Zinc Supplementation Guidelines

General Recommendations

The recommended daily dose of zinc for adults is 15 mg, which can be obtained through a complete multivitamin and mineral supplement containing at least the government recommended daily allowance for zinc, as recommended by the Clinical Nutrition society 1
Zinc supplementation should be in the form of a complete multivitamin and mineral supplement containing at least the government recommended daily allowance, according to the Obesity Reviews society 2, 3

Different zinc salts (sulfate, acetate, gluconate, citrate) are available, with similar efficacy but potentially different tolerability profiles, as reported by the Journal of Hepatology society 4, 5
Organic compounds such as zinc histidinate, zinc gluconate, and zinc orotate show better tolerability than inorganic zinc sulfate and zinc chloride, as stated by the Clinical Nutrition society 1, 6

Following bariatric surgery procedures like Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), 15 mg zinc daily is recommended, according to the Obesity Reviews society 2, 3
For malabsorptive procedures such as biliopancreatic diversion with duodenal switch (BPD/DS), at least 30 mg zinc daily is recommended, as recommended by the Obesity Reviews society 2, 3
For patients with Wilson's disease, higher doses of 150 mg elemental zinc daily are recommended, as stated by the Hepatology society 7, 4, 5
For children under 50 kg with Wilson's disease, 75 mg elemental zinc daily is recommended, according to the Journal of Hepatology society 4, 5
In acquired zinc deficiency, 0.5-1 mg/kg per day of elemental zinc can be given orally for 3-4 months, as recommended by the Clinical Nutrition society 1, 6

When giving additional zinc and copper supplements, maintain a ratio of 8-15 mg zinc to 1 mg copper, as recommended by the Obesity Reviews society 8
Taking zinc with food interferes with its absorption, but this may be necessary if it ensures compliance, as stated by the Journal of Hepatology society 4, 5

For mild zinc or copper deficiency, consider giving two Forceval daily and recheck levels after 3 months, as recommended by the Obesity Reviews society 8
For severe zinc deficiency with normal or borderline copper levels, treat with high-dose zinc supplement for 3 months and recheck levels, according to the Obesity Reviews society 8
If both zinc and copper are low, consider prescribing two Forceval daily for 3 months and recheck levels, as stated by the Obesity Reviews society 8
Adequacy of treatment with zinc is judged by clinical and biochemical improvement and by measuring 24-hour urinary excretion of copper (for Wilson's disease), as recommended by the Journal of Hepatology society 4, 5