What are the other Names for this Condition? (Also known as/Synonyms)

• Zinc Inadequacy
• Zn Deficiency

What is Zinc Deficiency? (Definition/Background Information)

• Zinc (Zn) is an element essential for many healthy bodily functions. Zinc Deficiency is a decrease in the levels of zinc in the body. The condition can manifest as a loss of appetite, weight loss, diarrhea, and appearance of skin lesions
• A reduction in zinc levels can occur in individuals of all ages and both genders, though such cases are more common in young individuals and those older than 65 years
• Zinc Deficiency is mainly caused by a lack of zinc uptake through a poor diet or by acrodermatitis enteropathica, a rare genetic disorder caused by the malabsorption of zinc through the intestines
• Some risk factors for Zinc Deficiency include insufficient zinc in one’s diet, certain gastrointestinal diseases, chronic kidney or liver disease, and diabetes
• In case of complications, it may include impaired growth and development, as well as an impaired immune system function. Blood tests for assessing plasma or serum zinc levels are the chief modes of diagnosing Zinc Deficiency
• Generally, the condition is treated with zinc supplements and a healthy well-balanced diet. With timely diagnoses and adequate treatment, the outcomes are good

Who gets Zinc Deficiency? (Age and Sex Distribution)

• Cases of Zinc Deficiency are reported worldwide, though they are more common in regions where zinc-rich foods (such as obtained by animal products) are limited
• Individuals of all ages and both genders may develop the condition. However, the condition is most common in infants, children, adolescents, and older adults (over 65 years of age)
• No racial or ethnic predilection is reported in the occurrence of this disorder

What are the Risk Factors for Zinc Deficiency? (Predisposing Factors)

The risk factors for Zinc Deficiency may include:

• Inadequate diet (essentially due to insufficient amounts of animal-derived products)
• Gastrointestinal diseases: These may include a variety of conditions, such as ulcerative colitis, Crohn’s disease, celiac disease, short bowel syndrome, and chronic diarrhea. These conditions may be malabsorption syndromes or inflammatory bowel diseases, which impair the body’s ability to uptake and retain zinc from the diet
• Chronic kidney or liver disease
• Alcoholism
• Uncontrolled diabetes
• A purely vegetarian diet
• Pregnancy and breast-feeding mothers
• Malnourishment, including individuals with anorexia nervosa
• Sickle cell disease
• Taking medications that decrease zinc absorption, increase zinc excretion, or impair zinc utilization
• Taking large amounts of iron supplements

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Zinc Deficiency? (Etiology)

Zinc Deficiency occurs when the body does not absorb sufficient quantities of the mineral zinc, or it excretes too much zinc from the body. The causes of Zinc Deficiency may include:

• Inadequate dietary intake of zinc including a strictly vegetarian diet, or due to eating disorders such as anorexia nervosa
  • The body does not store zinc, and therefore, a daily intake through proper diet is needed to keep levels normal
  • The normal amount of zinc in the body is estimated to be approximately 2 grams, most of which is found in the skeletal muscles and bones (about 90% of the amount). Only about 0.1% of zinc is found in serum plasma
  • The recommended daily zinc intake for men is 9.5 mg and for women it is 7 mg
• Disorders and conditions that impact uptake of zinc through intestinal cells include malabsorption syndromes, inflammatory bowel diseases, and acrodermatitis enteropathica (a rare genetic disorder caused by impaired absorption of zinc through the intestines)
• Disorders and conditions that cause excess excretion of zinc include chronic diarrhea and alcoholism (which leads to increase in the amount of zinc in the urine)

Zinc is essential for several bodily functions including: 

• Synthesis and metabolism of carbohydrates, lipids, proteins, and nucleic acids
• Stabilizing cellular components and membranes for cell and organ structure and integrity
• Cell division along with normal growth and development
• DNA synthesis
• Immune function
• Wound-healing and tissue repair
• Taste and smell

What are the Signs and Symptoms of Zinc Deficiency?

The signs and symptoms of Zinc Deficiency may include:

• Lethargy
• Lack of appetite; weight loss
• Swelling and clouding of the corneas
• Diarrhea
• Hair loss
• Impaired taste and smell
• Impaired wound healing
• Anorexia
• Behavioral disturbances; delayed growth and development
• Delayed sexual maturation

Skin lesions: These are commonly seen in association with conditions such as acrodermatitis enteropathica. They present as inflamed red patches of dry and scaly skin that turn into crusted, blistered, pus-filled, and eroded lesions. Typically, skin lesions occur around body openings, such as the mouth, anus, and eyes, as well as on the skin on knees, elbows, hands, and feet.

How is Zinc Deficiency Diagnosed?

The diagnosis of Zinc Deficiency is made through the following tests and exams:

• A complete physical examination and review of medical history, with emphasis on diet and pre-existing conditions (assessment of risk factors)
• Assessment of symptoms
• Blood tests for plasma or serum levels of zinc: These tests may be unreliable, as plasma or serum levels of zinc do not always coincide with the amount of zinc inside of cells and may be normal in individuals with Zinc Deficiency or abnormal in healthy individuals. These tests are often used along with an assessment of risk factors, to make a diagnosis, in other words, the specificity and sensitivity of zinc levels in blood to diagnose Zinc Deficiency is low
• A diagnosis of acrodermatitis enteropathica, which can be made through:
  • Blood tests
  • Urine tests
  • Blood count for anemia
  • Skin biopsies of lesions

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Zinc Deficiency?

Complications of Zinc Deficiency range from mild to severe, depending on the severity of the case and access to proper treatment. The possible complications include:

• Impaired immune function, which can cause increased susceptibility to infection and disease, as well as the body’s ability to fight them
• Impaired ability for the body to heal wounds
• Chronic diarrhea, which if left untreated, can cause dehydration and severe complications
• Slowed or abnormal growth and development, affecting both physical and neuropsychological functions
• Inhibited sexual maturation
• Pregnancy complications, including low birth weight of baby, premature delivery, and congenital anomalies in the newborn
• Increased susceptibility to malaria and other infections

How is Zinc Deficiency Treated?

Zinc Deficiency is treated in the following manner:

• Recommending zinc supplements to raise the level of zinc in the body
• Improving diet, including treatment for eating disorders such as anorexia nervosa
• Undertaking treatment of diseases and conditions that may lead to decreased levels of zinc in the body

How can Zinc Deficiency be Prevented?

Zinc Deficiency may be prevented by:

• Maintaining a healthy and well-balanced diet that includes sufficient amounts of zinc. Animal products, such as red meat, poultry, and milk, are rich sources of zinc
• Seeking early treatment for diseases, conditions, and disorders that may lead to Zinc Deficiency

If Zinc Deficiency occurs due to acrodermatitis enteropathica, then there are no specific methods or guidelines to prevent the condition, since it is caused by genetic factors.

• Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
• If there is a family history of the condition, then genetic counseling will help assess risks before planning for a child
• Active research is currently being performed to explore the possibilities for treatment and prevention of inherited and acquired genetic disorders such as acrodermatitis enteropathica

Regular medical screening at periodic intervals with tests, scans, and physical examinations are recommended.

What is the Prognosis of Zinc Deficiency? (Outcomes/Resolutions)

The prognosis of Zinc Deficiency is generally positive with suitable treatment. The outcome of the condition may be the following:

• Elimination of symptoms following appropriate treatment
• Prolonged signs and symptoms without adequate treatment, which may lead to additional complications. In rare and severe cases, these complications may be fatal

Additional and Relevant Useful Information for Zinc Deficiency:

Zinc intake should not exceed 25 mg per day, as excessive zinc in the body can also result in additional problems/abnormalities.