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Copper deficiency is a rare but clinically important nutritional disorder that occurs when there is not enough copper in the body. Copper is an essential trace element required for energy metabolism, red blood cell formation, bone growth, the maintenance of connective tissue, and antioxidant defence. It is rare in healthy adults but common in premature infants, in those recovering from severe undernutrition or in patients with recurrent diarrhoea.

In adults, the most prevalent causes are malabsorption disorders (e.g., coeliac disease, Crohn disease, and cystic fibrosis), weight-loss (bariatric) surgery, and high zinc consumption interfering with copper absorption. The known cause of copper deficiency is increasingly being diagnosed as bariatric bypass surgery.

Symptoms are nonspecific but typically involve the haematologic and neurologic systems. Patients become tired and weak from anaemia. Neutropenia (few white blood cells) makes them more at risk for infection. Neurological effects can include tingling, loss of sensation in the hands and feet, muscle weakness, poor coordination and disorientation or melancholy. It may also induce osteoporosis and nerve damage (myeloneuropathy).

The diagnosis is made by blood tests that demonstrate low levels of copper and ceruloplasmin. Treatment involves addressing the underlying cause and may include copper supplements administered orally or intravenously in severe cases. The earlier the diagnosis is made, the better the prognosis, especially neurologically.