Role of Zinc in AMH Levels and Medications to Improve AMH

Zinc supplementation may improve AMH levels, but there is currently insufficient evidence to recommend it as a primary treatment for low AMH. 1

Relationship Between Zinc and AMH

AMH is a polypeptide secreted by granulosa cells of pre-antral and small antral ovarian follicles, serving as a biomarker of the ovarian follicular pool 2
Zinc deficiency can affect reproductive function, but its specific relationship with AMH levels is not well established in current clinical guidelines 3
A retrospective pilot study showed that micronutrient supplementation including zinc was associated with increased serum AMH levels (from 1.42 ± 0.86 to 1.86 ± 0.82 ng/mL) after 3 months of treatment 1

AMH levels are significantly higher in women with PCOS compared to women with normal ovulatory function 3, 2
AMH inhibits primordial follicle recruitment and may suppress FSH action, contributing to ovulatory disturbances seen in PCOS 3, 2
Despite its association with PCOS, AMH is not currently recommended as a standalone diagnostic test for PCOS due to significant overlap in values between women with and without the condition 3

There is limited evidence supporting specific medications that directly improve AMH levels 2
A micronutrient supplementation containing omega-3 fatty acids, coenzyme Q10, vitamin E, folic acid, selenium, green tea extract, and licorice extract showed promising results in improving AMH levels in a retrospective study 1
Zinc supplementation may be beneficial as part of a broader micronutrient approach, particularly in cases of documented zinc deficiency 3, 1

For patients with documented zinc deficiency, oral supplementation of 0.5-1 mg/kg per day of elemental zinc can be provided for 3-4 months 3
Organic compounds such as zinc histidinate, zinc gluconate, and zinc orotate show better tolerability than inorganic zinc sulfate and zinc chloride 3
Monitoring plasma zinc levels is recommended to confirm clinical zinc deficiency and assess adequacy of supplementation 3
Zinc levels should be interpreted alongside CRP and albumin levels, as inflammation can significantly reduce serum zinc concentrations 3

AMH assays lack standardization, with significant variability between different testing methods 3, 2
Age-specific reference ranges are crucial when interpreting AMH levels, as values naturally decline with age 3, 2
AMH measurement should not be used in adolescents within 8 years of menarche for diagnostic purposes due to significant overlap with normal physiological values 3, 2
The evidence for micronutrient supplementation improving AMH levels comes from small retrospective studies and requires validation in larger, prospective clinical trials 1

For patients concerned about AMH levels, consider testing for zinc deficiency, particularly if there are risk factors such as malabsorption, increased gastrointestinal losses, or poor dietary intake 3
In patients with confirmed zinc deficiency, supplementation may be beneficial as part of a comprehensive approach 3, 1
For patients without zinc deficiency but with low AMH levels, consider a broader micronutrient supplementation approach that includes zinc, omega-3 fatty acids, coenzyme Q10, vitamin E, and other antioxidants 1
Monitor AMH levels after 3 months of supplementation to assess response 1