What are the symptoms of copper deficiency (hypocupremia)?

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From the Guidelines

Copper deficiency (hypocupremia) symptoms include cardiac arrhythmias, myeloneuropathy, delayed wound healing, microcytic anemia, neutropenia, osteoporosis, and hair de-pigmentation.

Acute Symptoms

  • Cardiac arrhythmias
  • Myeloneuropathy
  • Delayed wound healing 1 These acute symptoms are rare and require some weeks to develop, making them not readily recognized 1.

Chronic Symptoms

  • Microcytic anemia
  • Neutropenia
  • Osteoporosis
  • Hair de-pigmentation 1 Chronic symptoms are observed in patients on prolonged parenteral nutrition (PN) with inadequate copper, highlighting the importance of adequate copper supplementation in such cases 1. Copper is essential for melanin synthesis, which explains the hair de-pigmentation symptom 1.

From the Research

Symptoms of Copper Deficiency

The symptoms of copper deficiency, also known as hypocupremia, can be diverse and affect various systems in the body. Some of the common symptoms include:

  • Hematological manifestations such as anemia (microcytic, normocytic, or macrocytic) and neutropenia 2, 3, 4
  • Neurological manifestations such as myelopathy and peripheral neuropathy simulating subacute combined degeneration 2, 4
  • Thrombocytopenia, although relatively rare 2
  • Myeloneuropathy presenting with a spastic gait and prominent sensory ataxia 4
  • Bone marrow findings that can mimic myelodysplasia, resulting in occasional inappropriate referral for bone marrow transplantation 2, 5

Risk Factors and Diagnosis

Copper deficiency can be caused by various factors, including:

  • Foregut surgery 2, 6
  • Dietary deficiency 2
  • Enteropathies with malabsorption 2
  • Prolonged intravenous nutrition (total parenteral nutrition) 2
  • Excessive zinc ingestion 4
  • Malabsorption 4 Diagnosis of copper deficiency is crucial, as early treatment with copper replacement can lead to prompt resolution of hematological manifestations and prevention of neurological deterioration 2, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Copper deficiency, a new triad: anemia, leucopenia, and myeloneuropathy.

Journal of community hospital internal medicine perspectives, 2017

Research

Copper deficiency myelopathy (human swayback).

Mayo Clinic proceedings, 2006

Research

Hypocupremia and bone marrow failure.

Haematologica, 2008

Research

Copper deficiency after gastric surgery: a reason for caution.

The American journal of the medical sciences, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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