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Natural Medicine Journal

March 22, 2014

Zinc: Bottom Line Monograph

Mineral gets top marks in treating diarrhea in children, as well as gastric ulcers

Natural Standard

Zinc is necessary for the functioning of more than 300 different enzymes and plays a vital role in a large number of biological processes. This article distills the copious research surrounding the mineral and rates its effectiveness for a variety of conditions.

Related Terms

A-84, Articulin-F®, Astra, atomic number 30, Curiosin® (zinc and hyaluronic acid), Herpigon, Indian tin, Nels Cream®, Orazinc®, pewter, polaprezinc, Solvezink®, Virudermin Gel®, Zeta N®, Zicam® Nasal Gel, zinc acetate, zinc acexamate, zinc aspartate, zinc carbonate, zinc chloride, zinc citrate, zinc gluconate, zinc methionate, zinc methionine, zinc monomethionine, zinc oxide, zinc picolinate, zinc sulfate, Zincolak®, Zincomed, Zineryt®, Zink, Zinvit-C250, ZN, Zn.

Background

  • Zinc is necessary for the functioning of more than 300 different enzymes and plays a vital role in a large 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.
  • Its immune-enhancing activities include regulation of T lymphocytes, CD4 cells, natural killer cells, and interleukin-2. In addition, it has been claimed that zinc possesses antiviral activity. 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. In the endocrine system, zinc has been shown to regulate insulin activity and promote the conversion thyroid hormones thyroxine to triiodothyronine.
  • Zinc has been used since ancient Egyptian times to enhance wound healing, although the usefulness of this approach is only partially confirmed by clinical data today. In available research, it has been shown to play a role in wound healing, especially following burns or surgical incisions. Based on available scientific evidence, zinc may be effective for the treatment or management of a number of conditions, including diarrhea in malnourished children, skin conditions (such as acne vulgaris, eczema, and psoriasis), gastric ulcers, attention-deficit hyperactivity disorder (ADHD), immune disorders, sickle cell anemia, leg ulcers, infertility, Wilson's disease, herpes, taste or smell disorders, diabetes, and diabetic neuropathy. Zinc has also gained popularity for its use in the prevention of the common cold.
  • The role of zinc is controversial in some cases, as either the results of published studies provide contradictory information and/or the methodological quality of the studies does not allow for a confident conclusion regarding the role of zinc in the diseases in question.

Scientific Evidence

Uses
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.		Grade
Diarrhea (children)
Multiple studies 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.		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 what extent zinc may be beneficial for patients with this condition. Most studies report no or few adverse effects associated with its use.		A
Zinc deficiency
Zinc deficiency is caused by inadequate intake or absorption, increased zinc excretion, or increased bodily need for zinc. Zinc deficiency symptoms include growth retardation, hair loss, diarrhea, delayed sexual maturation, impotence, eye and skin conditions, and loss of appetite. Additional symptoms may include weight loss, delayed wound healing, taste changes, and mental lethargy. Zinc can be measured in plasma, red blood cells, white blood cells, and hair.		A
Acne vulgaris
Based on high-quality studies, topical or oral 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 have identified a positive correlation between serum zinc levels and severity of acne, while others did not. It remains to be determined to what degree internal zinc levels may correlate with the severity of acne.		B
Attention-deficit hyperactivity disorder (ADHD)
Early studies have shown a correlation between low serum free fatty acids and zinc serum levels in children with attention-deficit hyperactivity disorder. Additional 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. Further research is required before conclusions may be drawn.		B
Herpes simplex virus
Low-quality studies have been conducted to assess the effects of zinc (topical or taken by mouth) on herpes types 1 or 2. 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 types 1 and 2 and should encourage further research into the topic using well-designed studies.		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 have beneficial effects on immune cells. 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.		B
Sickle cell anemia (management)
There is good 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.		B
Wilson's disease
Wilson's disease is an inherited disorder of copper metabolism characterized by a failure of the liver to excrete copper, which leads to its accumulation in the liver, brain, cornea, and kidney, with resulting chronic degenerative changes. Early research suggests that zinc treatment may be effective in the management 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. Galzin® (zinc acetate) is an U.S. Food and Drug Administration (FDA)-approved drug used to inhibit the absorption of copper in patients with Wilson's disease. It is not indicated as an initial therapy for Wilson's disease in symptomatic patients but rather for maintenance treatment in patients who have already been treated with a chelating agent.		B
Age related macular degeneration
Most studies examining the relationship between dietary zinc intake and macular degeneration over many years have not reported positive correlations. However, some high-quality research, which examined the efficacy of zinc supplements in preventing loss of visual acuity, found that zinc supplements helped prevent the occurrence of age-related macular degeneration. Since study results are conflicting, additional well-designed clinical trials are needed before a conclusion can be made.		C
Alopecia areata (hair loss)
A few studies that examined the efficacy of zinc in treating alopecia reported conflicting results. Additional information is needed before a conclusion can be made.		C
Aphthous stomatitis (canker sores)
Zinc sulfate has been studied for the treatment of recurrent aphthous stomatitis (canker sores). However, the results are conflicting, and a clear conclusion may not be drawn at this time.		C
Appetite stimulation (in HIV-infected children)
In preliminary clinical research, multimacronutrient supplementation in HIV-infected children improved appetite. However, the effects of zinc alone cannot be determined from this study. More well-designed trials using zinc alone are needed before a conclusion may be made.		C
Beta-thalassemia
Limited research has noted that children with beta-thalassemia (a blood disorder that reduces the production of hemoglobin) who took oral zinc supplements for 1-7 years increased in height more than those who did not take zinc. More studies are needed to confirm these findings.		C
Blood disorders (aceruloplasminemia)
Data from case reports suggest a potential role for zinc supplementation in aceruloplasminemia, a neurodegenerative disease caused by a gene mutation. Further research is required before conclusions may be drawn.		C
Burns
Studies of zinc sulfate supplements given to burn victims to increase healing rate have yielded mixed results. Further research is needed before a conclusion can be made.		C
Cancer
In preliminary clinical research, patients with head and neck cancers receiving radiotherapy had a better clinical outcome following zinc supplementation compared to those who did not take zinc. More high-quality research is needed to confirm these findings.		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. More research is needed in this area.		C
Chronic inflammatory rheumatic disease
Early studies found that zinc supplementation did not seem to benefit patients with chronic inflammatory rheumatic disease. Further research is needed before a conclusion can be made.		C
Chronic prostatitis (prostate inflammation)
Early studies suggest 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 (prostate inflammation). Further research is needed to confirm these results.		C
Closed head injuries
Early poorly designed studies indicate that zinc supplementation may enhance neurological recovery in patients with closed head injuries. Further research is needed to confirm these results.		C
Cognitive disorders (children)
Early studies indicate that daily supplementation with zinc may be of limited usefulness for improving cognition in adolescent girls and lead-exposed schoolchildren. Further research may be warranted in this area.		C
Cognitive function
Based on one randomized controlled trial, zinc supplementation in younger adults (<70 years) may have beneficial effects on cognitive function. More well-designed trials are needed before a conclusion may be made.		C
Common cold
There are conflicting results regarding the effect of zinc formulations in treating the duration and severity of common cold symptoms. Although zinc may be beneficial in the treatment of cold symptoms if taken at the onset of 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. Negative results may be caused by using doses of zinc that are too low, or they may be affected by the presence of compounds like citric or tartaric acid, which may reduce efficacy due to chelating of the zinc ion.		C
Continuous ambulatory peritoneal dialysis (CAPD)
Zinc supplementation did not improve the nutritional status in patients on CAPD in a well-designed trial. Further research is needed to confirm these results.		C
Critical illness
Zinc is required for a functional immune system and is a necessary cofactor for many enzymes. In noncritically ill patients, zinc supplementation has been associated with an improvement in markers of immune function. Further research is required in patients with critical illness before conclusions may be drawn.		C
Cutaneous disorders (leishmaniasis)
In a few studies of varying quality, patients with cutaneous leishmaniasis were injected with zinc sulfate intralesionally. Zinc sulfate was shown to be better than meglumine antimoniate for the first four weeks, but significant differences were not observed after six weeks. Overall, results of the studies are mixed, and more research is needed in this area.		C
Cystic fibrosis
Zinc supplementation does not seem to affect clinical status, growth velocity, or lung function in children with cystic fibrosis. Further research is needed to confirm available study results.		C
Dandruff
Shampoo containing 1% of zinc pyrithione has been shown to reduce dandruff in some people. More high-quality research is needed in this area.		C
Dementia
In a small study, zinc supplementation did not have any effects on the psychological functioning of adults with senile dementia. Larger, more well-designed trials are needed.		C
Diabetes
Diabetic patients typically have significantly lower serum zinc levels compared with healthy controls. In early high-quality studies, zinc supplementation in type 2 diabetics may have beneficial effects in elevating serum zinc level and in improving glycemic control, shown by decreasing HbA1c concentrations. Further research is needed before a conclusion can be made.		C
Diabetic neuropathy (nerve damage)
Oral zinc supplementation may improve glycemic control and severity of peripheral neuropathy. Further research is needed before a conclusion can be made.		C
Diaper rash
Zinc may reduce the incidence of diaper rash and have a preventive effect. More well-designed trials are needed before a conclusion may be made.		C
Down's syndrome
In several studies, zinc supplements seemed to counteract hypothyroidism and slightly reduce the number of infections in children with Down syndrome. However, zinc did not seem to improve depressed immune systems. Additional human research is needed before a firm conclusion can be made.		C
Dysentery (adjunct therapy for shigellosis)
Based on clinical research, zinc may be beneficial in children with shigellosis, as an adjunct to therapy. More well-designed trials are needed before a conclusion may be made.		C
Eating disorders
Reports of zinc's effectiveness in treating symptoms of anorexia nervosa observed in young adults are based on small, low-quality studies. Well-designed trials with a larger number of participants are needed to confirm these results.		C
Eczema
There are conflicting data regarding the correlation of zinc serum levels and eczema. One study noted that zinc might have caused an increase in itching after several weeks of supplementation. Additional information is needed to help clarify these results.		C
Exercise performance
Zinc may improve exercise performance in athletes with low serum zinc or zinc deficiencies. Additional evidence is needed before a conclusion can be made.		C
Furunculosis (boils)
In preliminary research, boils in patients treated with zinc did not reappear. Well-designed clinical trials are needed to confirm this potential benefit.		C
Gilbert's syndrome
Gilbert's syndrome, named after a French gastroenterologist, 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 jaundice (yellowing of the skin), but the liver itself remains normal. It is more common in men than women. Zinc sulfate supplementation seemed to decrease serum unconjugated bilirubin levels in a small study. Well-designed clinical trials are needed to confirm these results.		C
Goiter
Zinc supplementation may alter thyroid hormone profiles in patients with goiter. Better-designed trials are needed before a conclusion may be made.		C
Halitosis (bad breath)
Chewing gum containing zinc or rinsing out the mouth with a solution containing zinc seemed to reduce bad breath (halitosis) in early studies. More well-designed trials are needed before a conclusion may be made.		C
Hepatic encephalopathy
Hepatic encephalopathy is abnormal brain function caused by passage of toxic substances from the liver to the blood. Early high-quality trials of zinc for this indication have yielded conflicting results.		C
Hepatitis (chronic)
Early studies have shown that zinc in combination with interferon, or interferon and ribavirin, for hepatitis C viral infection did not show significant benefits, except for a lower incidence of gastrointestinal side effects in one study. Further research may be warranted in this area. Recent high-quality evidence suggests that supplementation with polaprezinc in patients undergoing treatment with pegylated interferon alpha-2b and ribavirin may decrease damage to liver cells.		C
HIV/AIDS
Patients with HIV/AIDS, especially those with low zinc levels, may benefit from zinc supplementation. Some low-quality studies cited a reduction in infections, weight gain, and enhanced 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.		C
Hyperlipidemia (high cholesterol)
Zinc may improve blood cholesterol levels in hemodialysis patients. There is some evidence that zinc may improve the ratio of HDL ("good cholesterol") to LDL ("bad cholesterol"), which would be considered a positive effect. Well-designed clinical trials are needed before a conclusion can be made.		C
Hyperprolactinemia (high levels of prolactin in the blood)
Early research did not report an inhibitory effect of zinc on prolactin release in hyperprolactinemic patients. Further research is required before conclusions may be drawn.		C
Hypothyroidism (low thyroid hormone production)
Case report data suggest that zinc supplementation may improve thyroid hormone levels (particularly T3) among women with hypothyroidism. More well-designed trials are needed before a conclusion may be made.		C
Impaired glucose tolerance
Zinc supplementation may improve glucose tolerance in patients with cirrhosis. More research is needed before a conclusion may be made.		C
Incision wounds
Although zinc is frequently thought to have beneficial effects on incision wound healing, few studies have investigated this use. Further research is needed before a conclusion can be made.		C
Infant development / neonatal care
Clinical trial results suggest a lack of positive benefit from zinc on the mental and physical development of infants. More well-designed trials of zinc therapy alone are needed before a conclusion may be made.		C
Infections (children)
Zinc may decrease incidence of infection, although this may depend on the type of infection. More research is needed in this area.		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.		C
Inflammatory bowel disease
Studies of zinc supplementation for inflammatory bowel disease have had mixed results. One small clinical study found positive effects of zinc supplementation on thymulin levels in patients with Crohn's disease. However in another study, zinc supplementation did not report an improvement inflammatory bowel disease. Well-designed clinical trials are needed to confirm these results.		C
Kidney function
Early studies show potential improvement in uremic patients taking zinc supplements. Zinc supplementation may be recommended only in patients with proven zinc deficiency, but for all chronic renal failure patients, it is questionable. Further research is needed to confirm available study results.		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. More research is needed in this area.		C
Leg ulcers
There are conflicting findings regarding the potential benefit of zinc for healing leg ulcers. All studies, however, reported a lack of or few adverse effects. The healing process of leg ulcers may be enhanced through treatment with zinc, although further studies are needed to determine to which extent zinc may be beneficial for patients with leg ulcers.		C
Leprosy
A few studies have examined the efficacy of zinc treatment in leprosy. Studies of zinc taken by mouth have reported positive results, while other research on topical zinc has reported negative results. Further research is needed before a conclusion can be drawn.		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.		C
Lower respiratory infections in children
Results from large clinical trials suggest that supplementation with zinc may reduce the incidence and severity of lower respiratory infections. Some studies suggest that these effects are apparent only in boys and not girls. A trend toward increased respiratory infections in children has been noted in one study. A recent study did 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 adult populations have a similar response.		C
Malaria
Results are contradictory for the effect of zinc on malaria symptoms. Some high-quality studies suggest no effect of zinc supplementation on the severity of malaria. Other studies suggest that zinc supplementation may reduce the number of stays in the hospital and the death rate due to P. falciparum infection. Further well-designed trials are required to address these discrepancies.		C
Menstrual cramps
Case report data suggest a possible role for zinc supplementation in menstrual cramps. Additional research is needed to confirm these findings.		C
Mood disorders
Zinc supplementation may improve mood states in young women. More well-designed trials are needed before a conclusion may be made.		C
Mortality reduction
Evidence from available high-quality studies did not find an association between zinc supplementation and mortality among children. Additional research is needed in this area.		C
Mucositis (radiation-induced)
Radiation has the potential side effect of mucositis, which is inflammation of mucous membranes inside of the mouth, nose, and throat. Clinical studies suggest that zinc may lower the degree of mucositis in patients on radiation. Further research is needed to confirm these results.		C
Muscle cramps (cirrhosis)
Zinc supplementation may improve muscle cramps in patients with cirrhosis. Further research is needed to confirm available study results.		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 significant differences were observed after six weeks. Zinc may decrease the severity of infection and reinfection with S. mansoni, but it does not seem to prevent initial infection. More research is needed to examine how zinc affects the S. mansoni life cycle and whether these data can be extrapolated to other species of Schistosoma. The effects of zinc on the rate of parasitic reinfestation have been examined in children. No significant effect of zinc treatment was found. Recent high-quality study data suggest that supplementation with zinc and vitamin A may favorably alter the infection rate and duration among children. Due to conflicting results in this area, more research is needed before zinc can be recommended for the treatment of parasites.		C
Plaque / gingivitis
A few studies have reported a 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 may help to determine zinc's potential efficacy in other dental applications as well.		C
Pneumonia
Studies have found that zinc supplementation does not seem to lessen the duration of abnormally fast breathing, hypoxia (inadequate oxygen), chest indrawing, inability to feed, lethargy, severe illness, or hospitalization in children.		C
Poisoning (arsenic)
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.		C
Pregnancy
According to multiple reviews, evidence is lacking to suggest that zinc supplementation offers benefits during pregnancy, although there is a possible reduction in labor complications and preterm 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 examined 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 did not support a role for zinc in alleviating the symptoms of psoriasis. Further well-designed clinical trials are required to clarify these results.		C
Respiratory disease (respiratory papillomatosis)
Evidence from case reports suggests a possible role for zinc supplementation as adjuvant therapy in juvenile-onset recurrent respiratory papillomatosis (JORRP). Further investigation is warranted in this area.		C
Respiratory tract infections (upper)
Studies on the effects on zinc on upper respiratory tract infections have produced mixed results. More well-designed trials are needed before a conclusion may be made.		C
Rheumatoid arthritis
Most trials did not show significant improvements in arthritis symptoms following zinc treatment. Interpretation of some data is difficult, 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 conclusion can be made.		C
Sexual function / libido / erectile dysfunction
Several studies have been conducted in men on chronic maintenance hemodialysis. However, the results are conflicting. More well-designed trials are needed before a conclusion may be made.		C
Skin damage caused by incontinence
Early 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.		C
Stress
Zinc may help reduce stress in the elderly. More well-designed trials are needed before a conclusion may be made.		C
Taste disturbances
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.		C
Taste perception (hemodialysis, cancer)
Results from studies investigating the potential role of zinc in treating taste and smell disorders in patients with cancer or kidney disease are contradictory. Recently, a large high-quality trial showed no evidence of a benefit of zinc supplementation on taste alterations among patients undergoing radiation therapy for head and neck cancer. Well-designed research is needed in this area.		C
Tinea versicolor
Zinc pyrithione shampoo may be an effective treatment for tinea versicolor, a fungal infection of the skin. Side effects were not noted in available research. Additional research is needed before a conclusion may be made.		C
Tinnitus
Studies on the efficacy of zinc in treating tinnitus have yielded contradictory results based on subjective findings. Further research is necessary before a conclusion can be drawn.		C
Ulcers (foot ulcers)
Zinc hyaluronate may help heal foot ulcers in patients with diabetes. More well-designed trials are needed before a conclusion may be made.		C
Vaginitis (trichomoniasis)
Little research is available on the efficacy of zinc for the treatment of trichomoniasis, a sexually transmitted disease (STD). One very small study suggested 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.		C
Viral warts
Preliminary research suggests that zinc sulfate may be effective for recalcitrant viral warts. Well-conducted studies are needed to clarify early study results.		C
Growth
Some limited evidence suggests that supplementation with zinc plus iron (but not zinc alone) may improve linear growth (length) of stunted infants with low hemoglobin. Overall studies using zinc alone do not suggest any effect on growth.		D

Tradition/Theory

The below uses are based on tradition, scientific theories, or limited research. 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. There may be other proposed uses that are not listed below.

  • Acrodermatitis enteropathica (metabolic disorder affecting zinc absorption), aging, alcoholism, Alzheimer's disease, anti-inflammatory, antioxidant, antiseptic (skin), aphrodisiac, atherosclerosis (hardening of the arteries), benign prostate hyperplasia, bladder cancer, bone diseases, bowel disorders (short bowel syndrome), bulimia, cataracts, cleansing (douching), contraceptive, eye disorders (night blindness, retinol pigmentation abnormalities), gastrointestinal inflammation, human papilloma virus, Huntington's chorea/disease, hyperglycemia, hypogonadism, hypoxia, liver disease, menopause, non-Hodgkin's lymphoma, osteoarthritis, pancreatitis, Parkinson's disease, poisoning (nickel), postpartum depression, prostate cancer, psychosis, retinopathy, schizophrenia, seizures, skin disorders, spleen disorders (enlargement), tuberculosis, wound healing.

Dosing

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.

Adults (18 years and older)

Note: Avoid use of intranasal Zicam®. Numerous reports exist of loss of smell associated with zinc-containing Zicam® products. These zinc-containing formulas have since been withdrawn from the U.S. market.

  • For acetazolamide side effects, 0.2 grams of zinc sulfate has been taken three times daily by mouth.
  • For acne vulgaris, doses of 40-300 milligrams of zinc sulfate two or three times daily with or without food have been taken by mouth for 4-12 weeks. 30-200 milligrams of zinc gluconate prior to a meal daily for 2-3 months has also been studied. The following preparations have been used on the skin: zinc (1.2-1.3%) combined with 4% erythromycin two times daily for up to one year; Nel's cream (containing chloroxylenol and zinc oxide and 5% benzoyl peroxide) two times daily for eight weeks; and 2% zinc sulfate in propylene glycol and ethanol applied three times daily for 12 weeks.
  • For acrodermatitis enteropathica, experts recommend 1-3 milligrams of zinc sulfate or gluconate salts per kilogram, taken by mouth daily. 45-220 milligrams of zinc sulfate has been taken by mouth three times daily.
  • For age-related macular degeneration, 200 milligrams has been used with food once daily or in two divided doses for up to two years.
  • For alopecia areata, Zincomed, containing 220 milligrams of zinc sulfate, has been taken by mouth twice daily for three months.
  • For aphthous stomatitis, 220-660 milligrams of zinc sulfate has been taken daily by mouth.
  • For burns, 660 milligrams of zinc sulfate has been taken daily by mouth.
  • For cancer, 90 milligrams of zinc sulfate has been taken by mouth daily for five days, with a maintenance dose of 180 milligrams daily. Zinc gluconate (two tablets, each containing 10 milligrams of zinc) has also been used daily for 10 days.
  • For chronic inflammatory rheumatic disease, 45 milligrams of zinc by mouth daily for two months was not associated with beneficial effects on clinical outcomes or inflammatory indexes.
  • For cognitive function, 15-30 milligrams of zinc by mouth daily for six months improved spatial working memory. However, unfavorable effects were observed on attention with the 15 milligram daily dose.
  • For the common cold, doses have ranged from 4.5 to 24 milligrams of zinc (gluconate or acetate) as a lozenge taken by mouth every 1-2 hours during waking hours while cold symptoms were present.
  • For patients on continuous ambulatory peritoneal dialysis (CAPD), 100 milligrams of elemental zinc by mouth daily for three months did not improve nutritional status.
  • For cutaneous leishamaniasis, 2.5-10 milligrams of zinc sulfate per kilogram by mouth for 45 days has shown beneficial effects. Cure rates were dose dependent. Intralesional injections of 2% zinc sulfate have also been studied.
  • For dandruff, shampoo containing 1% zinc pythione (ZPT) has been used.
  • For dementia, 220 milligrams of zinc sulfate (containing 50 milligrams of elemental zinc) has been used by mouth three times daily for 24 weeks.
  • For diabetes and diabetic neuropathy, 660 milligrams of zinc sulfate has been taken by mouth for six weeks.
  • For patients on dialysis, 50 milligrams of zinc by mouth has been used daily for blood cell effects.
  • For patients with Down syndrome, 135 milligrams of zinc sulfate taken by mouth daily for two months improved immune function.
  • For eating disorders, 45-100 milligrams of zinc (zinc sulfate, zinc gluconate, or zinc acetate) has been taken daily by mouth. Twenty-five milligrams of zinc as zinc acetate in a solution taken daily by mouth 30 minutes before each of three meals, for three weeks in patients with bulimia nervosa and for four weeks in patients with anorexia nervosa, has been studied. For anorexia, 40 micromoles of zinc has been used intravenously daily for seven days, followed by 15 milligrams by mouth daily for 60 days.
  • For eczema, 220 milligrams of zinc sulfate has been taken daily by mouth (duration not specified).
  • For exercise performance, 20 milligrams of zinc has been taken by mouth daily for seven days.
  • For furunculosis (boils), 45 milligrams of zinc (Solvezink®, Tika) by mouth has been used three times daily for four weeks.
  • For gastric ulcers, 300 milligrams of A-84 (e-acetamide zinc caproate) has been taken with meals three times daily for three weeks, and 300-900 milligrams of zinc acexamate has been taken with or without food daily for up to 90 days.
  • For Gilbert's syndrome, 40 milligrams of zinc sulfate in a single dose by mouth has been used for acute conditions. For chronic conditions, 100 milligrams of zinc sulfate in a single dose has been used by mouth for seven days.
  • For halitosis (bad breath), one or two pieces of a zinc chewing gum has been chewed for at least 10 minutes, three times daily for one week.
  • For hepatic encephalopathy, 600 milligrams of zinc sulfate or zinc acetate has been taken by mouth daily for 7-10 days.
  • For herpes simplex virus, the following has been applied to the skin: 0.3% zinc oxide/glycine cream applied every two hours until the sore resolves or for 21 days; Virunderim Gel®, containing 10 milligrams of zinc sulfate, for up to 12 days; 0.01-0.05% zinc sulfate solution applied often during a breakout and once per week during remission; and 4% zinc sulfate solution in water.
  • For hyperlipidemia (high cholesterol), 7.7 micromoles of zinc sulfate (50 milligrams of elemental zinc) has been taken by mouth daily for 90 days, and 150 milligrams of zinc has been taken by mouth daily for 12 weeks.
  • For hyperprolactinemia, acute administration of 37.5 milligrams of zinc sulfate (as zinc sulfate diluted in 20 milliliters of deionized water) every 30 minutes for 240 minutes was not shown to have an effect on prolactin levels. Chronic administration of 47.7 milligrams of zinc three times daily for 60 days was also not shown to have an effect on prolactin levels.
  • For HIV/AIDS, 200 milligrams of zinc sulfate has been taken by mouth daily for four weeks as an aid to immune response, and 125 milligrams of zinc gluconate taken by mouth twice daily for three weeks increased the levels of immune cells.
  • For immune function, the following doses have been taken by mouth in various patients: in the elderly, 12-150 milligrams of elemental zinc daily for up to one month, or 440 milligrams of zinc sulfate in two divided doses daily for one month, or 100 milligrams of zinc daily for three months; in patients with alcoholic cirrhosis, 200 milligrams of zinc sulfate for two months; in patients with acute lymphoblastic leukemia, 0.02 milligrams of zinc per kilogram of body weight (duration unspecified); in healthy men, 30 milligrams of zinc daily for 14 weeks; in patients with cancer, two tablets of zinc gluconate (each containing 10 milligrams of zinc) daily for 10 days; and 120 milligrams of zinc sulfate after dialysis sessions. A 10% zinc sulfate in Aquaphor® ointment has also been applied to the skin as a one-time dose. Intravenous zinc (dose unavailable) for eight weeks has been used. 30 milligrams of zinc sulfate has been used for the first three days of total parenteral nutrition. 17.3 milligrams of zinc sulfate has been administered intravenously in saline daily for 28 days.
  • For incision wounds, 220 milligrams of zinc sulfate has been taken by mouth three times daily following surgery to promote wound healing.
  • For infertility, the following doses have been taken by mouth: 50 milligrams of zinc daily in hemodialysis patients; 66 milligrams of zinc sulfate daily for 26 weeks in fertile and subfertile males to increase sperm count; 250 milligrams of zinc sulfate twice daily for three months; 220 milligrams of zinc sulfate (Zincolak® caps, Shalaks Chemicals) once daily for four months; 440 milligrams of zinc sulfate for up to 24 months; 220 milligrams of zinc sulfate for impotence and hypogonadism in hepatic cirrhosis patients; and 500 milligrams of zinc daily with hydrochlorothiazide. Zinc-L-hydrogen-aspartate solution added to 10 liters of commercially available dialysis concentrate to achieve a plasma zinc concentration of 19.5-25 micromoles per liter has been used. Zinc chloride added to dialysate to achieve a serum zinc concentration of 17% has been used for six weeks.
  • For inflammatory bowel disease, 300 milligrams of zinc aspartate (equal to 60 milligrams of elemental zinc) has been taken by mouth daily for four weeks. In patients with ulcerative colitis, 220 milligrams of zinc sulfate has been taken by mouth three times daily for 3-4 weeks. 200 milligrams of zinc sulfate has been taken by mouth daily for three months in patients with Crohn's disease.
  • For intestinal malabsorption, the following doses of zinc have been taken by mouth: 100 milligrams three times daily; and 19 milligrams daily.
  • For leg ulcers, the following doses of zinc have been taken by mouth: 220 milligrams of zinc sulfate 1-3 times daily for up to 12 months; 660 milligrams daily; and 220 milligrams of zinc sulfate three times daily (duration not specified). The following has been applied to the skin: 250-510 micrograms of zinc oxide per square centimeter in polyvinyl pyrrolidone; zinc oxide dressings (Mezinc™) for eight weeks; gauze compress medicated with zinc oxide (400 micrograms of zinc oxide per square centimeter) for eight weeks; and zinc oxide (400 micrograms of zinc oxide per square centimeter) applied to gauze compresses, changed once daily for 8 weeks.
  • For leprosy, 220 milligrams of zinc sulfate has been taken by mouth as an adjunct to leprosy medication daily for up to 18 months. Zinc oxide tape (approximately 30%) on leprosy wounds has also been used
  • For leukemia, 0.02 milligrams of zinc sulfate per kilogram by mouth has been studied as an adjunct therapy.
  • For liver cirrhosis, the following doses of zinc have been taken by mouth: 200 milligrams of zinc sulfate daily for two months; 220 milligrams of zinc sulfate twice daily for 12 weeks; and 200 milligrams three times daily for 42-60 days.
  • For mood disorders, seven milligrams of zinc has been taken by mouth daily for 10 weeks.
  • For muscle cramps in patients with cirrhosis, 220 milligrams of zinc sulfate has been taken by mouth twice daily for 12 weeks.
  • For nickel-positive patients, 100 milligrams of zinc sulfate has been taken by mouth three times daily for 30 days.
  • For plaque or gingivitis, the following has been used: a mouthwash with 0.001% zinc has been used twice daily for three weeks; a dentifrice containing 0.5% zinc citrate as a substitute for toothpaste three times daily for 12 weeks; a dentifrice containing 0.5% zinc citrate trihydrate, 0.15% fluoride as sodium monofluorophosphate, silica abrasive, and 0.20% triclosan twice daily in combination with normal brushing for four weeks; and 10 milliliters of an active mouthwash of 0.2% zinc citrate (600 parts per million of zinc) for one minute twice daily for seven days.
  • For pregnancy, the recommended daily allowance (RDA) of zinc is as follows: 11 milligrams daily for pregnant women 19 years of age and older; or 13 milligrams daily in pregnant women 14-18 years of age. The following doses have been taken by mouth: 14 milligrams of iron and 250 micrograms of folate with 15 milligrams of zinc from week 10-24 of gestation until delivery; 44 milligrams of zinc (Zinclet®, Gunnar Kjems Aps) from <20 weeks of gestation until delivery; 66 milligrams of zinc sulfate daily after breakfast in women who were <20 weeks of gestation until delivery; 30-90 milligrams of zinc gluconate daily starting in the 20th week of pregnancy until delivery; and 22.5 milligrams of zinc as citrate in effervescent tablets for the last 15-25 weeks of pregnancy.
  • For psoriasis, the following doses of zinc have been taken by mouth: 220 milligrams of zinc sulfate three times daily for up to six months; 50 milligrams of elemental zinc three times daily; and one tablet containing 220 milligrams of zinc sulfate (45 milligrams of elemental zinc) daily after an evening meal for 12 weeks.
  • For upper respiratory tract infections, the following doses of zinc have been taken by mouth: 15 milligrams of zinc gluconate daily (duration unspecified); and 23 milligrams of zinc gluconate lozenges daily as an initial dose of four lozenges, then one lozenge every two hours for seven days.
  • For rheumatoid arthritis, 200-220 milligrams of zinc sulfate has been taken by mouth three times daily for up to eight months.
  • For sexual dysfunction, the following doses of zinc have been taken by mouth: 220 milligrams of zinc sulfate for impotence and hypogonadism in hepatic cirrhosis patients for 6-8 months; 500 milligrams of zinc as a supplement with hydrochlorothiazide for sexual side effects; and 150 milligrams of zinc daily in three divided doses in men undergoing hemodialysis.
  • For sickle cell anemia management, the following doses of zinc have been taken by mouth: 220 milligrams of zinc sulfate three times daily; 50-75 milligrams of zinc daily for up to three years; a solution of 1% zinc sulfate in distilled water; 15 milligrams of zinc as acetate; 25 milligrams every four hours; 15 milligrams of zinc as acetate three times daily for 12 months; and 660 milligrams of zinc sulfate daily.
  • For skin damage caused by incontinence, zinc oxide oil (concentration and frequency unspecified) has been applied to the skin for 14 days.
  • For stress, 10 milligrams of elemental zinc has been taken by mouth daily (duration unspecified) in the elderly.
  • For taste disturbances, the following doses of zinc have been taken by mouth: 15-30 milligrams daily (duration unspecified); 140 milligrams of zinc gluconate daily (duration unspecified); 29 milligrams of zinc picolinate three times daily for three months; 100 milligrams of zinc ion for three months; 15 milligrams of zinc sulfate daily for 95 days; 158 milligrams of anhydrous zinc gluconate three times daily for four months; 45 milligrams of zinc sulfate three times daily after meals; 100 milligrams of zinc ion for three months; 100 milligrams of zinc sulfate daily for 4-6 months; 220mg of zinc sulfate daily for six weeks or 50 milligrams of zinc acetate in hemodialysis patients. The following intravenous doses of zinc have also been used: 20-100 milliliters of a 4.25% zinc-L-hydrogen aspartate solution added to 10 liters of a commercially available dialysis concentrate to achieve a plasma concentration of 19.5-20.5 micromoles per liter; and 400 micrograms of zinc chloride per liter of dialysate for four weeks.
  • For tinea versicolor, 1% lathered zinc pyrithione shampoo has been applied using a long-handled brush to the trunk, arms, and thighs for five minutes prior to taking a shower once daily in the evening for 14 days.
  • For tinnitus, the following doses of zinc have been taken by mouth: 22 milligrams of zinc (administered as zinc sulfate in sustained-release tablets) three times daily for eight weeks; 50 milligrams of zinc daily for two months; and 34-68 milligrams of zinc daily for two weeks.
  • For trichomoniasis, 220 milligrams of zinc sulfate has been taken by mouth twice daily for three weeks in patients unresponsive to metronidazole.
  • For ulcers (foot ulcers), zinc hyaluronate gel has been applied once daily to the ulcer surface after cleaning it with physiologic saline solution (dose unspecified).
  • For viral warts, 10 milligrams of zinc sulfate per kilogram has been taken by mouth daily (up to 600 milligrams daily) for 2-6 months.
  • For Wilson's disease, the following doses of zinc have been taken by mouth: 25-50 milligrams of zinc three times daily; and 100-400 milligrams of zinc sulfate three times daily.

Children (under 18 years old)

  • For acrodermatitis enteropathica, 525 micromoles of zinc has been used by mouth daily in a 16 year-old male.
  • For attention-deficit hyperactivity disorder, the following doses of zinc have been taken by mouth: 150 milligrams of zinc sulfate sprinkled into a breakfast drink daily for 12 weeks; 55 milligrams of zinc sulfate (containing approximately 15 milligrams of elemental zinc) in addition to one milligram of methylphenidate per kilogram, daily for six weeks; and 30 milligrams of zinc oxide with or without 30 milligrams of iron for six months.
  • For beta-thalassemia, the following doses of zinc have been taken by mouth, based on age: 22.5-45 milligrams of elemental zinc (for ages 1-4 years); 67.5 milligrams of elemental zinc (for ages 4-10); and 90 milligrams of elemental zinc (for ages 10 and up).
  • For cognitive function, the following doses of zinc have been taken by mouth: 30 milligrams of zinc oxide with or without 30 milligrams of ferrous fumarate for six months; and 30 milligrams of zinc oxide with or without 30 milligrams of iron for six months.
  • For the common cold, the following doses of zinc have been taken by mouth: 10 milligrams of zinc lozenges 5-6 times daily, based on age; one-half of a zinc lozenge (23 milligrams) (Truett Laboratories, TX), for children under 27 kilograms, every two hours, not to exceed six daily; and zinc gluconate glycine lozenges (Cold-EEZE®) four times daily for the duration of the cold.
  • For cystic fibrosis, tablets containing zinc sulfate (equivalent to 45 milligrams of elemental zinc) have been taken by mouth twice daily for six months, in patients 12 and older (children under 12 received half of the dose).
  • For diaper rash, 10 milligrams of zinc gluconate has been taken by mouth for four months as an adjunct to antifungal cream.
  • For diarrhea, the following doses of zinc have been taken by mouth: 10-20 milligrams of zinc 1-2 times daily for up to six months; 50-70 milligrams weekly for 12 months; for children aged 3-6 months, 22.5 milligrams of elemental zinc; for children aged 7-60 months, 45 milligrams of elemental zinc daily until the resolution of diarrhea but not exceeding five days; 15 milligrams (for those aged ≤12 months) or 30 milligrams (for those aged >12 months) of elemental zinc daily in three divided doses for 14-30 days; zinc gluconate (10 milligrams of elemental zinc to infants and 20 milligrams to older children); 14.2-40 milligrams of zinc daily in children aged 3-24 months; 20 milligrams of zinc acetate in addition to oral rehydration solution (ORS) for 14 days; 10 milligrams of zinc in four milliliters liquid daily for seven months; zinc syrup (15 milligrams of zinc for 6-11 month-old children and 30 milligrams for 12-35 month-old children); multivitamin juice with 15 milligrams of zinc acetate per kilogram of body weight; and 5-20 milligrams daily for the duration of the illness.
  • For Down syndrome, the following doses of zinc have been taken by mouth: one milligram of zinc sulfate per kilogram of body weight for 2-4 months; 25 milligrams of zinc gluconate daily for children aged 1-9 years and 50 milligrams of zinc gluconate daily for children older than nine years of age, both for 12 months; 20 milligrams of zinc per kilogram daily for two months; and 135 milligrams of zinc daily for two months.
  • For eczema, 22.5 milligrams of zinc has been taken by mouth three times daily (in sustained-release capsules) for eight weeks.
  • For growth, 5-20 milligrams of elemental zinc has been taken by mouth daily for up to six months.
  • For HIV/AIDS, 1.8-2.2 milligrams of zinc per kilogram has been taken by mouth daily for 3-4 weeks.
  • For infant development, 10-20 milligrams of elemental zinc, based on age, has been taken by mouth daily for four months.
  • For infection, the following doses of zinc have been taken by mouth: 30-50 milligrams of zinc five times per week for 12 months for Schistosoma mansoni infection; 20 milligrams of zinc daily with or without 20 milligrams of iron five days per week for one year for episodes of infectious disease.
  • For kwashiorkor, 2-5 milligrams of zinc per kilogram has been taken by mouth for one week.
  • For lower respiratory tract infections, the following doses of zinc have been taken by mouth: 10 milligrams of zinc daily for six months; 10 milligrams of zinc sulfate in four milliliters of liquid daily for seven months; 10 milligrams for infants and 20 milligrams for older children for four months; and 10 milligrams of zinc twice daily for five days.
  • For malaria, the following doses of zinc have been taken by mouth: 12.5 milligrams of zinc sulfate six days per week for six months; 10 milligrams of zinc six days per week for up to 46 weeks; and 20mg zinc daily for infants and 40mg zinc daily for older children, each for four days.
  • For mortality reduction, 5-10 milligrams of zinc has been taken by mouth, based on age, for a mean of 484.7 days.
  • For parasites, 10 milligrams of zinc as amino acid chelate has been taken by mouth.
  • For plaque or gingivitis, 0.5% zinc citrate dentifrice has been used in the mouth for three years (frequency unspecified).
  • For pneumonia, the following doses of zinc have been taken by mouth: two teaspoons (35 milligrams of zinc acetate per five milliliters) once weekly for 12 months; 10-20 milligrams of zinc, based on age, daily for 14 days as an adjuvant to antibiotics; and 10 milligram tablets of zinc sulfate twice daily during hospitalization, along with standard therapy for severe pneumonia.
  • For shigellosis (adjunct therapy), 20 milligrams of zinc has been taken by mouth daily for two weeks.
  • For sickle cell anemia management, the following doses of zinc have been taken by mouth: 10 milligrams of zinc daily in five milliliters of cherry soup; 660 milligrams of zinc sulfate daily; and 220 milligrams of zinc sulfate three times daily.
  • For taste disturbances, the following doses of zinc have been taken by mouth: 1 milligram of zinc chelate per kilogram daily for three months; and 0.5-0.75 milligrams of zinc sulfate per kilogram daily for six months in patients with renal failure.
  • For taste perception (hemodialysis, cancer), zinc sulfate capsules, containing 15 milligrams of zinc for children <10 years of age or 50 milligrams for adolescents, have been taken by mouth for six weeks (frequency unspecified).
  • For Wilson's disease, the following doses of zinc have been taken by mouth: 25 milligrams of zinc twice daily for children 1-5 years of age; for patients 6-15 years of age, if under 125 pounds of body weight, 25 milligrams of zinc three times daily; 50 milligrams of zinc three times daily for children 16 years and older or over 125 pounds; 35 milligrams of elemental zinc twice daily for children under the age of six; 25 milligrams three times daily for children 7-16 or under 125 pounds of body weight; 50 milligrams three times daily for children older than 16 years of age or over 125 pounds; and D-penicillamine, followed by treatment with 150 milligrams of zinc sulfate, three times daily for the first doses, then 100 milligrams three times daily.

Safety

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.

Allergies

  • Zinc oxide allergy has been reported. Avoid with known allergy or hypersensitivity to zinc compounds.

Side Effects and Warnings

  • Zinc is regarded as relatively safe and generally well tolerated when taken at recommended doses, and few studies report side effects. Occasionally, adverse effects such as nausea, vomiting, or diarrhea have been observed. Reduced levels of high-density lipoprotein (HDL), or "good," cholesterol have been observed following daily supplementation with zinc. Reduced immune responses have also been observed. A 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. One case of hypersensitivity pneumonitis has been reported.
  • Unpleasant taste, taste distortion, and abdominal cramping 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.
  • 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 have shown positive effects of zinc on acne. A case report suggested the presence of dermatitis due to zinc deficiency.
  • Use amounts regularly exceeding the recommended upper tolerance levels (greater than 40 milligrams daily) under a physician's guidance only. Sideroblastic anemia, leukopenia, microcytic anemia, neutropenia, bleeding gastric erosion, hepatitis (liver inflammation), liver failure, intestinal bleeding, acute tubular necrosis, and interstitial nephritis have been reported following the ingestion of large amounts of zinc. High-quality studies have found evidence of an association between high-dose zinc supplement use and hospitalization for urinary complications, including benign prostatic hyperplasia or urinary retention, urinary tract infection, and urinary lithiasis. This was especially evident among males.
  • There is one report of death following the ingestion of 400 coins (mostly pennies). Pennies are composed mostly of zinc. There is also one case report of a fatal outcome from cystic degeneration in the 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 daily dose of zinc for several weeks, followed by penicillamine again for an unspecified time, so it remains unclear if zinc was responsible for the death.
  • Zinc may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
  • Zinc may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
  • Use cautiously in patients with high cholesterol or blood fats, a high risk of developing heart disease, various skin disorders, gastrointestinal disorders, liver disease, genitourinary conditions, blood disorders, neurological disorders, pulmonary or respiratory disorders, immune disorders, or kidney disease, or in patients taking antidepressants, potassium-sparing diuretics, antibiotics (particularly tetracyclines and quinolones), iron, penicillamine, thyroid hormones, or copper.
  • Avoid in patients who are homozygous for hemochromatosis (a metabolic disorder involving the deposition of iron-containing pigments in the tissues and characterized by bronzing of the skin, diabetes, and weakness).
  • Avoid use of intranasal Zicam®. Numerous reports exist of loss of smell associated with zinc-containing Zicam® products. These zinc-containing formulas have since been withdrawn from the U.S. market.
  • Avoid with known allergy or hypersensitivity to zinc compounds.

Pregnancy and Breastfeeding

  • Zinc is likely safe when consumed in amounts generally found in foods (or as part of a multivitamin or multimineral compound) in nonallergic women. There is insufficient reliable information available about the safety or efficacy of medicinal use of zinc during pregnancy or lactation. The relationship between zinc levels or intake and low birthweight or delivery complications has been studied, but the results are conflicting.
  • The recommended daily allowance (RDA) for zinc during pregnancy and lactation is as follows: for pregnant women 19 years old and older, 11 milligrams daily; for pregnant women 14-18 years of age, 13 milligrams daily; for breastfeeding women 19 years old and older, 12 milligrams daily; and for breastfeeding women 14-18 years of age, 14 milligrams daily.

Interactions

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

  • Zinc may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Zinc may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Zinc may also interact with acetazolamide, ACE inhibitors, angiotensin-converting enzyme receptor blockers, antibiotics, antidiarrheals, anti-inflammatory agents, anticancer agents, antiulcer agents, antivirals, caffeine, calcium salts, carbenoxolone analog (BX24), cholera vaccine, cholesterol-lowering agents, corticosteroids, deferoxamine (Desferal®), dexrazoxane, disulfiram, diuretics, drugs that affect the immune system, drugs used for osteoporosis, estrogens, ethanol (alcohol), folic acid, H2 blockers, iron salts, magnesium supplements, methylphenidate, niacin, pain relievers, pancreatic enzyme replacements, penicillamine (Cuprimine®), phenytoin, propofol, proton pump inhibitors, thyroid hormones, tricyclic antidepressants, trientine, and zidovudine.

Interactions with Herbs and Dietary Supplements

  • Zinc may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
  • Zinc may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Zinc may also interact with antibacterials, anticancer herbs and supplements, antidepressants, antidiarrheals, anti-inflammatory herbs and supplements, antioxidants, antiulcer herbs and supplements, antivirals, ascorbic acid, bromelain, caffeine, calcium, cat's claw, cholesterol-lowering herbs and supplements, chromium, citric acid, copper, dairy foods, diuretics, EDTA, fiber, folic acid, herbs and supplements believed to have estrogenic properties, herbs and supplements that affect the immune system, herbs and supplements that affect the thyroid, herbs and supplements used for acne, herbs and supplements used for osteoporosis, IP-6 (phytic acid), iron, magnesium, manganese, mushroom extracts, niacin, nicotinamide, pain relievers, phosphorous, riboflavin, selenium, tartaric acid, vitamin A, and vitamin D.

Categorized Under

Natural Standard

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
 
Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
 
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Al-Awadhi, A. M., Alfadhli, S. M., Al-Khaldi, D., et al. Investigation of the distribution of lymphocyte subsets and zinc levels in multitransfused beta-thalassemia major patients. Int J Lab Hematol. 2010;32(2):191-196.

2. Bao, B., Prasad, A. S., Beck, F. W., et al. Zinc decreases C-reactive protein, lipid peroxidation, and inflammatory cytokines in elderly subjects: a potential implication of zinc as an atheroprotective agent. Am J Clin Nutr. 2010;91(6):1634-1641.

3. Barbosa, E., Faintuch, J., Machado Moreira, E. A., et al. Supplementation of vitamin E, vitamin C, and zinc attenuates oxidative stress in burned children: a randomized, double-blind, placebo-controlled pilot study. J Burn Care Res. 2009;30(5):859-866.

4. Bhandari, N., Mazumder, S., Taneja, S., et al. Effectiveness of zinc supplementation plus oral rehydration salts compared with oral rehydration salts alone as a treatment for acute diarrhea in a primary care setting: a cluster randomized trial. Pediatrics. 2008;121(5):e1279-e1285.

5. Cereda, E., Gini, A., Pedrolli, C., et al. Disease-specific, versus standard, nutritional support for the treatment of pressure ulcers in institutionalized older adults: a randomized controlled trial. J Am Geriatr Soc. 2009;57(8):1395-1402.

6. Hu, D., Sreenivasan, P. K., Zhang, Y. P., et al. The effects of a zinc citrate dentifrice on bacteria found on oral surfaces. Oral Health Prev Dent. 2010;8(1):47-53.

7. Iannotti, L. L., Zavaleta, N., Leon, Z., et al. Maternal zinc supplementation reduces diarrheal morbidity in peruvian infants. J Pediatr. 2010;156(6):960-4, 964.

8. Latva-Pukkila, U., Isolauri, E., and Laitinen, K. Dietary and clinical impacts of nausea and vomiting during pregnancy. J Hum Nutr Diet. 2010;23(1):69-77.

9. Lin, Y. S., Lin, L. C., and Lin, S. W. Effects of zinc supplementation on the survival of patients who received concomitant chemotherapy and radiotherapy for advanced nasopharyngeal carcinoma: follow-up of a double-blind randomized study with subgroup analysis. Laryngoscope. 2009;119(7):1348-1352.

10. Orsini, G., Procaccini, M., Manzoli, L., et al. A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice. J Clin Periodontol. 2010;37(6):510-517.

11. Sawada, T. and Yokoi, K. Effect of zinc supplementation on mood states in young women: a pilot study. Eur J Clin Nutr. 2010;64(3):331-333.

12. Shi, Z., Yuan, B., Qi, L., et al. Zinc intake and the risk of hyperglycemia among Chinese adults: the prospective Jiangsu Nutrition Study (JIN). J Nutr Health Aging. 2010;14(4):332-335.

13. Shidfar, F., Aghasi, M., Vafa, M., et al. Effects of combination of zinc and vitamin A supplementation on serum fasting blood sugar, insulin, apoprotein B and apoprotein A-I in patients with type I diabetes. Int J Food Sci Nutr. 2010;61(2):182-191.

14. Taneja, S., Strand, T. A., Sommerfelt, H., et al. Zinc supplementation for four months does not affect growth in young north Indian children. J Nutr. 2010;140(3):630-634.

15. Valentiner-Branth, P., Shrestha, P. S., Chandyo, R. K., et al. A randomized controlled trial of the effect of zinc as adjuvant therapy in children 2-35 mo of age with severe or nonsevere pneumonia in Bhaktapur, Nepal. Am J Clin Nutr. 2010;91(6):1667-1674.

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