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ZMAEvidence & Dosage

Zinc + Magnesium + B6, claims for sleep and testosterone.

Studies last updated

Evidence at a glance

Total studies
277
With abstract
48
Meta / Systematic / RCT
99
Highly cited
50
Publication years
1969–2026

ZMA in the context of Performance

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Top studies on ZMA

Ranked by influential-citation count and publication year.

  1. A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes.

    JAMA1995n=27Meta-Analysis200 influential citations

    <h4>Objectives</h4>To determine the risk of elevated total homocysteine (tHcy) levels for arteriosclerotic vascular disease, estimate the reduction of tHcy by folic acid, and calculate the potential reduction of coronary artery disease…

    Finding: Elevations in total homocysteine were considered an independent graded risk factor for arteriosclerotic vascular diseases.

  2. Homocysteine lowering with folic acid and B vitamins in vascular disease.

    N Engl J Med2006n=552RCT200 influential citations

    <h4>Background</h4>In observational studies, lower homocysteine levels are associated with lower rates of coronary heart disease and stroke. Folic acid and vitamins B6 and B12 lower homocysteine levels. We assessed whether supplementation…

  3. Lowering blood homocysteine with folic acid based supplements: meta-analysis of randomised trials. Homocysteine Lowering Trialists' Collaboration.

    BMJ1998n=111Meta-Analysis200 influential citations

    <h4>Objective</h4>To determine the size of reduction in homocysteine concentrations produced by dietary supplementation with folic acid and with vitamins B-12 or B-6.<h4>Design</h4>Meta-analysis of randomised controlled trials that…

  4. Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial.

    JAMA2008n=5,442RCT108 influential citations

    <h4>Context</h4>Recent randomized trials among patients with preexisting cardiovascular disease (CVD) have failed to support benefits of B-vitamin supplementation on cardiovascular risk. Observational data suggest benefits may be greater…

  5. The Role of Vitamin B6 in Peripheral Neuropathy: A Systematic Review.

    Nutrients2023n=20Systematic Review77 influential citations

    Introduction: Vitamin B6 is a water-soluble vitamin that is naturally present in many foods and is accessible in many dietary supplements. The three natural forms are pyridoxine, pyridoxal, and pyridoxamine. Both vitamin B6 deficiency and…

  6. Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes: An Umbrella Review and Evidence Map.

    Ann Intern Med2019n=992Meta-Analysis74 influential citations

    <h4>Background</h4>The role of nutritional supplements and dietary interventions in preventing mortality and cardiovascular disease (CVD) outcomes is unclear.<h4>Purpose</h4>To examine evidence about the effects of nutritional supplements…

    Finding: Reduced salt intake decreased all-cause mortality in normotensive participants.

  7. The role of vitamins in the prevention and control of anaemia.

    Public Health Nutr2000Systematic Review66 influential citations

    <h4>Objective</h4>While iron deficiency is regarded as the major cause of nutritional anaemia, changes in vitamins A, B12, C and E, folic acid and riboflavin status have also been linked to its development and control. This paper provides…

  8. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life.

    Cochrane Database Syst Rev2018n=28Meta-Analysis65 influential citations

    <h4>Background</h4>Vitamins and minerals play multiple functions within the central nervous system which may help to maintain brain health and optimal cognitive functioning. Supplementation of the diet with various vitamins and minerals…

  9. Gut dysbiosis-induced vitamin B6 metabolic disorder contributes to chronic stress-related abnormal behaviors in a cortisol-independent manner.

    Gut microbes2025n=11E58 influential citations

    Chronic stress can result in various conditions, including psychological disorders, neurodegenerative diseases, and accelerated brain aging. Gut dysbiosis potentially contributes to stress-related brain disorders in individuals with…

  10. Homocysteine lowering by B vitamins and the secondary prevention of deep vein thrombosis and pulmonary embolism: A randomized, placebo-controlled, double-blind trial.

    Blood2007n=701RCT56 influential citations

    The Vitamins and Thrombosis (VITRO) study investigated the effect of homocysteine lowering by daily supplementation of B vitamins on the risk reduction of deep vein thrombosis (DVT) and pulmonary embolism (PE). Patients between 20 to 80…

Frequently asked

What does the evidence say about ZMA?
Elevations in total homocysteine were considered an independent graded risk factor for arteriosclerotic vascular diseases.
What dosage was studied?
• Increased folic acid intake (Approximately 200 micrograms/day) • Folic acid + vitamin B6 + vitamin B12 (2.5 mg folic acid, 50 mg vitamin B6, 1 mg vitamin B12 daily) • Folic acid based supplements, with or without vitamin B-12 or B-6 (Folic acid 0.5-5 mg daily; vitamin B-12 mean 0.5 mg daily; vitamin B-6 mean 16.5 mg daily)
Are there safety considerations for ZMA?
• Folic acid may mask cobalamin deficiency. • Authors suggest adding 1 mg cobalamin to folic acid supplements. • Higher unstable angina hospitalization with active treatment. • Not reported

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