Table 2.

Excess intake of zinc leads to anemia.

1.  Type of excess intake	References
a. Excess and prolonged intake of oral zinc supplement	[69,70,71,72,73,74,75,76,77,78,79]
b. High-dose one-time zinc administration (for Wilson’s disease)	[80]
c. Use of denture cream (containing a high zinc concentration of 17,000–34,000 (µg/g)	[81,82,83]
d. Ingestion of coins (by individual with mental disease)	[70,84]
2.  High zinc levels induce copper deficiency
(High zinc induces metallothionein, zinc and copper compete to bind metallothionein, and copper is preferentially bound by metallothionein)	[14,72,85,86,87,88,89,90]
(another suggested mechanism is that high zinc in the intestinal lumen directly interfered with the transport of copper across the mucosal cells)	[91,92,93]
3.  Mechanism of copper deficiency leads to anemia
(Copper is essential for normal hematopoiesis)	[74,96,97]