What is it about?
Elevated zinc level lead to increase metallothionein (MT) proteins in the small intestine. MT proteins form disulfide bond with various metals. Copper outcompetes zinc in binding to MT due to its greater affinity for the ligand. Copper that is bound to MT is unable to be absorbed. Ultimately, copper bound to MT is lost in the stool as enterocytes are shed and replaced
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Why is it important?
COVID-19 outbreak led to increase popularity of zinc sulfate use. Although the daily recommended dose of Zinc sulfate is 8-11 mg per day, over the counter Zinc sulfate preparation contain as much as 220 mg of Zinc sulfate or 50 mg of Zinc. Long term use of high dose Zinc supplement can lead to copper deficiency which can result in various clinical manifestation.
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This page is a summary of: Erythropoietin-Resistant Anemia Secondary to Zinc-Induced Hypocupremia in a Hemodialysis Patient, Case Reports in Nephrology and Dialysis, July 2021, Karger Publishers,
DOI: 10.1159/000512612.
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