Medications That May Deplete ZINC
Zinc supports immune function, wound healing, taste and smell, and many enzyme systems. See which medications carry a reported association, how strong the evidence is, and what to discuss with your pharmacist.
Zinc supports immune function, wound healing, taste and smell, and many enzyme systems.
Common food sources: Meat and shellfish (especially oysters); Beans and lentils; Nuts and seeds; Whole grains.
Ask about zinc status if you take an associated medication long-term and notice slow wound healing, frequent infections, or taste changes — a clinician can decide whether testing or an empiric plan makes sense.
Caution: Keep zinc doses moderate and time them away from interacting medications — ask your pharmacist.
HelloPharmacist pharmacist-reviewed education. The medication records below are licensed clinical data, shown as published.
Deep dive: Zinc — uses, safety & drug interactions
Medications associated with ZINC depletion
Each record is shown as published in our licensed clinical database. Open a medication for its full nutrient report.
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Amoxicillin, Omeprazole Magnesium, Rifabutin
Insignificant DepletionBrand names include Talicia
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Omeprazole is the piece of this combination that gets the most attention when it comes to zinc, a mineral your body uses for immune function, wound healing, and keeping your senses of taste and smell sharp. By reducing stomach acid, omeprazole may make it slightly harder for zinc from supplements to be absorbed in the gut, though zinc from food sources does not seem to be affected the same way. The good news is that a meaningful drop in zinc levels from this has not been reported, so most people taking this regimen do not need to worry or add a zinc supplement. If you have any concerns, your pharmacist or doctor can help you figure out whether monitoring makes sense for you.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Full nutrient report for Amoxicillin, Omeprazole Magnesium, Rifabutin →
Amphotericin, Tetracycline
Insignificant DepletionBrand names include Mysteclin-F
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc helps your immune system work and keeps your skin and wound healing on track. Tetracyclines like tetracycline and minocycline can latch onto zinc in your gut and form a complex that slightly reduces how much zinc your body absorbs from food or supplements. That said, for most people on a short course of treatment, this is not a meaningful concern. If you happen to be taking a zinc supplement alongside a tetracycline, spacing them a couple of hours apart is a simple way to avoid that interaction, and your pharmacist can help you figure out the best timing.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Azelastine Hydrochloride, Fluticasone Propionate
Insignificant DepletionBrand names include Dymista
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system, wound healing, and your sense of taste and smell. The fluticasone in this nasal spray is a corticosteroid, and there is some research suggesting corticosteroids can nudge zinc levels down slightly, possibly by shifting zinc from the bloodstream into body tissues or by nudging the kidneys to excrete a little more of it. Because this is an inhaled or nasal corticosteroid used in very small doses locally, any effect on zinc is considered insignificant for most people, so routine zinc supplements are not something most users need to think about. If you have other reasons to be concerned about your zinc levels, a quick conversation with your pharmacist or doctor is the right move.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Full nutrient report for Azelastine Hydrochloride, Fluticasone Propionate →
Bazedoxifene Acetate, Conjugated Estrogens
Insignificant DepletionBrand names include Duavee
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of enzymes throughout the body and helps support immune function, wound healing, and protein building. With this combination hormone therapy, the estrogen component may actually pull more zinc into body tissues to support protein synthesis, which can shift zinc out of the bloodstream rather than deplete it from the body overall. Research is genuinely mixed on whether blood zinc levels go up, down, or stay the same. This is rated as an insignificant depletion, so for most people taking this medication, no special action is needed. Still, if you have any concerns about your zinc status, your pharmacist or doctor is a great first stop.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Bazedoxifene Acetate, Conjugated Estrogens →
Beclometasone dipropionate
Insignificant DepletionBrand names include Becotide
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and many enzymes depend on every day. Beclometasone is an inhaled corticosteroid, and corticosteroids can interact with the body's hormonal axis in a way that may cause a small dip in circulating zinc levels, possibly by nudging zinc to shift into body tissues or by nudging the kidneys to excrete a little more of it. That said, this is rated as an insignificant depletion, so for most people using beclometasone there is no practical concern and no routine need for a zinc supplement. If you already have risk factors for low zinc, such as a poor diet or a condition affecting nutrient absorption, it is worth mentioning this to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Beclomethasone
Insignificant DepletionBrand names include Beclovent, Vanceril
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc supports your immune system, wound healing, and helps enzymes throughout the body do their jobs. Inhaled corticosteroids like beclomethasone can affect the body's hormone signaling system in a way that may shift zinc levels slightly, either by moving zinc into tissues or nudging the kidneys to release a bit more of it in urine. That said, this is rated as an insignificant depletion, meaning for most people using beclomethasone the effect is too small to be a real concern. If you have other reasons to worry about zinc levels, it's worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Beclomethasone dipropionate
Insignificant DepletionBrand names include Qvar, QNASL
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Beclomethasone is an inhaled corticosteroid, and corticosteroids as a class can interfere with how the body regulates zinc, possibly shifting it out of the bloodstream and into tissues, or nudging the kidneys to excrete a little more. That said, this interaction is rated insignificant for most people, so routine zinc supplements are not considered necessary. If you have other reasons to worry about your zinc levels, bring it up with your pharmacist or doctor just to be safe.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Betamethasone
Insignificant DepletionBrand names include Celestone, Diprolene AF, Diprosone
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and many enzymes depend on every day. Betamethasone is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down slightly, possibly by shifting zinc from the bloodstream into body tissues or by causing the kidneys to release a little more of it in urine. That said, the evidence for this is rated insignificant, meaning most people using betamethasone do not need to take a zinc supplement because of it. If you have other reasons to be concerned about your zinc levels, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Betamethasone Dipropionate
Insignificant DepletionBrand names include Sernivo
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, skin healing, and hundreds of body enzymes depend on. Betamethasone dipropionate is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down, possibly by shifting zinc out of the bloodstream and into body tissues, or by causing the kidneys to release a bit more of it in the urine. That said, the evidence for this is rated insignificant, so most people using this medication do not need to take a zinc supplement. If you have other reasons your zinc might already be low, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Betamethasone Dipropionate, Calcipotriene
Insignificant DepletionBrand names include Enstilar, Wynzora
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system work and keeps your skin and wound healing on track. Betamethasone dipropionate is a corticosteroid, and there is some research suggesting that corticosteroids can shift zinc levels, possibly by causing the body to move zinc into tissues or nudge the kidneys to release a little more of it in urine. That said, this combination product is applied to the skin, so any systemic effect is much smaller than with oral steroids, and the evidence rating here is insignificant. Most people using this medication do not need to worry about zinc, but if you have other reasons your zinc might already be low, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Full nutrient report for Betamethasone Dipropionate, Calcipotriene →
Betamethasone valerate
Insignificant DepletionBrand names include Luxiq
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, skin healing, and many enzymes depend on every day. Betamethasone valerate is a corticosteroid, and corticosteroids can nudge zinc levels down slightly, possibly by shifting zinc out of the bloodstream and into body tissues, or by causing the kidneys to release a bit more of it in the urine. That said, this effect is rated insignificant for most people, so routine zinc supplementation is not expected to be necessary. If you have other reasons your zinc might already be low, it is worth mentioning that to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Budesonide
Insignificant DepletionBrand names include Entocort EC, Pulmicort, Uceris
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system work and supports wound healing, so it is worth knowing that budesonide, like other corticosteroids, may cause a modest shift in zinc levels. Researchers think this happens partly because the hormone-signaling pathway that corticosteroids affect also plays a role in how the body manages zinc, possibly moving it from the bloodstream into tissues or nudging the kidneys to excrete a little more of it. That said, the evidence rates this as insignificant for most people, meaning routine zinc supplements are not considered necessary. If you have other reasons to be at risk for low zinc, it is worth mentioning that to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Captopril
Insignificant DepletionBrand names include Capoten, Acepril
Some data suggest captopril increases urinary zinc excretion, possibly due to chelation of zinc by sulfhydryl groups. Some studies have found a link between captopril, low zinc levels, and taste loss which can be reversed with zinc supplements, while others have not. Differences may be due to dose and duration of captopril therapy - increased zinc losses seem more likely with high captopril doses (greater than 150 mg/day) taken for several weeks or months. Routine zinc supplements aren't necessary with captopril. Monitor for symptoms of zinc depletion in patients on high doses of captopril for prolonged periods, especially if they have other risk factors. Significant zinc depletion doesn't occur with enalapril, and is unlikely with other ACE inhibitors.
Zinc is a mineral your body uses for immune function, wound healing, and even your sense of taste. Captopril contains a sulfhydryl group, a particular chemical structure that can bind to zinc in the body and nudge the kidneys to flush a bit more of it out in the urine. For most people on typical doses, this is unlikely to cause any real problem, and routine zinc supplements are not considered necessary. That said, if you take higher doses of captopril for months on end and notice a change in taste, it is worth mentioning to your pharmacist or doctor.
References (8)
- Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalapril on zinc metabolism in hypertensive patients. J Am Coll Nutr 1998;17:75-8. PubMed
- Golik A, Modai D, Averbukh Z, et al. Zinc metabolism in patients treated with captopril versus enalapril. Metabolism 1990;39:665-7.
- Abu-Hamdan DK, Desai H, Sondheimer J, et al. Taste acuity and zinc metabolism in captopril-treated hypertensive male patients. Am J Hypertens 1988;1:303S-8S. PubMed
- Smit AJ, Hoorntje SJ, Donker AJ. Zinc deficiency during captopril treatment. Nephron 1983;34:196-7. DOI
- Zumkley H, Bertram HP, Vetter H, et al. Zinc metabolism during captopril treatment. Horm Metab Res 1985;17;256-8. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- McNeil JJ, Anderson A, Christophidis N, et al. Taste loss associated with oral captopril treatment. BMJ 1979;448:1555-6.
- O'Connor DT, Strause L, Saltman P, et al. Serum zinc is unaffected by effective captopril treatment of hypertension. J Clin Hypertens 1987;3:405-8.
Captopril, Hydrochlorothiazide
Insignificant DepletionBrand names include Capozide, Acezide
Some data suggest captopril increases urinary zinc excretion, possibly due to chelation of zinc by sulfhydryl groups. Some studies have found a link between captopril, low zinc levels, and taste loss which can be reversed with zinc supplements, while others have not. Differences may be due to dose and duration of captopril therapy - increased zinc losses seem more likely with high captopril doses (greater than 150 mg/day) taken for several weeks or months. Routine zinc supplements aren't necessary with captopril. Monitor for symptoms of zinc depletion in patients on high doses of captopril for prolonged periods, especially if they have other risk factors. Significant zinc depletion doesn't occur with enalapril, and is unlikely with other ACE inhibitors.
Zinc is a mineral your body uses for immune function, wound healing, and keeping your sense of taste working normally. Captopril contains a sulfhydryl group, a particular chemical structure that can bind to zinc in the body and carry more of it out through the urine than usual, though this effect seems most relevant at higher doses taken for many months. For the vast majority of people on a typical captopril dose, this is not a practical concern and a zinc supplement is not needed. If you are on a high dose long-term and notice any changes in taste, that is worth mentioning to your pharmacist or doctor.
References (8)
- Golik A, Zaidenstein R, Dishi V, et al. Effects of captopril and enalapril on zinc metabolism in hypertensive patients. J Am Coll Nutr 1998;17:75-8. PubMed
- Golik A, Modai D, Averbukh Z, et al. Zinc metabolism in patients treated with captopril versus enalapril. Metabolism 1990;39:665-7.
- Abu-Hamdan DK, Desai H, Sondheimer J, et al. Taste acuity and zinc metabolism in captopril-treated hypertensive male patients. Am J Hypertens 1988;1:303S-8S. PubMed
- Smit AJ, Hoorntje SJ, Donker AJ. Zinc deficiency during captopril treatment. Nephron 1983;34:196-7. DOI
- Zumkley H, Bertram HP, Vetter H, et al. Zinc metabolism during captopril treatment. Horm Metab Res 1985;17;256-8. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- McNeil JJ, Anderson A, Christophidis N, et al. Taste loss associated with oral captopril treatment. BMJ 1979;448:1555-6.
- O'Connor DT, Strause L, Saltman P, et al. Serum zinc is unaffected by effective captopril treatment of hypertension. J Clin Hypertens 1987;3:405-8.
Chlortetracycline
Insignificant DepletionBrand names include Aureomycin
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc helps your immune system work and keeps your skin and wound healing on track. Chlortetracycline, like other tetracycline antibiotics, can latch onto zinc in the gut and form a bound complex, which may reduce how much zinc your body absorbs from food or supplements. That said, the evidence rates this as insignificant for most people, so unless you have other reasons to worry about low zinc or you are on this antibiotic for several months, there is generally nothing extra you need to do. If you have concerns, your pharmacist is a good first stop.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Cholestyramine
Insignificant DepletionBrand names include Questran
Limited animal research suggests cholestyramine might reduce zinc absorption; however, this is not likely to be clinically significant.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Cholestyramine works by binding substances in the gut to carry them out of the body, and there is some thought it could lightly interfere with zinc absorption the same way. That said, this comes mostly from animal studies, and the effect is considered insignificant for most people taking the medication. No action is needed for the average patient, but if you have concerns about your zinc levels, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (1)
- Watkins DW, Khalafi R, Cassidy MM, Vahouny GV. Alterations in calcium, magnesium, iron, and zinc metabolism by dietary cholestyramine. Dig Dis Sci 1985;30:477-82.. PubMed
Cimetidine
Insignificant DepletionBrand names include Tagamet HB, Tagamet, Cimetidine Injection
Limited data suggest inhibition of gastric acid secretion by H2-blockers might reduce absorption of zinc from supplements, but clinically significant zinc depletion hasn't been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Cimetidine works by reducing stomach acid, and there is some thought that lower acid levels could slightly slow how well zinc from supplements gets absorbed in the gut. That said, real-world zinc deficiency from cimetidine has not been reported, so this is considered an insignificant concern for most people. No action is needed, but if you take cimetidine long-term and have questions about your zinc intake, your pharmacist or doctor is a great person to ask.
References (1)
- Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr 1991;10:372. PubMed
Cinoxacin
Insignificant DepletionBrand names include Cinobac
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc is a mineral your immune system, wound healing, and dozens of enzymes depend on every day. Cinoxacin belongs to the quinolone antibiotic family, and these drugs can latch onto zinc in the gut, forming a complex that makes both the drug and the zinc a little harder to absorb. That said, for a typical short antibiotic course, this is not considered enough to meaningfully lower your zinc levels, and most people do not need any extra zinc because of it. If you happen to be taking a zinc supplement for another reason, just ask your pharmacist about spacing it apart from your dose.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Ciprofloxacin
Insignificant DepletionBrand names include Cipro, Ciprobay, Cipro XR
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc helps your immune system, wound healing, and hundreds of enzymes work properly throughout the body. Ciprofloxacin can latch onto zinc in your gut and form a paired complex, which may reduce how much zinc your body absorbs during a course of treatment. That said, for most people taking a standard antibiotic course, this is not enough to cause a real shortage, and no extra zinc is needed. If you happen to be taking a zinc supplement for another reason, just ask your pharmacist about spacing the two apart to avoid that interaction.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Cisplatin
Insignificant DepletionBrand names include Platinol-AQ
Limited research suggests that an acute increase in urinary zinc excretion occurs after a dose of cisplatin. Plasma zinc levels are sometimes reduced, but usually return to normal within 24-48 hours. Supplements aren't routinely necessary.
Zinc helps your immune system, wound healing, and many enzymes throughout the body, so keeping levels steady matters. Cisplatin appears to cause the kidneys to spill a bit more zinc into the urine shortly after each dose, which can nudge blood zinc levels down temporarily. The good news is that levels typically bounce back on their own within a day or two, and the evidence rates this as insignificant for most patients. Zinc supplements are not routinely recommended here, but if you have concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (2)
- Sweeney JD, Ziegler P, Pruet C, Spaulding MB. Hyperzincuria and hypozincemia in patients treated with cisplatin. Clin Nephrol 1982;17:254-7. PubMed
- Zumkley H, Bertram HP, Preusser P, et al. Renal excretion and magnesium and trace elements during cisplatin treatment. Clin Nephrol 1982;17:254.
Clinafloxacin
Insignificant DepletionClinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc helps your immune system, wound healing, and everyday cell function, so it is worth understanding this one. Clinafloxacin belongs to the quinolone antibiotic family, and these drugs can latch onto zinc in your gut and form a bound complex, which slightly reduces how much zinc your body absorbs from food or supplements taken at the same time. That said, a short antibiotic course is very unlikely to meaningfully dip your zinc levels, and for most people this is considered insignificant. If you happen to take a zinc supplement for another reason, just ask your pharmacist about timing the two apart.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Clobetasol
Insignificant DepletionBrand names include Temovate, Clobex
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and cell growth all depend on. Clobetasol is a potent topical corticosteroid, and corticosteroids as a class can mildly influence zinc levels, possibly by shifting zinc from the bloodstream into body tissues or nudging the kidneys to release a bit more of it in urine. That said, this interaction is rated insignificant, meaning most people using clobetasol do not need to take a zinc supplement or worry about this. If you have other reasons your zinc might already be low, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Conjugated Estrogens
Insignificant DepletionBrand names include Premarin, Cenestin, Enjuvia
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of enzyme reactions and helps support immune function and wound healing. With conjugated estrogens, the picture is genuinely mixed: some research shows a small drop in the zinc that circulates in the blood, while other studies show no change at all. One theory is that estrogens boost protein-building activity in the body, so tissues take up and hold onto more zinc, which may simply shift it out of the bloodstream rather than truly deplete it. Given that the evidence is conflicting and the overall rating is insignificant, most people taking this medication do not need to worry or add a zinc supplement, but feel free to bring it up with your pharmacist if you are curious.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Conjugated Estrogens, Medroxyprogesterone Acetate
Insignificant DepletionBrand names include Prempro, Premplus
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports immune function and wound healing. With estrogen-containing medications like this one, the picture is actually a bit complicated: estrogens may shift zinc from the bloodstream into body tissues (where it gets used for building proteins), rather than truly depleting it. Research is mixed, with some studies showing lower blood zinc levels and others showing no change at all. Because the overall evidence points to an insignificant effect, most people on this medication do not need to worry about zinc or take a supplement, but your pharmacist or doctor can address any specific concerns.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Conjugated Estrogens, Medroxyprogesterone Acetate →
Conjugated Estrogens, Meprobamate
Insignificant DepletionBrand names include PMB 200, PMB 400
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc is a mineral your body uses for immune function, wound healing, and as a helper molecule in hundreds of chemical reactions. Estrogens like conjugated estrogens have a complicated relationship with zinc: they may shift where zinc goes in the body rather than simply draining it, possibly pulling more of it into tissues for protein building while also lowering the protein that carries zinc in the blood. Research is genuinely mixed, with some studies showing lower blood zinc levels and others showing no change at all. Given the insignificant rating, most people taking this medication do not need to do anything about this, but if you have questions your pharmacist is a great first stop.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Conjugated Estrogens, Meprobamate →
Conjugated Estrogens, Methyltestosterone
Insignificant DepletionBrand names include Premarin with Methyltestosterone
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc is a mineral your body uses for immune defense, wound healing, and keeping hundreds of enzymes running properly. With conjugated estrogens, the picture is genuinely mixed: estrogen may shift where zinc goes in the body rather than simply draining it away, since it can boost protein-building activity that pulls zinc into tissues, while also lowering albumin, a blood protein that normally ferries zinc through the bloodstream. Because the research is conflicting and supplements are not considered necessary for most people on this medication, there is no action needed for the average patient, though you are always welcome to bring it up with your pharmacist if you have specific concerns.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Conjugated Estrogens, Methyltestosterone →
Cortisone Acetate
Insignificant DepletionBrand names include Cortone, Cortisone Tablets
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Cortisone acetate may nudge zinc levels down slightly, possibly because the drug shifts zinc out of the bloodstream and into body tissues, or in some cases causes a little more of it to leave through the urine. That said, the evidence rates this as insignificant for most people, meaning routine zinc supplements are not considered necessary. If you have other reasons you might already be low on zinc, it is worth mentioning that to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Cyproterone Acetate, Ethinyl Estradiol
Insignificant DepletionBrand names include Diane-35, Dianette
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports a healthy immune system. The estrogen component of this pill has a complicated relationship with zinc: some studies show a slight dip in blood zinc levels, while others show no change at all, and there is no good evidence that the medication flushes zinc out through the kidneys. In fact, estrogen may actually pull more zinc into body tissues, which could offset any drop in the bloodstream. Because the overall effect is considered insignificant, most people taking this medication do not need to worry about zinc or add a supplement, but mention it to your pharmacist if you have any concerns.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Cyproterone Acetate, Ethinyl Estradiol →
Demeclocycline
Insignificant DepletionBrand names include Declomycin
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc helps your immune system, wound healing, and your sense of taste and smell. Demeclocycline, like other tetracycline antibiotics, can bind to zinc in the gut and form a complex that makes both harder to absorb. That said, the evidence rates this as insignificant for most people, meaning that getting less zinc from your diet while on this antibiotic is unlikely to matter unless you already have risk factors for zinc deficiency and are taking the medication for several months. If either of those situations applies to you, a quick conversation with your pharmacist or doctor is all that is needed.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Desogestrel, Ethinyl Estradiol
Insignificant DepletionBrand names include Ortho-Cept 28, Ortho-Cept 21, Marvelon 21
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body power hundreds of enzymes and supports immune function, wound healing, and protein building. With estrogen-containing pills like this one, the picture is honestly mixed: some studies show a slight dip in zinc levels in the blood, while others show no change at all. One theory is that estrogens prompt your tissues to take up and hold onto more zinc for protein synthesis, which may shift where zinc sits in the body rather than truly depleting it. Because the evidence is conflicting and a supplement is not needed for most people on this medication, there is nothing you need to act on right now, though your pharmacist is always a good person to check in with if you have questions.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Dexamethasone
Insignificant DepletionBrand names include Decadron, Hexadrol, Dexone
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Dexamethasone is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down, possibly by shifting zinc from the bloodstream into body tissues or by causing the kidneys to lose a little more of it in urine. That said, the evidence here is rated insignificant, meaning most people taking dexamethasone do not need a zinc supplement because of it. If you have other reasons your zinc might already be low, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Dexlansoprazole
Insignificant DepletionBrand names include Dexilant Solutab
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your body uses for immune function, wound healing, and keeping your senses of taste and smell sharp. Dexlansoprazole lowers stomach acid, and there is some evidence that less acid in the stomach can slightly reduce how well zinc from supplements gets absorbed in the gut, though zinc from food does not appear to be affected the same way. The good news here is that this is rated as an insignificant depletion, meaning real-world zinc deficiency from this medication has not been reported. Most people taking dexlansoprazole long-term do not need to take any special action, but if you have concerns, your pharmacist or doctor is the right person to ask.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Doripenem
Insignificant DepletionBrand names include Doribax
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc helps your immune system, wound healing, and sense of taste, so it plays a quiet but important role day to day. Doripenem is a carbapenem antibiotic, not a quinolone, but the class overlap in research suggests that some antibiotics in related families may bind to zinc in the gut, making a little less of it available for absorption. That said, the evidence here is rated insignificant, meaning a short antibiotic course like doripenem is very unlikely to cause any real drop in your zinc levels. Most people do not need to take any extra zinc because of this medication, but if you already take a zinc supplement for another reason, mention it to your pharmacist just to make sure the timing is right.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Drospirenone, Estetrol
Insignificant DepletionBrand names include Nextstellis
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body make proteins, supports your immune system, and acts as a helper molecule for dozens of enzymes. The estrogen component in this pill may shift where zinc goes in the body: estrogen can boost protein-building activity, which pulls more zinc into tissues, and it may also affect how much zinc is carried in the blood by reducing certain carrier proteins. Research is genuinely mixed, though, with some studies showing lower zinc levels and others showing no change at all. Given that this is rated as an insignificant depletion, most people taking this medication do not need to worry about it or add a zinc supplement, but if you have questions your pharmacist is a great first stop.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Drospirenone, Ethinyl Estradiol
Insignificant DepletionBrand names include Yasmin, Gianvi, Angeliq
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and keeps your immune system working properly. The estrogen in this birth control pill has a complicated relationship with zinc: it may shift where zinc lives in your body, pulling more of it into tissues for protein-building, while also lowering the blood protein that carries zinc around. The net result in most people appears to be a wash, and the evidence here is rated insignificant. Most women taking this pill do not need a zinc supplement, but if you have questions about your nutrient levels, your pharmacist or doctor is a good place to start.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
drospirenone, ethinyl estradiol, levomefolate
Insignificant DepletionBrand names include Beyaz
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps power hundreds of enzymes in your body and supports immune function, wound healing, and cell growth. The estrogen in this pill may shift how zinc is distributed, possibly pulling more of it into body tissues for protein building rather than leaving it circulating in the blood. That said, studies on estrogens and zinc levels have gone back and forth, and there is no good evidence this pill flushes zinc out through the kidneys. Given the insignificant depletion rating here, most people taking this medication do not need to worry about zinc levels or consider a supplement, but feel free to bring it up with your pharmacist or doctor if you have concerns.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for drospirenone, ethinyl estradiol, levomefolate →
Enoxacin
Insignificant DepletionBrand names include Penetrex
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc helps your immune system, wound healing, and sense of taste, so it is worth knowing that enoxacin, like other quinolone antibiotics, can bind to zinc in your gut and slightly reduce how much of it gets absorbed. That said, a short course of this antibiotic is very unlikely to meaningfully lower your zinc levels, and for most people no extra zinc is needed. If you happen to be taking a zinc supplement for another reason, just ask your pharmacist about spacing the two apart to avoid any interaction.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Esomeprazole
Insignificant DepletionBrand names include Nexium
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Esomeprazole works by dialing down stomach acid, and there is some evidence that lower acid levels in the gut can make it slightly harder to absorb zinc from supplements (though food sources of zinc seem to be absorbed just fine). That said, actual zinc deficiency from this medication has not been reported in practice, so for most people this is not something to worry about. If you have been on esomeprazole for a long time and have questions, it is worth a quick chat with your pharmacist or doctor.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Esomeprazole Magnesium
Insignificant DepletionBrand names include Nexium 24hr
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Esomeprazole works by turning down stomach acid production, and there is some early evidence that lower acid levels in the stomach may slightly reduce how well zinc from supplements gets absorbed. Interestingly, zinc from food does not appear to be affected in the same way. Because no real-world cases of zinc deficiency from this medication have been reported, this is considered an insignificant concern for most people, and no routine action is needed. That said, if you have questions about your zinc intake, it is always fine to bring them up with your pharmacist or doctor.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Esomeprazole Strontium
Insignificant DepletionLimited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc plays a role in immune function, wound healing, and keeping your senses of taste and smell sharp. Esomeprazole strontium lowers stomach acid, and there is some evidence that this can slightly reduce how well zinc from supplements is absorbed in the gut, though it does not appear to affect zinc you get from food. That said, real-world zinc deficiency from this medication has not been reported, so this is considered insignificant for most people. No action is needed for most patients, but if you have concerns, it is always fine to bring it up with your pharmacist or doctor.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Esomeprazole, Naproxen
Insignificant DepletionBrand names include Vimovo
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste depend on. Because esomeprazole lowers the acid in your stomach, it may slightly reduce how well your body absorbs zinc from supplements, though your body seems to pull zinc from food just fine regardless. Real-world zinc deficiency from this combination has not been reported, so for most people this is not something to worry about. If you take zinc supplements and have concerns, your pharmacist is a good first stop.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Esterified Estrogens
Insignificant DepletionBrand names include Menest, Estratab
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body make enzymes, heal tissue, and support your immune system. With esterified estrogens, the picture is honestly a mixed one: some studies show a slight dip in blood zinc levels, others show no change at all, and there is no good evidence that these hormones cause your kidneys to flush extra zinc out. One reason levels might shift is that estrogens boost protein-building in the body, so tissues actually hold onto more zinc rather than losing it. Given the insignificant rating here, most people taking this medication do not need a zinc supplement, but if you have questions about your nutrition, your pharmacist or doctor is a great place to start.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Esterified Estrogens, Methyltestosterone
Insignificant DepletionBrand names include Estratest
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc is a mineral your body uses to power hundreds of enzymes and support immune function, so keeping levels in a healthy range matters. With estrogen-containing medications like this one, the picture is genuinely mixed: some research shows a modest dip in zinc carried in the bloodstream, while other studies show no change at all. One reason levels might shift is that estrogens can boost protein-building activity, which pulls more zinc into body tissues rather than losing it through the kidneys. Because the evidence is conflicting and the overall rating here is insignificant, most people taking this medication do not need a zinc supplement, but if you are curious about your levels, it is always worth a quick chat with your pharmacist or doctor.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Esterified Estrogens, Methyltestosterone →
Estradiol
Insignificant DepletionBrand names include Estrace, Gynodiol, Vagifem
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a key role in hundreds of enzymes throughout the body and helps support immune function and tissue repair. With estradiol, the picture is genuinely mixed: some research suggests estrogen may shift zinc away from the bloodstream and into body tissues, where it gets used for building proteins, while other studies show no change in zinc levels at all. Because the evidence is conflicting and any shift appears minor, most people taking estradiol do not need a zinc supplement. If you have concerns, your pharmacist or doctor is the right person to check in with.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Estradiol, Medroxyprogesterone
Insignificant DepletionBrand names include Divitren
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports immune function, wound healing, and cell growth. With estrogen-containing medications like these, the research is genuinely mixed: some studies show a modest dip in circulating zinc, while others show no change at all. One reason levels might shift is that estrogens can boost protein-building activity, so tissues pull in and hold onto more zinc, which actually means less may be lost. Given that this is rated an insignificant depletion, most people on this combination do not need a zinc supplement, but if you have questions about your diet or any symptoms, your pharmacist or doctor is a great starting point.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Estradiol, Norethindrone Acetate
Insignificant DepletionBrand names include Activella
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of enzyme reactions in the body, supporting everything from immune function to wound healing. With estrogen-containing hormones like this one, research is genuinely mixed: some studies have found slightly lower zinc levels in the blood, while others show no change at all. One reason levels might shift is that estrogens can boost protein building in tissues, which uses up more zinc internally, rather than the drug blocking absorption or flushing zinc out through the kidneys. Given that this is rated an insignificant depletion, most people on this medication do not need to worry or take a supplement, but if you have questions, your pharmacist or doctor is a good person to ask.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Estradiol, Norgestimate
Insignificant DepletionBrand names include Ortho-Prefest
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of enzyme reactions and supports immune function, wound healing, and normal cell growth. With estrogen-containing medications like this one, research on zinc levels is genuinely mixed: some studies show a small dip, others show no change at all. One theory is that estrogen encourages tissues to pull in and hold onto more zinc for protein building, which could shift zinc out of the bloodstream without actually depleting the body overall. Given the insignificant rating here, most people on this medication do not need to worry about zinc, but if you are curious whether monitoring makes sense for you personally, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Estradiol, Progesterone
Insignificant DepletionBrand names include Bijuvanda
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps power hundreds of enzymes throughout the body and supports immune function and cell repair. With estrogen-based therapy, the picture on zinc is genuinely mixed: some research shows a small drop in blood zinc levels, while other studies show no change at all. One reason levels might shift is that estrogen can boost protein building in tissues, which draws zinc in as a working partner for enzymes rather than losing it through excretion. Given that the evidence is conflicting and any effect appears insignificant for most people, routine zinc supplementation is not considered necessary, but if you have questions about your personal nutritional status, your pharmacist or doctor is the right person to ask.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Estrogen
Insignificant DepletionResearch on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of enzymes and helps support immune function, wound healing, and normal metabolism. With estrogen, the picture is genuinely mixed: some research suggests estrogen may shift how zinc is distributed in the body, partly because estrogen boosts protein-building activity and tissues may hold onto more zinc as a result, but studies do not consistently show an actual drop in zinc levels overall. Given the insignificant rating here, most people taking estrogen have no reason to worry about this or reach for a zinc supplement. If you still have questions, a quick conversation with your pharmacist is always a reasonable step.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Estrone
Insignificant DepletionBrand names include Ortho-Est
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps the body build proteins, support immune function, and power hundreds of enzymes. With estrone, the picture is genuinely mixed: some research shows a small dip in circulating zinc, while other studies show no change at all. One theory is that estrogen's natural push toward protein-building may draw zinc into tissues, slightly shifting where it sits in the body rather than truly depleting it. Given that the evidence rates this as insignificant, most people taking estrone do not need to worry about their zinc levels, but if you have questions about your diet or any symptoms, your pharmacist or doctor is a good first stop.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Estropipate
Insignificant DepletionBrand names include Ogen, Ortho EST
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc is a mineral your body uses to power hundreds of enzymes and support immune function, and the research on whether estrogens like estropipate actually lower zinc levels is genuinely mixed. One theory is that estrogen encourages tissues to take up and hold onto more zinc for protein building, which could nudge blood levels down slightly, but studies are split and there is no good evidence this medication causes more zinc to be flushed out through the kidneys. The evidence rating here is insignificant, meaning most people taking estropipate have nothing to worry about on this front. If you are still curious, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethiny Estradiol, Levonorgestrel
Insignificant DepletionBrand names include Logynon, Microgynon 30 ED
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body make enzymes, heal tissue, and keep the immune system running. Birth control pills containing estrogen like this one can slightly shift how zinc moves around in the body, possibly pulling more of it into tissues rather than leaving it circulating in the blood, though research on whether this actually lowers zinc levels is genuinely mixed. Given that this is rated an insignificant depletion, most people on this pill do not need to do anything differently. If you are still curious, a quick chat with your pharmacist can put your mind at ease.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethinyl Estradiol
Insignificant DepletionBrand names include Estinyl
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body power hundreds of enzymes and supports immune function, wound healing, and protein building. With ethinyl estradiol, the picture is genuinely mixed: estrogen may shift where zinc sits in the body (more gets taken up by tissues for protein-building work) rather than simply draining it, and studies have not shown that more zinc gets flushed out through the kidneys. Because the research goes back and forth with no clear harm signal, this is rated as an insignificant depletion, meaning most people on this medication do not need to take a zinc supplement. If you have concerns, a quick word with your pharmacist or doctor can give you personalized guidance.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethinyl Estradiol, Desogestrel
Insignificant DepletionBrand names include Linessa, Apri, Reclipsen
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports a healthy immune system, so it is worth understanding where it stands with this pill. The estrogen in this contraceptive may shift how zinc moves around in your body: it can boost protein-building activity, which pulls more zinc into tissues, but research on whether blood zinc levels actually drop is genuinely mixed, with some studies showing a small decrease and others showing no change at all. Given that this is rated an insignificant depletion, most people taking this combination pill have nothing to worry about and do not need a zinc supplement. If you are curious or have concerns, a quick chat with your pharmacist is always a good idea.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethinyl Estradiol, Drospirenone
Insignificant DepletionBrand names include Yaz
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports immune function, wound healing, and cell growth. With birth control pills containing estrogen, the picture on zinc is actually mixed: some studies show a slight dip in blood zinc levels, while others show no change at all. One theory is that estrogen nudges more zinc into body tissues rather than flushing it out. Because the effect appears small and inconsistent, a zinc supplement is not considered necessary for most people on this medication, though it is always fine to bring it up with your pharmacist if you have questions.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethinyl Estradiol, Ethynodiol Diacetate
Insignificant DepletionBrand names include Demulen 1/35, Zovia 1/35, Demulen Compack
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body build proteins, heal tissue, and keep your immune system working. This oral contraceptive contains estrogen, which may actually pull more zinc into your body's tissues for protein-building rather than flushing it out, so blood zinc levels could read a little lower even if your overall zinc isn't really depleted. The research on this is mixed, and for most people taking this medication it is not a meaningful concern. No action is needed for the average patient, but if you ever have questions about your nutrition, your pharmacist or doctor is a great person to ask.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Ethinyl Estradiol, Ethynodiol Diacetate →
Ethinyl estradiol, Levonogestrel
Insignificant DepletionBrand names include Lybrel
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body heal wounds, support your immune system, and keep hundreds of enzymes running properly. The research on whether combination birth control pills like this one actually lower zinc levels in the blood is genuinely mixed: some studies show a modest drop, others show no change at all. One theory is that estrogen prompts your tissues to take up and hold onto more zinc, which could shift it out of the bloodstream rather than truly depleting it from the body. Because the overall effect is considered insignificant, most people on this pill do not need to take a zinc supplement, but if you have questions your pharmacist is a great place to start.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethinyl Estradiol, Levonorgestrel
Insignificant DepletionBrand names include Levlite 28, Tri-Levlen 21, Tri-Levlen 28
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body heal wounds, support the immune system, and keep hundreds of enzymes running properly. Birth control pills containing estrogen may shift how zinc moves through your body: estrogen can increase how much zinc gets taken up and stored in tissues, which may slightly lower the amount circulating in your blood, though research on this is genuinely mixed and some studies show no change at all. Given that this interaction is rated as insignificant, most people on the pill do not need to worry about zinc or take a supplement for this reason. If you have specific concerns, your pharmacist or doctor is a good person to ask.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Ethinyl Estradiol, Levonorgestrel →
Ethinyl Estradiol, Norethindrone
Insignificant DepletionBrand names include Femhrt, Loestrin 21, Ovcon 35 21
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports immune function, wound healing, and cell growth. With combination birth control pills like this one, the picture on zinc is genuinely mixed: estrogen may shift where zinc is distributed in the body, pulling more of it into tissues for protein building, which could slightly lower the amount measured in the blood, but this does not appear to mean your overall zinc supply is actually reduced. Because the research is conflicting and supplements are generally considered unnecessary for most people on this medication, there is no action most users need to take, though your pharmacist is always a good person to check in with if you have questions.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethinyl Estradiol, Norethindrone, Ferrous Fumarate
Insignificant DepletionBrand names include Estrostep Fe, Loestrin Fe, Microgestin FE
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body make enzymes, heal tissue, and keep your immune system running. The estrogen component of this pill may shift how zinc moves around in your body, possibly pulling more of it into your tissues rather than leaving it circulating in your blood, but research on this is genuinely mixed and some studies show no change at all. Because the overall effect is considered insignificant, most people on this pill do not need a zinc supplement. If you are curious whether this applies to you, a quick conversation with your pharmacist is all it takes.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Ethinyl Estradiol, Norethindrone, Ferrous Fumarate →
Ethinyl Estradiol, Norgestimate
Insignificant DepletionBrand names include Ortho Tri-Cyclen 28, Ortho Tri-Cyclen Lo, Ortho-Cyclen
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body with immune function, wound healing, and keeping enzymes running properly. The estrogen in this birth control pill may shift where zinc ends up in your body, pulling more of it into tissues rather than leaving it circulating in the blood, though some studies show no change at all. Because the research is genuinely mixed and supplements are not considered necessary for most people on this medication, this is more of a 'good to know' than a reason to act. If you are ever curious about your zinc status, it is worth a quick conversation with your pharmacist or doctor.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ethinyl Estradiol, Norgestrel
Insignificant DepletionBrand names include Ovral, Lo/Ovral, Cryselle
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of enzyme reactions in your body, supporting immune function, wound healing, and normal metabolism. Birth control pills containing estrogen like this one can shift where zinc ends up in your body: estrogen may nudge more zinc into tissues and cells rather than keeping it circulating in your blood, which can make blood zinc levels look a little lower on a lab test. Researchers have found conflicting results, though, with some studies showing no change at all. Given that this is rated an insignificant depletion, most people on this pill do not need to take a zinc supplement, but if you have concerns your pharmacist or doctor can take a closer look.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Etonogestrel, Ethinyl Estradiol
Insignificant DepletionBrand names include NuvaRing
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of body processes, from immune function to wound healing, and it also acts as a helper molecule for many enzymes throughout the body. The estrogen in this birth control may shift how zinc moves around in the body, partly because estrogen can encourage tissues to take up and hold onto zinc for protein-building tasks. Research on whether that actually lowers zinc levels in the blood is mixed, with some studies showing a small dip and others showing no change at all. Given that this is rated an insignificant depletion, most people using this contraceptive do not need to worry about their zinc status, but if you have questions your pharmacist is always a good starting point.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Famotidine
Insignificant DepletionBrand names include Pepcid, Pepcid AC, Famotidine Injection
Limited data suggest inhibition of gastric acid secretion by H2-blockers might reduce absorption of zinc from supplements, but clinically significant zinc depletion hasn't been reported.
Zinc helps your immune system, wound healing, and your sense of taste and smell, so it is worth knowing that famotidine, by dialing down stomach acid, may slightly reduce how well zinc from supplements gets absorbed in the gut. That said, no real-world cases of zinc deficiency caused by this have been documented, and the evidence here is quite limited. For most people taking famotidine, this is not something that requires action, but if you have concerns or take zinc supplements regularly, a quick conversation with your pharmacist can put your mind at ease.
References (1)
- Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr 1991;10:372. PubMed
Famotidine, Ibuprofen
Insignificant DepletionBrand names include Duexis
Limited data suggest inhibition of gastric acid secretion by H2-blockers might reduce absorption of zinc from supplements, but clinically significant zinc depletion hasn't been reported.
Zinc helps your immune system, wound healing, and normal taste and smell. Famotidine works by reducing stomach acid, and since stomach acid plays a small role in how zinc from supplements gets absorbed, there is some theoretical reason to think famotidine could modestly affect zinc levels. That said, actual zinc deficiency from taking an H2-blocker like famotidine has not been reported in clinical practice, so for most people this is not something to worry about. If you take famotidine long-term and have concerns, it is worth a quick chat with your pharmacist.
References (1)
- Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr 1991;10:372. PubMed
Fludrocortisone
Insignificant DepletionBrand names include Florinef Acetate
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Fludrocortisone is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down a little, possibly by shifting zinc out of the bloodstream and into body tissues, or by causing the kidneys to release slightly more of it in urine. That said, this is rated as an insignificant depletion, meaning routine zinc supplementation is not considered necessary for most people on this medication. If you have other reasons your zinc might already be low, it is worth mentioning to your pharmacist or doctor just to keep an eye on things.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Fluticasone
Insignificant DepletionBrand names include Flovent, Flonase, Flixotide
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system, wound healing, and keeping your senses of taste and smell working properly. Fluticasone is an inhaled or nasal corticosteroid, and corticosteroids as a class have been linked to modest reductions in zinc, possibly by shifting zinc out of the bloodstream and into body tissues, or in some cases by nudging the kidneys to release a little more of it in urine. That said, this interaction is rated as insignificant, meaning the effect is small enough that most people using fluticasone do not need to take a zinc supplement. If you have other reasons you might already be low in zinc, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Fluticasone Furoate, Umeclidinium, Vilanterol
Insignificant DepletionBrand names include Trelegy Ellipta
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and cell growth all depend on. The fluticasone furoate component of this inhaler is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down slightly, possibly by encouraging the kidneys to release a bit more of it in the urine or by shifting zinc from the blood into body tissues. Because this is an inhaled corticosteroid rather than a high-dose oral or intravenous one, any effect on zinc is considered insignificant for most people. No routine action is needed, but if you have other reasons to worry about your zinc levels, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Full nutrient report for Fluticasone Furoate, Umeclidinium, Vilanterol →
Fluticasone Furoate, Vilanterol Trifenatate
Insignificant DepletionBrand names include Breo Ellipta
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and many enzymes depend on every day. The fluticasone furoate component is an inhaled corticosteroid, and corticosteroids can interfere with how the body handles zinc, possibly shifting it from the blood into tissues or nudging the kidneys to release a bit more of it in urine. That said, this is rated as an insignificant depletion, so for most people using this inhaler, no extra zinc is needed. If you have other reasons your zinc might already be low, such as a poor diet or a gut condition, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Full nutrient report for Fluticasone Furoate, Vilanterol Trifenatate →
Hydrocortisone
Insignificant DepletionBrand names include Cortef, Hydrocortone, Carmol HC cream
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on, so it matters more than people might expect. Hydrocortisone is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down slightly, possibly because the drug shifts zinc out of the bloodstream and into body tissues, or in some cases causes a bit more to be lost through urine. That said, the evidence for this is rated insignificant, meaning most people using hydrocortisone do not need a zinc supplement. If you have other reasons your zinc might already be low, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Lansoprazole
Insignificant DepletionBrand names include Prevacid
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your immune system, wound healing, and hundreds of enzymes depend on every day. Lansoprazole works by turning down acid production in your stomach, and because stomach acid helps pull zinc out of supplements during digestion, there is some evidence this drug may slightly reduce how much zinc you absorb from a zinc pill. Interestingly, food sources of zinc do not seem to be affected the same way. That said, this is rated as insignificant, meaning real-world zinc deficiency from lansoprazole has not been shown to be a problem, so most people taking it do not need to worry or take a supplement. If you have concerns, your pharmacist or doctor is a great person to ask.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Lansoprazole, Amoxicillin, Clarithromycin
Insignificant DepletionBrand names include Prevpac
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc supports your immune system, wound healing, and a healthy sense of taste and smell. The lansoprazole in this triple therapy lowers stomach acid, and there is some evidence that less stomach acid can slightly reduce how well your body absorbs zinc from supplements (though food sources of zinc seem to be absorbed just fine). That said, clinically meaningful zinc depletion from this combination has not been reported, so most people taking this short-course H. pylori regimen do not need to worry about it. If you have any concerns, a quick chat with your pharmacist is always a good idea.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Full nutrient report for Lansoprazole, Amoxicillin, Clarithromycin →
Levofloxacin
Insignificant DepletionBrand names include Levaquin, Levaquin Injection, Leva-pak
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc helps your immune system, wound healing, and your sense of taste and smell. Levofloxacin belongs to a family of antibiotics called quinolones, and these drugs can physically bind to zinc in your gut, which means a bit less zinc gets absorbed when you take them together. That said, for a typical short antibiotic course, this interaction is not considered clinically meaningful, and most people do not need to worry about it. If you happen to take a zinc supplement for another reason, just space it a few hours apart from your levofloxacin and mention it to your pharmacist.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Levofloxacin (ophthalmic)
Insignificant DepletionBrand names include Levofloxacin
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Oral quinolone antibiotics can latch onto zinc in the gut and pull each other's absorption down, but levofloxacin eye drops go straight to the eye and are not swallowed in meaningful amounts, so this interaction has essentially no real-world impact for you. The evidence rating here is insignificant, meaning this is not something most people using these drops need to worry about. That said, if you happen to take a zinc supplement for another reason, it is always fine to mention it to your pharmacist just to make sure your full medication picture looks good.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Levonorgestrel, Ethinyl Estradiol
Insignificant DepletionBrand names include Nordette, Logynon ED, Microgynon 30
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc plays a role in hundreds of enzyme reactions, immune function, and wound healing, so it is fair to wonder whether a combined estrogen-progestin pill might affect your levels. The estrogen component may shift how zinc is distributed in the body, partly because estrogens boost protein building, which draws zinc into tissues, and partly because estrogen can lower blood albumin, which is the protein that normally carries zinc through the bloodstream. That said, research on this is genuinely mixed, and most studies show little to no meaningful drop in actual zinc levels. This is rated an insignificant depletion, so most people on this pill do not need to take a zinc supplement, but if you have concerns your pharmacist or doctor can take a closer look.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Levonorgestrel, Ethinyl Estradiol →
Lomefloxacin
Insignificant DepletionBrand names include Maxaquin
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Lomefloxacin belongs to a class of antibiotics called quinolones, and research shows these drugs can bind to zinc in the gut, forming a complex that makes it harder for your body to absorb either one. That said, a short course of this antibiotic is very unlikely to meaningfully lower your zinc levels, which is why the evidence rates this as insignificant for most people. If you happen to take a zinc supplement for another reason, just ask your pharmacist about spacing it apart from your antibiotic dose.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Medroxyprogesterone Acetate, Oestrogens, Conjugated
Insignificant DepletionBrand names include Premique
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports a healthy immune system, so it is worth understanding where it fits here. The research on conjugated estrogens and zinc is genuinely mixed: some studies found slightly lower blood zinc levels, while others found no change at all. One reason levels might shift is that estrogens can boost protein-building activity in tissues, which draws more zinc in from the bloodstream rather than losing it through the kidneys. Because the evidence is conflicting and no clear loss has been proven, most people on this medication do not need a zinc supplement, though your pharmacist or doctor can always help if you have specific concerns.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Medroxyprogesterone Acetate, Oestrogens, Conjugated →
Mephenytoin
Insignificant DepletionBrand names include Mesantoin
Phenytoin can chelate zinc in vitro and has been associated with both reduced and increased zinc absorption in animals. Although there are occasional case reports of reduced serum zinc levels in people taking phenytoin, studies have not found a consistent reduction. Routine zinc supplements are not necessary with phenytoin.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Mephenytoin is closely related to phenytoin, and there is some evidence that phenytoin-type drugs may affect how the body handles zinc, possibly by binding to it in the gut or nudging the kidneys to excrete a little more. That said, studies have not found this to be a consistent or meaningful drop in most people, and the evidence is rated insignificant. For the vast majority of patients taking this medication, no extra zinc is needed, but if you have concerns, your pharmacist or doctor is a great person to ask.
References (6)
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Palm R, Hallmans G. Zinc and copper metabolism in phenytoin therapy. Epilepsia 1982;23:453-61. PubMed
- Higashi A, Ikeda T, Matsukura M, Matsuda I. Serum zinc and vitamin E concentrations in handicapped children treated with anticonvulsants. Devel Pharmacol Ther 1982;5:109-13. DOI
- Akram M, Sullivan C, Mack G, Buchannan N. What is the clinical significance of reduced manganese and zinc levels in treated epileptic patients? Med J Australia 1989;15:113. PubMed
- Ilhan A, Uz E, Kali S, et al. Serum and hair trace element levels in patients with epilepsy and healthy subjects: does the antiepileptic therapy affect the element concentrations of hair? Eur J Neurol 1999;6:705-9. PubMed
- Liu CS, Wu HM, Kao SH, Wei YH. Serum trace elements, glutathione, copper/zinc superoxide dismutase, and lipid peroxidation in epileptic patients with phenytoin or carbamazepine monotherapy. Clin Neuropharmacol 1998;21:62.
Methylprednisolone
Insignificant DepletionBrand names include Medrol, Medrol Dosepak
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc plays a quiet but important role in immune function, wound healing, and keeping your senses of taste and smell sharp. Methylprednisolone is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down a little, possibly by shifting zinc from the bloodstream into body tissues or by causing the kidneys to release slightly more of it in urine. That said, the evidence here is rated insignificant, meaning this is not something most people taking methylprednisolone need to worry about or act on. If you have other reasons to be concerned about your zinc levels, it is worth bringing that up with your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Metronidazole, Tetracyline, Bismuth Subcitrate Potassium
Insignificant DepletionBrand names include Pylera
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc helps your immune system work and supports wound healing, so it is worth knowing that tetracycline, one of the three drugs in this combination therapy, can latch onto zinc in the gut and reduce how much your body absorbs. That said, the evidence rates this as insignificant for most people, meaning short-term use is unlikely to cause a real problem unless you already have risk factors for low zinc. If you are taking zinc supplements alongside this regimen, spacing them at least two hours apart from your tetracycline dose is a sensible habit worth mentioning to your pharmacist.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Full nutrient report for Metronidazole, Tetracyline, Bismuth Subcitrate Potassium →
Minocycline
Insignificant DepletionBrand names include Vectrin, Dynacin, Minocin
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc is a mineral your immune system, skin, and wound healing depend on, and minocycline can latch onto zinc in the gut, forming a complex that makes a bit less of it available for absorption. That said, for most people this effect is rated insignificant, meaning it rarely causes a real problem in day-to-day life. The main practical note is timing: if you do take a zinc supplement, spacing it at least two hours away from your minocycline dose keeps the two from interfering. Unless you already have risk factors for low zinc and are on minocycline for many months, there is no reason to worry, but your pharmacist is always a good sounding board if you have questions.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Minocycline Hydrochloride
Insignificant DepletionBrand names include Ximino, Minolira
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Minocycline can latch onto zinc in the gut and form a complex that makes it harder for your body to absorb, which is the same quirk seen with other tetracycline antibiotics. That said, the evidence rates this as insignificant for most people, meaning a short course is very unlikely to cause any real problem. If you have other reasons your zinc might already be low and you are taking minocycline for several months, it is worth mentioning to your pharmacist or doctor.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Moxifloxacin
Insignificant DepletionBrand names include Avelox
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Moxifloxacin belongs to a class of antibiotics called quinolones, and these drugs can physically bind to zinc in your gut, forming a complex that makes it harder for your body to absorb either one fully. That said, a short antibiotic course like most people take is very unlikely to put a dent in your zinc levels, and this interaction is rated insignificant for most patients. If you happen to be taking a zinc supplement for another reason, just ask your pharmacist about the best timing so neither gets in the way of the other.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Nalidixic Acid
Insignificant DepletionBrand names include NegGram
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Nalidixic acid belongs to a drug class called quinolones, and these medications can latch onto zinc in the gut and form a complex that limits how well both the drug and the zinc get absorbed. In practice, a short course of this antibiotic is very unlikely to dent your zinc levels in any meaningful way, so for most people no extra action is needed. If you happen to be taking a zinc supplement for another reason, just ask your pharmacist about spacing the timing so neither one interferes with the other.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Nizatidine
Insignificant DepletionBrand names include Axid, Axid Injection
Limited data suggest inhibition of gastric acid secretion by H2-blockers might reduce absorption of zinc from supplements, but clinically significant zinc depletion hasn't been reported.
Zinc helps your immune system, wound healing, and normal taste and smell, so it is worth knowing that nizatidine, an H2-blocker that dials down stomach acid, may slightly reduce how well zinc is absorbed in the gut. The thinking is that stomach acid helps release zinc from food and supplements, so less acid could mean a little less zinc gets in. That said, meaningful zinc depletion from nizatidine has not actually been reported in studies, so most people taking it have nothing to worry about. If you take nizatidine long-term and have concerns, a quick conversation with your pharmacist is all you need.
References (1)
- Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr 1991;10:372. PubMed
Norelgestromin, Ethinyl Estradiol
Insignificant DepletionBrand names include Ortho Evra, Evra
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc is a mineral your body uses for immune function, wound healing, and countless enzyme reactions throughout your cells. The estrogen component in this patch has shown mixed results in studies, with some research suggesting it may slightly shift how zinc moves between the blood and body tissues, possibly because estrogen encourages protein building and more zinc gets taken up by cells rather than staying in circulation. That said, there is no solid evidence this patch increases zinc loss through the kidneys, and the overall picture here is rated insignificant, meaning most people using this contraceptive patch do not need to worry about their zinc levels. No action is needed for most users, but if you have concerns about your nutrition, your pharmacist or doctor is a great place to start.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Norelgestromin, Ethinyl Estradiol →
Norethindrone Acetate, Ethinyl Estradiol, Ferrous Fumarate
Insignificant DepletionBrand names include Minastrin 24 FE, LoMinastrin FE
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports immune function and wound healing. The estrogen in this pill may shift where zinc ends up in your body, pulling more of it into tissues rather than leaving it circulating in the blood, though studies on this are genuinely mixed and some show no change at all. Because the overall effect appears small, most people taking this combination do not need a zinc supplement. If you are curious or have concerns, it is worth a quick chat with your pharmacist.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Norethindrone Acetate, Ethinyl Estradiol, Ferrous Fumarate →
Norfloxacin
Insignificant DepletionBrand names include Norflox, Noroxin
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc plays a role in immune function, wound healing, and keeping your senses of taste and smell working properly. Norfloxacin, like other quinolone antibiotics, can latch onto zinc in the gut and form a complex that reduces how much of the mineral gets absorbed. That said, for a typical short course of this antibiotic, this interaction is considered insignificant and most people do not need to do anything about it. If you happen to take a zinc supplement for another reason, just ask your pharmacist about spacing them apart from your antibiotic doses.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Oestrogen
Insignificant DepletionResearch on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body build proteins and keeps hundreds of enzymes running properly. With oestrogen, the picture is genuinely mixed: some studies found slightly lower zinc in the blood, others found no change at all. One reason may be that oestrogen boosts protein building, so tissues actually pull in and hold onto more zinc rather than losing it. Because the overall evidence rates this as insignificant, most people on oestrogen do not need a zinc supplement, but if you have questions about your diet or a specific concern, your pharmacist or doctor is the right person to ask.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Ofloxacin
Insignificant DepletionBrand names include Oflox, Floxin, Floxin Injection
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc helps your immune system, wound healing, and sense of taste and smell. Ofloxacin, like other quinolone antibiotics, can bind to zinc in your gut and form a complex that reduces how much of each gets absorbed. In practice, a short antibiotic course is very unlikely to cause any meaningful drop in zinc levels, so most people do not need to worry. If you happen to be taking a zinc supplement for another reason, just space it a couple of hours apart from your antibiotic and let your pharmacist know.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Olopatadine Hydrochloride, Mometasone Furoate
Insignificant DepletionBrand names include Ryaltris
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system, wound healing, and sense of taste and smell. The mometasone in this combination is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down slightly, possibly by shifting zinc into body tissues or increasing how much the kidneys flush out. That said, this is rated as an insignificant depletion, so for most people using this nasal spray, it is not a practical concern. If you have other reasons to worry about your zinc intake, it is worth mentioning to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Full nutrient report for Olopatadine Hydrochloride, Mometasone Furoate →
Omadacycline (IV)
Insignificant DepletionBrand names include Nuzyra
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc helps your immune system, wound healing, and sense of taste and smell. Omadacycline belongs to the tetracycline antibiotic family, and some tetracyclines can bind to zinc in the gut, which may reduce how much zinc gets absorbed. That said, the evidence rates this as insignificant for most patients, meaning a short course is very unlikely to affect your zinc levels in any meaningful way. If you have other reasons to be concerned about zinc, it is worth mentioning to your pharmacist or doctor.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Omadacycline (Oral)
Insignificant DepletionBrand names include Nuzyra
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc helps your immune system, wound healing, and your sense of taste and smell. Omadacycline belongs to the tetracycline antibiotic family, and some drugs in this group can latch onto zinc in the gut and carry it out of the body before it gets absorbed. That said, the evidence rates this as insignificant for most people, so the average short-course user does not need to worry. If you have other reasons to be low in zinc or are taking this antibiotic for an extended period, it is worth mentioning to your pharmacist.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Omeprazole
Insignificant DepletionBrand names include Prilosec, Zegerid, Losec
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Omeprazole works by turning down acid production in your stomach, and there is some evidence that lower stomach acid can make it slightly harder for the body to absorb zinc from supplements, though food sources of zinc appear largely unaffected. Even so, this is rated insignificant, meaning real-world zinc deficiency from omeprazole has not actually been reported. For most people taking this medication, no special action is needed, but if you have concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Omeprazole, Sodium Bicarbonate
Insignificant DepletionBrand names include Konvomep
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Omeprazole works by dialing down stomach acid, and there is some evidence that lower acid levels can make it slightly harder to absorb zinc from supplements taken in pill or capsule form. The good news is that zinc from food does not appear to be affected, and no meaningful deficiency has ever been reported with this medication. This is rated as insignificant, so most people do not need to do anything special, though you are always welcome to mention it to your pharmacist if you have concerns.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Oxytetracycline
Insignificant DepletionBrand names include Terramycin
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc helps your immune system work and supports wound healing, so it is worth understanding how oxytetracycline fits in. Like other tetracycline antibiotics, oxytetracycline can bind to zinc in the gut and form a complex that makes it harder for your body to absorb the zinc from food or supplements. That said, for most people taking a short course of this antibiotic, the effect on zinc levels is considered insignificant. If you have other risk factors for low zinc or you are on this medication for several months, it is worth bringing up with your pharmacist or doctor.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Oxytetracycline, Phenazopyridine, Sulfamethizole
Insignificant DepletionBrand names include Urobiotic
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc supports your immune system, wound healing, and sense of taste and smell. Oxytetracycline, like other tetracyclines, can bind to zinc in the gut and slightly reduce how much your body absorbs from food or supplements. That said, for most people taking this combination short-term, the effect is considered insignificant, meaning a zinc supplement is not routinely needed. If you have other risk factors for low zinc or expect to be on this medication for several months, it is worth mentioning to your pharmacist or doctor.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Full nutrient report for Oxytetracycline, Phenazopyridine, Sulfamethizole →
Ozenoxacin
Insignificant DepletionBrand names include Xepi
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc helps your immune system, wound healing, and keeps your senses of taste and smell working properly. Ozenoxacin is a topical quinolone antibiotic used on the skin, so very little of it enters your body, making any effect on zinc absorption essentially a non-issue in practice. The evidence rates this as insignificant, and for a short course of a topical medication, there is really nothing to worry about here. If you happen to take zinc supplements for another reason, just mention it to your pharmacist to be safe.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Pantoprazole
Insignificant DepletionBrand names include Protonix, Pantoloc, Protonix IV
Each 40 mg vial of pantoprazole IV contains 1 mg EDTA, which can chelate zinc. This is a very low dose of EDTA compared with those used in EDTA chelation therapy. The manufacturer reports that pantoprazole IV 240 mg daily for 7 days increases urinary zinc excretion, but serum zinc levels are unchanged. Zinc supplements are not usually necessary with typical doses of pantoprazole IV.
Zinc plays a role in immune function, wound healing, and keeping your senses of taste and smell working properly. Pantoprazole IV contains a small amount of a compound called EDTA, which can latch onto zinc and pull a bit more of it out through the urine. That said, even at higher intravenous doses studied, actual zinc levels in the blood stayed normal, and this is rated as insignificant depletion. For most people taking standard doses of pantoprazole, this is not something that requires action, but if you have questions about your zinc status, your pharmacist or doctor is a good place to start.
References (1)
- Personal communication: Pantoprazole IV - safety and tolerability of EDTA. Medical Information Department, Wyeth Pharmaceuticals Inc., Philadelphia, PA. February 24, 2005.
Phenobarbital, Phenytoin
Insignificant DepletionBrand names include Dilantin with PB
Phenytoin can chelate zinc in vitro and has been associated with both reduced and increased zinc absorption in animals. Although there are occasional case reports of reduced serum zinc levels in people taking phenytoin, studies have not found a consistent reduction. Routine zinc supplements are not necessary with phenytoin.
Zinc is a mineral your body uses for immune function, wound healing, and keeping enzymes working properly. Phenytoin has been shown in some studies to increase how much zinc the kidneys excrete, and it may also interfere with zinc binding in the body, though results across studies have been inconsistent. The good news is that this is rated as an insignificant depletion, meaning a routine zinc supplement is not considered necessary for most people on this medication. If you have any concerns, a quick chat with your pharmacist or doctor can help put your mind at ease.
References (6)
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Palm R, Hallmans G. Zinc and copper metabolism in phenytoin therapy. Epilepsia 1982;23:453-61. PubMed
- Higashi A, Ikeda T, Matsukura M, Matsuda I. Serum zinc and vitamin E concentrations in handicapped children treated with anticonvulsants. Devel Pharmacol Ther 1982;5:109-13. DOI
- Akram M, Sullivan C, Mack G, Buchannan N. What is the clinical significance of reduced manganese and zinc levels in treated epileptic patients? Med J Australia 1989;15:113. PubMed
- Ilhan A, Uz E, Kali S, et al. Serum and hair trace element levels in patients with epilepsy and healthy subjects: does the antiepileptic therapy affect the element concentrations of hair? Eur J Neurol 1999;6:705-9. PubMed
- Liu CS, Wu HM, Kao SH, Wei YH. Serum trace elements, glutathione, copper/zinc superoxide dismutase, and lipid peroxidation in epileptic patients with phenytoin or carbamazepine monotherapy. Clin Neuropharmacol 1998;21:62.
Phenytoin
Insignificant DepletionBrand names include Dilantin Kapseals, Dilantin, Di-Phen
Phenytoin can chelate zinc in vitro and has been associated with both reduced and increased zinc absorption in animals. Although there are occasional case reports of reduced serum zinc levels in people taking phenytoin, studies have not found a consistent reduction. Routine zinc supplements are not necessary with phenytoin.
Zinc is a mineral your immune system, wound healing, and cell growth all depend on. Phenytoin has been studied for a possible link to lower zinc levels, possibly because it may interfere with how zinc is handled in the gut or how quickly the body clears it. That said, research has not found a reliable, consistent drop in zinc among people taking phenytoin, and this depletion is rated insignificant. For most patients on phenytoin, routine zinc supplements are not needed, though it is always fine to mention any concerns to your pharmacist or doctor.
References (6)
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Palm R, Hallmans G. Zinc and copper metabolism in phenytoin therapy. Epilepsia 1982;23:453-61. PubMed
- Higashi A, Ikeda T, Matsukura M, Matsuda I. Serum zinc and vitamin E concentrations in handicapped children treated with anticonvulsants. Devel Pharmacol Ther 1982;5:109-13. DOI
- Akram M, Sullivan C, Mack G, Buchannan N. What is the clinical significance of reduced manganese and zinc levels in treated epileptic patients? Med J Australia 1989;15:113. PubMed
- Ilhan A, Uz E, Kali S, et al. Serum and hair trace element levels in patients with epilepsy and healthy subjects: does the antiepileptic therapy affect the element concentrations of hair? Eur J Neurol 1999;6:705-9. PubMed
- Liu CS, Wu HM, Kao SH, Wei YH. Serum trace elements, glutathione, copper/zinc superoxide dismutase, and lipid peroxidation in epileptic patients with phenytoin or carbamazepine monotherapy. Clin Neuropharmacol 1998;21:62.
Prasterone (prescription drug)
Insignificant DepletionBrand names include Intrarosa
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and keeps your immune system working properly. Prasterone is a form of estrogen, and estrogen has a complicated relationship with zinc: it may shift zinc from the bloodstream into body tissues rather than truly depleting it, and research on whether blood zinc levels actually drop is genuinely mixed. Because this interaction is rated as insignificant, most people using prasterone do not need to worry about zinc or take a supplement for this reason. That said, if you have concerns about your nutrient levels, a quick conversation with your pharmacist or doctor can give you peace of mind.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Prednisolone
Insignificant DepletionBrand names include Sterane, Delta Cortef, Cortalone
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and cell growth all depend on. Prednisolone is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down a little, possibly because the drug affects how the body distributes zinc between the blood and tissues, or because slightly more zinc gets lost through the kidneys. That said, the evidence is rated as insignificant depletion, meaning most people taking prednisolone do not need to worry about this or take a zinc supplement. If you have other reasons your zinc might already be on the low side, it is worth mentioning that to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Prednisone
Insignificant DepletionBrand names include Deltasone, Cortan, Orasone
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system, wound healing, and cell growth, so it is worth knowing that prednisone has been linked to modest dips in zinc levels in some people. The leading theory is that the drug shifts zinc out of the bloodstream and into body tissues, though a small increase in how much zinc the kidneys spill into urine may also play a role. Because this is rated as an insignificant depletion, routine zinc supplements are not considered necessary for most people on prednisone. If you have other reasons to be concerned about zinc status, just bring it up with your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Rabeprazole
Insignificant DepletionBrand names include Pariet
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your body uses for immune defense, wound healing, and keeping your senses of taste and smell sharp. Rabeprazole works by dialing down stomach acid, and there is some evidence that lower acid levels may slightly reduce how well your gut absorbs zinc from supplements (though zinc from food does not appear to be affected the same way). That said, this is rated as insignificant, meaning real-world zinc deficiency from rabeprazole has not been reported. Most people on this medication do not need to take any action, but if you have concerns, it is always worth a quick conversation with your pharmacist or doctor.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Rabeprazole Sodium
Insignificant DepletionBrand names include Aciphex, Aciphex Sprinkle
Limited data suggest that inhibition of gastric acid secretion by PPIs might reduce absorption of zinc from supplements. PPIs don't seem to affect zinc absorption from food. Clinically significant zinc depletion has not been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on, so it is worth knowing where rabeprazole fits in. Because this medication reduces stomach acid, there is some evidence it may slightly interfere with zinc absorbed from supplements, since stomach acid appears to help release zinc from pill form. That said, zinc from food does not seem to be affected, and a true deficiency from this medication has not been reported in practice. For most people taking rabeprazole, this is not something that needs action, but if you take zinc supplements and have concerns, your pharmacist is a good person to ask.
References (2)
- Ozutemiz AO, Aydin HH, Isler M, et al. Effect of omeprazole on plasma zinc levels after oral zinc administration. Ind J Gastroenterol 2002;21:216-8.
- Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of calcium, phosphorus, magnesium, or zinc from food in humans. J Am Coll Nutr 1995;14:364-8. PubMed
Ranitidine
Insignificant DepletionBrand names include Zantac 150 EFFER, Zantac 150 GEL, Zantac 150
Limited data suggest inhibition of gastric acid secretion by H2-blockers might reduce absorption of zinc from supplements, but clinically significant zinc depletion hasn't been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Ranitidine works by reducing stomach acid, and there is some evidence that lower acid levels can slightly reduce how well zinc from supplements is absorbed in the gut. That said, clinically meaningful zinc depletion has not been reported with this type of medication, so for most people this is more of a theoretical footnote than a practical concern. If you have questions about whether your zinc levels need any attention, it is worth a quick conversation with your pharmacist or doctor.
References (1)
- Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr 1991;10:372. PubMed
Ranitidine Bismuth Citrate
Insignificant DepletionBrand names include Tritec
Limited data suggest inhibition of gastric acid secretion by H2-blockers might reduce absorption of zinc from supplements, but clinically significant zinc depletion hasn't been reported.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Ranitidine bismuth citrate belongs to a class of drugs that dials down stomach acid, and lower acid levels may slightly reduce how well your gut absorbs zinc, particularly from supplements. That said, real-world zinc deficiency from this type of medication has not been reported, and the evidence here is rated insignificant. For most people, no extra zinc is needed, but if you have concerns, it is always worth a quick conversation with your pharmacist.
References (1)
- Sturniolo GC, Montino MC, Rossetto L, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr 1991;10:372. PubMed
Relugolix, Estradiol, Norethindrone Acetate
Insignificant DepletionBrand names include Myfembree
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and supports immune function, wound healing, and cell growth. The estradiol in this combination medication may shift how zinc is distributed in your body, partly because estrogen can boost protein synthesis and draw more zinc into tissues, and partly because it may affect how much zinc circulates in the blood. That said, studies on this are genuinely mixed, and the overall evidence puts this in the 'insignificant' category, meaning most people on this medication do not need to take a zinc supplement. If you have any concerns, a quick conversation with your pharmacist or doctor is the right place to start.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Relugolix, Estradiol, Norethindrone Acetate →
Retapamulin
Insignificant DepletionBrand names include Altabax, Altargo
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc is a mineral your immune system, wound healing, and many enzymes depend on every day. Retapamulin is a topical antibiotic used on the skin, so it is not meaningfully absorbed into the bloodstream, and the gut interaction seen with oral quinolones simply does not apply here in any practical way. The evidence rates this as insignificant, meaning the vast majority of people using retapamulin have nothing to worry about on the zinc front. If you have separate questions about zinc or any supplement you are already taking, your pharmacist is a great first stop.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Segesterone Acetate, Ethinyl Estradiol
Insignificant DepletionBrand names include Annovera
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body build proteins, supports immune function, and acts as a helper molecule for dozens of enzymes. The estrogen component of this vaginal ring system may shift how zinc is distributed in the body, partly because estrogen can boost protein building in tissues, which draws more zinc in from the bloodstream. That said, research on this is genuinely mixed, and the overall evidence puts this in the insignificant category, meaning most people using this contraceptive do not need to worry about zinc or take a supplement. If you have specific concerns, a quick conversation with your pharmacist or doctor can put your mind at ease.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Full nutrient report for Segesterone Acetate, Ethinyl Estradiol →
Sodium valproate
Insignificant DepletionBrand names include Epilim
Valproic acid might bind zinc. Some researchers suggest this contributes to both its mechanism of action and side effects. Whether valproic acid affects zinc balance in humans is unclear. Some studies have reported reduced serum and tissue zinc levels, while others have found no change. However, epilepsy has also been associated with both increases and decreases in zinc levels. There are a few case reports of alopecia and skin problems associated with valproic acid therapy which have responded to zinc supplements. The zinc status of these patients prior to starting valproic acid is not clear. It's unlikely that valproic acid causes clinically significant zinc deficiency in most patients. Consider supplements only if the patient has other risk factors or shows symptoms of deficiency.
Zinc helps your body heal wounds, support immune function, and keep skin healthy. Sodium valproate may actually bind to zinc in the body, and some research suggests it could nudge the kidneys to excrete a little more of it, though studies have gone back and forth on whether this truly lowers zinc levels in people taking the drug. For most patients this is considered an insignificant concern, so there is no reason to worry or reach for a supplement on your own. If you notice unusual hair loss or skin changes while on this medication, that is worth mentioning to your pharmacist or doctor.
References (11)
- Hurd RW, Van Rinsvelt HA, Wilder BJ, et al. Selenium, zinc, and copper changes with valproic acid: possible relation to drug side effects. Neurology 1984;34:1393-5. PubMed
- Altunbasak S, Biatmakoui F, Baytok V, et al. Serum and hair zinc levels in epileptic children taking valproic acid. Biol Trace Element Res 1997;58;117-25. PubMed
- Lerman-Sagie T, Statter M, Szabo G, Lerman P. Effect of valproic acid therapy on zinc metabolism in children with primary epilepsy. Clin Neuropharmacol 1987;10:80-6. PubMed
- Hurd RW, Wilder BJ, Van Rinsvelt HA. Valproate, birth defects, and zinc (letter). Lancet 1983;1:181. PubMed
- Akram M, Sullivan C, Mack G, Buchannan N. What is the clinical significance of reduced manganese and zinc levels in treated epileptic patients? Med J Australia 1989;15:113. PubMed
- Verrotti A, Basciani F, Trotta D, et al. Serum copper, zinc, selenium, glutathione peroxidase and superoxide dismutase levels in epileptic children before and after 1 year of sodium valproate and carbamazepine therapy. Epilepsy Res 2002;48:71-5. PubMed
- Kaji M, Ito M, Okuno T, et al. Serum copper and zinc levels in epileptic children with valproate treatment. Epilepsia 1992;33:555-7. PubMed
- Yuen WC, Whiteoak R, Thompson RP. Zinc concentrations in leucocytes of patients receiving antiepileptic drugs. J Clin Pathol 1998;41:553-5. PubMed
- Ilhan A, Uz E, Kali S, et al. Serum and hair trace element levels in patients with epilepsy and healthy subjects: does the antiepileptic therapy affect the element concentrations of hair? Eur J Neurol 1999;6:705-9. PubMed
- Fatemi SH, Calabrese JR. Treatment of valproate-induced alopecia (letter). Ann Pharmacother 1995;29;1302. PubMed
- Lewis-Jones MS, Evans S, Culshaw MA. Cutaneous manifestations of zinc deficiency during treatment with anticonvulsants. BMJ 1985;290:603-4. PubMed
Sparfloxacin
Insignificant DepletionBrand names include Zagam
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc is a mineral your immune system, skin, and wound healing depend on, so it matters to keep levels steady. Sparfloxacin belongs to a drug class called quinolones, and these antibiotics can latch onto zinc in the gut and form a complex that makes both the drug and the zinc harder to absorb. That said, for a typical short course of this antibiotic, the effect is considered insignificant, meaning most people will not develop a zinc shortfall. If you happen to be taking a zinc supplement for another reason, just ask your pharmacist about spacing it apart from your dose.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Tetracycline
Insignificant DepletionBrand names include Sumycin, Sumycin 250, Tetrex BID
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc is a mineral your immune system, wound healing, and cell growth all depend on. Tetracycline can latch onto zinc in the gut and form a bound complex, which may reduce how much zinc gets absorbed from food or supplements. That said, the evidence rates this as insignificant for most people, meaning everyday dietary zinc is unlikely to be a real concern unless you have other risk factors for low zinc and are taking tetracycline for several months. If that sounds like your situation, just bring it up with your pharmacist or doctor.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Tibolone
Insignificant DepletionBrand names include Livial
Research on the effects of estrogens on plasma zinc levels is conflicting. Some studies report decreased levels, while others show no change. Estrogen-induced decreases in serum albumin may reduce the amount of zinc carried in the blood. Also, the anabolic effects of estrogens increase protein synthesis and use of zinc as an enzyme cofactor, increasing the amount of zinc taken up and retained by tissues. There is no reliable evidence that estrogens increase zinc excretion. Therefore, supplements generally are not necessary.
Zinc helps your body run hundreds of enzymes and keeps your immune system working properly. Tibolone has estrogen-like activity, and estrogens may shift how zinc moves around in the body, potentially pulling more of it into tissues for protein-building rather than reducing overall zinc stores. Research on this is genuinely mixed, though, with some studies showing no change at all in zinc levels. Given the insignificant rating here, most people taking tibolone do not need to worry about zinc, but if you have questions or eat a diet low in zinc, a quick chat with your pharmacist is always a reasonable step.
References (11)
- Tyrer LB. Nutrition and the pill. J Reprod Med 1984;29:547-50..
- King JC. Do women using oral contraceptive agents require extra zinc? J Nutr 1987;117:217-9. PubMed
- Smith JC, Brown ED. Effects of oral contraceptive agents on trace element metabolism - a review. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.II, Essential and Toxic Elements. New York: Academic Press, 1976. 315-45. DOI
- Prasad AS, Oberleas D, Lei KY, et al. Effect of oral contraceptive agents on nutrients: I. Minerals. Am J Clin Nutr 1975;28:377-84. PubMed
- Prema K, Ramalakshmi Ba, Babu S. Serum copper and zinc in hormonal contraceptive users. Fertil Steril 1980;33;267-71. PubMed
- Webb JL. Nutritional effects of oral contraceptive use: A review. J Reprod Med 1080;25:150.
- Vir SC, Love AH. Zinc and copper nutriture of women taking oral contraceptive agents. Am J Clin Nutr 1981;34:1479-83. PubMed
- Hinks LJ, Clayton BE, Lloyd RS. Zinc and copper concentrations in leukocytes and erythrocytes in healthy adults and the effect of oral contraceptives. J Clin Pathol 1983;36:1016-21.
- Chilvers DC, Jones MM, Selby PL, et al. Effects of oral ethinyl oestradiol and norethisterone on plasma copper and zinc complexes in post-menopausal women. Hormone Metab Res 1985;17:532-5. PubMed
- Powell-Beard L, Lei KY, Shenker L. Effect of long-term oral contraceptive therapy before pregnancy on maternal and fetal zinc and copper status. Obstet Gynecol 1987;69:26-32.
- Liukko P, Erkkola R, Pakarinen P, et al. Trace elements during 2 years' oral contraception with low-estrogen preparations. Gynecol Obstet Invest 1988;25:113-7. PubMed
Tigecycline
Insignificant DepletionBrand names include Tygacil
Clinical research shows that tetracyclines such as tetracycline, demeclocycline, and minocycline, form complexes with zinc in the gastrointestinal tract, which can reduce absorption of both dietary and supplemental zinc. Doxycycline doesn't seem to cause this interaction. Advise patients to take tetracyclines at least 2 hours before, or 4-6 hours after, zinc supplements. Effects of tetracyclines on dietary zinc absorption aren't likely to be clinically significant except in people with other risk factors for zinc deficiency who take tetracyclines for several months.
Zinc is a mineral your immune system, wound healing, and sense of taste all depend on. Tigecycline belongs to the tetracycline antibiotic family, and some drugs in this group can bind to zinc in the gut, forming a complex that makes it harder for your body to absorb. That said, this effect is rated as insignificant for most patients, meaning a short course of tigecycline is very unlikely to cause a problem for someone otherwise healthy. If you have other reasons to be concerned about your zinc levels or have been on a similar antibiotic for several months, it is worth a quick conversation with your pharmacist or doctor.
References (4)
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Neuvonen PJ. Interactions with the absorption of tetracyclines. Drugs 1976;11:45-54.. PubMed
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Penttila O, Hurme H, Neuvonen PJ. Effect of zinc sulfate on the absorption of tetracycline and doxycycline in man. Eur J Clin Pharmacol 1975;9:131-4.
Triamcinolone
Insignificant DepletionBrand names include Aristocort, Kenacort, Adcortyl Intra-articular / Intradermal
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc helps your immune system, wound healing, and countless chemical reactions throughout the body. Triamcinolone is a corticosteroid, and there is some evidence that corticosteroids can nudge zinc levels down a little, possibly by shifting zinc from the blood into body tissues or by causing the kidneys to release slightly more of it in the urine. That said, for most people this effect is considered insignificant, and routine zinc supplements are not expected to be necessary. If you have other reasons to be concerned about zinc, it is worth bringing up with your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Triamcinolone Acetonide
Insignificant DepletionBrand names include Zilretta, Xipere
The pituitary-adrenal axis seems to play a role in control of serum zinc levels. There's some evidence that disruption of this axis by single large doses of corticosteroids (equivalent to 50 mg prednisone or higher), or therapy with lower doses for several months, can cause a reduction in serum zinc levels. This may reflect redistribution of zinc into the tissues, although increased urinary excretion has also been reported. Zinc supplements aren't routinely necessary with corticosteroid therapy. Monitor patients closely if they have additional risk factors for zinc deficiency.
Zinc is a mineral your immune system, wound healing, and cell growth all depend on. Triamcinolone acetonide is a corticosteroid, and corticosteroids may interfere with how your body handles zinc, possibly shifting it out of the bloodstream into tissues or nudging the kidneys to excrete a little more. That said, the evidence here is rated insignificant, so for most people using this medication, zinc levels are not a practical concern. If you have other reasons to worry about your zinc status, it is worth mentioning that to your pharmacist or doctor.
References (6)
- Yunice AA, Czerwinski AW, Lindeman RD. Influence of synthetic corticosteroids on plasma zinc and copper levels in humans. Am J Med Sci 1981;282:68-74. PubMed
- Scott R, Ferrie B, McLelland A, Fell GS. The effect of steroid therapy on serum trace metal levels in sub-fertile males. Urol Res 1984;12:213-5. PubMed
- Flynn A, Pories WJ, Strain WH, et al. Rapid serum zinc depletion associated with corticosteroid therapy. Lancet 1971;2:1169-72. PubMed
- Weismann K, Hoyer H. Serum zinc levels during oral glucocorticoid therapy. J Invest Dermatol 1986;86:715-6. PubMed
- Ellul-Micallef R, Galdes A, Fenech FF. Serum zinc levels in corticosteroid-treated asthmatic patients. Postgrad Med J 1976;52:148-50. PubMed
- Henkin RI, Foster DM, Aamodt RL, Berman M. Zinc metabolism in adrenal cortical insufficiency: effects of carbohydrate-active steroids. Metabolism 1984;33:491-501. PubMed
Trovafloxacin
Insignificant DepletionBrand names include Trovan, Trovan Injection
Clinical research shows that quinolones form complexes with dietary and supplemental zinc in the gastrointestinal tract, reducing absorption of both the quinolone and zinc if taken at the same time. This isn't likely to cause zinc depletion with normal courses of antibiotic therapy. If zinc supplements are needed for other reasons, advise patients to take quinolones at least 2 hours before, or 4-6 hours after the supplement.
Zinc plays a role in immune function, wound healing, and keeping your senses of taste and smell working well. Trovafloxacin belongs to a class of antibiotics called quinolones, and these drugs can physically bind to zinc in the gut, forming a complex that makes it harder for your body to absorb either one properly. That said, a short course of this antibiotic is very unlikely to deplete your zinc to any meaningful degree, so most people simply do not need to worry about it. If you happen to take a zinc supplement for another reason, just ask your pharmacist about spacing it a couple of hours apart from the antibiotic.
References (4)
- Blondeau JM. Expanded activity and utility of the new fluoroquinolones: a review. Clin Ther 1999;21:3-40. PubMed
- Lomaestro BM, Bailie GR. Absorption interactions with fluoroquinolones. 1995 update. Drug Saf 1995;12:314-33. PubMed
- Hansten PD, Horn JR. Drug Interactions Analysis and Management. Vancouver, WA: Applied Therapeutics Inc., 1997 and updates.
- Polk RE, Healy DP, Sahai J, et al. Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers. Antimicrob Agents Chemother 1989;33:1841-4. PubMed
Valproic Acid
Insignificant DepletionBrand names include Depakene, Depacon, Valproate
Valproic acid might bind zinc. Some researchers suggest this contributes to both its mechanism of action and side effects. Whether valproic acid affects zinc balance in humans is unclear. Some studies have reported reduced serum and tissue zinc levels, while others have found no change. However, epilepsy has also been associated with both increases and decreases in zinc levels. There are a few case reports of alopecia and skin problems associated with valproic acid therapy which have responded to zinc supplements. The zinc status of these patients prior to starting valproic acid is not clear. It's unlikely that valproic acid causes clinically significant zinc deficiency in most patients. Consider supplements only if the patient has other risk factors or shows symptoms of deficiency.
Zinc is a mineral your body uses for immune function, wound healing, and healthy skin and hair. Valproic acid may latch onto zinc in the body and could nudge the kidneys to excrete a little more of it, but the research in humans is genuinely mixed, with some studies showing slightly lower zinc levels and others showing no change at all. For the vast majority of people taking this medication, this is not something that requires action. That said, if you notice unusual hair loss or skin changes while on valproic acid, it is worth mentioning to your pharmacist or doctor, since a small number of patients have seen those issues improve with zinc supplementation.
References (11)
- Hurd RW, Van Rinsvelt HA, Wilder BJ, et al. Selenium, zinc, and copper changes with valproic acid: possible relation to drug side effects. Neurology 1984;34:1393-5. PubMed
- Altunbasak S, Biatmakoui F, Baytok V, et al. Serum and hair zinc levels in epileptic children taking valproic acid. Biol Trace Element Res 1997;58;117-25. PubMed
- Lerman-Sagie T, Statter M, Szabo G, Lerman P. Effect of valproic acid therapy on zinc metabolism in children with primary epilepsy. Clin Neuropharmacol 1987;10:80-6. PubMed
- Hurd RW, Wilder BJ, Van Rinsvelt HA. Valproate, birth defects, and zinc (letter). Lancet 1983;1:181. PubMed
- Akram M, Sullivan C, Mack G, Buchannan N. What is the clinical significance of reduced manganese and zinc levels in treated epileptic patients? Med J Australia 1989;15:113. PubMed
- Verrotti A, Basciani F, Trotta D, et al. Serum copper, zinc, selenium, glutathione peroxidase and superoxide dismutase levels in epileptic children before and after 1 year of sodium valproate and carbamazepine therapy. Epilepsy Res 2002;48:71-5. PubMed
- Kaji M, Ito M, Okuno T, et al. Serum copper and zinc levels in epileptic children with valproate treatment. Epilepsia 1992;33:555-7. PubMed
- Yuen WC, Whiteoak R, Thompson RP. Zinc concentrations in leucocytes of patients receiving antiepileptic drugs. J Clin Pathol 1998;41:553-5. PubMed
- Ilhan A, Uz E, Kali S, et al. Serum and hair trace element levels in patients with epilepsy and healthy subjects: does the antiepileptic therapy affect the element concentrations of hair? Eur J Neurol 1999;6:705-9. PubMed
- Fatemi SH, Calabrese JR. Treatment of valproate-induced alopecia (letter). Ann Pharmacother 1995;29;1302. PubMed
- Lewis-Jones MS, Evans S, Culshaw MA. Cutaneous manifestations of zinc deficiency during treatment with anticonvulsants. BMJ 1985;290:603-4. PubMed
Amiloride, Hydrochlorothiazide
Moderate DepletionBrand names include Moduretic, Amilzide, Moduret 25
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and normal hormone activity, so keeping levels in a healthy range does matter over time. The hydrochlorothiazide portion of this combination causes the kidneys to flush out more zinc in the urine than usual, sometimes raising excretion by more than half. The good news is that amiloride, the other ingredient, actually works in the opposite direction and helps hold zinc in the body, which softens that loss. Still, if you have been on this combination for a long time, it is worth bringing up zinc levels at your next visit with your doctor or pharmacist.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Chlorothiazide
Moderate DepletionBrand names include Diuril
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and normal hormone function, so keeping levels steady matters over time. Chlorothiazide works by making your kidneys remove extra fluid, but it also causes the kidneys to flush out significantly more zinc in the urine than usual, and that extra loss can add up with long-term use. Most people's blood zinc stays in the normal range, but tissue levels may gradually decline, which is why this one is rated moderate. If you have been on this medication for a long while, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Chlorothiazide, Methyldopa
Moderate DepletionBrand names include Aldoclor 150, Aldochlor, Aldoclor 250
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your body needs for immune function, wound healing, and keeping hormones working properly. Chlorothiazide is a thiazide diuretic, meaning it works by making your kidneys flush out excess fluid, and research shows it can pull significantly more zinc out through the urine at the same time. Blood zinc levels often stay within the normal range, but long-term users may want to bring this up with their pharmacist or doctor, since tissue zinc can still drop over time even when lab values look okay.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Chlorothiazide, Reserpine
Moderate DepletionBrand names include Diupres
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your body heal wounds, support immune function, and maintain healthy hormone levels. Chlorothiazide is a thiazide diuretic, meaning it works by making your kidneys produce more urine, and research shows this process can pull significantly more zinc out through the urine as well, sometimes 50 to 60 percent more than normal. Blood zinc levels often stay within the normal range, but years of use may gradually lower zinc stored in body tissues. If you have been on this medication long term, it is worth asking your pharmacist or doctor whether monitoring or a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Chlorthalidone
Moderate DepletionBrand names include Hygroton, Thalitone
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Chlorthalidone works by making your kidneys excrete more fluid, but zinc, a mineral your immune system and wound healing depend on, gets swept out in the urine along with it. Studies show thiazide-type diuretics like chlorthalidone can push urinary zinc losses up by more than half, and that effect may continue for years of use. Serum zinc levels often stay in the normal range, so this is not an emergency situation, but long-term users are worth keeping an eye on. If you have been on chlorthalidone for a while, it is a reasonable thing to mention to your pharmacist or doctor at your next visit.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Chlorthalidone, Clonidine
Moderate DepletionBrand names include Clorpres, Combipres
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Chlorthalidone belongs to the thiazide diuretic family, and one well-documented effect of these medications is that they cause the kidneys to flush out more zinc in the urine, sometimes increasing that loss by more than half. Zinc is a mineral your immune system, wound healing, and hormone function all depend on. Blood levels often stay within the normal range, but research suggests that long-term use could quietly reduce zinc in the body's tissues over time. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether monitoring or a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Cryptenamine, Methyclothiazide
Moderate DepletionBrand names include Diutensen
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your body depends on for immune function, wound healing, and healthy hormone levels. Methyclothiazide, the thiazide diuretic in this combination, works on the kidneys to remove excess fluid, but in doing so it can cause the kidneys to flush out significantly more zinc in the urine than usual. Blood zinc levels often stay within the normal range despite this, though long-term use may gradually draw down zinc stored in body tissues. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Cyclothiazide
Moderate DepletionBrand names include Fluidil, Anhydron
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc supports immune function, wound healing, and normal hormone activity, so keeping levels adequate matters. Cyclothiazide is a thiazide diuretic, and this class of medications works by making the kidneys remove more fluid, but along the way the kidneys also flush out significantly more zinc in the urine. Research suggests this urinary loss can run 50 to 60 percent higher than normal and may persist for years, so people on long-term therapy are worth watching more closely. If you have been on this medication for a long time, it is worth asking your pharmacist or doctor whether checking your zinc status makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Deferoxamine Mesylate
Moderate DepletionBrand names include Desferal
Clinical research shows that deferoxamine increases urinary zinc excretion in a dose-dependent manner. The effect on serum and blood cell levels of zinc is variable. In some people they remain normal, presumably due to compensatory mechanisms, while in others they are low. Symptomatic zinc deficiency due to deferoxamine is rare, although visual and hearing loss corrected by zinc supplements has been reported. Monitor patients taking deferoxamine for signs of zinc deficiency and give supplements if necessary.
Zinc is a mineral your immune system, wound healing, and senses of taste and smell all depend on. Deferoxamine works by binding to excess iron in the body and pulling it out through the urine, but it can also latch onto zinc along the way, causing more zinc to be flushed out in the urine than normal. Not everyone on this medication ends up with low zinc levels since the body can sometimes compensate, but this is rated a moderate concern, and rare cases of vision or hearing problems linked to zinc loss have been reported. If you are on deferoxamine long term, it is worth asking your doctor or pharmacist whether your zinc levels should be checked.
References (5)
- Aydinok Y, Coker C, Kavakli K, et al. Urinary zinc excretion and zinc status of patients with beta-thalassemia major. Biol Trace Elem Res 1999;70:165-72.
- Canatan D, Temimhan N, Dincer N, et al. Continuous desferrioxamine infusion by an infusor in thalassemia major. Acta Paediatrica 1999;88:550-2.
- Silliman CC, Peterson VM, Mellman DL, et al. Iron chelation by deferoxamine in sickle cell patients with severe transfusion-induced hemosiderosis: a randomized, double-blind study of the dose-response relationship. J Lab Clin Med 1993;122:48-54.
- Schiliro G, Russo A, Azzia N, et al. Leukocyte alkaline phosphatase (LAP). A useful marker of zinc status in beta-thalassemic patients. Am J Ped Hematol Oncol 1987;9:149-52.
- Pinna A, Corda L, Carta F. Rapid recovery with oral zinc sulphate in deferoxamine-induced presumed optic neuropathy and hearing loss. J Neuroophthalmol 2001;21:32-3. PubMed
Deserpidine, Hydrochlorothiazide
Moderate DepletionBrand names include Oreticyl Forte, Oreticyl
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and sexual health, among other things. The hydrochlorothiazide in this combination works as a diuretic, meaning it makes your kidneys produce more urine, and research shows it can pull significantly more zinc out through the urine as well. Serum zinc levels often stay within the normal range, but there is real concern that tissue zinc may quietly drop over years of use. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Deserpidine, Methyclothiazide
Moderate DepletionBrand names include Enduronyl Forte, Enduronyl
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and normal hormone function, so keeping levels in a healthy range matters. The methyclothiazide in this combination is a thiazide diuretic, and thiazides are known to make the kidneys flush out more zinc in the urine than usual, sometimes 50 to 60 percent more. Blood zinc levels often stay within the normal range because the body compensates, but long-term use may quietly draw down zinc stored in tissues. If you have been on this medication for a year or more, it is worth asking your pharmacist or doctor whether monitoring your zinc status makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydralazine, Hydrochlorothiazide
Moderate DepletionBrand names include Apresoline-Esidrix, Apresazide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and hormone function, so keeping levels steady matters. The hydrochlorothiazide in this combination works as a water pill that makes your kidneys flush out more urine, and research shows it also pulls significantly more zinc out through the urine at the same time. Blood zinc levels often stay within the normal range anyway, but long-term use may quietly deplete zinc stored in body tissues. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydralazine, Hydrochlorothiazide, Reserpine
Moderate DepletionBrand names include Ser-Ap-Es, Unipres, Uniserp
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and everyday cell repair, and the hydrochlorothiazide in this combination tablet can cause your kidneys to flush out noticeably more zinc in the urine than normal. Research suggests that loss can reach 50 to 60 percent more zinc in the urine, and over years of use that adds up. Blood levels often stay in the normal range, but longer-term tissue stores may quietly drop. If you have been on this medication for a long time, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Full nutrient report for Hydralazine, Hydrochlorothiazide, Reserpine →
Hydrochlorothiazide
Moderate DepletionBrand names include Esidrix, Hydro, Microzide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and normal hormone function, so keeping levels steady matters. Hydrochlorothiazide works by making your kidneys flush out more fluid, and it pulls extra zinc out through the urine at the same time, potentially increasing zinc loss by more than half compared to not taking the drug. Blood zinc levels often stay in the normal range even so, but long-term users may want to bring this up with their pharmacist or doctor, especially if they notice any symptoms worth discussing.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Irbesartan
Moderate DepletionBrand names include Avalide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and several hormonal processes throughout the body. The hydrochlorothiazide component of this combination works as a thiazide diuretic, meaning it helps the kidneys remove extra fluid, but in doing so it can cause the kidneys to flush out significantly more zinc in the urine than normal. Blood zinc levels often stay within normal range because the body tries to compensate, but long-term use may gradually affect zinc stores in tissues. If you have been on this medication for an extended period, it is worth asking your pharmacist or doctor whether monitoring or a zinc supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Labetalol
Moderate DepletionBrand names include Trandate HCT
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a key role in immune function, wound healing, and several hormonal processes throughout the body. Hydrochlorothiazide, a thiazide diuretic, works by making your kidneys produce more urine, and research shows it can also pull significantly more zinc out through the urine along with the excess fluid. Over years of use, this ongoing loss may gradually affect your body's zinc stores even when blood levels look normal. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether monitoring your zinc status or considering a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Lisinopril
Moderate DepletionBrand names include Zestoretic, Prinzide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and normal hormone function, so keeping levels adequate matters over time. The hydrochlorothiazide in this combination works as a diuretic, meaning it makes your kidneys flush out extra fluid, and research shows it can pull significantly more zinc out through the urine as well. Blood zinc levels often stay in the normal range, but there is real concern that years of this effect could quietly lower zinc in body tissues. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Losartan Potassium
Moderate DepletionBrand names include Hyzaar
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your body uses for immune function, wound healing, and keeping many enzymes running properly. The hydrochlorothiazide in this combination works as a water pill, and research shows it can cause the kidneys to flush out significantly more zinc in the urine than usual. Blood zinc levels often stay in the normal range, but long-term use may gradually draw down the body's zinc stores. If you have been on this medication for a year or more, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Full nutrient report for Hydrochlorothiazide, Losartan Potassium →
Hydrochlorothiazide, Methyldopa
Moderate DepletionBrand names include Aldoril 15, Methazide, Aldoril 25
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and normal hormone activity, so keeping levels in a healthy range matters. Hydrochlorothiazide, the thiazide diuretic in this combination, works on the kidneys to flush out excess fluid, and as a side effect it can also push more zinc out in the urine, sometimes by quite a bit over time. Blood zinc levels often stay within normal limits, but long-term users may want to mention this to their pharmacist or doctor, since some people on extended thiazide therapy do end up needing a supplement.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Metoprolol
Moderate DepletionBrand names include Lopressor HCT
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and several enzymes your body depends on every day. Hydrochlorothiazide, the thiazide diuretic in this combination, works by making your kidneys excrete more fluid, and it appears to pull extra zinc out through the urine along the way. Research suggests urinary zinc losses can be quite significant with long-term use, though blood zinc levels often stay within the normal range thanks to the body's compensatory mechanisms. Because this is rated as moderate depletion, it is worth bringing up with your pharmacist or doctor if you have been on this medication for a long time, especially if you notice any unusual symptoms.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Moexipril
Moderate DepletionBrand names include Uniretic
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc supports your immune system, wound healing, and normal hormone function, so keeping levels adequate matters over time. Hydrochlorothiazide, the thiazide diuretic in this combination, works by making your kidneys produce more urine, and research shows it can also push significantly more zinc out through the urine along the way. Blood zinc levels often stay within the normal range because the body partly compensates, but with years of use there is real concern about gradual tissue depletion. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Pindolol
Moderate DepletionBrand names include Viskazide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and normal hormonal activity, so keeping levels adequate matters over time. Hydrochlorothiazide, a thiazide diuretic, works in the kidneys to help you lose excess fluid, but that same process can push significantly more zinc out through your urine, sometimes 50 to 60 percent more than usual. Blood levels often stay within the normal range, but longer-term use may gradually affect the body's zinc stores in tissues. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether monitoring or a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Propranolol
Moderate DepletionBrand names include Inderide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and several other body processes, so keeping levels steady matters over time. Hydrochlorothiazide, the thiazide diuretic in this combination, works by making the kidneys excrete more fluid and salt, and it appears to pull extra zinc out through the urine in the process. Research suggests this urinary loss can be substantial with long-term use, even if blood levels stay in the normal range for most people. If you have been on this medication for a long time, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Quinapril
Moderate DepletionBrand names include Accuretic
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your immune system, wound healing, and hormonal balance all depend on. Hydrochlorothiazide, the thiazide diuretic in this combination, works by making your kidneys produce more urine, and along with that extra fluid goes a meaningful amount of zinc. Research shows urinary zinc losses can climb 50 to 60 percent, and over years of use some people do see tissue zinc levels fall even when blood tests still look normal. If you have been on this medication long term, it is worth asking your pharmacist or doctor whether monitoring or a zinc supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Reserpine
Moderate DepletionBrand names include Hydropres, Serpasil-Esidrix, Serpasil-Esidrix #1
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc supports immune function, wound healing, and normal testosterone levels, so it is worth keeping an eye on. Hydrochlorothiazide, the thiazide diuretic in this combination, works in the kidneys to flush out excess fluid, and research shows it can also pull zinc out through the urine at a noticeably higher rate than usual. Blood zinc levels often stay in the normal range anyway, but after years of daily use there is some concern that body tissues may quietly run low. If you have been on this medication long-term, it is a reasonable thing to bring up with your pharmacist or doctor at your next visit.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Spironolactone
Moderate DepletionBrand names include Spirozine, Aldactazide, Aldactide 25
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and several enzymes your body depends on every day. Hydrochlorothiazide, a thiazide diuretic, works by making your kidneys produce more urine, and research shows it can pull significantly more zinc out through the urine at the same time, sometimes up to 50 to 60 percent more than normal. Blood zinc levels often stay within the normal range because the body compensates, but there is real concern that zinc in body tissues can quietly drop over years of use. If you have been on this medication long term, it is worth asking your pharmacist or doctor whether any monitoring or a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Full nutrient report for Hydrochlorothiazide, Spironolactone →
Hydrochlorothiazide, Timolol
Moderate DepletionBrand names include Timolide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and hormonal health, so keeping levels in a reasonable range matters over time. Hydrochlorothiazide, the diuretic component of this combination, works in the kidneys to flush out excess fluid, and research shows it can increase the amount of zinc the body loses through urine by more than half. Blood zinc levels often stay within the normal range despite this, but long-term users may want to bring it up with their pharmacist or doctor, since tissue stores can quietly drop even when lab values look acceptable.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Triamterene
Moderate DepletionBrand names include Maxzide, Dyazide, Maxzide-25
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and several enzymes your body depends on every day. Hydrochlorothiazide, the thiazide component in this combination, causes the kidneys to flush out significantly more zinc in the urine than normal, and research suggests this effect can persist for years of use. Blood zinc levels often stay within normal range, but long-term users may want to bring this up with their pharmacist or doctor, since tissue stores could gradually be affected over time.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydrochlorothiazide, Valsartan
Moderate DepletionBrand names include Diovan HCT
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc supports immune function, wound healing, and hormone balance throughout the body. The hydrochlorothiazide in this combination works as a diuretic by making the kidneys flush out excess fluid, and research shows this process also pushes significantly more zinc out through the urine, sometimes up to 60% more than normal. Blood zinc levels often stay in the normal range despite this, but over years of use there is a real concern that tissue zinc can quietly drop. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydroflumethiazide
Moderate DepletionBrand names include Saluron
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your immune system, wound healing, and hormone function all depend on. Hydroflumethiazide, like other thiazide water pills, causes the kidneys to flush out more zinc in the urine than usual, and research suggests this can add up to a meaningful loss over years of use. Blood zinc levels sometimes stay in the normal range even so, but long-term users are worth watching because tissue stores may still run low. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Hydroflumethiazide, Reserpine
Moderate DepletionBrand names include Salutensin-Demi, Salutensin
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your body uses for immune function, wound healing, and keeping hormone systems running properly. Hydroflumethiazide is a thiazide diuretic, meaning it works by making your kidneys produce more urine, and research shows this can pull significantly more zinc out through the urine as well. Blood zinc levels often stay in the normal range, but long-term use may quietly reduce zinc stored in body tissues, which is why this is rated a moderate concern worth watching. If you have been on this medication for a long time, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Indapamide
Moderate DepletionBrand names include Lozol, Lozide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your immune system, wound healing, and hormone function all depend on. Indapamide belongs to the thiazide diuretic family, and these medications cause the kidneys to flush significantly more zinc out through the urine than usual. Blood zinc levels often stay within the normal range because the body tries to compensate, but long-term use may quietly draw down zinc stored in tissues. If you have been on indapamide for a while, it is worth asking your pharmacist or doctor whether monitoring or a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Irbesartan, Hydrochlorothiazide
Moderate DepletionBrand names include CoAprovel
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
The hydrochlorothiazide portion of this medication works by making your kidneys produce more urine, and unfortunately zinc gets swept out along with the extra fluid. Studies show this type of diuretic can push urinary zinc excretion up by more than half, and that effect appears to continue with long-term use. Blood zinc levels often stay in the normal range, but tissue stores may quietly drop over time, which is why this combination carries a moderate depletion rating. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether checking your zinc status or taking a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Methyclothiazide
Moderate DepletionBrand names include Enduron, Aquatensen
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc supports immune function, wound healing, and normal hormone levels, so it is worth keeping an eye on when you are on a thiazide diuretic like methyclothiazide long term. This type of water pill causes the kidneys to flush out noticeably more zinc in the urine, and research suggests that loss can continue for years. Blood zinc levels often stay in the normal range even so, but tissue stores may quietly run low over time. If you have been on this medication for a while, it is a reasonable thing to bring up with your pharmacist or doctor.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Methyclothiazide, Pargyline
Moderate DepletionBrand names include Eutron
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays an important role in immune function, wound healing, and keeping many body processes running smoothly. Methyclothiazide is a thiazide diuretic, meaning it works partly by making your kidneys produce more urine, and research shows this class of drug can cause the kidneys to flush out significantly more zinc than usual. Blood zinc levels often stay within the normal range because the body tries to compensate, but long-term use may gradually reduce zinc stored in body tissues. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Methyclothiazide, Reserpine
Moderate DepletionBrand names include Diutensen-R
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and normal hormone function, so it is worth paying attention to here. The thiazide diuretic in this combination (methyclothiazide) works by making your kidneys produce more urine, and research shows it also causes the kidneys to flush out significantly more zinc than usual. Blood zinc levels often stay in the normal range, but long-term use may quietly reduce zinc in body tissues over time. Because this is rated as moderate depletion, it is a reasonable thing to bring up with your pharmacist or doctor, especially if you have been on this medication for a year or more.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Metolazone
Moderate DepletionBrand names include Diulo, Zaroxolyn, Mykrox
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and normal hormone activity, so keeping levels steady matters over time. Metolazone, a thiazide-type diuretic, works by making your kidneys produce more urine, and research shows this process can drag extra zinc out through the urine as well, raising excretion by a significant amount. Blood levels often stay within the normal range, but long-term use may gradually reduce zinc stored in body tissues. If you have been on this medication for a while, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Penicillamine
Moderate DepletionBrand names include Cuprimine, Depen Titratable
Penicillamine forms chelates with zinc, increasing urinary zinc excretion, but also increasing intestinal zinc absorption. In general, the two effects probably cancel out. However, there is a case report of severe, symptomatic zinc deficiency after two years of treatment with up to 2 grams/day of penicillamine. Monitor patients for signs and symptoms of zinc deficiency. If a supplement is necessary, the dose should be separated from penicillamine by 1-2 hours.
Zinc helps your immune system, wound healing, and your sense of taste and smell, so keeping levels in a healthy range matters. Penicillamine is a chelating drug, meaning it binds to zinc in the body and pulls more of it out through the urine. The catch is that it also nudges the gut to absorb a bit more zinc, and for most people those two forces roughly balance each other out. Still, at higher doses over a long period, zinc levels can fall enough to cause real symptoms in some patients, so it is worth asking your doctor or pharmacist whether monitoring or a supplement makes sense for you.
References (6)
- Brewer GJ, Yuzbasiyan-Gurkan V, Johnson V, et al. Treatment of Wilson's disease with zinc: XI. Interaction with other anticopper agents. J Am Coll Nutr 1993;12:26-30. PubMed
- Seelig MS. Auto-immune complications of D-penicillamine - A possible result of zinc and magnesium depletion and of pyridoxine inactivation. J Am Coll Nutr 1982;1:207-14. PubMed
- Cantilena LR, Klaassen CD. The effect of chelating agents on the excretion of endogenous metals. Toxicol Appl Pharmacol 1982;63:344-50.
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- McCall JT, Goldstein NP, Randall RV, Gross JB. Comparative metabolism of copper and zinc in patients with Wilson's Disease (hepatollenticular degeneration). Am J Med Sci 1967;254:13-23.
- Kingberg WG, Prasad AS, Oberleas D. Zinc deficiency following penicillamine therapy. In: Prasad AS (ed). Trace Elements in Human Health and Disease. Vol.I, Zinc and Copper. Academic Press, New York, 1976. pp51-65.
Polythiazide
Moderate DepletionBrand names include Renese
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and normal hormone function, and polythiazide may gradually pull more of it out through your urine. Research shows this type of diuretic can raise urinary zinc loss by more than half, and that effect may continue for years of use. Serum zinc levels often stay in the normal range thanks to the body compensating, but tissue stores could still drop over time. If you have been on this medication long-term, it is worth asking your pharmacist or doctor whether monitoring or a supplement makes sense for you.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Polythiazide, Prazosin
Moderate DepletionBrand names include Minizide
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc plays a role in immune function, wound healing, and even sexual health, so keeping levels in a reasonable range matters. The thiazide component in this combination (polythiazide) works by making your kidneys produce more urine, and research shows it also causes the kidneys to flush out significantly more zinc than normal. Over years of use, that extra loss can add up and may gradually deplete the body's zinc stores, even if blood tests look normal at first. Because this is rated moderate depletion, long-term users have a reasonable reason to mention it to their pharmacist or doctor and ask whether their zinc status is worth checking.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Polythiazide, Reserpine
Moderate DepletionBrand names include Renese R
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc helps your immune system, wound healing, and normal hormone function, so it is worth keeping an eye on. The thiazide diuretic in this combination works in the kidneys to flush out extra fluid, and research shows it can pull significantly more zinc out in the urine at the same time, roughly 50 to 60 percent more than usual. Blood zinc levels often stay in the normal range, but long-term users may want to ask their pharmacist whether monitoring or a supplement makes sense for them.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Propofol
Moderate DepletionBrand names include Diprivan
Propofol infusion contains 0.005% EDTA, which can chelate zinc. Zinc excretion is increased in critically ill patients and is increased about 2-fold more in patients receiving propofol infusions. Serum zinc levels are decreased in critically ill patients and then gradually recover as the patient's condition improves. This recovery is blunted in patients on propofol. It has been suggested that reduced zinc levels in critical illness may reduce the acute inflammatory response to stress, and the effects of zinc supplements in this population aren't fully understood. If patients are on propofol infusions for several days, monitor for symptoms of zinc deficiency and consider supplements if necessary.
Zinc helps your immune system, wound healing, and hundreds of chemical reactions throughout the body. Propofol contains a preservative called EDTA that can grab onto zinc in the bloodstream and pull more of it out through the urine. In critically ill patients who receive propofol infusions for several days, studies have found zinc levels drop noticeably and recover more slowly than in patients not on the drug. If you or a loved one is receiving propofol in an ICU setting, the care team should be watching zinc levels and may consider a supplement if needed.
References (1)
- Higgins TL, Murray M, Kett DH, et al. Trace element homeostasis during continuous sedation with propofol containing EDTA versus other sedatives in critically ill patients. Intensive Care Med 2000;26:s413-21. PubMed
Reserpine, Trichlormethiazide
Moderate DepletionBrand names include Naquival, Metatensin #2, Metatensin #4
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Trichlormethiazide is a thiazide diuretic, and this class of medication causes the kidneys to flush out more zinc in the urine than usual. Zinc is a mineral your immune system, wound healing, and many enzymes depend on. Research suggests this effect can increase urinary zinc losses by more than half, and while blood levels often stay in the normal range, tissue zinc may quietly drop over years of use. If you have been on this medication long term, it is worth asking your pharmacist or doctor whether your zinc status should be checked.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Trichlormethiazide
Moderate DepletionBrand names include Metahydrin, Naqua, Marazide II
Clinical research shows that thiazide diuretics increase urinary zinc excretion by 50% to 60%, and this is likely sustained during at least 3 years of treatment. Decreased serum zinc levels sometimes occur, although they usually remain within the normal range, possibly due to compensatory mechanisms. However, prolonged thiazide therapy might deplete tissue zinc. It's suggested this could contribute to the impotence sometimes seen with thiazides. Monitor patients on long-term thiazide therapy for symptoms of zinc deficiency. Amiloride is zinc-sparing and can counteract zinc losses caused by thiazides.
Zinc is a mineral your body uses for immune defense, wound healing, and normal hormone function. Trichlormethiazide, like other thiazide water pills, causes the kidneys to flush out significantly more zinc in the urine than usual, and research suggests this can continue for years of use. Blood zinc levels often stay in the normal range, but long-term users may want to ask their pharmacist or doctor whether monitoring or a supplement makes sense for them.
References (7)
- Reyes AJ, Olhaberry JV, Leary WP, et al. Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics. S Afr Med J 1983;64:936-41.
- Cohanim M, Yendt ER. The effects of thiazides on serum and urinary zinc in patients with renal calculi. Johns Hopkins Med J 1975;136:137-44.
- Khedun SM, Naicker T, Maharaj B. Zinc, hydrochlorothiazide and sexual dysfunction. Cent Afr J Med 1995;41:312-5.
- Wester PO. Urinary zinc excretion during treatment with different diuretics. Acta Med Scand 1980;208:209-12. PubMed
- Golik A, Modai D, Weissgarten J, et al. Hydrochlorothiazide-amiloride causes excessive urinary zinc excretion. Clin Pharmacol Ther 1987;42:42-4. PubMed
- Suliburska J, Skrypnik K, Szulinska M, Kupsz J, Markuszewski L, Bogdanski P. Diuretics, Ca-Antagonists, and Angiotensin-Converting Enzyme Inhibitors Affect Zinc Status in Hypertensive Patients on Monotherapy: A Randomized Trial. Nutrients. 2018;10(9). PubMed
- Mountokalakis T, Dourakis S, Karatzas N, et al. Zinc deficiency in mild hypertensive patients treated with diuretics. J Hypertens Suppl 1984;2:S571-2.
Disulfiram
Insufficient EvidenceBrand names include Antabuse
A metabolite of disulfiram is a chelating agent that binds zinc. Preliminary data suggest that doses of disulfiram up to about 320 mg daily may decrease intestinal zinc absorption, while higher doses of 400 mg daily might increase it slightly. The clinical significance of this is not clear.
Zinc helps your immune system, wound healing, and a number of enzymes your body depends on every day. When disulfiram breaks down in the body, one of its byproducts appears to latch onto zinc in the gut, which may reduce how much zinc gets absorbed, though interestingly this effect seems to vary with the dose. The honest truth is that researchers do not yet have enough data to know whether this matters clinically for most people. If you have been on disulfiram long-term and are curious about your zinc status, it is a reasonable thing to bring up with your pharmacist or doctor.
References (2)
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- Sorensen JA, Andersen O. Effects of diethyldithiocarbamate and tetrathylthiuram disulfide on zinc metabolism in mice. Pharmacol Toxicol 1989;65:209-13.
Ethambutol
Insufficient EvidenceBrand names include Myambutol, Etibi
Ethambutol chelates zinc and might reduce plasma and tissue levels. This could contribute to ocular side effects of the drug. The incidence of visual dysfunction increases with the dose of ethambutol, especially above 25 mg/kg/day, and also seems to be more common in people with low plasma zinc levels less than 0.7 mg/L. Counsel patients taking ethambutol to report visual changes, and consider regular monitoring of visual function. Visual changes are usually reversible if the drug is stopped promptly. It is not clear whether zinc supplements are helpful to reduce side effects of ethambutol, and there's some concern that zinc chelation is involved in the mechanism of action of the drug, so taking zinc supplements could reduce its efficacy.
Zinc helps your immune system, wound healing, and eye health, so it is worth knowing that ethambutol appears to bind to zinc in the body, a process called chelation, which may pull zinc out of your tissues and raise how much you lose through urine. The evidence here is still thin, so we cannot say this is a clear-cut problem for most people, but there is an interesting detail: low zinc levels in the blood seem to be linked to a higher chance of vision changes, which are already a known side effect of ethambutol. Do not start zinc supplements on your own without checking first, because zinc might actually interfere with how the drug works. If you notice any changes in your vision while taking ethambutol, let your doctor or pharmacist know right away.
References (5)
- Campbell IA, Elmes PC. Ethambutol and the eye: zinc and copper (letter). Lancet 1975;2:711. DOI
- Weismann K. Chelating drugs and zinc. Dan Med Bull 1986;33:208-11.
- De Palma P, Franco F, Bragliani G, et al. The incidence of optic neuropathy in 84 patients treated with ethambutol. Metab Pediatr Syst Ophthalmol 1989;12:80-2.
- Solecki TJ, Aviv A, Bogden JG. Effect of a chelating drug on balance and tissue distribution of four essential metals. Toxicology 1984;31:207-16. PubMed
- King AB, Schwartz R. Effects of the antituberculous drug ethambutol on zinc absorption, turnover and distribution in rats fed diets marginal and adequate in zinc. J Nutr 1987;117:704-8. DOI
Lamivudine, Zidovudine
Insufficient EvidenceBrand names include Combivir
Some data suggest that zidovudine contributes to the decreased zinc plasma levels associated with AIDS. However, the role of zinc supplementation is controversial. It has been reported that zinc supplements can reduce the incidence of opportunistic infections in AIDS patients.
Zinc is a mineral your immune system, wound healing, and cell growth all depend on. Some research has found that zidovudine may be linked to lower zinc levels in the blood, possibly because the drug affects how the body handles this mineral during HIV infection, though it is hard to separate the drug's effect from the disease itself. The evidence here is rated insufficient, meaning researchers simply do not yet have enough data to know how meaningful this is for most people taking this combination. If you have concerns, it is worth bringing up with your doctor or pharmacist, especially if you have been on this therapy long-term.
References (2)
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Mocchegiani E, Veccia S, Ancarani F, et al. Benefit of oral zinc supplementation as an adjunct to zidovudine (AZT) therapy against opportunistic infections in AIDS. Int J Immunopharmacol 1995;17:719-27. PubMed
Zidovudine
Insufficient EvidenceBrand names include Retrovir, Retrovir Injection
Some data suggest that zidovudine contributes to the decreased zinc plasma levels associated with AIDS. However, the role of zinc supplementation is controversial. It has been reported that zinc supplements can reduce the incidence of opportunistic infections in AIDS patients.
Zinc helps your immune system fight off infections and keeps many body processes running smoothly, so it is especially important for people living with HIV. There is some data suggesting zidovudine may contribute to lower zinc levels in the blood, possibly because HIV itself already tends to deplete zinc and the medication may add to that effect. That said, the evidence here is still too limited to draw firm conclusions, so most people taking zidovudine do not need to act on this right away. If you are curious whether your zinc levels are worth checking, that is a good question to raise with your doctor or pharmacist.
References (2)
- Segal S, Kaminski S. Drug-nutrient interactions. American Druggist 1996 Jul;42-8.
- Mocchegiani E, Veccia S, Ancarani F, et al. Benefit of oral zinc supplementation as an adjunct to zidovudine (AZT) therapy against opportunistic infections in AIDS. Int J Immunopharmacol 1995;17:719-27. PubMed
This tool is educational and is not a substitute for professional medical advice. An association is not a diagnosis and does not mean a deficiency will occur. Always talk to your pharmacist or healthcare provider before starting, stopping, or changing any medication or supplement.
Disclaimer: This checker finds which nutrients might be depleted by prescription or over-the-counter medications. Each nutrient depletion issue is rated based on clinical significance. Use your own professional judgment prior to making clinical decisions.© 2026 Therapeutic Research Center Licensed records refresh weekly · last updated July 3, 2026.
What drug-induced nutrient depletion means
Some medications can, over time, lower the levels of certain vitamins, minerals, or other nutrients — through reduced absorption, increased loss, or changes in how the body uses them.
Association is not deficiency
An entry here means a depletion has been reported or studied — not that it happens to everyone, or that you are deficient. Dose, duration, diet, and your own health all matter.
Evidence varies by pair
Some drug–nutrient links (like metformin and vitamin B12) are well studied; others rest on limited or preliminary research. Each entry shows the evidence rating from our licensed clinical database.
When to ask about labs
If you take an associated medication long-term, ask your healthcare provider whether monitoring is appropriate for you. Not everyone needs testing — your provider can weigh your dose, duration, and symptoms.
Don't self-supplement blindly
Supplements are not risk-free: some can interact with medications, and some (like potassium or magnesium) can be risky with kidney disease. Talk to your pharmacist before adding anything.
Never stop a medication over this
These medications are prescribed for good reasons, and the benefit usually far outweighs a manageable nutrient consideration. Any change belongs in a conversation with your prescriber.
Food first, usually
For many nutrients, a varied diet covers the gap. Each entry lists common food sources; a supplement is a decision to make with your pharmacist or provider, not a default.
ZINC & medications: FAQs
Which medications can lower ZINC?
I take one of these medications — am I deficient in ZINC?
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Other commonly implicated nutrients
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Sources & How We Checked
Medication associations with ZINC are evidence-graded and sourced from the Natural Medicines database, and are displayed as published with their citations.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for drug-induced nutrient depletions, supplements, and interactions — the basis for this page.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for medication overviews across the site.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.