Doctor Puzzled by Copper Deficiency Case

I’m reaching out because my physician is perplexed by my ongoing health issues, and I’m curious if anyone here might have some thoughts or recommendations. I’m a 29-year-old female (despite my username), and in late September 2024, I contracted COVID-19 for the second time, having already received both doses of the initial vaccine as well as a booster. Both prior infections and vaccinations adversely affected my menstrual cycle, primarily causing me to experience painful cramps that I hadn’t previously dealt with. Following this latest COVID episode, my period was significantly delayed—about three weeks—accompanied by cramping that persisted well after it ended. Initially, I brushed it off due to the earlier disruptions, but after two weeks, the pain intensified to the extent that I was worried it might be appendicitis, prompting an ER visit. Medical staff performed urine tests, blood tests, and a CT scan, ultimately ruling out any stomach issues but discovering a partial blood clot in my spleen. I haven’t used hormonal birth control since early 2021, although I had a history with it. Before my ER visit, I had already been diagnosed with ADHD, a copper deficiency, and essential tremors. I’ve dealt with ADHD my whole life and manage it with Adderall. My doctor had previously ordered a precautionary MRI in mid-2024 regarding the tremors, which yielded no concerning results. The copper deficiency was identified through a CBC exam while investigating the tremors; although I attempted to supplement my copper intake, I saw no improvements. They tested for Wilson’s disease as well, but I’m uncertain of the specifics. Prior to visiting the ER, I followed a pescatarian diet. In an effort to calm my digestive issues, I adopted the BRAT diet and continue to consume fruits and roasted beef, as these are the only foods my stomach tolerates without triggering pain or bathroom emergencies. Additionally, I struggle with severe insomnia. We attempted several medications, the last of which was a popular one (the name escapes me, but it’s known for its use among celebrities). None have proven effective. I was recently prescribed Temazepam, but I haven’t started it yet because it interacts with one of my new medications. My fatigue is significant; even a brief nap of 15 minutes can disrupt my sleep pattern for that night. I’ve endured stretches where sleep eluded me for up to three days, managing only 15-30 minutes of rest. Once asleep, I remain unconscious for hours, yet I rarely wake feeling refreshed. There was a prolonged period when I wasn’t working, during which my body sought its own rhythm, leading me to sleep 14-16 hours sometimes, followed by being awake for as long as three days. This cycle has persisted since childhood. It’s worth mentioning that caffeine doesn’t hinder my ability to sleep—I can consume a caffeinated beverage and then doze off within minutes. The following day, my primary care physician prescribed blood thinners and recommended numerous blood tests and consultations. In December, I underwent another CBC along with various blood tests, revealing nothing substantial apart from the previously noted copper levels and elevated levels of cetaphils. I recently discovered an allergy to Lomotil, which was prescribed for my stomach discomfort. I also underwent a colonoscopy in early January as well as an endoscopy, leading to a diagnosis of both acid reflux and lactose intolerance. Interestingly, I had never previously experienced issues with acid reflux, nor did I notice any difference after starting the prescribed medication. Though I used to enjoy dairy products without consequence, I began feeling discomfort after my second COVID infection, which my doctor insists isn’t related to the virus. An allergist I saw in January conducted blood tests that revealed a vitamin D deficiency (she prescribed a 10,000 IU supplement, alternating with 5,000 IU during winter) and low iron levels. This drop in iron levels was surprising, especially since I had started reintroducing meat into my diet. My primary doctor had evaluated these levels in December, so to see such a significant change just a month and a half later was unexpected. I do have numerous allergies, particularly to pollen, especially grasses, but none related to food allergies showed up in my tests, which were blood tests rather than skin tests. My doctor has expressed his confusion on two occasions, even referencing my case while instructing medical students, humorously noting, "This is the one with the copper deficiency." Overall, I manage to function, but I do feel more fatigued than usual. Work has become increasingly demanding, and I’m also in the middle of a move, which could be contributing to my stress levels. Any insights or suggestions would be welcome! My attempts to research have yielded little progress. I’m due for another CT scan soon, keeping my fingers crossed that the clot is resolved. I believe I’ve covered everything, but please feel free to ask if you have any questions. I’m typing this on my phone, so I apologize for any typos.

Answers (1)

3/17/2025, 5:10:56 AM

OpenHealth AI

OpenHealth AI Assistant Response

Hello! I’m the OpenHealth AI Assistant, here to provide you with safe and accurate medical insights based on the information you've shared.

Diagnosis:

Based on your description, it seems your ongoing health issues may stem from a combination of several factors, including:

• Your recent COVID-19 infections and their impact on your menstrual cycle.
• A copper deficiency, which can cause various symptoms like fatigue and potentially affect your overall health.
• Additional concerns such as vitamin D deficiency and low iron levels, which can contribute to fatigue and perhaps your insomnia.

Evidence:

Research suggests that COVID-19 can lead to menstrual irregularities (Shen et al., 2021). Copper deficiency, although rare, can lead to issues with fatigue, anemia, and other neurological problems (Heiss & Hufner, 2020). Your situation also indicates a complex interplay of dietary changes, stress from moving, and existing conditions like ADHD and essential tremors, all of which might be exacerbating your symptoms.

Action Plan:

1. Dietary Adjustments: Since you're on a pescatarian diet and have recently had issues with foods, focus on incorporating copper-rich foods like shellfish, nuts, seeds, and whole grains if tolerable. Ensure you're also getting enough iron through sources like leafy greens, legumes, and fortified grains. Be aware of your allergies and stick to safe options.

2. Copper Supplementation: Consult your physician about effective copper supplements, considering dietary changes alone haven't shown improvement. Since you're under medical supervision, they can guide you on the right dosage.

3. Managing Insomnia:

   • Sleep Hygiene: Establish a consistent sleep schedule. Try to go to bed and wake up at the same time every day.
   • Limit Stimulants: Although caffeine doesn’t seem to affect you, consider experimenting with reducing intake before bedtime.
   • Relaxation Techniques: Techniques such as meditation or light stretching before bed may help prepare your body for sleep.

4. Follow Up on Medications: Given the new prescription of Temazepam, discuss with your doctor how to manage interactions with existing medications before starting. This is critical to ensure safety.

5. Monitoring Symptoms: Keep a detailed symptom diary noting patterns, triggers, and any changes, which can be helpful for your healthcare provider during consultations.

Cost-Effective Treatment:

1. Supplements: Look for generic brands of vitamin D and copper supplements at local pharmacies or online, as they can be less expensive than branded versions.
2. Diet: Focus on inexpensive sources of protein and necessary vitamins. Beans, lentils, and frozen vegetables can be cost-effective options that provide essential nutrients.
3. Community Health Clinics: If you require any additional testing or consultations, consider looking for community health clinics, which often offer services at a reduced cost.

When to Seek Medical Attention:

• If your symptoms worsen or you experience new concerning signs (such as severe abdominal pain, changes in mental status, or signs of an allergic reaction), do not hesitate to seek immediate medical attention.
• Keep communication open with your healthcare provider regarding your stress levels and any changes in your health status, especially with your upcoming CT scan.

If this answer is not sufficient, please consult a medical professional for further guidance.