Zinc is an abundant essential trace element and important for cell function as well as metabolism, protein synthesis, detoxification, thyroid function, blood clotting, cognitive functions, fetal growth, immune response, growth and maintenance, sperm production, signaling transduction and gene regulation and essential for over 300 enzymatic reactions. Zinc is also an essential antioxidant and anti-inflammatory agent [27].

Zinc deficiency can either be genetic or can be acquired and can happen due to low intake, intestinal malabsorption (e.g. RYGB, inflammatory bowel disease (IBD), celiac disease, chronic diarrhea) or increased depletion (infection, pregnancy, burns, alcoholism, stress) [28, 29]. Serum zinc levels can also be lowered by medicines like penicillamine, diuretics, antimetabolites and valproate [28].

A moderate zinc deficiency can be seen as growth retardation, male hypoga- nadism in adolescents, rough skin, poor appetite, mental lethargy, delayed wound healing, cell mediated immune dysfunctions and abnormal neurosensory changes. Manifestations of severe deficiency include bullous pustular dermatitis, alopecia, diarrhea, pica, significant dysgeusia, emotional disorders, weight loss, intercurrent infections. If the deficiency is not treated then it may lead to a fatal situation [27].

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