Google Scholar
  34. Trade-Offs Between Anti-Aging Dietary Supplementation and Exercise
    Go to citation Crossref Google Scholar
  35. A–Z of nutritional supplements: dietary supplements, sports nutrition ...
    Go to citation Crossref Google Scholar
  36. Vitamin C for preventing and treating the common cold
    Go to citation Crossref Google Scholar
  37. Efficacy and Safety of High-dose Vitamin C on Complex Regional Pain Sy...
    Go to citation Crossref Google Scholar
  38. Electrocatalytic Oxidation of Ascorbic Acid on Quaternized Carbon Nano...
    Go to citation Crossref Google Scholar
  39. Development of a Cyclic Voltammetry Method for DNA Electrochemical Det...
    Go to citation Crossref Google Scholar

Figures and tables

Figures & Media

Tables

View Options

View options

PDF/ePub

View PDF/ePub

Get access

Access options

If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:

Alternatively, view purchase options below:

Purchase 24 hour online access to view and download content.

Subscribe to this journal

Access journal content via a DeepDyve subscription or find out more about this option.

Start 2 week free trial
Need help?
Download PDF

Also from Sage