this is from the US Office of Dietary Supplements; NIH National Institutes of Health...A.W.

[Guest guest]

I only send this article from the Office of Dietary Supplements for your

information

Quotes from Articles; (I won't be on line until next Saturday; check w/ doc; Re:

Zn

 

" Numerous case reports of anosmia (loss of smell), in some cases long-lasting or

permanent, from the use of zinc-containing nasal gels or sprays [14,15] raise

questions about the safety of intranasal zinc. In June 2009, the FDA warned

consumers to stop using three zinc-containing intranasal products because they

might cause anosmia [16]. The manufacturer has voluntarily withdrawn these

products from the marketplace. These safety concerns do not apply to cold

lozenges containing zinc.

ANOSMIA FROM ZINC GELS IS THE " LOSS OF SENSE OF SMELL AND TASTE;

 

I don't recommend Zinc; I know Andy Cutler a pharmacist does; but I a

nutritoinsist do not!

 

THANKS FOR READING; I ONLY do this to speak for the children not old enuf to

read; etc

 

In North America, overt zinc deficiency is uncommon [2]. When zinc deficiency

does occur, it is usually due to inadequate zinc intake or absorption, increased

losses of zinc from the body, or increased requirements for zinc [24,25,32].

 

As previously noted, the safety of intranasal zinc has been called into question

because of numerous reports of anosmia (loss of smell), in some cases

long-lasting or permanent, from the use of zinc-containing nasal gels or sprays

[14-16].

 

Health Risks from Excessive ZincZinc toxicity can occur in both acute and

chronic forms. Acute adverse effects of high zinc intake include nausea,

vomiting, loss of appetite, abdominal cramps, diarrhea, and headaches [2]. One

case report cited severe nausea and vomiting within 30 minutes of ingesting 4 g

of zinc gluconate (570 mg elemental zinc) [78]. Intakes of 150–450 mg of zinc

per day have been associated with such chronic effects as low copper status,

altered iron function, reduced immune function, and reduced levels of

high-density lipoproteins [79]. Reductions in a copper-containing enzyme, a

marker of copper status, have been reported with even moderately high zinc

intakes of approximately 60 mg/day for up to 10 weeks [2]. The doses of zinc

used in the AREDS study (80 mg per day of zinc in the form of zinc oxide for 6.3

years, on average) have been associated with a significant increase in

hospitalizations for genitourinary causes, raising the

possibility that chronically high intakes of zinc adversely affect some aspects

of urinary physiology [80].

The FNB has established ULs for zinc (Table 3). Long-term intakes above the UL

increase the risk of adverse health effects [2]. The ULs do not apply to

individuals receiving zinc for medical treatment, but such individuals should be

under the care of a physician who monitors them for adverse health effects.

Table 3: Tolerable Upper Intake Levels (ULs) for Zinc [2]

Age

Male

Female

Pregnant

Lactating

0 to 6 months

4 mg

4 mg

 

 

7 to 12 months

5 mg

5 mg

 

 

1 to 3 years

7 mg

7 mg

 

 

4 to 8 years

12 mg

12 mg

 

 

9 to 13 years

23 mg

23 mg

 

 

14 to 18 years

34 mg

34 mg

34 mg

34 mg

19+ years

40 mg

40 mg

40 mg

40 mg

Interactions with MedicationsZinc supplements have the potential to interact

with several types of medications. A few examples are provided below.

Individuals taking these medications on a regular basis should discuss their

zinc intakes with their healthcare providers.

Antibiotics

Both quinolone antibiotics (such as Cipro®) and tetracycline antibiotics (such

as Achromycin® and Sumycin®) interact with zinc in the gastrointestinal tract,

inhibiting the absorption of both zinc and the antibiotic [81,82]. Taking the

antibiotic at least 2 hours before or 4–6 hours after taking a zinc supplement

minimizes this interaction [83].

Penicillamine

Zinc can reduce the absorption and action of penicillamine, a drug used to treat

rheumatoid arthritis [84]. To minimize this interaction, individuals should take

zinc supplements at least 2 hours before or after taking penicillamine [83].

Diuretics

Thiazide diuretics such as chlorthalidone (Hygroton®) and hydrochlorothiazide

(Esidrix® and HydroDIURIL®) increase urinary zinc excretion by as much as 60%

[85]. Prolonged use of thiazide diuretics could deplete zinc tissue levels, so

clinicians should monitor zinc status in patients taking these medications.

Zinc and Healthful DietsAccording to the 2005 Dietary Guidelines for Americans,

" nutrient needs should be met primarily through consuming foods. Foods provide

an array of nutrients and other compounds that may have beneficial effects on

health. In certain cases, fortified foods and dietary supplements may be useful

sources of one or more nutrients that otherwise might be consumed in less than

recommended amounts. However, dietary supplements, while recommended in some

cases, cannot replace a healthful diet. "

The Dietary Guidelines for Americans describes a healthy diet as one that:

Emphasizes a variety of fruits, vegetables, whole grains, and fat-free or

low-fat milk and milk products.

Whole grains and milk products are good sources of zinc. Many ready-to-eat

breakfast cereals are fortified with zinc.

Includes lean meats, poultry, fish, beans, eggs, and nuts.

Oysters, red meat, and poultry are excellent sources of zinc. Baked beans,

chickpeas, and nuts (such as cashews and almonds) also contain zinc.

Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added

sugars.

Stays within your daily calorie needs.For more information about building a

healthful diet, refer to the Dietary Guidelines for Americans

(http://www.health.gov/dietaryguidelines/dga2005/document/default.htm) and the

U.S. Department of Agriculture's food guidance system, My Pyramid

(http://www.mypyramid.gov).

About ODS and Other Sponsors

General Safety Advisory

Disclaimer

Print-friendly version

Posted Date:

11/7/2008

Updated:

6/30/2009 9:17 AM

 

 

 

 

 

 

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  Dietary Supplement Fact Sheet: Zinc

  

Office of Dietary Supplements • National Institutes of Health

Table of Contents

Introduction

Recommended Intakes

Sources of Zinc

Zinc Intakes and Status

Zinc Deficiency

Groups at Risk of Zinc Inadequacy

Zinc and Health

Health Risks from Excessive Zinc

Interactions with Medications

Zinc and Healthful Diets

References

IntroductionZinc is an essential mineral that is naturally present in some

foods, added to others, and available as a dietary supplement. Zinc is also

found in many cold lozenges and some over-the-counter drugs sold as cold

remedies.

Zinc is involved in numerous aspects of cellular metabolism. It is required for

the catalytic activity of approximately 100 enzymes [1,2] and it plays a role in

immune function [3,4], protein synthesis [4], wound healing [5], DNA synthesis

[2,4], and cell division [4]. Zinc also supports normal growth and development

during pregnancy, childhood, and adolescence [6–8] and is required for proper

sense of taste and smell [9]. A daily intake of zinc is required to maintain a

steady state because the body has no specialized zinc storage system [10].

Recommended IntakesIntake recommendations for zinc and other nutrients are

provided in the Dietary Reference Intakes (DRIs) developed by the Food and

Nutrition Board (FNB) at the Institute of Medicine of the National Academies

(formerly National Academy of Sciences) [2]. DRI is the general term for a set

of reference values used for planning and assessing nutrient intakes of healthy

people. These values, which vary by age and gender [2], include the following:

Recommended Dietary Allowance (RDA): average daily level of intake sufficient to

meet the nutrient requirements of nearly all (97%–98%) healthy individuals.

Adequate Intake (AI): established when evidence is insufficient to develop an

RDA and is set at a level assumed to ensure nutritional adequacy.

Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause

adverse health effects [2].The current RDAs for zinc are listed in Table 1 [2].

For infants aged 0 to 6 months, the FNB established an AI for zinc that is

equivalent to the mean intake of zinc in healthy, breastfed infants.

Table 1: Recommended Dietary Allowances (RDAs) for Zinc [2]

Age

Male

Female

Pregnancy

Lactation

Birth to 6 months

2 mg*

2 mg*

 

 

7 months to 3 years

3 mg

3 mg

 

 

4 to 8 years

5 mg

5 mg

 

 

9 to 13 years

8 mg

8 mg

 

 

14 to 18 years

11 mg

9 mg

13 mg

14 mg

19+ years

11 mg

8 mg

11 mg

12 mg

* Adequate Intake (AI)

Sources of ZincFood

A wide variety of foods contain zinc (Table 2) [2]. Oysters contain more zinc

per serving than any other food, but red meat and poultry provide the majority

of zinc in the American diet. Other good food sources include beans, nuts,

certain types of seafood (such as crab and lobster), whole grains, fortified

breakfast cereals, and dairy products [2,11].

Phytates—which are present in whole-grain breads, cereals, legumes, and other

foods—bind zinc and inhibit its absorption [2,12,13]. Thus, the

bioavailability of zinc from grains and plant foods is lower than that from

animal foods, although many grain- and plant-based foods are still good sources

of zinc [2].

Table 2: Selected Food Sources of Zinc [11]

Food

Milligrams (mg)

per serving

Percent DV*

Oysters, 6 medium

76.7

513

Beef shanks, cooked, 3 ounces

8.9

59

Crab, Alaska king, cooked, 3 ounces

6.5

43

Pork shoulder, cooked, 3 ounces

4.2

28

Breakfast cereal fortified with 25% of the DV for zinc, ¾ cup serving

3.8

25

Chicken leg, roasted, 1 leg

2.7

18

Pork tenderloin, cooked, 3 ounces

2.5

17

Lobster, cooked, 3 ounces

2.5

17

Baked beans, canned, ½ cup

1.7

11

Cashews, dry roasted, 1 ounce

1.6

11

Yogurt, fruit, low fat, 1 cup

1.6

11

Raisin bran, ¾ cup

1.3

9

Chickpeas, ½ cup

1.3

9

Cheese, Swiss, 1 ounce

1.1

7

Almonds, dry roasted, 1 ounce

1.0

7

Milk, 1 cup

0.9

6

Chicken breast, roasted, ½ breast with skin removed

0.9

6

Cheese, cheddar or mozzarella, 1 ounce

0.9

6

Kidney beans, cooked, ½ cup

0.8

5

Peas, boiled, ½ cup

0.8

5

Oatmeal, instant, 1 packet

0.8

5

Flounder or sole, cooked, 3 ounces

0.5

3

* DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration

to help consumers compare the nutrient contents of products within the context

of a total diet. The DV for zinc is 15 mg for adults and children age 4 and

older. Food labels, however, are not required to list zinc content unless a food

has been fortified with this nutrient. Foods providing 20% or more of the DV are

considered to be high sources of a nutrient.

The U.S. Department of Agriculture’s Nutrient Database Web site,

http://www.nal.usda.gov/fnic/foodcomp/search/ [11], lists the nutrient content

of many foods and provides a comprehensive list of foods containing zinc:

http://www.nal.usda.gov/fnic/foodcomp/Data/SR20/nutrlist/sr20w309.pdf.

Dietary supplements

Supplements contain several forms of zinc, including zinc gluconate, zinc

sulfate, and zinc acetate. The percentage of elemental zinc varies by form. For

example, approximately 23% of zinc sulfate consists of elemental zinc; thus, 220

mg of zinc sulfate contains 50 mg of elemental zinc. The elemental zinc content

appears in the Supplement Facts panel on the supplement container. Research has

not determined whether differences exist among forms of zinc in absorption,

bioavailability, or tolerability.

In addition to standard tablets and capsules, some zinc-containing cold lozenges

are labeled as dietary supplements.

Other sources

Zinc is present in several products sold over the counter as natural medicines

for colds, typically in the form of lozenges and nasal sprays and gels.

Zinc Intakes and StatusMost infants (especially those who are formula fed),

children, and adults in the United States consume recommended amounts of zinc

according to two national surveys, the 1988-1991 National Health and Nutrition

Examination Survey (NHANES III) [17] and the 1994 Continuing Survey of Food

Intakes of Individuals (CSFII) [18].

However, some evidence suggests that zinc intakes among older adults might be

marginal. An analysis of NHANES III data found that 35%–45% of adults aged 60

years or older had zinc intakes below the estimated average requirement of 6.8

mg/day for elderly females and 9.4 mg/day for elderly males. When the

investigators considered intakes from both food and dietary supplements, they

found that 20%–25% of older adults still had inadequate zinc intakes [19].

Zinc intakes might also be low in older adults from the 2%–4% of U.S.

households that are food insufficient (sometimes or often not having enough

food) [20]. Data from NHANES III indicate that adults aged 60 years or older

from food-insufficient families had lower intakes of zinc and several other

nutrients and were more likely to have zinc intakes below 50% of the RDA on a

given day than those from food-sufficient families [21].

Zinc DeficiencyZinc deficiency is characterized by growth retardation, loss of

appetite, and impaired immune function. In more severe cases, zinc deficiency

causes hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism

in males, and eye and skin lesions [2,8,22,23]. Weight loss, delayed healing of

wounds, taste abnormalities, and mental lethargy can also occur [5, 8, 24–28].

Many of these symptoms are non-specific and often associated with other health

conditions; therefore, a medical examination is necessary to ascertain whether a

zinc deficiency is present.

Zinc nutritional status is difficult to measure adequately using laboratory

tests [2,29,30] due to its distribution throughout the body as a component of

various proteins and nucleic acids [31]. Plasma or serum zinc levels are the

most commonly used indices for evaluating zinc deficiency, but these levels do

not necessarily reflect cellular zinc status due to tight homeostatic control

mechanisms [8]. Clinical effects of zinc deficiency can be present in the

absence of abnormal laboratory indices [8]. Clinicians consider risk factors

(such as inadequate caloric intake, alcoholism, and digestive diseases) and

symptoms of zinc deficiency (such as impaired growth in infants and children)

when determining the need for zinc supplementation [2].

Groups at Risk of Zinc InadequacyIn North America, overt zinc deficiency is

uncommon [2]. When zinc deficiency does occur, it is usually due to inadequate

zinc intake or absorption, increased losses of zinc from the body, or increased

requirements for zinc [24,25,32]. People at risk of zinc deficiency or

inadequacy need to include good sources of zinc in their daily diets.

Supplemental zinc might also be appropriate in certain situations.

People with gastrointestinal and other diseases

Gastrointestinal surgery and digestive disorders (such as ulcerative colitis,

Crohn’s disease, and short bowel syndrome) can decrease zinc absorption and

increase endogenous zinc losses primarily from the gastrointestinal tract and,

to a lesser extent, from the kidney [2,24,33,34]. Other diseases associated with

zinc deficiency include malabsorption syndrome, chronic liver disease, chronic

renal disease, sickle cell disease, diabetes, malignancy, and other chronic

illnesses [35]. Chronic diarrhea also leads to excessive loss of zinc [22].

Vegetarians

The bioavailability of zinc from vegetarian diets is lower than from

non-vegetarian diets because vegetarians do not eat meat, which is high in

bioavailable zinc and may enhance zinc absorption. In addition, vegetarians

typically eat high levels of legumes and whole grains, which contain phytates

that bind zinc and inhibit its absorption [29,36].

Vegetarians sometimes require as much as 50% more of the RDA for zinc than

non-vegetarians [2]. In addition, they might benefit from using certain food

preparation techniques that reduce the binding of zinc by phytates and increase

its bioavailability. Techniques to increase zinc bioavailability include soaking

beans, grains, and seeds in water for several hours before cooking them and

allowing them to sit after soaking until sprouts form [36]. Vegetarians can also

increase their zinc intake by consuming more leavened grain products (such as

bread) than unleavened products (such as crackers) because leavening partially

breaks down the phytate; thus, the body absorbs more zinc from leavened grains

than unleavened grains.

Pregnant and lactating women

Pregnant women, particularly those starting their pregnancy with marginal zinc

status, are at increased risk of becoming zinc insufficient due, in part, to

high fetal requirements for zinc [37]. Lactation can also deplete maternal zinc

stores [38]. For these reasons, the RDA for zinc is higher for pregnant and

lactating women than for other women (see Table 1) [2].

Older infants who are exclusively breastfed

Breast milk provides sufficient zinc (2 mg/day) for the first 4–6 months of

life but does not provide recommended amounts of zinc for infants aged 7–12

months, who need 3 mg/day [2,31]. In addition to breast milk, infants aged

7–12 months should consume age-appropriate foods or formula containing zinc

[2]. Zinc supplementation has improved the growth rate in some children who

demonstrate mild-to-moderate growth failure and who have a zinc deficiency

[22,39].

People with sickle cell disease

Results from a large cross-sectional survey suggest that 44% of children with

sickle cell disease have a low plasma zinc concentration [40], possibly due to

increased nutrient requirements and/or poor nutritional status [41]. Zinc

deficiency also affects approximately 60%–70% of adults with sickle cell

disease [42]. Zinc supplementation has been shown to improve growth in children

with sickle cell disease [41].

Alcoholics

Approximately 30%–50% of alcoholics have low zinc status because ethanol

consumption decreases intestinal absorption of zinc and increases urinary zinc

excretion [42]. In addition, the variety and amount of food consumed by many

alcoholics is limited, leading to inadequate zinc intake [2,44,45].

Zinc and HealthImmune function

Severe zinc deficiency depresses immune function [46], and even mild to moderate

degrees of zinc deficiency can impair macrophage and neutrophil functions,

natural killer cell activity, and complement activity [47]. The body requires

zinc to develop and activate T-lymphocytes [2,48]. Individuals with low zinc

levels have shown reduced lymphocyte proliferation response to mitogens and

other adverse alterations in immunity that can be corrected by zinc

supplementation [47,49]. These alterations in immune function might explain why

low zinc status has been associated with increased susceptibility to pneumonia

and other infections in children in developing countries and the elderly

[50–53].

Wound healing

Zinc helps maintain the integrity of skin and mucosal membranes [47]. Patients

with chronic leg ulcers have abnormal zinc metabolism and low serum zinc levels

[54], and clinicians frequently treat skin ulcers with zinc supplements [55].

The authors of a systematic review concluded that zinc sulfate might be

effective for treating leg ulcers in some patients who have low serum zinc

levels [56,57]. However, research has not shown that the general use of zinc

sulfate in patients with chronic leg ulcers or arterial or venous ulcers is

effective [56,57].

Diarrhea

Acute diarrhea is associated with high rates of mortality among children in

developing countries [58]. Zinc deficiency causes alterations in immune response

that probably contribute to increased susceptibility to infections, such as

those that cause diarrhea, especially in children [47].

Studies show that poor, malnourished children in India, Africa, South America,

and Southeast Asia experience shorter courses of infectious diarrhea after

taking zinc supplements [59]. The children in these studies received 4–40 mg

of zinc a day in the form of zinc acetate, zinc gluconate, or zinc sulfate [59].

In addition, results from a pooled analysis of randomized controlled trials of

zinc supplementation in developing countries suggest that zinc helps reduce the

duration and severity of diarrhea in zinc-deficient or otherwise malnourished

children [60]. Similar findings were reported in a meta-analysis published in

2008 and a 2007 review of zinc supplementation for preventing and treating

diarrhea [61,62]. The effects of zinc supplementation on diarrhea in children

with adequate zinc status, such as most children in the United States, are not

clear.

The World Health Organization and UNICEF now recommend short-term zinc

supplementation (20 mg of zinc per day, or 10 mg for infants under 6 months, for

10–14 days) to treat acute childhood diarrhea [58].

The common cold

The effect of zinc treatment on the severity or duration of cold symptoms is

controversial. Researchers have hypothesized that zinc directly inhibits

rhinovirus binding and replication in the nasal mucosa and suppresses

inflammation [63,64]. However, no data are available to support this hypothesis

[64].

In a randomized, double-blind, placebo-controlled clinical trial, 50 subjects

(within 24 hours of developing the common cold) took a zinc acetate lozenge

(13.3 mg zinc) or placebo every 2–3 wakeful hours. Compared with placebo, the

zinc lozenges significantly reduced the duration of cold symptoms (cough, nasal

discharge, and muscle aches) [65].

In another clinical trial involving 273 participants with experimentally induced

colds, zinc gluconate lozenges (providing 13.3 mg zinc) significantly reduced

the duration of illness compared with placebo but had no effect on symptom

severity [66]. However, treatment with zinc acetate lozenges (providing 5 or

11.5 mg zinc) had no effect on either cold duration or severity. Neither zinc

gluconate nor zinc acetate lozenges affected the duration or severity of cold

symptoms in 281 subjects with natural (not experimentally induced) colds in

another trial [66].

In 77 participants with natural colds, a combination of zinc gluconate nasal

spray and zinc orotate lozenges (37 mg zinc every 2–3 wakeful hours) was also

found to have no effect on the number of asymptomatic patients after 7 days of

treatment [67].

In September of 2007, Caruso and colleagues published a structured review of the

effects of zinc lozenges, nasal sprays, and nasal gels on the common cold [64].

Of the 14 randomized, placebo-controlled studies included, 7 (5 using zinc

lozenges, 2 using a nasal gel) showed that the zinc treatment had a beneficial

effect and 7 (5 using zinc lozenges, 1 using a nasal spray, and 1 using lozenges

and a nasal spray) showed no effect. A Cochrane review of the effects of zinc

lozenges on cold symptoms also reported inconclusive findings [68], although the

author of another review concluded that zinc can reduce the duration and

severity of cold symptoms [63].

The available data are therefore inconclusive regarding the use of zinc

lozenges, nasal gels, and sprays to treat the common cold.

As previously noted, the safety of intranasal zinc has been called into question

because of numerous reports of anosmia (loss of smell), in some cases

long-lasting or permanent, from the use of zinc-containing nasal gels or sprays

[14-16].

Age-related macular degeneration

Researchers have suggested that both zinc and antioxidants delay the progression

of age-related macular degeneration (AMD) and vision loss, possibly by

preventing cellular damage in the retina [69,70]. In a population-based cohort

study in the Netherlands, high dietary intake of zinc as well as beta carotene,

vitamin C, and vitamin E was associated with reduced risk of AMD in elderly

subjects [71]. However, the authors of a systematic review and meta-analysis

published in 2007 concluded that zinc is not effective for the primary

prevention of early AMD [72], although zinc might reduce the risk of progression

to advanced AMD.

The Age-Related Eye Disease Study (AREDS), a large, randomized,

placebo-controlled, clinical trial (n = 3,597), evaluated the effect of high

doses of selected antioxidants (500 mg vitamin C, 400 IU vitamin E, and 15 mg

beta-carotene) with or without zinc (80 mg as zinc oxide) on the development of

advanced AMD in older individuals with varying degrees of AMD [70]. Participants

also received 2 mg copper to prevent the copper deficiency associated with high

zinc intakes. After an average follow-up period of 6.3 years, supplementation

with antioxidants plus zinc (but not antioxidants alone) significantly reduced

the risk of developing advanced AMD and reduced visual acuity loss. Zinc

supplementation alone significantly reduced the risk of developing advanced AMD

in subjects at higher risk but not in the total study population. Visual acuity

loss was not significantly affected by zinc supplementation alone.

Two other small clinical trials evaluated the effects of supplementation with

200 mg zinc sulfate (providing 45 mg zinc) for 2 years in subjects with drusen

or macular degeneration. Zinc supplementation significantly reduced visual

acuity loss in one of the studies [73] but had no effect in the other [74].

A Cochrane review concluded that the evidence supporting the use of antioxidant

vitamins and zinc for AMD comes primarily from the AREDS study [69]. Further

research is required before public health recommendations can be made, but

individuals who have or are developing AMD might wish to talk to their physician

about using dietary supplements.

Interactions with iron and copper

Iron-deficiency anemia is a serious world-wide public health problem. Iron

fortification programs have been credited with improving the iron status of

millions of women, infants, and children. Fortification of foods with iron does

not significantly affect zinc absorption. However, large amounts of supplemental

iron (greater than 25 mg) might decrease zinc absorption [2,75].. Taking iron

supplements between meals helps decrease its effect on zinc absorption [75].

High zinc intakes can inhibit copper absorption, sometimes producing copper

deficiency and associated anemia [76,77]. For this reason, dietary supplement

formulations containing high levels of zinc, such as the one used in the AREDS

study [70], sometimes contain copper.

Health Risks from Excessive ZincZinc toxicity can occur in both acute and

chronic forms. Acute adverse effects of high zinc intake include nausea,

vomiting, loss of appetite, abdominal cramps, diarrhea, and headaches [2]. One

case report cited severe nausea and vomiting within 30 minutes of ingesting 4 g

of zinc gluconate (570 mg elemental zinc) [78]. Intakes of 150–450 mg of zinc

per day have been associated with such chronic effects as low copper status,

altered iron function, reduced immune function, and reduced levels of

high-density lipoproteins [79]. Reductions in a copper-containing enzyme, a

marker of copper status, have been reported with even moderately high zinc

intakes of approximately 60 mg/day for up to 10 weeks [2]. The doses of zinc

used in the AREDS study (80 mg per day of zinc in the form of zinc oxide for 6.3

years, on average) have been associated with a significant increase in

hospitalizations for genitourinary causes, raising the

possibility that chronically high intakes of zinc adversely affect some aspects

of urinary physiology [80].

The FNB has established ULs for zinc (Table 3). Long-term intakes above the UL

increase the risk of adverse health effects [2]. The ULs do not apply to

individuals receiving zinc for medical treatment, but such individuals should be

under the care of a physician who monitors them for adverse health effects.

Table 3: Tolerable Upper Intake Levels (ULs) for Zinc [2]

Age

Male

Female

Pregnant

Lactating

0 to 6 months

4 mg

4 mg

 

 

7 to 12 months

5 mg

5 mg

 

 

1 to 3 years

7 mg

7 mg

 

 

4 to 8 years

12 mg

12 mg

 

 

9 to 13 years

23 mg

23 mg

 

 

14 to 18 years

34 mg

34 mg

34 mg

34 mg

19+ years

40 mg

40 mg

40 mg

40 mg

Interactions with MedicationsZinc supplements have the potential to interact

with several types of medications. A few examples are provided below.

Individuals taking these medications on a regular basis should discuss their

zinc intakes with their healthcare providers.

Antibiotics

Both quinolone antibiotics (such as Cipro®) and tetracycline antibiotics (such

as Achromycin® and Sumycin®) interact with zinc in the gastrointestinal tract,

inhibiting the absorption of both zinc and the antibiotic [81,82]. Taking the

antibiotic at least 2 hours before or 4–6 hours after taking a zinc supplement

minimizes this interaction [83].

Penicillamine

Zinc can reduce the absorption and action of penicillamine, a drug used to treat

rheumatoid arthritis [84]. To minimize this interaction, individuals should take

zinc supplements at least 2 hours before or after taking penicillamine [83].

Diuretics

Thiazide diuretics such as chlorthalidone (Hygroton®) and hydrochlorothiazide

(Esidrix® and HydroDIURIL®) increase urinary zinc excretion by as much as 60%

[85]. Prolonged use of thiazide diuretics could deplete zinc tissue levels, so

clinicians should monitor zinc status in patients taking these medications.

Zinc and Healthful DietsAccording to the 2005 Dietary Guidelines for Americans,

" nutrient needs should be met primarily through consuming foods. Foods provide

an array of nutrients and other compounds that may have beneficial effects on

health. In certain cases, fortified foods and dietary supplements may be useful

sources of one or more nutrients that otherwise might be consumed in less than

recommended amounts. However, dietary supplements, while recommended in some

cases, cannot replace a healthful diet. "

The Dietary Guidelines for Americans describes a healthy diet as one that:

Emphasizes a variety of fruits, vegetables, whole grains, and fat-free or

low-fat milk and milk products.

Whole grains and milk products are good sources of zinc. Many ready-to-eat

breakfast cereals are fortified with zinc.

Includes lean meats, poultry, fish, beans, eggs, and nuts.

Oysters, red meat, and poultry are excellent sources of zinc. Baked beans,

chickpeas, and nuts (such as cashews and almonds) also contain zinc.

Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added

sugars.

Stays within your daily calorie needs.For more information about building a

healthful diet, refer to the Dietary Guidelines for Americans

(http://www.health.gov/dietaryguidelines/dga2005/document/default.htm) and the

U.S. Department of Agriculture's food guidance system, My Pyramid

(http://www.mypyramid.gov).

About ODS and Other Sponsors

General Safety Advisory

Disclaimer

Print-friendly version

Posted Date:

11/7/2008

Updated:

6/30/2009 9:17 AM

References

Sandstead HH. Understanding zinc: recent observations and interpretations. J Lab

Clin Med 1994;124:322-7. [PubMed abstract]

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