- Inadequate intake or absorption of copper
- Gastric bypass w/o supplementation
- Malabsorption of copper for any reason (e.g. celiac disease)
- Excessive zinc ingestion (interferes w/copper absorption) - e.g. via overuse of supplements
- Affects spinal cord (dorsal columns as well as motor tracts) and peripheral nerves (motor and sensory)
- Slowly progressive paresthesias affecting legs, ascending numbness starting in feet, gait and balance problems
- Weakness & numbness can also affect arms/hands
- Fatigue, sob w/anemia
- Ataxia
- Some weakness
- + romberg
- Brisk reflexes
- + Babinski
- Tachycardia if sig anemia
- Diminished peripheral sensation
- Impaired proprioception
- Impaired vibration sense
- Often spasticity
- Copper level, Zinc level
- Copper deficiency can also cause leukopenia, anemia