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Ethambutol effect on zinc and copper levels

Posted by formergardener @formergardener, Aug 19, 2023

My concern over potential visual effects from Ethambutol (I am on a 3 times wkly regimen of 500 mg Azithromycin and 1200 mg Ethambutol- dosed by weight), led me to search for ways to prevent eye damage.

Multiple studies mention that Ethambutol is a metal chelator. It binds with zinc and copper. Patients’ levels lower on this drug. Both zinc anc copper are essential for healthy vision. A vegetarian diet is correlated with lower zinc levels as well. NYU Langone recommended in an article to supplement with copper and zinc when on Ethambutol and to take them apart from the drug. I also have read that calcium supplements bind with zinc and should not be taken at the same time.

These are important points that doctors either don’t know about or don’t mention. So, people’s diets and supplement usage could play a big part in a serious side effect from not only this med, but others as well.

It might be worth it to bring this up with your doctor, particularly if you are on Ethambutol. I remember reading somewhere that excessive zinc can cause a copper deficiency. It recommended that for every 15 mg of zinc, you supplement with 1 mg copper (they are dosed very differently). You can also google the zinc and copper contents of foods to get an idea of how much you may already consume. A high fiber diet with high phytate content results in lower zinc levels, so that should be considered.

Patients with MAC are told to increase calorie intake and to maintain a healthy diet, but I really wish that there was an approach that also dealt with the impact that the meds have on our nutrient status.

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

irenea8 | @irenea8 | Aug 20, 2023
In reply to @irenea8 "Oh thank goodness you clarified Zinc deficiency encourages Pseudo. I really did not understand what binding..." + (show)
@irenea8

Oh thank goodness you clarified Zinc deficiency encourages Pseudo. I really did not understand what binding to actually meant on a practical level. It correlates with my experience. Often times I feel better after taking Zinc. My pulmo mentioned about iron also. But it is a bit confusing since he made it sound like it could be an issue taking iron or getting an iron infusion if you have Pseudo. But he did say if you really need it, take it.

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maybe he was cautioning more about ever getting an iron infusion if you have Pseudomonas than taking supplements?

REPLY
liz440 | @liz440 | Aug 20, 2023

I would only take iron if I was really anemic... a little anemic and I would just eat more meat etc. Sometimes iron can appear low but not be low if you have inflammation. It's a complicated subject. Iron in the blood can somehow be hidden so bad things don't eat it! LOL. look up "anemia of chronic disease" if you are interested in the hiding iron business!

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harrynsc | @harrynsc | Aug 20, 2023

" google the zinc and copper contents of foods"
There's a really good app that can tell you all the zinc and copper you had in one day.
I saw an RD last year, and she told me about cronometer.com
This is the best written software I have seen in 20 years.
You enter everything you eat and it gives you the totals for more than 60 minerals and vitamins.
It's free, but if you pay $50/year, you get a couple of enhancements. I like the fact I can give
it a URL and it will download the complete recipe so you don't have to type it in.
You can turn your camera on and read the bar code for an item such as a quart of ice cream,
and it has thousands of bar codes so it knows all the ingredients.
I have more than 50 custom recipes.
It will tell you total protein, carbs, and fat for the day.
When you type in an item such as Boston Butt, it gives you eight choices, etc.
If you type in chicken pot pie, it lists more 60 choices: homemade, Marie Callender,
Trader Joes, Stauffer, Banquet, etc.
You can log all the exercise you do every day.
You can enter your weight every day and show your doctor a six month graph proving you are
gaining or losing weight.
Download the free version and use it for a week.
Harry

REPLY
1 reply
formergardener | @formergardener | Aug 20, 2023
In reply to @harrynsc "" google the zinc and copper contents of foods" There's a really good app that can..." + (show)
@harrynsc

" google the zinc and copper contents of foods"
There's a really good app that can tell you all the zinc and copper you had in one day.
I saw an RD last year, and she told me about cronometer.com
This is the best written software I have seen in 20 years.
You enter everything you eat and it gives you the totals for more than 60 minerals and vitamins.
It's free, but if you pay $50/year, you get a couple of enhancements. I like the fact I can give
it a URL and it will download the complete recipe so you don't have to type it in.
You can turn your camera on and read the bar code for an item such as a quart of ice cream,
and it has thousands of bar codes so it knows all the ingredients.
I have more than 50 custom recipes.
It will tell you total protein, carbs, and fat for the day.
When you type in an item such as Boston Butt, it gives you eight choices, etc.
If you type in chicken pot pie, it lists more 60 choices: homemade, Marie Callender,
Trader Joes, Stauffer, Banquet, etc.
You can log all the exercise you do every day.
You can enter your weight every day and show your doctor a six month graph proving you are
gaining or losing weight.
Download the free version and use it for a week.
Harry

Jump to this post

@harrynsc
That is such helpful information. After a stem cell transplant, my husband had permanent kidney damage. We worked with a renal dietitian, and she gave us info about that app. She also mentioned nutrition value.com. For example, you type in: nutrition value in carrots. It pulls up the info providing all the detailed nutrition information. You are able to specify the units of measure, and it adjusts accordingly. It has really helped me when I am putting together a meal in the spot. Counting and limiting grams of protein, phosphorus, potassium, and sodium for all the ingredients becomes necessary.

Cronometer is a great aid and really helps awareness of eating a balanced diet.

REPLY
1 reply
helen1000 | @helen1000 | Jul 21 10:08pm

That is very helpful advice. I am taking multiple minerals from Market America. The zinc / copper ration is 37.5/1. Please see attached and hope this helps! ❤️🙏
REPLY
helen1000 | @helen1000 | Jul 25 7:57am
In reply to @formergardener "@harrynsc That is such helpful information. After a stem cell transplant, my husband had permanent kidney..." + (show)
@formergardener

@harrynsc
That is such helpful information. After a stem cell transplant, my husband had permanent kidney damage. We worked with a renal dietitian, and she gave us info about that app. She also mentioned nutrition value.com. For example, you type in: nutrition value in carrots. It pulls up the info providing all the detailed nutrition information. You are able to specify the units of measure, and it adjusts accordingly. It has really helped me when I am putting together a meal in the spot. Counting and limiting grams of protein, phosphorus, potassium, and sodium for all the ingredients becomes necessary.

Cronometer is a great aid and really helps awareness of eating a balanced diet.

Jump to this post

If zinc is too high, it will affect the copper absorption. That is why they make the ratio 37.5 / 1.
Nutrition is a science! 🙂

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