slamming the zinc reference range
Posted: Wed Jan 10, 2018 9:49 am
they say zinc just gradually 'gets lower' as part of the aging process. but what does that mean exactly? lower than what? how do we know when to take action?
to my mind, zinc (and other) 'normal' ranges are massively and ultimately unethically deceptive
case in point. here is a selection of zinc reference or normal ranges
Zinc, Serum
https://www.mayomedicallaboratories.com ... etive/8620
Normal serum zinc is 0.66 to 1.10 mcg/mL......................................(aka 66-110 μg/dl)
Pediatric reference intervals for serum copper and zinc
Based on the central 95% ... the resulting reference interval determined for serum zinc was
................................................................................................64-124 μg/dl
(central 95% of course referring to the bell curve, so we are not seeing absolute highest and lowest values obtained)
local labs i've encountered here and elsewhere:
..................................................................11.5-18.5 μmol/L.......(75 - 121 μg/dl)
...............................................................10-20 μmol/L...............(65 - 131 μg/dl)
in research:
Determination of Serum Zinc Concentrations in Normal Adult Subjects ...
https://academic.oup.com/ajcp/article/57/4/506/1770331
'healthy young men'............................................serum mean 102, range 68-136 ug/dl
interesting contrasts:
Reference range of zinc in adult population (20-29 years) of Lahore, Pakistan
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048503/
healthy individuals:..............serum mean 24, range 11.5-36.7 µmol/L (157, 75 - 240 μg/dl)
males:..............................serum mean 22, range 11.9-32.4 µmol/L (144, 78 - 212 μg/dl)
females:.............................serum mean 22, range 9.9-36.9 µmol/L (144, 65 - 241 μg/dl)
Reference values for serum zinc concentration and prevalence of zinc deficiency in adult Iranian subjects.
https://www.ncbi.nlm.nih.gov/pubmed/22592845
men...........................................................9.6 - 31.6 μmol/L........(63 - 207 μg/dl)
women.......................................................8.9 - 29.9 μmol/L.........(58 - 195 μg/dl)
total population...........................................9.3 - 30.8 μmol/L..........(61 - 201 μg/dl)
(and recall, based on that central 95% idea, we are not seeing the very highest or lowest levels identified in these groups)
Serum Zinc and Copper Status in Hospitalized vs. Healthy Elderly Subjects
http://www.tandfonline.com/doi/abs/10.1 ... 7.10719643
(you can download a pdf via researchgate)
this study's cutoff to establish low zinc status................ 0.70 mg/L (aka <70 μg/dl)
next, serum mean zinc levels in study subjects:
healthy elderly controls...........................................1.10 mg/L (aka 110 μg/dl);..........0% below 70 μg/dl
hospitalized group...................................................0.87 mg/L (aka 87 μg/dl);...............only 20% below 70 μg/dl
(clearly this cutoff leaves something to be desired)
nervous system disease ............................................94 μg/dl; 6% below 70 μg/dl
mental disturbance .................................................90 μg/dl; 13% below 70 μg/dl
cancers .................................................................89 μg/dl; 26% below 70 μg/dl
undefined symptoms .................................................88 μg/dl; 15% below 70 μg/dl
digestive diseases ....................................................88 μg/dl; 19% below 70 μg/dl
osteo-muscular disease ..............................................87 μg/dl; 14% below 70 μg/dl
endocrine/metabolic disease .......................................87 μg/dl; 19% below 70 μg/dl
infectious disease ...................................................87 μg/dl; 21% below 70 μg/dl
blood disease ..........................................................87 μg/dl; 24% below 70 μg/dl
cardiovascular disease ..............................................86 μg/dl; 19% below 70 μg/dl
genitourinary disease.................................................84 μg/dl; 21% below 70 μg/dl
trauma..................................................................81 μg/dl; 27% below 70 μg/dl
respiratory disease....................................................80 μg/dl; 36% below 70 μg/dl
takeaway points:
every single mean serum zinc level shown above, whether for healthy controls or across the entire spectrum of diseased and hospitalized patients, is technically 'normal'. *not*. *one*. serum mean zinc level reported for any patient/hospitalized subject comes in below the bottom of the listed reference ranges. that means no red flag if you request serum zinc test at the neighbourhood lab. you *must know* going in, the implications of results found inside the reference range.
70 μg/dl is not a beneficial cutoff to use when evaluating low or normal serum zinc in health vs disease
yes, when i gun for serum zinc ~ 120 μg/dl it can sound high, but it's well within 9 out of the 10 ranges shown above, and distinctly *outside* the patient ballpark. in some groups studied above, 'normal' serum zinc can exceed 200 μg/dl!
so to answer my own original question, what i am taking away from this personally, is that i'll accept a naturally healthy aging serum zinc decline to the ~ 110 μg/dl neighbourhood, but no lower.
question: where do *you* fit in?
to my mind, zinc (and other) 'normal' ranges are massively and ultimately unethically deceptive
case in point. here is a selection of zinc reference or normal ranges
Zinc, Serum
https://www.mayomedicallaboratories.com ... etive/8620
Normal serum zinc is 0.66 to 1.10 mcg/mL......................................(aka 66-110 μg/dl)
Pediatric reference intervals for serum copper and zinc
Based on the central 95% ... the resulting reference interval determined for serum zinc was
................................................................................................64-124 μg/dl
(central 95% of course referring to the bell curve, so we are not seeing absolute highest and lowest values obtained)
local labs i've encountered here and elsewhere:
..................................................................11.5-18.5 μmol/L.......(75 - 121 μg/dl)
...............................................................10-20 μmol/L...............(65 - 131 μg/dl)
in research:
Determination of Serum Zinc Concentrations in Normal Adult Subjects ...
https://academic.oup.com/ajcp/article/57/4/506/1770331
'healthy young men'............................................serum mean 102, range 68-136 ug/dl
interesting contrasts:
Reference range of zinc in adult population (20-29 years) of Lahore, Pakistan
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048503/
healthy individuals:..............serum mean 24, range 11.5-36.7 µmol/L (157, 75 - 240 μg/dl)
males:..............................serum mean 22, range 11.9-32.4 µmol/L (144, 78 - 212 μg/dl)
females:.............................serum mean 22, range 9.9-36.9 µmol/L (144, 65 - 241 μg/dl)
Reference values for serum zinc concentration and prevalence of zinc deficiency in adult Iranian subjects.
https://www.ncbi.nlm.nih.gov/pubmed/22592845
men...........................................................9.6 - 31.6 μmol/L........(63 - 207 μg/dl)
women.......................................................8.9 - 29.9 μmol/L.........(58 - 195 μg/dl)
total population...........................................9.3 - 30.8 μmol/L..........(61 - 201 μg/dl)
(and recall, based on that central 95% idea, we are not seeing the very highest or lowest levels identified in these groups)
Serum Zinc and Copper Status in Hospitalized vs. Healthy Elderly Subjects
http://www.tandfonline.com/doi/abs/10.1 ... 7.10719643
(you can download a pdf via researchgate)
this study's cutoff to establish low zinc status................ 0.70 mg/L (aka <70 μg/dl)
next, serum mean zinc levels in study subjects:
healthy elderly controls...........................................1.10 mg/L (aka 110 μg/dl);..........0% below 70 μg/dl
hospitalized group...................................................0.87 mg/L (aka 87 μg/dl);...............only 20% below 70 μg/dl
(clearly this cutoff leaves something to be desired)
nervous system disease ............................................94 μg/dl; 6% below 70 μg/dl
mental disturbance .................................................90 μg/dl; 13% below 70 μg/dl
cancers .................................................................89 μg/dl; 26% below 70 μg/dl
undefined symptoms .................................................88 μg/dl; 15% below 70 μg/dl
digestive diseases ....................................................88 μg/dl; 19% below 70 μg/dl
osteo-muscular disease ..............................................87 μg/dl; 14% below 70 μg/dl
endocrine/metabolic disease .......................................87 μg/dl; 19% below 70 μg/dl
infectious disease ...................................................87 μg/dl; 21% below 70 μg/dl
blood disease ..........................................................87 μg/dl; 24% below 70 μg/dl
cardiovascular disease ..............................................86 μg/dl; 19% below 70 μg/dl
genitourinary disease.................................................84 μg/dl; 21% below 70 μg/dl
trauma..................................................................81 μg/dl; 27% below 70 μg/dl
respiratory disease....................................................80 μg/dl; 36% below 70 μg/dl
takeaway points:
every single mean serum zinc level shown above, whether for healthy controls or across the entire spectrum of diseased and hospitalized patients, is technically 'normal'. *not*. *one*. serum mean zinc level reported for any patient/hospitalized subject comes in below the bottom of the listed reference ranges. that means no red flag if you request serum zinc test at the neighbourhood lab. you *must know* going in, the implications of results found inside the reference range.
70 μg/dl is not a beneficial cutoff to use when evaluating low or normal serum zinc in health vs disease
yes, when i gun for serum zinc ~ 120 μg/dl it can sound high, but it's well within 9 out of the 10 ranges shown above, and distinctly *outside* the patient ballpark. in some groups studied above, 'normal' serum zinc can exceed 200 μg/dl!
so to answer my own original question, what i am taking away from this personally, is that i'll accept a naturally healthy aging serum zinc decline to the ~ 110 μg/dl neighbourhood, but no lower.
question: where do *you* fit in?
