The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
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    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

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    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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Using zinc to prolong botulinum toxin treatment response

Structure of Botulinum ToxinResearchers at Baylor College of Medicine, Houston, Texas, determined the effect of oral zinc supplementation on the efficacy and duration of botulinum toxin treatments.

First, the details.

3 botulinum toxin preparations (onabotulinumtoxinA [Botox], abobotulinumtoxinA [Dysport], and rimabotulinumtoxinB [Myobloc]) were studied in 77 patients treated for cosmetic facial rhytids (skin wrinkles), benign essential blepharospasm (twitchy eyelid), and hemifacial (one side of the face) spasm.

  • Prior to “toxin” treatment they received one of the following treatments.
    • Zinc citrate 50 mg and phytase 3,000 PU
    • Zinc gluconate 10 mg
    • Lactulose placebo

Neither the patients nor researchers knew the treatment given — double blind.

And, the results.

  • zinc and phytase
    • 92% of patients supplemented experienced an average increase in toxin effect duration of nearly 30%.
    • 84% of participants reported a subjective increase in toxin effect.
  • No significant increase in duration or effect was reported following supplementation with lactulose placebo or 10 mg of zinc gluconate.
  • The dramatic impact of the zinc/phytase supplementation on some patients’ lives prompted an early termination of the study.

The bottom line?

The authors concluded: “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.”

When a skeletal muscle nerve ending is stimulated it releases acetylcholine, which triggers an impulse to the muscle. Botulinum toxin blocks release of acetylcholine at the neuromuscular junction. As shown in the photo above, zinc is part of the botulinum toxin structure. A more detailed explanation is here.

Phytases are enzymes that increase zinc absorption from the intestines, making more available in the circulation and at the botulinum toxin site of action.

This study is important because it shows that taking more zinc may increase the response and duration of effect of “Botox” type drugs. This may be particularly useful for patients who experience a decline in response over time.

4/10/13 9:28 JR

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