Zinc

1. See Also
   1. Zinc Deficiency
2. Indications
   1. Zinc Deficiency
   2. Wilson Disease
3. Physiology
   1. Absorbed in Small Intestine
   2. Functions
      1. Cofactor for polymerases and proteases (functions in Wound Repair, cell regeneration)
      2. Cofactor for thymulin (T-Cell maturation related hormone)
      3. Antioxidant
4. Adverse Effects
   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
5. Contraindications
   1. Pregnancy and Lactation in excess of RDA (unless significant deficiency)
6. Preparations
   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)
7. Dosing: Recommended Daily Allowance (RDA)
   1. Age 0-6 months: 2 mg elemental zinc
   2. Age 7-36 months: 3 mg elemental zinc
   3. Age 4-8: 5 mg elemental zinc
   4. Age 9-13: 8 mg elemental zinc
   5. Age 14 and older: 11 mg (men) or 8 mg (women) elemental zinc
   6. Pregnancy and Lactation: 11-12 mg elemental zinc
8. Efficacy: Benefits
   1. Zinc Deficiency
   2. Wilson Disease
      1. Brewer (1998) J Lab Clin Med 132(4): 264-78
9. Efficacy: Possible Benefit
   1. Pediatric Diarrhea
      1. Zinc 5-20 mg orally daily
      2. Lukacik (2008) Pediatrics 121(2): 326-36
   2. Macular Degeneration (protection from oxidative stress)
      1. Grahn (2001) J Am Coll Nutr 20:106-18
   3. 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
10. Efficacy: Disproven Benefits
    1. Wound Healing
       1. Agren (2006) Wound Repair Regen 14(5): 526-35
    2. Upper Respiratory Infection
       1. No consistent benefit with zinc preparations
       2. Turner (2000) Clin Infect Dis 31:1202-8
    3. Human Immunodeficiency Virus (unless significant Zinc Deficiency)
       1. Bobat (2005) Lancet 366(9500): 1862-7
    4. Acne Vulgaris
       1. Dreno (2001) Dermatology 203(2): 135-40
11. Drug Interactions
    1. Absorption decreased by zinc
       1. Penicillamine
       2. Tetracyclines
       3. Quinolones
    2. Interfere with zinc absorption (avoid within 2 hours of zinc dose)
       1. Iron supplements
       2. Grains or legumes (phytates)