Our body is fueled everyday by different nutrients – some that are required in larger quantities while others in lesser, and few in traces amounts. Some nutrients form structural components of our cells whereas, there are others that participate or regulate various functions and processes in the body. One such trace mineral, and an essential one too, is Copper.

Why does our body need copper?

Our body needs minerals for various physiological processes.

While some minerals are needed in larger quantities like sodium, calcium, and potassium, some like copper are essential trace minerals that are vital for survival.

Copper is found in all body cells and plays an important role in the formation of blood vessels, maintenance of the nervous, and the immune system.

Our body has about 2 mg of copper per kilogram of body mass.

Though copper is found in all parts of the body, organs like the liver, kidney, heart, and the brain have it in higher quantities.

As mentioned earlier, our body needs copper for plenty of activities. These include:

• The formation, maintaining structure and functioning of red blood cells
• Wound healing
• Formation of white blood cells (an integral part of the immune system)
• Generation and storage of energy in the cell mitochondria
• Maintenance of efficient communication between cells of the nervous system
• Fetal and postnatal brain growth and development
• Maintenance of healthy skin and connective tissue
• Collagen formation
• It prevents conditions like osteoporosis and delays arthritis
• Antioxidant functions
• Maintenance of structural integrity and cardiovascular health support

Requirements: How much do we need? 

Intake of less than the Required Dietary Allowance (RDA) of copper can lead to Copper Deficiency whereas, taking in more than the RDA can lead to copper toxicity, both of which can be harmful.

For adolescents and adults, the RDA is about 900 mcg per day.

Any intake above 10,000 mcg or 10 mg per day can be toxic.

The copper requirement of the body changes with age, gender, and conditions like pregnancy.

Copper deficiency: Everything you need to know

Common causes

Copper Deficiency can occur due to diet, nutritional deficiencies, or digestive issues resulting from surgeries or other conditions.

These are called acquired copper deficiencies.

Another type of copper deficiency is inherited copper deficiency that is genetic in origin.

Dietary causes of copper deficiency

• Childhood protein deficiency: Can occur in children fed with formula milk which contains much less copper than mother’s milk or cow’s milk
• Excess zinc: Excess zinc in the body impairs the absorption of copper. Consuming an excess of 50mg/day of zinc for a long period of time can result in copper deficiency.
• Persistent diarrhea during infancy: Infants who suffer from persistent diarrhea during their infancy are often deficient in many essential nutrients, including copper
• Total Parenteral Nutrition (TPN): Individuals who are unable to eat with their mouths are prescribed parenteral nutrition and many a time, the parenteral formulas lack copper, resulting in its deficiency

GI diseases that can result in copper deficiency

• Celiac Diseases
• Cystic Fibrosis
• Short gut syndrome
• Inflammatory Bowel Syndrome

Surgeries like bariatric surgery, gastrectomy, upper GI tract surgery, and other stomach surgeries result in copper deficiency.

Inherited copper deficiency is rare and affects one in every 1,00,000 births.

The gene causing this condition is inherited in an X-linked recessive manner and runs in families.

Genetics and copper: What’s the connection?

SELENBP1

The SELENBP1 is located on chromosome 1 and is a part of the selenium-binding protein family.

Selenium is an essential mineral and is known for its anticarcinogenic properties and a deficiency of it can result in neurologic diseases.

The protein encoded by the SELENBP1 gene is said to play a selenium-dependent role a ubiquitination/deubiquitination-mediated protein degradation.

One of the phenotypes for the SELENNP1 gene is serum copper measurement.

The presence of the G allele in this SNP causes a decreased absorption of copper resulting in an increased risk of developing a copper deficiency.

SMIM1

The SMIM1 gene or Small Integral Member Protein 1 is located on chromosome 1 and codes for a small, conserved protein that takes in part in the formation of red blood cells.

The A allele of the SNP rs1175550 is associated with serum copper measurement. 

Clinical manifestation of copper deficiency

The main problem with copper deficiency is that it is hard to diagnose as its symptoms are very similar to other nutritional deficiencies such as vitamin B12 deficiency.

Since low copper levels in the body can affect a person’s immunity, it is important to identify it in time. 

Clinical symptoms of copper deficiency include:

• Fatigue 
• Weakness
• Frequent bouts of illness
• Sensitivity to cold
• Easy bruising
• Premature hair greying
• Weak, brittle bones that are easily breakable
• Pale skin
• Skin sores
• Skin inflammation
• Unexplained muscle soreness
• Difficulty in learning and remembering
• Loss of vision

Copper deficiency can also be recognized hematologically as it presents with a triad of anemia, neutropenia, and thrombocytopenia (rare).

 How is it diagnosed?

Copper deficiency is usually not the first thing that is diagnosed when one presents with symptoms as many nutritional deficiencies present with similar clinical symptoms.

However, your doctor may suspect copper deficiency if you have a history of any of the following:

• Excessive zinc supplementation
• History of upper GI or bariatric surgery, gastrectomy
• History of malabsorption diseases like celiac disease, IBS, or other conditions in which a person is unable to absorb nutrients

If your doctor suspects a copper deficiency, he/she may order a blood test for detecting plasma copper levels.

However, one must note that this is not a conclusive test for copper deficiency as many other factors can cause a false elevation of blood copper levels.

Treatment options for copper deficiency

Copper supplements

The first step in the treatment of copper deficiency is identifying the cause and removing or treating it.

For example, if the copper deficiency is due to excess zinc supplements, your doctor will reduce the zinc supplements to allow more absorption of copper.

Many a time, doctors prescribe copper supplements to make up for the deficiency of the mineral.

Common copper supplements include copper sulfate, copper gluconate, and copper chloride.

It can take about 4 to 12 weeks to treat a copper deficiency.

Taking 2 mg of copper per day can help restore normal copper levels in a deficient individual.

However, the exact dosage is determined by a doctor after evaluating other health and lifestyle factors.

In the case of individuals who cannot take oral copper supplements, they may be put on IV copper treatment. 

Along with copper supplements, consuming copper-rich foods can really help.

Who should take the supplements?

Copper is an essential mineral for the body but it is also a trace mineral which means that our body needs a very little amount of copper to function.

However, many people suffer from a deficiency of this mineral that can result in complications over a period of time.

Some people who require copper supplements include:

• Those who take high amounts of zinc supplements
• People who load up on iron
• People who have a diet rich in vitamin C

However, care must be taken to consult with your doctor before taking copper supplements as copper toxicity can be as harmful to the body as copper deficiency.

Apart from this, people who have had surgery such as bariatric surgery, gastrectomy, or those who suffer from GI tract diseases such as IBS, celiac disease, etc., also need supplements as they are more likely to have copper deficiency due to the poor absorption.

When is the best time to take it?

There are certain rules to follow when taking copper supplements. We know that zinc interferes with copper supplements and so, avoid taking both zinc and copper supplements at the same time.

Fix two different times for both supplements and stick to these times every day.

Ideally, take your copper supplement at least two hours after taking your zinc supplements for maximum absorption.

Copper supplements can cause stomach irritation and acidity, and hence, copper supplements can be taken with meals can help reduce irritation.

Many people who take antacids may need higher dosages of copper supplements as antacids interfere with the absorption of copper.

Side effects of the supplements

Copper supplements can cause side effects and the common ones are:

• Nausea
• Vomiting
• Liver dysfunction and necrosis(long-term use)

There are symptoms of overdose that one must watch out for and avoid:-

• Dizziness or fainting
• Diarrhea
• Loss of appetite
• Heartburn
• Headache
• Metallic taste
• The yellowness of skin and eyes
• Pain or burning while urinating
• Blood in urine
• Lower backache
• Coma

Diet: Including copper-rich foods

Apart from supplements, diet plays an important role in restoring normal copper levels in the body.

To treat copper deficiency and maintain optimum copper levels in the body, some copper-rich foods that you can include in your diet are:

• Shiitake mushrooms
• Oysters
• Sweet potatoes
• Dry roasted cashews
• Sesame seeds
• Salmon
• Chickpeas
• Dark chocolate
• Avocado
• Organ meats like liver
• Most nuts and seeds
• Spirulina
• Leafy green vegetables like spinach, kale, Swiss chard

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References

https://ods.od.nih.gov/factsheets/Copper-HealthProfessional/#en3

https://www.genecards.org/cgi-bin/carddisp.pl?gene=SELENBP1

https://www.snpedia.com/index.php/Rs2769264

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3766178/

https://www.genecards.org/cgi-bin/carddisp.pl?gene=SMIM1&keywords=SMIM1

Published July 17, 2020

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