Key Takeaways (expand)
- Zinc is a trace element, and is the second most abundant metal in the body.
- Zinc helps facilitate protein folding via “zinc fingers”—small structural motifs that coordinate zinc ions and help stabilize the protein fold.
- Zinc serves as a cofactor for over 300 enzymes and more than 1000 transcriptional factors.
- Due to being essential for DNA and RNA transcription, zinc has a role in controlling gene expression and cellular communication.
- Zinc also helps regulate the activity of inflammatory cells, as well as programmed cell death (apoptosis)—an important part of the cell cycle.
- Zinc is involved in regulating the expression of metallothioneins, a family of metal-binding proteins that buffer against toxicity from heavy metals and protect against oxidative stress.
- Zinc serves as a cofactor for collagenase (a collagen-remodeling enzyme), and also helps activate proteins essential for collagen synthesis—giving it a role in collagen formation and skin health.
- Zinc is also important for the function of sensory organs; in fact, zinc deficiency can cause the loss of smell and taste!
- When it comes to vision, zinc is required for synthesizing proteins involved in retinol release and transport, as well as for producing rhodopsin—a protein that allows the eye to absorb light and adapt to darkness.
- Zinc also influences hormone release, making it relevant to some hormone-related diseases and conditions.
- Several other micronutrients require zinc for their absorption and metabolism, including the B vitamins, vitamin D, magnesium, and vitamin A.
- Zinc is heavily involved in the immune system, and essential for the development of cells mediating both the innate and adaptive immune responses.
- When started within 24 hours of the onset of illness, zinc supplements (especially lozenges) can shorten the length of the common cold—reducing the duration of symptoms like nasal discharge, coughing, congestion, throat hoarseness or scratchiness, sneezing, and muscle ache.
- Some research suggests that zinc deficiency is associated with poorer outcomes for Covid-19 patients, whereas higher zinc levels are associated with Covid-19 survival and a more successful Covid-19 vaccination response.
- In elderly adults, zinc supplements may help reverse age-related decline in immune function.
- Zinc supplements may also help reduce the risk of opportunistic infections and immune failure in HIV/AIDS patients.
- Some evidence suggests zinc can help prevent the recurrence of canker sores.
- Higher zinc intake is associated with lower diabetes risk—possibly due to its involvement in synthesizing and storing insulin, stimulating glucose uptake, and improving glycemic control.
- Research shows a protective effect of zinc against several neurological conditions, including Alzheimer’s disease and depression.
- Zinc deficiency causes a disruption in hundreds of metabolic pathways, potentially leading to immune dysfunction, increased infection risk, poor night vision, skin problems, impaired wound healing, higher risk of pregnancy complications, and potentially increased susceptibility to some chronic conditions—including cancer, cardiovascular disease, and autoimmune disease.
- In children, zinc deficiency can impair mental and psychomotor development, as well as delay growth and weight gain.
- Foods high in zinc include red meat, some organ meats (especially liver and heart), seafood (especially oysters), eggs, legumes, nuts, and whole grains.
- Due to the zinc-binding phytate found in many zinc-rich plant foods, zinc bioavailability is generally lower in plant foods than animal foods.
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Zinc is a trace element and the second most abundant metal in the body, and was first identified as essential for all forms of life in 1963 (although it was known to the Greeks and Romans as far back as 20 BCE, when powdered zinc was used along with charcoal and copper to form brass!). The origin of the word zinc isn’t fully known, but it may come from the German Zinke, meaning “prong” or “point.”
Since the discovery of its nutritional importance, research has revealed an astounding number of roles for this trace mineral—including being used in nearly every cellular function (from protein and carbohydrate metabolism to cell division and growth), neurotransmission, vision, reproduction, intestinal transport, immune function, DNA synthesis, and wound healing—and more!
Good sources of zinc include red meat, some organ meats (especially liver and heart), seafood (especially oysters), eggs, legumes, nuts, and whole grains. But, due to the phytate content of zinc-rich plant foods, its bioavailability is much higher in animal products. Some foods are also fortified with zinc, such as breakfast cereals.
The Biological Roles of Zinc
Zinc is needed for the body’s structural, catalytic, and regulatory functions. It helps facilitate protein folding via “zinc fingers”—small structural motifs that coordinate zinc ions in order to stabilize the protein fold. It also serves as a cofactor for an astounding 300-plus enzymes and over 1000 transcriptional factors! In fact, zinc is essential for DNA and RNA transcription (the “reading” of the DNA map to make proteins), and as a result, controls gene expression and communication within cells. Zinc also regulates apoptosis, or programmed cell death, which is an important part of the cell cycle. Zinc also helps control the activity of the body’s inflammatory cells and regulates the expression of metallothioneins—a family of metal-binding proteins that protect against oxidative stress and buffer against toxicity from heavy metals. And, along with these direct regulatory functions, zinc can stimulate a zinc-sensing receptor that causes intracellular calcium to be released, which then serves as a messenger in signaling pathways.
Because of its involvement in cell membrane structure and cell signaling, zinc is required for for muscle contraction. It’s also needed for collagen formation and maintenance, due to activating the proteins essential for collagen synthesis, as well as the collagen-remodeling enzyme collagenase. It plays a role in skin health and the function of sensory organs (that’s why zinc deficiency is associated with loss of smell and taste!). It’s also a critical micronutrient for a healthy immune system, essential for the development of cells mediating both the innate and adaptive immune responses (including neutrophils, natural killer cells, macrophages, B-lymphocytes, and T-lymphocytes); zinc has even been shown to reduce cytokine production by Th1 and Th17 cells. Not only that, but zinc influences hormone release, making it relevant to some hormone-related diseases and conditions.
Interactions with Other Nutrients
Zinc also plays a role in our ability to use other micronutrients. For example, it’s important for the absorption and activity of B vitamins, and is an essential component of the vitamin D receptor (the binding site of vitamin D in cells)—meaning that the actions of vitamin D are at least in part dependent on zinc. Zinc also works synergistically with magnesium, with zinc boosting magnesium absorption and magnesium helping the body regulate zinc levels. However, extremely high doses of zinc (typically 142 mg daily and above) can begin hindering magnesium absorption rather than helping it.
Vitamin A metabolism, too, is dependent on zinc, since zinc is used in the synthesis of retinol-binding protein that transports retinol throughout circulation to organs and tissues, and is required for the enzyme that releases retinol from storage in the liver. Zinc is also needed for the enzyme that converts retinol into retinal, a form of vitamin A used in the synthesis of an important protein called rhodopsin, which allows the eye to absorb light and adapt to darkness (not surprisingly, zinc deficiency is associated with night blindness!).
Drug Interactions with Zinc
Zinc supplementation may also reduce the absorption of certain medications, including penicillamine, cephalexin, and several antiretroviral drugs (including ritonavir and atazanavir). And, taking zinc alongside the antibiotics tetracycline and quinolone can reduce the absorption of both the zinc and the drug, making it important to take them at least two hours apart. If you’re on prescription medication and plan on supplementing with zinc, it may be wise to seek medical advice from a healthcare professional in order to help avoid possible interactions.
Zinc in Health and Disease
Research shows zinc (particularly in the form of lozenges) can reduce the duration of the common cold, as long as supplementation begins shortly after the onset of illness; this is due to both its direct effects on viruses and its overall influence on immunity. Zinc’s immune-boosting effects also give it a role in protecting against age-related immune decline, improving Covid-19 survival and health outcomes, preventing the recurrence of canker sores, and reducing the risk of opportunistic infections and immune failure in HIV/AIDS patients. Other research suggests zinc could help protect against several neurological conditions, including Alzheimer’s disease and depression, as well as improve blood lipid profiles.
Due to zinc’s wide-ranging roles in the body, insufficiency can disrupt hundreds of metabolic pathways—subsequently impacting immune function, vision, wound healing, and pregnancy outcomes, as well as potentially increasing the risk of some chronic conditions like heart disease, cancer, and autoimmunity. Zinc is particularly important during childhood for supporting healthy mental and psychomotor development and physical growth, with deficiency in early childhood causing impairments in these areas.
Zinc and Immunity
One of the most notable effects of zinc is its effects on immunity and infectious disease. In fact, zinc’s reputation for combatting colds goes all the way back to 1984, when a study showed zinc supplementation helped prevent people from getting sick!
Since then, more and more research has confirmed a role for zinc in the common cold. Across studies, zinc supplementation has been shown to help reduce the duration of colds, with meta-analyses showing that using lozenges containing 75 – 80 mg per day of zinc acetate or zinc gluconate can help significantly reduce the length of illness (however, above 80 mg daily doesn’t appear to have much added benefit). One meta-analysis showed that when properly dosed and started early enough in the cold cycle, zinc supplementation was able to shorten the duration of nasal discharge by 34%, congestion by 37%, coughing by 46%, throat hoarseness by 43%, sore throat by 18%, scratchy throat by 33%, muscle ache by 54%, and sneezing by 22%! And another meta-analysis found that on average, taking zinc reduced the length of the cold by 2.7 days (down from an average of seven days). These effects appear due to zinc’s ability to prevent cold viruses (typically rhinovirus) from binding and multiplying in the mucous membranes of the throat and nose, as well as reducing nasal inflammation. In order to shorten the length of cold symptoms, it may be necessary to begin zinc supplementation within 24 hours of the onset of illness, and the mode of delivery seems key: lozenges allow for direct, prolonged contact between zinc and the cold virus, whereas dietary supplements in the form of pills may be less effective.
Some studies have also looked at zinc in relation to Covid-19. Although there’s no strong evidence that zinc supplementation can significantly alter the course of the disease, some studies have found a link between zinc deficiency and worse Covid-19 outcomes—including more severe inflammatory responses, longer hospital stays, and higher risk of mortality. One study found that nearly 80% of ICU patients requiring mechanical ventilation had low zinc levels upon hospital admission. Meanwhile, higher zinc levels have been associated with greater Covid-19 survival. And, one study found that free zinc levels in the body were associated with a more successful Covid-19 vaccination response (as measured by induced antibodies and the potency of neutralizing antibodies after being vaccinated)—suggesting that being zinc-replete helps the body more effectively build immunity.
Among elderly adults, studies have found that zinc supplementation helps reverse age-related declines in T-cell function (including increasing blood concentrations of helper T-cells and cytotoxic T-cells). In patients with HIV/AIDS, zinc supplementation (12 – 15 mg of zinc daily) appears to decrease the risk of opportunistic infections, diarrhea, and immunological failure, particularly among subjects who initially had low zinc levels.
The use of zinc may also benefit canker sores, also known as aphthous ulcers—which are small, shallow lesions that form in the soft tissues of the mouth. Some studies have linked low serum zinc levels to higher recurrence of canker sores, and several trials found that supplementing with zinc sulfate (between 150 and 660 mg daily) reduced the recurrence of canker sores by 50 to 100%!
Zinc and Type 2 Diabetes
In addition, zinc may help manage some chronic diseases. For example, zinc is involved in synthesizing and storing insulin, and stimulates the uptake and metabolism of glucose within insulin-sensitive tissues (by triggering the intracellular insulin signaling pathway)—giving it a potential role in diabetes.
In fact, several large studies have shown a significantly lower risk of diabetes among women with the highest versus lowest dietary zinc intake, and some short-term intervention trials indicate that supplementing with zinc could improve the glycemic control of people with pre-diabetes. In diabetics with existing zinc deficiency, zinc supplementation has also been shown to reduce the proportion of glycated hemoglobin.
And, in pregnant women with gestational diabetes, zinc supplementation (30 mg per day) was able to reduce fasting blood sugar and improve insulin sensitivity.
Zinc and Eye Health
Zinc is also hypothesized to play a role in age-related macular degeneration, a disease affecting part of the eye’s retina known as the macula (which has a high concentration of zinc, but that declines with age—as do some zinc-dependent retinal enzymes). Although studies have had mixed results in linking dietary zinc intake with this condition, consuming supplemental zinc in combination with some antioxidants (vitamin C, vitamin E, and beta-carotene) has been shown to reduce the incidence of age-related macular degeneration over the course of four years. An early randomized trial also found that taking 200 mg daily of zinc sulfate (equivalent to 81 mg daily of elemental zinc), for a duration of two years, reduced vision loss among people with age-related macular degeneration.
Zinc and Genetic Disorders
Zinc also plays a role in Wilson’s disease—a genetic condition where the body can’t properly filter copper, causing it to accumulate in the liver, brain, eyes, and other vital organs. In people with this condition, zinc supplementation is able to induce metallothionein within the gut mucosa, which in turn binds copper and prevents its absorption and buildup.
Zinc and Cardiovascular Disease
Although zinc isn’t typically known as a nutrient associated with heart health, there’s evidence it can improve blood lipid levels. A meta-analysis of 24 controlled clinical trials found that zinc supplementation (15 to 240 mg daily, for a duration of anywhere between one month and 7.5 years) significantly lowered LDL cholesterol, total cholesterol, and triglycerides.
Zinc, Neurodegenerative Disease and Mental Health
Lastly, zinc may be connected to several neurological conditions, including Alzheimer’s disease and depression.
In elderly patients with Alzheimer’s disease, zinc supplementation (150 mg per day of zinc acetate, for six months total) was shown to prevent the deterioration of their cognitive scores, suggesting an ability of zinc to stabilize cognitive deficits in older Alzheimer’s patients.
Likewise, research has explored the possibility that zinc could play a role in depression, with some trials showing that zinc supplementation (25 mg per day for six or 12 weeks) reduced depression symptoms.
Health Effects of Zinc Deficiency
Due to zinc’s vital role in so many body functions, zinc deficiency causes a disruption in hundreds of metabolic pathways—leading to a wide range of potential health issues.
In general, zinc deficiency has been associated with immune dysfunction and impaired wound healing, including increased likelihood of infections (such as pneumonia and intestinal infections that cause diarrhea). This is particularly true when it comes to zinc-deficient children and elderly adults. And, in patients with HIV/AIDS, low zinc concentrations have been linked to greater disease progression and higher mortality.
Zinc insufficiency can also increase the likelihood of pregnancy complications, including higher risk and greater severity of preeclampsia, and can lead to congenital malformations in newborns. Pre-term babies born from zinc-deficient mothers have also been shown to suffer from impaired growth, dermatitis, greater infection risk, necrotizing enterocolitis, retinopathy, and chronic lung disease. Zinc deficiency occurring during early childhood can likewise impair mental and psychomotor development, as well as delay growth and weight gain (sometimes called “failure to thrive”). Meanwhile, zinc supplementation for deficient infants and children has been shown to reduce morbidity and mortality among these age groups.
Although more research is needed (especially in humans), zinc deficiency may increase the risk of some chronic diseases, especially inflammation-linked diseases like cardiovascular disease and cancer. This is due to zinc’s role in regulating inflammatory responses in cells, with zinc insufficiency causing inappropriate immune cell activation and dysregulation of the inflammatory molecule cytokine IL-6.
Additional research has linked low levels of zinc to a variety of autoimmune conditions, including rheumatoid arthritis, multiple sclerosis, pemphigus vulgaris, autoimmune hepatitis, primary biliary cirrhosis, autoimmune thyroid disease, systemic lupus erythematosus, and type 1 diabetes. In all cases in which supplementation of zinc has been evaluated, benefits have been observed, in some cases including dramatic reversal of the disease. In general, zinc insufficiency is linked to autoimmunity due to its role in regulating the immune system and inflammation: inadequate levels of this mineral lead to incorrect maturation and function of B and T cells, an imbalance between regulatory and pro-inflammatory T cells, weakened NK cell function, and a disturbed ratio between Th1 and Th2, all of which can contribute to autoimmunity. In addition, zinc inhibits Th17 lymphocytes—cells that play a pathogenic role in autoimmune disease due to being strongly pro-inflammatory. (That being said, the research linking zinc and autoimmune diseases can be murky in terms of causality, since reduced zinc levels can also be a product of inflammation occurring during autoimmunity.)
General symptoms of zinc deficiency include reduced alertness, slower wound healing, dulled sense of taste and smell, hair loss, frequent infections, reduced appetite, diarrhea, alterations in sex hormones (including reduced testosterone), impaired night vision, and various skin conditions (including acne, dry skin, eczema, and seborrheic dermatitis)—although many of these symptoms can be caused by a number of other health issues, too, and are worth getting investigated with the help of a medical professional!
In less developed areas of the world, zinc deficiency is estimated to plague around 2 billion people—due largely to the consumption of phytate-rich foods that impair zinc absorption, combined with a low amount of zinc-rich animal foods. Although zinc deficiency is less common in developed nations, alcoholism and some chronic diseases like malabsorption syndromes (like Celiac disease), liver disease, and chronic renal disease can cause it to occur. Likewise, acrodermatitis enteropathica (a rare inherited disorder involving intestinal abnormalities that impair zinc absorption in the intestine) can induce severe zinc deficiency. Other people at higher risk of zinc deficiency include premature and low-birth weight infants, adults 65 and older, people with inflammatory bowel diseases (including ulcerative colitis and Crohn’s disease), people with sickle cell anemia, children and adolescents, pregnant or lactating individuals, and people taking medications that affect the absorption or metabolism of zinc (such as diuretics, the antibiotic cephalexin, the antiviral drugs atazanavir and ritonavir, and some anticonvulsants like sodium valproate).
Problems From Too Much Zinc
Consuming zinc at very high intake levels for extended periods of time (for adults, daily doses of over 40 or 50 mg, for weeks) can cause copper deficiency, due to zinc inducing the synthesis of the copper-binding protein metallothionein. However, this doesn’t seem to occur on a short-term basis, such as when taking high doses of zinc during a cold! And luckily, the reverse isn’t true: high copper intakes don’t impair the absorption of zinc.
In some cases, zinc supplements can cause unwanted side effects such as nausea, vomiting, diarrhea, and stomach pain—especially when taken on an empty stomach. Reports have also emerged of zinc-containing nasal sprays damaging people’s sense of smell, sometimes permanently.
It’s also worth noting that different forms of zinc have different bioavailability, with zinc picolinate generally being the most absorbable. Zinc citrate, zinc acetate, zinc gluconate, zinc glycerate, and zinc monomethionine are also readily absorbed, whereas zinc sulfate and zinc oxide tend to be less bioavailable and more likely to cause stomach upset.
How Much Zinc Do We Need?
The recommended dietary allowance (RDA) for zinc is 8 mg per day for women (11 if pregnant; 12 if nursing) and 11 mg per day for men. However, vegetarians and vegans who rely heavily on grains and legumes may need up to 50% higher dietary zinc intake to avoid deficiency, due to the high phytate levels in these foods.
Best Food Sources of Zinc
The following foods have high concentrations of zinc, containing at least 50% of the recommended dietary allowance per serving, making them our best food sources of this valuable mineral!
Good Food Sources of Zinc
The following foods are also excellent or good sources of zinc, containing at least 10% (and up to 50%) of the daily value per serving.
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