Vitamins, minerals and amino acids
Koper
The copper in your blood; mainly used when a copper deficiency or the rare Wilson's disease is suspected.
Everything about this testWhat it measures
Copper is a trace element that the body builds into enzymes, including for energy production, the brain, connective tissue and the immune system. Copper from food is absorbed in the gut and taken to the liver. The liver stores copper or binds it to the protein ceruloplasmin, which carries it through the blood. This analysis measures the total copper in the blood, which therefore depends strongly on the amount of ceruloplasmin.
- A copper deficiency, for example with poor absorption in the gut, loss through the kidneys (nephrotic syndrome) or long-term high-dose zinc supplements
- A sign of Wilson's disease (inherited copper buildup), only together with ceruloplasmin and copper in the urine
- Copper poisoning (rare)
High
A raised copper usually does not mean that there is too much copper in the body. According to the Dutch Society for Clinical Chemistry (NVKC), copper in the blood rises with liver disease, an infection, after surgery or a heart attack, with diabetes and with thyroid problems. In pregnant women and women who use the pill, the value can be two to three times higher than normal. According to the Netherlands Nutrition Centre (Voedingscentrum), you are unlikely to get too much copper from food. Rarely, it is copper poisoning, for example from water from copper pipes or from supplements, with nausea, vomiting and diarrhea.
Low
A low copper is uncommon. It may fit a general copper deficiency, for example due to poor absorption in the gut, loss through the kidneys (nephrotic syndrome) or long-term high doses of zinc. According to the Netherlands Nutrition Centre (Voedingscentrum), a severe deficiency can cause anemia, lighter skin and bone loss. In Wilson's disease, a rare inherited disease in which copper builds up in the liver and brain, among other places, the copper in the blood is actually often low, together with a low ceruloplasmin and a high copper in the urine. So a low copper alone is no proof of that disease.
If your result is abnormal
With an abnormal copper, the GP first looks at explanations such as the pill, pregnancy, inflammation or supplements. If Wilson's disease is suspected, referral follows to an internist (specialist in internal medicine) or a gastroenterologist for tests including ceruloplasmin, copper in the urine and DNA testing if needed.
Reliability
Copper in the blood says little about the copper status of healthy people. According to the Health Council of the Netherlands, which follows the European Food Safety Authority EFSA on this point, copper and ceruloplasmin in the blood hardly respond to the amount of copper in the diet and have limited value for an individual, especially for showing an excess. The Dutch Society for Clinical Chemistry (NVKC) states that copper must always be assessed together with other tests, such as ceruloplasmin and copper in the urine. Testing for Wilson's disease is done in hospital.
Limitations
- Pregnancy and the pill raise the value two to three times.
- Inflammation, infection, liver disease and recent surgery raise the value without an excess of copper.
- Long-term high doses of zinc lower copper absorption and the value.
- Reference values differ between laboratories.
How common is this
According to the Netherlands Nutrition Centre (Voedingscentrum), there are no signs that copper deficiencies occur in the Netherlands in people who eat a varied diet. Wilson's disease is a rare inherited metabolic disease. A raised copper due to the pill, pregnancy or inflammation is much more common than true copper buildup.
Who is this useful for
Useful when Wilson's disease is suspected, such as with unexplained symptoms of the liver or nervous system (jaundice, problems walking or swallowing) or with Wilson's disease in the family, and then always together with ceruloplasmin and urine testing. Also useful with unexplained anemia after bowel surgery or with long-term high-dose zinc supplements, and as a clue when copper poisoning is suspected. In healthy people without symptoms, a copper value on its own says little about copper status.
Downsides and risks
- A raised copper due to the pill, pregnancy or inflammation can wrongly be read as copper poisoning and cause unnecessary worry.
- A slightly low copper can cause unnecessary concern about Wilson's disease; that diagnosis always requires further testing.
Sources
Always discuss an abnormal result with your GP. If a result is strongly abnormal, we try to reach you as soon as possible. Read your result yourself as well and contact your GP if in doubt. A test does not make a diagnosis. Read more about risks and results