Zytaze Dietary Supplementation Enhances Botox Injections?

A patient with spasmodic dysphonia recently asked me whether Zytaze dietary supplement would help enhance the effectiveness of the botox injections I perform to treat spasmodic dysphonia. This dietary supplement contains Zinc Citrate 25mg and Phytase 500mg.

Phytase is an enzyme that effectively breaks down phytates commonly found in whole grain products and cereals. Phytase basically enhances zinc absorption in the gut.

So what's so special about zinc as it relates to botox? Theoretically, botox requires zinc to work and some patients may be zinc deficient which may cause botox injections to not work as well. As such, by adding dietary zinc, botox injections should work better that is, assuming, a patient is zinc deficient.

But does it work???

According to a single small study published in 2012, it might... In the double-blind, placebo-controlled, crossover pilot study in 77 patients, 92% of subjects supplemented with Zytaze 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 placebo. With this basically means for patients is that the duration of botox effect instead of lasting the normal 3 months... it might last 4 months instead.

Interestingly, taking not enough or even too much reduces the effectiveness of this dietary supplement. The suggested dosing is 2 capsules daily for 4 days prior to botox injection as well as on the same day of the injection (or 5 days total or 10 pills total).

As with most dietary supplements, it can't hurt to try... It costs $45.40 for 10 pills.

But beware, the small study had lots of problems with it that bring into doubt the conclusion that Zytaze actually works as summarized in this paper.

I personally do not recommend without better research evidence. But for those interested, it can't hurt given the minimal side effects.

Research:
Effect of dietary zinc and phytase supplementation on botulinum toxin treatments. J Drugs Dermatol. 2012 Apr;11(4):507-12.

Poster 405 Prolongation of Botulinum Toxin Effect with Zinc Supplementation: A Case Report. PM R. 2016 Sep;8(9S):S294. doi: 10.1016/j.pmrj.2016.07.332. Epub 2016 Sep 24.

Scientific skepticism and new discoveries: an analysis of a report of zinc/phytase supplementation and the efficacy of botulinum toxins in treating cosmetic facial rhytides, hemifacial spasm and benign essential blepharospasm. J Cosmet Laser Ther. 2014 Oct;16(5):258-62. doi: 10.3109/14764172.2014.948882. Epub 2014 Sep 2.

Botulinum Toxins and Zinc: From Theory to Practice-A systematic Review. Clin Neuropharmacol. 2023 Jun 20. doi: 10.1097/WNF.0000000000000557.