Iatrogenic copper deficiency: Risks and cautions with zinc prescribing

Andrew Duncan (Lead / Corresponding author), Ian Morrison, Scott Bryson

    Research output: Contribution to journalArticlepeer-review

    2 Citations (Scopus)
    26 Downloads (Pure)


    Aims: Copper deficiency resulting from prescribing zinc in high doses is a rare but life-changing diagnosis that is frequently overlooked. The aim of this study is to gauge how often zinc-induced copper deficiency is missed, to raise awareness of the condition and to stress the need for guidelines for prescribing zinc.

    Methods: Suspected cases of zinc-induced copper deficiency were retrospectively obtained by selecting those patients with hyperzincaemia and hypocupraemia from the database of the Scottish Trace Element Laboratory. Case records were reviewed to determine the validity of the suspected diagnosis.

    Results: After exclusions, 23 instances of high serum zinc and low serum copper concentrations were found. A positive diagnosis of zinc-induced copper deficiency was made in 14 patients of which 7 (50%) were previously undiagnosed.

    Conclusion: Serum zinc and copper concentrations are rarely measured in patients prescribed zinc and so the vast majority of cases of zinc-induced copper deficiency are likely to be undiagnosed. We recommend the current official advice on the dose and frequency of zinc administration is revised in order to limit, and potentially eradicate, the condition.

    Original languageEnglish
    Pages (from-to)2825-2829
    Number of pages5
    JournalBritish Journal of Clinical Pharmacology
    Issue number9
    Early online date17 Apr 2023
    Publication statusPublished - Sept 2023


    • copper
    • deficiency
    • zinc

    ASJC Scopus subject areas

    • Pharmacology (medical)
    • Pharmacology


    Dive into the research topics of 'Iatrogenic copper deficiency: Risks and cautions with zinc prescribing'. Together they form a unique fingerprint.

    Cite this