Zinc is a powerful antioxidant and anti-inflammatory mineral, acting to quell inflammation, scavenge free radicals, support the immune system, heal wounds, and support fertility. Pretty cool. Zinc supplementation alone can significantly reduce inflammation markers and oxidative stress (two factors endometriosis is renowned for).

Unfortunately, women with endo appear to be shockingly deficient compared to their non-endo sisters, and it may be a contributing factor to pathogenesis, progression, and infertility. [1,3]

Why is Endometriosis Associated with a Zinc Deficiency?

Zinc is a prime example of a nutrient we both need more of (due to excess inflammation eating it up) and simultaneously aren’t getting enough of in our diet (or aren’t absorbing because of digestive issues). This makes us with endo quite susceptible to deficiency.

In terms of needing more, zinc is a free-radical squelching anti-oxidant. Basically, if you have some free radicals produced in usual bouts of inflammation, zinc will come to a stop them from causing too much damage. But if you have an area saturated in free radicals (as the peritoneal cavity of those with endo is known to be), you will need a TONNNNNN of zinc. So much. Everyday. To stop the damage.

To demonstrate, I made this incredible picture involving a dragon spitting fire, which symbolizes your immune system scorching with inflammation. While you’ll only need an average amount of zinc for limited inflammation, you’ll need much more if your immune dragon is leveling your pelvis with fire, like Deaneries in Game of Thrones.

Symptoms of deficiency include cuts that are slow to heal, hair loss, acne, an underperforming immune system and/or chronically coming down with something, menstrual pain, white spots on fingernails, or a reduced sense of taste or smell. Oh, infertility, endo belly, and endo too.

Basically, if you’re deficient in zinc, you have a higher chance of having endometriosis, and a LOT more endometriosis symptoms.

Zinc for Fertility

For fertility, you can’t procreate without zinc, as deficiency has been found to decrease egg size, cause problems within the egg cells, and prohibit the egg's ability to properly divide after fertilization. Researchers in one study found zinc to be so low in women with endo they suggest it could be used as one helpful diagnosis marker (to detect women at high risk of endometriosis), as well as for the treatment of infertility from which we with endo often suffer. [2,3]

Zinc for Endometriosis Pain

For painful periods, zinc treatment reduces menstrual pain.[4,5] That’s right, if you have painful periods (or more than painful, like French Revolution torture camp level pain), you may be able to reduce that pain to something more bearable with just some zinc.

Endo-Belly and Zinc

Zinc is crucial for your microbiome health, as it’s estimated that 20% of your dietary zinc will be used up by your intestinal bacteria! This may be why zinc-deficient diets are associated with increased markers for leaky gut, low bacterial diversity, less anti-inflammatory species, and increased inflammation (check out this detailed post on why this is important info for endo!). These studies remind us that your microbiome needs that zinc as much as your body cells do, and since rehabbing the gut microbiome is of utmost importance with endometriosis replenishing zinc should also be prioritized. [6,7]

Endometriosis Diet Fix: Getting Enough Zinc

Zinc is best absorbed from animal foods, especially red meat and shellfish. Omnivores need only 6.25 oz beef - or 2 oysters - per day to meet the RDI, making it much easier not just to meet basic needs but also work to reverse deficiencies. Because, yes, you want to reverse existing deficiencies just as much as you need to meet your daily requirement.

Two oysters offers your daily RDI of zinc, versus 5 cups oatmeal for the same.

Plant-based options like seeds, nuts, grains, and legumes are considered secondary sources. The problem with plant-based zinc is that it’s not as easily absorbed - why the recommended daily intake for zinc is set 50% higher for vegetarians at 12 mg instead of 8/mg day- why long-time vegetarians and vegans are consistently (and significantly) lower in zinc than omnivores. [8,9]

As an example of what constitutes 12mg plant-based zinc daily, think 16 tablespoons pumpkin seeds (touted as one of the best sources of plant-based zinc) or 5 cups oatmeal or 4.5 cups garbanzo beans. Every Day! You can see how you’d have to go out of your way to meet this mark every day, not to mention having a stellar digestive system to process all of it (which we endo gals are not known for).

And because we may be substantially deficient, it may also be important to consider supplementation while you also increase the amount of zinc-rich foods simultaneously. Ask your doctor about 30mg zinc taken for 3 months to get you back up to sufficiency, fast.

Want to learn more about diet and endometriosis?

There’s so much research about specific nutrients and their association with endo (and how to get enough). Interested? Check out my book, Heal Endo: An Anti-Inflammatory Approach to Healing From Endometriosis, on Amazon.

Lai, G. L., Yeh, C. C., Yeh, C. Y., Chen, R. Y., Fu, C. L., Chen, C. H., & Tzeng, C. R. (2017). Decreased zinc and increased lead blood levels are associated with endometriosis in Asian Women. Reproductive toxicology (Elmsford, N.Y.), 74, 77–84. https://doi.org/10.1016/j.reprotox.2017.09.001
American Physiological Society. "Preconception zinc deficiency could spell bad news for fertility: Micronutrient availability can have early and long-lasting effects on egg quality." ScienceDaily. ScienceDaily, 24 April 2018. <www.sciencedaily.com/releases/2018/04/180424133639.htm>.
Messalli, E. M., Schettino, M. T., Mainini, G., Ercolano, S., Fuschillo, G., Falcone, F., Esposito, E., Di Donna, M. C., De Franciscis, P., & Torella, M. (2014). The possible role of zinc in the etiopathogenesis of endometriosis. Clinical and experimental obstetrics & gynecology, 41(5), 541–546.
Eby G. A. (2007). Zinc treatment prevents dysmenorrhea. Medical hypotheses, 69(2), 297–301. https://doi.org/10.1016/j.mehy.2006.12.009
Teimoori, B., Ghasemi, M., Hoseini, Z. S., & Razavi, M. (2016). The Efficacy of Zinc Administration in the Treatment of Primary Dysmenorrhea. Oman medical journal, 31(2), 107–111. https://doi.org/10.5001/omj.2016.21
Sauer AK, Grabrucker AM. Zinc Deficiency During Pregnancy Leads to Altered Microbiome and Elevated Inflammatory Markers in Mice. Front Neurosci. 2019 Nov 29;13:1295. doi: 10.3389/fnins.2019.01295. PMID: 31849598; PMCID: PMC6895961.
Reed S, Neuman H, Moscovich S, Glahn RP, Koren O, Tako E. Chronic Zinc Deficiency Alters Chick Gut Microbiota Composition and Function. Nutrients. 2015 Nov 27;7(12):9768-84. doi: 10.3390/nu7125497. PMID: 26633470; PMCID: PMC4690049.
Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2001)
National Academies of Sciences, Engineering, and Medicine. 2001. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: The National Academies Press. https://doi.org/10.17226/10026.
Foster, M., Chu, A., Petocz, P., & Samman, S. (2013). Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. Journal of the science of food and agriculture, 93(10), 2362–2371. https://doi.org/10.1002/jsfa.6179