There are cases of deficiencies of trace elements described after weight loss surgical procedures. Copper as a trace element plays a number of roles in out body. It is uncommon. As a result in most cases it is corrected with oral supplementation. Copper deficiency after weight loss surgery has been described and seen more freuquently than general population. In refractory cases, patient may need to have copper in form of IV infusion to normalize the levels. This will require coordination with a hematologist, an infusion centers, and a pharmacists.

Complete blood work is needed before recommendation for dosing can be made and specific supplementation regiment is formulated. It’s important to look at all of the lab values, the patients health status, diet, supplements, and medications when evaluating a deficiency issue.

Past blog post regarding Copper Information

Example of laboratory studies needed.

Copper is a trace element. It is a co-factor and enzyme that regulates iron metabolism and is essential in cell production, immune function, cellular energy storage, anti-oxidative effect, nerve transmission and connective tissue and bone development. There are several research article linking dental bone health, alveolar bone and tooth enamel wear, to copper levels.

Copper’s co-ezymes work with transferrin to transport the iron for red blood cell formation. It is important to also look at copper levels and intake when a patient is at risk for deficiencies when diagnosing anemia. It is interesting to note that anemia can show an abnormal high level of copper on laboratory studies.

People at risk for Copper deficiency are:

• Cow milk fed infants
• Low birth weight infants
• Prolonged diarrhea
• Malnutrition
• Malabsorptive syndromes
• Menkes Syndrome
• Gastric or Weight loss surgery
• Short bowel syndromes
• Sprue’s disease
• Total Parenteral Nutrition need
• Celiac Disease
• Cystic Fibosis

Deficiency can impair red cell production, causing anemia,  and cause iron overload in organs, such as liver, brain, or retina. It may also cause a decrease in neutrilphils, a type of white blood cell. Osteoporosis can also be a side effect of low copper intake. There have also been reports of neurologic syndrome in at risk patient who are deficient.

Recommended Daily Allowance for the average male and female is 900 mcg/daily. Pregnant women daily RDA is 1,00mcg/daily and breastfeeding mothers RDA is 1,300 mcg/daily. The highest tolerable dose for the average person is 10,000 mcg/daily.

Medications and supplements that can increase levels are estrogen, birth control pills, and Tagamet. Medications and supplements that lower levels are allopurinol and nifedipine. Penicillamine may lower copper level and decrease amounts of pencillamine. Copper binds with NSAIDS and may increase their effect. Zinc supplementation over an extended period can decrease absorption of copper.

Toxicity symptoms are nausea, vomiting, abdominal pain, and  diarrhea.

This is not meant to be an all inclusive  or complete discussion. As always, consult with your physician based on your laboratory values regarding any supplementation.

Another article regarding Micro-elements for Bone Health