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Copper Deficiency: The Complete Guide

Copper Deficiency: The Complete Guide

Copper deficiency is a condition that is often underdiagnosed or mistaken for other health issues. It can occur due to different reasons, but it mainly happens because of low dietary copper intake. Even a mild deficiency can lower the immune system and cause fatigue. Severe copper deficiency, on the other hand, can lead to serious health issues and, in extreme cases, death.

Copper belongs to a small group of metals that play an important role in human health. However, the human body cannot manufacture copper, and we, therefore, need to supply our body with it from outside sources. Copper deficiency mainly occurs when we consume too little dietary copper.

Unfortunately, modern research has shown that despite general belief, most people do not consume adequate amounts of copper. In fact, the World Health Organization (WHO) has recently noted that copper deficiency is likely a common and worldwide phenomenon. Even if this includes a large population with marginal or ‘mild’ copper deficiency, it still poses a problem, as even a mild deficiency can impair one’s health in subtle ways.

In this guide, we will look at the common culprits behind copper deficiency, the problems it can cause, and how you can treat it.

The Importance of Copper to the Body

Copper is one of the essential minerals needed for the proper function of many important processes in the body. By binding with certain proteins, it aids in the production of enzymes that function as catalysts to a number of bodily functions.

To name a few, copper plays an important role in providing energy to the body, transforming melanin for pigmentation of the skin, and in the formation of collagen and elastin (and, thus, the maintenance and repair of connective tissues). The last process is especially important for the heart and arteries.

Furthermore, copper is essential for the proper function of the immune system. It helps the body in numerous ways, from the production of white and red blood cells and the absorption of iron all the way to ensuring proper brain and nerve function.

In other words, a lack of this important metal affects all the previously mentioned processes and can even lead to further complications.

How Much Copper Is Present in the Body and How Much Do We Need Per Day?

The adult body contains around 0.6 – 0.95 milligrams of copper per a pound of body weight (1.4 - 2.1 mg/kilogram). When looking at a healthy person weighing 130 pounds (60 kilograms), this translates to approximately 0.1g of copper.

The recommended amount of copper intake per day (micrograms/day) varies based on age, gender, and other factors:

  • 0-6 months: 200 mcg/day (AI or Adequate Intake);
  • 7-12 months: 220 mcg/day (AI);
  • 1-3 years: 340 mcg/day;
  • 4-8 years: 440 mcg/day;
  • 9-13 years: 700 mcg/day;
  • 14-18 years: 890 mcg/day;
  • 19+ years: 900 mcg/day;
  • Pregnancy (all ages): 1,000 mcg/day;
  • Lactation: 1,300 mcg/day.

Copper is naturally found in many different types of food as well as in copper-infused water which can be created with a copper water bottle. While ensuring that enough copper enters the body, you should also take into consideration the interest in not exceeding the recommended upper limits.

If you believe you should increase your or your child’s copper intake, it is always best to consult a health professional first.

What Causes Copper Deficiency?

There are several culprits behind copper deficiency. They range from nutrition and lifestyle to genetics. A simple answer to the question of what causes copper deficiency is that copper deficiency occurs when copper is not supplied or absorbed within the body in the necessary amounts.

The risk factors which can lead to lower copper content in the body include:

Low Intake of Dietary Copper

Simply put, if you do not ingest enough copper regularly, the body will bind or flush out the copper you already have and start being deficient in it if it is not replenished. This phenomenon can happen if you regularly eat foods low in copper without introducing more variety to your diet.

Vegetarians, for example, are at greater risk of becoming copper-deficient because they typically consume plant foods in which copper bioavailability is low. As a study explains, the mineral bioavailability can be affected by the increased presence of fiber, phytic acid, and oxalic acid. This should be worrisome when unrefined cereal intakes are high and copper intakes are low.

People with chronic diseases that result in low food intakes, such as alcoholics and people with eating disorders, are also at risk of ingesting low amounts of copper because of the sheer lack of necessary nutrients that are otherwise present in food.

Another common risk of becoming copper-deficient is when a patient is maintained on total parenteral nutrition for long periods of time without proper copper supplementation.

The risk for copper deficiency may also be higher among the elderly and athletes due to special needs which increase their daily copper requirements.

Prenatal and Postnatal Copper Deficiency

Copper deficiency during pregnancy can cause problems for the child as well. This is because the child receives the necessary nutrients from their mother. In the case of copper, a mother that lacks the necessary copper can put their child at risk of birth defects, serious growth issues, and deadly genetic disorders. The higher the copper deficiency in the mother, the higher the risk to the baby’s health.

Newborn babies are also at risk of becoming copper-deficient because of a diet poor in copper. Essentially, babies that are breastfed or fed with fortified formula do receive the necessary copper amounts. On the other hand, babies fed with cow’s milk, or premature infants who undergo rapid growth on a diet poor in copper, are at a high risk of nutritional copper deficiency.

The Competitive Trio: Zinc, Iron, and Copper

Copper deficiency can be induced by select mineral supplements, particularly zinc and iron. This is because these three important minerals behave in a competitive manner. When there is an excess of one of these minerals, the intestinal absorption of copper is blocked, and remains so until the excess is eliminated. This process works either way; high copper intake can affect zinc and iron intake, and vice versa.

Zinc has been found to cause copper deficiency in circumstances where there has been high zinc intake over a period of time, leading to anemia and other health issues. In fact, it has been established that 62% of patients have been prescribed zinc at doses high enough to cause copper deficiency. To avoid zinc-induced copper deficiency, the zinc to copper intake ratio should not exceed 30:1.

The same is true for high iron intake, which has been found to negatively affect copper intake resulting, again, in anemia, cardiovascular issues, and other copper-related health issues. While iron-induced copper deficiency is not as common as one caused by zinc, it is nevertheless something you need to be aware of.

While all of these minerals are very important for the body, it is also important to maintain a healthy balance in terms of intake. The current recommended dietary allowance for zinc is around 8 mg/day for women and 11 mg/day for men. In the case of iron, the current RDA for adults aged 19-50 is 8 mg/day for men and 18 mg/day for women.

The recommended values, however, vary depending on age and other factors, such as pregnancy or lactation.

Malabsorption of Copper in the Intestine

Certain cases can lead to impaired absorption of copper in the intestine, even if you ingest enough copper. Aside from malabsorption caused by high zinc and iron amounts, copper absorption can also be blocked by high amounts of Vitamin C intake (more than 1500 mg/day) because of the same reason as with zinc and iron: competition for absorption.

The most common cause of copper deficiency is reduced absorption related to surgery on the gastrointestinal system. This can include a gastric bypass, gastrectomy, and upper gastrointestinal surgery.

Additionally, there could be issues related to copper absorption if you suffer from malabsorption syndrome, such as celiac disease or inflammatory bowel syndrome. In such a case, your body is not able to fully absorb all the nutrients in the food you ingest, leading to copper deficiency and other nutrient deficiencies.

Hereditary Disorders – Menkes Disease

Menkes disease is a genetic mutation that affects the copper-transport protein ATP7A, leading to serious copper deficiency. It is characterized by a peculiar steel-colored, kinky hair, floppy muscles, seizures, hypothermia, growth failure, and nervous system deterioration.

This disease occurs during early to middle childhood, generally affecting male infants. Female children of a carrier mother have an even chance of carrying the disorder but not be affected by it.

The Effects of Copper Deficiency

Depending on the severity of the deficiency, copper deficiency may lead to some of the following health issues:

  • Anemia;
  • Compromised immune function;
  • An increased risk of infection;
  • Low body temperature;
  • Skin and hair depigmentation;
  • Osteoporosis;
  • Bone fractures;
  • Thyroid problems;
  • Loss of skin;
  • Growth retardation;
  • Delayed puberty;
  • Brain tissue and nervous system damage;
  • Cardiovascular disease; and
  • Other complications.

The Symptoms of Copper Deficiency

Copper deficiency takes time to develop and show symptoms. In fact, you may be deficient without knowing it until the deficiency becomes more severe. However, there are a few signs which can point to deficiency.

Fatigue

As copper plays an important role in the formation of the red blood cells, the body, when deficient, becomes depleted of the necessary oxygen which helps our bodies  function properly. In other words, we develop anemia which affects our energy levels.

Additionally, the cells use copper to generate adenosine triphosphate (ATP), which is the main source of energy for our bodies. When deficient, the body cannot generate enough ATP, resulting in weakness and fatigue.

Pain, Numbness, Weakness, and Disrupted Mood

Copper plays an important role in the production and maintenance of myelin. This is a substance that coats the nerves and facilitates the communication of signals throughout the nervous system. Additionally, a copper-containing enzyme is also responsible for converting dopamine into norepinephrine, resulting in mood disruptions.

The lack of copper can result in neurological conditions such as:

  • Myelopathy, which causes diminishing body function, pain, and weakness;
  • Peripheral neuropathy, which causes weakness, numbness, and pain, usually felt in the hands and feet; and
  • Improper synthesis of neurotransmitters, which can cause lowered feelings of pleasure and reward and other mood-related issues.

Frequent Colds and Sicknesses

A copper-deficient body is one with a compromised immune system. This is because copper helps in the formation of white blood cells. The compromised ability of the body to fight pathogens results in frequent colds and other infections.

Problems with Memory and Learning

Copper deficiency can lead to difficulties with learning and remembering. This is because the brain needs copper to function properly and develop. More precisely, copper is used by enzymes that supply energy to the brain and aid in the brain’s ability to defend itself and relay signals to the body.

Difficulties Walking

The nervous system relies on copper due to certain enzymes that require it to maintain optimal health of the spinal cord. They do so by insulating it, resulting in better signal relay between the body and the brain. When deficient in copper, these signals are not relayed efficiently, resulting in loss of coordination and unsteadiness.

Weak and Brittle Bones

Also known as osteoporosis, this condition has been linked to lower copper amounts in the body. This is because copper helps to create cross-links inside your bones, which ensure that the bones are strong and healthy. Additionally, copper contributes to the creation of osteoblasts, which are cells that help to reshape and strengthen bone tissue.

Sensitivity to Cold

Copper deficiency negatively affects the function of the thyroid gland in a manner that can cause it to fail to regulate metabolism and heat production. This is because copper affects the production of the T3 and T4 levels of thyroid hormones. When these are low, the thyroid gland may not work as effectively.

Pale Skin and Premature Gray Hair

Melanin is a pigment that determines the color of the skin and hair. As copper is used by enzymes that help in the production of melanin, a lack of it can affect the production of the pigment, resulting in pale skin and premature gray hair.

Vision Loss

In cases of long-term copper deficiency, the nervous system can become seriously affected, and this includes the optic nerve. If damaged due to a severe lack of copper for a longer time, it can result in partial or total vision loss.

How to Diagnose Copper Deficiency

If you suspect that your copper levels may be low, you should consult your doctor and ask to be tested. Copper deficiency is diagnosed by analyzing blood, 24-hour urine, and liver (hepatic) tissue.

The blood test measures the ceruloplasmin, blood copper levels, and free (unbound) copper in the blood. Ceruloplasmin is a protein that is made in the liver and which carries copper from the liver into the bloodstream and to the parts of the body that need it.

The urine test usually accompanies the blood test if the ceruloplasmin levels are abnormal or unclear. This test measures copper elimination levels. A 24-hour urine means the collection of all urine over a 24-hour period of time.

The liver biopsy is done to evaluate copper storage in the liver, as this is where copper is stored in the body.

A ceruloplasmin test is usually done if the person shows symptoms of Wilson disease, copper deficiency, or copper toxicity. It is also done on infants that show symptoms of Menkes syndrome.

Copper Deficiency Treatment

Copper deficiency is treated with either oral supplementation or intravenous copper. In cases of zinc intoxication, people are advised to stop taking zinc in order for the copper levels to go back to normal. This is also accompanied by oral copper supplementation.

Sources of Copper

Copper is important, so even if you do not have a copper deficiency it is paramount to ensure that it is present in your diet. You can find naturally occurring copper in different foods and you can also take copper supplements or drink copper-infused water.

Food

Copper is found in a wide variety of foods. Foods such as oysters and other shellfish, whole grains, beans, nuts, potatoes, and organ meats (kidneys, liver) are rich in dietary copper. Additionally, leafy greens, dried fruits, and yeast are also good sources of copper.

You can read more about the Top 28 Foods High in Copper to understand which foods are best, why they are high in copper, and how much you would need to satisfy your daily copper needs.

Copper Pills and Supplements

Copper pills and supplements are an excellent source of copper in cases of copper deficiency. There are different forms of copper available to purchase in pill and supplement form, and the absorption varies in terms of bioavailability. Namely, you can find copper supplements in the form of cupric oxide, cupric sulfate, copper amino acid chelates, and copper gluconate.

While there are not enough studies that confirm which form of copper is more easily absorbed in the body, one study has examined the difference between copper sulfate and copper glycinate (chelated copper). That study established that copper glycinate has better bioavailability.

In either case, it is important that you do not take copper supplements with iron or zinc and avoid zinc denture creams because of the competitive nature between these minerals.

Copper-Infused Water

Copper-infused water, or water stored in a copper vessel, is also a good source of copper supplementation. While drinking this type of water can help in fighting copper deficiency, the amounts are not high enough to replace oral or intravenous supplementation. However, regular consumption of copper-infused water can help to prevent copper deficiency and can lend a helping hand in the treatment of the same.

On the Opposite Side of the Spectrum: Copper Toxicity

According to the Copper Alliance, people are at a higher risk of copper deficiency than of copper toxicity. The World Health Organization has recognized that people worldwide are at greater risk of adverse health effects from a copper deficiency than from excess copper.

Although rare, copper toxicity is a serious issue that should be looked into when it comes to consuming products and substances which contain copper. It occurs when too much copper has entered the body and can be the result of either chronic copper buildup or acute copper poisoning.

Symptoms of acute copper poisoning include abdominal pain, nausea, vomiting, and diarrhea. More serious complications include brain damage, severe liver damage, kidney failure, coma, and death.

The tolerable uptake levels for copper are:

  • 0-12 months: not possible to establish (sources should be only from food and formula);
  • 1-3 years: 1,000 mcg/day;
  • 4-8 years: 3,000 mcg/day;
  •  9-13 years: 5,000 mcg/day;
  • 14-18 years: 8,000 mcg/day;
  • 19+ years: 10,000 mcg/day.

The Bottom Line

Copper is a very important mineral that aids in many crucial functions in our body. In cases of copper deficiency, we become at risk of various conditions and complications which can lead to further health problems.

What is more, if you are a pregnant mother or are lactating, your child will need the copper you provide them. Babies that have not received enough copper during the pre-natal and post-natal period can experience stunted growth and other complications that can affect their lives negatively.

While the general truth is that severe copper deficiency is rare, mild copper deficiency is more common than you may think, and it contributes to a compromised immune function, mood changes, and other problems that lower the quality of your day-to-day life.

Taking measures to prevent copper deficiency is as simple as eating a variety of foods rich in copper and drinking copper-infused water.These approaches can also help in cases of already-existing copper deficiency.

If you suspect that you may be suffering from copper deficiency, we recommend that you consult a health professional and get tested. In this case, you may need to boost your diet with copper supplements and lower your zinc intake.

About the Authors: This article was collaboratively written by our team of researchers and writers with the benefit of all available scientific studies and other relevant literature. Our team of researchers and writers include experienced health researchers including a qualified medical professional. Please note that information in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment.

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