Copper deficiency

Last revised by Daniel J Bell on 16 Mar 2019

Copper deficiency (also known as hypocupremia) is unusual due to the ubiquity of copper in the normal diet.

Copper deficiency is thought to be rare, but exact numbers are difficult to ascertain.

The typical presentation of copper deficiency mimics the more common vitamin B12 deficiency, which will usually need to be excluded first.

  • blood dyscrasias e.g. anemia, leukopenia, thrombocytopenia
  • neurotoxicity e.g. neuropathy, myelopathy, visual impairment
  • artificial alimentation e.g. total parenteral nutrition, chronic tubal feeding
  • post-surgical e.g. post-gastrectomy, bariatric surgery
  • excessive zinc intake
  • alcoholism (rare) 1

Copper deficiency myeloneuropathy may produce identical neuroradiological findings to subacute combined degeneration of the cord and therefore be indistinguishable.

Cocoa is often trialled initially as it contains copper naturally in reasonable amounts and is palatable to the patient 1. In cases where gastrointestinal dysfunction is the underlying issue then intravenous copper administration may be required.

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