Airborne Cold Remedy: Helpful, Dangerous, or Both?
Using Airborne as directed on the label can result in a potentially serious overdose of several substances.
[Updated 13 Jan 2006 at bottom of post--look for the **** asterisks.]
Airborne is a combination of vitamins and herbs intended to prevent and shorten the duration of common illnesses like colds and flus. It's become amazingly popular in a short period of time--to the extent that stores often have trouble keeping it on the shelves.
The airborne website can be found at http://www.airbornehealth.com/ (Warning, annoying noise on the homepage, so if you're at work turn off your speakers.)
Anecdotal evidence as well as my own experience seems to suggest that, if taken at the first sign of illness, it does work. Even Oprah is talking about it.
Generic versions are now appearing on the market with the same ingredients in different packaging. One example is Health Smart dietary supplement, which is in swallowable capsules instead of Airborne's effervescent dissolve-in-water tablets.
This particular supplement is unusual in that it was not developed by a pharmaceutical company or a dietary supplement manufacturer. It was invented by a second-grade schoolteacher who was tired of catching illnesses from her young students.
When my friend the doctor was here, I showed her a bottle. She mentioned that it has a full day's dose of Vitamin A in one tablet and recommended caution in using it for that reason. The issue with this is that an excess of vitamin A can cause liver damage and other serious problems, including--in severe cases--death.
The instructions on the bottle say "repeat every three hours as necessary."
Well, every three hours could result in as many as 8 doses in a 24-hour period. There's no warning on the Airborne packaging not to exceed a certain number of doses in any specific time frame. But 8 doses of Airborne would give you eight times the recommended daily allowance of Vitamin A--and would be at least 4 times the amount to start causing damage.
Multiply that by a week or so (the duration of a cold?) and it would result in a colossal overdose of Vitamin A.
So I started wondering whether taking it as directed would lead to an overdose of other vitamins as well.
I worked up a spreadsheet comparing the amounts of the various vitamins and minerals with the recommended daily amounts and the amount of overdose required to cause ill effects.
My figures compare the current recommended Daily Values (the newer version of the RDAs) with the amount present in one and eight doses of Airborne, respectively. I also included for comparison the UL for each nutrient. UL stands for Upper Limit--it is the FDA's figure of the maximum amount that can be consumed per day without hurting a person.
Here are the column headers:
1: Nutrient name
2: Amount in 1 dose of Airborne
3: Unit of Measure
4: % of DV in 1 Dose Airborne
5: DV (U.S. recommended daily value based on a 2,000 calorie diet)
6: UL (Upper limit that can be taken without ill effects)
7: Amount in 8 doses Airborne
Here is the table as a .gif file. Click the image to see it full size.
As you can see, the amounts of several nutrients reach or exceed the UL with only 2 doses of Airborne. 8 doses exceeds the UL for at least 4 different nutrients. There is no established UL for several of the nutrients, but this does not mean that excesses cannot be harmful. For instance, an excess of one B vitamin can cause symptoms of deficiency of the other B vitamins. A severe potassium overdose can result in heart and muscle problems, among other things.
Here are some of the symptoms of overdose for the 4 nutrients which would be in excess:
What are the health risks of too much vitamin A?
Hypervitaminosis A refers to high storage levels of vitamin A in the body that can lead to toxic symptoms. There are four major adverse effects of hypervitaminosis A: birth defects, liver abnormalities, reduced bone mineral density that may result in osteoporosis (see previous section), and central-nervous-system disorders [1,48-49].
Toxic symptoms can also arise after consuming very-large amounts of preformed vitamin A over a short period of time. Signs of acute toxicity include nausea and vomiting, headache, dizziness, blurred vision, and muscular uncoordination [1,48-49]. Although hypervitaminosis A can occur when large amounts of liver are regularly consumed, most cases result from taking excess amounts of the nutrient in supplements.
Vitamin C is one of the safest supplements you can take. The main symptom of overdose is diarrhea, but it can cause other problems in very large amounts. (i.e. a gram-sized dose).
The critical adverse effects are elevated blood magnesium concentration and neurotoxicity.
Signs of excess magnesium can be similar to magnesium deficiency and include changes in mental status, nausea, diarrhea, appetite loss, muscle weakness, difficulty breathing, extremely low blood pressure, and irregular heartbeat [5,57-60].)
The critical adverse effect is the influence of excess zinc on copper metabolism. Other effects include epigastric pain, nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, headaches, and immune response impairment.
Most of this information about various nutrients is from government sources: two excellent ones are the FDA's Center for Food Safety and Applied Nutrition website and the National Institute of Health's Office of Dietary Supplements website (be sure to check out their Dietary Supplement Fact Sheets). These sites deal with everything from herbs and nutritional supplements to dietary recommendations, and there's a lot of interesting information there. There's also a great site at the University of Nebraska-Lincoln with various articles, including this one: Upper Safe Levels of Intake for Adults: Vitamins, Macrominerals, and Trace Minerals.
Please also note that, while the Airborne package says it contains 350 MG of a blend of other substances, mostly herbs (Maltodextrin, Lonicera, Forsythia, Schizonepeta, Ginger, Chinese Vitex, Isatis Root, Echinacea), it does not give amounts for the individual herbs. So you don't really know how much you are getting. It is worth mentioning that most sources agree that Echinacea should not be taken daily over a long period of time, so that would be something to be careful of also.
I haven't stopped using Airborne completely, but I have become much more cautious about it. I'll take it if I feel a cold coming on, but only one dose per day on a very occasional basis. I'm also very careful what other vitamins and supplements I take along with it.
If you do use Airborne, I would recommend checking any other supplements you are taking and limiting your doses so that you are not exceeding the ULs for the various nutrients.
[Update:] I wrote a note to the Airborne company about these concerns, and received this e-mail in reply:
Thank you for your inquiry. Take Airborne at the first sign of a cold symptom or a day or two before entering crowded places like airplanes, movie theatres or offices. People use it as a preventative, and some take it daily. Plop an Airborne tablet into a glass of water, let it effervesce, and drink up!
The recommended dosage for Airborne is every 3 hours or as needed, not to exceed 5 doses in a day. Discontinue use when cold symptoms subside.
Airborne is meant to be taken in short duration. If used properly there is no concern of the higher dose vitamins. For further guidance, please consult with your family physician.
Have a great day and stay healthy!
I scoured every bit of the packaging my bottle of Airborne came in, the package itself, and the Airborne website. I could find absolutely no information saying anything remotely similar to "not to exceed 5 doses in a day. Discontinue use when cold symptoms subside." or "Airborne is meant to be taken in short duration." Wouldn't that be rather important information to put on the packaging and website? Also, those statements seem directly contradictory to the earlier statement in the letter that "people use it as a preventative, and some take it daily."
The only warning I can find on the package and the website is this: "As with all dietary supplements, pregnant women or people on medication should consult physician before taking."
The generic version I bought (with exactly the same ingredients) had a warning not to take the product if you have kidney disease, but the Airborne packaging does not share this caution. The reason for the caution, I'm told by a doctor, is that several of the listed nutrients are eliminated by the kidneys and could easily build up to toxic levels if these organs are not working properly. The threshold for permament damage with Vitamin A is much lower in patients with renal failure.
Vitamins and herbs can be contraindicated if you have certain conditions or if you are taking other drugs that can cause interactions. That's just one more thing to be aware of.
Here's the Airborne analysis table reworked with 5 doses instead of 8 doses in the last column. As you can see, 5 doses still meets or exceeds the UL for all four of the nutrients mentioned earlier.
Airborne, Inc. publicizes a double-blind placebo clinical trial that they funded, saying that there were no adverse affects noted. I'm trying to find more information about this trial, conducted by a GNG Pharmaceutical company.
So far I've found information that the participants took Airborne for 5 days, but nothing saying how much they took. We also don't know if tests were run to check kidney and liver function, etc. or if they just went by externally observable signs to determine adverse effects.
Again, I'm not saying that everyone should stop taking Airborne. But I would be cautious about taking it more than once a day or taking it over an extended period of time.
The bottom line is this: Vitamins and herbal supplements don't have to meet safety and efficacy requirements like drugs do. But being made of vitamins and herbs doesn't make a supplement safe. You can't trust the ingredient levels or the dosage instructions to be safe, either. It's always best to check things out for yourself, and it's usually a good idea to talk to your doctor before taking a supplement.
****Update 2007: By early 2007, about a year after this post was written, the company did start printing a warning not to exceed 3 doses per day on the packaging. The package also now contains a warning not to take the product if pregnant or nursing.****