Merck Manual

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Zinc Toxicity

By

Larry E. Johnson

, MD, PhD, University of Arkansas for Medical Sciences

Reviewed/Revised Jul 2023
View PATIENT EDUCATION

Zinc (Zn) is contained mainly in bones, teeth, hair, skin, liver, muscle, leukocytes, and testes. Zinc is a component of several hundred enzymes, including many nicotinamide adenine dinucleotide (NADH) dehydrogenases, RNA and DNA polymerases, and DNA transcription factors as well as alkaline phosphatase, superoxide dismutase, and carbonic anhydrase.

The recommended upper limit in adults for zinc intake is 40 mg/day; the upper limit is lower for younger people. Toxicity is rare.

Ingesting doses of elemental zinc ranging from 100 to 150 mg/day for prolonged periods interferes with copper metabolism and causes low blood copper levels, red blood cell microcytosis, neutropenia, and impaired immunity; higher doses should be given only for short periods of time and the patient followed closely.

Ingesting larger amounts (200 to 800 mg/day), usually by consuming acidic food or drinking from a galvanized (zinc-coated) container, can cause anorexia, vomiting, and diarrhea. Chronic toxicity may result in copper deficiency and may cause nerve damage.

Metal fume fever, also called brass-founders’ ague or zinc shakes, is caused by inhaling industrial zinc oxide fumes; it results in fever, dyspnea, nausea, fatigue, myalgias, and a metallic taste in the mouth. Symptom onset is usually 4 to 12 hours after exposure. Symptoms usually resolve after 12 to 24 hours in a zinc-free environment.

Diagnosis of zinc toxicity is usually based on the time course and a history of exposure.

Treatment of zinc toxicity consists of eliminating exposure to zinc; no antidotes are available.

Drugs Mentioned In This Article

Drug Name Select Trade
Aquaphor 3 IN 1 Diaper Rash, Aquaphor Baby Fast Relief Diaper Rash, Aquaphor Fast Relief Diaper Rash, Balmex, Boudreaux Butt Paste, Boudreauxs Rask, Carlesta, Coppertone, COZIMA, DermacinRx Zinctral, Desitin, Desitin Maximum Strength, Desitin Rapid Relief, Diaper Rash , Dr. Smith Adult Barrier, Dr. Smith's, Dr. Smith's Diaper Rash, Dr. Smith's Rash + Skin, DynaShield, Eucerin Baby Sunscreen Sensitive Mineral , Eucerin Sunscreen Sensitive Mineral, Flanders Buttocks , Medi-Paste, Novana Protect, PanOxyl AM, Triple Paste, Triple Paste Adult Incontinence, Z-Bum
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NOTE: This is the Professional Version. CONSUMERS: View Consumer Version
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