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.

Clinical presentation

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)

Radiographic features

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

Treatment and prognosis

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

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