Recommended Zinc Lozenge Dosage for Anorexia Nervosa Recovery
For individuals with anorexia nervosa, the recommended dosage of zinc supplementation is 0.5-1 mg/kg per day of elemental zinc for 3-4 months, which typically translates to 14-50 mg of elemental zinc daily. 1
Evidence-Based Dosing Recommendations
The ESPEN micronutrient guidelines specifically address zinc deficiency in eating disorders such as anorexia nervosa, recognizing it as a potentially underdiagnosed condition that can develop in these patients 1. The guidelines recommend:
- For acquired zinc deficiency (including anorexia nervosa): 0.5-1 mg/kg per day of elemental zinc for 3-4 months
- Organic compounds (zinc histidinate, zinc gluconate, zinc orotate) show better tolerability than inorganic forms (zinc sulfate, zinc chloride)
Clinical Evidence Supporting Zinc Supplementation
Multiple studies have demonstrated the benefits of zinc supplementation in anorexia nervosa:
- A randomized controlled trial showed that 50 mg elemental zinc daily significantly decreased depression and anxiety levels in anorexia nervosa patients 2
- Another study demonstrated that 14 mg of elemental zinc daily for 2 months should be routine in anorexia nervosa treatment 3
- Supplementation with 45-90 mg of elemental zinc daily resulted in >15% weight gain in 17 out of 20 anorexia nervosa patients during an 8-56 month follow-up period 4
- A case report showed dramatic improvement with initial IV zinc (40 μmol/day for 7 days) followed by oral zinc (15 mg/day for 60 days) 5
Mechanism of Action
Zinc supplementation benefits anorexia nervosa through several mechanisms:
- Corrects abnormalities in neurotransmitters, particularly GABA in the amygdala 3
- Improves exocrine pancreatic function and intestinal absorption 5
- May act by removing a "sustaining factor" for abnormal eating behavior 6
Monitoring and Assessment
- Plasma zinc levels should be measured to confirm clinical zinc deficiency and monitor adequacy of provision 1
- Simultaneous determination of CRP and albumin is required for proper interpretation
- Urinary zinc excretion below 200 μg/day may indicate either non-adherence to therapy or overtreatment 1
Important Considerations and Precautions
- Zinc supplementation should be part of a comprehensive treatment approach that includes psychological interventions
- Taking zinc with food may interfere with absorption, but dose adjustments can compensate for this effect 1
- When giving additional zinc and copper, maintain a ratio of 8-15 mg zinc to 1 mg copper to prevent imbalances 1
- Monitor for potential side effects, which are rare but may include gastric irritation
Formulation Preferences
- Lozenges are an acceptable form of zinc supplementation
- Organic compounds (zinc histidinate, zinc gluconate, zinc orotate) are better tolerated than inorganic forms (zinc sulfate, zinc chloride) 1
- If gastric irritation occurs, changing the zinc salt form may improve tolerability
This dosing recommendation is based on the most recent and highest quality evidence available, with particular emphasis on the ESPEN micronutrient guidelines that specifically address zinc deficiency in anorexia nervosa.