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Zinc: Are you Deficient?

Adequate nutrition is essential for the normal functioning of the immune system, although some nutrients are more important than others when it comes to defending the body from infection.[1] Among the essential minerals, deficiencies in zinc can greatly increase one’s susceptibility to infection and may worsen the course of any infection when it does occur. In fact, a study of patients admitted to a hospital’s infectious disease ward revealed that zinc was among the most prevalent micronutrient deficiencies, finding that two thirds of the patients were deficient in zinc.[2]

Widespread evidence from laboratory, epidemiological, and clinical investigations further suggest that infections and other disease conditions can further deplete the body’s supply of these minerals and worsen the prognosis.[3],[4],[5],[6]

Herein, we take a look at the mechanisms by which zinc affects immune function, epidemiological data, outcomes of clinical interventions, and populations at greatest risk for deficiency.


Zinc promotes immunity through direct, indirect, and antioxidant mechanisms,[7],[8],[9],[10]and a deficiency state is well documented to increase one’s susceptibility to opportunistic infections.2,[11],[12],[13],[14] In vitro studies have also shown that zinc and its complexes have antiviral effects, and can inhibit the replication of many different respiratory viruses, including influenza, rhinovirus, and respiratory syncytial virus.[15],[16],[17],[18],[19]

Zinc is essential for the structure and activity of thymulin, a hormone that regulates the production and maturation of T-lymphocytes.[20],[21],[22],[23] Prolonged zinc deficiency leads to thymic atrophy, a reduction in T-cell numbers, and impaired immunity.[24],[25]As discussed below, zinc supplementation may help prevent and/or reverse these changes.

Zinc deficiency is thought to contribute to the incidence and severity of respiratory tract infections in children. Randomized controlled trials (RCT), for example, have shown that supplemental zinc can reduce the risk of acute lower respiratory tract infections (ALRTI).[26],[27] In an RCT of infants and preschool children, supplemental zinc (10 mg zinc gluconate daily for 120 days) reduced the risk of acute lower respiratory tract infections (ALRTI) by 45%.[26] The children who received zinc supplements also recovered more quickly from infections. In another RCT, looking at children under the age of five, zinc supplementation (10 mg zinc gluconate daily for 60 days) reduced the incidence of ALRTI by more than 50% after six months.[27] The number of episodes of ALRTI and severe ALRTI were significantly lower in the zinc group compared to the placebo group (20.8% vs. 45.8%, and 21.7% vs. 58.3%, respectively).

Zinc deficiency not only compromises immunity, but it shifts the immune system toward an inflammatory state that can predispose the body for damage to the lungs and other organs.[28],[29]Zinc supplementation has been shown to ameliorate lung damage in animal models of respiratory infections.[7],[30]

Zinc deficiency is also associated with poor outcomes in patients with sepsis.[31],[32],[33]In one study, 20 out of 22 septic patients had below-normal plasma zinc concentrations, and there was a correlation between lower plasma zinc concentrations and greater disease severity.30 In another study, both zinc and selenium were significantly lower in patients with sepsis than in controls, and the low levels of these nutrients were associated with elevated levels of inflammatory markers.[34]

Zinc deficiency has been observed in 30% or more of individuals over the age of 60. It contributes to the age-related decline in immune system function known as immunosenescence, which in turn increases the risk and severity of infections in the elderly.[35],[36],[37],[38],[39],[40]Animal and human studies suggest that various measures of immunosenescence, including thymulin activity and peripheral immune function, can be corrected by simply supplementing with zinc.[41],[42],[43],[44],[45],[46]

Similarly, although white blood cells (WBCs) collected from elderly individuals produce less interferon (IFN) than those from young adults, the IFN-producing capacity may not be permanently lost. When WBCs from the elderly were incubated with physiologic concentrations of zinc, they produced IFN in amounts comparable to those from the younger subjects.[47]

Clinically, we also see the impact of zinc on immune function, particularly in the elderly. In one randomized, double-blind, placebo-controlled trial, study participants were given a daily multivitamin and mineral supplement, including zinc, for one year.[48] Individuals who developed normal zinc levels had a lower incidence and duration of pneumonia, and a reduced need for antibiotics, compared to subjects with low serum zinc concentrations. Another study showed that zinc supplementation reduced the risk of pneumonia by 64% in critical care (trauma) patients on ventilators.[49]

In addition to the well-documented effects of zinc on infections, population studies have shown that the maintenance of adequate serum zinc concentrations is associated with a reduced risk of mortality from all causes.[50],[51],[52]

Who is at risk for zinc deficiency?

Zinc is found in many different foods but it is particularly concentrated in meat, poultry, and shellfish.[53] As a result, vegetarians, and especially vegans who consume no animal products, have an increased risk of zinc deficiency, particularly if they also avoid nuts and seeds which contain relatively high levels of zinc.[54],[55],[56] The zinc present in plant-based foods is also less bioavailable due to the presence of phytates, which strongly bind zinc and prevent its absorption.[57],[58],[59]

Obese and diabetic patients typically have lower levels of zinc than healthy individuals,[60],[61],[62],[63]along with an increased risk for respiratory tract infections.[64],[65],[66]In one study of young, obese females, at baseline, multiple inflammatory markers were significantly higher in the obese than the non-obese women.[67] However, levels of both high sensitivity C-reactive protein (hs-CRP) and interleukin (IL)-6 were significantly decreased by zinc supplementation (in the obese women), suggesting that zinc may have a favorable effect on obesity-related inflammation. Zinc also has positive effects on glucose metabolism and insulin resistance in diabetic and prediabetic patients.[68],[69],[70],[71],[72]

Zinc levels decline with age as a result of physiopathological changes of various kinds.[73] Intestinal malabsorption,[74],[75] inflammatory bowel disease,[76] autoimmune disease,[77] kidney or liver disease,[78],[79],[80] cancer or cancer treatments,[81] and the use of medications (including antibiotics, statins, and blood pressure medications)[82],[83]can all contribute to zinc deficiency. Individuals with celiac disease, including those consuming gluten-free (GF) diets, may also be at risk for a deficiency of zinc and several other nutrients.[84] One study reported that 67% of newly diagnosed adult patients with celiac disease had suboptimal serum zinc levels,[85] while another study observed that 40% of individuals consuming long-term GF diets still were deficient in zinc.[86]

If you are interested in taking zinc, but not quite sure where to get it or what brand, just ask Dr. John or Dr. Pam.

Levinson Family Chiropractic, (330)928-3420


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