On 2014 Feb 13, David Keller commented:

The April 2010 Resident's Clinic discussed a 38-year-old woman with a history of gastric bypass who presented with profound anemia due to severe copper deficiency. She was noted to have an abnormally high zinc level. Her copper deficiency was attributed mainly to malabsorption due to her bowel surgery, and it was also noted that high zinc levels may induce copper deficiency. The question then arises as to why her zinc level was so high. The only clue is that the patient "had a history of frequent upper respiratory infections". Unfortunately, she was not asked whether she had used any of the over-the-counter zinc lozenge products which are sold as alternative sore throat remedies (for example "Cold-Eze"). Clinicians should not neglect to inquire about such non-prescription remedies or supplements when taking a patient's medication history, as important information may be learned.

On 2014 Feb 13, David Keller commented:

The April 2010 Resident's Clinic discussed a 38-year-old woman with a history of gastric bypass who presented with profound anemia due to severe copper deficiency. She was noted to have an abnormally high zinc level. Her copper deficiency was attributed mainly to malabsorption due to her bowel surgery, and it was also noted that high zinc levels may induce copper deficiency. The question then arises as to why her zinc level was so high. The only clue is that the patient "had a history of frequent upper respiratory infections". Unfortunately, she was not asked whether she had used any of the over-the-counter zinc lozenge products which are sold as alternative sore throat remedies (for example "Cold-Eze"). Clinicians should not neglect to inquire about such non-prescription remedies or supplements when taking a patient's medication history, as important information may be learned.