Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds—Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds
Evidence-Based Complementary and Alternative Medicine Volume 2018, Article ID 5813095, 36 pages https://doi.org/10.1155/2018/5813095
Mariangela Rondanelli ,1 Alessandra Miccono,1 Silvia Lamburghini,1 Ilaria Avanzato,1 Antonella Riva ]»),2 Pietro Allegrini,2 Milena Anna Faliva,1 Gabriella Peroni,1 Mara Nichetti,1 and Simone Perna simoneperna at hotmail.it
1) Department of Applied Health Sciences, Azienda di Servizi alla Persona (ASP) di Pavia, University of Pavia, Pavia, Italy
2) Research and Development Unit, Indena, Milan, Italy
Maintaining a normal healthy immune defense system lowers the incidence and/or the severity of symptoms and/or the duration of common cold (CC). Physical barriers and innate and adaptive immunity have been involved during a CC episode. Vitamins C and D, zinc, and Echinacea have evidence-based efficacy on these immune system barriers.
This review includes 82 eligible studies to consider the preventive role of these nutrients in immune clusters and in CC to provide advice on dosage and assumption of these nutrients. Regarding vitamin C, regular supplementation (1 to 2 g/day) has shown that vitamin C reduces the duration (in adults by 8%, in children by 14%) and the severity of CC.
Considering zinc, the supplementation may shorten the duration of colds by approximately 33%. CC patients may be instructed to try zinc within 24 hours of onset of symptoms.
As for vitamin D, the supplementation protected against CC overall, considering baseline levels and age. Patients with vitamin D deficiency and those not receiving bolus doses experienced the most benefit.
Regarding Echinacea, prophylactic treatment with this extract (2400 mg/day) over 4 months appeared to be beneficial for preventing/treating CC.
In conclusion, the current evidence of efficacy for zinc, vitamins D and C, and Echinacea is so interesting that CC patients may be encouraged to try them for preventing/treating their colds, although further studies are needed on this topic.
- "In European populations, adults have from 2 to 5 infections annually, children typically present 6 to 12 “colds” per year, "
3.2 Vitamin D and Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds. This research has been carried out based on the following keywords: “vitamin D” OR “vitamin D supplementation” AND “immune response” AND “innate immunity” AND “adaptive immunity” AND “respiratory tract infections” AND “common cold” AND “immunodeficiency.”
Figure 1 shows the study selection process.
Table 2 summarizes the studies presented in the narrative review.
3.2.1 First Barrier: Physical Barrier. The active hormone 1,25(OH)2D is important in upregulating genes via the 1a- hydroxylase enzyme, which then encode proteins required for tight junctions (e.g., occludin), gap junctions, and adherensjunctions (e.g., E-cadherin) .
Vitamin D supplementation increases cathelicidin production and it is involved in the production of defensins .
These antimicrobial peptides are also involved in the second barrier.
3.2.2 Second Barrier: Cellular Natural Immunity. A review by Hewison et al. shows that vitamin D supplementation is successful in raising serum levels of 25OHD in TB patients and it may also play a role in promoting innate immune responses to enhance monocyte phagocytosis and degradation of b- amyloid.
The effects of vitamin D3 on macrophage phagocytosis may be related to the ability of that vitamin to alter monocyte maturation. Thus, D3 enhances immunoglobulin and complement-mediated phagocytosis by human monocytes through its stimulation of monocyte maturation to macrophages .
Enhancing protective innate immune responses, 1,25(OH)2D helps maintain self-tolerance by dampening overly zealous adaptive immune responses.
In addition, oral supplementation with HyD (25(OH)D3 metabolite) at a dose of 20 ug per day may explain the benefit of HyD on systolic blood pressure reduction, improvement in lower extremity function, and the more pronounced reduction in several markers of innate immunity among healthy postmenopausal women .
3.2.3 Third Barrier: Adaptive Immunity. Human epidemiological studies indicate supplementation with 1,25(OH)2D3 as an independent protective factor influencing the occurrence of Th-1 mediated autoimmunity . The effects of 1,25(OH)2D on the immune system include decreasing Th1/Th17 CD4+ T cells and cytokines, increasing regulatory T cells, downregulation ofT cell-driven IgG production, and inhibition of dendritic cell differentiation . The adaptive immune effects of vitamin D are not restricted to effector T cells and also include actions on suppressor or regulatory T cells (Treg), a group of CD4+ T cells known for inhibiting the proliferation of other CD4+ T cells. Treatment of naive CD4+ T cells with 1,25(OH)2D potently induces the development of Treg, and this may exert beneficial effects in autoimmune disease and host-graft rejection .
A short term high-dose vitD3 supplementation (140.000 IU) significantly increased the frequency of regulatory T cells (Tregs) but did not further improve p-cell function in apparently healthy subjects.
VitD3 may be a useful therapeutic agent in autoimmune diseases exerting immune modulatory effects involving stimulatory actions on Tregs .
Vitamin D deficiency or insufficiency has immunological implications in patients with recurrent miscarriage (RM). The percentage of B cells, the percentage of TNF- a-producing Th cells, and NK cytotoxicity are significantly reduced under 0.5 "g/day of 1,25(OH)2D supplementation for 2 months . Treatment with 4000IU vitamin D3 significantly reduced CD4+ T cell activation compared to low- dose vitamin D3, providing human evidence that vitamin D can influence cell-mediated immunity .
Vitamin D associated with upper respiratory tract infections (URI) burden probably involves lymphocytes and their activity. However, thymus activity, represented by higher T cell receptor excision circles (TREC, markers of thymus activity) levels, is not related to vitamin D concentrations or status and is not affected by 2000 IU/d vitamin D supplementation in adolescent swimmers .
3.2.4 Vitamin D and Common Colds. Clinical trials demonstrate that 400 IU/d vitamin D supplementation is needed for the prevention of respiratory infections [67, 68]. Vitamin D supplementation decreases the events related to respiratory tract infections. In particular, vitamin D is useful in prevention of these types of infections, assuming dosage of vitamin D ranging from 400 IU/day to 2000 IU/day . Epidemiologic studies have found high vitamin D levels to be associated with lower risk of infections of the upper respiratory tract (colds). 4000 IE/day vitamin D supplementation is found to significantly increase the probability of staying infection free during the study period. This finding further supports the notion that vitamin D status should be monitored in adult patients with frequent respiratory tract infections, and patients with vitamin D deficiency must be supplemented . The more vitamin D is reserved within the infants* bodies, the more they will be immune to respiratory infections. It is assumed that the lack of significant differences in vitamin D is due to the gestational age and other factors except that vitamin D deficiency plays crucial roles in respiratory system infections . Supplementation with vitamin D in children seems to be a strong ally in fighting the onset of respiratory infections. The combination of vaccines and vitamin D supplementation can significantly reduce the appearance of URTIs and the use of antibiotics, with a consequent decrease of global indicators ofbacterial resistance . In Mongolian children, who received milk fortified with 300IU of vitamin D3, vitamin D supplementation significantly reduced the risk of acute respiratory infections (ARIs) in winter among children with vitamin D deficiency . Finally, 1200 IU/d vitamin D3 supplementation during the winter may reduce the incidence of influenza A and enhance innate immunity by upregulating antimicrobial peptides, especially in specific subgroups of schoolchildren . Weekly supplementation with 10,000 IU of vitamin D3 is preventive for UrTI in young adults .
Vitamin D supplementation is safe and protected against acute respiratory tract infection overall, but patients who are very deficient in vitamin D and those not receiving bolus doses experienced the most benefit, as demonstrated very recently in a meta-analysis that considered 25 eligible randomized controlled trials (total 11,321 participants, aged 0 to 95 years) .
On the other hand, some evidence shows no significant correlation between vitamin D levels and lower respiratory tract infections in terms of the disease and its severity , despite a 50 "g vitamin D3 (2000IU) daily supplementation
. The sub-sunburn sunbed treatment is effective in tanning and increasing the 25(OH)D serum level, more so than 1000 IU per day, but had no appreciable effect on colds
. In patients with mild to moderate asthma undergoing an inhaled corticosteroid dose reduction, the use of vitamin D supplementation (100,000 IU load plus 4,000 IU/d) is not supported for the purpose of reducing cold severity or frequency . In addition, monthly administration of 100,000 IU of vitamin D does not reduce the incidence or severity of URTIs in healthy adults . It is reasonable and safe to take approximately 1000 IU of vitamin D daily, as suggested by Zittermann et al., in order to optimize nonspecific immunity and prevent infection. It is important to start supplementation in early autumn in order to ensure an adequate vitamin D level in winter .
In conclusion, vitamin D supplementation was safe and it may protect against acute respiratory tract infections overall, although there are numerous studies that do not support this indication and therefore it is necessary that further research will be conducted on the dosage of intake of vitamin D and prevention/treatment of common cold. Baseline levels of vitamin D, age, and dose of vitamin D need to be taken under consideration in order to personalize therapy. Patients who were very deficient in vitamin D and those not receiving bolus doses experienced the most benefit, and it is important to start supplementation in early autumn in order to ensure an adequate vitamin D level in winter.
I am amazed that the study had very few data points for taking Zinc and Vitamin C every 2-3 hours
- Vitamin D
Having a good level reduces the likelihood of CC (prevention) by about 20%
A "vitamin D hammer" (50,000 IU, single dose appears to stop a cold (treatment) if taken within a day of the start of the cold
- Vitamin C
Appears to be great for both prevention and treatment of CC
Treatment: Take some Vitamin C every few hours after the start of cold
The clinical trials using Zinc lozenges every 2 hours found great success when started within a day of the start of the cold
- That Zinc coats the throat lining
- We found Natures Way $6 to be the best
Appears to be useful for prevention and perhaps treatment - no personal experience
- UVC germ killer
Family and friends have found that a UV sterilizer kills the air-borne cold germs
UVC both reduces the cold duration AND reduces the risk of a family member "catching" the cold
- We have purchased two Germ Guardians - they cost $35 each and are almost silent
- We have loaned out the cleaners so many times that we have put our phone number on them so they get returned
Update Dec 2018
My daily bulk supplements now include Zinc (1/3 of a cent per day)
So far ZERO colds this season
- Immune system is fortified by micronutrients such as vitamin D – Review Jan 2020
- Review of common cold (42 billion dollars) prevention and treatment - Zinc works – Feb 2014
- Vitamin C
- Stopped my cold in 1 day (3 of the 9 techniques used fast-acting Vitamin D) July 2017
- Flu 1 dose of 50,000 IU Vitamin D treats the flu
- Common cold (Acute Rhinosinusitis) 12 percent more likely for every 10 nanogram lower Vitamin D – Oct 2015
- Overview Colds and flu and Vitamin D
- Breath better if higher level of Vitamin D – meta-analysis March 2018
- Many additional ways to improve your immune system with Vitamins and Metals
- Number of people to treat to prevent 1 case of flu: Vitamin D 4, Vaccination 40 – Feb 2017 - Vitamin D
- Zinc and Vitamin D category listing has
In addition, Zinc helps Vitamin D in many ways
- Reduced viral respiratory track infections by half by having more than 38 ng of vitamin D – June 2010
Group with >38 ng of vitamin D was 2X less likely to get viral infection
- Reduction in Cold and Flu with Vitamin D has the following
Note: This graph is for the adults who were taking Vitamin D.
No indication that adults were also giving vitamin D to their children, who are typically the sorce of colds in a household - see chart below
Some Respiratory Infection Randomized Controlled Trials
- Respiratory infections (RTI) cut in half by 20,000 IU weekly vitamin D if initially deficient – RCT March 2015
- Note This would be a daily average of 2,900 IU, but some studies find weekly to be better than daily
- Respiratory tract infection eliminated in 36 percent of people by 4000 IU of Vitamin D – RCT Sept 2015
- Respiratory Virus risk reduced 35 percent by Vitamin D (14,000 IU weekly) – RCT Oct 2018
Colds and Influenza share some symptoms
Common cold prevented and treated by Vitamin D, Vitamin C, Zinc, and Echinacea – review April 2018
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- Reduced viral respiratory track infections by half by having more than 38 ng of vitamin D – June 2010