Zinc

Aka: Zinc, Zinc Gluconate, Zinc Acetate

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II. Indications

  1. Zinc Deficiency
  2. Wilson Disease
    1. Brewer (1998) J Lab Clin Med 132(4): 264-78 [PubMed]

III. Physiology

  1. Absorbed in Small Intestine (jejunum)
  2. Functions
    1. Cofactor for polymerases and proteases
      1. Protein Synthesis
      2. Wound Repair
      3. Cell regeneration
    2. Cofactor for thymulin
      1. T-Cell maturation related Hormone
    3. Antioxidant
      1. Reduces Cytokine expression (associated with organ failure and Sepsis)

IV. Precautions

  1. Avoid intranasal zinc (risk of permanent Loss of Smell)

V. Adverse Effects: Supplementation

  1. Gastrointestinal effects
    1. Metallic Taste
    2. Nausea or Vomiting
    3. Abdominal cramping
    4. Diarrhea
  2. Genitourinary effects
    1. Urinary Tract Infection
    2. Nephrolithiasis
  3. Miscellaneous effects
    1. Decreased HDL Cholesterol

VI. Contraindications: Supplementation (aside from Zinc Deficiency)

  1. Pregnancy and Lactation in excess of RDA (unless significant deficiency)
  2. Copper deficiency
    1. High zinc levels inhibit Copper absorption (competitively inhibits cation transporter)

VII. Preparations: Dietary Zinc Sources

  1. Human Breast Milk
  2. Meats
  3. Shellfish
  4. Chickpeas
  5. Cashews
  6. Pumpkin seeds

VIII. Preparations: Medications

  1. Zinc Acetate: 25 mg (7.5 mg elemental zinc), 50 mg (15 mg elemental zinc)
  2. Zinc Gluconate: 50 mg (7 mg elemental zinc), 100 mg (14 mg elemental zinc)
  3. Zinc Sulfate: 110 mg (25 mg elemental zinc), 220 mg (50 mg elemental zinc)
  4. Zinc Oxide: 100 mg (80 mg elemental zinc)

IX. Dosing: Recommended Daily Allowance (RDA)

  1. See Zinc Deficiency for dosing
  2. Age 0-6 months: 2 mg elemental zinc
  3. Age 7-36 months: 3 mg elemental zinc
  4. Age 4-8: 5 mg elemental zinc
  5. Age 9-13: 8 mg elemental zinc
  6. Age 14 and older: 11 mg (men) or 8 mg (women) elemental zinc
  7. Pregnancy and Lactation: 11-12 mg elemental zinc

X. Dosing: Upper Respiratory Infection

  1. One zinc lozenge every 2 hours while awake (studied dose, elemental zinc 9-24 mg/dose)
  2. Zinc Acetate or Zinc Gluconate lozenges used during symptomatic URI period

XI. Efficacy: Supplementation Possible Benefits (Aside from Zinc Deficiency)

  1. Pediatric Diarrhea
    1. Zinc 5-20 mg orally daily
    2. Lukacik (2008) Pediatrics 121(2): 326-36 [PubMed]
  2. Macular Degeneration (protection from oxidative stress)
    1. Grahn (2001) J Am Coll Nutr 20:106-18 [PubMed]
  3. Upper Respiratory Infection
    1. Taken as Zinc Acetate or Zinc Gluconate lozenges
    2. May decrease symptom duration by 3 days when started within 48 hours
    3. Zinc offers no benefit in URI prevention
    4. Hemila (2016) Br J Clin Pharmacol 82(5):1393-8 +PMID: 27378206 [PubMed]
  4. Pediatric Pneumonia
    1. Zinc supplementation associated with decreased mortality, shorter hospitalizations and fewer treatment failures
    2. Greatest benefit appears to be in developing countries where Zinc Deficiency occurs frequently (30% of world population)
    3. Basnet (2012) Pediatrics 129(4): 701-8 [PubMed]
    4. Srinivasan (2012) BMC Med 10: 14 [PubMed]
  5. Pregnancy
    1. Zinc (25 mg) in Prenatal Vitamins
    2. Effects
      1. Increased birth weight and Head Circumference
      2. Resulted in birth at later Gestational Age
      3. Resulted in shorter hospital stay
      4. Greatest benefit in thin women
    3. Goldenberg (1995) JAMA 274:463-8 [PubMed]

XII. Efficacy: Supplementation Disproven Benefits

  1. Wound Healing
    1. Agren (2006) Wound Repair Regen 14(5): 526-35 [PubMed]
  2. Upper Respiratory Infection
    1. No consistent benefit with zinc preparations
    2. Turner (2000) Clin Infect Dis 31:1202-8 [PubMed]
  3. Human Immunodeficiency Virus (unless significant Zinc Deficiency)
    1. Bobat (2005) Lancet 366(9500): 1862-7 [PubMed]
  4. Acne Vulgaris
    1. Dreno (2001) Dermatology 203(2): 135-40 [PubMed]

XIII. Drug Interactions: Supplementation

  1. Copper absorption
    1. High zinc levels inhibit Copper absorption (competitively inhibits cation transporter)
  2. Absorption decreased by zinc
    1. Penicillamine
    2. Tetracyclines
    3. Quinolones
    4. Integrase Strand Transfer Inhibitors (ISTI, Bictegravir, Dolutegravir, Raltegravir)
      1. Take zinc at least 2 hours before or 6 hours after ISTIs
  3. Interfere with zinc absorption (avoid within 2 hours of zinc dose)
    1. Iron supplements
    2. Grains or legumes (phytates)

XIV. References

  1. Maverakis (2007) J Am Acad Dermatol 56(1): 116-24 [PubMed]
  2. Snow (2022) Am Fam Physician 105(3): 319-20 [PubMed]

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Cost: Medications

zinc (on 3/22/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
ZINC OXIDE 20% OINTMENT Generic OTC $0.06 per gram
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Minerals and Other Inorganic Chemicals

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