Highlights & Basics
- Zinc deficiency is rarely severe and usually congenital. Milder zinc deficiency is usually acquired and is common in older people.
- Manifestations of zinc deficiency may be subtle and can affect many organ systems. Delayed wound healing, impaired taste, loss of appetite, hair loss, fertility issues, and increased susceptibility to infection are common manifestations.
- Plasma or serum zinc levels are useful in the evaluation of patients with suspected zinc deficiency. Milder forms of zinc deficiency may not be detected in plasma or serum tests, but supplementation may still be considered for patients with typical symptoms.
- In most cases, standard oral zinc supplementation leads to increased zinc levels and amelioration of symptoms.
- Zinc supplementation is generally safe, although acute toxicity with high doses may lead to adverse changes in immune, iron, copper, and cholesterol status, as well as to potential genitourinary problems.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Citations
Lassi ZS, Kurji J, Oliveira CS, et al. Zinc supplementation for the promotion of growth and prevention of infections in infants less than six months of age. Cochrane Database Syst Rev. 2020 Apr 8;4:CD010205.[Abstract][Full Text]
U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2020-2025. Dec 2020 [internet publication].[Full Text]
Centers for Disease Control and Prevention. Nutrition and growth refugee health domestic guidance. May 2024 [internet publication].[Full Text]
1. Krebs NF, Miller LV, Hambidge KM. Zinc deficiency in infants and children: a review of its complex and synergistic interactions. Paediatr Int Child Health. 2014 Nov;34(4):279-88.[Abstract]
2. Zupo R, Sila A, Castellana F, et al. Prevalence of zinc deficiency in inflammatory bowel disease: a systematic review and meta-analysis. Nutrients. 2022 Sep 29;14(19):4052.[Abstract][Full Text]
3. Jivraj A, Hutchinson JM, Ching E, et al. Micronutrient deficiencies are frequent in adult patients with and without celiac disease on a gluten-free diet, regardless of duration and adherence to the diet. Nutrition. 2022 Nov-Dec;103-104:111809.[Abstract]
4. Katayama K, Kawaguchi T, Shiraishi K, et al. The prevalence and implication of zinc deficiency in patients with chronic liver disease. J Clin Med Res. 2018 May;10(5):437-44.[Abstract][Full Text]
5. Baj J, Flieger W, Teresiński G, et al. Magnesium, calcium, potassium, sodium, phosphorus, selenium, zinc, and chromium levels in alcohol use disorder: a review. J Clin Med. 2020 Jun 18;9(6):1901.[Abstract][Full Text]
6. Prasad AS. Zinc deficiency in patients with sickle cell disease. Am J Clin Nutr. 2002 Feb;75(2):181-2.[Abstract][Full Text]
7. Perrone L, Gialanella G, Giordano V, et al. Impaired zinc metabolic status in children affected by idiopathic nephrotic syndrome. Eur J Pediatr. 1990 Mar;149(6):438-40.[Abstract]
8. Koch J, Neal EA, Schlott MJ, et al. Zinc levels and infections in hospitalized patients with AIDS. Nutrition. 1996 Jul-Aug;12(7-8):515-8.[Abstract]
9. Meunier N, O'Connor JM, Maiani G, et al. Importance of zinc in the elderly: the ZENITH study. Eur J Clin Nutr. 2005 Nov;59 Suppl 2:S1-4.[Abstract][Full Text]
10. Tumer N, Baskan S, Arcasoy A, et al. Hypozincemia in nephrotic syndrome. Clin Nephrol. 1991 Mar;35(3):135-7.[Abstract]
11. Stec J, Podracka L, Pavkovcekova O, et al. Zinc and copper metabolism in nephrotic syndrome. Nephron. 1990;56(2):186-7.[Abstract]
12. Lindberg L, Ostberg M, Isacson IM, et al. Feeding disorders related to nutrition. Acta Paediatr. 2006 Apr;95(4):425-9.[Abstract]
13. Castro J, Deulofeu R, Gila A, et al. Persistence of nutritional deficiencies after short-term weight recovery in adolescents with anorexia nervosa. Int J Eat Disord. 2004 Mar;35(2):169-78.[Abstract]
14. Atik OS, Uslu MM, Eksioglu F, et al. Etiology of senile osteoporosis: a hypothesis. Clin Orthop Relat Res. 2006 Feb;443:25-7.[Abstract]
15. Haase H, Mocchegiani E, Rink L. Correlation between zinc status and immune function in the elderly. BBiogerontology. 2006 Oct-Dec;7(5-6):421-8.[Abstract]
16. Passarelli S, Free CM, Shepon A, et al. Global estimation of dietary micronutrient inadequacies: a modelling analysis. Lancet Glob Health. 2024 Oct;12(10):e1590-9.[Abstract][Full Text]
17. Ackland ML, Michalczyk A. Zinc deficiency and its inherited disorders - a review. Genes Nutr. 2006 Mar;1(1):41-9. [Abstract]
18. Bhatnagar S, Natchu UC. Zinc in child health and disease. Indian J Pediatr. 2004 Nov;71(11):991-5.[Abstract]
19. Prasad AS. Zinc deficiency. BMJ. 2003 Feb 22;326(7386):409-10.[Abstract][Full Text]
20. Prasad AS, Miale A Jr, Farid Z, et al. Zinc metabolism in patients with the syndrome of iron deficiency anemia, hepatosplenomegaly, dwarfism, and hypogonadism. J Lab Clin Med. 1963 Apr;61:537-49.[Abstract]
21. Müller O, Krawinkel M. Malnutrition and health in developing countries. CMAJ. 2005 Aug 2;173(3):279-86.[Abstract][Full Text]
22. Kalantar-Zadeh K, Kopple JD. Trace elements and vitamins in maintenance dialysis patients. Adv Ren Replace Ther. 2003 Jul;10(3):170-82.[Abstract]
23. Mahajan SK. Zinc in kidney disease. J Am Coll Nutr. 1989 Aug;8(4):296-304.[Abstract]
24. Mafra D, Cuppari L, Favaro DI, et al. Zinc levels after iron supplementation in patients with chronic kidney disease. J Ren Nutr. 2004 Jul;14(3):164-9.[Abstract]
25. Yuzbasiyan-Gurkan VA, Brewer GJ, Vander AJ, et al. Net renal tubular reabsorption of zinc in healthy man and impaired handling in sickle cell anemia. Am J Hematol. 1989 Jun;31(2):87-90.[Abstract]
26. Chaudhry AA, Warthan MM, Pariser RJ, et al. Acquired acrodermatitis enteropathica secondary to alcoholism. Cutis. 2008 Jul;82(1):60-2.[Abstract]
27. West BL, Anderson PC. Alcohol and acquired acrodermatitis enteropathica. J Am Acad Dermatol. 1986 Dec;15(6):1305.[Abstract]
28. Hunt JR. Moving toward a plant-based diet: are iron and zinc at risk? Nutr Rev. 2002 May;60(5 Pt 1):127-34.[Abstract]
29. Donovan UM, Gibson RS. Iron and zinc status of young women aged 14 to 19 years consuming vegetarian and omnivorous diets. J Am Coll Nutr. 1995 Oct;14(5):463-72.[Abstract]
30. Gardner CD, Kim S, Bersamin A, et al. Micronutrient quality of weight-loss diets that focus on macronutrients: results from the A TO Z study. Am J Clin Nutr. 2010 Aug;92(2):304-12.[Abstract][Full Text]
31. Lutter CK, Rivera JA. Nutritional status of infants and young children and characteristics of their diets. J Nutr. 2003 Sep;133(9):2941S-9S.[Abstract][Full Text]
32. Das JK, Kumar R, Salam RA, et al. Systematic review of zinc fortification trials. Ann Nutr Metab. 2013;62(suppl 1):44-56.[Abstract][Full Text]
33. Shah D, Sachdev HS, Gera T, et al. Fortification of staple foods with zinc for improving zinc status and other health outcomes in the general population. Cochrane Database Syst Rev. 2016;(6):CD010697.[Abstract][Full Text]
34. Stewart CP, Christian P, LeClerq SC, et al. Antenatal supplementation with folic acid + iron + zinc improves linear growth and reduces peripheral adiposity in school-age children in rural Nepal. Am J Clin Nutr. 2009 Jul;90(1):132-40.[Abstract][Full Text]
35. Imdad A, Rogner J, Sherwani RN, et al. Zinc supplementation for preventing mortality, morbidity, and growth failure in children aged 6 months to 12 years. Cochrane Database Syst Rev. 2023 Mar 30;3(3):CD009384.[Abstract][Full Text]
36. Garcia-Guerra A, Neufeld LM, Hernandez-Cordero S, et al. Prenatal multiple micronutrient supplementation impact on biochemical indicators during pregnancy and postpartum. Salud Publica Mex. 2009 Jul-Aug;51(4):327-35.[Abstract][Full Text]
37. Carducci B, Keats EC, Bhutta ZA. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database Syst Rev. 2021 Mar 16;3:CD000230.[Abstract][Full Text]
38. Lassi ZS, Kurji J, Oliveira CS, et al. Zinc supplementation for the promotion of growth and prevention of infections in infants less than six months of age. Cochrane Database Syst Rev. 2020 Apr 8;4:CD010205.[Abstract][Full Text]
39. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary guidelines for Americans, 2020-2025. Dec 2020 [internet publication].[Full Text]
40. Troesch B, van Stujivenberg ME, Smuts CM, et al. A micronutrient powder with low doses of highly absorbable iron and zinc reduces iron and zinc deficiency and improves weight-for-age Z-scores in South African children. J Nutr. 2011 Feb;141(2):237-42.[Abstract][Full Text]
41. DiGirolamo AM, Ramirez-Zea M, Wang M, et al. Randomized trial of the effect of zinc supplementation on the mental health of school-age children in Guatemala. Am J Clin Nutr. 2010 Nov;92(5):1241-50. [Abstract][Full Text]
42. Lassi ZS, Moin A, Bhutta ZA. Zinc supplementation for the prevention of pneumonia in children aged 2 months to 59 months. Cochrane Database Syst Rev. 2016;(12):CD005978.[Abstract][Full Text]
43. Aggarwal R, Sentz J, Miller MA. Role of zinc administration in prevention of childhood diarrhea and respiratory illnesses: a meta-analysis. Pediatrics. 2007 Jun;119(6):1120-30.[Abstract]
44. Staub E, Evers K, Askie LM. Enteral zinc supplementation for prevention of morbidity and mortality in preterm neonates. Cochrane Database Syst Rev. 2021 Mar 12;3(3):CD012797.[Abstract][Full Text]
45. Haase H, Overbeck S, Rink L. Zinc supplementation for the treatment or prevention of disease: current status and future perspectives. Exp Gerontol. 2008 May;43(5):394-408. [Abstract]
46. Gibson RS, Hess SY, Hotz C, et al. Indicators of zinc status at the population level: a review of the evidence. Br J Nutr. 2008 Jun;99(suppl 3):S14-23.[Abstract]
47. Kodama H, Tanaka M, Naito Y, et al. Japan's Practical Guidelines for Zinc Deficiency with a Particular Focus on Taste Disorders, Inflammatory Bowel Disease, and Liver Cirrhosis. Int J Mol Sci. 2020 Apr 22;21(8):.[Abstract][Full Text]
48. Heaney RP. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr. 2004 Dec;80(6 suppl):1706S-9S.[Abstract][Full Text]
49. Chapuy MC, Preziosi P, Maamer M, et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int. 1997;7(5):439-43.[Abstract]
50. Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S suppl):1344S-1349S.[Abstract][Full Text]
51. Hess SY, King JC. Effects of maternal zinc supplementation on pregnancy and lactation outcomes. Food Nutr Bull. 2009 Mar;30(1 suppl):S60-78.[Abstract][Full Text]
52. Centers for Disease Control and Prevention. Nutrition and growth refugee health domestic guidance. May 2024 [internet publication].[Full Text]
53. Mazariegos M, Hambidge KM, Westcott JE, et al. Neither a zinc supplement nor phytate-reduced maize nor their combination enhance growth of 6- to 12-month-old Guatemalan infants. J Nutr. 2010 May;140(5):1041-8.[Abstract][Full Text]
54. Chang S, El AS, Bari S, et al. Supplementing iron and zinc: double blind, randomized evaluation of separate or combined delivery. Eur J Clin Nutr. 2010 Feb;64(2):153-60. [Abstract][Full Text]
55. Institute of Medicine (U.S.). Panel on Micronutrients. DRI: Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Chapter 12: zinc. Washington, DC: National Academy Press; 2001:442-501.[Full Text]
56. Prasad AS, Beck FW, Bao B, et al. Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress. Am J Clin Nutr. 2007 Mar;85(3):837-44.[Abstract][Full Text]
57. Vakili R, Vahedian M, Khodaei GH, et al. Effects of zinc supplementation in occurrence and duration of common cold in school aged children during cold season: a double-blind placebo-controlled trial. Iran J Pediatr. 2009;19:376-80.[Full Text]
58. Berger MM, Shenkin A, Schweinlin A, et al. ESPEN micronutrient guideline. Clin Nutr. 2022 Jun;41(6):1357-424.[Abstract][Full Text]
59. Sriram K, Lonchyna VA. Micronutrient supplementation in adult nutrition therapy: practical considerations. JPEN J Parenter Enteral Nutr. 2009 Sep-Oct;33(5):548-62.[Abstract]
60. Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016;(12):CD005436.[Abstract][Full Text]
61. Haider BA, Bhutta ZA. The effect of therapeutic zinc supplementation among young children with selected infections: a review of the evidence. Food Nutr Bull. 2009 Mar;30(1 suppl):S41-59.[Abstract][Full Text]
62. Fischer Walker C, Black RE. Zinc and the risk for infectious disease. Annu Rev Nutr. 2004;24:255-75.[Abstract]
63. Valentiner-Branth P, Shrestha PS, Chandyo RK, et al. A randomized controlled trial of the effect of zinc as adjuvant therapy in children 2-35 mo of age with severe or nonsevere pneumonia in Bhaktapur, Nepal. Am J Clin Nutr. 2010 Jun;91(6):1667-74.[Abstract][Full Text]
64. Yakoob MY, Theodoratou E, Jabeen A, et al. Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malaria. BMC Public Health. 2011 Apr 13;11(suppl 3):S23. [Abstract][Full Text]
65. Imdad A, Bhutta ZA. Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool. BMC Public Health. 2011 Apr 13;11(suppl 3):S22.[Abstract][Full Text]
66. Cole CR, Lifshitz F. Zinc nutrition and growth retardation. Pediatr Endocrinol Rev. 2008 Jun;5(4):889-96.[Abstract]
67. Brown KH, Peerson JM, Baker SK, et al. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull. 2009 Mar;30(1 suppl):S12-40.[Abstract][Full Text]
68. Black MM. The evidence linking zinc deficiency with children's cognitive and motor functioning. J Nutr. 2003 May;133(5 suppl 1):1473S-6S.[Abstract][Full Text]
69. Sayeg Porto MA, Oliveira HP, Cunha AJ, et al. Linear growth and zinc supplementation in children with short stature. J Pediatr Endocrinol Metab. 2000 Sep-Oct;13(8):1121-8.[Abstract][Full Text]
70. Palacios C. The role of nutrients in bone health, from A to Z. Crit Rev Food Sci Nutr. 2006;46(8):621-8.[Abstract]