Health Library

Zinc

Supplement Forms/Alternate Names:

  • Zinc Sulfate
  • Zinc Gluconate
  • Zinc Citrate
  • Zinc Picolinate
  • Chelated Zinc
  • Requirements/Sources
  • Therapeutic Dosages
  • Therapeutic Uses
  • What Is the Scientific Evidence for Zinc?
  • Safety Issues
  • Interactions You Should Know About
  • References

Zinc is an important element that is found in every cell in the body. More than 300 enzymes in the body need zinc in order to function properly. Although the amount of zinc we need in our daily diet is tiny, it's very important that we get it. However, the evidence suggests that many of us do not get enough. Mild zinc deficiency seems to be fairly common, and for this reason taking a zinc supplement at nutritional doses may be a good idea.

However, taking too much zinc isn’t a good idea—it can cause toxicity. In this article, we discuss the possible uses of zinc at various doses.

Requirements/Sources

Requirements

The official US recommendations for daily intake of zinc are as follows:

  • Infants
    • 0-6 months: 2 mg
    • 7-12 months: 3 mg
  • Children
    • 1-3 years: 3 mg
    • 4-8 years: 5 mg
  • Males
    • 9-13 years: 8 mg
    • 14 years and older: 11 mg
  • Females
    • 9-13 years: 8 mg
    • 14-18 years: 9 mg
    • 19 years and older: 8 mg
  • Pregnant Women
    • 18 years and younger: 13 mg
    • 19 years and older: 11 mg
  • Nursing Women
    • 18 years and younger: 14 mg
    • 19 years and older: 12 mg

Sources

Oysters have a very high zinc content—a 3-ounce serving of cooked oysters has about 74 milligrams of zinc. Besides oysters, other types of shellfish, along with meat and chicken are high in zinc. In the table below, the National Institutes of Health's Office of Dietary Supplements offers an extensive list of foods that are high in zinc:207

FoodServing size Zinc content (milligrams [mg]) % Daily Value
Oysters, cooked3 ounces74493
Beef chuck roast, braised3 ounces747
Alaska king crab, cooked3 ounces6.543
Beef patty, broiled3 ounces5.335
25% fortified breakfast cereal¾ cup3.825
Lobster, cooked3 ounces3.423
Pork chop, cooked3 ounces2.919
Baked beans, canned½ cup2.919
Chicken (dark meat), cooked3 ounces2.416
Fruit yogurt, low-fat8 ounces1.711
Cashews, dry roasted1 ounce1.611
Chickpeas, cooked½ cup1.39
Swiss cheese1 ounce1.28
Instant oatmeal1 serving1.17
Milk, low-fat or non-fat1 cup1.07
Almonds, dry roasted`1 ounce0.96
Kidney beans, cooked½ cup0.96
Chicken breast, roasted½ breast0.96
Cheddar or mozzarella cheese1 ounce0.96
Green peas, cooked½ cup0.53

Zinc can also be taken as a nutritional supplement, in one of many forms. Zinc citrate, zinc acetate, or zinc picolinate may be the best absorbed, although zinc sulfate is less expensive. When you purchase a supplement, you should be aware of the difference between the milligrams of actual zinc that the product contains (so-called elemental zinc) and the total milligrams of the zinc product, which includes the weight of the sulfate, picolinate, and so forth. All dosages given in this article refer to elemental zinc (unless otherwise stated).

Zinc Deficiency

The average diet in the developed world may provide insufficient zinc, especially in women, adolescents, infants, and the elderly. 1-5,163 Thus, it may be a wise idea to increase your intake of zinc on general principles.

Zinc Absorption

Various drugs may tend to reduce levels zinc in the body by inhibiting its absorption or increasing its excretion. These include captopril and possibly other ACE inhibitors , oral contraceptives , thiazide diuretics , 6-12,31,32 and drugs which reduce stomach acid (including H 2 blockers and proton pump inhibitors ). Certain nutrients may also inhibit zinc absorption, including calcium , soy , manganese , copper , and iron. 13-29 Contrary to previous reports, folate is not likely to have this effect. 30

Therapeutic Dosages

For most purposes, zinc should simply be taken at the recommended daily requirements listed previously.

Some evidence suggests that 30 mg of zinc daily may be helpful for acne. This is a safe dose for most people. However, in most studies of zinc for acne, a much higher dose was used: 90 mg daily or more. Doses this high should only be used under physician supervision (see Safety Issues ). Potentially dangerous doses of zinc have also been recommended for sickle-cell anemia, macular degeneration, and rheumatoid arthritis.

For best absorption, zinc supplements should not be taken at the same time as high-fiber foods. 33,34 However, many high-fiber foods provide zinc in themselves.

Zinc gluconate may be slightly better absorbed than zinc oxide. 180

When taking zinc long-term it is advisable to take 1 mg to 3 mg of copper daily as well, because zinc supplements can cause copper deficiency. 35,36 Zinc may also interfere with magnesium37 and iron38 absorption.

Zinc is used topically in lozenge or nasal gel form for the treatment of colds. When using zinc this way, the purpose is not to increase zinc levels in your body, but to interfere with the action of viruses in the back of your throat or in the nose. It appears that of the common forms of zinc, only zinc gluconate and zinc acetate have the required antiviral properties. 39,40 Certain sweeteners and flavorings used in lozenges can block zinc's antiviral action. Dextrose, sucrose, mannitol, and sorbitol appear to be fine, but citric acid and tartaric acid are not. The information on glycine as a flavoring agent is a bit equivocal.

Note : When using zinc nasal gel products, do not deeply inhale, as this may cause severe pain. Rather, simply squeeze the gel into the nose, according to the directions.

Therapeutic Uses

Use of zinc nasal spray or zinc lozenges at the beginning of a cold may reduce the duration and severity of symptoms, but study results are somewhat inconsistent. 41,42,164,181-183 These treatments are thought to work by directly interfering with viruses in the nose and throat, and involve relatively high doses of zinc used for a short time.

Zinc can also be taken long-term at nutritional doses orally to improve overall immunity and reduce risk of infection; 43,44, 197 however, this approach probably only works if you are deficient in zinc to begin with.

A significant body of evidence suggests that oral zinc can reduce symptoms of acne. 48-53,165 But, in most studies, potentially toxic doses were used, and in any case, the benefits appear to be rather slight.

Growing evidence suggests that oral zinc, especially in combination with antioxidants, can help slow the progression of macular degeneration. 105,106,156 Oral zinc has also shown promise for sickle cell anemia , 54,161,166,204ADHD , 172,173 and stomach ulcers. 55,56 Zinc has also been shown to be beneficial for acute diarrhea in children, the most convincing evidence coming from studies done in developing countries. 202,203 This suggests that zinc is most useful for this condition in the presence of a nutritional deficiency.

Topical zinc may be helpful for cold sores. 45

Zinc has shown some promise for treating dysgeusia (impaired taste sensation). In a study of 50 people with idiopathic dysgeusia (impaired taste sensation of no known cause), use of zinc at a rather high dose of 140 mg daily improved taste ability. 184 Another study enrolled seniors with dysgeusia and gave them either placebo or 30 mg of zinc daily; the results were equivocal. 199 Dysgeusia can also be caused by radiation therapy in the vicinity of the mouth, but the overall evidence regarding the use of zinc for this purpose is more negative than positive. 167,198 Kidney dialysis also impairs taste sensation, but once more zinc supplements failed to prove effective. 174 ( Note : Use of any mineral supplement by people undergoing kidney dialysis is potentially dangerous.)

In one study, use of zinc appeared to modestly decrease inflammation of the mucous membranes and skin caused by radiation therapy. 195

Weak and/or contradictory results have been seen in studies of zinc for anorexia nervosa , 81-83,162depression , 175rheumatoid arthritis , 57-62,159,160 enhancing sexual function in men on kidney dialysis, 100,168,169tinnitus , 110,170 and warts. 185

Some, but not all, studies have found that HIV-positive people tend to be deficient in zinc, with levels dropping lower in more severe disease. 64-69 Higher zinc levels have been linked to better immune function and higher CD4+ cell counts, whereas zinc deficiency has been linked to increased risk of dying from HIV. 70-72 One preliminary study among people taking AZT found that 30 days of zinc supplementation led to decreased rates of opportunistic infection over the following 2 years. 73 However, other research has linked higher zinc intake to more rapid development of AIDS. 74,75 Another failed to find that zinc supplementation reduces diarrhea associated with HIV. 193 The bottom line: If you have HIV, consult your physician before supplementing with zinc.

Although the evidence that zinc works is not yet meaningful, the supplement is sometimes recommended for the following conditions as well: Alzheimer's disease , 77-80 and minor memory loss in seniors, 196benign prostatic hyperplasia , 87-93bladder infection , cataracts , diabetes , 94-96 Down's syndrome, 97-99infertility in men , 76,188inflammatory bowel disease ( ulcerative colitis and Crohn's disease ), 101-104osteoporosis , 107periodontal disease , prostatitis , 108psoriasis , and wound and burn healing. 111-113

An 8-week, double-blind trial of zinc at 67 mg daily failed to find any benefit for eczema symptoms. 158

What Is the Scientific Evidence for Zinc?

Colds

Use of lozenges containing zinc gluconate or zinc acetate have shown somewhat inconsistent, but generally positive results for reducing the severity and duration of the common cold. For example, in a double-blind trial, 100 people who were experiencing the early symptoms of a cold were given a lozenge that either contained 13.3 mg of zinc from zinc gluconate or a placebo. 116 Participants took the lozenges several times daily until their cold symptoms subsided. The results were impressive. Coughing disappeared within 2.2 days in the treated group versus 4 days in the placebo group. Sore throat disappeared after 1 day versus 3 days in the placebo group, nasal drainage in 4 days (versus 7 days), and headache in 2 days (versus 3 days). Positive results have also been seen in double-blind studies of zinc acetate. 117,118,201 While not all studies have been supportive, 119 on balance, results appear to favor the effectiveness of zinc lozenges for treating symptoms of the common cold. 120,186, 206

It has been suggested that the exact formulation of the zinc lozenge plays a significant role in its effectiveness. 40 According to this view, certain flavoring agents, such as citric acid and tartaric acid, might prevent zinc from inhibiting viruses. In addition, chemical forms of zinc other than zinc gluconate or zinc acetate might be ineffective. Zinc sulfate in particular might not work. 121 Along the same lines, sweeteners such as sorbitol, sucrose, dextrose, and mannitol are said to be fine, while glycine has been discussed in an equivocal manner.

Use of zinc in the nose is somewhat more controversial. 187 In addition to showing inconsistent results in studies, use of zinc nasal gel can cause pain and possibly loss of sense of smell. ( See Safety Issues.)

For example, in a double-blind, placebo-controlled trial of a widely available zinc nasal gel product , 213 people with a newly starting cold used one squirt of zinc gluconate gel or placebo gel in each nostril every 4 hours while awake. 114 The results were significant: treated participants stayed sick an average of 2.3 days, while those receiving placebo were sick for an average of 9 days, a 75% reduction in the duration of symptoms. Somewhat more modest, but still significant relative benefits were seen with zinc nasal gel in a double-blind, placebo-controlled study of 80 people with colds. 164 However, another study, this one involving 77 people, failed to find benefit even with near constant saturation of the nasal passages with zinc gluconate nasal spray. 189 Furthermore, a study of 91 people using the standard commercially available nasal spray failed to find benefit. 190 Yet another double-blind, placebo-controlled trial, this one enrolling 185 individuals, failed to find benefit with zinc nasal spray. 115 However, this study used a much lower amount of zinc—50 times lower—per squirt of spray than was used in the studies just described.

Other than its direct affect on viruses during an infection, zinc supplements (not lozenges) may play a role in reducing the risk of coming down with a cold in the first place. In a review of 2 randomized trials, which included 394 healthy children, researches found that the groups who took zinc had fewer colds, school absences, and prescriptions for antibiotics. 206

In a review of 17 randomized trials with 2,121 patients, oral zinc started within 3 days of cold symptom appearance showed mixed results when compared to placebo or no treatment. Four trials with 412 patients showed no significant decrease in symptom severity. However, the risk of being symptomatic after 7 days was reduced significantly in 9 trials with 1,325 patients. Cold symptoms were reduced by an average of 2.6 days in an analysis of 5 trials with 371 adults. No significant differences in cold symptom duration were found in 3 trials with 563 children.208

Chronic zinc deficiency is known to weaken the immune system. 123 Although low levels of zinc are uncommon in healthy children and adults living in developed countries, deficiencies may be found among the elderly and are widespread among populations in developing countries. A 1-year, double-blind study of 50 nursing home residents found that zinc supplements reduced rates of infection compared to placebo. 197 Additionally, in a 2-year study of nursing home residents, participants given zinc and selenium developed illnesses less frequently than those given placebo. 122

Numerous studies in developing countries have also found benefit. For example, a 6-month, double-blind, placebo-controlled study of 609 preschool children in India found that zinc supplements reduced the rate of respiratory infections by 45%. 124 In addition, more than 10 other studies performed in developing countries have also found that zinc supplements were helpful for preventing respiratory and other infections in children, and that zinc might reduce symptom severity. 125,194,200

Cold Sores

Cold sores are infections caused by the herpes virus. One study suggests that topical zinc may be helpful. In this trial, 46 individuals with cold sores were treated with a zinc oxide cream or placebo every 2 hours until cold sores resolved. 126 The results showed that individuals using the cream experienced a reduction in severity of symptoms and a shorter time to full recovery.

Zinc is thought to interfere with the ability of the herpes virus to reproduce itself. As with colds, the formulation of zinc must be properly designed to release active zinc ions. This study used a special zinc oxide and glycine formulation.

Some participants in this study experienced burning and inflammation caused by the zinc itself, but this seldom caused a serious problem.

Macular Degeneration

Macular degeneration is one of the most common causes of vision loss in the elderly. 

A double-blind, placebo-controlled trial evaluated the effects of zinc with or without antioxidants on the progression of macular degeneration in 3,640 individuals in the early stage of the disease. 156 Participants were randomly assigned to receive one of the following: antioxidants ( vitamin C 500 mg, vitamin E 400 IU, and beta-carotene 15 mg), or zinc (80 mg) and copper (2 mg), antioxidants plus zinc, or placebo. (Copper was administered along with zinc to prevent zinc-induced copper deficiency.)

The results suggest that zinc (alone or, even better, with antioxidants) significantly slowed the progression of the disease.

Previous studies of zinc for macular degeneration found mixed results, but they were much smaller. 141,142

There is also some evidence that making sure to get your dietary requirement of zinc on a daily basis over many years might reduce the risk of developing macular degeneration later in life. 143

Keep in mind that the dosages of zinc used in most of these studies are rather high, and should be used only under a physician's supervision.

Attention Deficit Hyperactivity Disorder

Zinc has shown some promise for treatment of attention deficit hyperactivity disorder (ADHD). In a large (approximately 400-participant), double-blind, placebo-controlled study, use of zinc at a dose of 40 mg daily produced statistically significant benefits as compared to placebo among children not using any other treatment. 176 This dose of zinc, while higher than nutritional needs, should be safe. However, the benefits seen were quite modest: about 28% of the participants given zinc showed improvement as compared to 20% in the placebo group.

Another, much smaller double-blind, placebo-controlled study evaluated whether zinc at 15 mg per day could enhance the effect of Ritalin. 177 Again, modest benefits were seen.

Finally, extremely weak evidence hints that zinc might enhance the effectiveness of evening primrose oil for ADHD. 178

Acne

Studies suggest that people with acne have lower-than-normal levels of zinc in their bodies. 127-129 This fact alone does not prove that taking zinc supplements will help acne, but several small double-blind studies involving a total of more than 300 people have found generally positive results.

In one of these studies, 54 people were given either placebo or 135 mg of zinc (as zinc sulfate) daily. Zinc produced slight, but measurable benefits. 130 Similar results have been seen in other studies using 90 mg to 135 mg of zinc daily. 131-134 Some evidence suggests that a lower and safer dose, 30 mg daily, may offer some benefits. 135,165 In some studies, however, no benefits were seen. 136,137

Two studies have compared zinc against a standard treatment for acne, the antibiotic tetracycline. One study found that zinc was as effective as tetracycline taken at 250 mg daily, 138 but another found the antibiotic far more effective when taken at 500 mg daily. 139

Keep in mind that the dosages of zinc used in most of these studies are rather high; case reports indicate that people have made themselves extremely ill by taking zinc in hopes of treating their acne symptoms. 147,171 Doses of zinc higher than the recommended safe levels (see Safety Issues ) should be used only under a physician's supervision.

Sickle-cell Disease

Children with sickle cell disease often do not grow normally. There is some evidence that people with sickle cell disease are more likely than others to be deficient in zinc. 161 Since zinc deficiency can also cause delayed growth, zinc supplementation at nutritional doses has been suggested for children with sickle cell disease. In a placebo-controlled study, 42 children (ages 4 to 10) with sickle cell disease were given either zinc supplements (10 mg of zinc daily) or placebo for a period of 1 year. 161 Results showed that by the end of the study, the participants given zinc showed enhanced growth compared to those given placebo. Curiously, researchers did not find any solid connection between the severity of zinc deficiency and the extent of response to treatment.

Zinc is thought to have a stabilizing effect on the cell membrane of red blood cells in people with sickle cell disease. For this reason, it has been tried as an aid for preventing sickle cell crisis. In a double-blind, placebo-controlled study of 145 people with sickle cell disease conducted in India, participants received either placebo or about 50 mg of zinc 3 times daily. 54 During 18 months of treatment, the zinc-treated subjects had an average of 2.5 crises, compared to 5.3 for the placebo group. However, zinc didn't seem to reduce the severity of a crisis, as measured by the number of days spent in the hospital for each crisis.

Sickle cell disease can also cause skin ulcers (nonhealing sores). In a 12-week, placebo-controlled trial, use of zinc at 88 mg 3 times per day for 12 weeks enhanced the rate of ulcer healing. 166

Warning : The high dosages of zinc used in the last two studies can cause dangerous toxicity and should be taken (if at all) only under the supervision of a doctor. The nutritional dose described in the first study, however, is safe. (See Safety Issues.)

Safety Issues

Zinc taken orally seldom causes any immediate side effects other than occasional stomach upset, usually when it's taken on an empty stomach. Some forms do have an unpleasant metallic taste. Use of zinc nasal gel, however, has been associated with anosmia (loss of sense of smell). 191 In fact, After receiving over 130 reports of anosmia, the FDA warned consumers and healthcare providers in 2009 to discontinue use of certain Zicam Cold Remedy intranasal zinc-containing products, including Zicam Cold Remedy Nasal Gel, Cold Remedy Nasal Swabs and Cold Remedy Swabs in kids size. 205 Furthermore, if the gel is inhaled too deeply, severe pain may occur.

Long-term use of oral zinc at dosages of 100 mg or more daily can cause a number of toxic effects, including severe copper deficiency, impaired immunity, heart problems, and anemia. 144-147 Zinc at a dose of more than 50 mg daily might reduce levels of HDL ("good") cholesterol. 192 In addition, very weak evidence hints that use of zinc supplements might increase risk of prostate cancer in men. 179

A bad taste in the mouth and nausea were the most common side effects in an analysis of 17 trials with 2,121 patients taking zinc to reduce the duration and severity of cold symptoms.208

The US government has issued recommendations regarding "tolerable upper intake levels" (ULs) for zinc. The UL can be thought of as the highest daily intake over a prolonged time known to pose no risks to most members of a healthy population. The ULs for zinc are as follows: 157

  • Infants
    • 0-6 months: 4 mg
    • 7-12 months: 5 mg
  • Children
    • 1-3 years: 7 mg
    • 4-8 years: 12 mg
    • 9-13 years: 23 mg
  • Males and Females
    • 14-18 years: 34 mg
    • 19 years and older: 40 mg
  • Pregnant Women and Nursing Women
    • 18 years or younger: 34 mg
    • 19 years and older: 40 mg

There are also some interactions between zinc and certain medications to consider:

Use of zinc can interfere with the absorption of the drug penicillamine and also antibiotics in the tetracycline or fluoroquinolone (Cipro, Floxin) families. 148-153

The potassium-sparing diuretic amiloride was found to significantly reduce zinc excretion from the body. 154 This means that if you take zinc supplements at the same time as amiloride, zinc accumulation could occur. This could lead to toxic side effects. However, the potassium-sparing diuretic triamterene does not seem to cause this problem. 155

Interactions You Should Know About

If you are taking:

  • ACE inhibitors ; estrogen-replacement therapy ; oral contraceptives ; thiazide diuretics ; or medications that reduce stomach acid (such as H 2 blockers [ Zantac ] or proton pump inhibitors [ Prilosec ]): You may need to take extra zinc.
  • Amiloride : This medication could reduce zinc excretion from the body, leading to zinc accumulation, which could cause toxic side effects. Do not take zinc supplements unless advised by a physician.
  • Manganese ; calcium ; copper ; iron ; antacids ; soy ; or antibiotics in the fluoroquinolone (such as, Cipro , Floxin ) or tetracycline families: It may be advisable to separate your doses of zinc and these substances by at least 2 hours.
  • Penicillamine : Zinc interferes with penicillamine's absorption so it may be advisable to take zinc and penicillamine at least 2 hours apart.
  • Zinc supplements: You should also take extra copper and perhaps magnesium as well because zinc interferes with their absorption. Zinc interferes with iron absorption, too, but you shouldn't take iron supplements unless you know you are deficient.

References

1
Sandstead HH. Zinc nutrition in the United States. Am J Clin Nutr. 1973;26:1251-1260.
2
Prasad AS. Role of zinc in human health. Bol Asoc Med PR. 1991;83:558-560.
3
Prasad AS. Zinc deficiency in women, infants, and children. J Am Coll Nutr. 1996;15:113-120.
4
Goldenberg RL, Tamura T, Neggers Y, et al. The effect of zinc supplementation on pregnancy outcome. JAMA. 1995;274:463-468.
5
Stang J, Story MT, Harnack L, et al. Relationships between vitamin and mineral supplement use, dietary intake, and dietary adequacy among adolescents. J Am Diet Assoc. 2000;100:905-910.
6
Baum MK, Javier JJ, Mantero-Atienza E, et al. Zidovudine-associated adverse reactions in a longitudinal study of asymptomatic HIV-1-infected homosexual males. J Acquir Immune Defic Syndr. 1991;4:1218-1226.
7
Golik A, Modai D, Averbukh Z, et al. Zinc metabolism in patients treated with captopril versus enalapril. Metabolism. 1990;39:665-667.
8
Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalapril on zinc metabolism in hypertensive patients. J Am Coll Nutr. 1998;17:75-78.
9
Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr. 1991;10:372-375.
10
Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J. 1983;64:936-941.
11
Reyes AJ, Leary WP, Lockett CJ, et al. Diuretics and zinc. S Afr Med J. 1982;62:373-375.
12
Webb JL. Nutritional effects of oral contraceptive use: a review. J Reprod Med. 1980;25:150-156.
13
Argiratos V, Samman S. The effect of calcium carbonate and calcium citrate on the absorption of zinc in healthy female subjects. Eur J Clin Nutr. 1994;48:198-204.
14
Spencer H, Kramer L, Norris C, et al. Effect of calcium and phosphorus on zinc metabolism in man. Am J Clin Nutr. 1984;40:1213-1218.
15
Dawson-Hughes B, Seligson FH, Hughes VA. Effects of calcium carbonate and hydroxyapatite on zinc and iron retention in postmenopausal women. Am J Clin Nutr. 1986;44:83-88.
16
Spencer H, Norris C, Osis D. Further studies of the effect of zinc on intestinal absorption of calcium in man. J Am Coll Nutr. 1992;11:561-566.
17
Crowther RS, Marriott C. Counter-ion binding to mucus glycoproteins. J Pharm Pharmacol. 1984;36:21-26.
18
Hwang S-J, Lai YH, Chen HC, et al. Comparisons of the effects of calcium carbonate and calcium acetate on zinc tolerance test in hemodialysis patients. Am J Kidney Dis. 1992;19:57-60.
19
Pecoud A, Donzel P, Schelling JL. Effect of foodstuffs on the absorption of zinc sulfate. Clin Pharmacol Ther. 1975;17:469-474.
20
Navert B, Sandstrom B, Cederblad A. Reduction of the phytate content of bran by leavening in bread and its effect on zinc absorption in man. Br J Nutr. 1985;53:47-53.
21
Vohra P, Gray GA, Kratzer FH. Phytic acid-metal complexes. Proc Soc Exp Biol Med. 1965;120:447-449.
22
Sandstrom B, Davidsson L, Cederblad A, et al. Oral iron, dietary ligands and zinc absorption. J Nutr. 1985;115:411-414.
23
Meadows NJ, Grainger SL, Ruse W, et al. Oral iron and the bioavailability of zinc. Br Med J (Clin Res Ed). 1983;287:1013-1014.
24
Solomons NW, Jacob RA. Studies on the bioavailability of zinc in humans: effects of heme and nonheme iron on the absorption of zinc. Am J Clin Nutr. 1981;34:475-482.
25
Davidsson L, Almgren A, Sandstrom B, et al. Zinc absorption in adult humans: the effect of iron fortification. Br J Nutr. 1995;74:417-425.
26
Newhouse IJ, Clement DB, Lai C. Effects of iron supplementation and discontinuation on serum copper, zinc, calcium, and magnesium levels in women. Med Sci Sports Exerc. 1993;25:562-571.
27
Aggett PJ, Crofton RW, Khin C, et al. The mutual inhibitory effects on their bioavailability of inorganic zinc and iron. Prog Clin Biol Res. 1983;129:117-124.
28
Scott KC, Turnlund JR. A compartmental model of zinc metabolism in adult men used to study effects of three levels of dietary copper. Am J Physiol. 1994;267: E165-E173.
29
Freeland-Graves JH. Manganese: an essential nutrient for humans. Nutr Today. 1988;23:13-19.
30
Butterworth CE Jr, Tamura T. Folic acid safety and toxicity: a brief review. Am J Clin Nutr. 1989;50:353-358.
31
Reyes AJ, Leary WP, Lockett CJ, et al. Diuretics and zinc. S Afr Med J. 1982;62:373-375.
32
Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J. 1983;64:936-941.
33
Navert B, Sandstrom B, Cederblad A. Reduction of the phytate content of bran by leavening in bread and its effect on zinc absorption in man. Br J Nutr. 1985;53:47-53.
34
Vohra P, Gray GA, Kratzer FH. Phytic acid-metal complexes. Proc Soc Exp Biol Med. 1965;120:447-449.
35
Hoffman HN II, Phyliky RL, Fleming CR. Zinc-induced copper deficiency. Gastroenterology. 1988;94:508-512.
36
Sandstead HH. Requirements and toxicity of essential trace elements, illustrated by zinc and copper. Am J Clin Nutr. 1995;61(suppl 3):621S-624S.
37
Spencer H, Norris C, Williams D. Inhibitory effects of zinc on magnesium balance and magnesium absorption in man. J Am Coll Nutr. 1994;13:479-484.
38
Yadrick MK, Kenney MA, Winterfeldt EA. Iron, copper, and zinc status: Response to supplementation with zinc or zinc and iron in adult females. Am J Clin Nutr. 1989;49:145-150.
39
Marshall S. Zinc gluconate and the common cold. Review of randomized controlled trials. Can Fam Physician. 1998;44:1037-1042.
40
Eby GA. Zinc ion availability—the determinant of efficacy in zinc lozenge treatment of common colds. J Antimicrob Chemother. 1997;40:483-493.
41
Marshall S. Zinc gluconate and the common cold. Review of randomized controlled trials. Can Fam Physician. 1998;44:1037-1042.
42
Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: a double-blind, placebo-controlled trial. Ear Nose Throat J. 2000;79:778-781.
43
Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab. 1997;41:98-107.
44
Bhutta ZA, Black RE, Brown KH, et al. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: Pooled analysis of randomized controlled trials. J Pediatr. 1999;135:689-697.
45
Godfrey HR, Godfrey NJ, Godfrey JC, et al. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med. 2001;7:49-54,56.
46
Goldenberg RL, Tamura T, Neggers Y, et al. The effect of zinc supplementation on pregnancy outcome. JAMA. 1995;274:463-468.
47
Jonsson B, Hauge B, Larsen MF, et al. Zinc supplementation during pregnancy: a double blind randomised controlled trial. Acta Obstet Gynecol Scand. 1996;75:725-729.
48
Dreno B, Amblard P, Agache P, et al. Low doses of zinc gluconate for inflammatory acne. Acta Derm Venereol. 1989;69:541-543.
49
Goransson K, Liden S, Odsell L. Oral zinc in acne vulgaris: a clinical and methodological study. Acta Derm Venereol. 1978;58:443-448.
50
Verma KC, Saini AS, Dhamija SK. Oral zinc sulfate therapy in acne vulgaris: a double-blind trial. Acta Derm Venereol. 1980;60:337-340.
51
Weimar VM, Puhl SC, Smith WH, et al. Zinc sulfate in acne vulgaris. Arch Dermatol. 1978;114:1776-1778.
52
Hillstrom L, Pettersson L, Hellbe L, et al. Comparison of oral treatment with zinc sulphate and placebo in acne vulgaris. Br J Dermatol. 1977;97:681-684.
53
Michaelsson G, Juhlin L, Vahlquist A. Effects of oral zinc and vitamin A in acne. Arch Dermatol. 1977;113:31-36.
54
Gupta VL, Chaubey BS. Efficacy of zinc therapy in prevention of crisis in sickle-cell anemia: a double-blind, randomized controlled clinical trial. J Assoc Physicians India. 1995;43:467-469.
55
Frommer DJ. The healing of gastric ulcers by zinc sulphate. Med J Aust. 1975;2:793-796.
56
Garcia-Plaza A, Arenas JI, Belda O, et al. A multicenter clinical trial. Zinc acexamate versus famotidine in the treatment of acute duodenal ulcer [in Spanish; English abstract]. Rev Esp Enferm Dig. 1996;88:757-762.
57
Simkin PA. Treatment of rheumatoid arthritis with oral zinc sulfate. Agents Actions Suppl. 1981;8:587-596.
58
Pandey SP, Bhattacharya SK, Sundar S. Zinc in rheumatoid arthritis. Indian J Med Res. 1985;81:618-620.
59
Mattingly PC, Mowat AG. Zinc sulphate in rheumatoid arthritis. Ann Rheum Dis. 1982;41:456-457.
60
Rasker JJ, Kardaun SH. Lack of beneficial effect of zinc sulphate in rheumatoid arthritis. Scand J Rheumatol. 1982;11:168 -170.
61
Dixon JS, Bird HA, Martin MF, et al. Biochemical and clinical changes occurring during the treatment of rheumatoid arthritis with novel antirheumatoid drugs. Int J Clin Pharmacol Res. 1985;5:25-33.
62
Job C, Menkes CJ, Delbarre F. Zinc sulphate in the treatment of rheumatoid arthritis. Arthritis Rheum. 1980;23:1408-1409.
63
Simkin PA. Treatment of rheumatoid arthritis with oral zinc sulfate. Agents Actions Suppl. 1981;8:587-596.
64
Fabris N, Mocchegiani E, Galli M, et al. AIDS, zinc deficiency, and thymic hormone failure [letter]. JAMA. 1988;259:839-840.
65
Sappey C, Leclercq P, Coudray C, et al. Vitamin, trace element and peroxide status in HIV seropositive patients: asymptomatic patients present a severe beta-carotene deficiency. Clin Chim Acta. 1994;230:35-42.
66
Odeh M. The role of zinc in acquired immunodeficiency syndrome. JIntern Med. 1992;231:463-469.
67
Periquet BA, Jammes NM, Lambert WE, et al. Micronutrient levels in HIV-1-infected children. AIDS. 1995;9:887-893.
68
Tomaka FL, Imoch PJ, Reiter WM, et al. Prevalence of nutritional deficiencies in patients with HIV Infection [abstract]. Int Conf AIDS. 1994;10:221.
69
Baum MK, Shor-Posner G, Lu Y, et al. Micronutrients and HIV-1 disease progression. AIDS. 1995;9:1051-1056.
70
Campa A, Lai H, Shor-Posner G, et al. Relationship between zinc deficiency and survival in HIV+ homosexual men [abstract]. FASEB J. 1998;12:A217.
71
Baum MK, Shor-Posner G, Lu Y, et al. Micronutrients and HIV-1 disease progression. AIDS. 1995;9:1051-1056.
72
Bogden JD, Kemp FW, Han S, et al. Status of selected nutrients and progression of human immunodeficiency virus type 1 infection. Am J Clin Nutr. 2000;72:809-815.
73
Mocchegiani E, Rivabene R, Santini MT. Benefit of oral zinc supplementation as an adjunct to zidovudine (AZT) therapy against opportunistic infections in AIDS. Int J Immunopharmacol. 1995;17:719-727.
74
Tang AM, Graham NHM, Kirby AJ, et al. Dietary micronutrient intake and risk of progression to acquired immunodeficiency syndrome (AIDS) in human immunodeficiency virus type 1 (HIV-1)-infected homosexual men. Am J Epidemiol. 1993;138:937-951.
75
Tang AM, Graham NM, Saah AJ. Effects of micronutrient intake on survival in human immunodeficiency virus type 1 infection. Am J Epidemiol. 1996;143:1244-1256.
76
Netter A, Hartoma R, Nahoul K. Effect of zinc administration on plasma testosterone, dihydrotestosterone, and sperm count. Arch Androl. 1981;7:69-73.
77
Constantinidis J. Alzheimer's disease: the zinc theory [in French; English abstract]. Encephale. 1990;16:231-239.
78
Constantinidis J. The hypothesis of zinc deficiency in the pathogenesis of neurofibrillary tangles. Med Hypotheses. 1991;35:319-323.
79
Cuajungco MP, Lees GJ. Zinc metabolism in the brain: Relevance to human neurodegenerative disorders. Neurobiol Dis. 1997;4:137-169.
80
Lovell MA, Robertson JD, Teesdale WJ, et al. Copper, iron and zinc in Alzheimer's disease senile plaques. J Neurol Sci. 1998;158:47-52.
81
Birmingham CL, Goldner EM, Bakan R. Controlled trial of zinc supplementation in anorexia nervosa. Int J Eat Disord. 1994;15:251-255.
82
Katz RL, Keen CL, Litt IF, et al. Zinc deficiency in anorexia nervosa. J Adolesc Health Care. 1987;8:400-406.
83
Lask B, Fosson A, Rolfe U, et al. Zinc deficiency and childhood-onset anorexia nervosa. J Clin Psychiatry. 1993;54:63-66.
84
Roijen SB, Worsaae U, Zlotnik G. Zinc in patients with anorexia nervosa [in Danish; English abstract]. Ugeskr Laeger. 1991;153:721-723.
85
Ward NI. Assessment of zinc status and oral supplementation in anorexia nervosa. J Nutr Med. 1990;1:171-177.
86
Castillo-Duran C, Heresi G, Fisberg M, et al. Controlled trial of zinc supplementation during recovery from malnutrition: effects on growth and immune function. Am J Clin Nutr. 1987;45:602-608.
87
Bandlish U, Prabhakar BR, Wadehra PL. Plasma zinc level estimation in enlarged prostate. Indian J Pathol Microbiol. 1988;31:231-234.
88
Gonick P, Oberleas D, Knechtges T, et al. Atomic absorption spectrophotometric determination of zinc in the prostate. Invest Urol. 1969;6:345-347.
89
Schrodt GR, Hall T, Whitmore WF. The concentration of zinc in diseased human prostate glands. Cancer. 1964;17:1555-1566.
90
Gyorkey F, Min KW, Huff JA, et al. Zinc and magnesium in human prostate gland: normal, hyperplastic and neoplastic. Cancer Res. 1967;27:1348-1353.
91
Gyorkey F, Sato CS. In vitro 65Zn-binding capacities of normal, hyperplastic, and carcinomatous human prostate gland. Exp Mol Pathol. 1968;8:216-224.
92
Leake A, Chisholm GD, Habib FK. The effect of zinc on the 5 alpha-reduction of testosterone by the hyperplastic human prostate gland. J Steroid Biochem. 1984;20:651-655.
93
Leake A, Chrisholm GD, Busuttil A, et al. Subcellular distribution of zinc in the benign and malignant human prostate: evidence for a direct zinc androgen interaction. Acta Endocrinol (Copenh). 1984;105:281-288.
94
Schmidt LE, Arfken CL, Heins JM. Evaluation of nutrient intake in subjects with non-insulin-dependent diabetes mellitus. J Am Diet Assoc. 1994;94:773-774.
95
Blostein-Fujii A, DiSilvestro RA, Frid D, et al. Short-term zinc supplementation in women with non-insulin-dependent diabetes mellitus: effects on plasma 5'-nucleotidase activities, insulin-like growth factor I concentrations, and lipoprotein oxidation rates in vitro. Am J Clin Nutr. 1997;66:639-642.
96
Rauscher AM, Fairweather-Tait SJ, Wilson PD, et al. Zinc metabolism in non-insulin dependent diabetes mellitus. J Trace Elem Med Biol. 1997;11:65-70.
97
Sustrova M, Strbak V. Thyroid function and plasma immunoglobulins in subjects with Down's syndrome (DS) during ontogenesis and zinc therapy. J Endocrinol Invest. 1994;17:385-390.
98
Licastro F, Mocchegiani E, Masi M, et al. Modulation of the neuroendocrine system and immune functions by zinc supplementation in children with Down's syndrome. J Trace Elem Electrolytes Health Dis. 1993;7:237-239.
99
Lockitch G, Puterman M, Godolphin W, et al. Infection and immunity in Down syndrome: a trial of long-term low oral doses of zinc. J Pediatr. 1989;114:781-787.
100
Rodger RS, Sheldon WL, Watson MJ, et al. Zinc deficiency and hyperprolactinaemia are not reversible causes of sexual dysfunction in uraemia. Nephrol Dial Transplant. 1989;4:888-892.
101
Sjogren A, Floren CH, Nilsson A. Evaluation of zinc status in subjects with Crohn's disease. J Am Coll Nutr. 1988;7:57-60.
102
Van de Wal Y, Van der Sluys Veer A, Verspaget HW, et al. Effect of zinc therapy on natural killer cell activity in inflammatory bowel disease. Aliment Pharmacol Ther. 1993;7:281-286.
103
Mulder TP, van der Sluys Veer A, Verspaget HW, et al. Effect of oral zinc supplementation on metallothionein and superoxide dismutase concentrations in patients with inflammatory bowel disease. J Gastroenterol Hepatol. 1994;9:472-477.
104
Dronfield MW, Malone JD, Langman MJ. Zinc in ulcerative colitis: a therapeutic trial and report on plasma levels. Gut. 1977;18:33-36.
105
Stur M, Tittl M, Reitner A, et al. Oral zinc and the second eye in age-related macular degeneration. Invest Ophthalmol Vis Sci. 1996;37:1225-1235.
106
Newsome DA, Swartz M, Leone NC, et al. Oral zinc in macular degeneration. Arch Ophthalmol. 1988;106:192-198.
107
Relea P, Revilla M, Ripoll E, et al. Zinc, biochemical markers of nutrition, and type-I osteoporosis. Age Ageing. 1995;24:303-307.
108
Neal DE Jr, Kaack MB, Fussell EN, et al. Changes in seminal fluid zinc during experimental prostatitis. Urol Res. 1993;21:71-74.
109
Gersdorff M, Robillard T, Stein F, et al. The zinc sulfate overload test in patients suffering from tinnitus associated with low serum zinc. Preliminary report [in French; English abstract]. Acta Otorhinolaryngol Belg. 1987;41:498-505.
110
Paaske PB, Pederson CB, Kjems G, et al. Zinc therapy of tinnitus. A placebo-controlled study [in Danish; English abstract]. Ugeskr Laeger. 1990;152:2473-2475.
111
Han CM. Changes in body zinc and copper levels in severely burned patients and the effects of oral administration of ZnS04 by a double-blind method [in Chinese; English abstract]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1990;6:83-86, 155.
112
Agren MS, Stromberg HE, Rindby A, et al. Selenium, zinc, iron and copper levels in serum of patients with arterial and venous leg ulcers. Acta Derm Venereol. 1986;66:237-240.
113
Floersheim GL, Lais E. Lack of effect of oral zinc sulfate on wound healing in leg ulcer [in German; English abstract]. Schweiz Med Wochenschr. 1980;110:1138-1145.
114
Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: a double-blind, placebo-controlled trial. Ear Nose Throat J. 2000;79:778-781.
115
Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med. 2001;111:103-108.
116
Mossad SB, Macknin ML, Medendorp SV, et al. Zinc gluconate lozenges for treating the common cold: a randomized, double-blind placebo-controlled study. Ann Intern Med. 1996;125:81-88.
117
Petrus EJ, Lawson KA, Bucci LR. Randomized, double-masked, placebo-controlled clinical study of the effectiveness of zinc acetate lozenges on common cold symptoms in allergy-tested subjects. Curr Ther Res. 1998;59:595-607.
118
Prasad AS, Fitzgerald JT, Bao B, et al. Duration of symptoms and plasma cytokine levels in patients with the common cold treated with zinc acetate. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2000;133:245-252.
119
Macknin ML, Piedmonte M, Calendine C, et al. Zinc gluconate lozenges for treating the common cold in children: a randomized controlled trial. JAMA. 1998;279:1962-1967.
120
Marshall S. Zinc gluconate and the common cold. Review of randomized controlled trials. Can Fam Physician. 1998;44:1037-1042.
121
Eby GA. Linearity in dose-response from zinc lozenges in treatment of common colds. J Pharm Technol. 1995;11:110-122.
122
Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab. 1997;41:98-107.
123
Sugarman B. Zinc and infection. Rev Infect Dis. 1983;5:137-147.
124
Sazawal S, Black RE, Jalla S, et al. Zinc supplementation reduces the incidence of acute lower respiratory infections in infants and preschool children: a double-blind, controlled trial. Pediatrics. 1998;102:1-5.
125
Bhutta ZA, Black RE, Brown KH, et al. Prevention of diarrhea and pneumonia by zinc supplementation in children in developing countries: Pooled analysis of randomized controlled trials. J Pediatr. 1999;135:689-697.
126
Godfrey HR, Godfrey NJ, Godfrey JC, et al. A randomized clinical trial on the treatment of oral herpes with topical zinc oxide/glycine. Altern Ther Health Med. 2001;7:49-54,56.
127
Pohit J, Saha KC, Pal B. Zinc status of acne vulgaris patients. J Appl Nutr. 1985;37:18-25.
128
Amer M, Bahgat MR, Tosson Z, et al. Serum zinc in acne vulgaris. Int J Dermatol. 1982;21:481-484.
129
Michaelsson G, Vahlquist A, Juhlin L. Serum zinc and retinol-binding protein in acne. Br J Dermatol. 1977;96:283-286.
130
Goransson K, Liden S, Odsell L. Oral zinc in acne vulgaris: a clinical and methodological study. Acta Derm Venereol. 1978;58:443-448.
131
Verma KC, Saini AS, Dhamija SK. Oral zinc sulfate therapy in acne vulgaris: a double-blind trial. Acta Derm Venereol. 1980;60:337-340.
132
Weimar VM, Puhl SC, Smith WH, et al. Zinc sulfate in acne vulgaris. Arch Dermatol. 1978;114:1776-1778.
133
Hillstrom L, Pettersson L, Hellbe L, et al. Comparison of oral treatment with zinc sulphate and placebo in acne vulgaris. Br J Dermatol. 1977;97:681-684.
134
Michaelsson G, Juhlin L, Vahlquist A. Effects of oral zinc and vitamin A in acne. Arch Dermatol. 1977;113:31-36.
135
Dreno B, Amblard P, Agache P, et al. Low doses of zinc gluconate for inflammatory acne. Acta Derm Venereol. 1989;69:541-543.
136
Weismann K, Wadskov S, Sondergaard J. Oral zinc sulphate therapy for acne vulgaris. Acta Derm Venereol. 1977;57:357-360.
137
Orris L, Shalita AR, Sibulkin D, et al. Oral zinc therapy of acne. Absorption and clinical effect. Arch Dermatol. 1978;114:1018-1020.
138
Michaelsson G, Juhlin L, Ljunghall K. A double-blind study of the effects of zinc and oxytetracycline in acne vulgaris. Br J Dermatol. 1977;97:561-566.
139
Cunliffe WJ, Burke B, Dodman B, et al. A double-blind trial of a zinc sulphate/citrate complex and tetracycline in the treatment of acne vulgaris. Br J Dermatol. 1979;101:321-325.
140
Gupta VL, Chaubey BS. Efficacy of zinc therapy in prevention of crisis in sickle-cell anemia: a double-blind, randomized controlled clinical trial. J Assoc Physicians India. 1995;43:467-469.
141
Newsome DA, Swartz M, Leone NC, et al. Oral zinc in macular degeneration. Arch Ophthalmol. 1988;106:192-198.
142
Stur M, Tittl M, Reitner A, et al. Oral zinc and the second eye in age-related macular degeneration. Invest Ophthalmol Vis Sci. 1996;37:1225-1235.
143
Mares-Perlman JA, Klein R, Klein BE, et al. Association of zinc and antioxidant nutrients with age-related maculopathy. Arch Ophthalmol. 1996;114:991-997.
144
Hoffman HN II, Phyliky RL, Fleming CR. Zinc-induced copper deficiency. Gastroenterology. 1988;94:508-512.
145
Sandstead HH. Requirements and toxicity of essential trace elements, illustrated by zinc and copper. Am J Clin Nutr. 1995;61(suppl 3):621S-624S.
146
Fosmire GJ. Zinc toxicity. Am J Clin Nutr. 1990;51:225-227.
147
Porea TJ, Belmont JW, Mahoney DH Jr. Zinc-induced anemia and neutropenia in an adolescent. J Pediatr. 2000;136:688-690.
148
Lim D, McKay M. Food-drug interactions. Drug Information Bulletin (UCLA Dept. of Pharmaceutical Services). 1995;15(2).
149
Drug Evaluations Annual. Milwaukee, WI: American Medical Association; 1993(2).
150
Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs. 1976;11:45-54.
151
Mapp RK, McCarthy TJ. The effect of zinc sulphate and of bicitropeptide on tetracycline absorption. S Afr Med J. 1976;50:1829-1830.
152
Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother. 1989;33:1841-1844.
153
Campbell NR, Kara M, Hasinoff BB, et al. Norfloxacin interaction with antacids and minerals. Br J Clin Pharmacol. 1992;33:115-116.
154
Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J. 1983;64:936-941.
155
Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand. 1980;208:209-212.
156
Age-Related Eye Disease Study Research Group. 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.8. Arch Ophthalmol. 2001;119:1417-1436.
157
Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001). National Academies Press website. Available at http://www.nap.edu. Accessed October 4, 2001.
158
Ewing CI, Gibbs AC, Ashcroft C, et al. Failure of oral zinc supplementation in atopic eczema. Eur J Clin Nutr. 1991;45:507-510.
159
Simkin PA. Oral zinc sulphate in rheumatoid arthritis. Lancet. 1976;2:539-542.
160
Peretz A, Neve J, Jeghers O, et al. Zinc distribution in blood components, inflammatory status, and clinical indexes of disease activity during zinc supplementation in inflammatory rheumatic diseases. Am J Clin Nutr. 1993;57:690-694.
161
Zemel BS, Kawchak DA, Fung EB, et. al. Effect of zinc supplementation on growth and body composition in children with sickle cell disease. Am J Clin Nutr. 2002;75:300-307.
162
Su JC, Birmingham CL. Zinc supplementation in the treatment of anorexia nervosa. Eat Weight Disord. 2002;7:20-22.
163
Ervin RB, Kennedy-Stephenson J. Mineral intakes of elderly adult supplement and non-supplement users in the third national health and nutrition examination survey. J Nutr. 2002;132:3422-3427.
164
Mossad SB. Effect of zincum gluconicum nasal gel on the duration and symptom severity of the common cold in otherwise healthy adults. QJM. 2003;96:35-43.
165
Meynadier J. Efficacy and safety study of two zinc gluconate regimens in the treatment of inflammatory acne. Eur J Dermatol. 2000;10:269-273.
166
Serjeant GR, Galloway RE, Gueri MC. Oral zinc sulphate in sickle-cell ulcers. Lancet. 1970;2:891-893.
167
Ripamonti C, Zecca E, Brunelli C, et al. A randomized, controlled clinical trial to evaluate the effects of zinc sulfate on cancer patients with taste alterations caused by head and neck irradiation. Cancer. 1998;82:1938-1945.
168
Mahajan SK, Abbasi AA, Prasad AS, et al. Effect of oral zinc therapy on gonadal function in hemodialysis patients. A double-blind study. Ann Intern Med. 1982;97:357-361.
169
Brook AC, Johnston DG, Ward MK, et al. Absence of a therapeutic effect of zinc in the sexual dysfunction of hemodialysed patients. Lancet. 1980;2:618-620.
170
Arda HN, Tuncel U, Akdogan O, et al. The role of zinc in the treatment of tinnitus. Otol Neurotol. 2003;24:86-89.
171
Igic PG, Lee E, Harper W, et al. Toxic effects associated with consumption of zinc. Mayo Clin Proc. 2002;77:713-716.
172
Akhondzadeh S, Mohammadi MR, Khademi M. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: A double blind and randomized trial [ISRCTN64132371]. BMC Psychiatry. 2004 Apr 8. [Epub ahead of print]
173
Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2004;28:181-190.
174
Matson A, Wright M, Oliver A, et al. Zinc supplementation at conventional doses does not improve the disturbance of taste perception in hemodialysis patients. J Ren Nutr. 2003;13:224-228
175
Nowak G, Siwek M, Dudek D, et al. Effect of zinc supplementation on antidepressant therapy in unipolar depression: a preliminary placebo-controlled study. Pol J Pharmacol. 2003;55:1143-1147.
176
Bilici M, Yildirim F, Kandil S, et al. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2004;28:181-190.
177
Akhondzadeh S, Mohammadi MR, Khademi M. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: A double blind and randomized trial [ISRCTN64132371]. BMC Psychiatry. 2004 Apr 8. [Epub ahead of print]
178
Arnold LE, Pinkham SM, Votolato N. Does zinc moderate essential fatty acid and amphetamine treatment of attention-deficit/hyperactivifty disorder? J Child Adolesc Psychopharmacol. 2000;10:111-117.
179
Leitzmann MF, Stampfer MJ, Wu K, et al. Zinc supplement use and risk of prostate cancer. J Natl Cancer Inst. 2003;95:1004-1007.
180
Siepmann M, Spank S, Kluge A, et al. The pharmacokinetics of zinc from zinc gluconate: a comparison with zinc oxide in healthy men. Int J Clin Pharmacol Ther. 2005;43:562-565.
181
Eby GA. Zinc lozenges: cold cure or candy? Solution chemistry determinations. Biosci Rep. 2004;24:23-39.
182
Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis. 2001;33:1865-1870. Epub 2001 Oct 25.
183
Eby GA, Halcomb WW. Ineffectiveness of zinc gluconate nasal spray and zinc orotate lozenges in common-cold treatment: a double-blind, placebo-controlled clinical trial. Altern Ther Health Med. 2006;12:34-38.
184
Heckmann SM, Hujoel P, Habiger S, et al. Zinc Gluconate in the treatment of dysgeusia—a randomized clinical trial. J Dent Res. 2004;84:35-38.
185
Al-Gurairi FT, Al-Waiz M, Sharquie KE. Oral zinc sulphate in the treatment of recalcitrant viral warts: randomized placebo-controlled clinical trial. Br J Dermatol. 2002;146:423-431.
186
Eby GA. Zinc lozenges: cold cure or candy? Solution chemistry determinations. Biosci Rep. 2004;24:23-39.
187
Eby GA, Halcomb WW. Ineffectiveness of zinc gluconate nasal spray and zinc orotate lozenges in common-cold treatment: a double-blind, placebo-controlled clinical trial. Altern Ther Health Med. 2006;12:34-38.
188
Ebisch IM, Pierik FH, DE Jong FH, et al. Does folic acid and zinc sulphate intervention affect endocrine parameters and sperm characteristics in men? Int J Androl. 2006;29:339-345.
189
Eby GA, Halcomb WW. Ineffectiveness of zinc gluconate nasal spray and zinc orotate lozenges in common-cold treatment: a double-blind, placebo-controlled clinical trial. Altern Ther Health Med. 2006;12:34-38.
190
Turner RB. Ineffectiveness of intranasal zinc gluconate for prevention of experimental rhinovirus colds. Clin Infect Dis. 2001;33:1865-1870. Epub 2001 Oct 25.
191
Jafek BW, Linschoten MR, Murrow BW. Anosmia after intranasal zinc gluconate use. Am J Rhinol. 2004;18:137-141.
192
Hughes S, Samman S. The effect of zinc supplementation in humans on plasma lipids, antioxidant status and thrombogenesis. J Am Coll Nutr. 2006;25:285-291.
193
Carcamo C, Hooton T, Weiss NS, et al. Randomized Controlled Trial of Zinc Supplementation for Persistent Diarrhea in Adults With HIV-1 Infection. J Acquir Immune Defic Syndr. 2006 Aug 24. [Epub ahead of print]
194
Kurugol Z, Akilli M, Bayram N, et al. The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children. Acta Paediatr. 2006;95:1175-1181.
195
Lin LC, Que J, Lin LK, et al. Zinc supplementation to improve mucositis and dermatitis in patients after radiotherapy for head-and-neck cancers: a double-blind, randomized study. Int J Radiat Oncol Biol Phys. 2006;65:745-750.
196
Maylor EA, Simpson EE, Secker DL, et al. Effects of zinc supplementation on cognitive function in healthy middle-aged and older adults: the ZENITH study. Br J Nutr. 2006;96:752-760.
197
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;85:837-844.
198
Halyard MY, Jatoi A, Sloan JA, et al. Does zinc sulfate prevent therapy-induced taste alterations in head and neck cancer patients? Results of phase III double-blind, placebo-controlled trial from the North Central Cancer Treatment Group (N01C4). Int J Radiat Oncol Biol Phys. 2007;67:1318-1322.
199
Stewart-Knox BJ, Simpson EE, Parr H, et al. Taste acuity in response to zinc supplementation in older Europeans. Br J Nutr. 2007 Jul 26. [Epub ahead of print]
200
Kurugol Z, Bayram N, Atik T. Effect of zinc sulfate on common cold in children: Randomized, double blind study. Pediatr Int. 2007;49:842-847.
201
Prasad AS, Beck FW, Bao B, et al. Duration and severity of symptoms and levels of plasma interleukin-1 receptor antagonist, soluble tumor necrosis factor receptor, and adhesion molecules in patients with common cold treated with zinc acetate. J Infect Dis. 2008 Feb 15.
202
Patro B, Golicki D, Szajewska H. Meta-analysis: zinc supplementation for acute gastroenteritis in children. Aliment Pharmacol Ther. 2008 Jul 1.
203
Lazzerini M, Ronfani L. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2008;CD005436.
204
Bao B, Prasad AS, Beck FW, et al. Zinc supplementation decreases oxidative stress, incidence of infection, and generation of inflammatory cytokines in sickle cell disease patients. Transl Res. 2008;152:67-80.
205
FDA Public Health Advisory on Loss of Sense of Smell with Intranasal Cold Remedies Containing Zinc. Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm166059.htm. Accessed: July 9, 2009.
206
Singh M, Das RR. Zinc for the common cold. Cochrane Database Syst Rev. 2011;2:CD001364.
207
Dietary supplement fact sheet: zinc. Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/. Accessed September 10, 2012.
208
Science M, Johnstone J, Roth DE, et al. Zinc for the treatment of the common cold: a systematic review and meta-analysis of randomized controlled trials. CMAJ. 2012;184(10). E551-E561.