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Moderate evidenceGut health

Zinc Carnosine

A zinc-carnosine chelate approved as a gastric ulcer drug in Japan since 1994, with reasonable evidence for mucosal repair and for improving H. pylori eradication rates. Nearly all human data comes from East Asia; Western trials are sparse and small.

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What the science says

  • Improves H. pylori eradication rates as an adjunct Moderate evidence

    A 2022 systematic review and meta-analysis of RCTs found polaprezinc-based regimens achieved higher H. pylori eradication rates than standard triple therapy, with no increase in adverse events. Trials were predominantly conducted in East Asian populations, where background antibiotic resistance patterns differ from Europe and North America.

  • Protects against NSAID-induced small bowel damage Moderate evidence

    In the landmark human study (Mahmood, Gut 2007), 37.5 mg zinc carnosine twice daily for 5 days roughly halved the threefold increase in small-bowel permeability caused by indomethacin, and stimulated migration and proliferation of gut epithelial cells in vitro. Sample size was small (n=10 in the permeability crossover) and the endpoint was a surrogate marker, not clinical ulceration.

  • Heals gastric ulcers Moderate evidence

    Polaprezinc is licensed in Japan for gastric ulcer, and a multicentre randomised double-blind positive-controlled trial found it comparable to an active comparator for ulcer healing. It is not established as superior to, or a replacement for, proton pump inhibitors, which remain first-line.

  • Treats reflux, IBS or general 'gut healing' Limited evidence

    These are the uses driving Western sales, and they have essentially no RCT support. A small trial of polaprezinc enemas in ulcerative colitis showed some promise but does not generalise to oral use in otherwise healthy people.

Dosage & safety

Studied dose75 mg/day of zinc L-carnosine (polaprezinc), usually 37.5 mg twice daily before meals — this is the dose used in both the Japanese ulcer indication and the Mahmood permeability study. 75 mg of the chelate supplies roughly 16 mg elemental zinc, which counts toward your daily zinc total. Trial durations range from 5 days to 8 weeks.
SafetyWell tolerated in trials; occasional nausea, constipation and taste disturbance. The elemental zinc load matters: combining zinc carnosine with a multivitamin, a separate zinc supplement and zinc lozenges can push intake past the 40 mg/day tolerable upper limit, and chronic excess zinc causes copper deficiency, anaemia and neutropenia — add copper if using high doses long-term. Zinc reduces absorption of tetracyclines, quinolone antibiotics and bisphosphonates; separate doses by at least 2 hours. There are rare case reports of hepatic dysfunction and, in Japanese pharmacovigilance data, copper-deficiency myelopathy with long-term use. Regulatory note: polaprezinc is a prescription drug in Japan, South Korea and China, but sold as an unregulated dietary supplement in the US and UK, so potency and chelation quality vary between brands.

How to take it

Timing37.5 mg twice daily, before breakfast and before bed.
With food?Before food; if it makes you nauseous, take it with a small snack instead.
Worth knowing75 mg of the chelate is only about 16 mg of elemental zinc — useful to know when adding up your intake, and when comparing it to a plain zinc tablet.

Interactions

With medications

  • tetracycline and quinolone antibiotics

    Zinc chelates them in the gut and cuts absorption of the antibiotic. separate by at least 2 hours

  • bisphosphonates

    Zinc reduces their already poor absorption. separate by at least 2 hours

With other supplements

  • copper

    Chronic zinc intake depletes copper, causing anaemia, neutropenia and, in reported cases, myelopathy. add 1-2 mg copper daily if using it for more than a few months

  • other zinc sources (multivitamins, zinc lozenges, separate zinc tablets)

    Stacking pushes total elemental zinc past the 40 mg/day upper limit. count the 16 mg this delivers into your daily zinc total

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

What is zinc carnosine used for?

Zinc carnosine (polaprezinc) is a gastric ulcer drug in Japan, with moderate evidence for ulcer healing, stomach-lining protection and improving H. pylori eradication. Nearly all the data come from East Asia, and it does not replace proton pump inhibitors.

Does zinc carnosine help leaky gut, reflux or IBS?

These Western uses of zinc carnosine have essentially no trial support (limited evidence). The strongest related data are a small study showing zinc carnosine reduced NSAID-induced gut permeability, a surrogate marker.

How much zinc carnosine per day?

The standard zinc carnosine dose is 75 mg/day, as 37.5 mg twice daily before meals. That supplies roughly 16 mg of elemental zinc, which counts toward your daily zinc total.

Can zinc carnosine cause copper deficiency?

Yes, with long-term use: chronic zinc intake depletes copper, causing anaemia and neutropenia. If you take zinc carnosine for more than a few months, add 1-2 mg copper daily and keep total zinc under 40 mg/day.

Scientific references

Where to buy

Source Naturals, GastricSoothe™, 120 Capsules

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