From the Guidelines
For elevated copper levels, the recommended dose of zinc is 150 mg elemental zinc/day, administered in three divided doses, 30 min before meals, as stated in the EASL clinical practice guidelines for Wilson's disease 1. The dosing of zinc picolinate for elevated copper levels should be based on the most recent and highest quality evidence available.
- The mechanism of action of zinc in treating elevated copper levels is through the induction of enterocyte metallothionein, which binds to copper and prevents its absorption, leading to a negative balance for copper and removal of stored copper 1.
- Different zinc salts, including zinc picolinate, can be used, but the recommended dose is 150 mg elemental zinc/day, administered in three divided doses, 30 min before meals, to maximize absorption and efficacy 1.
- It is essential to take zinc supplements 30 min before meals, as taking them with food can interfere with absorption 1.
- Regular monitoring of copper levels, as well as urinary excretion of copper, is necessary to assess the effectiveness of treatment and adjust the dose as needed 1.
- While zinc picolinate is not specifically mentioned in the guidelines, the recommended dose of 150 mg elemental zinc/day can be applied to zinc picolinate, taking into account the elemental zinc content in the supplement.
- It is crucial to consult with a healthcare provider before starting zinc supplementation, as individual factors and the severity of copper elevation may require adjustments to the dose or treatment plan.
From the Research
Dosing of Zinc Picolinate for Elevated Copper Level
- There is no direct evidence to support the use of zinc picolinate for elevated copper levels 2, 3, 4, 5, 6.
- Copper deficiency can be caused by high doses of zinc, which can lead to life-changing diagnoses that are frequently overlooked 3.
- The current official advice on the dose and frequency of zinc administration should be revised to limit and potentially eradicate zinc-induced copper deficiency 3.
- Copper deficiency can have devastating individual consequences and potential public health consequences, and its diagnosis is made by measuring serum copper, serum ceruloplasmin, and 24-h urine copper levels 2, 4.
- Elevated serum copper levels have been found in a pre-surgical intervention population of a bariatric center, and additional studies are needed to understand the trends and correlations with other variables 5.
- Copper toxicity can cause oxidative damage, and antioxidant nutrients such as vitamin E, ascorbic acid, zinc, beta-carotene, alpha-lipoic acid, and polyphenols may provide protection against Cu toxicity 6.