From the Guidelines
Treatment for zinc overdose should prioritize immediate discontinuation of zinc intake, supportive care, and potentially chelation therapy with calcium disodium edetate (CaNa2 EDTA) or DTPA, as recommended by the 2022 espen micronutrient guideline 1. When managing zinc overdose, it is crucial to consider the severity and duration of exposure. For acute toxicity, treatment involves:
- Anti-emetics to control nausea and vomiting
- Fluids to maintain hydration
- Proton pump inhibitors or H-blockers to reduce gastrointestinal symptoms, as suggested by the espen micronutrient guideline 1
- Whole bowel irrigation may be required in severe cases For chronic zinc toxicity, treatment primarily involves:
- Copper sulfate administration
- Chelation therapy may be necessary in severe cases, as indicated by the 2022 espen micronutrient guideline 1 It is essential to monitor serum zinc levels, complete blood count, liver, and kidney function during treatment. In severe cases, hemodialysis may be considered, especially with renal impairment. The goal of treatment is to remove excess zinc, manage symptoms, and prevent long-term complications, such as copper deficiency and associated hematological and neurological issues.
From the Research
Treatment for Zinc Overdose
- Zinc overdose can be treated with chelating agents, other pharmacological treatment, protective lung ventilation, extracorporeal membrane oxygenation (ECMO), and supportive care 2
- Activated charcoal may be used to prevent toxicity or improve clinical outcome and survival of poisoned patients, including those with zinc overdose, although the evidence is heterogeneous and more research is needed 3
- Zinc therapy may be used to treat symptomatic hepatic Wilson's disease, a condition that can cause zinc overload, and has been shown to be effective in maintaining liver function and disease severity scores 4
Management of Zinc Toxicity
- The tolerable upper intake level (UL) for zinc is defined as 25 mg per day by the European Food Safety Authority (EFSA), and 40 mg per day by the Food and Drug Administration (FDA) 5
- Chelation therapy may be used to treat zinc toxicity, and metallothionein, a protein that binds metallic ions, plays a critical role in maintaining zinc and copper homeostasis 6
- Zinc intake is not limited to oral consumption, and other routes, such as inhalation or topical application, may also pose risks of zinc intoxication 5