Copper Toxicity

Copper Toxicity: Overview

Copper is a heavy metal that is toxic in its unbound form.  Almost all of the copper in the body is bound to proteins, thereby reducing the concentration of unbound copper ions to almost zero.  Most diets contain enough copper (2-5mg daily) to prevent a deficiency and not enough to cause toxicity.  The World Health Organization (WHO) suggests that 10-12mg per day may be the upper safe limit for consumption.

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Causes and Development

Copper toxicity is usually due to:

  • excessive supplementation
  • the increasingly common problem of low levels of zinc in the diet
  • contaminated food and drinking water due to contact with metallic copper
  • external exposures such as a copper IUD or accidental agricultural overspray
  • elevated levels of estrogens.

Since copper and zinc compete with each other for absorption in the gut, copper toxicity has been the subject of greater concern in recent years.  This is primarily due to reduced zinc in the diet and the switch from galvanized to copper water pipes.  Acidic water such as rain water, left standing in copper plumbing pipes, can be a source of toxicity when consumed.  In prolonged contact with copper cooking utensils, an acidic food or beverage can dissolve milligram quantities of copper, sufficient to cause acute toxicity symptoms such as self-limited nausea, vomiting and diarrhea.  High copper levels, especially when associated with low zinc levels, have been linked to a variety of symptoms and conditions.

Diagnosis and Tests

The best means of testing for copper toxicity are 24-hour urine copper or serum ceruloplasmin level tests.  Red blood cell copper levels may be a good test to measure increased copper levels as well.  Hair levels of copper are not very helpful in detecting increased body copper because of external contamination.  If contamination is ruled out, hair copper is suggestive of body state.

Complications

If as little as 2gm of a copper salt are ingested, usually with suicidal intent, the resulting copper-induced hemolytic anemia and kidney damage are generally fatal.

Conditions that suggest Copper Toxicity:

Mental

Metabolic

Reproductive

Premenstrual Syndrome

Estrogen results in increased copper absorption.  Copper is closely related to estrogen metabolism, so an imbalance can cause many female health problems such as premenstrual syndrome.  Taking extra zinc and vitamin B6 before the menstrual period can reduce copper levels and thus the symptoms of PMS.

Risk factors for Copper Toxicity:

Autoimmune

Ulcerative Colitis

Patients with ulcerative colitis may absorb excess copper in their intestinal tissues which can lead to intestinal disorders, impaired healing and reduced resistance to infections.

Hormones

Progesterone Low or Estrogen Dominance

Elevated estrogen levels often increase serum copper levels to more than double normal values, while at the same time red blood cell levels, where copper is important, may actually be lower.  This may contribute to some of the psychological or other symptoms seen during pregnancy or with birth control pill use.

Nutrients

Molybdenum Need

The exact mechanism by which molybdenum prevents copper toxicity is poorly understood.  However, it is known that an insoluble complex of copper and molybdenum can be formed in the gastrointestinal tract thus reducing copper absorption.  This theory is substantiated by the fact that increasing dietary copper is an effective treatment of molybdenum toxicity.

Supplements and Medications

Current birth control pill use

Estrogen-containing birth control pills can raise serum copper levels.

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Copper Toxicity suggests the following may be present:

Nutrients

Molybdenum Need

The exact mechanism by which molybdenum prevents copper toxicity is poorly understood.  However, it is known that an insoluble complex of copper and molybdenum can be formed in the gastrointestinal tract thus reducing copper absorption.  This theory is substantiated by the fact that increasing dietary copper is an effective treatment of molybdenum toxicity.

Copper Toxicity can lead to:

Metabolic

Recommendations for Copper Toxicity:

Amino Acid / Protein

Methionine

Methionine is a useful treatment for copper poisoning and for lowering serum copper.

Detoxification

Heavy Metal Detoxification / Avoidance

If copper levels are very high, treatment with DMSA, penicillamine or EDTA may be needed.

Mineral

Manganese

Vitamin C, zinc and manganese all interfere with copper absorption.

Zinc

Zinc and manganese with vitamin C remove copper from the tissues.

Molybdenum

Since high levels of copper in the body or diet may result in molybdenum insufficiency and cause low uric acid levels, reducing copper toxicity can result in normalizing uric acid and molybdenum levels.  Intake of molybdenum at doses as low as 0.54mg per day has been associated with an increased loss of copper in the urine.

Not recommended

Vitamins

Vitamin C (Ascorbic Acid)

See link between copper toxicity and manganese.

Vitamin B6 (Pyridoxine)

Carl Pfeiffer, M.D.  also suggests using vitamin B6 at 50mg daily without supplemental copper to increase copper excretion.

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