The Role of Zinc in Magnesium Deficiencies

by Herbert C. Mansmann, Jr. M.D.

As a child in the 1920’s, Zinc (Zn) oxide was our antibiotic ointment for all sorts of skin conditions. As a pediatrician in the 1950’s, it was still the treatment of choice for infected diaper rashes. Recently Zn lozenges have become the treatment for symptoms of the common cold, although meta-analysis of multiple clinical studies has not borne this out as being effective. Most common cold viruses grow and reside in the nose, not in the throat, so this analysis should not be unsuspected. Yet Zn is very safe and if it seems to work for you, I would recommend that one continue to use the lozenges.

In the 1990’s my grandson with severe facial cystic acne, after three days of 50 mg twice a day of Zn, he suggested that I should patent it. A graduate student in my Division studied the Zn status of asthmatic prone (asymptomatic) and asthmatics during cortisone treatment and non-asthmatic children. (Goldey, 1984)., Zn deficiency (ZnD) was found in those receiving prednisone. Zn is lost when magnesium is lost from the kidneys due to the cortisone.

Sources and Symptoms

Meat provides 70% of the dietary Zn. The RDA of Zn is 15 mg and about 15-60% is absorbed. Urinary Zn is 300-700 ug/day and ZnD results from alcoholism and intestinal malabsorption. (Brody, 1994, p581-7). Large amounts of Zn are excreted into the bowel after a meal, via the gall bladder, and most must be reabsorbed to maintain positive Zn balance. It is lost in the bowels during diarrhea, and in other bowel diseases, such as cystic fibrosis. The symptoms are a rash, diarrhea, and alopecia. Evidence suggests that ZnD leads to decreased immunocompetence (the body’s ability to fight infections) and increased infectious disease morbidity. Some infants have been seen with a typical rash, called acrodermatitis enteropathica, which is cured by Zn supplementation (Nelder KN 1975). Furthermore, ZnD may be associated with complications of pregnancy and childbirth, such as lower birth weigh, and other fetal effects lasting into childhood. In these infants and children evidence of reduced growth and motor and cognitive development, is accumulating (Black, 1998). All of these symptoms improved with Zn supplements.

Supplementation with 5 mg/d of Zn in low-birth-weight full-term infants for 8 wks had 28% reduction in diarrhea and had a 4.2% mortality vs. placebo 10.6%, (Lira PIC 1988). Zn supplementation in small-for-gestational-age infants can result in a substantial reduction in infectious disease mortality, by 68%. (Sazawal, 2001). Zn is known to play a central role in immune function by multiply mechanisms. (Shankar, 1988).

But be couscous as a Zn intake of 150 mg per day causes copper deficiency.

ZnD Diagnosis

Zn circulates at a serum concentration of 70 to 120 µg/dL, with 60 percent loosely bound to albumin and 30 percent tightly bound to macroglobulins. Urinary excretion typically ranges from 0.5 to 0.8 mg/day. The primary stores of Zn include the liver and kidney.

Zn status can be assessed by measurement of zinc in serum, plasma, erythrocytes, neutrophils, lymphocytes, and hair. Measurement of Zn in the plasma is simple and readily available in many laboratories. A low plasma Zn usually is defined as a value less than 60 µg/dL. Because much of plasma Zn is bound to albumin, correcting values for the level of serum albumin in conditions associated with hypoalbuminemia is important.

The plasma/serum Zn and hair Zn tests, are not as good as the red blood cell Zn, which most laboratories can get done. Normal rbcZn is 10-14 ug/ml (Brody, p588).

Personal Experiences

At the peak of my undiagnosed and uncontrolled diabetes, I could not read for more than an hour at a time and even then I needed a magnifying glass. My son and I were committed to writing a chapter for “Current Pediatrics Therapy”, so I told him to write it and we would meet to review it. Two years previously we wrote two chapters, one on Mg, in which I was the first author and he was the first author on the second chapter on Zn in children. So before we met to complete the paper, I felt I should read about Zn. So I went to my “Nutritional Bible”, Shill’s Textbook on “Modern Nutrition in Health and Disease”. On the first page, third paragraph it said that the cornea of the eye had the highest concentration Zn, of all the tissues in the body. The next line said that in ZnD the cornea developed edema, swelling due to water content. That meant it was like looking through water on glass. I started Zn and I took 50 mg twice a day for years and it worked, since whenever I stopped it, the blurred vision returned. At about this time my type II diabetes (DM) was diagnosed. I have had a life long MgD.

Subjects with type II DM had lower concentrations of Mg, K and Zn in skeletal muscle. Furthermore, the excretions of uMg and uZn were higher, as compared with those in healthy controls (Sjogren, 1988). In addition, hyperzincuria and hypermagnesuria were evident in another study of diabetic subjects compared with control subjects (Walter RM 1990). Finally another study showed diabetics of both types excreted significantly (p<0.031) more Zn than did the control subjects. There was positive correlation between hemoglobin A1c and urinary loss of Mg (p<0.013) or Zn (p<0.0241) in patients with type II diabetes (el-Yazigi A 1993). In addition I was on thiazide diuretics, which can increase urinary Zn and Mg loss (Reyes AJ 1982).

Recommendations

1. For colds (URI) I suggest one try the following product, because it has been studied (Hurt 2000).

ZICAM Nasal Gel: 1 pump each nostril every 2 to 4 hours.

The zinc nasal gel consisted of zinc gluconate in an emulsion of benzalkonium chloride, glycerin, hydroxyethylcellulose, sodium chloride, and sodium hydroxide; its pH level was 7.2. The composition of the placebo gel was identical except that it did not contain zinc. Both gels were dispensed in a double-blind fashion in metered doses of 120ml in applicators supplied by Botanical Laboratories (Ferndale, Wash.). Subjects were instructed to spray one dose into each nostril every 4 hours (9 a.m., 1 p.m., 5 p.m., and 9 p.m.) for as long as they experienced symptoms. Participants were instructed not to take any other cold remedies or any drugs that might affect symptom scores. The mean resolution time was 2.3 days (±0.9) for the zinc patients and 9.0 days (±2.5) for the controls (figure 2). The difference was statistically significant (p<0.05).

2. Anyone with recurrent infections in the Bartter’s and Gitelman’s syndromes, and anyone with MgD need to realize that uMg wasting take out not only K but also Zn.

3. Zn 50 mg twice a day will cut the infection rate.

References

  1. Black RE. Preface. Zinc in Child Health. Am J Clin Nutr. 1998; 68(suppl):409.
  2. Brody T. Nutritional Biochemistry. Academic Press Inc. San Diego, 1994.
  3. Goldey, DH., Mansmann, Jr., H.C., and Rasmussen, A.I.: Zinc Status of Asthmatic, Prednisone-Treated Asthmatic and Non-Asthmatic Children. J Am Dietetic Assoc, l984;84:l57-63.
  4. el-Yazigi A, Hannan N, Raines DA. Effect of diabetic state and related disorders on the urinarymagnesium and zinc in patients. Diabetes Research. 22(2):67-75, 1993. excretion of

5. Hirt M, Nobel S, Barron E, BS. Zinc nasal gel for the treatment of common cold symptoms: A double-blind, placebo-controlled trial, ENT Journal, 2000;9:79.

6. Karcioglu ZA. Zinc in the eye. Surv Ophthalmol. 1982; 27(2):114-122.

7. Lira PIC.,Ashworth A, Morris SS. Effect of zinc supplementation on morbidity, immune function, and growth of low-birth-weight, full-term infants in northwest Brazil. Am J Clin Nutr;1998;68:418S-24S

8. Pak CYC, Ruskin B, Diller E. Enhancement of renal excretion of zinc by hydrochlorothiazide. Clin Chim Acta. 1972; 39:511-517.

  1. Reyes AJ, Leary WP, Lockett CJ, et al. Diuretics and zinc. S Afr Med J 1982;62:373.
  2. Shankar AH, Pasad AS. Zinc and immune function. Am J Cl Nutr. 1998:68:447S-63S.
  3. Shill ME, Olson JA, Shine M, Ross AC. Modern Nutrition in Health and Disease. 8th Ed. 1994.
  4. Sjogren A, Floren CH Nilsson A. Magnesium, potassium and zinc deficiency in subjects with type II diabetes mellitus. Acta Medica Scandinavica. 224(5):461-6, 1988.
  5. Sazawal S, PhD. Pediatrics Dec 2001.

14. Walter RM, Uriu-Hare JY Olin KL Oster MH Anawalt BD Critchfield JW Keen CL. Copper, zinc, manganese, and magnesium status and complications of diabetes mellitus. Diabetes Care. 1991; 14(11):1050-1056.

15. Wood RJ, Zheng JJ. High dietary calcium intakes reduce zinc absorption and balance in humans. Am J Clin Nutr. 1997;65:1803-1809.

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