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Zinc Supplements

See Also: Zinc Deficiency, and Zinc Excess and Zinc Toxicity.

Zinc Deficiency

Zinc deficiency can occur as a result of inadequate diet or malabsorption; excessive loss of zinc can occur in trauma, burns and protein-losing conditions.
It may be caused by the rare autosomal recessive disorder acrodermatitis enteropathica.

Clinical features of zinc deficiency include diarrhoea, alopecia, poor wound healing, defective taste and failure to thrive.

Indications for Supplements
  • Zinc supplements (zinc sulphate) should be given only when there is good evidence of deficiency or in zinc-losing conditions.1
  • Zinc sulphate is used to treat Wilsons disease.
    Studies have also reported its use to enhance wound healing and slow macular degeneration.
  • Zinc has also been claimed to ameliorate a variety of conditions including the common cold. The effect of zinc treatments on the severity or duration of cold symptoms is controversial and unproven.2
  • A zinc supplement is given until clinical improvement occurs but it may need to be continued in severe malabsorption, metabolic disease or in zinc-losing states.
  • Total parenteral nutrition regimens usually include trace amounts of zinc. If necessary, further zinc can be added to intravenous feeding regimens.
Cautions
  • May accumulate in acute renal failure.
  • A small study has suggested that zinc supplementation increases the levels of glycosylated haemoglobin in diabetics.
  • Sufferers from haemochromatosis may absorb larger amounts of zinc.
Interactions
  • Zinc and copper are mutually antagonistic, each interfering with the gastrointestinal uptake of the other. Zinc and iron also compete for absorption.
  • Excess zinc may also decrease magnesium and calcium uptake. High levels of calcium in the diet can decrease zinc absorption.
  • Zinc salts reduce the bioavailability of fluoroquinoline antibiotics, e.g. ciprofloxacin.
  • Absorption of zinc is reduced by penicillamine and zinc also reduces the absorption of penicillamine
  • Absorption of zinc is reduced by tetracyclines and zinc also reduces the absorption of tetracyclines
Side-effects
  • Zinc supplements have been reported to cause gastrointestinal effects, including abdominal pain, dyspepsia, nausea, vomiting, diarrhoea, gastric irritation, gastritis. This is more likely when supplements are taken with little or no food.
  • Irritability, headache, lethargy, dizziness
  • Prolonged use of high doses of zinc can result in deficiency of copper.
  • It has been suggested but not proven that excess zinc is atherogenic.2

Document References
  1. British National Formulary British Medical Association and Royal Pharmaceutical Society of Great Britain. London.
  2. Food Standards Agency; Zinc
Acknowledgements EMIS is grateful to Dr Colin Tidy for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2007.
DocID: 569
Document Version: 21
DocRef: bgp25341
Last Updated: 23 Aug 2007
Review Date: 22 Aug 2009
















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PS - Health and Poverty

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See also MAKEPOVERTYHISTORY North East for details and links to campaigns against poverty.

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