Zinc lozenges: are they really effective for preventing the onset and lessening the severity of the cold and flu? According to the scientific literature, the answer is yes, but you have to make sure you use a very specific kind.
Just read the final sentence of this abstract: "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."
Keep reading to see the specific qualities that the science says an effective zinc lozenge needs to have, so that you don’t waste your money!
Beyond effective zinc lozenges, I have learned about several other tools over the years to help me say well during cold and flu season.
Important disclaimer: please remember that while I am a scientist, this is not to be misconstrued as medical advice and this info is shared for educational purposes only. Consult your qualified healthcare practitioner with questions or concerns and before starting any new supplements.
A quick summary of my tools to prevent cold and flu:
Zinc Lozenges (a very specific type! Most on the market are a waste of money.)
Gua Sha on the neck and upper back with Po Sum On Oil
Lymphatic drainage self-massage
If I’m unlucky enough to get sick, I add to that list:
Chinese medicine herbal throat lozenges
Antiviral Chinese herbs
Bone broth/homemade soup/congee
Po Sum On oil as a chest rub and for body aches
At the first sign of illness I start taking zinc lozenges and Do Gua Sha Skin Scraping
Effective Zinc Lozenges For Cold & Flu
There is good scientific evidence that a specific type of zinc lozenge can be effective at both preventing the onset of respiratory illnesses as well as reducing their duration and severity.
We've known this since 1984 when George Eby published his paper that showed treatment with a specific kind of zinc lozenge reduced both the duration and severity of the common cold compared to placebo lozenges, as shown in the graphs below:
So what specific qualities does an effective zinc lozenge for colds or the flu need to have?
It must produce ionic zinc
Positively charged ionic 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”. Zinc acetate is the only form that releases 100% ionic zinc. (source)
It must provide a high enough dosage
At least 18 mg per lozenge. (source)
It cannot contain Certain additives to mask the metallic taste
Ingredients like citric acid, mannitol, sorbitol, maltitol, tartaric acid, sodium bicarbonate and others bind to ionic zinc which makes the lozenges useless for the common cold.
In fact, in one randomized controlled trial using lozenges that included citric acid (which tightly binds to zinc ions) they found that the lozenges actually “lengthened the mean duration of colds by at least one day compared to placebo […] This formulation is the most common zinc lozenge formulation on the United States market and results in zinc lozenges that do not shorten common colds”. (source)
From the same paper: “The overriding source of failure [for zinc lozenges to show efficacy] was the requirement by pharmaceutical marketing companies for pleasant tasting, candy-like, non-metallic, non-astringent and non-drying zinc lozenges. [This] resulted in testing multi-ligand, non-ionic zinc compositions that produced nearly all clinical failures.”
Zinc lozenges are supposed to taste metallic. If they don’t, they’re not going to be effective. Unfortunately, MOST zinc lozenges marketed for use with colds are a waste of money because of the additives present to make them palatable.
One lozenge needs to take 20-30 mins to dissolve
Not pleasant, I know, but this gives the ionic zinc the opportunity to work its antiviral magic on the infection in the local tissues. (source)
Lozenges need to be taken once every 2 waking hours
Set a timer, don’t fudge it! It is important to be strict with the schedule. (source)
Lozenges Need to Be started at the very first sign of illness
Don’t wait a day - research shows that when you start the 2 hour regimen ASAP after noticing that little tickle in your throat, fatigue, sniffle, or whatever clues your body gives you when you’re first getting sick it is most effective. (source)
This is why I always keep a fresh bottle of zinc lozenges in my medicine cabinet year-round, especially during cold and flu season. That way I know I can start them immediately if I need them!
Bottom Line: Effective Zinc Lozenges Do Exist and 30+ years of research supports their use for colds and the flu
Here is a great 2017 meta-analysis of over 30 years of randomized, double-blind, placebo-controlled studies. The authors' conclusion: "the current evidence of efficacy for zinc lozenges, in particular zinc acetate lozenges, is so strong that common cold patients may be encouraged to try them for treating their colds."
The studies conducted since 1984 that did NOT find zinc lozenges to be effective were not studying lozenges that fit all of the criteria I have outlined here. Wrong form, contained inactivating additives, etc. Details like this are important!
Effective Zinc Lozenges for around $9/bottle
The Life Extension product called Enhanced Zinc Lozenges is the only one I know of on the market right now that fits all of the necessary requirements to be effective, as demonstrated in the literature. (If you know of another brand PLEASE tell me! I’d love to update the post with more options if they are available).
BE WARNED that this brand makes other zinc lozenges that DO NOT meet all the requirements. Make sure you double check the name of what you buy.
And per the product label, you should only take these for 3 consecutive days max because they can disrupt the zinc:copper ratio in your body.
One bottle, which costs around $9 on Amazon at the time of this publication, is more than enough for one person to kick a cold or flu in the butt before it makes you miserable.
I am in no way affiliated with this brand, I just know it works from personal use over the last ~5 years and that it was formulated with the scientific evidence in mind. If you buy it using the link above I may receive a tiny commission.
If you have children, please be aware that these lozenges are quite large and could pose a choking hazard.
I actually have this on standby in my Amazon Subscribe & Save, and I just remove it if I don’t need a refill - saves a little extra money!
Remember, consult your healthcare provider before adding a new supplement
Got questions about zinc lozenges I didn’t cover? Ask in the comments!
Gua Sha Skin Scraping with Po Sum On Oil
peppermint oil, dragon blood, cinnamon oil, scutellaria, and licorice
Menthol is a constituent of the peppermint oil and is the only thing the FDA recognizes as an “active ingredient” on the label.
However, all of the herbs are certainly active ingredients as well in the Chinese medicine materia medica.
This fragrant oil can be rubbed into the chest so that the vapors may be inhaled to provide relief from congestion as a non-toxic alternative to drugstore chest rubs. The strong peppermint aroma is very soothing and enjoyable and helps to open clogged nasal passages.
But the main way I use this oil at the first sign of or exposure to cold/flu is to perform the Chinese medicine skin scraping technique called Gua Sha.
Gua Sha is a traditional Chinese medicine healing modality related to cupping (remember Michael Phelps and those funny red circles on his back during the 2016 Olympics?)
Gua Sha is a type of massage done using a smooth-edged tool that is scraped across the skin using firm pressure and some type of oil as a lubricant.
Gua sha leaves red marks and often tiny speckled bruising (called petechiae) on the surface of the skin and it is said that the darker the marks, the more your body needed the treatment because it means you had more stagnation and blocked Qi in that area of the body.
You can actually use any skin-safe oil as the lubricant for Gua Sha, but I was taught by multiple Chinese medicine doctors to use Po Sum On due to the benefits of inhaling the vapors of the herbs when you're fighting off a virus.
There are a number of tools you can use to perform gua sha. The easiest is the metal lid from the outer container of the Po Sum On oil! It’s the perfect self-contained gua sha package.
Ceramic soup spoons also work very well (gua sha is also called “spooning” for this reason, see above photo), and of course, you can purchase Gua Sha tools often made of things like jade or natural horn (see first photo in this section).
Gua Sha has been demonstrated to be a powerful anti-inflammatory therapy in the scientific literature. Researchers at Harvard found gua sha to elicit both an immediate and sustained immune response by upregulating gene expression of heme oxygenase 1 (HO-1), which is an antioxidant and anti-inflammatory cytoprotectant (source).
You can read more about the science of Gua Sha here, and learn more about other health conditions it can be helpful for (Hepatitis B, liver inflammation, perimenopausal symptoms, neck pain, emphysema, migraines, and breast distention/mastitis - what a list!)
After a Gua Sha session I always notice a profound sense of relief/release that makes me want to release a deep sigh of relief, ahhhhh :-)
I was taught how to do gua sha from a licensed acupuncturist, and it is best to get training from someone qualified. Proceed at your own risk if you decide to try it on yourself without professional guidance first.
I was taught that when you are doing Gua Sha to prevent illness or after the onset of illness to focus on the back of the neck, all over the shoulders, and immediately on either side of the spine.
I didn’t have time to record my own tutorial video, but you can see one in this great blog post geared towards using this technique on children. The person demonstrating isn’t using as much pressure as I was taught to do since she is doing it on a child.
This is a helpful PDF from a community acupuncture group in Seattle about treating cold and flu at home with Chinese medicine.
You can make your own elderberry syrup at home, but I purchase organic elderberry syrup. My acupuncturist turned me on to elderberry syrup because in Chinese medicine it is very good for supporting the Lung throughout the fall and winter. And of course Western medicine and science recognize it for it’s potent antiviral effects, not just for cold and flu viruses but other viruses like herpes simplex and even human immunodeficiency virus (HIV) (source).
I was instructed by my acupuncturist to take a small dose of elderberry syrup daily and to increase it if I actually get sick. Using the brand I linked to, that is 1 tsp per day if I am well, increasing that to 1 tsp twice a day if I am actively sick with a virus.
This study found that megadoses of vitamin C (1000 mg given once every hour for 6 hours, and then 3 times daily thereafter) resulted in an 85% reduction in cold and flu symptoms compared to the control group (who were treated with decongestants and analgesics).
However other researchers have found that large doses of vitamin C have no effect on cold duration. The Cochrane collaboration examined the data in 2013 in a meta-analysis and did not find Vitamin C to be more effective than placebo for reducing the incidence of colds, but they do say that the “evidence suggests that it could be justified in people exposed to brief periods of severe physical exercise or cold environments”.
However another group conducted a meta-analysis in mid-2018 to see if adding extra vitamin C on top of a normal regular supplement regimen is an effective treatment for the common cold and they state: “we can safely conclude that vitamin C is therapeutic to some degree. […] On account of this therapeutic effect, we would like to recommend a small daily dose of vitamin C (no more than 1.0g/day) to boost immunity and a larger dose of vitamin C during the common cold (a large dose than before, usually 3.0 g/day to 4.0 g/day) to better recover health.”
So basically they are saying that taking 1000 mg per day is good as a prophylactic measure and to increase that amount if you are actively sick.
You can draw your own conclusions from this information, but I like to follow a dosing protocol similar to the first study, by taking 1000 mg about every hour when I am trying to stop a virus from taking hold, usually aiming for 3-6 grams (3000-6000mg) per day, which I have done with the blessing of my conventional-minded MD.
I like this Vitamin C supplement since it uses the high quality Quali-C (the only Vitamin C manufactured in the Western hemisphere) and contains rosehips and citrus bioflavonoids for extra antioxidants.
I also keep this one on standby in my Subscribe & Save so that I can save a little extra money when I need to replenish! Which isn’t often since it contains 250 capsules.
Self-Massage for Lymph Drainage
In 2017 I caught a bad case of bronchitis and I was absolutely floored at how effective this easy self-massage was at helping lymph (and other yucky junk) drain out of my head/sinuses/ears.
I noticed the effects anywhere from during the massage to delayed 30-60 minutes after performing it, and they persisted for a few hours after. I did this massage every day, sometimes more than once per day to help keep my head and sinuses clear. ABSOLUTELY AMAZING!
It’s easy to do this massage while you are doing something like watching TV. Once you watch the video once or twice, you’ll probably get the hang of it and can do it from memory.
What I add to my anti-crud protocol if I actually get sick
My Favorite Herbal Throat Lozenges
Surprise surprise, my favorite herbal throat lozenges are a Chinese medicine formula. They provide both symptomatic relief and support the body to heal.
I was introduced to these many years ago by an acupuncturist and they are a must-have for me any time I am fighting off something affecting my throat and/or lungs.
Chinese Herbal Medicine for cold and flu
In addition to using the lozenges I will also utilize systemic Chinese herbal formulas when I catch a cold or flu. I am lucky enough to have an acupuncturist currently who crafts personalized herbal formulas for me, which I simmer into a decoction that I drink.
Chinese herbs can come in pill or powder format, too, or something called “tea pills” which are meant to be dissolved in hot water to make a tea (or they can be chewed and swallowed).
I actually am on a long-term course of herbs to treat long-standing conditions (fibroids and endometriosis - read more about that HERE) but when I got sick in 2017 my doctor changed my formula to one specifically formulated to treat the acute illness.
When we are acutely ill with a virus our bodies are not in a place to heal long-standing chronic conditions.
Years ago I saw an acupuncturist who only used off-the-shelf herbal formulas in tablets. That doctor would often put me on either Gan Mao Ling or Yin Chiao (or both at the same time), depending on my symptoms. These are readily available at health food stores and even on Amazon.
Plum Flower brand is readily available and trustworthy; they utilize a certified GMP facility and screen for heavy metals. Beware that some other brands of Gan Mao Ling may be adulterated with acetaminophen or other medications.
Gan Mao Ling translates to “common cold effective remedy” and can be used at any stage of illness and is a stronger antiviral and is a modern formula. It is best to begin it at the first sign of illness.
Yin Chiao is a bit less strong and is an older formula, but can be used prophylactically if you’ve been exposed to someone who is sick. It is most effective when taken at the first sign of illness. Some people will take it prior to traveling, going to crowded places, etc. during cold/flu season to prevent getting ill, though I have never done this.
Remember, it is ALWAYS best to consult a qualified Chinese herbalist before using herbs. Use the NCCAOM database to find someone near you. Someone who is a Dipl O.M. (Oriental Medicine) will have training in both herbs and acupuncture, or look for a combo Dipl Ac. (acupuncture) who also has Dipl C.H. (Chinese herbs).
IMPORTANT NOTE: There are many other formulas designed to treat viral respiratory illnesses and consulting a Chinese Medicine doctor will help you determine the most appropriate formula based on your individual symptoms. And don’t forget to bring your qualified healthcare provider in the loop with any supplement changes, especially if you are already taking supplements or prescription drugs.
Homemade Bone Broth and Congee
Making rich, delicious bone broth in the Instant Pot is so easy that I can do it even if I am feeling really under the weather. It’s also an easy task to pass off to a family member.
I have a tutorial HERE for how to make it. Please note that chicken broth only needs 30 minutes - I see many recipes that call for much longer cook times and they are not necessary to produce a rich broth that gels.
I also love to make congee from bone broth. Congee is a traditional healing food in Chinese medicine made from short grain rice that has been cooked down into a thick porridge.
Congee is extremely easy to digest and, no exaggeration, every acupuncturist I have ever seen has told me it is one of the best foods I can eat based on my constitution and symptom history (Spleen Qi deficiency, if you’re interested).
I have a tutorial HERE for how to make congee in the Instant Pot. Sometimes I will add an equal amount of rinsed lentils to the pot to make a heartier meal with some protein (so if I am doing 1 cup rice, I add 1 cup rinsed lentils). Cook time is exactly the same!
Rest and Relaxation
Our culture does not place value on rest, recovery, play, fun….basically anything that isn’t work. Unfortunately the best thing we can do for ourselves when we are sick is to REST.
Sleep in, nap during the day, lay reclined on the couch or in bed, do gentle things like read, watch TV, or if you are me, play video games (right now I am loving Red Dead Redemption 2!).
The worst thing you can do is push yourself to stick to your normal routine and obligations when you are fighting a virus like cold or flu. Not just because that means you are exposing people to your germs, but also because you’re making it harder for your body to fight the infection and get you well faster.
So forget the societal pressures and do you best to REST when you’re sick or fighting something off.
Bonus: Baby Balm to Soothe My Raw Nose
Small side note: being sick often means a red, raw nose from needing to blow it so often. Regular moisturizers just do NOT cut it.
In 2017 when I caught that bad case of bronchitis I learned that the Beautycounter Baby Balm is INCREDIBLE to use around the nose when you are sick. So soothing, and it helped heal the cracked and flaking skin. I was using it multiple times per day during that time. It’s great in general for any extremely dry, cracked skin or windburned skin which can occur more frequently in the dry winter months. I’m glad to have a tube of it on hand for when I need it!
If you are looking for other safer skincare and cosmetics products (honestly, being vigilant about the ingredients in those products is equally important to watching the ingredients in the food you eat) you can fill out my quick Skincare Consultation and I will get back to you with personalized recommendations. Please also join my Safer Skincare, Better Beauty email list to stay in the loop!