Short-term oral zinc supplementation does not improve chronic hepatic encephalopathy

Abstract

The effect of short-term oral zinc supplementation (zinc sulfate 600 mg/day) on hepatic encephalopathy, was assessed in a double-blind, crossover trial. Fifteen cirrhotic patients with stable, chronic hepatic encephalopathy were randomized to receive either oral zinc or a placebo for 10 days. Following a two-week washout period, these were crossed over to the alternate treatment. Conn's index, which comprises the evaluation of the mental state, asterixis, number connection test, EEG record, and plasma ammonia, was used to score the degree of hepatic encephalopathy, both at the beginning and end of each treatment period. Serum zinc was significantly raised after oral zinc administration and reached the levels observed in cirrhotics without hepatic encephalopathy. Despite this, however, no modification in the parameters included in Conn's index were observed. In conclusion, this study failed to confirm that short-term oral zinc supplementation improves chronic hepatic encephalopathy.

Hepatic encephalopathy

“…Zinc supplementation improves the activity of the urea cycle in experimental models of cirrhosis (28). One trial has evaluated the effects of zinc over a short period (up to a week), without major improvement (29). A positive study administered zinc for 3 months, though the study was not randomized (30).…”

The Use of Selected Nutrition Supplements and Complementary and Alternative Medicine in Liver Disease

“…The authors found no significant improvement between the 2 groups in a standardized hepatic encephalopathy index. 80 A third nonrandomized, prospective study looked at patients with hepatic encephalopathy treated with oral zinc supplementation. Eight patients with cirrhosis and documented encephalopathy were treated with oral zinc sulfate (600 mg/day) for 3 months and matched for cirrhosis and encephalopathy with 8 control patients.…”

Treatment of Hepatic Encephalopathy in Patients with Cirrhosis of the Liver

“…In a first small study, HE was improved by zinc supplementation Dig Dis 1996;14(suppl 1 ):40-52 [52], However, in two more recent studies oral zinc supplementation (600 mg/day) raised se rum zinc levels significantly and to levels observed in cirrhotics without HE, but no modification in the parameters included in Conn's PSE index were observed [53,54],…”