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Copper
Assessment and Plan: Copper
Copper is a mineral that the body needs for normal growth and health, but both copper deficiency and elevated copper levels may cause disease states.
Copper recommended daily allowance according to the USDA (6):
0.9 mg daily for adults, 1.3 mg daily during pregnancy or breast feeding
According to the USDA, at least 50% of diets tested showing insufficient intake of copper in the U.S., Belgium, Canada and the United Kingdom.
The USDA found an association of low copper intake with an increase in risk of heart attacks and osteoporosis.
The tolerable upper intake of copper for adults was set by the USDA at 10 mg daily (6), but Turnlund, JR et al suggested that 7.8 mg per day had a negative impact upon oxidative stress and immune function (7).
Copper deficiency:
Anemia: Copper deficiency may be an overlooked cause of sideroblastic anemia, neutropenia, myeloneuropathy, and myelodyspalstic syndrome in patients with history of gastrointestinal resection, bariatric surgery for weight reduction, use of total parenteral nutrition (TPN), and malabsorption states.
Copper deficiency is characterized by low serum copper, low ceruloplasmin, low 24 urine for copper excretion, presence of sideroblasts, and may be misdiagnosed as myelodysplastic syndrome (3,4). Copper deficiency may also be caused by zinc toxicity.
Copper deficiency symptoms: Copper deficiency may cause fatigue, bradycardia, weakness, cachexia, and ataxia (5).
Copper deficiency treatment has not been standardized but requires supplementation for 4 weeks up to 3 months to reverse the symptoms and hematologic manifestations. Clinicians have treated patients successfully with copper chloride, copper sulfate, and copper gluconate at doses of elemental copper of 2 mg to 8 mg daily. Higher doses are generally used the first week and tapered weekly by 2 mg increments until a daily dose of 2 mg per day is reached which is continued long term.
Copper and Alzheimer’s disease: The protection in cognitive decline by a zinc supplement of 150 mg oral daily (unknown zinc formula) resulted in protection from cognitive decline for 6 months was believed to be either restoration of neuronal zinc levels or reduction in serum copper levels by the zinc supplement or both (2). It is unclear how long term zinc supplementation will affect copper levels which may need periodic monitoring.
