Hey Cecil, can we please get an update on the zinc-for-the-common-cold debate?

[Moe]

http://www.straightdope.com/classics/a980206.html

I consider myself among the more skeptical people I know. I’m really not one to get taken in easy by a placebo effect. But man, I’ll tell ya, since I discovered cold-eeze (zinc losenges) a few years back and began taken them the moment I felt the onset of a cold, I have not had a cold nearly as bad or as long as the ones I had in my pre-zinc losenge days.

Now, everytime I get a cold I search around the net for the latest research and I’m always amazed when I see that no consensus has been reached in the scientific community.

From here

The median duration of illness was 2.5 days in patients in the zinc gluconate group compared with 3.5 days in the placebo group,

a very modest effect compared to my own anecdotal experience, but an effect nevertheless.

Now, from here we have this:

a 2002 study shows that taking zinc lozenges on a daily basis can significantly reduce the possibility of getting a cold. The study, involving 378 subjects over a total of 170,000 patient days, was published in the November 21, 2002 issue of the American Journal of Therapeutics. The study showed that the incidence of colds was reduced by as much as 62%. The study was conducted at a high school, an environment where colds spread easily.

Of course, this is from a site with a commercial interest which is reason for skepticism, but they are at least citing a study, not just making random claims. So what’s the deal with this study? Afterall, the results seem pretty dramatic.

(I’m not even going to complicate this thread with that sites claims of elderberry and the flu, though the results they cite seem pretty dramatic as well).

In this article from CNN:

[quote]
“We showed that by giving zinc lozenges, the duration of the cold was almost 50 percent decreased and severity was also decreased,” Prasad said.

Prasad’s study is just one of at least 10 careful studies evaluating zinc lozenges for the common cold. Half the studies showed zinc shortens the duration of cold symptoms; the other half showed it did not.

“In spite of the fact that these studies have been repeated and that the designs have been modified in a way that has tried to make the studies more valid, we continue to see this disparity in the final results of the study,” said Dr. Ron Turner, a noted cold remedy researcher at the Medical University of South Carolina.

<snip>

A third popular cold treatment, a zinc nasal spray called Zicam, showed very promising results in a study of 213 patients published in ENT, the Ear, Nose and Throat journal. Symptoms were reduced by as much as 75 percent.

Turner, however, called the study design flawed and cautioned that such dramatic results must be replicated.

[quote]

So what’s the problem here? Why can’t the scientific community come to some sort of agreement? It seems so many of these studies are attacked for methodological flaws. Can’t these be controlled better?

And still, it seems to me that there have been enough studies in support of zinc to assume that there is at least something going on. I mean, one study? two studies? OK, chance factors can play a role. But aren’t there enough studies to show that, under certain conditions, with the right kind of ionized zinc that the results are significant? and even dramatic?

But I think the studies I cited, along with many others I read but didn’t cite, are a few years old.

So Cecil, I’m asking for an update on this column. Surely you’re in a better position than most of us to evaluate the most up-to-date research on the subject and give us some new conclusions. And this is important; IT’S THE FREAKIN’ COMMON COLD WE’RE TAKING ABOUT HERE!!!

Isn’t this a topic worth updating by now?

Thank you <sniffle> humbly,
Moe

[John_W.Kennedy]

@Moe

I’m really not one to get taken in easy by a placebo effect.

You do not understand the placebo effect. It is not a question of being “taken in”. The placebo effect really works.

[Moe]

@John W. Kennedy

You do not understand the placebo effect. It is not a question of being “taken in”. The placebo effect really works.

Are you saying that, in addition to simply feeling better, my immune system will actually defeat the cold virus quicker if I believe?

Because if that’s true, than you are correct, I don’t understand the placebo effect.

[Askance]

@Moe

Are you saying that, in addition to simply feeling better, my immune system will actually defeat the cold virus quicker if I believe?

Because if that’s true, than you are correct, I don’t understand the placebo effect.

Yes, that’s precisely what he means.

[C_K_Dexter_Haven]

@Moe

Are you saying that, in addition to simply feeling better, my immune system will actually defeat the cold virus quicker if I believe?

@AndrewT

Yes, that’s precisely what he means.

Well, that’s sort of what he means, I wouldn’t say it was “precisely.” The placebo effect means that, for a small but detectable percentage of the any sample, “just believing” can have an impact (which includes not just feeling better, which one might expect, but physically being better – defeating the cold virus quicker, or whatever it is.

It’s not like a cure-all, where if you believe, it will happen. It’s not a huge phenomenon, it happens for a small percentage of cases. However, that small percentage is statistically significant.

[Saltire]

SDSTAFF David cited a study that casts doubt on whether the placebo effect even exists in this old Mailbag column.

[Kythereia]

Thinking may not make you better, but scientists believe it can make you sick…

[ouryL]

As I see it, many of the tests claim to be blind or double blind and many of the critics question: How do you meaningful disguise the awful taste of Zinc gluconate in a blind test.

The answers have been obfuscating.

[Moe]

@Saltire

SDSTAFF David cited a study that casts doubt on whether the placebo effect even exists in this old Mailbag column.

I think that bottom portion addresses to a degree what was going to be my response to CK and others - “wow! really?” (and not “Bullshit!” mainly because I respect SD veterans’ critical thinking skills).

And this is not to say that the one study cited in the column is some iron-clad refutation of the placebo effect…BUT…

the skeptic in me is trying to figure out how your mind, in believing that a sugar pill is actual medicine, will cause the body to actually physically replicate the results that real medicine would have yielded. I mean, I can understand how a placebo can affect one’s perception of, say, pain, or anything else that relies solely on subjective reports, but if a chemical is put into the body to interact with the illness in some way, how can the mind possibly create a similar (though weaker) result in the absence of the chemical?

I mean, I gotta tell ya, this almost sounds like new ageism. And moreso with the nocebo effect.

[JillGat]

@Moe

I mean, I gotta tell ya, this almost sounds like new ageism. And moreso with the nocebo effect.

This is the reason scientists do case/control studies. It’s not new age at all.

[Moe]

@ouryL

As I see it, many of the tests claim to be blind or double blind and many of the critics question: How do you meaningful disguise the awful taste of Zinc gluconate in a blind test.

The answers have been obfuscating.

I don’t understand why that’s so difficult (though apparently it is since I’ve read about that aspect in a few articles/studies). Cold-eeze has managed through use of sugar, corn syrup, and fruit extract to not taste bad at all. It certainly doesn’t taste so distinctive that it would be difficult to make something comparable but inactive.

That’s part of the frustration of me starting this thread. It seems so many studies have been criticized for methodological flaws. What’s so difficult here? 200 people; 100 gets cold-eeze, 100 gets placebo. Check results. Wash, rinse, repeat.

Incidentally, if it really has been a placebo effect with me these last few years, than FUCK ME FOR STARTING THIS DAMN THREAD!!! :mad:

[Moe]

@JillGat

This is the reason scientists do case/control studies. It’s not new age at all.

Oh I understand that. I said it sounds like new age.

As JWK pointed out I really didn’t understand the placebo effect correctly; I had always assumed it was just a perceptual thing. If I’d heard that it can have the physical effects described in this thread from somewhere else, and not from the respectable posters here, my natural reaction would be likely to lean towards the BS side, the way I would when hearing about some new age idea. It just sorta has that mystical feel is all.

[antechinus]

@Moe

I think that bottom portion addresses to a degree what was going to be my response to CK and others - “wow! really?” (and not “Bullshit!” mainly because I respect SD veterans’ critical thinking skills).

And this is not to say that the one study cited in the column is some iron-clad refutation of the placebo effect…BUT…

the skeptic in me is trying to figure out how your mind, in believing that a sugar pill is actual medicine, will cause the body to actually physically replicate the results that real medicine would have yielded. I mean, I can understand how a placebo can affect one’s perception of, say, pain, or anything else that relies solely on subjective reports, but if a chemical is put into the body to interact with the illness in some way, how can the mind possibly create a similar (though weaker) result in the absence of the chemical?

I mean, I gotta tell ya, this almost sounds like new ageism. And moreso with the nocebo effect.

There is a fairly stong connection between state-of-mind and chemicals being released by the body itself.

A placebo response can involve the release of pain-killers (endorphins). There are many other ways state-of-mind controls the release of chemicals in the body. Talking to an audience, thinking of food, hearing baby cry, daydreaming or looking at naked ladies all involve secretion of hormones.

[C_K_Dexter_Haven]

What antechinus said.

Also, please note, we’re not talking about a placebo effect repairing a broken arm. We’re talking about diseases – bacterial or viral – that the body has mechanisms to fight anyway. It’s not surprising that a “positive attitude” encourages such mechanisms. (One also wonders if a “positive attitude” includes things like eating healthier, exercising, etc. It’s impossible to run a study on people and only allow one variable to be altered for the control group.)

[chorpler]

@Moe

I don’t understand why that’s so difficult (though apparently it is since I’ve read about that aspect in a few articles/studies). Cold-eeze has managed through use of sugar, corn syrup, and fruit extract to not taste bad at all. It certainly doesn’t taste so distinctive that it would be difficult to make something comparable but inactive.

I don’t know about that. They certainly seem to have a distinctive taste; I don’t know if it’s from the zinc or just the particular flavors they offer, but they don’t taste like normal lozenges. Nobody that I know likes the taste of Cold-Eeze; in my daughter’s pre-school class, not one of the kids kept them in their mouth longer than a few seconds before spitting them out.

Also, the last time I tried a Cold-Eeze, it killed my ability to taste sweetness for several hours. I don’t know if it was the zinc’s fault or some fluke of the flavoring or other inert ingredients, though.

[dangermouse1956]

@chorpler

…Also, the last time I tried a Cold-Eeze, it killed my ability to taste sweetness for several hours. I don’t know if it was the zinc’s fault or some fluke of the flavoring or other inert ingredients, though.

I also noticed a marked (not easily overlooked) alteration in my taste perception, although it wasn’t as easily described as chorpler’s. This, to me, would be the most difficult thing to disguise when double-blind testing–this issue of messing with one’s sense of taste would be difficult to mask or simulate with a placebo. It would be too obvious to a participant whether he/she was actually taking something biologically active.

[chorpler]

@dangermouse1956

I also noticed a marked (not easily overlooked) alteration in my taste perception, although it wasn’t as easily described as chorpler’s. This, to me, would be the most difficult thing to disguise when double-blind testing–this issue of messing with one’s sense of taste would be difficult to mask or simulate with a placebo. It would be too obvious to a participant whether he/she was actually taking something biologically active.

I bet it would be much easier to disguise if they formulated it as a pill to be swallowed and dissolved in the stomach rather than sucked on and dissolved in the mouth. Unless it’s actually getting the substance in your bloodstream that is causing the alteration in taste perception, rather than having it in your mouth – then it would be very hard to disguise under any circumstances.

[dangermouse1956]

Actually, I think there is a reason for it to be in lozenge form, although I’ve forgotten what that reason is. Anyone remember?

[John_W.Kennedy]

@dangermouse1956

Actually, I think there is a reason for it to be in lozenge form, although I’ve forgotten what that reason is. Anyone remember?

Because you can anything into candy as long as its sanitary and not poisonous, but you have to prove that “medicine” works. (Unless you call it “homeopathic medicine”, of course, in which case our corrupt government won’t do a damn thing.)

[Moe]

@John W. Kennedy

Because you can anything into candy as long as its sanitary and not poisonous, but you have to prove that “medicine” works. (Unless you call it “homeopathic medicine”, of course, in which case our corrupt government won’t do a damn thing.)

Zinc is sold in pill form too. But it certainly doesn’t seem unreasonable for a lozenge to be more effective in a case where it will need to be absorbed in the area where the disease it’s fighting is concentrated, namely the throat and nasal passages (I also use a zinc nasal gel).

Incidentally, the cold I felt coming on which inspired this thread, never fully hit. It is possible that I could have been imagining the symptoms, but I don’t think so. The soreness in my throat seemed pronounced, and distinct from the usual dryness I get from my allergies.

The symptoms were completely gone in about 3 days. Could I possibly have stimulated my own body’s defense mechanisms to such a degree?

BTW, your just gonna have to take my word for it on this, but I am someone who, before I started treating my colds this way a few years ago, had the worst colds of anyone I knew typically. They were rarely gone in a week, and 9 outta 10 times caused an ear infection. I also typically had lingering symptoms, such as a cough and mucous for weeks, sometimes months afterwards. Hasn’t happened since I began the zinc.

If it really is just a placebo effect, this is some ignorance I wouldn’t mind wallowing in