Zinc Protoporphyrin (ZPP)

Optimal Result: 0 - 36 ug/dL.

What is Zinc protoporphyrin (ZPP)?

Zinc protoporphyrin (ZPP) is a normal metabolite that accumulates in trace amounts in erythrocytes (Red blood cells) during hemoglobin (=a protein in red blood cells that carries oxygen) synthesis (=the production of hemoglobin).

The final step in the heme pathway involves the enzyme ferrochelatase, which binds ferrous iron with protoporphyrin IX through a process called chelation. This reaction is crucial for the synthesis of heme, a compound that plays a vital role in various biological functions such as oxygen transport. However, in cases of iron deficiency or impaired iron utilization, an alternative metal substrate, zinc, can be used by ferrochelatase. On the other hand, lead toxicity can interfere with the transfer of iron within cells, leading to a condition similar to iron deficiency. Essentially, lead toxicity mimics the effects of iron deficiency by disrupting the normal functioning of intracellular iron transfer.

What does the ZPP test measure?

The test measures the concentration of zinc protoporphyrin (ZPP) in the blood. ZPP is present in blood in trace amounts and is formed during the production of heme. Concentrations of ZPP are increased in patients with lead poisoning and iron deficiency. Heme is an essential component of hemoglobin, the protein in red blood cells (RBCs) that carries oxygen from the lungs to the body’s tissues and cells. The formation of heme occurs in a series of reactions that conclude with the insertion of an iron into the center of a molecule called protoporphyrin. If there is not enough iron available, then protoporphyrin combines with zinc instead of iron to form zinc protoporphyrin (ZPP). ZPP serves no useful purpose in the red blood cells since it cannot transport oxygen around the body. Lead prevents iron (but not zinc) from attaching to protoporphyrin so zinc protoporphyrin will also be elevated in severe cases of lead poisoning.

References:

Ogun AS, Joy NV, Valentine M. Biochemistry, Heme Synthesis. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537329/

Rivett ED, Heo L, Feig M, Hegg EL. Biosynthesis and trafficking of heme o and heme a: new structural insights and their implications for reaction mechanisms and prenylated heme transfer. Crit Rev Biochem Mol Biol. 2021 Dec;56(6):640-668. doi: 10.1080/10409238.2021.1957668. Epub 2021 Aug 25. PMID: 34428995; PMCID: PMC8877297.

Layer G. Heme biosynthesis in prokaryotes. Biochim Biophys Acta Mol Cell Res. 2021 Jan;1868(1):118861. doi: 10.1016/j.bbamcr.2020.118861. Epub 2020 Sep 23. PMID: 32976912.

What does it mean if your Zinc Protoporphyrin (ZPP) result is too high?

The ZPP concentration in blood is usually very low. An increase in ZPP indicates a disruption of normal heme production but is not specific as to its cause. The main reasons for increases in ZPP are iron deficiency and lead poisoning. It is important that ZPP concentrations be evaluated in the context of a patient’s history, clinical findings, and the results of other tests such as ferritin, lead, and a complete blood count (CBC). It is possible that the patient may have both iron deficiency and lead poisoning.

In cases of chronic lead exposure, ZPP reflects the average lead concentration over the previous 3-4 months. However, the amount of lead currently present in the blood and the burden of lead in the body (the amount in the organs and bones) cannot be determined with a ZPP test. Values for ZPP rise more slowly than the blood lead concentration following exposure, and they take longer to drop after exposure to lead has ceased.

ZPP levels must be evaluated in the context of your history, clinical findings, and the results of other tests such as ferritin, lead, and a complete blood count (CBC). You may have both iron deficiency and lead poisoning.

In cases of chronic lead exposure, ZPP reflects the average lead level over the previous three to four months. However, the amount of lead currently present in the blood and the amount in the organs and bones cannot be determined with a ZPP test. Values for ZPP rise more slowly than blood lead concentrations following exposure and take longer to drop after exposure to lead has ceased.

ZPP can also be elevated in anemia caused by chronic inflammatory diseases, infections, and cancer, but it is not generally used to monitor or diagnose these diseases.

Depending on the method used to test ZPP, high levels of other substances in the blood, such as bilirubin and riboflavin, can produce false-positive results. Falsely low values may occur if the sample is not protected from light before testing.

10 000+ happy customers

100% satisfaction

★ ★ ★ ★ ★ customer support

Understand blood, stool, and urine medical results from all your laboratories.

Upload Your Personal Results

Upload Personal Results

For professional account plans go here

for professional account plans go here

Monthly plan

Annual plan

Own it for life

Subscription
Data entry service included

Data entry service

Our exclusive data entry service is a convenient way to get your results into your private dashboard. Simply attach an image or a file of your lab test results, and one of our qualified data entry team members will add the results for you. We support all sorts of files, whether PDFs, JPGs, or Excel. This service is excellent whether you have a lot of reports to upload or are too busy to do the data entry yourself.
Instant interpretation
Use free data entry form

Free data entry form

We strive to make the data entry process easy for you. Whether by offering dozens of templates to choose from that pre-populate the most popular laboratory panels or by giving you instant feedback on the entered values. Our data entry forms are an easy, fast, and convenient way to enter the reports yourself. There is no limit on how many lab reports you can upload.
4000+ biomarkers explained
Nutrition recommendations
Cancel anytime

Complete

$15 /month

billed every month

monthly
$15 per report

✓ Instant interpretations
✓ 4000+ biomarkers explained
✓ Nutrition recommendations
✓ Free data entry form
✓ Unlimited data
✓ $15 data entry service
✓ Cancel anytime

Advanced

$79 /year

$6.60/month billed annually

yearly
5 reports free

✓ Instant interpretations
✓ 4000+ biomarkers explained
✓ Nutrition recommendations
✓ We enter 5 reports for you
✓ Yearly subscription
✓ Cancel anytime

Data entry included

Unlimited

$250 /once

own it for life

pay once
10 reports free

✓ Instant interpretations
✓ 4000+ biomarkers explained
✓ Nutrition recommendations
✓ We enter 10 reports for you
✓ No subscription
✓ Dedicated support
✓ Unlimited access

Welcome to Healthmatters Pro.

Save time on interpreting lab results with the largest database of biomarkers online. In-depth research on any test at your fingertips, all stored and tracked in one place. Learn more

Pro Monthly Plus

for health professionals

✓ Track multiple clients results
✓ No setup fees
✓ No hidden costs
✓ Instant interpretations
✓ 4000+ biomarkers explained
✓ Includes data entry service
✓ Personal training and support
✓ Cancel anytime

$75 per month

We implement proven measures to keep your data safe.

At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. Our internal code of conduct adds additional privacy protection. All data is backed up multiple times a day and encrypted using SSL certificates. See our Privacy Policy for more details.

Navigate to LabCorp (various)