Zinc Supplementation Reduces Symptoms of Both Vitiligo and Hypothyroidism

N00968153

Introduction
According to experts, about two billion people around the world are zinc deficient. Zinc is a trace
element that has many vital functions in humans. It plays a role as an antiapoptotic factor (prevents cell
death) and is needed as a cofactor for the bodys antioxidant defense system. 1 Hypothyroidism is also
called underactive thyroid and it is when your thyroid does not make enough thyroid hormones. This
disease can slow many of the bodys functions, including the metabolism. 2 Vitiligo is a disease that may
be autoimmune and causes the skin to lose pigment all over ones body.3 The purpose of this paper is to
determine whether there is a relationship between zinc deficiencies, hypothyroidism, and vitiligo and
whether or not zinc can be used as an effective treatment in individuals with these diseases.
Zinc is considered to be the second most important trace mineral in the body. It plays a crucial
role in blood clotting, reproduction, growth and smell and immune function. Many of these functions are
of the thyroid gland and zinc deficiency is characterized by poor wound healing, loss of appetite, weight
changes and white marks on the fingernails.1 About two billion people around the world are zinc deficient
and it seems to be a bigger problem in underdeveloped countries than in the United States. The main
source of zinc is in meat and therefore, vegetarians should consider taking zinc supplements if their zinc
levels become low. A human will absorb between 15 and 35 percent of the zinc they consume and the
more zinc they intake, the more zinc that will be absorbed. If one is zinc deficient, they should also be
wary of the compounds that interfere with zinc absorption. Legumes and whole grains contain phytates
which interfere with zinc absorption and people who consume a lot of fiber from breads and cereals may
not be absorbing enough zinc. Other vitamins such as iron, copper and calcium also compete with zinc for
absorption so people with deficiencies have to be aware of this and make sure they are not consuming
these vitamins in amounts that are too high.1 Many journal articles on zinc include ways to determine
whether or not one is zinc deficient. One way to determine whether people are zinc deficient with is to
take a zinc taste test. This test requires putting a zinc solution in ones mouth, swishing it around for 30
seconds and noting any specific tastes. If one detects an unpleasant taste that gets worse over time, they

may have a mild deficiency and if one notices a strong unpleasant metallic taste immediately, they many
have a severe zinc deficiency.4
About 4.6 percent of the United States population age 12 and older has hypothyroidism. For the
active form of thyroid hormone (T3, also known as triiodothyronine) to be produced, zinc is required as a
cofactor. T4 (also known as thyroxine) is the inactive form of thyroid hormone and when activated, it
converts to T3. These hormones are needed for the thyroid gland to function properly for the body to
maintain healthy. Zinc is also important to form TSH (Thyroid-stimulating hormone) which stimulates
thyroid hormone production.3 When it comes to vitiligo, it is a disease that effects one percent of the
worlds population (about fifty million people) and two to five million people in the United States. There
is only one symptom of vitiligo and this is depigmentation which causes white patches on many areas of
the skin. The areas of the skin that commonly show the vitiligo include the armpits and groin, around the
mouth, eyes, nostrils, navel, genitals, and rectal areas. People with vitiligo may also see their hair turn
gray early and loss of color inside their mouths. Several theories on vitiligo causes have been suggested
and these include trauma, stress, autoimmune and genetic predisposition, accumulation of toxic
compounds, altered cellular environment, imbalance in the oxidant antioxidant system, impaired
melanocyte migration and/or proliferation, infection, and psychological factors. Like thyroid disease,
many of the symptoms associated with vitiligo are also symptoms associated with zinc. 2

Methods
When researching this topic, I mainly used the UNF database and PubMed. I first started off just
researching zinc and how it helps with immune functions in the body. After gaining enough understanding
on the role of zinc, I started researching vitiligo and hypothyroidism. I wanted to know how the diseases
were caused, whether or not they were autoimmune and what treatments were given. Next I started
putting in just zinc and vitiligo in the search bars of the databases and then zinc and hypothyroidism. I
wanted to make sure there were a sufficient amount of studies done on zinc and both of the diseases
individually. Then I started putting both diseases and zinc in the search tabs and found many studies that

brought zinc, vitiligo and hypothyroidism together. Both hypothyroidism and vitiligo are called
autoimmune diseases by many scientists and though they are considered incurable, many papers showed
that patients who took zinc and had these diseases had many positive outcomes and reduced symptoms.
The main studies I found where review studies and randomized control studies. The main challenge I
faced was finding inconclusive/non-supporting studies on zincs effectiveness towards hypothyroidism
and vitiligo. There were also many more review studies than studies talking about just one experiment,
making finding primary sources difficult. In the end, I was able to find three well described inconclusive
studies which questioned zincs effectiveness on these diseases. Overall, there was an abundance of
studies that showed positive correlations between zinc treatment, hypothyroidism and vitiligo.

Main Findings
In a study called Lipid peroxidation in kidney and testis tissues in experimental hypothyroidism:
the role of zinc, scientists aimed to determine the effect of zinc supplementation and zinc deficiency on
rats with induced hypothyroidism. The scientists had two groups: one group of rats with hypothyroidism
and 3 mg/kg/day of zinc supplementation and one group of rats with hypothyroidism and zinc deficiency.
The study was a randomized control study and was held over four weeks. When the experiment was over,
the results showed that the rats who were given zinc had increased MDA levels and decreased GSH levels
which helped to alleviate symptoms and increase thyroid hormone amounts while the group of rats with
induced zinc deficiencies had the opposite MDA and GSH levels and health outcomes. This study helped
to show that zinc does play a crucial role in hypothyroidism and that zinc deficiency may lead to lower
thyroid hormones and thyroid gland function. Many studies also include ways to determine whether or
not one is zinc deficient. One way to determine whether people are zinc deficient with hypothyroidism is
to take a zinc taste test. This test requires putting a zinc solution in ones mouth, swishing it around for 30
seconds and noting any specific tastes. If one detects an unpleasant taste that gets worse over time, they
may have a mild deficiency and if one notices a strong unpleasant metallic taste immediately, they many
have a severe zinc deficiency.4

In a paper called Zinc Can Be Effective in Treatment of Vitiligo, seven different mechanisms in
which zinc plays a therapeutic role with vitiligo are pointed out. These mechanisms include, zinc being a
potential antiapoptotic factor, it being involved with cytosolic antioxidant-defense system against reactive
oxygen species, playing an important role in the process of melanogenesis, preventing probable
environmental factors through prevention of toxic infected cells, having a role in the synthesis and release
of a-melanocyte stimulating hormone in bovine, regulating melanin production by normal and malignant
melanocytes when in ZAG form and its deficiency causing nonspecific suppression of cell-mediated
immunity.5 The study also points out many of the mechanisms that zinc helps to function properly, are the
same mechanisms that vitiligo patients have failing in their bodies which cause their disease.
In a review paper called Serum Copper to Zinc ration: Relationship with aging and health
status, the serum copper to zinc ratio was examined. The paper also examined nutrition, oxidative stress,
inflammation and hormone impact, immune defense, growth stimuli and stress response with copper and
zinc. The study showed that an impairment in this ratio is usually associated with a decrease in zinc and
an increase in copper. This phenomenon happens because when something negative happens to the body,
such as inflammation or stress, zinc is used in the bodys attempt to repair itself. Being that zinc is high in
meat, it is more common for vegetarians to be zinc deficient. One of the jobs of zinc is to be in a balanced
relationship with copper. When zinc is present in abundance, and when enough quality protein is available
to bind to it, copper can also be bound to the zinc complexes and excreted through bile. However, if ones
diet is lacking in zinc, there can be a promotion of copper buildup in the tissues. The copper that builds up
in the tissues is unbound, in its inorganic form, highly immobile and creates a low-level toxicity that
interferes with many functions and systems within the body. People who have a build-up are then
considered copper-toxic. Research has shown that copper toxicity is commonly seen in both hypothyroid
patients and vitiligo patients and that by increasing zinc deficiency, it is possible to have improvements
with both of these diseases.1 When applying this information to a vitiligo or hypothyroid case, it would
make sense that a victim of one or both of these diseases would have a zinc deficiency and copper
toxicity. Do to the stress and inflammation the body is put in, it will use the effects of zinc to go back

towards homeostasis. This would require these individuals to consume more zinc to maintain the zinc and
copper ratio and to avoid zinc deficiency.6
Increasing research shows that many people with vitiligo have thyroid dysfunctions as well. This
is one of the reasons why many people believe that vitiligo is an autoimmune disease. An autoimmune
disease is a disease in which the bodys immune system produces antibodies that attack the bodys own
tissues and sometimes this process involves the thyroid gland. Vitiligo precedes thyroid dysfunction by
many years. This gives people with vitiligo an opportunity to get screened for thyroid problems before
hypothyroidism develops. However, if this opportunity is missed, it can result in severe comorbidity.2,5 In
a case-control study called Increased Prevalence of thyroid dysfunction and diabetes mellitus in Indian
vitiligo patients, scientists focused on the relation between vitiligo, autoimmune thyroid dysfunction and
diabetes mellitus. Out of the 150 cases of vitiligo, 30 of them also were diagnosed with hypothyroidism.
This 20% further proves the relationship that vitiligo has with hypothyroidism. 7 In another study called
Vitiligo, Hypothyroidism and Cardiomyopathy, a case report was done on a 30-year-old male and found
that he was diagnosed with vitiligo at the age of 6 and then diagnosed with hypothyroidism years later.
This is another study that shows there is a correlation between vitiligo and hypothyroidism. 8
In a study called Vitiligo and alopecia areata associated with subclinical/clinical
hypothyroidism, an 18-year-old woman was diagnosed with having both vitiligo and hypothyroidism.
During the course of seven weeks, this woman and four other patients were given PUVA therapy and
thyroxin. PUVA therapy is a type of ultraviolet radiation combination treatment (phototherapy) used for
severe skin diseases. After the therapy was finished, her thirteen de-pigmented exposure spots had
become erythematous with an appearance of marginal pigmentation and her thyroid profile showed an
increase in T3, T4 and TSH levels.9 This connects with zinc because according to the study Combination
therapy with zinc gluconate and PUVA for alopecia areata totalis: an adjunctive but crucial role of zinc
supplementation, zinc is an important contributor to PUVA therapy. In this study, zinc gluconate (in
supplement form) was given with PUVA in a combination therapy to treat hair regrowth with one group
of subjects and PUVA therapy without zinc gluconate to another group of subjects. The group of subjects

who had the zinc gluconate included in their therapy had high amounts of regrowth while the group of
subjects without the zinc gluconate had little to no regrowth. 10 This supports the notion that zinc plays a
key role in improving both vitiligo and hypothyroidism. It also poses the question of whether or not zinc
gluconate is the best form of zinc for treatment. Many studies did not specify the type of zinc that was
supplemented in their experiment, making this question hard to answer.
Though there is much research on the relationships between zinc, vitiligo and hypothyroidism,
there are also studies that have been done which claim to have inconclusive results. In a study done in
2015 called Study of Serum Zinc in Vitiligo, the aim was to measure and compare the serum zinc level
in vitiligo patients and to compare it with non vitiligo patients. The study included 60 individuals with
vitiligo and 60 individuals without vitiligo. The results showed that the patients with vitiligo had
significantly lower amounts of serum zinc than the healthy patients, however, their ranges were still
within the normal ranges of what their levels should have been. This study concluded that it was
inconclusive and that further studies may reveal a more significant relation between serum zinc and
vitiligo.11 In another study called Effects of zinc and selenium supplementation on Thyroid Function in
Overweight and Obese Hypothyroid Female Patients: A Randomized Double-Blind Controlled Trial, the
aim was to see if selenium and zinc supplements would help obese women who also have hypothyroidism
in a double-blind test. The patients were given either Se + Zn supplements, Se + placebo, Zn + placebo or
placebo + placebo. The most positive results were with the patients that had either the zinc alone or the
zinc and selenium combined, however, none of the treatments were considered significant on changing
T3, T4 or TSH levels. This study also concluded that more research and studies may reveal more evidence
for these relationships.12 A third randomized clinical trial study called Comparison of therapeutic
efficacy of topical corticosteroid and oral zinc sulfate-topical corticosteroid combination in the treatment
of vitiligo patients, thirty-five vitiligo patients were separated and given either topical corticosteroid
treatments (Group A) or a combination of oral zinc sulfate-topical corticosteroid treatments (Group B).
The results showed that the mean responses in both groups were 21.43% (Group A) and 24.7% (Group
B).13 They concluded that there was no significant difference between the two treatments in this study and

that more trials with higher doses of zinc and a more robust long-term randomized controlled trials with
more patients needed to be done to see if zinc truly had a helping hand with vitiligo treatments. Though
these papers were inconclusive and claim that more research and tests needed to be done, they did not
successfully disprove the relationships between zinc, vitiligo and hypothyroidism.

Conclusion
Therefore, based on the studies that have been done, zinc deficiencies have a relationship with
hypothyroidism and vitiligo and can be given as or with treatments effectively to help symptoms. Zinc
has many roles in the body including wound healing, blood clotting, reproduction, growth and smell and
immune function.1,5,7,9 Scientific research supports the notion that in diseases such as hypothyroidism and
vitiligo, zinc deficiency may be occurring and that with increased zinc, symptoms may be alleviated.
Research also shows that many people with vitiligo also have hypothyroidism and that they may be
correlated together and with zinc deficiency.2,3,12 There are some studies that were inconclusive about
zincs effectiveness on these diseases, however, each of these studies concluded that their experiments
could have been more accurate and that zinc does not have a negative relationship with vitiligo and
hypothyroidism. There is still much research that needs to be done. One big question that is still not
answered from the primary sources found is if the type of zinc supplement used matter and if so, what
type of zinc supplement would be best fitted for treatments. From the studies that have already been
produced, it is highly possible that a person with vitiligo and/or hypothyroidism may be zinc deficient and
should take a prescribed amount of zinc supplements or high zinc containing foods (such as beef) to
reduce symptoms.

References

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