A metallic taste, nausea after taking the capsule: these are the side effects of zinc that trials most often measure. In a meta-analysis of 17 randomized trials, nausea was 64% more frequent with zinc than with placebo. The most serious risk is rarer and more subtle: taken at high doses for months, zinc can cause copper deficiency, with anemia, decreased white blood cells, and sometimes nerve damage.
This guide reviews studies identified via PubMed, risk by risk, classifying each as established, rare, theoretical, or misconception, then provides practical rules and warning signs that require stopping or consulting a healthcare provider.
What is established : nausea, metallic taste, and digestive discomfort are more frequent with zinc than with placebo, especially with lozenges (nausea in 20% versus 4% in one trial) and at very high doses. Long-term, zinc slows copper absorption: from 50 mg per day, trials lasting 6 to 10 weeks measured a decrease in an enzyme that depends on copper. Zinc nasal sprays and gels have caused loss of smell.
What is rare : anemia, neutropenia, and myelopathy, a spinal cord disorder, due to copper deficiency, described with approximately 50 mg to over 1,500 mg of zinc per day for weeks to years, often via denture adhesive creams. Blood disorders most often regress upon stopping; neurological damage much less so.
- Zinc in brief: requirements, doses, and forms
- Nausea and metallic taste: measured frequencies
- Zinc on an empty stomach or with meals
- Zinc and copper: demonstrated antagonism
- Anemia, neutropenia, myelopathy: published cases
- Overdose: thresholds and dose chart
- High doses long-term: urinary tract, prostate, cholesterol, immunity
- Cumulative sources: supplement, multivitamins, lozenges
- Nasal sprays and gels: loss of smell
- Drug interactions: the chart
- Pregnancy, breastfeeding, children
- Best practices: practical rules and warning signs
- Frequently asked questions
Zinc in brief: requirements, doses and forms
Zinc participates in over 300 enzymatic reactions and in immunity, with no real reserve in the body. According to a review published in Molecules in 2024, reference intakes for adults range from approximately 9.4 to 16.3 mg per day in men and 7.5 to 12.7 mg in women, depending on the amount of phytates in the diet. Phytates from whole grains, legumes and seeds bind zinc and reduce its absorption; this is why vegetarians and vegans are more at risk of deficiency, as detailed in our guide to benefits of zinc.
According to the same review, excess from food alone is very unlikely: it comes from supplements, dental adhesive creams or, at work, from inhaled zinc fumes.
Forms are not equal. In 15 adults, 10 mg of zinc taken without food was absorbed at 60.9% in gluconate form, 61.3% in citrate form and 49.9% in oxide form, with three participants who absorbed almost nothing from the oxide. Our Zinc uses gluconate: two capsules per day, with meals, provide 14.16 mg of zinc and 2 mg of vitamin B6.
Established : observed repeatedly in controlled trials or directly measured. Rare : real, but described in isolated cases or case series. Theoretical : plausible based on mechanism, experimentation or statistical association, without proof of cause and effect in humans at usual doses. Common misconception : assertion that data do not support.
Nausea and metallic taste: measured frequencies
In a meta-analysis of 17 trials and 2,121 participants treated for a cold, published in 2012, people taking zinc had more adverse effects of all types (relative risk of 1.24), bad taste (1.65) and nausea (1.64) than placebo. A relative risk of 1.64 means 64% more nausea: if 10 people per 100 experience it with placebo, approximately 16 per 100 will experience it with zinc.
The 2024 Cochrane review, the most recent, with 34 trials and 8,526 participants, confirms: to treat a cold, zinc probably increases non-serious adverse effects (relative risk of 1.34, 16 studies, 2,084 participants, moderate certainty). In these trials, gluconate lozenges provided 45 to 276 mg of zinc per day, much more than a daily supplement.
In 100 employees with a cold, a lozenge containing 13.3 mg of zinc in gluconate form taken every two hours during waking hours shortened symptoms (4.4 days versus 7.6). In exchange, 90% of participants taking zinc reported a side effect, compared to 62% on placebo: nausea in 20% versus 4%, and a bad taste in 80% versus 30%.
Mossad SB, Macknin ML, Medendorp SV, Mason P. Ann Intern Med 1996;125(2):81-88. DOI: 10.7326/0003-4819-125-2-199607150-00001
The dose carries weight. In a double-blind crossover trial in 47 volunteers, 50 mg of zinc in sulfate form three times daily, totaling 150 mg per day for six weeks, caused headaches, abdominal cramps, nausea, loss of appetite, or vomiting in 84% of women and 18% of men; six women discontinued the trial, five of them due to stomach irritation. Those most affected were the lightest volunteers.
At moderate doses, tolerance is better. In 332 people with acne, over three months, 30 mg of zinc daily in gluconate form primarily caused digestive effects deemed moderate, with five dropouts compared to four with minocycline. Our article on zinc for acne details its efficacy.
Verdict: established, frequent with lozenges and high doses. These side effects remain benign: in three trials conducted in 199 people with 80 to 92 mg of zinc daily in acetate lozenges, no serious adverse effects were observed.
Zinc on an empty stomach or with meals
The timing of intake changes absorption. In a study using labeled zinc, zinc dissolved in water with a small amount of iron and taken on an empty stomach was absorbed at 58 to 59%, compared to 22 to 25% with a meal.
No identified study directly compares nausea depending on whether the capsule is taken on an empty stomach or with a meal; however, side effects increase with dose and affect people with lower body weight more. In 115 patients with Wilson's disease who receive high-dose zinc away from meals, zinc sulfate was associated with significantly more stomach lesions on gastroscopy than no treatment (adjusted odds ratio of 4.57).
If zinc causes you nausea, take it in the middle of a meal rather than on an empty stomach or at bedtime. This is also the instruction for our Zinc : two capsules per day, during meals. This advice is based on practice, not a comparative trial.
Meals have another benefit, this time demonstrated. In the same labeled zinc study, a dose of iron 25 times higher than that of zinc, taken on an empty stomach, reduced zinc absorption from 59% to 34%; with a meal, iron had no measurable effect.
Zinc and copper: a demonstrated antagonism
In intestinal cells, zinc triggers the production of metallothionein, a protein that binds copper more than zinc. Trapped copper is excreted in feces. This mechanism is used as treatment for Wilson's disease, an inherited copper overload: in these patients, a negative effect on copper status was reported at doses as low as 25 mg of zinc per day.
In healthy men, 25 mg of zinc twice daily for six weeks reduced the activity of copper and zinc superoxide dismutase in red blood cells, an enzyme sensitive to copper status, while blood copper and ceruloplasmin remained unchanged.
In adult women, 50 mg of zinc daily in gluconate form for 10 weeks reduced ferritin, hematocrit, and erythrocyte superoxide dismutase activity, a marker of copper status. Adding 50 mg of iron corrected the effect on iron, but not on copper. The authors conclude that zinc supplementation poses a risk to iron and copper status.
Yadrick MK, Kenney MA, Winterfeldt EA. Am J Clin Nutr 1989;49(1):145-150. DOI: 10.1093/ajcn/49.1.145
These results describe the decline of a marker, not a disease: at 150 mg per day for six weeks, plasma copper had not changed. Deficiency with symptoms requires longer exposures.
Verdict: established as a biological effect from 50 mg per day over several weeks; identified trials did not study this criterion around 15 mg per day.
Anemia, neutropenia, myelopathy: published cases
A systematic review published in 2026 gathered 37 cases of zinc blood toxicity, described in 34 publications between 1972 and 2025. The zinc came from oral supplements, dental adhesive creams, or swallowed coins, at doses of approximately 50 mg to over 1,500 mg per day, for weeks to years. Anemia was present in almost all cases, most often with neutropenia, a lack of white blood cells that expose patients to infections; blood copper was low in all patients. Bone marrow often falsely suggested a myelodysplastic syndrome.
A 1994 review examining 14 cases judged zinc-related anemia to be completely reversible upon discontinuation. In 2005, three men aged 21 to 47 presented with anemia and neutropenia, two with neuropathy that had progressed for 8 and 18 months. In 2024, a 74-year-old woman developed anemia and neutropenia due to an over-the-counter vitamin and mineral supplement, which improved after stopping the product and taking copper.
Among 198 published cases of copper deficiency myelopathy, a spinal cord disorder causing unstable gait and leg sensory disturbances, the most common cause was stomach surgery (36.2%), followed by excess zinc from denture adhesive cream (39 cases, 19.9%). Despite copper supplementation, only 24% of patients, across all causes, improved neurologically, and 5.1% returned to their baseline state.
Chen JW, Zeoli T, Hughes NC, et al. Spine J 2024;24(11):2026-2034. DOI: 10.1016/j.spinee.2024.06.018
Denture adhesive creams hold a special place. In 2008, four patients using very large quantities of cream were described; the analyzed creams contained approximately 17 to 34 mg of zinc per gram, and after discontinuation and copper supplementation, neurological improvement was only slight in two of them. In 2017, a 62-year-old man remained wheelchair-bound despite stopping the paste. The risk lies in quantities well above those intended, over years.
Tingling or numbness in the feet then hands, unstable gait, falls, unusual fatigue and shortness of breath, paleness, recurrent infections. In someone taking zinc for months or using large amounts of adhesive cream, these signs warrant stopping zinc and seeking medical consultation. A blood test including complete count, copper, ceruloplasmin, and zinc will guide diagnosis. Speed matters: nerves recover much less readily than blood.
Verdict: rare, but established regarding the cause, with intakes of approximately 50 mg per day and above, over long durations.
Overdose: thresholds and dose table
The 2024 review published in Molecules reports two upper safety limits for total zinc intake in adults, including diet: 25 mg per day according to one framework, 40 mg per day according to another. Beyond this, the copper balance may be disrupted; the authors consider the 25 mg value more reasonable.
These figures include a safety margin: effects on copper were measured starting from 50 mg per day.
| Zinc intake per day | What studies show | Level |
|---|---|---|
| 10 to 16 mg approximately | Reference intake range for adults | Normal intake |
| 25 and 40 mg, total intake | Two upper safety limits reported by a 2024 review | Safety benchmark |
| 30 mg, gluconate, 3 months | Mainly digestive, moderate effects, in acne patients | Established |
| 50 mg, 6 to 10 weeks | Decrease in a copper-related enzyme; decrease in ferritin in women | Established, biological effect |
| Approximately 50 mg and above, for months | Published cases of anemia, neutropenia, and myelopathy | Rare |
| 80 mg with 2 mg of copper, 6 years | More hospitalizations for urinary reasons, 11.1% versus 7.6% | Signal from a secondary analysis of a large trial |
| More than 75 mg, for years | Association with aggressive prostate cancers | Theoretical, association |
| 150 mg, 6 weeks | Digestive disorders in 84% of women and 18% of men | Established |
Acute overdose, massive ingestion at once, causes nausea, vomiting, diarrhea, abdominal pain, and headaches, according to the 2024 review.
High doses long-term: urinary tract, prostate, cholesterol, immunity
Urinary tract: signal at 80 mg per day, from a secondary analysis. The AREDS trial, in 3,640 people aged 55 to 80 with macular degeneration, gave 80 mg of zinc in oxide form with 2 mg of copper for an average of 6.3 years. The trial found no significant serious adverse effects, but a 2007 secondary analysis counted more hospitalizations for genitourinary reasons with zinc: 11.1% versus 7.6%. The risk was especially increased in men (relative risk of 1.26); in women, urinary tract infections leading to hospitalization rose from 0.4% with placebo to 2.3% with zinc. This signal concerns a dose more than five times higher than the 14 mg per day in our Zinc (two capsules).
Prostate: theoretical, association. In 46,974 men followed for 14 years, taking zinc supplementation up to 100 mg per day was not associated with prostate cancer; above 100 mg per day, the risk of advanced cancer was multiplied by 2.29; and, regardless of dose, taking it for ten years or more was associated with a risk multiplied by 2.37. In the same cohort followed for a median of 28.3 years, more than 75 mg per day was associated with a risk multiplied by 1.76 for fatal cancer and by 1.80 for aggressive cancer, with no link to cancers overall. In this follow-up, 15 years of use or more, regardless of dose, was also associated with a higher risk of fatal cancer (1.91) and aggressive cancer (1.55). These are associations, and the authors do not exclude bias from other factors. Conversely, in 35,242 men, more than 15 mg per day over ten years was associated with fewer advanced cancers, and the AREDS trial showed no increase in cancers at 80 mg.
Cholesterol: misconception at usual doses. Does zinc lower good HDL cholesterol? A meta-analysis of 24 studies and 14,515 participants, with 15 to 240 mg of zinc per day, found no significant decrease in HDL (+2.12 mg per deciliter, not significant), but a decrease in total cholesterol, LDL, and triglycerides.
Immunity: theoretical, except in case of copper deficiency. In the laboratory, very high concentrations of zinc slow the functioning of T and B lymphocytes. In humans, the documented consequence occurs through copper deficiency and neutropenia from section 5. In the 2024 Cochrane review, serious adverse effects from cold prevention trials were not significantly more frequent with zinc (relative risk of 1.67, interval 0.78 to 3.57, three studies, low certainty). The benefits for the common cold are detailed in our guides on zinc for the common cold and onimmunity in winter.
Cumulative sources: supplement, multivitamins, lozenges
The case cited by the 2024 review is telling: a 66-year-old woman with an intestinal disease took a multivitamin and zinc gluconate daily, totaling 65 mg of zinc per day to protect herself from Covid-19 instead of vaccination. Her copper became undetectable, with neutropenia that required treatment.
Lozenges are the other trap. In the 1996 trial, a 13.3 mg lozenge every two hours represents, by our calculations, more than 100 mg per day over 16 waking hours; the gluconate lozenges from the Cochrane review trials provided 45 to 276 mg per day. These doses were studied for a few days, the duration of a cold, not for months.
Let's do the calculation for our own products. Our Multivitamins provide 10 mg of zinc in gluconate form, with copper, and our Zinc 14.16 mg. Taken together, they combine approximately 24 mg of zinc per day, to which dietary zinc is added. The total intake then exceeds the lower of the two limits reported by the 2024 review, 25 mg, and generally remains below the higher limit, 40 mg, except for a diet very high in zinc; it also remains below the 50 mg per day above which studies in healthy individuals measured an effect on copper, even though in patients with Wilson's disease, an effect on copper levels was reported as low as 25 mg per day. For most people, one or the other is sufficient. Our article should you take multivitamins helps you choose.
Add up the zinc from each product you take daily: supplement, multivitamin, hair or skin formula, lozenges, eye product. The 25 mg limit reported by the 2024 review includes dietary intake: if the zinc from your products, added to that from meals, exceeds 25 mg daily over time, keep only one product, or ask your doctor or pharmacist for advice.
Nasal sprays and gels: loss of smell
Nasal gels with zinc gluconate were sold to treat colds. In a series published in 2006, 17 patients at a specialized clinic in San Diego had lost their sense of smell after using them. All described the same sequence: a deep breath at the moment of application, an immediate burning sensation lasting minutes or hours, then loss of smell within 48 hours. Seven of the 17 had not even experienced infection symptoms.
Based on 25 patients who lost their sense of smell after a zinc gluconate nasal gel and published literature, the authors applied the nine Bradford Hill criteria, the reference method for judging a cause-and-effect relationship. Their conclusion: clinical, biological, and experimental data demonstrate that zinc gluconate applied in the nose causes a decrease or loss of smell.
Davidson TM, Smith WM. Arch Otolaryngol Head Neck Surg 2010;136(7):673-676. DOI: 10.1001/archoto.2010.111
The mechanism is local: according to the authors of the 2006 series, the syndrome occurs after ionized zinc contacts the olfactory epithelium, the mucous membrane that carries smell receptors. This mechanism does not exist for zinc taken orally, which never reaches this mucous membrane. Verdict: established for nasal sprays and gels, to be avoided; misconception for capsules and lozenges.
Drug interactions: the table
Antibiotics. In 12 men, 500 mg of ciprofloxacin, a quinolone, taken with a multivitamin containing zinc achieved approximately 22% lower blood exposure than when taken alone, without the responsible component being identified; iron sulfate reduced it by 63%. In seven volunteers, 45 mg of zinc in sulfate form taken at the same time as 500 mg of tetracycline reduced its absorption by approximately 30%, with no significant effect on doxycycline; the authors judge the clinical relevance to be limited.
Penicillamine. In patients with Wilson's disease, a team found probable interactions between zinc and this metal-binding medication, with no advantage to combining them. Thiazide diuretics. In hypertensive patients treated long-term with hydrochlorothiazide, alone or with amiloride, urinary zinc elimination was abnormally elevated, while blood zinc remained comparable to that of controls.
| Medication or nutrient | What was measured | Level and practical guidance |
|---|---|---|
| Quinolones, ciprofloxacin | Approximately −22% exposure with a multivitamin containing zinc | Probable (zinc not isolated); space out doses, ask pharmacist for the interval |
| Tetracyclines | Approximately −30% for tetracycline, no net effect on doxycycline | Established for tetracycline; space out doses |
| Penicillamine | Probable interactions, no advantage to combining | Probable; no zinc without medical advice |
| Thiazide diuretics | Increased urinary zinc losses | Established; effect on status to be monitored long-term |
| Iron supplementation | Disputed effect: clear at 2 parts iron to 1 in one study, only at 25 to 1 in another | Probable; take with meals |
| Zinc at high dose on iron | Lower ferritin after 10 weeks at 50 mg per day | Established at this dose |
Iron. Iron and zinc partly share the same absorption pathway. Taken on an empty stomach in salt form, in a study tracking zinc rise in blood, one part iron to one part zinc slightly slowed zinc absorption, two or three parts significantly; another study, using labeled zinc, found an effect only at 25 parts to one; heme iron, that from meat, had no effect. With a meal, the iron effect disappeared in the labeled zinc study. Our Multivitamins combine 10 mg iron and 10 mg zinc, a ratio of one to one, to be taken with a meal. In case of low iron stores, our guide on iron deficiency details the solutions.
Pregnancy, breastfeeding, children
During pregnancy and breastfeeding, zinc requirements increase: the 2024 review cites a reference that adds 1.6 mg per day during pregnancy and 2.9 mg during breastfeeding. The 2021 Cochrane review, which gathers 25 trials and over 18,000 pregnant women, finds insufficient evidence of a benefit of supplementation on prematurity (relative risk of 0.87, not significant) or birth weight, nor any signal of harmful effect on measured outcomes: stillbirth was not significantly different (relative risk of 1.22, interval of 0.80 to 1.88). Very few of these trials involved women with normal zinc status.
This data does not justify self-medication: the choice and dose are the responsibility of the doctor or midwife. Our Zinc is not recommended for pregnant and breastfeeding women. The studies we identified do not provide information on the safety of zinc supplements during breastfeeding in well-nourished women.
In children, according to a meta-analysis of 33 trials, zinc treats acute diarrhea in countries where deficiency is common, with vomiting as an established side effect. Without a prescription, no supplements for adults, and keep packages out of reach.
Stomach surgery or bypass, intestinal disease that impairs absorption, Wilson's disease, kidney disease, long-term treatment with a diuretic or penicillamine. Monitoring copper and zinc in the blood helps then in deciding.
Proper use: practical rules and warning signs
These practical recommendations for healthy adults are based on the studies cited, without being trial results.
Our Zinc respects these guidelines: 14.16 mg of zinc in gluconate form per day, in two capsules taken with meals. It is not recommended for pregnant or breastfeeding women, and should not be added without calculation to another product containing zinc. Our guide what really works for immunity places zinc among other levers.
Stop in case of nausea or stomach pain that persists despite taking it with meals. Stop and consult promptly in case of tingling or numbness in the feet or hands, balance problems, unusual fatigue or shortness of breath, paleness, recurrent infections or unexplained fever, or loss of smell. Call a poison control center in case of accidental ingestion of a large quantity, especially by a child.
Zinc gluconate combined with vitamin B6, in vegetable capsules, with Méritose. Two capsules per day, taken with meals, provide 14.16 mg of zinc, or 141.6% of the reference nutritional values, and 2 mg of vitamin B6. Not recommended for pregnant or breastfeeding women.
See ZincOur guide to zinc benefits details its roles, forms, and situations where it is useful.
Frequently asked questions
What are the side effects of zinc?
The most common are digestive: nausea, metallic taste, stomach pain, sometimes vomiting. In a meta-analysis of 17 trials, nausea was 64% more frequent with zinc than with placebo. The most serious risk, though rare, is copper deficiency during prolonged high-dose use.
Is zinc dangerous?
At doses close to reference intakes, approximately 10 to 15 mg per day, studies show no danger in healthy adults, apart from digestive problems. The danger comes from prolonged overdosing: published cases of copper deficiency involve intakes of approximately 50 mg per day or more for weeks to years.
What are the symptoms of zinc overdose?
After massive intake: nausea, vomiting, diarrhea, abdominal pain, headaches. After prolonged excess: fatigue, paleness, recurrent infections, tingling in the feet and hands, unsteady gait. These signs warrant stopping zinc and consulting a healthcare provider.
What daily dose of zinc should not be exceeded?
A 2024 review reports two upper safety limits for total intake in adults, including food: 25 mg per day according to one standard, 40 mg according to another, and its authors consider the lower limit more reasonable.
Why does zinc cause nausea?
Zinc irritates the stomach, especially when the dose is high and the person is lightweight: at 150 mg per day, 84% of women and 18% of men experienced side effects in one trial. Taking it with meals and respecting the dose limit this effect.
Should zinc be taken on an empty stomach?
On an empty stomach, zinc is better absorbed: approximately 59% compared to 22-25% with a meal in a study using labeled zinc, given with a small amount of iron. No identified study compares tolerance; in practice, taking it with meals is often recommended to limit nausea.
Does zinc lower copper levels?
Yes, at high doses: zinc stimulates a protein in the intestine that binds copper. Trials have measured a decrease in an enzyme linked to copper with 50 mg per day for 6 to 10 weeks, and published deficiencies with symptoms concern approximately 50 mg per day and above, over long durations.
Do denture creams contain zinc?
Some have contained significant amounts: creams analyzed in 2008 contained approximately 17 to 34 mg of zinc per gram. Used in very large quantities over years, they are the second cause of myelopathy from copper deficiency in a review of 198 cases, accounting for 19.9% of cases.
Can zinc cause loss of smell?
Yes when applied in the nose: zinc gluconate nasal gels have caused loss of smell, and a causality analysis concluded there is a cause-and-effect relationship. Zinc taken orally in capsules or lozenges does not reach the olfactory mucosa and does not present this risk.
Can zinc be taken with antibiotics?
Not at the same time as quinolones or tetracyclines: zinc reduces their absorption, by approximately 30% for tetracycline in one trial, and a multivitamin containing zinc reduced ciprofloxacin exposure by approximately 22%. The doses must be spaced apart.
Can zinc and iron be taken together?
Yes, preferably with a meal. Taken on an empty stomach, iron salt can inhibit zinc absorption, notably starting from a 2:1 iron-to-zinc ratio in one study, to 25:1 in another; with a meal, this effect disappeared.
Can zinc be taken during pregnancy or while breastfeeding?
Only on medical advice. Needs increase during pregnancy and breastfeeding, and a review of 25 trials in over 18,000 pregnant women shows neither net benefit nor signal of harmful effect. The choice of product is up to the doctor or midwife.
Sources
The studies cited below were identified via PubMed.
- Science M, Johnstone J, Roth DE, et al. Zinc in the treatment of the common cold: systematic review and meta-analysis of randomized controlled trials. CMAJ: Canadian Medical Association Journal, 2012;184(10):E551-E561. DOI
- Schoofs H, Schmit J, Rink L. Zinc toxicity: understanding the limits. Molecules, 2024;29(13):3130. DOI
- Wegmüller R, Tay F, Zeder C, Brnic M, Hurrell RF. Zinc absorption in young adults from zinc citrate is comparable to zinc gluconate and superior to zinc oxide. The Journal of Nutrition, 2014;144(2):132-136. DOI
- Nault D, Machingo TA, Shipper AG, et al. Zinc for the prevention and treatment of the common cold. The Cochrane Database of Systematic Reviews, 2024;5(5):CD014914. DOI
- Mossad SB, Macknin ML, Medendorp SV, Mason P. Zinc gluconate lozenges for treating the common cold: randomized double-blind placebo-controlled trial. Annals of Internal Medicine, 1996;125(2):81-88. DOI
- Samman S, Roberts DC. Effect of zinc supplements on plasma zinc and copper and on symptoms reported in healthy volunteers. The Medical Journal of Australia, 1987;146(5):246-249. DOI
- Dreno B, Moyse D, Alirezai M, et al. Randomized double-blind multicenter trial comparing the safety and efficacy of zinc gluconate and minocycline hydrochloride in inflammatory acne. Dermatology, 2001;203(2):135-140. DOI
- Hemilä H, Fitzgerald JT, Petrus EJ, Prasad A. Zinc acetate lozenges may accelerate the healing of the common cold: meta-analysis of individual data. Open Forum Infectious Diseases, 2017;4(2):ofx059. DOI
- Sandström B, Davidsson L, Cederblad A, Lönnerdal B. Oral iron, dietary ligands and zinc absorption. The Journal of Nutrition, 1985;115(3):411-414. DOI
- Antczak-Kowalska M, Członkowska A, Litwin T, et al. Gastropathy in patients with Wilson's disease. Scandinavian Journal of Gastroenterology, 2020;55(1):14-17. DOI
- Brewer GJ, Yuzbasiyan-Gurkan V, Lee DY. Use of metabolic interactions between zinc and copper in the treatment of Wilson's disease. Journal of the American College of Nutrition, 1990;9(5):487-491. DOI
- Fischer PW, Giroux A, L'Abbé MR. Effect of zinc supplementation on copper status in adult men. The American Journal of Clinical Nutrition, 1984;40(4):743-746. DOI
- Yadrick MK, Kenney MA, Winterfeldt EA. Iron, copper and zinc status: response to zinc or zinc and iron supplementation in adult women. The American Journal of Clinical Nutrition, 1989;49(1):145-150. DOI
- Dutta A, Chaudhary V, Kumari S, et al. Zinc-induced hematologic toxicities: systematic review of descriptive studies. Biological Trace Element Research, 2026;204(9):6628-6642. DOI
- Fiske DN, McCoy HE, Kitchens CS. Zinc-induced sideroblastic anemia: a case, literature review and description of the hematologic syndrome. American Journal of Hematology, 1994;46(2):147-150. DOI
- Willis MS, Monaghan SA, Miller ML, et al. Zinc-induced copper deficiency: three cases initially recognized on bone marrow examination. American Journal of Clinical Pathology, 2005;123(1):125-131. DOI
- Stagg MP, Miatech J, Majid B, Polala R. An over-the-counter zinc-containing product causing sideroblastic anemia and neutropenia. Cureus, 2024;16(5):e59796. DOI
- Chen JW, Zeoli T, Hughes NC, et al. Myelopathy from copper deficiency mimicking cervical spondylotic myelopathy: systematic literature review and case report. The Spine Journal, 2024;24(11):2026-2034. DOI
- Nations SP, Boyer PJ, Love LA, et al. Denture cream: an unusual source of excess zinc leading to hypocupremia and neurological disease. Neurology, 2008;71(9):639-643. DOI
- Carroll LS, Abdul-Rahim AH, Murray R. A zinc-containing dental fixative causing myelopathy from copper deficiency. BMJ Case Reports, 2017;2017:bcr2017219802. DOI
- Age-Related Eye Disease Study Research Group. Randomized, placebo-controlled trial of high-dose vitamins C and E, beta-carotene, and zinc in age-related macular degeneration and vision loss: AREDS Report No. 8. Archives of Ophthalmology, 2001;119(10):1417-1436. DOI
- Johnson AR, Munoz A, Gottlieb JL, Jarrard DF. High-dose zinc increases hospitalizations for genitourinary complications. The Journal of Urology, 2007;177(2):639-643. DOI
- Leitzmann MF, Stampfer MJ, Wu K, et al. Zinc supplement use and risk of prostate cancer. Journal of the National Cancer Institute, 2003;95(13):1004-1007. DOI
- Zhang Y, Song M, Mucci LA, Giovannucci EL. Zinc supplement use and risk of aggressive prostate cancer: 30-year follow-up. European Journal of Epidemiology, 2022;37(12):1251-1260. DOI
- Gonzalez A, Peters U, Lampe JW, White E. Zinc intake from supplements and diet and prostate cancer. Nutrition and Cancer, 2009;61(2):206-215. DOI
- Ranasinghe P, Wathurapatha WS, Ishara MH, et al. Effects of zinc supplementation on blood lipids: a systematic review and meta-analysis. Nutrition & Metabolism, 2015;12:26. DOI
- Alexander TH, Davidson TM. Intranasal zinc and anosmia: the zinc-induced anosmia syndrome. The Laryngoscope, 2006;116(2):217-220. DOI
- Davidson TM, Smith WM. Bradford Hill criteria and zinc-induced anosmia: a causality analysis. Archives of Otolaryngology, Head and Neck Surgery, 2010;136(7):673-676. DOI
- Polk RE, Healy DP, Sahai J, Drwal L, Racht E. Effect of ferrous sulfate and multivitamins with zinc on ciprofloxacin absorption in healthy volunteers. Antimicrobial Agents and Chemotherapy, 1989;33(11):1841-1844. DOI
- Penttilä O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on tetracycline and doxycycline absorption in humans. European Journal of Clinical Pharmacology, 1975;9(2-3):131-134. DOI
- Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson disease with zinc, XI: interactions with other copper-lowering agents. Journal of the American College of Nutrition, 1993;12(1):26-30. DOI
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide and amiloride association causes excessive urinary zinc excretion. Clinical Pharmacology and Therapeutics, 1987;42(1):42-44. DOI
- Solomons NW, Jacob RA. Studies on zinc bioavailability in humans: effects of hemic and non-hemic iron on zinc absorption. The American Journal of Clinical Nutrition, 1981;34(4):475-482. DOI
- Carducci B, Keats EC, Bhutta ZA. Zinc supplementation to improve pregnancy outcomes and infant health. The Cochrane Database of Systematic Reviews, 2021;3(3):CD000230. DOI
- Lazzerini M, Wanzira H. Oral zinc for treating childhood diarrhea. The Cochrane Database of Systematic Reviews, 2016;12(12):CD005436. DOI
