Lozenges and colds
70% vs 27% recovered by day 5; 3 RCTs, 199 patients, 80–92 mg/day zinc acetate; recovery rate ratio 3.1; colds about 40% shorter; start within 24 h, no more than 100 mg/day. Hemilä H, Fitzgerald JT, Petrus EJ, Prasad A. "Zinc Acetate Lozenges May Improve the Recovery Rate of Common Cold Patients: An Individual Patient Data Meta-Analysis." Open Forum Infect Dis 2017;4(2):ofx059. https://pmc.ncbi.nlm.nih.gov/articles/PMC5410113/
The 3 trials:
- Petrus et al. 1998, Curr Ther Res, 101 patients
- Prasad et al. 2000, Ann Intern Med, 48 patients
- Prasad et al. 2008, J Infect Dis, 50 patients
Same data: Hemilä et al., Br J Clin Pharmacol 2016;82:1393–98, which found colds 2.73 days shorter.
Acetate 40% shorter, gluconate 28%; 7 trials, 575 patients, 33% overall; no extra benefit above 100 mg/day. Hemilä H. JRSM Open 2017;8:2054270417694291. https://pmc.ncbi.nlm.nih.gov/articles/PMC5418896/
Under 75 mg/day showed no effect; over 75 mg/day did. Hemilä H. Open Respir Med J 2011;5:51–58. https://pmc.ncbi.nlm.nih.gov/articles/PMC3136969/
Binders such as citric acid lower free zinc; choose lozenges without citric acid. Hemilä H, Chalker E, Front Med 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11521859/
2024 Cochrane review (34 trials, 8,526 people):
- Prevention: may make little or no difference (low certainty).
- Treatment: may shorten colds by about 2.4 days (low certainty).
- Non-serious side effects probably increase (taste, nausea or vomiting, stomach upset).
- Trials varied widely.
Nault D et al., Cochrane Database Syst Rev 2024;5:CD014914. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014914.pub2/full
Mechanism hypotheses:
- Zinc ions inhibit rhinovirus replication in vitro: Korant BD et al., Nature 1974;248:588–590. https://www.nature.com/articles/248588a0
- Zinc may interfere with ICAM-1 docking: Novick SG et al., Med Hypotheses 1996;46:295–302. This is a hypothesis paper.
Eby: his daughter's tablet anecdote, then the first trial (23 mg zinc gluconate lozenges, 1984). Eby GA, Davis DR, Halcomb WW, Antimicrob Agents Chemother 1984;25:20–24. https://pmc.ncbi.nlm.nih.gov/articles/PMC185426/ The anecdote is retold in Hemilä and Chalker 2024 (above).
Nasal zinc and loss of smell. In June 2009, FDA told consumers to stop using three Zicam intranasal zinc products after more than 130 reports of anosmia, which can be long-lasting or permanent. https://www.fda.gov/media/163755/download and https://abcnews.com/Health/ColdandFluNews/story?id=7853178 Biology
About 10% of human proteins (around 2,800) are zinc proteins. Andreini C et al., J Proteome Res 2006. https://pubs.acs.org/doi/10.1021/pr050361j
Zinc fingers. Miller J, McLachlan AD, Klug A, EMBO J 1985;4:1609–14. https://pmc.ncbi.nlm.nih.gov/articles/PMC554390/
NIH Office of Dietary Supplements, Zinc fact sheets (updated 2026). https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/ and https://ods.od.nih.gov/factsheets/Zinc-Consumer/
- Hundreds of enzymes; growth; wound healing; taste and smell; high zinc in the retina.
- Phytates in beans, nuts and whole grains inhibit absorption.
- Food table, per serving: oysters 32 mg (3 oz, raw farmed Eastern), beef 3.8 mg, blue crab 3.2 mg, pumpkin seeds 2.2 mg (1 oz), cheddar 1.5 mg (1.5 oz). "Oysters contain more zinc per serving than any other food."
- Upper limits: 1–3 y 7 mg, 4–8 y 12, 9–13 y 23, 14–18 y 34, adults 40. Too much zinc lowers copper.
- Deficiency signs: slow growth, loss of appetite, frequent infections, slow wound healing.
"No specialized zinc storage system", so a daily intake is needed. This is the older ODS wording, preserved at https://loinc.org/LP203296-1
Immune function: zinc deficiency disturbs thymulin (needed for T-cell development), T-cell maturation in the thymus depends on zinc, and zinc acts as a signal. Wessels I, Maywald M, Rink L, Nutrients 2017;9:1286. https://pmc.ncbi.nlm.nih.gov/articles/PMC5748737/
Prasad's discovery:
- Index case: Shiraz, Iran, 1958. Village young men with stunted growth who ate mainly bread.
- First report: 1961. Zinc deficiency confirmed in Egypt in the 1960s.
Prasad AS, "Discovery of Human Zinc Deficiency," Adv Nutr 2013;4:176–190. https://pmc.ncbi.nlm.nih.gov/articles/PMC3649098/
Zinc sparks: first seen in mouse eggs (NIH, 2011): https://www.nih.gov/news-events/news-releases/zinc-sparks-fly-egg-within-minutes-fertilization. Human eggs: Duncan FE et al., Sci Rep 2016 (Northwestern): https://news.northwestern.edu/stories/2016/04/radiant-zinc-fireworks-reveal-quality-of-human-egg
Insulin is stored as zinc-containing hexamer crystals in beta-cell granules. https://pmc.ncbi.nlm.nih.gov/articles/PMC4112161/
Soaking, sprouting and fermentation lower phytate. Gibson RS, Perlas L, Hotz C, Proc Nutr Soc 2006;65:160–168. History and fun facts
Romans knew zinc ores and made brass; India (Zawar) refined zinc on a large scale in the Middle Ages; Marggraf, 1746, "as far as Europe was concerned". Royal Society of Chemistry. https://periodic-table.rsc.org/element/30/zinc and https://edu.rsc.org/elements/zinc/2020033.article
"Perhaps related to Zinke, prong, point". https://www.etymonline.com/word/zinc
Cent: copper-plated zinc, 97.5% Zn. US Mint coin specifications. https://www.usmint.gov/learn/coin-and-medal-programs/coin-specifications Circulating production ended in November 2025. https://www.coinnews.net/2025/11/12/us-mint-marks-end-circulating-penny/
Zinc oxide in sunscreen (FDA proposed GRASE). https://www.fda.gov/drugs/understanding-over-counter-medicines/questions-and-answers-fdas-regulatory-actions-over-counter-sunscreen
Most zinc goes to galvanizing steel (about 60%). RSC; International Zinc Association. https://www.zinc.org/coatings-2/
Zinc-air button cells are the standard disposable hearing-aid battery. https://www.audiologyonline.com/articles/power-to-hear-powered-by-1174
