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Low Iron may contribute to depression in women who are not anaemic Prolonged use of thiazide diuretics could deplete zinc tissue levels, so clinicians should monitor zinc status in patients taking these medications. Key Findings Report Apple iPhone unit sales worldwide , by quarter. B12 deficiency is so very common. Each year, around 9 million children die from preventable and treatable illnesses before reaching their fifth birthday. Corporate solution including all features.
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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 [ 38 ]. 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 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 [ 39 ]. Lactation can also deplete maternal zinc stores [ 40 ].
For these reasons, the RDA for zinc is higher for pregnant and lactating women than for other women see Table 1 [ 2 ]. 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 [ 24 , 41 ]. Zinc supplementation has been shown to improve growth in children with sickle cell disease [ 43 ]. In addition, the variety and amount of food consumed by many alcoholics is limited, leading to inadequate zinc intake [ 2 , 46 , 47 ].
Severe zinc deficiency depresses immune function [ 48 ], and even mild to moderate degrees of zinc deficiency can impair macrophage and neutrophil functions, natural killer cell activity, and complement activity [ 49 ].
The body requires zinc to develop and activate T-lymphocytes [ 2 , 50 ]. 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 [ 49 , 51 ]. 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 [ ].
Zinc helps maintain the integrity of skin and mucosal membranes [ 49 ]. Patients with chronic leg ulcers have abnormal zinc metabolism and low serum zinc levels [ 56 ], and clinicians frequently treat skin ulcers with zinc supplements [ 57 ].
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 [ 58 , 59 ].
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 [ 58 , 59 ].
Acute diarrhea is associated with high rates of mortality among children in developing countries [ 60 ]. Zinc deficiency causes alterations in immune response that probably contribute to increased susceptibility to infections, such as those that cause diarrhea, especially in children [ 49 ]. Studies show that poor, malnourished children in India, Africa, South America, and Southeast Asia experience shorter courses of infectious diarrhea after taking zinc supplements [ 61 ]. The children in these studies received 4—40 mg of zinc a day in the form of zinc acetate, zinc gluconate, or zinc sulfate [ 61 ].
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 [ 62 ]. Similar findings were reported in a meta-analysis published in and a review of zinc supplementation for preventing and treating diarrhea [ 63 , 64 ]. 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 [ 60 ].
Researchers have hypothesized that zinc could reduce the severity and duration of cold symptoms by directly inhibiting rhinovirus binding and replication in the nasal mucosa and suppressing inflammation [ 65 , 66 ].
Although studies examining the effect of zinc treatment on cold symptoms have had somewhat conflicting results, overall zinc appears to be beneficial under certain circumstances. Several studies are described below in which zinc is administered as a lozenge or zinc-containing syrup that temporarily "sticks" in the mouth and throat.
This allows zinc to make contact with the rhinovirus in those areas. In a randomized, double-blind, placebo-controlled clinical trial, 50 subjects within 24 hours of developing the common cold took a zinc acetate lozenge Compared with placebo, the zinc lozenges significantly reduced the duration of cold symptoms cough, nasal discharge, and muscle aches [ 67 ]. In another clinical trial involving participants with experimentally induced colds, zinc gluconate lozenges providing However, treatment with zinc acetate lozenges providing 5 or Neither zinc gluconate nor zinc acetate lozenges affected the duration or severity of cold symptoms in subjects with natural not experimentally induced colds in another trial [ 68 ].
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 [ 69 ].
In September of , Caruso and colleagues published a structured review of the effects of zinc lozenges, nasal sprays, and nasal gels on the common cold [ 66 ]. 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.
More recently, a Cochrane review concluded that "zinc lozenges or syrup is beneficial in reducing the duration and severity of the common cold in healthy people, when taken within 24 hours of onset of symptoms" [ 70 ]. The author of another review completed in also concluded that zinc can reduce the duration and severity of cold symptoms [ 65 ]. However, more research is needed to determine the optimal dosage, zinc formulation and duration of treatment before a general recommendation for zinc in the treatment of the common cold can be made [ 70 ].
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 [ ]. 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 [ 71 , 72 ].
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 [ 73 ]. However, the authors of a systematic review and meta-analysis published in concluded that zinc is not effective for the primary prevention of early AMD [ 74 ], although zinc might reduce the risk of progression to advanced AMD.
Participants also received 2 mg copper to prevent the copper deficiency associated with high zinc intakes. After an average follow-up period of 6. 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 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 [ 76 ] but had no effect in the other [ 77 ]. 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 , 78 ]. Taking iron supplements between meals helps decrease its effect on zinc absorption [ 78 ]. High zinc intakes can inhibit copper absorption, sometimes producing copper deficiency and associated anemia [ 79 , 80 ].
For this reason, dietary supplement formulations containing high levels of zinc, such as the one used in the AREDS study [ 72 ], sometimes contain copper. Zinc 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 mg elemental zinc [ 81 ]. Intakes of — 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 [ 82 ].
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.
Zinc 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.
Taking the antibiotic at least 2 hours before or 4—6 hours after taking a zinc supplement minimizes this interaction [ 86 ]. Zinc can reduce the absorption and action of penicillamine, a drug used to treat rheumatoid arthritis [ 87 ]. To minimize this interaction, individuals should take zinc supplements at least 2 hours before or after taking penicillamine [ 85 ]. Prolonged use of thiazide diuretics could deplete zinc tissue levels, so clinicians should monitor zinc status in patients taking these medications.
The federal government's Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.
For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U. Department of Agriculture's MyPlate. This fact sheet by the Office of Dietary Supplements ODS provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.
March 2, History of changes to this fact sheet. Strengthening Knowledge and Understanding of Dietary Supplements. Zinc Fact Sheet for Health Professionals.
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Midlife Body Changes Chapter 3: Clinical Issues Chapter 4: Disease Risk Chapter 5: Clinical Evaluation and Counseling Chapter 6: Complementary and Alternative Medicine Chapter 7: Nonprescription Options Chapter 8: Sexual Problems and Activity by the Numbers.