Prolonged zinc use for dysgeusia causing copper deficiency.

A patient with multiple myeloma developed copper deficiency (hypocupremia) after 2 years of zinc supplementation prescribed for dysgeusia.

• Patient was in his 70s with multiple myeloma and gastroparesis
• Zinc supplementation had been taken for approximately 2 years to treat dysgeusia
• Overconsumption of zinc is identified as the mechanism leading to copper deficiency
• Copper deficiency from zinc overconsumption is described as 'likely under-recognized'

The patient presented with a broad constellation of symptoms attributable to copper deficiency including neurological, hematological, and constitutional manifestations.

• Symptoms included generalized fatigue, lightheadedness, and nausea
• Hematological findings included neutropenia and anemia
• Neurological symptoms included gait disturbance and worsening numbness and tingling in the bilateral lower extremities and hands
• Copper deficiency can present as fatigue, nausea, anemia, and myelopathy

The patient was treated with inpatient IV cupric chloride and symptoms gradually improved over approximately 5-6 weeks.

• Treatment required inpatient admission for IV cupric chloride administration
• Symptom improvement occurred over the course of approximately 5-6 weeks
• Prompt diagnosis and treatment are emphasized to prevent permanent neurological deficits

Zinc is used as a micronutrient supplement for dysgeusia in cancer patients undergoing treatment, but prolonged use carries risk of inducing copper deficiency.

• Zinc is described as 'a micronutrient essential for taste perception'
• Zinc may be prescribed for dysgeusia in cancer patients undergoing treatment
• Clinicians are advised to screen for copper deficiency symptoms in patients taking zinc supplementation
• Prolonged courses or overprescribing of zinc should be avoided