Can Zinc Deficiency Cause Atrophic Glossitis and Oral Candidiasis?

The issue of zinc?

I have been experiencing intermittent pain in my tongue and have consulted both an otolaryngologist and an oral surgeon, but they could not determine the cause.
The pain has been fluctuating, and recently the affected area has started to resemble the image at this link: https://imgur.com/a/FtFU4dh, with overall atrophy and redness, but no open sores.
I have taken high doses of B vitamins without any effect.
Four days ago, I started taking zinc supplements, and the atrophied area has begun to decrease.
Today, I noticed that there are only two small depressed areas left.
Additionally, the acne on my body and limbs, which I have had for years, has also disappeared.
Previously, I experienced significant bowel movements and had issues with anal fissures, but those have not occurred recently.

I would like to ask if severe zinc deficiency could lead to atrophic glossitis or localized oral candidiasis.
If so, can restoring zinc levels lead to recovery?

Niming, 30~39 year old female. Ask Date: 2021/06/23

Dr. Hong Yuanbin reply Internal Medicine

Hello, zinc deficiency can indeed cause the symptoms you described.
However, it is still uncertain whether your symptoms are truly due to zinc deficiency.
It may be advisable to go to a larger hospital to test your blood zinc levels for confirmation.
In Taiwan, the likelihood of zinc deficiency is relatively low; rather, conditions such as staying up late, high stress, or irregular sleep patterns are more commonly associated with the occurrence of angular cheilitis.
Thank you for your inquiry.

Reply Date: 2021/06/23

More Info

Zinc deficiency can indeed lead to various oral health issues, including atrophic glossitis and oral candidiasis. Atrophic glossitis is characterized by a smooth, often painful tongue that may appear red and swollen, and it can result from deficiencies in several nutrients, including iron, vitamin B12, and zinc. Zinc plays a crucial role in maintaining the integrity of mucosal membranes, and its deficiency can lead to changes in the tongue's appearance and function.

Oral candidiasis, or thrush, is a fungal infection caused by an overgrowth of Candida species, which can occur when the immune system is compromised or when there is an imbalance in the oral microbiome. Zinc has antimicrobial properties and is essential for a healthy immune response. Therefore, a deficiency in zinc can predispose individuals to infections like oral candidiasis.

In your case, the symptoms you describe—painful areas on the tongue that resemble atrophic glossitis—could indeed be linked to zinc deficiency. The fact that you have started taking zinc supplements and noticed some improvement in the affected areas is encouraging. Zinc supplementation can help restore normal function and appearance to the tongue, provided that the deficiency is the underlying cause.

It's important to note that while zinc supplementation can aid in recovery, the extent of recovery may depend on the severity and duration of the deficiency. If the deficiency has been long-standing, it may take time for the tissues to heal and for the tongue to return to its normal state. Additionally, if there are other underlying conditions contributing to your symptoms, such as chronic inflammation or other nutritional deficiencies, these should also be addressed.

To ensure optimal recovery, consider the following recommendations:
1. Continue Zinc Supplementation: Follow the dosage recommended by your healthcare provider. The typical daily allowance for zinc in adult males is around 11 mg, but therapeutic doses can be higher depending on the severity of the deficiency.

2. Monitor Symptoms: Keep track of any changes in your symptoms as you continue supplementation. If you notice persistent or worsening symptoms, consult your healthcare provider for further evaluation.

3. Dietary Considerations: Incorporate zinc-rich foods into your diet, such as meat, shellfish, legumes, seeds, nuts, dairy, and whole grains. This can help support your recovery and prevent future deficiencies.

4. Address Other Nutritional Deficiencies: If you suspect other deficiencies (like vitamin B12 or iron), consider discussing this with your healthcare provider. They may recommend blood tests to assess your nutritional status.

5. Oral Hygiene: Maintain good oral hygiene to prevent infections. This includes regular brushing and flossing, as well as using an antibacterial mouthwash if recommended by your dentist.

6. Follow-Up Care: Schedule follow-up appointments with your healthcare provider to monitor your progress and adjust your treatment plan as necessary.

In conclusion, zinc deficiency can lead to atrophic glossitis and oral candidiasis, and addressing this deficiency through supplementation and dietary changes can facilitate recovery. However, it is essential to work closely with your healthcare provider to ensure a comprehensive approach to your oral health and overall well-being.

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