From the Guidelines
Copper is a crucial trace mineral in the body, and its levels should be checked in patients with symptoms like fatigue, weakness, or neurological issues, as well as those with a history of malabsorption conditions, liver disease, or genetic disorders like Wilson's disease. Copper plays a vital role in various physiological processes, including the formation of red blood cells, maintenance of nerve cells and the immune system, iron absorption, bone health, and antioxidant functions. According to the most recent guideline, copper levels should be measured in patients coming for post-bariatric surgery follow up, those admitted for neuropathy of unclear etiology, major burn patients, and those on long-term parenteral nutrition 1. This is because copper deficiency can occur due to malabsorption conditions like celiac disease, gastric bypass surgery, excessive zinc supplementation, or certain genetic disorders like Wilson's disease. Conversely, copper toxicity can result from liver disease or Wilson's disease. Testing typically involves a blood test measuring serum copper and ceruloplasmin levels.
Some key scenarios where copper levels should be checked include:
- Post-bariatric surgery follow up
- Neuropathy of unclear etiology
- Major burn patients
- Long-term parenteral nutrition
- Patients on home enteral nutrition fed by jejunostomy tubes
- Continuous renal replacement for more than 2 weeks. It is essential to consult with a healthcare provider about copper testing if you have unexplained symptoms or risk factors for imbalance, as both deficiency and excess can cause health problems 1.
From the FDA Drug Label
Copper is also deposited as characteristic, asymptomatic, golden-brown Kayser-Fleischer rings in the corneas of all patients with cerebral symptomatology and some patients who are either asymptomatic or manifest only hepatic symptomatology Wilson's disease (hepatolenticular degeneration) occurs in individuals who have inherited an autosomal-recessive defect that leads to an accumulation of copper far in excess of metabolic requirements The excess copper is deposited in several organs and tissues, and eventually produces pathological effects primarily in the liver, where damage progresses to postnecrotic cirrhosis, and in the brain, where degeneration is widespread
Copper's role in the body is not explicitly stated in the provided drug labels, but it can be inferred that copper accumulation is harmful and can lead to pathological effects.
- The drug labels discuss Wilson's disease, a condition where copper accumulates in excess of metabolic requirements.
- Copper is essential for various bodily functions, but an excess of it can be toxic. The provided drug labels do not explicitly state why one would need to check copper levels, but it can be inferred that monitoring copper levels is crucial in managing Wilson's disease 2 3.
From the Research
Copper's Role in the Body
- Copper is an essential micronutrient for the human body, involved in several metabolic processes, including terminal oxidation, elimination of free radicals, iron metabolism, hormone and neurotransmitter synthesis, and stabilization of the extracellular matrix 4.
- It plays a crucial role in various physiological functions, such as hemoglobin synthesis, antioxidant defense, and connective tissue formation 5.
- Copper is also necessary for proper immune function, with recent studies suggesting its involvement in regulating immunity and the host response to bacterial infection 6.
Importance of Copper Balance
- Both copper deficiency and excess can lead to severe symptoms and diseases, highlighting the need for a delicate balance of copper in the body 4.
- Copper deficiency can affect various physiological systems, including bone marrow hematopoiesis, optic nerve function, and the nervous system, leading to conditions such as anemia, neutropenia, and bone abnormalities 5, 7, 8.
- Excessive copper intake can cause cell damage, primarily through free radical reactions, and has been implicated in the development of chronic diseases, including neurodegenerative and cancerous diseases 4, 6.
Checking Copper Levels
- Measuring serum copper, serum ceruloplasmin, and 24-hour urine copper levels can help diagnose copper deficiency or excess 5.
- Erythrocyte superoxide dismutase and platelet cytochrome c activities may be useful indexes for evaluating marginal copper deficiency 8.
- Regular monitoring of copper levels is essential, particularly in individuals with genetic disorders, such as Menkes and Wilson disease, or those at risk of copper deficiency due to malnutrition, bariatric surgery, or other medical conditions 4, 7.