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.
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.
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Every lab result is automatically organized on a chronological timeline, giving you a complete picture of your health journey.
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Our database covers over 10,000 biomarkers with clear, simple explanations—so you can finally understand your results and what to do next.
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If you'd like to handle inputting your health data into your account, you can do so with our easy-to-use data entry forms. Our user-friendly form is designed to guide you through the quick and easy submission process, making it simple to keep track of your health metrics. This is available to both Complete plan and Unlimited plan members.
Our user-friendly form guides you through a quick, simple submission process, making it easy to enter your health metrics.
Add your results anytime with our easy entry form. It's quick, guided, and helps you stay organized — free for all members.
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View your lab data through easy-to-read graphs and tables. Quickly spot patterns, track changes, and compare results across different dates — all without digging through multiple reports. You can also select and compare graphs of specific biomarkers side-by-side to better understand how they relate and change over time.
See your lab reports in clear graphs and tables. Spot patterns, track changes, and compare results over time — all in one place.
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After collecting lab results from different providers, you can download your entire history combined into a single file.
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Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest. Complete plan members receive one report entered for free, then $15 per report after that. Unlimited plan members receive ten report entries for free, then $15 per report after that.
Our inclusive service handles the data entry for your lab reports. Just submit your information and we'll take care of the rest.
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Whether you're working with a doctor, nutritionist, caregiver, or wellness coach, you can securely share your complete lab history by sending an invite link to anyone you trust. You have full control over who sees your information and for how long, ensuring your privacy and peace of mind at every step.
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Healthmatters is a personal health dashboard that helps you organize and understand your lab results. It collects and displays your medical test data from any lab in one secure, easy-to-use platform.
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You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you're on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
The Complete Plan ($15/month) is perfect for individuals who want ongoing access to their health data. It includes unlimited lab imports, visual tracking, custom ranges, result explanations, full account exports, and secure sharing — all with a simple monthly subscription. You can cancel anytime and restart your plan whenever you're ready — your data will still be there waiting for you. You can also upgrade to the Unlimited Plan at any time, with the cost prorated based on what you've already paid.
The Unlimited Plan ($250 one-time) is also designed for individuals but offers lifetime access with no ongoing subscription. You'll get all the same features as the Complete Plan, plus a larger initial data entry allowance (10 reports), making it a great choice if you prefer a one-time payment and long-term use without monthly fees.
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There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our Data Entry Service is for when you don't want to manually type in your lab results yourself. You simply upload your report (PDF, image, or screenshot), and our trained team enters the information into your Healthmatters account for you — accurately and neatly organized, ready to view in graphs, tables, and timelines.
The $15 per report covers the time and care it takes for a real person to review your file, make sure each result is entered correctly, and double-check for accuracy. This ensures your health data is precise and easy to work with — without you having to spend the time doing it yourself.
Prefer to do it yourself? You can always use our free self-entry tool to add results manually — it just takes a bit more time and attention.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
Unlimited account holders enjoy the entry of ten reports without charge. Subsequent reports are subject to a $15 fee per report.
Additionally, users on the Complete plan can upgrade to a yearly subscription from the account settings. The annual subscription includes a data entry service for five reports.
All professional accounts allow you to import and onboard an unlimited number of clients and their lab results. The distinction between professional plans lies solely in the data entry service.
The Pro Monthly Plus plan is priced at $75 per month and includes a data entry service for five reports each month. Additional reports can be self-entered at no extra cost or, if preferred, you can use our data entry service for an additional fee of $15 per report.
The Pro Monthly plan is priced at $45 per month and does not include a data entry service. Self-entry is free for an unlimited number of reports, and you can opt for the data entry service at a fee of $15 per report.
You also have the option to upgrade to higher monthly or to annual plans, which come with substantial discounts. All upgrades can be done directly from your account.
Simply log in and navigate to your account settings to cancel your subscription. Scroll down to locate the 'Cancel' button at the bottom of the page. Ensure you cancel at least one day before the renewal date to prevent any charges. Once cancellation is requested, the subscription remains active until the conclusion of the current billing cycle.
Our goal has been to make your Healthmatters account as intuitive as possible.
We've crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
1. Graph View:Dive into a visual journey with our biomarker graphs, showcasing over 40 data points. Combining years of results unveils trends, empowering you to make informed decisions. Our visualization tools make it a breeze to compare and understand changes over time, even if your results are from different labs. A search function and filters simplify the exploration of extensive data, allowing you to focus on what needs attention.
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Yes, you can download your information anytime. We offer two easy ways to export your lab data:
This makes it simple to save, back up, or share your health data whenever you need.
Yes, you can print your report. To do so, navigate to "All tests" and open the report you wish to print. You'll find a print button in the right corner of the report. Click on it, and your browser's print window will open. If you prefer to print in a bigger typeface, adjust the scale using the print window settings.
Yes, you can! We highly recommend activating Two-Factor Authentication (2FA) for your account. To do so, please navigate to the "Profile and Security" section of your account, where you will find instructions for activating 2FA.
Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
The professional account is designed for health professionals who wish to track and organize their clients' laboratory results.
To learn more about Healthmatters Pro, please refer to the professional page.
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Optimal Result:
0 - 36 ug/dL.