title: Effect of dietary zinc and phytase supplementation on botulinum toxin treatments.
abstract: OBJECTIVE
  To determine whether oral zinc supplementation might affect the efficacy and duration of botulinum toxin treatments.
  
  
  METHODS
  In a double-blind, placebo-controlled, crossover pilot study, we examined the efficacy of three botulinum toxin preparations (onabotulinumtoxinA, abobotulinumtoxinA, and rimabotulinumtoxinB) following oral supplementation with zinc citrate 50 mg and phytase 3,000 PU, zinc gluconate 10 mg, or lactulose placebo in individuals treated for cosmetic facial rhytids, benign essential blepharospasm, and hemifacial spasm.
  
  
  RESULTS
  In seventy-seven patients, 92% of subjects supplemented with zinc 50 mg and phytase experienced an average increase in toxin effect duration of nearly 30%, and 84% of participants reported a subjective increase in toxin effect, whereas no significant increase in duration or effect was reported by patients following supplementation with lactulose placebo or 10 mg of zinc gluconate. The dramatic impact of the zinc/phytase supplementation on some patients' lives clinically unmasked the study and prompted an early termination.
  
  
  CONCLUSIONS
  This study suggests a potentially meaningful role for zinc and/or phytase supplementation in increasing the degree and duration of botulinum toxin effect in the treatment of cosmetic facial rhytids, benign essential blepharospasm, and hemifacial spasm.
authors.affiliation: Department of Plastic Surgery, Baylor College of Medicine, Houston, TX, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Koshy
authors.forename: Safa E
authors.initials: SE
authors.lastname: Sharabi
authors.forename: Evan M
authors.initials: EM
authors.lastname: Feldman
authors.forename: Larry H
authors.initials: LH
authors.lastname: Hollier
authors.forename: James R
authors.initials: JR
authors.lastname: Patrinely
authors.forename: Charles N S
authors.initials: CN
authors.lastname: Soparkar
mesh_terms: D010832:6-Phytase / Q000494:pharmacology*; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001764:Blepharospasm / Q000188:drug therapy; D001905:Botulinum Toxins / Q000008:administration & dosage*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005942:Gluconates / Q000494:pharmacology; D019569:Hemifacial Spasm / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage; D010865:Pilot Projects; D015595:Skin Aging / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D017967:Zinc Compounds / Q000494:pharmacology*
chemical_list: D005942:Gluconates; D009465:Neuromuscular Agents; D017967:Zinc Compounds; C096323:rimabotulinumtoxinB; D010832:6-Phytase; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA; C030691:gluconic acid