Zinc
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| Zinc |
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Zinc formulations have been used since Ancient Egyptian times to enhance wound
healing, although the usefulness of this approach is only partially confirmed
by clinical data of today.
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Zinc is necessary for the functioning of over 300 different enzymes and plays
a vital role in an enormous number of biological processes. Zinc is a cofactor
for the antioxidant enzyme superoxide dismutase (SOD) and is in a number of
enzymatic reactions involved in carbohydrate and protein metabolism.
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Its immunologic activities include regulation of T lymphocytes, CD4, natural
killer cells, and interleukin II. In addition, zinc has been claimed to
possess antiviral activity. It has been shown to play a role in wound healing,
especially following burns or surgical incisions. Zinc is necessary for the
maturation of sperm and normal fetal development. It is involved in sensory
perception (taste, smell, and vision) and controls the release of stored
vitamin A from the liver. Within the endocrine system, zinc has been shown to
regulate insulin activity and promote the conversion thyroid hormones
thyroxine to triiodothyronine.
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Based on available scientific evidence, zinc may be efficacious in the
treatment of (childhood) malnutrition, acne vulgaris, peptic ulcers, leg
ulcers, infertility, Wilson's disease, herpes, and taste or smell disorders.
Zinc has also gained popularity for its use in prevention of the common cold.
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The role for zinc is controversial in some cases, as the results of published
studies provide either contradictory information, and/or the methodological
quality of the studies do not allow for a confident conclusion regarding the
role of zinc in those diseases.
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Atomic number 30, Indian tin, pewter, zinc acetate, zinc acexamate, zinc
aspartate, zinc carbonate, zinc citrate, zinc chloride, zinc gluconate, zinc
methionate, zinc methionine, zinc monomethioine, zinc oxide, zinc picolinate,
zinc sulfate, Zink, ZN, Zn.
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Brands used in clinical trials: A-84, Acexamate, Articulin-F, Astra, Herpigon,
Nels Cream, Orazinc®, Solvezink, Virudermin Gel®, Zeta N, Zicam Nasal Gel,
Zincolak, Zincomed, Zineryt, Zinvit-C250.
These uses have been tested in humans or animals. Safety
and effectiveness have not always been proven. Some of these conditions are
potentially serious, and should be evaluated by a qualified healthcare provider.
| Uses based on scientific evidence |
Grade* |
| Diarrhea (children)
Multiple studies of children in developing countries found that zinc
supplementation in malnourished children with acute diarrhea may reduce
the severity and duration of diarrhea, especially in children with low
zinc levels.
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A |
| Gastric ulcers
The healing process of gastric ulcers may be enhanced through treatment
with zinc, although further studies will be needed to determine to which
extent zinc may be beneficial for patients with this condition. Most
studies report no or few adverse effects associated with its use.
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A |
| Sickle cell anemia (management)
There is strong scientific evidence to suggest that zinc may help manage
or reduce symptoms of sickle cell anemia. Most of these studies reported
increased height, weight, immune system function and testosterone
levels, and decreased numbers of crises and sickled cells following zinc
treatment.
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A |
| Acne vulgaris
Based on high quality studies, topical or systemic use of zinc seems to
be a safe and effective treatment for acne vulgaris; however some
studies report no or negative effects of zinc. Additionally, many
studies used combination treatments.Several studies identify a positive
correlation between serum zinc levels and severity of acne, however
others did not, and it remains to be determined to which degree internal
zinc levels may correlate with the severity of acne.
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B |
| Attention-deficit hyperactivity disorder (ADHD)
One study has shown a correlation between low serum free fatty acids and
zinc serum levels in children with attention deficit hyperactivity
disorder. Two other studies found that zinc supplements reduced
hyperactive, impulsive and impaired socialization symptoms, but did not
reduce attention deficiency symptoms. Zinc supplementation may be a more
effective treatment for older children with higher body mass index (BMI)
scores.
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B |
| Down's syndrome
In several studies, zinc supplements seemed to counteract hypothyroidism
and slightly reduce the number of infections in children with Down's
syndrome. However, zinc did not seem to improve depressed immune
systems. Additional human research is needed before a firm conclusion
can be made.
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B |
| Fungal infections (scalp)
Evidence from two human trials suggests that zinc pyrithione shampoo may
be an effective treatment for tinea versicolor fungal infections of the
scalp. No side effects were noted. Additional research is needed before
a strong recommendation can be made.
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B |
| Herpes simplex virus
Lesser quality studies have been conducted to assess the effects of zinc
(topical or taken by mouth) on herpes type I or II. Several of these
studies used combination treatments or permitted the continued use of
other medications, so the exact role of zinc in those studies is
unclear. However, the positive results obtained in most trials suggest
that zinc may represent a safe and effective alternative treatment for
herpes type I and II, and should encourage further research into the
topic using well-designed studies.
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B |
| High cholesterol
Zinc may improve serum cholesterol levels in hemodialysis patients.
There is some evidence that zinc may improve cholesterol ratio of HDL
"good cholesterol" versus LDL "bad cholesterol"
which would be considered a positive effect. Well-designed clinical
trials are needed before a recommendation can be made.
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B |
| Immune function
Zinc appears to be an essential trace element for the immune system, but
research on the effect of zinc supplementation on immune function is
scant and mostly focuses on patients with specific diseases. Zinc
gluconate appears to exert beneficial effects on immune cells, improving
CD3 and CD4 counts and increasing CD4/CD8 ratios in children. There are
relatively few studies that examine zinc levels and the effects of zinc
supplementation on the health of the elderly population. Further
research is needed before a recommendation can be made.
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B |
| Plaque/gingivitis
A few studies have reported significant reduction in plaque accumulation
following treatment with zinc rinses and dentifrices. Preliminary
research suggests that zinc citrate dentifrice may reduce the severity
and occurrence of supragingival calculus formation. However, more
well-designed studies are needed to confirm such benefits. More research
might help to determine zinc's potential efficacy in other dental
applications.
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B |
| Wilson's disease
Wilson's disease is an inherited disorder of copper metabolism
characterized by a failure of the liver to excrete copper, leading to
its accumulation in the liver, brain, cornea, and kidney, with resulting
chronic degenerative changes. Preliminary research suggests that zinc
treatment may be effective in maintenance of Wilson's disease.
Relatively few cases of adverse effects have been reported, including
one case report presenting a fatality, however, it is unclear whether or
not the death was caused by zinc. Several studies have been conducted by
the same authors, resulting in possible bias. More well-designed trials
are needed to confirm these early results.
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B |
| Alopecia (hair loss)
A few studies that examined the efficacy of zinc in treating alopecia
report contradictory results. Additional information is needed before a
conclusion can be made.
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C |
| Anorexia
Reports of zinc's effectiveness in treating symptoms of anorexia
nervosa, observed in young adults are based on small, non-randomized
studies, but all agree on the beneficial effects of zinc. Well-designed
trials with a larger number of participants are needed to confirm these
results.
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C |
| Bad breath
Chewing gum containing zinc seemed to reduce bad breath (halitosis) in
preliminary study.
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C |
| Beta-thalassemia (hereditary disorder)
One small study notes that children with beta-thalassemia who took oral
zinc supplements for one to seven years increased in height more than
those who did not take zinc. Additional information is needed to confirm
these findings.
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C |
| Boils
In one study, patients with recurrent boils (furunculosis) treated with
zinc found their furuncles did not reappear. Well-designed clinical
trials are needed to confirm this potential benefit.
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C |
| Burns
Study results of zinc sulfate supplements given to burn victims to
increase healing rate yield mixed results. Further research is needed
before a recommendation can be made.
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C |
| Chronic prostatitis (CP)
One study suggests that zinc supplements taken with antibiotics may be
more effective than antibiotics alone in reducing pain, urinary
symptoms, quality of life and maximum urethra closure pressure for
patients with chronic prostatitis. Further research is needed to confirm
these results.
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C |
| Closed head injuries
One poorly designed study indicates that zinc supplementation may
enhance neurological recovery in patients with closed head injuries.
Further research is needed to confirm these results.
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C |
| Cognitive deficits (children)
One study indicates that daily supplementation with zinc may be of
limited usefulness for improving cognition in lead-exposed
schoolchildren. Further study may be warranted in this area.
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C |
| Common cold
There are contradictory results regarding the efficacy of zinc
formulations in treating duration and severity of common cold symptoms.
Although zinc might be beneficial in the treatment of cold symptoms,
more studies are needed to clarify which zinc formulations may be most
effective, which rhinoviruses are affected by zinc, and if nasal sprays
provide a useful alternative application route for zinc treatment. A
recent study found no significant differences between zinc nasal spray
and placebo.Negative results may be the cause of too using doses of zinc
that are too low or the presence of compounds like citric or tartaric
acid, which may reduce efficacy due to chelating of the zinc ion.
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C |
| Crohn's disease
Preliminary research of zinc supplements in patients with Crohn's
disease has yielded positive results. Well-designed clinical trials are
needed to confirm these results.
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C |
| Dandruff
Shampoo containing 1% of zinc pyrithione has been shown to reduce
dandruff in some people.
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C |
| Diabetes (type 1 and type 2)
Diabetic patients typically have significantly lower serum zinc levels
compared with healthy controls. Based on one randomized, controlled
trial, zinc supplementation for type-2 diabetics may have beneficial
effects in elevating their serum zinc level, and in improving their
glycemic control that is shown by decreasing their HbA1c% concentration.
Further study is needed before a recommendation can be made.
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C |
| Diabetic neuropathy (nerve damage)
Oral zinc supplementation may improve glycemic control and severity of
peripheral neuropathy. Further research is needed before a
recommendation can be made.
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C |
| Diaper rash
Zinc may reduce the incidence of diaper rash and have a preventative
effect.
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C |
| Eczema
There is conflicting data regarding the correlation of zinc serum levels
and eczema. One study noted zinc might have caused an increase in
itching after several weeks of supplementation. Additional information
is needed to help clarify these results.
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C |
| Exercise performance
Zinc may improve exercise performance in athletes with low serum zinc or
zinc deficiencies. Additional evidence is needed before a recommendation
can be made.
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C |
| Gilbert's syndrome
Gilbert's syndrome is a common, often inherited disorder that affects
processing by the liver of the greenish-brown pigments in bile (called
bilirubin). The resulting abnormal increase of bilirubin in the
bloodstream can lead to yellowing of the skin (jaundice) but the liver
itself remains normal. It is more common in men than women and is named
after a French gastroenterologist. Zinc sulfate supplementation seemed
to decrease serum unconjugated bilirubin levels in a small study.
Well-designed clinical trials are needed to confirm these results.
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C |
| Hepatic encephalopathy
Hepatic encephalopathy is abnormal brain function caused by passage of
toxic substances from the liver to the blood. Three small randomized,
double-blind trials of zinc for this indication have yielded conflicting
results.
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C |
| Hepatitis C viral infection (chronic)
Two studies have shown that zinc in combination with interferon or
interferon and ribavirin for hepatitis C viral infection patients did
not show significant benefits, except for lower incidence of
gastrointestinal side effects in one study. Further study may be
warranted in this area.
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C |
| HIV/AIDS
Patients with HIV/AIDS, especially in those with low zinc levels, may
benefit from zinc supplementation. Some low quality studies cite
reduction in infections, enhanced weight gain and immune system
function, including increased CD4 and CD8 cells. However, other low
quality studies conflict with these findings. Further research is needed
before a conclusion can be drawn.
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C |
| Incision wounds
Although zinc is frequently cited as having beneficial effects on
incision wound healing, few studies have investigated this use. Further
research is needed before a recommendation can be made.
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C |
| Infertility
Many studies report beneficial results of zinc supplements on
infertility, as expressed in improved sperm quality and number, although
this effect may depend on the cause of infertility. A minor increase in
abnormal spermatozoa in subfertile males taking zinc was noted in one
study. Additional information is needed before a firm conclusion can be
drawn.
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C |
| Kidney function
Preliminary study shows a potential improvement in uremic patients
taking zinc supplements. Further research is needed to confirm these
results. Zinc supplementation may be recommended only in the patients
with proven zinc deficiency, but for all chronic renal failure patients
it is questionable.
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C |
| Kwashiorkor (malnutrition from inadequate protein
intake)
Short-term zinc supplementation may increase weight gain and decrease
infections, swelling, diarrhea, anorexia and skin ulcers in children
with extreme malnourishment.
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C |
| Leg ulcers
There are conflicting findings regarding the potential benefit of zinc
for healing leg ulcers. All studies, however, reported no or few adverse
effects.
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C |
| Leprosy
A few studies have examined the efficacy of zinc treatment in leprosy.
Studies of zinc taken by mouth report positive results, while one study
of topical zinc reports negative results. Further research is needed
before a conclusion can be drawn.
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C |
| Liver cirrhosis
People with alcoholic liver cirrhosis may be deficient in zinc.
Preliminary studies suggest that zinc may benefit these patients.
Further evidence is needed to confirm these findings.
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C |
| Lower respiratory infections in children
Results from large clinical trials suggest that supplementation with
zinc may reduce the incidence of lower respiratory infections. Some
studies suggest these effects to be only apparent in boys, and not
girls. A trend toward increased respiratory infections in children has
been noted in one study. A recent study does not support the use of zinc
supplementation in the management of acute lower respiratory infections
requiring hospitalization in indigenous children living in remote areas.
Due to conflicting results, further research is needed before a
conclusion can be drawn. Future studies could examine whether these
adult populations have a similar response.
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C |
| Macular degeneration
Most studies examining the relationship between dietary zinc intake over
many years and macular degeneration have not reported positive
correlations. However, one large well-designed, randomized study, which
examined the efficacy of zinc supplements in preventing loss of visual
acuity, found zinc supplements to be beneficial in preventing the
occurrence of age related macular degeneration. Since study results are
conflicting, additional well-designed clinical trials are needed before
a recommendation can be made.
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C |
| Malaria
Results are contradictory for the effect of zinc on malaria symptoms.
Some randomized, double-blind clinical trials suggest no effect of zinc
supplementation on the severity of malaria. Other studies suggest that
zinc supplementation may reduce the number of stays in hospital and
death rate due to P. falciparum infection. Further
well-designed, randomized and controlled trials are required to address
these discrepancies.
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C |
| Muscle cramps (cirrhosis)
The results of one case series suggest that zinc supplementation may
improve muscle cramps in patients with cirrhosis. Further research is
needed to confirm these results.
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C |
| Parasites
In a few studies of varying quality, patients with cutaneous
leishmaniasis were injected with zinc sulfate intralesionally. One study
found zinc sulfate was better than meglumine antimoniate for the first
four weeks, but no statistical differences were observed after six
weeks. Zinc may decrease the severity of infection and re-infection of S.
mansoni , but does not seem to prevent initial infection. More
research should be done in this area to examine how zinc affects the S.
mansoni life cycle and whether this data can be extrapolated to
other species of Schistosoma .The effects of zinc on
the rate of parasitic re-infestation have been examined in children. No
significant effect of zinc treatment was found. Due to conflicting
results in this area, more research is needed before zinc can be
recommended for the treatment of parasites.
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C |
| Poisoning (arsenic)
Results from one study show that a combination of spirulina extract plus
zinc may be useful for the treatment of chronic arsenic poisoning with
melanosis and keratosis. More research is needed to confirm the effects
of zinc alone.
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C |
| Pregnancy
According to one review, there is no evidence to suggest that zinc
supplementation offers benefits during pregnancy, although there is a
possible reduction in labor complications and pre-term deliveries.
However, results from individual studies suggest a possible benefit of
zinc supplementation on blood pressure during pregnancy. Further
research is needed before a conclusion can be drawn.
|
C |
| Psoriasis
There are only a few studies that examine the efficacy of zinc treatment
on symptoms of psoriasis, including psoriasis induced arthritis-like
symptoms. One trial noted a reduction in pain and joint swelling. Other
studies do not support a role for zinc in alleviating the symptoms of
psoriasis. Further, well-designed clinical trials are required to
clarify these results.
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C |
| Radiation-induced mucositis
Radiation has the potential side effect of mucositis, which is
inflammation of mucous membranes inside of the mouth, nose and throat.
Two trials suggest that zinc may lower the degree of mucositis in
patients on radiation. Further research is needed to confirm these
results.
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C |
| Rheumatoid arthritis
The majority of trials do not show significant improvements in arthritis
symptoms following zinc treatment. Interpretation of some data is
difficult by because patients in the studies were permitted to continue
their previous arthritis medication and most studies used a small number
of participants. Well-designed clinical trials are needed before a
decision can be made.
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C |
| Skin damage caused by incontinence
Preliminary evidence suggests that topical zinc oxide oil may help
manage perianal and buttock skin damage in incontinent patients. Further
research is needed to confirm these results.
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C |
| Stomatitis
Zinc sulfate has been studied for the treatment of recurrent aphthous
stomatitis (RAS). Study results conflict and no clear conclusion can be
drawn at this time.
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C |
| Taste perception (hemodialysis, cancer)
Results from studies investigating the potential role of zinc in
treating taste and smell disorders are contradictory. Well-designed
research is needed to determine if zinc contributes to the treatment of
taste and smell disorders.
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C |
| Tinnitus
Studies on the efficacy of zinc in treating tinnitus yield contradictory
results based on subjective findings. Further research is necessary
before a conclusion can be drawn.
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C |
| Trichomoniasis
Little research is available on the efficacy of zinc for the treatment
of trichomoniasis, a sexually transmitted disease (STD). One very small
study suggests that a zinc sulfate douche and the prescription
antibiotic metronidazole may effectively treat patients with
recalcitrant trichomoniasis. However, more well-designed human studies
are necessary before a firm conclusion can be drawn.
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C |
| Viral warts
One study suggests that zinc sulfate may be an efficacious therapy
option for recalcitrant viral warts. Well-conducted studies are needed
to confirm these early results.
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C |
| Celiac disease
In a very small study, oral zinc supplements did not seem to improve the
clinical condition of patients with unresponsive celiac syndrome.
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D |
| Chronic inflammatory rheumatic disease
In a small study, zinc supplementation did not seem to have a beneficial
effect on symptoms of patients with chronic inflammatory rheumatic
disease.
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D |
| Continuous ambulatory peritoneal dialysis (CAPD)
Zinc supplementation did not improve the nutritional status in patients
on CAPD based on one well-designed trial.
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D |
| Cystic fibrosis
Zinc supplementation does not seem to affect clinical status, growth
velocity or lung function in children with cystic fibrosis.
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D |
| Inflammatory bowel disease
One small study found that zinc supplementation does not seem to improve
inflammatory bowel disease.
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D |
| Pneumonia (children)
One study found that zinc supplementation does not seem to lessen the
duration of tachypnea, hypoxia, chest indrawing, inability to feed,
lethargy, severe illness, or hospitalization in children.
|
D |
*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.
Grading rationale
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often
have not been thoroughly tested in humans, and safety and effectiveness have
not always been proven. Some of these conditions are potentially serious, and
should be evaluated by a qualified healthcare provider.
Acrodermatitis enteropathica, alcoholism, Alzheimer's disease, benign prostate
hyperplasia, bladder cancer, bulimia, cancer (pre-cancerous esophagus lesions,
pre-cancerous lesions in their upper aerodigestive tract), diabetic retinopathy,
diarrhea (AIDS), encephalopathy, eye disorders (night blindness, retinol
pigmentation abnormalities), hypoxia, activity stimulant (children), growth
disorders, human papilloma virus, hypogonadism, hyperprolactinemia, liver
enlargement and disorders, menopause, nutritional deficiencies (consumption of
dirt), pancreatitis, psychosis, Parkinson's disease, poisoning (nickel),
schizophrenia, seizures, skin disorders (parakeratosis), smell disorders, spleen
disorders (enlargement), tuberculosis, wound healing.
The below doses are based on scientific research,
publications, traditional use, or expert opinion. Many herbs and supplements
have not been thoroughly tested, and safety and effectiveness may not be proven.
Brands may be made differently, with variable ingredients, even within the same
brand. The below doses may not apply to all products. You should read product
labels, and discuss doses with a qualified healthcare provider before starting
therapy.
Standardization:
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Zinc is used in different forms, as elemental zinc, zinc acetate, zinc
aspartate, zinc chloride, zinc citrate, zinc carbonate, zinc gluconate, zinc
methionate, zinc oxide, zinc sulphate etc., so that the doses used in various
studies may not be comparable, unless they are standardized to elemental zinc
content.
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Recommended daily allowance: The current recommended dietary allowance for
zinc is 3mg for 7 month-olds to 3 year-olds; 5mg for 4 to 8 year-olds; 8mg for
9 to 13 year-olds; 11mg for 14+ year-old males; 9mg for 14 to 18 year-old
males; 8mg for 19+ year-old males; 13mg for 14 to 18 year-old pregnant
females; 11mg for 19+ year-old pregnant females; 14mg for 14 to 18 year-old
lactating females; and 12mg for 19+ year-old lactating females.
Adult Dosing (18 years and older):
Oral:
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Acetazolamide side effects: 0.2g zinc sulfate three times daily has been
studied in those with grave acetazolamide-induced side effects.
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Acne vulgaris: Doses ranging from 45-220mg of zinc sulfate (Orazinc® or
effervescent), three times daily, up to 12 weeks have been studied. Doses of
45-135mg of zinc in divided doses have been studied for up to 12 weeks, and
30-200mg zinc gluconate has been used for three months.
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Acrodermatitis enteropathica: Various doses have been studied: 100mg zinc,
three times daily; 45mg, two times daily; 30mg-65mg daily; 200mg per day (Solvezink®,
Tika AB); 135mg zinc sulfate daily; 220mg, three time daily, or 50mg, twice
daily; 45mg zinc, three times daily (Solvezink®, Tika AB); and 45mg zinc,
three times daily for two months.
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Acute lymphoblastic leukemia: 0.02mg/kg body weight of zinc has been studied
as an adjunct therapy for leukemia.
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Alopecia areata: Zincomed, 220mg zinc sulfate twice daily has been studied for
three months.
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Anorexia: 45-100mg daily of zinc, zinc sulfate or zinc acetate have been
studied. 15mg zinc (as sulfate), three times daily for two weeks, followed by
50mg, three times daily, has also been used.
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Burns: A dose of 660mg of zinc sulfate (ZnSO4) has been used.
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Cancer: 90mg zinc sulfate per day for five days, with a maintenance dose of
180mg per day has been used to treat pustules in a woman with squamous cell
carcinoma and a zinc deficiency.
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Chronic inflammatory rheumatic disease: 45mg zinc as gluconate has been used
daily for two months.
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Cirrhosis/alcoholism: 200mg as sulfate has been used three times daily. A
daily oral intake of 200mg of zinc sulfate for two months has been studied for
its immune-enhancing effects in these patients.
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Common cold/lower respiratory infection: Doses ranged from 4.5-23.7mg
zinc/lozenge and were taken every half hour during waking hours. Lozenges
containing 5mg or 11.5mg zinc acetate or 13.3mg zinc gluconate (Quigley
Corporation PA) were taken every 2-3 waking hours (total of six lozenges per
day). Zinc lozenges (Heiko Chemicals, PA) containing zinc acetate, 42.96mg,
12.8mg zinc) have been studied. Zinc lozenges with 10mg zinc (Quigley
Corporation) has been used three times daily. 23mg zinc (as gluconate)
lozenges has been taken daily for seven days. Lozenges (Quigley Corporation,
PA) containing zinc (13.3mg zinc gluconate trihydrate with molar
concentrations of glycine) have been used every two hours of waking time.
Effervescent lozenges (containing 10mg zinc acetate) taken for three days, and
at least four lozenges a day have also been studied. 23mg zinc lozenges
containing 2% citric acid were taken every half hour while awake. 23mg zinc
lozenges (Truett Laboratories, TX) were used in one study where patients were
instructed to let them dissolve in their mouth. Initial dose consisted of two
lozenges, then one every two hours.
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Continuous ambulatory peritoneal dialysis (CAPD): 100mg per day of elemental
zinc for three months has been studied.
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Crohn's disease: 60mg per day ZnSO4; 200mg per day ZnSO4 for three months has
been studied for thyroid function in Crohn's disease patients. 200mg of zinc
sulfate daily for six weeks has also been studied.
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Cutaneous leishamaniasis: 2.5-10mg of zinc sulfate has been used (Analar [BDH]).
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Dental application: One or two pieces of a zinc chewing gum for at least ten
minutes, three times daily for one week has been studied to treat halitosis.
0.5% zinc citrate dentifrice has also been studied for three months.
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Diabetes: 30mg per day as amino acid chelate for three weeks. 30mg of zinc,
(as glycine) for three weeks has been given to alleviate oxidate stress in
diabetics; 30mg of zinc (as gluconate) has been studied; 50mg zinc has been
used daily for 28 days.
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Diabetic neuropathy: Zinc sulfate (660mg) for six weeks has been studied.
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Dialysis: 50mg per day as acetate have been used in dialysis patients for
effects on lymphocyte and granulocyte function.
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Diaper rash: 10mg zinc gluconate supplements have been used as an adjunct to
anti-fungal cream for diaper rash.
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Down syndrome/hypothyroidism: Zinc supplements (1mg/kg/body weight) for two
months, followed by a ten-month break, and then again for two months of zinc
treatment. 135mg zinc (as sulfate) daily for two months.
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Dysgeusia: Zinc gluconate 140mg daily.
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Eczema: 220mg of daily oral zinc treatment as sulfate has been studied.
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Exercise performance: Zinc at 3mg/kg body weight has been studied for four
weeks.
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Furunculosis: 45mg have been used three times daily (Solvezink, Tika) for four
weeks.
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Gastro-duodenal ulcers: Doses of zinc Acexamate 300-1800mg, three times daily
have been studied for five weeks with maintenance doses of 600mg for up to six
months. 220mg zinc sulfate taken three times daily for three weeks has also
been used
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Gastro-intestinal disease: 300mg per day zinc acexamate.
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Gastric/gastroduodenal ulcers: A-84, 300mg, three times daily for three weeks.
Doses of zinc Acexamate 300mg-600mg per day. 220mg as sulfate, three times per
day for four weeks.
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Gilbert's syndrome: 40mg of ZnSO4 in a single dose has been used for acute
conditions, and 100mg ZnSO4 in a single dose has been given for seven days for
chronic conditions.
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Hepatic encephalopathy: Zinc sulfate or zinc acetate, 600mg, has been used for
seven to ten days.
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Hypercholesterolemia: 7.7mcmol zinc sulfate (50mg elemental zinc) for 90 days
has been studied.
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Hyperlipidemia: 150mg zinc daily for 12 weeks has been studied.
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Hyperprolactinemia: 37.5mcg oral zinc as sulfate and 15.9mg as sulfate has
been used three times daily for 60 days.
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HIV/AIDS: 200mg of zinc sulfate has been used daily for four weeks as an aid
in immune response. Zinc gluconate (125mg of zinc gluconate has been used
twice daily for three weeks.
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Immune function: 30mg zinc daily for 14 weeks has been investigated. 200mg of
zinc sulfate has been used for two months.
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Immune function in the elderly: 25mg of zinc phosphate has been investigated.
220mg zinc sulfate, twice daily for one month. 50, 100 and 150mg elemental
zinc has been used daily. 12mg of Zn+ has been used daily for one month in
infected elderly subjects.
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Infertility: 50mg zinc per day. 66mg zinc sulfate per day for 26 weeks has
been used to improve sperm count in fertile and subfertile males. 250mg of
zinc sulfate has been used twice daily for three months. 220mg of zinc sulfate
has been used once daily, for four months (Cap, ZINCOLAK, Shalaks Chemicals).
440mg zinc sulfate for 12 months. 220mg zinc sulfate for impotence and
hypogonadism in hepatic cirrhosis patients. 500mg zinc has been used daily as
a supplement with hydrochlorothiazide and sexual side effects.
-
Inflammatory bowel disease: 300mg zinc aspartate (equal to 60mg elemental
zinc) has been used daily for four weeks.
-
Intestinal malabsorption: 100mg, three times daily and 19mg daily have been
used.
-
Leg ulcers: 220mg zinc sulfate, 1-3 times daily for up to ten months has been
studied. 200mg zinc sulfate, three times daily (Solvezink, Astra) for up to
one year.
-
Leprosy: 220mg zinc sulfate daily has been studied as an adjunct to leprosy
medication for up to 18 months.
-
Macular degeneration: 100mg, two times per day for up to two years.
-
Muscle cramps (cirrhosis): 220mg twice-daily oral zinc sulfate thrice weekly
for 12 weeks has been used.
-
Nickel-positive patients: Zinc sulfate 100mg, three times per day, for 30 days
has been studied.
-
Pancreatitis/home parenteral nutrition: 30mg zinc sulfate for the first three
days of total parenteral nutrition has been used.
-
Pregnancy: 30mg elemental zinc has been studied during the last two trimesters
of pregnancy, but did not improve birth outcome in Bangladeshi urban poor.
14mg iron and 250mcg folate with 15mg zinc has been studied in pregnancy.
-
Psoriasis: 220mg, three times daily for the first for six weeks, then six
months. 220mg zinc sulfate three times daily for two months. 50mg of zinc,
three times daily.
-
Rheumatoid arthritis: 220mg of zinc sulfate three times daily has been used up
to (Mericon Industries, Ill) 12 weeks. 220mg has been used three times daily
for six months (356). 200mg has been used three times daily. 220mg zinc
sulfate, three times daily for at least two months (Solvezinc, Astra). 600mg
has been used every 24 hours, (divided up into three doses) for eight months,
but showed little success.
-
Sickle cell anemia: 220mg zinc, three times per day has been used. 75mg of
zinc supplements have been used daily for up to three years. A solution of 1%
of zinc sulfate in distilled water has been used. 15mg zinc as acetate has
been used twice daily. 25mg every four hours has been studied to enhance
healing of leg ulcers and control sickling of erythrocytes in people with
sickle cell anemia. 15mg zinc as acetate, has been used three times daily for
12 months to treat serum testosterone deficiency in adults with sickle cell
anemia.
-
Skin lesions: 400mg zinc sulfate has been used daily.
-
Stomatitis: A dose of 200mg zinc sulfate once daily for up to 12 weeks has
been studied.
-
Supplementation: 15mg or 100mg daily for three months has been studied in
healthy, elderly people.
-
Supragingingival calculas formation: Dentrifices containing 0.5% zinc citrate
have been used.
-
Taste disorders: 45mg zinc sulfate, three times daily has been used as an
adjunct to external radiotherapy. 100mg zinc ion has been used daily for three
months. 220mg of zinc sulfate has been used daily for six weeks. 29mg of zinc
picolinate capsules have been used three times daily for three months. 100mg
zinc sulfate has been used daily for six months. 50mg of zinc acetate has been
used daily.
-
Tinnitus: 22mg of zinklet tablets (slow release tablets) have been taken three
times daily for over eight weeks. 50mg of zinc has been taken daily. Zinc
(34-68mg per day, for two weeks).
-
Trichomoniasis: 220mg Zincaps has been used twice daily for three weeks to
treat trichomoniasis infection that was unresponsive to metronidazole.
-
Viral warts: Oral zinc sulfate at a dose of 10mg kg-1 daily up to 600 mg day-1
and followed-up for resolution of their warts and for any evidence of
recurrence for 2-6 months has been studied.
-
Wilson's disease: 50mg zinc acetate, three times per day for up to one year.
Dosages used ranged from 100mg to 400mg zinc sulfate, three times per day.
75mg per day has been given in at least two doses; zinc acetate 150mg per day,
in six doses. Doses of 25-50mg three times daily have been investigated to
examine the appropriate dose for maintaining copper balance in those with
Wilson's disease. Zinc acetate 25mg, six times per day, for 3-7 weeks has also
been used.
-
D-penicillamin, followed by treatment with zinc sulfate 150mg, three times per
day first dose, then 100mg, three times per day has been used.
-
Zinc (sulfate 200-300mg, three times per day) has been used as a therapy for
up to two years when patients did not respond to cupriuretic drugs.
-
Zinc acetate treatment (every four hours during day) has been used.
-
Zinc sulfate 200mg, three times per day has been used for up to 14 years.
-
Wound healing: 220mg zinc sulfate, three times per day has been used following
surgery to promote wound healing.
Topical:
-
Acne vulgaris: Erythromycin (4%) plus 1.2% zinc has been studied for one year.
Also, erythromycin (4%) plus zinc two times per day, for ten weeks has been
studied.
-
Erythromycin (4%) plus zinc (1.2%) has been used two times per day for 12
weeks.
-
Erythromycin (4%) plus zinc (1.2%)has been applied as a topical solution two
times per day for 12 weeks for one year.
-
Nels' cream (containing chloroxylenol and zinc oxide, though no information
about zinc concentration provided), 5% benzoyl peroxide cream and the vehicle
of Nels' cream in treating acne vulgaris has been used two times per day, for
eight weeks.
-
A 4% erythromycin and 1.3% zinc gel has been used for two weeks.
-
Dandruff: Shampoo containing 1% zinc pythione (ZPT) has been shown to reduce
the number of PAS-positive microorganisms (but not Gram-positive
micro-organisms).
-
Dental application: 0.5% zinc citrate has been used.
-
Herpes: Two applications daily of 0.3% zinc oxide/glycine cream has been
studied. Virunderim Gel®, containing 10mg zinc sulfate has also been used up
to 12 days. 0.01%-0.05% zinc sulfate solutions has been applied often during a
breakout and once a week during remission. Immersion treatment with liquid
soap containing 1% zinc sulfate has been used for three months followed by
weekly application. A 4% zinc sulfate solution in water has also been used.
-
Immune enhancement: 10mg zinc gluconate has been studied, and during diarrhea,
20mg of zinc gluconate has been reported.
-
Leg ulcers: Topical 250-510mcg/cm2 topical zinc oxide in polyvinyl pyrrolidone
has been studied for eight weeks. Zinc oxide dressings (Mezinc) have been
investigated for eight weeks. Gauze compress medicated with zinc oxide (400mcg
ZnO/cm2) has been studied for eight weeks.
-
Psoriasis: Cow udder ointment (containing zinc) has been studied for
psoriasis.
-
Sebum levels: Erythromycin lotions (4%) with (1.2%, Zineryt Lotion) have been
studied for three months for effects on sebum levels.
-
Sickle cell anemia: 10mg daily of zinc in a 5mL cherry soup has been taken for
one year.
-
Trichomoniasis: Zinc sulfate douche (1%) and metronidazole has been used.
Intravenous, Intramuscular:
-
Anorexia: 40mcmol per day zinc, intravenously for seven days, followed by 15mg
per day for 60 days has been reported.
-
Cutaneous leishmaniasis: Intralesional injections of ZS 2% and ZnSO4 2% have
been studied.
Nasal:
-
Common cold: 0.12% zinc sulfate nasal spray administered four times per day
into each nostril has been reported. Gels containing zinc gluconate (Zicam)
have been used at the recommended dose of one spray (120mcL) into each
nostril, every four hours.
Pediatric Dosing (younger than 18 years):
-
Childhood malnutrition: 10mg per day or 1mg/kg body weight per day by mouth
has been studied.
-
Common cold: 10mg per day taken by mouth or 23mg zinc lozenges (Truett
Laboratories, TX) have been studied with initial dose consisting of one
lozenge (half of the adult dose) every two hours, not to exceed six per day.
-
Diarrhea: Children aged 6 months to 2 years received zinc (20mg as acetate, in
syrup) for treatment of dehydration and diarrhea; 14.2mg zinc acetate or 40mg
zinc acetate has also been studied in 6 month-old to 2 year-old children,
respectively. In 3-24 month-old infants, 20mg zinc acetate per day for two
weeks has been used. A zinc syrup containing 15mg zinc was used on 6-11
month-old children and 30mg with 12-35 month-old children. 15mg (in children
younger than or equal to 12 months-old) or 30mg (in children older than 12
months-old) elemental zinc daily in three divided doses has been studied for
14 days. Another study reported using 10mg zinc per day for five days of the
week or 50mg zinc once weekly for 16 weeks. Other doses used in children
include 20mg zinc daily for up to two weeks; 20mg of zinc as sulfate, two
times per day; 10-20mg zinc in a multivitamin formula for six months;
multivitamin juice with 15mg zinc acetate/kg body weight; 10mg zinc sulfate in
4mL liquid per day, for seven months; and zinc gluconate (elemental zinc 10mg)
to infants and 20mg to older children.
-
Down syndrome: 20mg/kg zinc per day for two months showed an increase in DNA
synthesis. 50mg (for up to six months) and 1 mg/kg per day (for up to four
months) zinc have shown a reduction in the number of infections.
-
Eczema: 22.5mg zinc, three times per day (in sustained release capsules) for
eight weeks has been reported.
-
HIV/AIDS: 1.8-2.2mg/kg body weight per day, for three to four weeks has been
studied as an immune response aid in children.
-
Infection: 20mg zinc for one year has been studied for stunted growth and
episodes of infectious disease.
-
Infection with Schistosoma mansoni : 30-50mg, as zinc
sulfate five times a week for 12 months has been studied for S.
mansoni infection in children .
-
Kwashiorkor: Doses of 2-5mg/kg zinc supplements have been studied for one week
in children.
-
Lower respiratory tract infectionschildren: Studied doses include 10mg zinc
gluconate six times a week; 10mg zinc sulfate in 4mL liquid per day, for seven
months; 10mg to infants and 20mg to older children or placebo for four months;
and 10mg zinc as acetate (twice daily for five days).
-
Malaria: Studied doses include 12.5mg zinc sulfate for six days per week for
six months; 10mg zinc gluconate per day, six days per week; 10mg elemental
zinc for six days a week for 46 weeks; and zinc 20mg day for infants or 40mg
per day for older children for four days.
-
Parasites: Zinc supplements 10mg as amino acid chelate have been used.
-
Sickle cell anemia: Zinc 10mg per day in 5mL cherry soup has been used in
children.
-
Taste perception: Zinc chelate 1mg/kg daily for three months has been used in
children.
-
Wilson's disease: Pediatric patients of 1-5 years of age were given 25mg of
zinc twice daily; patients of 6-15 years of age, if under 125 pounds body
weight, were given 25mg of zinc three times daily; and patients 16 years of
age or older were given 50mg of zinc three times daily.
The U.S. Food and Drug Administration does not strictly
regulate herbs and supplements. There is no guarantee of strength, purity or
safety of products, and effects may vary. You should always read product labels.
If you have a medical condition, or are taking other drugs, herbs, or
supplements, you should speak with a qualified healthcare provider before
starting a new therapy. Consult a healthcare provider immediately if you
experience side effects.
Side Effects and Warnings
-
General: Zinc is regarded as a relatively safe and generally well tolerated
when taken at recommended doses, and few studies report side effects.
Occasionally adverse affects such as nausea, vomiting, or diarrhea has been
observed.
-
Blood: Sideroblastic anemia, leukopenia, microcytic anemia, neutropenia have
bee reported in individual case reports following ingestion of large amounts
of zinc.
-
Endocrine: Reduced levels of high-density-lipoprotein (HDL) "good"
cholesterol have been observed following daily supplementation with zinc.
-
Gastrointestinal: Nausea, vomiting, unpleasant taste, taste distortion,
abdominal cramping, and diarrhea have been occasionally reported, especially
in studies examining the efficacy of zinc containing lozenges in treating
symptoms of common cold or treatment of diarrhea in children. Bleeding gastric
erosion, hepatitis (liver inflammation), liver failure and intestinal bleeding
have been reported in individual case reports following ingestion of higher
zinc doses. Nasal zinc spray has caused olfactory region pain in some
patients.
-
Kidney: Acute tubular necrosis and interstitial nephritis have been reported
following ingestion of large amounts of zinc (doses not specified). Patients
with severe kidney disease should reduce or omit taking zinc because it is
primarily eliminated in urine.
-
Liver: A case has been reported of a young woman with Wilson's disease who
began treatment with zinc therapy but developed hepatitis (liver
inflammation). It is unclear whether the zinc treatment caused the hepatitis.
Treatment was changed to the prescription drug penicillamine and the infection
cleared.
-
Neurologic/CNS: There is one case report of a fatal outcome from cystic
degeneration in putamen and necrosis in the hypothalamus. It was reported as a
consequence of zinc treatment for Wilson's disease; however, the patient had
received penicillamine, followed by a relatively high does of zinc per day for
several weeks, followed by penicillamine again for an unspecified time so it
remains unclear if zinc was responsible for the death.
-
Pulmonary/respiratory: Slight tingling or burning sensation in the nostril has
been reported from zinc nasal gel. A trend toward increased respiratory
infections in children has been noted.
-
Skin: Reports of skin conditions have been noted. In one study, worsening of
an acne condition was observed following topical application of zinc, although
many studies show positive effects of zinc on acne.
-
Other: There is one report of death following the ingestion of 400 coins
(mostly pennies). Pennies are composed mostly of zinc. Reduced immune
responses have also been observed in a small study.
Pregnancy & Breastfeeding
-
Pregnancy, Category A: Zinc is categorized as Pregnancy Category A. If this
drug is used during pregnancy, the possibility of fetal harm appears remote.
Because studies cannot rule out the possibility of harm, however, zinc acetate
should only be used during pregnancy if clearly needed. Zinc appears to be
safe in amounts that do not exceed the established tolerable upper intake
level.
-
Pregnancy, Category C: Animal reproduction studies have not been conducted
with zinc chloride. It is also not known whether zinc chloride can cause fetal
harm when administered to a pregnant woman or can affect reproduction
capacity. Zinc chloride should be given to a pregnant woman only if clearly
needed under medical supervision.
Most herbs and supplements have not been thoroughly
tested for interactions with other herbs, supplements, drugs, or foods. The
interactions listed below are based on reports in scientific publications,
laboratory experiments, or traditional use. You should always read product
labels. If you have a medical condition, or are taking other drugs, herbs, or
supplements, you should speak with a qualified healthcare provider before
starting a new therapy.
Interactions with Drugs
-
Amiloride(Midamor®): Amiloride reduces urinary zinc excretion and increases
zinc blood levels. Theoretically, concurrent use of amiloride with zinc
supplementation could cause zinc toxicity.
-
Caffeine: Caffeine may decrease zinc concentrations.
-
Captopril (Capoten®)/Enalapril (Vasotec®): Captopril and enalapril might
increase urinary zinc excretion in patients with high blood pressure. Data on
other ACE-inhibitor (ACEIs) drugs is lacking. The clinical consequence of
urinary zinc loss in patients with high blood pressure is unknown.
-
Carbenoxolone analog (BX24): Zinc sulfate may interact with this drug.
-
Chlorthalidone (Hygroton®): Chlorthalidone may increase serum zinc levels.
-
Cholera vaccine: Supplementation with zinc has the potential to improve the
efficacy of oral cholera vaccine in children.
-
Cholesterol-lowering drugs: Zinc may interact with LDL, HDL lipoproteins, and
triglycerides, reducing HDL "good" cholesterol levels.
-
Cholestyramine: Cholestyramine appears to decrease zinc excretion in the urine
and alkalinization of urinary zinc.
-
Cisplatin (Platinol-AQ®): Zinc may increase the cytotoxicity of cisplatin
when in the presence of the chelate ethylenediaminetetraacetic acid (EDTA), as
compared to cisplatin treatment alone.
-
Deferoxamine (Desferal®): Deferoxamine increases urinary zinc elimination.
-
Drugs that cause depletion of zinc (e.g. birth control pills, loop and
thiazide diuretics): These drugs may decrease zinc absorption.
-
Erythromycin: Zinc may decrease the absorption of erythromycin. However, in a
study comparing erythromycin with and without added zinc, the results showed a
significant reduction in severity and number of acne vulgaris lesions
(including inflamed lesions) in the zinc treated group compared to those
taking erythromycin alone.
-
Ethanol (alcohol): Alcohol may decrease serum zinc concentrations.
-
Fluoroquinolone antibiotics: Zinc may decrease the effectiveness of
fluoroquinolone antibiotics (e.g. Cipro®).
-
Hormone replacement therapy (HRT): Hormone replacement therapy may reduce zinc
excretion in the urine.
-
Insulin: Zinc may improve both insulin secretion, insulin sensitivity and
exerts insulin-like effects.
-
Interferon Alfa-2B (Intron A®): High amounts of zinc may result in the
prevention of interferon release.
-
Pancreatic enzyme replacements: The agents may improve absorption of zinc
compared to pancreatic insufficiency.
-
Penicillamine (Cuprimine®): Penicillamine chelates zinc and can reduce the
effects of supplemental zinc. Dosing time should be separated by at least two
hours.
-
Tetracycline antibiotics: Zinc decreases absorption and serum levels of
demeclocycline, minocycline, and tetracycline due to zinc binding. Doxycycline
does not seem interact with zinc.
-
Thyroid active drugs: Zinc supplementation has been shown to alter thyroid
hormone metabolism in disabled patients with zinc deficiency.
Interactions with Herbs and Dietary Supplements
-
Cholesterol-lowering herbs/supplements: Zinc may interact with LDL, HDL
lipoproteins, and triglycerides, reducing HDL "good" cholesterol
levels.
-
Copper: Zinc may interfere with copper metabolism. However, one study
indicates no detrimental effects of zinc on plasma copper levels in healthy
volunteers over a period of six weeks.
-
Iron: Non-heme iron may decrease zinc absorption. Non-heme iron and zinc
compete for a common absorption pathway in the gut. However, when iron and
zinc are taken with food, this interaction is not likely to occur. When taken
with food, zinc absorption is facilitated by proteins in food through an
alternate pathway that does not compete with iron. Protein-bound heme iron
(found in red meats) does not seem to affect zinc absorption.
-
Thyroid active herbs and supplements: Zinc supplementation has been shown to
alter thyroid hormone metabolism in disabled patients with zinc deficiency.
Interactions with Foods
-
General: Foods and beverages have been shown to decrease the uptake of zinc
thereby decreasing the levels of zinc in the plasma of healthy study
volunteers. For this reason, it has been recommended that an oral dose of zinc
be separated from food and beverages, other than water, by at least one hour.
-
Dairy foods: May decrease zinc concentrations.
-
Fiber (including bran): May interfere with the absorption of zinc.
-
IP-6 (phytic acid): IP-6 in foods can decrease zinc absorption. Theoretically,
IP-6 supplements could also interfere with zinc absorption as IP-6 chelates
multivalent metal ions in the gastrointestinal tract, preventing absorption.
-
Phosphorous: May interfere with the absorption of zinc.
Interactions with Laboratory Tests
-
Blood cell counts: Sideroblastic anemia, leukopenia, microcytic anemia, and
neutropenia have been reported in individual case reports following ingestion
of large amounts of zinc.
-
Copper: Zinc may interfere with copper metabolism. However, one study
indicates no detrimental effects of zinc on plasma copper levels in healthy
volunteers over a period of six weeks.
-
Cortisol: Zinc may interact with cortisol excretion.
-
HbA1c/MNL-Zn: Large-dose Zn supplementation increases MNL-Zn and induces an
undesirable elevation of HbA1c in all individuals. This is especially
disconcerting for those with diabetes (IDDM), and may reflect an exacerbation
of a chronic "Zn diabetes." These data suggest a potential for
toxicity from large-dose Zn supplementation.
-
LH, FSH, testosterone, sperm count: Significant increases in serum
testosterone and sperm count with a decrease in LH and FSH has occurred
following zinc supplementation compared to pre-supplementation. Laboratory
studies showed an increase of 5 α-reduction at low concentrations of
zinc, and a decrease at higher zinc concentrations. Zinc deficiency has been
shown to decrease serum testosterone levels.
-
Lipid panel: Zinc may interact with LDL, HDL lipoproteins, and triglycerides,
reducing HDL "good" cholesterol levels.
-
Thyroid hormone: Zinc supplementation has been shown to alter thyroid hormone
metabolism in disabled patients with zinc deficiency.
-
Tuberculin test: Zinc supplementation may increase the tuberculin test in
duration and decrease false negative results.