Although copper deficiency is rare, signs and symptoms of long-term depletion
of copper include anemia, changes in the structure and appearance of hair, heart
damage, growth retardation, impaired bone formation, osteoporosis (bone loss),
and emphysema (lung disease).
Selenium deficiency may be associated with muscular, digestive, and heart
disorders; long-term deficiency may be associated with increased risk of
developing certain chronic illnesses such as cancer, diabetes, or liver
Signs and symptoms of zinc deficiency include loss of appetite or sense of
taste, growth retardation, skin changes, and increased susceptibility to
The selected depletions information presented here identifies some of the
nutrients that may be depleted by certain medications. The signs and symptoms
associated with nutrient deficiency may also indicate conditions other than
nutrient deficiency. If you are experiencing any of the signs or symptoms
mentioned, it does not necessarily mean that you are nutrient deficient.
Nutrient depletion depends upon a number of factors, including your medical
history, diet, and lifestyle as well as the length of time you have been taking
the medication. Please consult your healthcare provider; he or she can best
assess and address your individual healthcare needs, and determine if you are at
risk for nutrient depletions from these medications as well as others not listed
Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY
Acad Sci. 2000;889:87-106.
Castro-Gago, M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine
levels in epileptic children before and during treatment with valproic acid,
carbamazepine, and phenobarbital. J Child Neurol.
Chung S, Choi J, Hyun T, Rha Y, Bae C. Alterations in the carnitine
metabolism in epileptic children treated with valproic acid. JKMS.
Covington T, ed. Nonprescription Drug Therapy Guiding Patient
Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.
Falchuk KH. Disturbances in Trace Elements. In: Fauci A, Braunwald E,
Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine.
14th ed. New York, NY: McGraw-Hill Companies Health Professional
Goggin T, Gough H, Bissessar A, et al. A comparative study of the relative
effects of anticonvulsant drugs and dietary folate on the red cell folate status
of patients with epilepsy. Q J Med. 1987;65(247):911-919.
Graf WD, Oleinik OE, Glauser TA, et al. Altered antioxidant enzyme activities
in children with a serious adverse experience related to valproic acid therapy.
Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S
Hurd RW, Rinsvelt HA, Wilder RJ, et al. Selenium, zinc, and copper changes
with valproic acid: possible relation to drug side effects. Neurol.
Kaji M, Ito M, Okuno T, et al. Serum copper and zinc levels in epileptic
children with valproate treatment. Epilepsia. 1992;33(3):555-557.
Lerman-Sagie T, Statter M, Szabo G, et al. Effect of valproic acid therapy on
zinc metabolism in children with primary epilepsy. Clin Neuropharmacol.
National Research Council. Recommended Dietary Allowances.
10th ed. Washington, DC: National Academy Press; 1989.
Navarro-Alarcon M, Lopez-Martinez MC. Essentiality of selenium in the human
body: relationship with different diseases. Sci Total Environ.
Sozuer DT, Baruteu UB, Karakoe Y, et al. The effects of antiepileptic drugs
on serum zinc and copper levels in children. J Basic Clin Physiol
Van Wouwe JP. Carnitine deficiency during valproic acid treatment. Int J
Vitam Nutr Res. 1995;65(3):211-214.
Review Date: October 2000
Reviewed By: All depletions monographs have been reviewed by a team of experts including
Derrick M. DeSilva, Jr., MD, Raritan Bay Medical Center, Perth Amboy, NJ;
Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley
Hospital, Harvard University and Senior Medical Editor, A.D.A.M., Inc., Boston,
MA; John Hinze, PharmD, NMD, Woodbine, IA; Ruth Marlin, MD, Medical Director and
Director of Medical Education, Preventive Medicine Research Institute,
Sausalito, CA; Brian T Sanderoff, PD, BS in Pharmacy, Clinical Assistant
Professor, University of Maryland School of Pharmacy; President, Your
Prescription for Health, Owings Mills, MD; Leonard Wisneski, MD, FACP, George
Washington University, Rockville, MD; Ira Zunin, MD, MPH, MBA, President and
Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu,
The publisher does not accept any responsibility for the accuracy of
the information or the consequences arising from the application, use, or misuse
of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed