Dr. Nina Shapiro: The Food and Drug Administration (FDA) has announced that Zicam cold remedy nasal gel, and other related products, should not be used, as they can be associated with permanent damage to the nerves associated with smell.

Loss of smell, or "anosmia," can be both debilitating and dangerous. We rely on our sense of smell for recognition and enjoyment of foods, pleasant smells, and even memory. Blunting this important sense can lead to loss of interest in food, and even social isolation. The smell sense is also protective, as it helps us detect dangers such as smoke from a fire or burning substance, gas leaks, or even spoiled food.

The active ingredient, zincum gluconicum, has been pointed to as the source. Zinc has often been considered a homeopathic cold remedy, and is found in many "alternative" treatments such as zinc lozenges. However, when used directly in the nose, it may actually injure the delicate olfactory epithelium (the lining of the nose responsible for smell). Several peer-reviewed studies have demonstrated either no effect or deleterious effects from using zinc directly on nasal tissues. Zinc is a heavy metal, and has not been proven to be safe or effective in reducing cold symptoms.

Because products such as Zicam contain such substances as herbs, minerals, and flowers, they are considered homeopathic, and are not required to undergo review by the FDA before being marketed. However, "homeopathic," "natural," and "alternative" are not necessarily equivalent to "safe," "effective," or "inert," especially for children. Many "natural" remedies may actually do a good deal of harm. Worse, they have unknown risks because they have not been tested appropriately and judiciously on patients. Consumers have fallen into the trap of believing that "natural" is better. On the contrary, many homeopathic products (such as Zicam) are not undergoing the rigorous review required by conventional therapies to gain FDA approval.

Dr. Nina Shapiro is a graduate of Harvard Medical School, and she completed her residency in ear, nose, and throat surgery at Harvard. She is an Associate Professor and Director of Pediatric Ear, Nose, and Throat at the Mattel Children's Hospital at UCLA. She has treated tens of thousands of children with ear problems, sleep problems, and breathing problems. She lives with her husband and two young children in Los Angeles.