It is important to differentiate the common cold viruses from influenza. Flu activity is widespread in most of the United States at this point. People who are very sick or who are at high risk of serious flu complications & get flu symptoms should be treated with antiviral drugs (like Tamiflu) as soon as possible. The antiviral drugs — oseltamivir (Tamiflu), zanamivir (Relenza), or peramivir (Rapivab) — are used to treat or even prevent the flu. These drugs can shorten the duration of the flu and prevent complications such as pneumonia. However, ideally you need to take them within the first 48 hours of getting sick for them to work. Get vaccinated if you haven’t yet. There are still weeks of flu activity to come. While vaccine effectiveness can vary, recent studies show vaccine reduces the risk of flu illness by about 40% to 60% among the overall population during seasons when most circulating flu viruses are like the vaccine viruses. In the United States last season, overall vaccine effectiveness against all circulating flu viruses was 39%, and VE was only a bit lower (32%) against H3N2 viruses. Vaccine effectiveness against other flu viruses (i.e., H1N1 or B viruses) was‎ higher. Remember the flu is often associated with much more in body aches and a higher fever. Symptoms come on much faster often than the common cold and may be associated with chills and sweats. More of the flu symptoms are often below the neck such as very severe muscle aches, fever, and terrible fatigue. Both can have a cough, sore throat, stuffy nose, and sneezing although these symptoms may be more common with the cold viruses. Symptoms can overlap, so unless your doctor runs a rapid flu test — a quick check done with a cotton swab from the back of your nose or throat — it’s hard to know for sure.

Unfortunately we have no cure for the common cold. We have multiple home remedies to shorten the cold but Zinc may have some benefit. They bind to the sites that viruses bind while entering the cells. This may prevent entry and decrease replication. In my experience the earlier they are used the better but using too much Zinc may be deleterious so do not go overboard.

The common cold is an acute, self-limiting viral infection of the upper respiratory tract, involving, to variable degrees, sneezing, nasal congestion and discharge, sore throat, cough, low grade fever, headache, and malaise. It can be caused by members of several families of viruses; the most common are the more than 100 serotypes of rhinoviruses. The common cold is the most frequent human illness.

There is no significant difference between zinc acetate lozenges and zinc gluconate lozenges regarding their efficacy in shortening the duration of common colds according to a meta–analysis published in Journal of the Royal Society of Medicine Open. Seven randomized trials with zinc acetate and zinc gluconate lozenges found that the duration of colds was shortened on average by 33%.

Zinc lozenges appear to influence the common cold through the release of free zinc ions into the oro–pharyngeal region. However, zinc ions can bind tightly to various chemical complexes in such a way that little or no free zinc ions are released. Previously zinc lozenges containing citric acid were shown to be ineffective in treating colds because citric acid binds zinc ions very tightly and no free zinc is released.

Zinc acetate has been proposed as the most ideal salt for zinc lozenges since acetate binds to zinc ions very weakly. Zinc gluconate is another salt that has been frequently used in zinc lozenges. However, gluconate binds the zinc ion more tightly than acetate does. Because of the somewhat stronger binding, zinc gluconate has been proposed to be less suitable constituent for lozenges. Although the binding difference between zinc acetate and zinc gluconate is a fact, it is not evident whether that causes significant differences at the clinical level for treating the common cold.

In the meta–analysis, Dr. Harri Hemilä from the University of Helsinki, Finland, collected randomized trials on zinc acetate and zinc gluconate lozenges and compared their observed efficacies. Three trials had used zinc acetate lozenges and found that colds were shortened on average by 40%. Four trials had used zinc gluconate lozenges and colds were shortened on average by 28%. The 12% difference between the average effects of the two kinds of lozenges was explained purely by random variation. Furthermore, one of the zinc gluconate lozenge trials was an outlier inconsistent with all the other six zinc lozenge trials. If that outlier trial was excluded, the difference between the three zinc acetate and the three zinc gluconate trials shrinked to just 2%, i.e., a 40% vs. 38% reduction in common cold duration. Thus, properly composed zinc gluconate lozenges may be as effective as zinc acetate lozenges. Cold EEZE and others on the market are Zinc gluconate.

Dr. Hemilä also analyzed the dose response relationship between the elemental zinc dose and the observed efficacy in reducing common cold duration. There was no difference in the efficacy between five trials that used 80 to 92 mg of zinc per day and the two trials that used 192 and 207 mg of zinc per day. Thus, zinc doses of over 100 mg per day do not seem to provide any more benefit.

According to Dr. Hemilä, there is no justification for the popular phrase that “there is no cure for the common cold” because of the strong evidence that zinc lozenges can shorten common cold duration by over 30%. However, in future studies the optimal composition of zinc lozenges should be investigated. The optimum frequency of their administration also warrants further investigation. Nevertheless, he also considers that “the current evidence of efficacy for zinc lozenges is so strong that common cold patients should be encouraged to try them for treating their colds, but the patients should ascertain that the lozenges do not contain citric acid or its salt citrate.”

The most important thing is not to get sick in the first place and since we have no effective vaccine for these viruses Zinc is intriguing.

So how do I really improve my chances of staying well? It is going to be the season for multiple claims about preventing viral illnesses. Make sure to wash your hands frequently, get your flu shot (early indications are that it will be more effective this year), use disinfectant wipes on airplane arm rests and tray tables, eat a diet rich in whole fruits and vegetables, and stay away from sick people as much as possible. Get plenty of sleep, since this may be one of your most effective tools in avoiding viral illnesses this winter. And keep in mind there have never been any quality studies showing benefits from Vitamin A, C, D, or E supplementation in preventing upper respiratory illnesses or colds.

A fascinating fact is that shorter sleep duration measured behaviorally prior to viral exposure was associated with significantly increased susceptibility to the common cold. Specifically, those sleeping < 5 hours or sleeping between 5 to 6 hours were at greater risk of developing the cold compared to those sleeping > 7 hours per night.

What is the interaction of obesity and infections? People who are overweight or obese had higher susceptibility to developing post-surgical infections, H1N1 influenza and periodontal disease. More severe infections tend to be present in people with a larger BMI. People with a higher BMI have a reduced response to vaccinations and antimicrobial drugs.

There is no role for antibiotics in the absence of bacterial superinfection in treatment of the common cold. In fact when we prescribe antibiotics for the cold there is no benefit and potential significant harm. The bacterial flora in our colon can take up to 6 months to recover and we risk an infection of the colon called C. difficile colitis. These colonic bacteria are very beneficial to our overall health. Remember that if we look at all the DNA in a human being we are only 10 percent human. We are 90 percent bacterial. Antiviral therapy is not available for most of the viruses that cause the common cold although they are available and work for influenza. Over-the-counter (OTC) cough and cold medications have no proven efficacy and potential for serious adverse effects. There is no definitive evidence to indicate that treatment with Echinacea purpurea, or vitamin C is beneficial in the treatment of the common cold.

Never forget the time tested supportive interventions. Ingest enough liquids including warm liquids such as tea and soup. Inhaled steam and an ultrasonic humidifier may help loosen respiratory secretions enhancing their removal. Also topical saline may help soothe the nasal cavity.

Remember that complications of the cold can occur. Complications of the common cold may include acute sinusitis, lower respiratory tract disease, asthma exacerbation, or acute otitis media or ear infections.