Copper Deficiency and Excess
Copper Deficiency and Excess
Jake Ames, MD, HMD
Since
being a physician since 1986 I have never seen patients with excess RBC
copper. Most of my patients have had low
RBC copper and low hair analysis copper.
It has been a major mistake for vitamin manufacturers to remove copper
from their multimineral supplements.
Causes of Copper Deficiency
Copper
deficiency can be either genetic or non-genetic origin. Copper deficiency is very common. Causes of copper deficiencies are low dietary
copper, gastrointestinal surgery, such as gastric bypass surgery, malabsorption
such as celiac disease, Crohn’s disease, inflammatory bowel disease, excess
supplementary zinc and iron, DMPS chelation, diabetes, low-birth-weight infants,
infants being fed cow's milk instead of breast milk, patients receiving total
parenteral nutrition, chronic diseases that result in low food intake, such as
alcoholics, and persons with eating disorders. The elderly and athletes due to
special needs that increase their daily requirements. Vegetarians may have decreased
copper intake due to consuming low copper in plant foods. Genetic defects such
as Menkes disease also cause low copper.
Symptoms of Copper Deficiency
Copper
deficiency can cause anemia, confusion, decrease in number of white blood cells,
depression, fatigue, hemorrhoids, arthritis, muscle weakness, strokes,
myocardial infarction, hypochromic anemia, hypothyroidism, impaired coordination,
iron deficiency, thinning and wrinkling of skin, irritability, neutropenia, osteoporosis,
peripheral neuropathy, varicose veins, vitamin B12 deficiency, weakened blood
vessels, white, gray and silver hair,
and poor tanning
Food Sources of Copper
Almonds,
Avocados, Beef Liver, Calamari, Cashews, Chia Seeds, Chickpeas, Cocoa powder,
Goat Cheese, Kale, Lentils, Lobster, Prunes, Pumpkin seeds, Quinoa, Raw Kale, Oysters,
Sesame seeds, Shiitake mushrooms, Spirulina, Squid, Sunflower seeds, Tempeh
Daily Copper Recommendation
The World Health Organization recommends a minimal acceptable intake of
approximately 1.3 mg/day. In the United
States the RDA for copper is 900 μg/day for adults. I have found this dose to be too low for all
of my patients. Since 1994, I have found
almost all of my patients need 4-8 mg a day of copper. I would test their RBC copper, and RBC zinc
and do a hair analysis from Doctors Data Company in Chicago, Illinois. The hair analysis is not accurate if it shows
elevated copper, but I have found that it correlates well with a low RBC copper
blood test quite frequently. Keep your
zinc to copper ratio at 10:1 when taking copper supplements. Zinc and copper should be taken at different
meals, since they both interfere with each other’s absorption.
The best
absorbable forms of copper are copper sebacate and copper glycenate. Copper gluconate and copper sulfate are
poorly absorbed. Cupric oxide is a very
poor choice.
Copper
can be obtained by drinking water from a pure copper container, and cooking
with pure copper pots and pans.
The
immediate side effects of taking copper supplements are nausea, so they must be
taken with a meal.
Some Copper Containing Enzymes Include
Ceruloplasmin: Essential
for iron transport.
Cytochrome
C Oxidase: Involved in the mitochondrial
respiratory chain and involved in electron transport to make ATP.
Amine
oxidases: A group of enzymes oxidizing
primary amines (e.g., Tyramine, Histidine and Polylamines)
Dopamine
β-hydroxylase: Involved in catecholamine
metabolism and catalyzes the conversion of dopamine to norepinephrine
Hephaestin: A protein involved in iron and copper
transport.
Multi-copper
ferroxidase, involved in iron transport across intestinal mucosa into portal
circulation
Lysyl
oxidase: Needed for cross-linking of
collagen and elastin.
Prevents
thinning and wrinkling of skin. Prevents
aneurysms.
Peptidylglycine
alpha-amidating mono-oxygenase (PAM):
A multifunction
enzyme involved in maturation and modification of neuropeptides, neurotransmitters, and neuroendocrine
peptides)
Superoxide
dismutase (Cu, Zn): Intracellular and
extracellular enzymes involved in defending reactive oxygen species (e.g., destruction
of superoxide radicals)
Tyrosinase: Enzyme involved in melanin and other pigment
production. Needed for tanning.
Symptoms
of High or Excess Copper
Acute symptoms of copper poisoning by ingestion are vomiting, sometimes
with blood (hematemesis), hypotension, black, tarry stools (melena), coma,
jaundice (yellow skin), and gastrointestinal distress.
Chronic elevated levels of copper exposure can damage the liver and
kidneys.
There is little evidence to indicate that chronic human exposure to copper
results in systemic effects other than liver and possibly kidney injury.
Wilson's disease is a rare autosomal (chromosome 13) recessive genetic
disorder of copper transport that causes an excess of copper to build up in the
liver. It can be treated effectively
these days if caught early.
My
favorite test to diagnose copper status is the RBC copper test.
An
elevated serum copper or ceruloplasmin levels are not reliable since elevated
levels can be seen in inflammation, infectious diseases, malignancies, and
pregnancy. A liver biopsy can help
determine copper toxicity.
Seventy-Five
to Ninety-Five percent of copper is excreted by the liver and is incorporated
into ceruloplasmin, the main copper carrier in blood. Copper is transported to
cells and tissues by ceruloplasmin, albumin and some amino acids, and is
excreted into the bile which is the major pathway for the excretion of
copper. By regulating copper release, the liver exerts
homeostatic control over extrahepatic copper.
It is
not likely that you will get enough copper from your diet, unless you are
cooking with 100% copper cookware and drinking water from 100% copper
vessels. The worst case scenario is being low on copper will cause you to die of a
heart attack or stroke. Check your RBC
copper, zinc, manganese, selenium, molybdenum, cobalt, magnesium and
potassium. We are low on many minerals
besides copper
© 2017 Jake
Ames, MD, HMD All Rights Reserved