How is Copper Used in the Body?
Copper is an integral part (cofactor) of a group of enzymes called cuproenzymes, which are important for :
- Energy production in the cell (cytochrome C oxidase) 
- Formation of strong and flexible connective tissue (lysyl oxidase) 
- Iron metabolism (multiple copper oxidases, ferroxidases) 
- The normal function of the brain and nervous system (dopamine β-hydroxylase, cytochrome C oxidase) 
- Antioxidant activity (superoxide dismutase, ceruloplasmin) 
- Formation of the pigment melanin (tyrosinase) 
Health Benefits of Copper Supplementation
1) Proper Immune Function
Copper plays an important role in white blood cell growth and function.
One month of copper supplementation in infants with deficiency significantly increased the ability of white blood cells to engulf pathogens (R).
In the 19th century, workers exposed to copper salts did not develop cholera during the cholera epidemics .
2) Bone Health
Copper plays an important role in bone formation .
A study in perimenopausal women showed that 3 mg/day of copper supplementation for two years slowed down the loss of bone mineral density that typically accompanies menopause (18).
Copper supplementation reversed bone abnormalities in copper-deficient infants .
In copper-deficient elderly patients, copper supplementation improved overall copper status and markers of bone resorption and formation .
3) Heart and Blood Vessels Health
Copper is essential for the strength and integrity of the heart and blood vessels. Copper supplementation improves altered heart function and promotes the regression of heart enlargement caused by copper deficiency [22, 23, 24, 25, 26, 27].
Copper supplementation and dietary copper may decrease the chances of atherosclerosis, heart attack, and stroke .
A study in healthy young women found that supplementation with 6mg of copper for 4 weeks led to a 30% reduction in plasminogen activator inhibitor-1 (PAI-1), thus decreasing the risk for atherosclerosis [29, 30].
In rats, copper supplementation decreased blood levels of total cholesterol, triglycerides, and “bad” LDL–cholesterol while slightly increasing “good” HDL-cholesterol. This was because copper increased the body’s own antioxidant defenses, by increasing total antioxidant levels and glutathione peroxidase enzyme activity [31, 31].
A clinical study confirmed this finding , which suggests that copper supplementation can be used in the treatment of patients with high triglycerides and cholesterol.
4) May Prevent Neurodegenerative Diseases
Copper is important for the activity of enzymes that are crucial for brain development and function .
Long-term copper treatment decreases cerebral spinal fluid levels of Aβ42, a diagnostic marker for Alzheimer’s disease .
Copper sulfate prevents motor deficits in a Parkinson’s disease model in mice .
5) May Protect Against Cancer
Treatment with copper decreased tumor growth and increased survival rate in mice with cancer .
6) Improves the Well-Being of the Skin
Copper oxide, due to its antimicrobial and antifungal properties, can be used for treating athlete’s foot infections when used as copper-impregnated socks .
Copper-impregnated socks may also be used to prevent skin infection, cuts, and wounds that often lead to hard to treat ulcers in diabetic patients .
Cooper used in wound dressings can help enhance wound healing by increasing skin regeneration and the formation of new blood vessels . In addition, the copper in wound dressings also has potent antimicrobial properties, which can reduce the risk of wound contamination .
These copper oxide products are non-irritating and safe to use both on intact and damaged skin .
7) May Heal Stomach Ulcers
Studies show that copper complexes (copper aspirinate, copper tryptophanate) prevent or even heal stomach ulcers associated with aspirin therapy .
8) May Reduce Anxiety and Depression During Pregnancy
The Bad: Copper Overload
Causes of Copper Excess
- Inflammation 
- Infection (tuberculosis, leprosy, viral hepatitis, pneumonia, and chickenpox) [56, 57]
- Hematologic diseases (iron deficiency anemia, aplastic and pernicious anemia, sickle cell anemia, and beta-thalassemia) [58, 59]
- Diabetes 
- Heart and blood vessel disease [61, 62]
- Malignant diseases (acute and chronic leukemia, Hodgkin’s disease, multiple myeloma, breast and lung cancer) (63, 64, 65, 66)
- Liver disease (cirrhosis, hepatitis, obstruction to bile flow) [67, 68]
- Contraception (oral contraceptive use, copper intrauterine device) [69, 70]
- Pregnancy 
- Drugs (water pills) 
Signs of Copper Overload
Acute Copper Toxicity
Copper toxicity occurs with the ingestion of copper compounds usually with suicidal intent, or with accidental consumption of copper-contaminated foods, or water.
Ingestion of more than 1 g of copper can cause copper toxicity. However, this is only a rough threshold for toxicity and depends on individual factors .
Symptoms include stomach ache, nausea, vomiting, diarrhea, dizziness, and muscle pain. More serious signs of copper toxicity include severe liver and kidney damage, hemolytic anemia, massive gut bleeding, and even death [74, 75, 73].
Chronic Copper Toxicity
The long-term copper toxicity is not frequent in individuals who do not have inherited disorders of copper metabolism.
Chronic ingestion of copper supplements taken in a dose of 30 – 60 mg/day during 3 years caused severe liver disease .
Negative Health Effects of Copper Excess
1) Causes Oxidative Damage
Excess free copper is toxic .
2) Associated with Alzheimer’s Disease
Copper is thought to contribute to AD since alterations in copper levels tend to precede symptoms of AD in some, but not all patients .
A study has shown that copper is a component of the amyloid-beta plaques which are found in the brains of people with AD .
3) May Increase Risk of Parkinson’s Disease
Occupational studies showed that long-term exposure to copper and manganese increases the risk of Parkinson’s disease .
Free copper has the ability to produce free radicals, and increase Lewy body formation, the hallmark of Parkinson’s disease .
4) Alters Immune System Function
High intakes of copper significantly reduced the number of neutrophils, levels of IL-2, and levels of antibody level against the Beijing strain of influenza.
Excess blood copper and ceruloplasmin may suppress immune function, especially in older organisms (R).
5) Increases Risk of Heart and Blood Vessel Disease
Copper levels in the blood and in the blood vessel wall are elevated in individuals with atherosclerosis.
6) May Be Associated with Diabetes
Blood copper levels are significantly increased in type 1 and 2 diabetics [93, R].
7) May Be Associated with Depression
Sources of Copper
- Liver (especially calf, lamb, beef)
- Seafood (oysters, squid, lobster, crab)
- Fruit and vegetables (dark leafy vegetables, potatoes, mushrooms, avocados, dried fruit)
- Seeds (sesame, sunflower, pumpkin)
- Nuts (cashew, hazelnuts, Brazil nuts, walnuts),
- Beans (chickpeas, soybeans, adzuki),
- Goat cheese
- Soy products (tofu, tempeh, soy milk, soy powder)
- Chocolate, cocoa
- Wheat bran cereals and whole-grain products
A number of copper supplements are available in the form of copper oxide, copper chloride, copper gluconate, copper sulfate, and copper amino acid chelates .
Although copper is essential to health, supplementation is unnecessary for most healthy individuals .
Copper supplementation should not be used in individuals with genetic disorders affecting copper metabolism:
- Wilson’s disease 
- Idiopathic copper toxicosis 
- Childhood cirrhosis syndromes (Indian childhood cirrhosis, idiopathic copper toxicosis) [110, 109]
The Recommended Dietary Allowance (RDA) for copper :
- Children 0.3 – 0.9 mg/day (depending on age)
- Adults 0.9 mg/day
- Pregnancy and lactation 1 – 1.3 mg/day
The average intake of copper from food in the United States is approximately 1.0 to 1.6 mg/day for adult men and women.
The Tolerable Upper Intake Level, the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects for almost all individuals, for adults is 10 mg/day .
The human body is somewhat protected from copper deficiency and toxicity because the body can balance copper absorption with physiological needs and elimination.
Copper absorption becomes more efficient with reduced dietary copper intake, and vice versa . When measured in humans, copper absorption was only 12% when the intake was 7.5 mg/d, but it increased to 36% when the intake was 1.7 mg/d .
The balance of copper in the body is also maintained by excretion. The excretion is low when dietary copper is low, whereas excretion increases as dietary copper increases .
In the liver, it is either incorporated into the proteins and enzymes or secreted into the bile .
Most of it (70 – 95%) is bound to ceruloplasmin, the main carrier in the blood, while the remaining 10% is bound to albumin or carried as amino acid-bound copper, and transported into various tissues [79, 118].
Organs with high content include liver, brain, kidneys, and heart .
Approximately 80 – 90% of dietary copper is excreted in the feces. The amount excreted in urine, hair, and sweat is negligible .
Dietary copper is partially absorbed in the stomach. However, the largest portion is absorbed in the beginning region of the small intestine .
Absorption of copper ranges from 15 – 97%, depending on several factors including age and sex of the individual, levels of dietary copper, its forms, and composition of the diet.
Ways to Increase Absorption
High dietary protein intake has been shown to increase absorption, although individual amino acids can either increase or decrease absorption .
Ways to Decrease Absorption
Zinc supplementation increases metallothioneins, proteins which bind copper and prevent its absorption.
Adequate copper blood levels are necessary for normal iron metabolism and red blood cell formation .
Copper absorption may be influenced by the type of carbohydrate consumed.
Dietary fiber may decrease copper absorption .
Excessive dietary intake of molybdenum may form complexes with copper and can induce deficiency .
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