Zinc seems to be on many people’s minds these days, given its role in supporting immune health and protecting against respiratory viruses. Pandemic aside, zinc is an important topic for us to talk about anyhow, seeing as people with IBD are at greater risk of a zinc deficiency. 

What is zinc?

Zinc is an essential trace mineral, meaning that our bodies need small amounts of it to function. Our bodies do not store excess zinc so we must get it from food or supplements. Many key physical processes require zinc, including growth, tissue repair, wound healing and reproductive function. Plus, it’s an essential nutrient for the immune system.

Zinc and inflammatory bowel disease 

We commonly see low serum/plasma zinc levels in people with IBD. Studies estimate that 15-40% of people with IBD have a zinc deficiency. Even a mild zinc deficiency can make it more difficult for the immune system to fight off invading bacteria and viruses.

What’s more? Research suggests that a zinc deficiency contributes to intestinal inflammation, a weakened gut barrier, and increased risk of IBD-related complications, hospitalizations, surgeries. Complications might include anemia, fistula, malnutrition, dehydration, and abscess. Correcting the deficiency leads to better outcomes.  

Why are people with IBD at greater risk for a zinc deficiency? 

Both Crohn’s disease and ulcerative colitis can increase one’s risk of developing a zinc deficiency, although it’s more common in Crohn’s.

People with IBD may develop a zinc deficiency because of: 

  • Poor dietary intake because of reduced appetite or food restrictions
  • Decreased absorption because of active inflammation or previous small bowel resection (more common in Crohn’s disease)
  • Excessive diarrhea 
  • Fistula output (Crohn’s)
  • Medications for IBD, such as glucocorticoids and certain antibiotics, can inhibit zinc absorption 

How do I know if I have a zinc deficiency? 

Talk to your doctor about closely monitoring your serum/plasma zinc level.  This measurement isn’t perfect, so beware of common signs, symptoms and risk factors:

  • Excessive diarrhea
  • Poor appetite
  • Vegetarian or vegan diet 
  • Altered sense of smell and taste
  • Hair loss
  • Slow wound healing
  • Significant weight loss / inadequate growth
  • Difficulty seeing at night 
  • Fistulizing Crohn’s disease 

What should I do if I have a zinc deficiency?

  1. Seek a registered dietitian nutritionist (RDN) to review your normal diet. She will help you figure out how to add more zinc-rich foods to your diet. Foods with zinc include red meat, dark meat chicken, seafood, dairy products, nuts, legumes, whole grains, and fortified breakfast cereals. Zinc is easier to absorb from meat and seafood than it is from dairy or plant-based sources. You might have reasons for avoiding some of these foods, so work closely with your RDN to find out what works for you. 
  2. Talk to your doctor and/or RDN about a zinc supplement. Your provider can recommend the appropriate form, dose, and duration. You may or may not require one. For some individuals, a diet higher in zinc plus a multivitamin might be enough to correct the deficiency. If you need a zinc supplement, please note that supplements should not be taken for longer than 2-3 weeks as too much zinc can interfere with iron and copper absorption.  

Anything else you’d like to know about zinc and IBD? Leave a comment below.

References: 

Hwang, C., Ross, V. and Mahadevan, U. (2012), Micronutrient deficiencies in inflammatory bowel disease: From A to zinc. Inflamm Bowel Dis, 18: 1961-1981. doi:10.1002/ibd.22906

Siva S, Rubin DT, Gulotta G, Wroblewski K, Pekow J. Zinc Deficiency is Associated with Poor Clinical Outcomes in Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis. 2017;23(1):152–157. doi:10.1097/MIB.0000000000000989

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