Recommended Zinc Dosage for Adults with Deficiency
For adults with zinc deficiency, the recommended treatment is 0.5-1 mg/kg per day of elemental zinc for 3-4 months, preferably using organic compounds such as zinc histidinate, zinc gluconate, or zinc orotate which show better tolerability than inorganic zinc forms. 1
Diagnosis and Assessment
Before initiating zinc supplementation, proper assessment is crucial:
- Plasma zinc levels should be measured to confirm clinical zinc deficiency
- Simultaneous determination of CRP and albumin is required for proper interpretation of zinc levels 1
- Consider checking both zinc and copper levels together, as zinc supplementation can affect copper absorption 1
Dosing Guidelines Based on Severity and Condition
Mild Zinc Deficiency
- Consider prescribing two Forceval daily (multivitamin with minerals) for 3 months and recheck levels 1
Severe Zinc Deficiency
- With normal or borderline copper levels: Treat with high-dose zinc supplement for 3 months and recheck levels
- If no improvement or if copper levels fall, refer for specialist advice 1
- Dosage: 0.5-1 mg/kg per day of elemental zinc for 3-4 months 1
Special Conditions Requiring Higher Doses
- Parenteral nutrition with gastrointestinal losses (fistulae, stomas, diarrhea): IV doses up to 12 mg per day 1
- Major burns >20% BSA: 30-35 mg/day IV for 2-3 weeks 1
- Acrodermatitis enteropathica: Life-long oral intake of 3 mg/kg per day of elemental zinc, adjusted according to plasma/serum zinc levels 1
Formulation Considerations
- Organic zinc compounds (zinc histidinate, zinc gluconate, zinc orotate) show better tolerability than inorganic forms (zinc sulfate, zinc chloride) 1
- When giving additional zinc and copper, maintain a ratio of 8-15 mg zinc to 1 mg copper 1
Monitoring and Follow-up
- Recheck zinc levels after 3 months of supplementation 1
- For patients on long-term parenteral nutrition, check zinc levels every 6-12 months 1
- Close monitoring is required if higher zinc doses are indicated, as zinc affects copper absorption 1
Important Cautions
- Excessive zinc intake (100-300 mg/day) can induce copper deficiency with symptoms of anemia and neutropenia 2
- Even lower levels of zinc supplementation can interfere with copper and iron utilization and adversely affect HDL cholesterol 2
- Zinc absorption follows a saturable dose-response model, with diminishing returns at doses above 20 mg 3
- Overt toxicity symptoms (nausea, vomiting, epigastric pain, lethargy) can occur with extremely high zinc intakes 2
By following these guidelines and monitoring appropriately, zinc deficiency can be effectively treated while minimizing the risk of adverse effects from excessive supplementation.