Zinc deficiency

Both acute and chronic infections are exacerbated by zinc deficiency, and can exacerbate zinc deficiency themselves. The role for zinc supplementation in diarrheal illness is clear, and there is limited but growing evidence in the case of other infections, including malaria and pneumonias, although this is not supported by all trials.[60]Lazzerini M, Wanzira H. Oral zinc for treating diarrhoea in children. Cochrane Database Syst Rev. 2016;(12):CD005436. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005436.pub5/full http://www.ncbi.nlm.nih.gov/pubmed/27996088?tool=bestpractice.com [61]Haider BA, Bhutta ZA. The effect of therapeutic zinc supplementation among young children with selected infections: a review of the evidence. Food Nutr Bull. 2009 Mar;30(1 suppl):S41-59. http://journals.sagepub.com/doi/pdf/10.1177/15648265090301S104 http://www.ncbi.nlm.nih.gov/pubmed/19472601?tool=bestpractice.com [62]Fischer Walker C, Black RE. Zinc and the risk for infectious disease. Annu Rev Nutr. 2004;24:255-75. http://www.ncbi.nlm.nih.gov/pubmed/15189121?tool=bestpractice.com [63]Valentiner-Branth P, Shrestha PS, Chandyo RK, et al. A randomized controlled trial of the effect of zinc as adjuvant therapy in children 2-35 mo of age with severe or nonsevere pneumonia in Bhaktapur, Nepal. Am J Clin Nutr. 2010 Jun;91(6):1667-74. http://ajcn.nutrition.org/content/91/6/1667.long http://www.ncbi.nlm.nih.gov/pubmed/20375190?tool=bestpractice.com [64]Yakoob MY, Theodoratou E, Jabeen A, et al. Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malaria. BMC Public Health. 2011 Apr 13;11(suppl 3):S23. http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-S3-S23 http://www.ncbi.nlm.nih.gov/pubmed/21501441?tool=bestpractice.com

If zinc deficiency is identified and treated in childhood, full growth potential is likely; however, acquired zinc deficiency is often associated with permanently impaired growth and development.[65]Imdad A, Bhutta ZA. Effect of preventive zinc supplementation on linear growth in children under 5 years of age in developing countries: a meta-analysis of studies for input to the lives saved tool. BMC Public Health. 2011 Apr 13;11(suppl 3):S22. http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-S3-S22 http://www.ncbi.nlm.nih.gov/pubmed/21501440?tool=bestpractice.com [66]Cole CR, Lifshitz F. Zinc nutrition and growth retardation. Pediatr Endocrinol Rev. 2008 Jun;5(4):889-96. http://www.ncbi.nlm.nih.gov/pubmed/18552751?tool=bestpractice.com [67]Brown KH, Peerson JM, Baker SK, et al. Preventive zinc supplementation among infants, preschoolers, and older prepubertal children. Food Nutr Bull. 2009 Mar;30(1 suppl):S12-40. https://www.doi.org/10.1177/15648265090301S103 http://www.ncbi.nlm.nih.gov/pubmed/19472600?tool=bestpractice.com [68]Black MM. The evidence linking zinc deficiency with children's cognitive and motor functioning. J Nutr. 2003 May;133(5 suppl 1):1473S-6S. https://www.doi.org/10.1093/jn/133.5.1473S http://www.ncbi.nlm.nih.gov/pubmed/12730446?tool=bestpractice.com [69]Sayeg Porto MA, Oliveira HP, Cunha AJ, et al. Linear growth and zinc supplementation in children with short stature. J Pediatr Endocrinol Metab. 2000 Sep-Oct;13(8):1121-8. https://www.doi.org/10.1515/jpem.2000.13.8.1121 http://www.ncbi.nlm.nih.gov/pubmed/11085191?tool=bestpractice.com

Evaluation of short stature

Zinc is known to have multiple roles in bone metabolism. However, the impact of zinc deficiency on bone density is not clear. There is limited evidence that zinc supplementation along with calcium is more beneficial than calcium alone.[70]Palacios C. The role of nutrients in bone health, from A to Z. Crit Rev Food Sci Nutr. 2006;46(8):621-8. http://www.ncbi.nlm.nih.gov/pubmed/17092827?tool=bestpractice.com

The many dermatologic manifestations of zinc deficiency include acrodermatitis enteropathica, cheilitis, and nonspecific dermatitis. They typically respond well to supplementation, but time to complete resolution is variable.​[Figure caption and citation for the preceding image starts]: Acrodermatitis enteropathica seen with severe zinc deficiencyAdapted from Maverakis E, Lynch PJ, Fazel N. Acrodermatitis enteropathica. Dermatol Online J. 2007;13:11; used with permission [Citation ends].[Figure caption and citation for the preceding image starts]: Acrodermatitis enteropathica on the face seen with severe zinc deficiencyAdapted from Maverakis E, Lynch PJ, Fazel N. Acrodermatitis enteropathica. Dermatol Online J. 2007;13:11; used with permission [Citation ends].

Overview of dermatitis

Typically responds well to supplementation, but time to complete resolution is variable.

These include nystagmus, tremor, dysarthria, and impaired concentration. They typically respond well to supplementation, but time to complete resolution is variable.