Send all comments or additions to: Frankp@chiro.org FROM: Anaesthesist 1975 (Aug); 24 (8): 329–342 Seeling W, Ahnefeld FW, Dick W, Fodor L A meta-analysis of the effects of oral zinc in the treatment of acute and persistent diarrhea. The transition metals and zinc are among the least abundant metal ions in the sea water from which contemporary organisms are thought to have evolved (Table 1.1).1-5 For many of the metals, the concentration in human blood plasma greatly exceeds that in sea water. 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 [69]. Neurology. The metals are generally found either bound directly to proteins or in cofactors such as porphyrins or cobalamins, or in clusters that are in turn bound by the protein; the ligands are usually O, N, S, or C. Proteins with which transition metals and zinc are most commonly associated catalyze the intramolecular or intermolecular rearrangement of electrons. In more severe cases, zinc deficiency causes hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism in males, and eye and skin lesions [2,8,27,28]. [, Nations SP, Boyer PJ, Love LA, Burritt MF, Butz JA, Wolfe GI, Hynan LS, Reisch J, Trivedi JR. Denture cream: an unusual source of excess zinc, leading to hypocupremia and neurologic disease. Interagency Board for Nutrition Monitoring and Related Research. [, Black RE. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. The History of Zinc . [, Prasad AS. Numerous case reports of anosmia (loss of the sense of smell), in some cases long-lasting or permanent, have been associated with the use of zinc-containing nasal gels or sprays [17,18]. Absorption interactions with fluoroquinolones. The peptidases, kinases, and phosphorylases are most sensitive to zinc depletion. In proteins, vanadium is a cofactor in an algal bromoperoxidase and in certain prokaryotic nitrogenases. 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 [88]. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet. The DV for zinc on the new Nutrition Facts and Supplement Facts labels and used for the values in Table 2 is 11 mg for adults and children aged 4 years and older [15]. Several important functions of zinc include: Making DNA and RNA, which is important to actively dividing cells Acute adverse effects of high zinc intake include nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, and headaches [2]. Severe zinc deficiency depresses immune function [51], and even mild to moderate degrees of zinc deficiency can impair macrophage and neutrophil functions, natural killer cell activity, and complement activity [52]. Food Assistance and Nutrition Report Number 36, 2003. J Trace Elem Med Biol 2006;20:3-18. Alaimo K, McDowell MA, Briefel RR, et al. Zinc deficiency tests can also be done with a urine sample and hair analysis. [, Zemel BS, Kawchak DA, Fung EB, Ohene-Frempong K, Stallings VA. Effect of zinc supplementation on growth and body composition in children with sickle cell disease. [, Lewis MR, Kokan L. Zinc gluconate: acute ingestion. Zinc for the common cold. reversible binding of dioxygen, e.g., hemocyanin (Cu), hemerythrin (Fe), and hemoglobin (Fe); activation of dioxygen, e.g., dopamine hydroxylase (Cu) (important in the synthesis of the hormone epinephrine), tyrosinases (Cu), and catechol dioxygenases (Fe); electron transfer, e.g., plastocyanins (Cu), ferredoxins, and c-type cytochromes (Fe); dismutation of superoxide by Cu or Fe as the redox-active metal (superoxide dismutases). [, Dixon LB, Winkleby MA, Radimer KL. 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) [25]. Zinc is also found in many cold lozenges and some over-the-counter drugs sold as cold remedies. Your body doesn’t store zinc, so regular intake is required to avoid a deficiency. Zinc is an essential mineral that is naturally present in some foods, added to others, and available as a dietary supplement. Such toxicity has been reported in individuals who used 2 or more standard 2.4 oz tubes of denture cream per week [20,21]. Am J Physiol 1997;272:E1002-7. Maintaining adequate nutritional status, especially during periods of illness and metabolic stress, is an important part of patient care. [, Krebs NF. J Urol 2007;177:639-43. For a reader-friendly overview of Zinc, see our consumer fact sheet on Zinc. 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 [87]. Clin Infect Dis 2007;45 (1 Suppl):S73-7. Cobalt is found in vitamin B12 , its only apparent biological site.12 The vitamin is a cyano complex, but a methyl or methylene group replaces CN in native enzymes. Zinc is an essential mineral that is naturally present in some foods, added to others, and available as a dietary supplement. Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA. What is zinc gluconate? Nitrogenases, which also contain iron, have been the focus of intense investigations by bioinorganic chemists and biologists; the iron is found in a cluster with molybdenum (the iron-molybdenum cofactor, or FeMoCo) and in an iron-sulfur center (Chapter 7). For this reason, dietary supplement formulations containing high levels of zinc, such as the one used in the AREDS study [75], sometimes contain copper. 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. [, Ribar DS, Hamrick KS. Recently a group of nucleic-acid binding proteins, with a repeated sequence containing the amino acids cysteine and histidine, were shown to bind as many as eleven zinc atoms necessary for protein function (transcribing DNA to RNA).10 Zinc plays a structural role, forming the peptide into multiple domains or "zinc fingers" by means of coordination to cysteine and histidine (Figure 1.2A See color plate section, page C-l.). In addition, the variety and amount of food consumed by many alcoholics is limited, leading to inadequate zinc intake [2,49,50]. The author of another review completed in 2004 also concluded that zinc can reduce the duration and severity of cold symptoms [68]. [, Maret W, Sandstead HH. 1.1: Biological Significance of Iron, Zinc, Copper, Molybdenum, Cobalt, Chromium, Vanadium, and Nickel, https://chem.libretexts.org/@app/auth/2/login?returnto=https%3A%2F%2Fchem.libretexts.org%2FBookshelves%2FInorganic_Chemistry%2FBook3A_Bioinorganic_Chemistry_(Bertini_et_al. Zinc in the fetus and newborn. One study demonstrated that after restricting the zinc intake of the participants for 5 months, supplementing with zinc had a significant impact on testosterone levels in the majority of participants. Ann Pharmacother 1996;30:186-7. The zinc present in the pancreas may aid in the storage of insulin. When metals compete: a case of copper-deficiency myeloneuropathy and anemia. ABSTRACT. In addition, vegetarians typically eat high levels of legumes and whole grains, which contain phytates that bind zinc and inhibit its absorption [34,41]. Zinc deficiency in women, infants and children. Visual acuity loss was not significantly affected by zinc supplementation alone. [, Turner RB, Cetnarowski WE. [, Wang LC, Busbey S. Images in clinical medicine. Treatment of naturally acquired common colds with zinc: a structured review. AREDS2 found that a formulation providing 25 mg zinc (about one-third the amount in the original formulation) provided the same protective effect against developing advanced AMD. Role of zinc in the process of pancreatic fibrosis in chronic alcoholic pancreatitis. Arch Dermatol 1998;134:1556-60. J Toxicol Clin Toxicol 1998;36:99-101. The LibreTexts libraries are Powered by MindTouch® and are supported by the Department of Education Open Textbook Pilot Project, the UC Davis Office of the Provost, the UC Davis Library, the California State University Affordable Learning Solutions Program, and Merlot. Nutr Rev 1998;56:27-8. Zinc deficiency in men is linked to significantly reduced testosterone levels which can have a very damaging effect on both fertility and sex drive. Am J Clin Nutr 1998;68 (2 Suppl):414S-7S. 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. High zinc intakes can inhibit copper absorption, sometimes producing copper deficiency and associated anemia [84,85]. Long-term intakes above the UL increase the risk of adverse health effects [2]. 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 [63]. Zinc Sulfate. 2008 Aug 26;71(9):639-43. Biological Significance of Zinc The zinc atomic structure plays an integral role in every other living organism. The processes and reactions in which iron participates are crucial to the survival of terrestrial organisms, and include ribonucleotide reduction (DNA synthesis), energy production (respiration), energy conversion (photosynthesis), nitrogen reduction, oxygen transport (respiration, muscle contraction), and oxygenation (e.g., steroid synthesis, solubilization and detoxification of aromatic compounds). [, Lukacik M, Thomas RL, Aranda JV. Despite the small number of characterized Ni-proteins, it is clear that many different environments exist, from apparently direct coordination to protein ligands (urease) to the tetrapyrrole F430 in methylreductase and the multiple metal sites of Ni and Fe-S in a hydrogenase from the bacterium Desulfovibrio gigas. Zinc, chemical symbol Zn, is a corrosion resistant metal with a bluish white color. Second, the biological roles of each remain largely unknown.18 Finally, each has served as a probe to characterize the sites of other metals, such as iron and zinc. Compared with placebo, the zinc lozenges significantly reduced the duration of cold symptoms (cough, nasal discharge, and muscle aches) [70]. Studies show that poor, malnourished children in India, Africa, South America, and Southeast Asia experience shorter courses of infectious diarrhea after taking zinc supplements [64]. Zinc deficiency causes alterations in immune response that probably contribute to increased susceptibility to infections, such as those that cause diarrhea, especially in children [52]. The Dietary Guidelines for Americans describes a healthy eating pattern as one that: This fact sheet by the Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. Intake 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]. 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 [75]. BMJ 2003;326:409-10. [, Lomaestro BM, Bailie GR. Zinc toxicity can occur in both acute and chronic forms. Copper and iron proteins participate in many of the same biological reactions: The two metal ions also function in concert in proteins such as cytochrome oxidase, which catalyzes the transfer of four electrons to dioxygen to form water during respiration. 0; Significance of Zinc in a human body. WHO/UNICEF Joint Statement, August, 2004. Authors: Josko Osredkar. Oral zinc for arterial and venous leg ulcers. Such data indicate the importance of mechanisms for accumulation, storage, and transport of transition metals and zinc in living organisms. Zinc is also important to wound healing and your sense of taste and smell.With a varied diet, your body usually gets enough zinc. Chromium imbalance affects sugar metabolism and has been associated with the glucose tolerance factor in animals. In fact, almost 20 metalloenzymes have an active site formed through zinc. A survey of the sequences of many nucleic-acid binding proteins shows that many of them have the common motif required to form zinc fingers. For more information contact us at info@libretexts.org or check out our status page at https://status.libretexts.org. 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 [26]. 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 [41]. 1986 Jul;31(7):724-31. [, Whittaker P. Iron and zinc interactions in humans. 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 [2,36]. [, Prasad AS. FDA required manufacturers to use these new labels starting in January 2020, but companies with annual sales of less than $10 million may continue to use the old labels that list a zinc DV of 15 mg until January 2021 [14,16]. The most common zinc ore is sphalerite (zinc blende), a zinc sulfide mineral. Zinc supplementation alone significantly reduced the risk of developing advanced AMD in subjects at higher risk but not in the total study population. [, World Health Organization and United Nations Children Fund. A reversible cause of sideroblastic anemia and bone marrow depression. Effect of weekly zinc supplements on incidence of pneumonia and diarrhoea in children younger than 2 years in an urban, low-income population in Bangladesh: randomised controlled trial. Dermatology 1996;193:361-3. Contribution of selected vitamins and trace elements to immune function. [, Rink L, Gabriel P. Zinc and the immune system. 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