Abstract Details

Title Unsupervised Chronic Zinc Supplementation for COVID-19 Prevention Leading to Longstanding Painful Myeloneuropathy

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 9-011

Objective To present a case of copper deficiency myeloneuropathy resulting from chronic, unsupervised zinc supplementation undertaken for unproven COVID-19 prevention, and to highlight the neurologic consequences associated with misinformation-driven supplement use.

Background The COVID-19 pandemic was marked by dissemination of unverified health advice, prompting many individuals to adopt self-directed therapies such as zinc supplementation. While zinc is generally considered safe, excessive intake impairs gastrointestinal copper absorption leading to copper deficiency. Copper is required for myelin and neuronal integrity; deficiency can result in myeloneuropathy with painful sensory loss, weakness, and gait instability.

Design/Methods A 65-year-old woman with minimal change disease treated with prednisone and rituximab, pancytopenia, COPD, and chronic vitamin B12 and D deficiencies presented with progressive bilateral lower extremity pain, numbness, and weakness. She reported electric shock-like sensations and severe allodynia extending from the feet to the hands, resulting in gait impairment that necessitated the use of a walker. Gabapentin and tramadol provided minimal relief.

CT head and infectious workup was unremarkable. Electromyography and nerve conduction studies identified right carpal tunnel syndrome and a generalized sensorimotor peripheral neuropathy. Laboratory evaluation demonstrated elevated zinc (130 µg/dL) and markedly reduced serum copper (<10 µg/dL). Further history revealed daily over-the-counter zinc use since 2021, initiated after exposure to online claims regarding immune benefits for COVID-19 prevention. Copper supplementation was initiation with discontinuation of supplemental Zinc with no further progression but lack of improvement on initial follow up.

Results NA

Conclusions This case demonstrates the neurologic harm that may result from misinformation and unsupervised supplement use. Unproven COVID-19 prevention practices can cause lasting, preventable neurologic deficits. In this case, given the 4-year history of daily zinc supplementation, there will likely be some residual deficits despite initiation of copper supplementation. Clinician vigilance and proactive counseling are necessary to mitigate the long-term consequences of misinformation-driven self-medication.

Authors/Disclosures
Kiana Moussavi, MD (Dartmouth Hitchcock Medical Center) PRESENTER	Dr. Moussavi has nothing to disclose.
Megan Donohue, MD	Dr. Donohue has nothing to disclose.

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