Zinc (Serum)

Immunity

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No Fasting Required

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Measures the concentration of zinc, an essential trace mineral, in the blood

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ZINC (SERUM) - Comprehensive Medical Test Information Guide

Why is it done?
- Measures serum zinc levels to assess zinc status and nutritional status in the body. Zinc is an essential trace element critical for immune function, protein synthesis, wound healing, and DNA synthesis.
- Diagnose zinc deficiency in patients presenting with symptoms such as alopecia, dermatitis, diarrhea, immune dysfunction, delayed wound healing, or growth retardation
- Evaluate nutritional status in patients with malabsorption disorders, chronic liver disease, or those receiving total parenteral nutrition (TPN)
- Monitor zinc levels in patients with chronic conditions affecting nutrient absorption such as Crohn's disease, ulcerative colitis, celiac disease, or cystic fibrosis
- Assess zinc toxicity in patients with excessive zinc supplementation or occupational exposure
- Evaluate immunocompromised patients, including those with HIV/AIDS or undergoing cancer treatment
- Monitor elderly patients or those with poor dietary intake who are at increased risk for zinc deficiency
Normal Range
- Reference Range: 70-110 mcg/dL (10.7-16.8 µmol/L) for adults. Normal ranges may vary slightly between laboratories.
- Units of Measurement: Micrograms per deciliter (mcg/dL) or micromoles per liter (µmol/L)
- Low Zinc (<70 mcg/dL): Indicates zinc deficiency which may require supplementation and investigation into underlying causes
- Normal Range (70-110 mcg/dL): Indicates adequate zinc status and normal nutritional status for this micronutrient
- High Zinc (>110 mcg/dL): Suggests excessive zinc supplementation, occupational exposure, or potential zinc toxicity which requires clinical correlation
- Borderline Low (60-70 mcg/dL): May warrant closer monitoring and consideration of dietary zinc intake or supplementation
Interpretation
- Zinc Deficiency (Hypozincemia): Values below 70 mcg/dL indicate zinc deficiency. Clinical presentation may include weakened immune response, alopecia (hair loss), dermatitis or skin lesions, diarrhea, impaired wound healing, anorexia, and in severe cases, mental confusion or neurological symptoms. Consider evaluating for underlying causes such as malabsorption, chronic diarrhea, inadequate dietary intake, or increased losses.
- Normal Zinc Status: Results within 70-110 mcg/dL suggest adequate zinc nutrition and normal immune and metabolic function. Patient can maintain current dietary intake and supplementation status.
- Zinc Toxicity (Hyperzincemia): Values above 110 mcg/dL may indicate zinc toxicity. Acute toxicity symptoms include nausea, vomiting, abdominal pain, and diarrhea. Chronic excess may cause copper deficiency, neurological symptoms, and immune suppression. Review supplementation practices and consider dose reduction.
- Factors Affecting Results: • Timing of supplementation or recent dietary zinc intake • Stress and acute illness (may transiently lower levels) • Medications (diuretics, ACE inhibitors may affect zinc) • Time of day (mild circadian variation exists) • Albumin and other binding proteins (albumin is major zinc carrier) • Hemolysis of sample (may falsely elevate results) • Recent transfusions or blood donation
- Clinical Significance: Serum zinc is considered a general marker of zinc status, though it may not reflect total body zinc stores accurately. Zinc deficiency is particularly significant in immune-compromised patients, children, pregnant women, and elderly populations. Interpretation should consider clinical context and other nutritional markers.
Associated Organs
- Primary Organ Systems Involved: Gastrointestinal system (zinc absorption), immune system, integumentary system (skin), endocrine system, and nervous system
- Conditions Associated with Zinc Deficiency: • Acrodermatitis enteropathica (genetic zinc malabsorption disorder) • Inflammatory bowel disease (Crohn's disease, ulcerative colitis) • Chronic liver disease and cirrhosis • Chronic kidney disease • Diabetes mellitus (increased urinary zinc losses) • Celiac disease and other malabsorption syndromes • Cystic fibrosis • Chronic diarrhea from any cause • HIV/AIDS • Alcoholism and nutritional deficiency • Myocardial infarction • Sepsis and critical illness • Total parenteral nutrition without adequate zinc supplementation • Anorexia nervosa and eating disorders
- Conditions Associated with Zinc Toxicity: • Occupational exposure (metal fumes, welding) • Excessive supplementation • Aceruloplasminemia (rare copper metabolism disorder) • Wilson's disease (if treated with excess zinc)
- Potential Complications of Abnormal Zinc Status: • Impaired immune response and increased infection risk (deficiency) • Delayed wound healing and compromised tissue repair • Growth retardation in children • Hair loss and skin disorders • Hypogeusia (taste dysfunction) • Neuropsychological symptoms including depression and cognitive decline • Copper malabsorption and neurological complications (toxicity) • Increased cardiovascular risk • Altered glucose metabolism
Follow-up Tests
- Recommended Follow-up Tests for Low Zinc: • Serum albumin (as zinc carrier protein and nutritional marker) • Serum copper and ceruloplasmin (to evaluate copper-zinc balance) • Complete metabolic panel (to assess kidney and liver function) • Complete blood count (to assess immune function and anemia) • 24-hour urinary zinc (to assess zinc losses) • Serum iron, ferritin, and iron-binding capacity • Vitamin A and other fat-soluble vitamins • Prealbumin (transthyretin as nutritional marker)
- Recommended Follow-up Tests for High Zinc: • Serum copper and ceruloplasmin (zinc interferes with copper absorption) • Comprehensive metabolic panel • Complete blood count with differential • 24-hour urinary copper • Medication and supplementation review
- Diagnostic Tests to Investigate Underlying Causes: • Fecal fat (if malabsorption suspected) • Tissue transglutaminase antibody (for celiac disease screening) • Inflammatory markers (ESR, CRP) for inflammatory bowel disease • Liver function tests (AST, ALT, bilirubin, albumin) • Kidney function tests (BUN, creatinine, eGFR) • Immunological testing (CD4/CD8 counts if HIV suspected) • Stool examination for parasites or pathogens
- Monitoring Frequency: • For deficiency: Recheck 4-8 weeks after initiating supplementation • For toxicity: Recheck 2-4 weeks after dose adjustment • For chronic conditions: Monitor every 3-6 months if deficiency is present • For patients on TPN: Monitor at baseline, 1-2 weeks, then monthly • Routine screening in at-risk populations: Annually
- Complementary Nutritional Tests: • Serum selenium • Serum magnesium • Serum manganese • Vitamin B12 and folate levels • Vitamin D (25-hydroxyvitamin D) • Nutritional assessment panel
Fasting Required?
- Fasting Requirement: NO - Fasting is not required for serum zinc testing. The test can be performed at any time of day regardless of meal status.
- Important Considerations: • Do not take zinc supplements or multivitamins containing zinc for at least 24 hours before the test if possible, as recent supplementation may artificially elevate results • If patient is actively taking zinc supplements, note the timing and dose in the test requisition • Avoid contamination of collection tube with zinc-containing substances • If possible, perform test in morning for consistency, as mild circadian variation may exist
- Medications to Avoid or Note: • Zinc supplements and multivitamins (note dose and timing if being taken) • Some antibiotics may affect zinc absorption • ACE inhibitors and diuretics may affect serum zinc levels • Corticosteroids may deplete zinc • Inform laboratory of any medications patient is taking
- Patient Preparation Requirements: • Normal clothing may be worn; no special preparation needed • Inform phlebotomist about any metal allergies or sensitivities • Allow arm to hang naturally to prevent hemoconcentration • Collect blood in appropriate zinc-free collection tube (typically SST or plasma tube) • Avoid excessive hemolysis during collection • Ensure patient identification to prevent specimen mix-up • Specimen should be labeled with patient name, date, and time of collection • Promptly transport specimen to laboratory; zinc is relatively stable

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