Chris mentioned that the tests for zinc and copper have relatively low sensitivity. With this in mind, how reliable is zinc-copper ratio and does the information that it acquires worth the extra cost? I use Principal Labs for my cash patients and the costs from these two additional tests is $141. The comprehensive panel that includes the majority markers is $199.

Yes, it’s hard. It’s case by case. I think sometimes serum copper and serum zinc can be very helpful even despite their limitations, but given that additional costs relative to the full case review panel, I mean, one option is just to give them the zinc and copper handout and tell them to eat liberally from those foods that are highest in zinc and copper. Frankly, if they’re willing to eat oysters, then they can knock out their entire zinc and copper requirement by a couple of servings of oysters a week, or even one. Getting the nutrients from food like that, as I’ve explained in the course and elsewhere, is far less likely to cause problems than taking zinc and copper supplements. That said, we do include zinc and copper in our case review panel and often catch people with very low zinc in those situations. It can be a sign of inflammation or it can also be a sign, especially if it’s on the extremes, like if you are very high or very low, there often is a nutritional cause there or at least that’s partly in play. As always with this kind of thing, we have to take it on a case-by-case situation, if you have a patient with thyroid issues, for example. Zinc is very important for thyroid function, so you may want to maybe work during the additional testing there, or again, in that case, you can just give them the handout and make sure that they’re meeting their zinc needs through food.