Zinc

Table of Contents > Interactions & Depletions > Zinc

ACE inhibitorsACE inhibitors: Based on human research, ACE inhibitors such as captopril (Capoten®) and enalapril (Vasotec®) may increase urine zinc excretion, resulting in zinc deficiency (557). In human research, an effect of perindopril on salivary or plasma zinc levels was not observed (558).

AcetazolamideAcetazolamide: In a human study, zinc administration did not demonstrate any effects on acetazolamide-induced side effects (e.g., gustatory disorder, anorexia, and paraesthesia) (233).

Acne agentsAcne agents: In clinical research, zinc has been shown to decrease the number of acne lesions (234; 235; 165; 163; 238; 174; 236; 237; 175; 180; 559).

AnalgesicsAnalgesics: In psoriasis patients, use of zinc resulted in a decreased need for analgesics (338).

Angiotensin-converting enzyme receptor blockersAngiotensin-converting enzyme receptor blockers: In human research, an effect of losartan on salivary or plasma zinc levels was not observed (558).

AntibioticsAntibiotics: Based on expert opinion, tetracyclines forms complexes with zinc in the gastrointestinal tract, thereby decreasing the absorption and serum levels of tetracyclines, including demeclocycline, minocycline, and tetracycline (216). However, in human research, doxycycline did not seem to interact with zinc (217; 218). Similarly, quinolones (e.g., ciprofloxacin) may also form complexes with zinc in the gastrointestinal tract and decrease the absorption of these antibiotics (219). Based on secondary sources, zinc may decrease the absorption of erythromycin. However, other studies have shown that zinc may increase the efficacy of topical erythromycin. In a study comparing erythromycin with and without added zinc, the results showed a significant reduction in severity and number of acne vulgaris lesions (including inflamed lesions) in the zinc-treated group compared to those taking erythromycin alone (560). Erythromycin has been used in combination formulas with 1.2% zinc for the treatment of acne vulgaris for up to one year (378; 377). Supplementation with zinc in children with shigellosis resulted in an increase in serum shigellacidal antibodies and an increase in circulating CD20+ and CD20+CD38+ cells (467). Zinc citrate dentifrice decreased oral bacteria from plaque, tongue, cheek, and saliva (561). Zinc has been shown to increase the antienterobacterial activity of Hemidesmus indicus root in vitro (562). Zinc may aid in adjunctive therapy with leprosy treatments (563).

Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In humans, zinc demonstrated an effect on platelet aggregation (198). In an in vitro study, zinc inhibited and reversed platelet-activating factor-induced aggregation, and similar inhibitory effects of zinc were observed on serotonin release (564).

Antidiabetic agentsAntidiabetic agents: In humans, zinc has been reported to decrease fasting blood sugar and postprandial blood sugar (230). In one human study, zinc improved both insulin secretion and insulin sensitivity, and exerted insulin-like effects (565).

AntidiarrhealsAntidiarrheals: In human research, zinc supplementation has been shown to reduce the severity and duration of diarrhea (431; 432; 434; 202; 421; 544; 566; 430; 422; 439; 178; 28; 436; 437; 425; 426; 427; 440; 203; 567; 435; 433; 429; 568; 188; 428; 569; 423; 424).

Anti-inflammatory agentsAnti-inflammatory agents: In human research, zinc has been shown to decrease C-reactive protein, lipid peroxidation, and inflammatory cytokines, and increase anti-inflammatory proteins A20 and peroxisome proliferator-activated receptor-alpha in elderly patients and in hemodialysis patients (83; 570). Additionally, in human research, zinc acexamate has been shown to be effective and well tolerated for the prevention of NSAID-induced gastroduodenal damage in patients with rheumatic disease (282). The incidence of gastric and duodenal ulcers decreased in 92% of the zinc-supplemented group when compared to placebo.

Antilipemic agentsAntilipemic agents: Zinc may interact with LDL and HDL lipoproteins and triglycerides (571; 486; 487; 472), reducing HDL cholesterol levels. However, alterations were not observed in other studies (572; 573). In animal research, cholestyramine, a bile acid sequestrant, decreased urinary zinc excretion (164). In in vitro research, treatment with HMG-CoA reductase inhibitors resulted in an active zinc signal in peripheral blood mononuclear cells (PBMCs) from low-grade atherosclerotic patients (574).

Antineoplastic agentsAntineoplastic agents: In human research, cisplatin was shown to increase urinary zinc excretion and reduce plasma zinc levels (575). Zinc may increase the cytotoxicity of cisplatin when in the presence of the chelate ethylenediaminetetraacetic acid (EDTA), compared to cisplatin treatment alone (220). Zinc has been studied as an adjunctive therapy to leukemia medication, and side effects have not been observed besides a slight decrease in granulocyte count (241). Based on microarray analysis, in malignant prostate cells, zinc upregulated the expression of metallothionein (MT)-1 isotypes MT-1J and MT-1M; furthermore, certain genes implicated in oncogenic pathways, such as Fos, Akt1, Jak3, and PI3K, were also regulated by zinc (576).

Antiulcer agentsAntiulcer agents: In clinical research, zinc acexamate has been shown to enhance the healing process of gastric ulcers (279; 280; 282; 577; 283; 310; 578; 281; 579; 284).

Antiviral agentsAntiviral agents: In clinical research, zinc has been shown to resolve symptoms of herpes simplex and herpes labialis (383; 384). In vitro studies indicate that zinc may have antiviral activity (580). In vitro, zinc significantly decreased viral yield (with moderate cytotoxicity) when applied to kidney cell lines of African green monkeys infected with herpes simplex virus, but reduction in viral DNA synthesis was not observed (581). In in vitro research, high amounts of zinc prevented interferon release (582).

Calcium saltsCalcium salts: Calcium supplements may require higher intake of zinc to retain a balanced zinc status (100). A decrease in zinc absorption following calcium supplementation has been observed (100); increased calcium levels were observed in children following zinc supplementation (50).

CaffeineCaffeine: According to secondary sources, caffeine may decrease zinc concentrations.

Carbenoxolone analog (BX24)Carbenoxolone analog (BX24): Based on human research, zinc sulfate 220mg, three times daily for four weeks, may interact with BX24 (310).

Cholera vaccineCholera vaccine: Supplementation with zinc has the potential to improve the efficacy of oral cholera vaccine in children (583).

CorticosteroidsCorticosteroids: In human research, large doses or prolonged use of corticosteroids may reduce zinc levels, as the pituitary-adrenal axis may play a role in controlling zinc levels (584; 585). Increased urinary excretion of zinc has also been reported (586).

Deferoxamine (Desferal®)Deferoxamine (Desferal®): Deferoxamine increased urinary zinc elimination (587; 588).

DexrazoxaneDexrazoxane: In human research, dexrazoxane has been shown to increase zinc excretion (589).

DisulfiramDisulfiram: In animal research, disulfiram has been shown to decrease intestinal absorption of zinc (590). Based on expert opinion, disulfiram may act as a chelator of zinc (591).

DiureticsDiuretics: In humans, thiazide diuretics (e.g., hydrochlorothiazide) and thiazide-like diuretics (e.g., chlorthalidone) may increase the urinary excretion of zinc (592; 593; 308; 594). Loop diuretics (e.g., furosemide) have been shown to reduce zinc concentrations and increase zinc excretion to a lesser extent than thiazide diuretics (592). However, in human research, the potassium-sparing diuretic amiloride (Midamor®) was also shown to reduce urinary zinc excretion (214). In other research, administration of diuretics did not alter serum zinc levels (215).

Drugs used for osteoporosisDrugs used for osteoporosis: In human research, zinc supplementation increased total alkaline phosphatase activity (ALP), bone-specific alkaline phosphatase activity (BAP-E), and BAP mass (BAP-M), markers of bone turnover, without any effects on parameters of bone resorption (595).

EstrogensEstrogens: In human research, estrogens have been shown to reduce zinc excretion (596; 597).

Ethanol (alcohol)Ethanol (alcohol): Alcohol may decrease serum zinc concentrations (598).

Folic acidFolic acid: Based on human research, folic acid supplementation may interfere with intestinal absorption of zinc (599). However, in other human and animal research, impairment was not observed (600).

H2 blockersH2 blockers: Administration of the histamine-2 (H(2) blocker cimetidine (Tagamet®) may alter zinc levels (601). Based on human research, combined use of cimetidine and zinc may have immunopotentiating effects and reduce the occurrence of diseases like candidiasis and recurrent herpetic infections (602; 603; 604).

ImmunosuppressantsImmunosuppressants: In human research, zinc supplementation increased various indices of immune function, including lymphocyte ratios of CD4 to CD8, and increased interleukin-2 and interferon-gamma (207; 208; 209; 210; 211; 212). In another study, it was determined that zinc supplementation did not have any long-lasting effects on immune status in healthy adults (605). Based on expert opinion long-term, high-dose administration of zinc may result in suppressed immunity (1).

Iron saltsIron salts: Nonheme iron may decrease zinc absorption. Nonheme iron and zinc compete for a common absorption pathway in the gut. However, when iron and zinc are taken with food, this interaction is not likely to occur. When taken with food, zinc absorption is facilitated by proteins in food through an alternate pathway that does not compete with iron (606; 607). Protein-bound heme iron (found in red meats) does not seem to affect zinc absorption. In human research, an effect of zinc on the bioavailability of iron was not observed at low doses (0.5mg of elemental iron and 0.59mg of zinc sulfate); however, at higher doses (10mg of iron and 11.71mg of zinc), iron bioavailability was inhibited by 56% (608). Zinc supplementation has resulted in decreased serum iron and transferrin saturation (419). In breastfed infants, iron supplementation did not affect zinc absorption (609). Elevated intakes of zinc did not interfere with erythrocyte incorporation of iron in premature formulas (610). Iron, zinc, and vitamin A have been used in combination to increase hemoglobin values most effectively in anemic women (611). According to a review, in most studies, iron supplementation did not affect the biochemical status of zinc (612). Low dietary zinc (45.9mcM daily; 3mg daily) apparently resulted in undesirable changes in circulating calcitonin and osteocalcin. As a moderately high intake of zinc decreased magnesium balance, further research on the possibility that a high intake of zinc is a health concern for individuals consuming less than the recommended amounts of magnesium is warranted (613).

Magnesium supplementsMagnesium supplements: In postmenopausal women, zinc supplementation increased excretion of magnesium, resulting in a magnesium imbalance (613).

MethylphenidateMethylphenidate: Based on human research, zinc may improve outcome of methylphenidate therapy in children with attention-deficit hyperactivity disorder (414).

NiacinNiacin: In alcoholic patients with pellagra, an interaction between zinc and niacin metabolism was observed, likely due to mediation by vitamin B6 (614).

Pancreatic enzyme replacementsPancreatic enzyme replacements: In human research, pancreatic enzyme replacements improved absorption of zinc (615).

Penicillamine (Cuprimine®)Penicillamine (Cuprimine®): In human and in vitro research, penicillamine chelated zinc and may reduce the effects of supplemental zinc (220; 162). Dosing times should be separated by at least two hours.

PhenytoinPhenytoin: In human research, phenytoin use has been associated with reduced zinc levels (616). Based human research and on expert opinion, phenytoin may act as a chelator of zinc (616; 591).

PropofolPropofol: Propofol in fusion contains EDTA, a chelator of zinc. Based on human research, concurrent use may increase the urinary excretion of zinc and reduce zinc levels (617).

Proton pump inhibitorsProton pump inhibitors: In human research, gastric acid suppression of omeprazole was shown to reduce the intestinal absorption of zinc (618).

Thyroid hormonesThyroid hormones: Zinc supplementation has been shown to alter thyroid hormone metabolism in disabled patients with zinc deficiency (221).

Tricyclic antidepressantsTricyclic antidepressants: In human research, supplementation with zinc decreased the efficacy of imipramine in treatment-resistant patients (213).

TrientineTrientine: Based on secondary sources, there was a lack of an interaction between zinc acetate and trientine in the treatment of Wilson's disease.

ZidovudineZidovudine: Based on secondary sources, zidovudine may play a role in reducing zinc levels in individuals with AIDS. In human research, zinc supplementation as an adjunct to zidovudine therapy in AIDS patients appeared to restrict opportunistic infections caused by Pneumocystis carinii and Candida, but not cytomegalovirus or toxoplasma infections (294).

Zinc/Herb/Supplement Interactions:

Acne herbs and supplementsAcne herbs and supplements: In clinical research, zinc has been shown to decrease the number of acne lesions (234; 235; 165; 163; 238; 174; 236; 237; 175; 180; 559).

AnalgesicsAnalgesics: In psoriasis patients, use of zinc resulted in decreased need for analgesics (338).

AntibacterialsAntibacterials: Based on expert opinion, tetracyclines forms complexes with zinc in the gastrointestinal tract. thereby decreasing the absorption and serum levels of tetracyclines, including demeclocycline, minocycline, and tetracycline (216). However, in human research, doxycycline did not seem interact with zinc (217; 218). Similarly, quinolones (e.g., ciprofloxacin) may also form complexes with zinc in the gastrointestinal tract and decrease the absorption of these antibiotics (219). Based on secondary sources, zinc may decrease the absorption of erythromycin. However, other studies have shown that zinc may increase the efficacy of topical erythromycin. In a study comparing erythromycin with and without added zinc, the results showed a significant reduction in severity and number of acne vulgaris lesions (including inflamed lesions) in the zinc-treated group compared to those taking erythromycin alone (560). Erythromycin has been used in combination formulas with 1.2% zinc for the treatment of acne vulgaris for up to one year (378; 377). Supplementation with zinc in children with shigellosis resulted in an increase in serum shigellacidal antibodies and an increase in circulating CD20+ and CD20+CD38+ cells (467). Zinc citrate dentifrice decreased oral bacteria from plaque, tongue, cheek, and saliva (561). Zinc has been shown to increase the antienterobacterial activity of Hemidesmus indicus root in vitro (562).

AntidepressantsAntidepressants: In human research, supplementation with zinc decreased the efficacy of imipramine in treatment-resistant patients (213).

Anti-inflammatory herbsAnti-inflammatory herbs: In human research, zinc has been shown to decrease C-reactive protein, lipid peroxidation, and inflammatory cytokines, and increase anti-inflammatory proteins A20 and peroxisome proliferator-activated receptor-alpha in elderly patients and in hemodialysis patients (83; 570). Additionally, in human research, zinc acexamate has been shown to be effective and well tolerated for the prevention of NSAID-induced gastroduodenal damage in patients with rheumatic disease at risk (282). The incidence of gastric and duodenal ulcers decreased in 92% of the zinc-supplemented group when compared to placebo.

AntilipemicsAntilipemics: Zinc may interact with LDL and HDL lipoproteins, and triglycerides (571; 486; 487; 472), reducing HDL cholesterol levels. However, alterations were not observed in other studies (572; 573). In animal research, cholestyramine, a bile acid sequestrant, decreased urinary zinc excretion (164). In in vitro research, treatment with HMG-CoA reductase inhibitors resulted in an active zinc signal in peripheral blood mononuclear cells (PBMCs) from low-grade atherosclerotic patients (574).

AntineoplasticsAntineoplastics: Zinc has been studied as an adjunctive therapy to leukemia medication, and side effects have not been observed, besides a slight decrease in granulocyte count (241). Based on microarray analysis, in malignant prostate cells, zinc upregulated the expression of metallothionein (MT)-1 isotypes MT-1J and MT-1M; furthermore, certain genes implicated in oncogenic pathways, such as Fos, Akt1, Jak3, and PI3K, were also regulated by zinc (576).

AntioxidantsAntioxidants: Zinc is purported to have antioxidant effects (571; 619). Zinc and iron supplementation has been shown to improve zinc-related antioxidant indicators that had been impaired by iron supplementation (620).

Antiulcer herbs and supplementsAntiulcer herbs and supplements: In clinical research, zinc acexamate has been shown to enhance the healing process of gastric ulcers (279; 280; 282; 577; 283; 310; 578; 281; 579; 284).

AntiviralsAntivirals: In clinical research, zinc has been shown to resolve symptoms of herpes simplex and herpes labialis (383; 384). In vitro studies indicate that zinc may have antiviral activity (580). In vitro, zinc significantly decreased viral yield (with moderate cytotoxicity) when applied to kidney cell lines of African green monkeys infected with herpes simplex virus, but a reduction in viral DNA synthesis was not observed (581). In in vitro research, high amounts of zinc prevented interferon release (582).

Ascorbic acidAscorbic acid: Based on secondary sources, there is a lack of an interaction between zinc acetate and ascorbic acid in the treatment of Wilson's disease.

BromelainBromelain: Based on secondary sources, zinc may inhibit the enzymatic activity of bromelain.

CaffeineCaffeine: According to secondary sources, caffeine may decrease zinc concentrations.

CalciumCalcium: Calcium supplements may require higher intake of zinc to retain a balanced zinc status (100). A decrease in zinc absorption following calcium supplementation has been observed (100), and increased calcium levels were observed in children following zinc supplementation (50).

Cat's clawCat's claw: In in vitro research, a combination of cat's claw water extract (C-Med-100), medicinal mushroom extracts (Cordyceps sinensis, Grifola blazei, Grifola frondosa, Trametes versicolor, and Ganoderma lucidum), nicotinamide, and zinc inhibited the growth of HL-60 human leukemic cells (621). In human research, this formulation reduced pain, fatigue, and weight loss, and decreased DNA damage.

ChromiumChromium: Based on animal research, chromium and zinc may compete for the same transport site in the intestine and theoretically may interfere with each one's absorption (622).

Citric acidCitric acid: According to secondary sources, citric acid may complex zinc.

CopperCopper: Zinc may interfere with copper metabolism (222; 223; 224; 225; 226; 227; 228; 229). However, two studies did not report an effect of zinc supplementation on plasma copper levels in healthy volunteers over a period of 6-16 weeks (623; 624).

EDTAEDTA: In human research, high doses of EDTA has been shown to increase zinc excretion; symptoms of depletion have been observed (625).

HypoglycemicsHypoglycemics: In humans, zinc has been reported to decrease fasting blood sugar and postprandial blood sugar (230). In one human study, zinc improved both insulin secretion and insulin sensitivity, and exerted insulin-like effects (565).

ImmunomodulatorsImmunomodulators: In human research, zinc supplementation increased various indices of immune function, including lymphocyte ratios of CD4 to CD8, and increased interleukin-2 and interferon-gamma (207; 208; 209; 210; 211; 212). In another study, it was determined that zinc supplementation did not have any long-lasting effects on immune status in healthy adults (605). Based on expert opinion long-term, high-dose administration of zinc may result in suppressed immunity (1).

IP-6 (phytic acid)IP-6 (phytic acid): IP-6 in foods may decrease zinc absorption (626). Theoretically, IP-6 supplements could also interfere with zinc absorption, as IP-6 chelated multivalent metal ions in the gastrointestinal tract, preventing absorption (627). However, in human research, zinc absorption was not increased by the long-term use of low-phytate corn in children (628). In human research, dietary calcium did not exacerbate phytate inhibition of zinc absorption in women (629).

IronIron: Nonheme iron may decrease zinc absorption. Nonheme iron and zinc compete for a common absorption pathway in the gut. However, when iron and zinc are taken with food, this interaction is not likely to occur. When taken with food, zinc absorption is facilitated by proteins in food through an alternate pathway that does not compete with iron (606; 607). Protein-bound heme iron (found in red meats) did not seem to affect zinc absorption. In human research, an effect of zinc on the bioavailability of iron was not observed at low doses (0.5mg of elemental iron and 0.59mg of zinc sulfate); however, at higher doses (10mg of iron and 11.71mg of zinc), iron bioavailability was inhibited by 56% (608). Zinc supplementation has resulted in decreased serum iron and transferrin saturation (419). In breastfed infants, iron supplementation did not affect zinc absorption (609). Elevated intakes of zinc did not interfere with erythrocyte incorporation of iron in premature formulas (610). Iron, zinc, and vitamin A have been used in combination to increase hemoglobin values most effectively in anemic women (611). According to a review, in most studies, iron supplementation did not affect the biochemical status of zinc (612). Low dietary zinc (45.9mcM daily; 3mg daily) apparently resulted in undesirable changes in circulating calcitonin and osteocalcin. As a moderately high intake of zinc decreased magnesium balance, further research on the possibility that a high intake of zinc is a health concern for individuals consuming less than the recommended amounts of magnesium is warranted (613).

MagnesiumMagnesium: In postmenopausal women, zinc supplementation increased excretion of magnesium, resulting in a magnesium imbalance (613).

ManganeseManganese: In human research, oral load of zinc increased plasma uptake of manganese (630).

Mushroom extractsMushroom extracts: In in vitro research, a combination of cat's claw water extract (C-Med-100), medicinal mushroom extracts (Cordyceps sinensis, Grifola blazei, Grifola frondosa, Trametes versicolor, and Ganoderma lucidum), nicotinamide, and zinc inhibited the growth of HL-60 human leukemic cells (621). In human research, this formulation reduced pain, fatigue, and weight loss, and decreased DNA damage.

NiacinNiacin: In alcoholic patients with pellagra, an interaction between zinc and niacin metabolism was observed, likely due to mediation by vitamin B6 (614).

NicotinamideNicotinamide: In in vitro research, a combination of cat's claw water extract (C-Med-100), medicinal mushroom extracts (Cordyceps sinensis, Grifola blazei, Grifola frondosa, Trametes versicolor, and Ganoderma lucidum), nicotinamide, and zinc inhibited the growth of HL-60 human leukemic cells (621). In human research, this formulation reduced pain, fatigue, and weight loss, and decreased DNA damage.

Osteoporosis herbs and supplementsOsteoporosis herbs and supplements: In human research, zinc supplementation increased total alkaline phosphatase activity (ALP), bone-specific alkaline phosphatase activity (BAP-E), and BAP mass (BAP-M), markers of bone turnover, without effects on parameters of bone resorption (595).

PhosphorusPhosphorus: According to secondary sources, phosphorus may interfere with the absorption of zinc.

PhytoestrogensPhytoestrogens: In human research, estrogens have been shown to reduce zinc excretion (596; 597).

RiboflavinRiboflavin: Based on human research, riboflavin may improve zinc absorption (631).

SeleniumSelenium: Interactions with selenium have been reported (632). Zinc and selenium may play a role in thyroid metabolism (633). In human research, concurrent deficiencies in selenium and zinc may increase the risk of squamous cell carcinoma of the esophagus (634).

Tartaric acidTartaric acid: According to secondary sources, tartaric acid may complex zinc.

Thyroid agentsThyroid agents: Zinc supplementation has been shown to alter thyroid hormone metabolism in disabled patients with zinc deficiency (221).

Vitamin AVitamin A: Supplementation with zinc may interact with vitamin A (635; 636). Zinc supplementation has been shown to increase plasma vitamin A levels in middle-aged and older men and women (637). Increased retinol levels were observed following zinc supplementation (20mg of zinc daily for six months) (635), and synergistic effects of vitamin A and zinc have been suggested (537). Zinc has been used in combination with vitamin A (300 IU daily) for 12 weeks to treat symptoms of acne (236). Iron, zinc, and vitamin A have been used in combination to increase hemoglobin values most effectively in anemic women (611).

Vitamin DVitamin D: In laboratory research, vitamin D has been found to be involved in zinc absorption (638). In animal research, interactions between vitamin D3 and zinc have been reported, suggesting that the combination may stimulate bone growth and mineralization (639).

Zinc/Food Interactions:

GeneralGeneral: According to secondary sources, foods and beverages have been shown to decrease the uptake of zinc, thereby decreasing the levels of zinc in the plasma of healthy volunteers. For this reason, it is recommended that an oral dose of zinc should be separated from food and beverages, other than water, by at least one hour.

CoffeeCoffee: In human research, concomitant use of coffee and zinc decreased zinc absorption (640).

Dairy foodsDairy foods: In human research, concomitant use of dairy products and zinc decreased zinc absorption (640). Based on animal and human research, these negative effects may be due to the casein content found in dairy products (641).

FiberFiber: According to secondary sources, foods high in fiber content may interfere with the absorption of zinc.

IP-6 (phytic acid)IP-6 (phytic acid): IP-6 in foods like grains (e.g., corn), legumes, seeds (e.g., sunflower), and soy may decrease zinc absorption (626). Theoretically, IP-6 supplements could also interfere with zinc absorption, as IP-6 chelated multivalent metal ions in the gastrointestinal tract, preventing absorption (627). However, in human research, zinc absorption was not increased by the long-term use of low-phytate corn in children (628). In human research, dietary calcium did not exacerbate phytate inhibition of zinc absorption in women (629).

Leafy green vegetablesLeafy green vegetables: In in vitro research, it was shown that some green leafy vegetables contained high levels of zinc (642).

PhosphorusPhosphorus: According to secondary sources, phosphorus may interfere with the absorption of zinc.

SugarSugar: In human research, high consumption of sugar resulted in a decrease in zinc density in children and teenagers (643).

Zinc/Lab Interactions:

Alkaline phosphataseAlkaline phosphatase: Increases have been noted in clinical trials using zinc (423; 424).

Apoprotein levelsApoprotein levels: In human research, a combination of zinc and vitamin A improved serum apoprotein A-I, apoprotein B, and the apoprotein B:apoprotein A-I ratio in patients with diabetes mellitus type 1 (644).

Blood cell countsBlood cell counts: Sideroblastic anemia, leukopenia, microcytic anemia, and neutropenia have been reported in individual case reports following ingestion of large amounts of zinc (193; 194; 195; 197; 490).

Blood urea nitrogenBlood urea nitrogen: In human research, zinc increased blood urea nitrogen levels (288).

Blood viscosityBlood viscosity: In human research, zinc decreased blood viscosity after exercise (277).

CalciumCalcium: In human research, zinc increased salivary calcium (355).

CaroteneCarotene: In human research, zinc decreased carotene levels (329).

CD4 and CD8 testCD4 and CD8 test: In human research, zinc supplementation increased various indices of immune function, including lymphocyte ratios of CD4 to CD8, increased interleukin-2, and interferon-gamma (207; 442; 444).

Coagulation panelCoagulation panel: In human research, zinc increased prothrombin levels (329). In humans, zinc demonstrated an effect on platelet aggregation (198). In an in vitro study, zinc inhibited and reversed platelet-activating factor-induced aggregation, and similar inhibitory effects of zinc were observed on serotonin release (564).

CopperCopper: Zinc may interfere with copper metabolism (222; 223; 224; 225; 226; 227; 228; 229). Administration of zinc in the absence of copper may cause a decrease in serum copper levels (223). However, two studies did not report an effect of zinc supplementation on plasma copper levels in healthy volunteers over a period of 6-16 weeks (623; 624). Hepatic and urinary copper were reduced in patients with Wilson's disease (473).

CortisolCortisol: Zinc may interact with cortisol excretion (645).

C-reactive proteinC-reactive protein: In human research, zinc supplementation decreased C-reactive protein in hemodialysis patients (570).

Follicle-stimulating hormone (FSH)Follicle-stimulating hormone (FSH): In human research, decreases in FSH occurred following zinc supplementation (302).

GlucoseGlucose: In patients with cirrhosis, zinc supplementation improved impaired glucose tolerance (328). In humans, zinc has been reported to decrease fasting blood sugar and postprandial blood sugar (230).

HbA1cHbA1c: Large-dose zinc supplementation increased MNL-zinc and induced an undesirable elevation of HbA1c in all individuals. This is especially disconcerting for those with IDDM and may reflect an exacerbation of a chronic "zinc diabetes." These data suggest a potential for toxicity from large-dose zinc supplementation (646).

HemoglobinHemoglobin: In human research, zinc supplementation in children did not alter hemoglobin concentrations (647). Zinc use decreased serum hemoglobin in pregnant women (549).

InsulinInsulin: In one human study, zinc improved both insulin secretion and insulin sensitivity, and exerted insulin-like effects (565).

Insulin-like growth factorInsulin-like growth factor: In human research, greater dietary intake of zinc was associated with higher insulin-like growth factor I concentrations (648).

Lipid profileLipid profile: Zinc may interact with LDL and HDL lipoproteins, and triglycerides (571; 486; 487; 472; 649; 290; 291; 292), reducing HDL ("good") cholesterol levels. However, alterations were not observed in other studies (572; 573).

Liver function testLiver function test: In human research, zinc decreased serum ALT, AST, and bilirubin levels (329; 286; 473).

Luteinizing hormone, follicle-stimulating hormone, testosterone, sperm countLuteinizing hormone, follicle-stimulating hormone, testosterone, sperm count: Significant increases in serum testosterone and sperm count, with a decrease in LH and FSH, has occurred following zinc supplementation compared to presupplementation (302). Zinc deficiency has been shown to decrease serum testosterone levels (650).

Magnesium levelsMagnesium levels: In postmenopausal women, zinc supplementation increased excretion of magnesium, resulting in a magnesium imbalance (613).

MalondialdehydeMalondialdehyde: In human research, zinc resulted in decreased malondialdehyde levels (651).

Mononuclear leukocyte zinc (MNL-Zn)Mononuclear leukocyte zinc (MNL-Zn): Large-dose zinc supplementation increased MNL-zinc and induced an undesirable elevation of HbA1c in all individuals. This is especially disconcerting for those with IDDM and may reflect an exacerbation of a chronic "zinc diabetes." These data suggest a potential for toxicity from large-dose zinc supplementation (646).

ProlactinProlactin: In one laboratory study, zinc increased the uptake of prolactin into the prostate gland (652).

Semen analysisSemen analysis: Based on human research, zinc increased sperm count, improved motility, and decreased antisperm antibody (305; 303; 304; 302).

TestosteroneTestosterone: Zinc deficiency has been associated with reduced serum testosterone levels (650). In human research, increased testosterone and dihydrotestosterone was shown (347; 653).

ThymulinThymulin: In human research, zinc increased thymulin levels (311; 654; 442).

Thyroid function testsThyroid function tests: Zinc supplementation altered thyroid hormone metabolism in disabled patients with zinc deficiency (221). In human research, zinc supplementation increased thyroid hormone levels in goitrous patients (655). TSH was decreased in Down syndrome (656; 657; 654). Triiodothyronine was normalized in human research (658).

Tuberculin testTuberculin test: Zinc supplementation may increase the tuberculin test in duration and decrease false negative results (659; 660).

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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