Can I take zinc and copper supplements together?

Taking Zinc and Copper Together: Guidelines and Considerations

Yes, zinc and copper supplements can be taken together, but they must be properly balanced as zinc inhibits copper absorption, with a recommended ratio of 8-15 mg zinc to 1 mg copper to prevent zinc-induced copper deficiency. 1

Zinc-Copper Interaction Mechanism

Zinc and copper have an inverse relationship in terms of absorption:

• Zinc induces metallothionein in enterocytes, which has a greater affinity for copper than zinc
• This metallothionein preferentially binds copper in the intestine, preventing its absorption 2
• When bound to metallothionein, copper is excreted in feces as enterocytes are shed 2

Recommended Supplementation Approach

Optimal Ratios

• Maintain a ratio of 8-15 mg zinc for each 1 mg copper 1, 2
• Most complete multivitamin and mineral supplements (like Forceval) contain approximately 2 mg copper and 15 mg zinc, which provides an appropriate ratio 2

Timing Considerations

• If taking separate supplements, consider taking them at different times to minimize interaction
• For those taking zinc therapeutically (as in Wilson's disease), zinc should be taken 30 minutes before meals 2

Health Risks of Imbalanced Supplementation

Excessive Zinc Without Adequate Copper

• Can induce copper deficiency 3, 4
• May lead to:
  • Hypochromic-microcytic anemia resistant to iron therapy 4
  • Leukopenia and neutropenia 4
  • Impaired immune function 3
  • Adverse effects on LDL/HDL cholesterol ratios 3
  • Neurological symptoms in severe cases 1

Signs of Copper Deficiency

• Hematological abnormalities (microcytic anemia despite normal iron stores) 1
• Bone abnormalities due to impaired collagen synthesis 1
• Decreased energy production 1
• Physical changes including hypopigmentation of skin, delayed wound healing 1

Special Populations and Considerations

Bariatric Surgery Patients

• May require higher supplementation of both minerals
• After sleeve gastrectomy or Roux-en-Y gastric bypass, 15 mg/day zinc is suggested
• After biliopancreatic diversion with duodenal switch, 30 mg/day zinc is recommended 2
• Monitor both zinc and copper levels if additional zinc is supplemented 2

Wilson's Disease

• These patients should NEVER take copper supplements
• Zinc is used therapeutically to reduce copper absorption 2
• Recommended dose is 150 mg elemental zinc/day in three divided doses 2

Practical Recommendations

1. For general supplementation, choose a balanced multivitamin/mineral that contains both zinc and copper in appropriate ratios
2. If taking individual supplements, ensure the total daily intake maintains the 8-15:1 zinc-to-copper ratio
3. Monitor for signs of deficiency if taking higher doses of either mineral
4. Consult with a healthcare provider before starting high-dose supplementation of either mineral, especially if you have existing health conditions

The evidence clearly shows that while both minerals are essential for health, their balance is critical to prevent deficiency states that can significantly impact morbidity and mortality through effects on hematological, neurological, and immune function.