In episode 33, we continue the series on assessing and managing nutritional status. This time we talk about copper. Copper deficiency can cause anemia that is very difficult to tell apart from iron-deficiency anemia, osteoporosis, histamine intolerance, high cholesterol, and a variety of mental effects resulting from neurotransmitter imbalances. Serum copper and ceruloplasmin are excellent tools for assessing nutritional status, but are confounded by inflammation, birth control, menopausal status, and hormone replacement therapy, making it necessary to look at the diet, lifestyle, digestive problems, and other factors that make copper deficiency plausible.
I discuss how to protect yourself from the small risk of copper in your drinking water, and why I think many claims about excess copper outside the context of frank toxicity are misleading.
Everything converges on the practical questions of what to do in these situations. Listen in and enjoy!
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This is part of a series on managing nutritional status where all of the episodes are collated on the shownotes page for the introductory post, What Makes a Good Marker of Nutritional Status?
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Copper Status Show Notes
In this episode, you will find all of the following and more:
0.00.35 Cliff Notes
0.10:25 A case of copper deficiency?
0.14.00 Biochemical and physiological roles of copper
0:18:55 Copper's intimate relationship with iron
0:30:10 What is the best marker of copper status?
0:33:38 Effect of inflammation on ceruloplasmin
0:35:10 Effect of estrogen on ceruloplasmin
0:43:18 Causes of deficiency
0:43:50 How much copper do we need?
0:43:45 Best food sources
0:48:30 Variation within food sources according to soil
0:51:00 Zinc supplementation
0:51:53 Digestive problems
1:00:52 How to treat deficiency
1:02:01 Which form of copper to use?
1:04:10 Toxicity: copper-mediated oxidative stress
1:05:22 Wilson's Disease
1:08:15 Infants and copper absorption
1:11:00 Contribution of water
1:16:50 One case of supplement megadosing leading to liver failure
1:17:30 Toxicity claims based on serum Cu or serum ZN/CU ratio are not reliable
1: 20:50 Summing up
Copper in Foods and Supplements
Liver, oysters, shiitake mushrooms, spirulina and cocoa powder are all very high in copper. Decent amounts are found in other organ meats and shellfish, other mushrooms and seaweed, potatoes, legumes, and whole grains.
Above all, eat liver once a week, because liver covers a multitude of deficiencies.
You can find a more extensive list of copper-rich foods by going to nutritiondata.com, selecting “tools” in the upper left, then “nutrient search tool,” then “foods that are highest in copper,” and then limit your search to a specific category of foods to prevent getting blasted with foods you don't care about.
Copper contents of each food vary widely, however, according to the amount of copper in soil and water. As such, nutritional databases should be used with great caution.
This review provides a more detailed summary of its distribution of foods, as well as a table showing its variation within particular foods.
I only recommend supplementing with copper in the case of fixing a verified deficiency. In any other case, 1 mg per day is a reasonable hedge against deficiency from unknown variation within foods, but I would not supplement with more than that. You can take 2-3 mg two to three times a week to reach that average from a higher-dose supplement.
In this case report of Celiac-induced copper deficiency associated with anemia and neutropenia, a multivitamin providing roughly 6.68 mg per day of copper sulfate reversed the hematological abnormalities in two months. The supplement they used contained 3.34 mg per tablet and they used one tablet twice per day.
Most multivitamins do not have that much copper. They often have 0.5 mg or 2 mg. If you are not conscientious about eating nutrient-dense foods, or if you have digestive issues that could be compromising the absorption of multiple nutrients, a supplement containing at least 2 mg per tablet 2-3 times per day for two months should be used to resolve a clear case of copper deficiency.
However, I think it is better to use nutrient-dense foods and to supplement copper on top of that. This copper sulfate costs $21.99 per bottle and is available for Prime free one-day shipping through Amazon. 40 drops provides 7 mg of copper, and at this dose a bottle would last 28 days. Taking it for two months to fix a copper deficiency would require two bottles and thus a total expenditure of just under $44.
There are less expensive forms of copper sulfate that are not sold for use as a supplement, but I am not sure if they are safe to consume.
It is actually less expensive to use an amino acid chelate, and it is possibly more effective. Solgar's copper glycinate is cost-effective and available at similar prices from Amazon and iHerb. It is slightly less expensive at iHerb but available for Prime free one-day shipping from Amazon. Three tablets per day would provide 7.5 mg, and at that dose a bottle would last 33 days. Taking the dose for two months would require two bottles, which, at the Amazon price of $8.86 per bottle, would cost a total of just under $18.
The evidence that copper glycinate is more effective than copper sulfate is weak. For example, it is 40% more effective in steers. There seem to be very few comparisons in humans, none of which examine the relative ability to fix a copper deficiency.
Copper Status Links and Research
The copper chapter of Modern Nutrition in Health and Disease is a great starting place for anyone who is scientifically inclined. This is one of the few textbooks I was required to purchase in school and found so useful I kept as a cherished reference. When the most recent edition came out, I bought the Kindle version, which is incredibly easy to navigate and take notes from compared to the hardcover version of the previous addition that I also still have.
Inflammation regulates ceruloplasmin.
Estrogen status regulates ceruloplasmin and serum copper.
Pregnancy regulates ceruloplasmin, serum copper, and the zinc-to-copper ratio.
Inflammation moves zinc from plasma into cells.
Risk assessment for excess copper consumption due to soil contamination in the European Union.
World Health Organization report on copper in drinking water.