Why Zinc Matters in Mucositis

Zinc plays essential roles in:

• immune function
• protein synthesis
• wound healing
• inflammation modulation
• maintaining mucosal barrier integrity

These are all functions that become stressed during cancer treatment with the zinc stores becoming lower with chemotherapy and radiation treatment (1,2)

What the Research Says

The role of zinc in cancer treatment is an area of emerging interest in the following studies:

1. Effectiveness of Zinc Supplementation on the Incidence of Oral Mucositis During Chemotherapy and Radiation (3) – This study found that adequate zinc levels were associated with a reduced incidence and severity of oral mucositis in patients undergoing chemotherapy and radiation.
2. A Systematic Review of Patients Undergoing Chemotherapy and Radiation for Head and Neck Cancer (4) – Reported that both systemic zinc supplements and topical oral zinc preparations showed promise in reducing mucositis and improving patient comfort.
3. Zinc Adequacy is Essential for the Maintenance of Optimal Oral Health (5) – This study provided mechanistic insight: zinc supports mucosal repair, which may explain its potential therapeutic role during treatment-induced tissue damage. Many studies used 30 mg/day of zinc citrate, starting at least 10 days before treatment; however, optimal dosing is still being investigated, and a qualified health practitioner should prescribe doses.

Key Points on Zinc

Zinc is not a cure for mucositis, nor is it appropriate for everyone; however, exciting research suggests it may offer supportive benefits for mucosal health during cancer treatment.
Early nutritional intervention, especially when part of comprehensive supportive care, may improve comfort, reduce complications, and enhance the treatment experience.

1. Sakaguchi C, Nishina T, Kono Y, Hino K, Asagi A, Ohno Y, et al. Prospective observational study of zinc deficiency symptoms during first-line chemotherapy for gastric and colorectal cancer. J Gastrointest Oncol [Internet]. 2023 Dec 31;14(6):2384–94. Available from: http://dx.doi.org/10.21037/jgo-23-517
2. Mirnam Niha M, Faroughi F, Beigi Harchegani A, Bagheri H, Mahdi Modares M, Salehi Barough M. Investigation of the effects of gamma radiation on plasma levels of Zn, Cu, Mn and Se in nuclear medicine staff. Radioprotection [Internet]. 2019 Jan [cited 2025 Dec 14];54(1):47–53. Available from: http://dx.doi.org/10.1051/radiopro/2018045
3. Liu X, Zhang W, Chen Y, Rastogi S, Choudhury R. Effectiveness of zinc supplementation on the incidence of oral mucositis during chemotherapy and radiation: A meta‑analysis. Exp Ther Med [Internet]. 2023 Jul;26(1):347. Available from: http://dx.doi.org/10.3892/etm.2023.12046
4. Agare GI, Chidike Ezeorba TP, Michael DC, Agbamu E, Aghoja OC, Alalor CA. Zinc supplementation for mitigating oral mucositis in head and neck cancer patients undergoing radiotherapy and chemoradiotherapy – A systematic review. Clin Nutr ESPEN [Internet]. 2025 Jun;67:8–24. Available from: http://dx.doi.org/10.1016/j.clnesp.2025.02.011
5. Uwitonze AM, Ojeh N, Murererehe J, Atfi A, Razzaque MS. Zinc adequacy is essential for the maintenance of optimal oral health. Nutrients [Internet]. 2020 Mar 30 [cited 2025 Oct 16];12(4):949. Available from: https://www.mdpi.com/2072-6643/12/4/949