A Root Cause Approach To Copper Toxicity: A Comprehensive Guide

While often overlooked, copper toxicity can be a significant health concern in affected individuals. Many people may not know that copper and zinc are intricately linked or that levels of one can affect the other. Deficient in zinc? Your copper/zinc ratio may be out of balance. 

Some people might also be naturally prone to copper buildup because of their genes, while others might unknowingly be adding to their copper load through their diet and lifestyle choices. Plus, environmental factors, like the kind of water pipes in our homes or where we live, can contribute to imbalances as well. 

In this article, we discuss what copper toxicity is, what causes it, what functional medicine labs can help support a return to balance, and what the best treatment options are for affected individuals. 

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What is Copper?

Copper is a vital mineral that our bodies need in small amounts to function properly. This element is involved in various functions of the body, including energy production, forming connective tissues, managing iron in the body, and maintaining a healthy nervous system.

Copper acts as an antioxidant, meaning it helps protect our cells from damage by harmful molecules called free radicals. It also has a role in how our body responds to stress at the cellular level and how it interacts with other nutrients, like iron and zinc (3). 

Getting too little copper from our diet can lead to health problems, like a weaked immune function, poor bone health, and a higher risk of heart and brain diseases. On the other hand, having excessive levels without obvious cause is usually linked to certain genetic disorders (3). 

Foods rich in copper include organ meats (like liver), shellfish, nuts, seeds, and whole grains. It's usually not hard to get enough copper through a balanced diet (3). 

What is Copper Toxicity?

Copper toxicity is a health condition that arises from excess copper in the body, although severe cases are rare. While copper is essential for various bodily functions, having too much of it can result in adverse effects. As copper and zinc balance each other in the body, copper imbalances may result from conditions that cause low zinc levels, therefore leading to an imbalance in copper/zinc ratios (3). 

Acute copper poisoning has been noted in instances where beverages were stored in copper-containing containers or from contaminated water supplies. The U.S. Environmental Protection Agency and the World Health Organization have set guideline values for copper in drinking water at 1.3 mg/liter and 2 mg/liter, respectively (3). 

Chronic copper toxicity, arising from long-term exposure to lower doses of copper, can potentially cause liver damage. However, in generally healthy individuals, daily doses of up to 10 mg have not been seen to result in liver damage. Consequently, the U.S. Food and Nutrition Board has set the tolerable upper intake level for copper at 10 mg/day from food and supplements. Individuals with genetic disorders affecting copper metabolism may be at risk of adverse effects of chronic copper toxicity at significantly lower intake levels (3). 

In some instances, overconsumption has been reported, with copper intake levels as high as 7.8 mg/day over a period of 147 days. There is a possibility that this high intake could have an adverse impact on immune function and antioxidant status (3). 

Copper exists in two forms in the blood: approximately 85% to 95% is bound to ceruloplasmin, and the remaining is "free," loosely bound to albumin and other small molecules. The incidence of copper poisoning varies widely by region and is uncommon in Western countries. However, it's more prevalent in South Asian countries, especially among rural populations. Neonates and infants face a higher risk due to an immature biliary excretion system and enhanced intestinal absorption (2). 

Copper Toxicity Signs & Symptoms

The signs and symptoms vary and depend on how the excess copper is introduced into the body. In cases of acute copper toxicity, symptoms might include abdominal pain, nausea, vomiting, and diarrhea. These symptoms can serve as a body's defense mechanism, discouraging further intake and absorption of copper. More severe signs of toxicity can include liver damage, kidney failure, coma, and even death (2). 

• Gastrointestinal issues: These are common, especially when copper toxicity is due to ingestion. Symptoms can include abdominal pain, vomiting blood (hematemesis), black, tarry stools (melena), jaundice (yellowing of the skin and eyes), lack of appetite (anorexia), severe thirst, diarrhea, and vomiting. The presence of blue-green material in vomit or stools can be a telltale sign.
• Neurological symptoms: Altered mental state, headache, and rapid heart rate (tachycardia) can also be present. More severe neurological symptoms can include depression, fatigue, irritability, excitability, and difficulty focusing.
• Severe symptoms: In its most severe forms, copper toxicity can lead to a range of serious health problems. These include rhabdomyolysis (a condition where muscle tissue breaks down, releasing a damaging protein into the blood), heart and kidney failure, an increase in a type of hemoglobin that can't carry oxygen effectively (methemoglobinemia), breakdown of red blood cells within blood vessels (intravascular hemolysis), liver cell death (hepatic necrosis), and brain dysfunction (encephalopathy). In severe cases, copper toxicity can be fatal.

What Are The Possible Causes Of Copper Toxicity

Copper toxicity can be caused by various factors such as specific foods, contaminated water, environmental exposure, and certain genetic disorders:

High-Copper Foods and Drinks

Consumption of foods and drinks with high copper content, like organ meats, shellfish, nuts, seeds, and chocolate, can lead to copper toxicity. If suspected, doctors can run blood tests to check your copper levels. If the levels are too high, they may recommend you decrease your copper intake and increase your zinc intake to balance the copper levels in your body (8). 

Water Contamination and Copper Pipes

Copper can get into your drinking water from copper pipes, especially if the water is acidic or the flow rate is high. To confirm this, you can get your water tested. If the copper levels are too high, you may need to install a water filtration system or replace copper pipes with those made from other materials.

Environmental Exposure

‍Living near a copper mine or smelter can increase your risk of copper toxicity (9). 

Copper in Agriculture

Copper-based pesticides and fertilizers can lead to copper accumulation in soil and crops. To check for this, you can get the soil tested. If the copper content is too high, reducing the use of copper-based products and adding soil amendments can help lower the copper levels (9).

Occupational Hazards

If you work in industries such as mining, smelting, or electronics manufacturing, you may be exposed to high levels of copper (9).

Zinc Deficiency

There's a delicate balance between zinc and copper in the body. An excess of one can lead to a deficiency of the other. Therefore, zinc deficiency may lead to high levels of copper in the body. Zinc deficiency can result from factors such as a lack of meat intake, overconsumption of phytates found in legumes, seeds, soy products, and whole grains, excessive intake of oxalates present in spinach, okra, nuts, and tea, as well as from chronic illnesses like gastrointestinal diseases, diabetes, liver disease, sickle cell disease, kidney disease, excessive alcohol consumption, HIV infection, or persistent infections (1). 

Genetic Disorders

Certain genetic disorders, such as Wilson's disease and Menkes disease, can affect how your body metabolizes copper and increase your risk of copper toxicity. If you have one of these disorders, you'll likely need lifelong management of your copper levels, which could involve taking medication, changing your diet, and having regular check-ups.

Functional Medicine Labs to Test for Root Cause of Copper Toxicity

Functional medicine labs offer a variety of tests that can help tailor treatment to patients, allowing providers to optimize management strategies.

Blood and Urine Copper Levels 

These tests measure the amount of copper in the body differently. A serum copper test evaluates the quantity of copper in the blood. In contrast, a urine copper test measures the amount of copper being excreted from the body, reflecting the body's ability to remove excess copper. Higher levels in either test can indicate copper toxicity.

Copper/Zinc Profile Testing

The Copper/Zinc Profile by Mosaic Diagnostics examines six biomarkers. It measures the levels of copper and zinc, which often balance each other in the body, making it a necessary component of testing for copper levels. 

The test also quantifies nonceruloplasmin-copper, the amount of copper that isn't tied to ceruloplasmin and thus freely circulates. It also calculates the copper/zinc ratio to provide insight into the overall mineral balance. In addition, it evaluates ceruloplasmin, the protein that carries copper in the plasma, and ceruloplasmin-copper, the portion of copper attached to this protein. This test helps guide therapeutic strategies to maintain a healthy balance of these essential minerals and helps to diagnose conditions such as Wilson’s disease (1). 

Heavy Metal Testing

This test helps identify the presence of various heavy metals in the body, including but not limited to mercury, lead, and arsenic. Similar symptoms to copper toxicity can be caused by different heavy metals, making it essential to determine if copper is the true culprit (2). 

Additional Testing

Elevated copper levels can cause liver damage when chronically exposed or when one is at higher risk due to genetic factors. Therefore, liver function tests, such as ALT and AST, can provide information about liver health and indirectly suggest copper toxicity if the results are elevated. In addition, if environmental exposure is thought to be the cause of copper toxicity, testing for both heavy metals and environmental pollutants may be beneficial (3,9). 

Conventional Treatment for Copper Toxicity

Copper toxicity treatment focuses on four key steps: limiting copper absorption, monitoring the patient, managing complications, and using chelation therapy. Early on, high doses of zinc can help by competing with copper for absorption in the gut and promoting copper-binding proteins. If needed, chelating drugs like D-Penicillamine are used to bind and remove copper from the body. In severe cases, treatments may include dialysis or even a liver transplant, though a transplant isn't recommended for patients with neurological symptoms (2). 

Functional Medicine Treatment for Copper Toxicity

Functional medicine targets the underlying causes of disease, considering the body as a whole and focusing on systems function and balance. In the case of copper toxicity, functional medicine would take into account the varied causes, such as dietary intake, water supply, environmental and occupational exposure, and genetic disorders, to devise personalized treatment strategies.

Nutrition To Help Treat Copper Toxicity

Addressing copper toxicity with nutrition involves two main strategies: reducing the intake of high-copper foods and increasing the consumption of high-zinc foods.

Foods high in copper include beef liver, oysters, mushrooms, cashew nuts, sunflower seeds, potatoes, dark chocolate, and tofu. While these are generally healthy foods, those dealing with copper toxicity may need to limit their consumption to prevent further accumulation of copper in the body.

On the other hand, increasing the intake of zinc-rich foods can help restore the balance between zinc and copper. Zinc and copper compete for absorption in the intestines, so more zinc can mean less copper is absorbed. Red meat, poultry, wheat germ, wild rice, seeds, nuts, baked beans, peas, cashews, and almonds are all excellent sources of zinc. For vegetarians, who may find it more challenging to get enough zinc, the options include baked beans, peas, cashews, and almonds (11). 

Following a nutrient-dense diet can also help manage copper toxicity. For example, the Mediterranean diet, known for its high content of fruits, vegetables, whole grains, lean proteins, and healthy fats, provides a variety of nutrients that support overall health and can help restore nutritional balance.

Lastly, it's worth noting that acidic foods cooked in uncoated copper cookware can leach copper, so it's best to avoid this cooking method if you're dealing with copper toxicity (2). 

Supplements & Herbs To Help Treat Copper Toxicity

Zinc supplementation can be beneficial for individuals experiencing copper toxicity, not just those with specific conditions like Wilson's Disease. This is because zinc has the ability to limit the body's absorption of copper, thereby potentially reducing the levels of copper in the body. As such, incorporating a zinc supplement could serve as a balancing measure for those with high copper levels (1,11). 

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Summary

Copper toxicity underscores the importance of mineral balance in the body. It's evident that while copper plays a vital role in many bodily functions, an excess can lead to serious health complications. 

Factors like diet, environmental exposure, and certain genetic conditions can contribute to copper imbalances. Thus, understanding and monitoring one's copper and zinc levels, recognizing signs of toxicity, and seeking timely interventions can prevent potential health challenges related to this mineral imbalance.