Iatrogenic copper deficiency: Risks and cautions with zinc prescribing

Area of Science:

• Clinical Medicine
• Trace Element Metabolism
• Nutritional Science

Background:

• High-dose zinc supplementation can lead to copper deficiency, a condition often overlooked.
• Zinc-induced copper deficiency (ZICD) can cause significant neurological and hematological issues.

Purpose of the Study:

• To determine the frequency of missed diagnoses of zinc-induced copper deficiency.
• To increase awareness of ZICD and advocate for prescribing guidelines.

Main Methods:

• Retrospective analysis of patients with hyperzincemia and hypocupruria from the Scottish Trace Element Laboratory database.
• Review of case records to confirm ZICD diagnosis.

Main Results:

• 23 cases with high serum zinc and low serum copper were identified.
• 14 patients were diagnosed with ZICD, with 7 (50%) being previously undiagnosed.

Conclusions:

• The majority of ZICD cases remain undiagnosed due to infrequent monitoring of serum zinc and copper levels.
• Recommendations are made to revise official advice on zinc dosage and frequency to prevent ZICD.