Copper

Copper is the third most abundant trace mineral found in the body (behind Iron and Zinc) and is found in every tissue in the body but primarily stored in the liver. The highest concentration is thus found in the liver with lesser amounts found in the brain, heart, kidneys and muscles. The total amount of Copper in the body is between 75 to 100 milligrams (which is less than the weight of Copper found in a penny), was first recognised in the 1870’s as a normal constituent of blood which plays a vital role in our bodies’ metabolism mainly because it allows many critical enzymes to function correctly.

Copper is an essential component of many enzymes. Each of the copper containing enzymes has a distinct function, indicating that Copper plays a part in a wide range of physiological processes including Iron utilization, elimination of free radicals, development of bone and connective tissue, and the production of the skin and hair pigment (Melanin). Below are some of its functions in relation to bodily requirements.

Approximately 90% of the Copper in the blood is incorporated into a compound called Ceruloplasmin, which is responsible for carrying Copper to tissues that require the mineral. In addition to its role as a transport protein, Ceruloplasmin also acts as an enzyme, catalyzing the oxidation of minerals, most notably Iron. The oxidation of Iron by Ceruloplasmin is necessary for Iron to be bound to its transport protein (namely Transferrin) so that it too can be carried to tissue where it is needed. Because copper is necessary for the utilization of Iron, Iron deficiency Anaemia may be a symptom of Copper deficiency.

Superoxide Dismutase (SOD) is a Copper-dependent enzyme that catalyzes the removal of Superoxide radicals from the body. Superoxide radicals are generated during normal bodily metabolism, as well as when white blood cells attack invading bacteria and viruses (a process called Phagocytosis). If not rapidly eliminated, Superoxide radicals cause damage to cell membranes. When Copper is not present in sufficient quantities, the activity of Superoxide Dismutase is reduced, and the damage to cell membranes caused by Superoxide radicals is increased. When functioning in this enzyme, Copper works together with the mineral Zinc, so it is important that two minerals are well balanced otherwise the enzyme will not function correctly

Copper is a component of Lysyl Oxidase, the enzyme that collaborates with the synthesis of collagen and elastin, two important structural proteins found in bone and connective tissue. Tyrosinase, a Copper containing enzyme, converts Tyrosine to melanin, which is the pigment that gives hair and skin its colour.

As a part of the enzymes Cytochrome Oxidase, dopamine Hydroxylase, and Factor IV, Copper assists in energy production, and the conversion of dopamine to Norepinephrine and blood clotting, respectively. Copper is important for the production of the thyroid hormone called Thyroxine and is necessary for the synthesis of phospholipids found in myelin sheaths that cover and protect nerves.

Deficiency Symptom

Because Copper is involved in so many functions of the body, a deficiency produces a wide pattern of symptoms. These include Iron deficiency anaemia, ruptured blood vessels, osteoporosis, joint problems, brain disturbances, elevated LDL cholesterol and reduced HDL cholesterol levels, an increased susceptibility to infections due to poor immune system function, loss of pigment in the hair and skin, weakness, fatigue, breathing difficulties, skin sores, poor thyroid function, and irregular heart beat.  Certain medical conditions including chronic Diarrhoea, Celiac sprue, and Crohn's disease result in decreased absorption of Copper and may increase the risk of developing a Copper deficiency. In addition, Copper requires sufficient stomach acid for absorption, so if antacids are taken regularly the risk of developing a Copper deficiency increases. Inadequate Copper can also observed in children with low protein intake and in infants fed solely cow's milk without any supplemental Copper.

Toxicity Symptoms

In recent years, nutritionists have been more concerned about Copper toxicity than Copper deficiency. One explanation for this is the increase in the amount of Copper found in drinking water due to the switch in most areas of the country from galvanized water pipes to Copper water pipes.

Excessive intake of Copper can cause abdominal pain and cramps, nausea, diarrhoea, vomiting, and liver damage. In addition, some experts believe that elevated Copper levels, particularly when Zinc levels are low, may be a contributing factor in many medical conditions including schizophrenia, hypertension, stuttering, autism, fatigue, muscle and joint pain, headaches, childhood hyperactivity, depression, insomnia, senility, and premenstrual syndrome.
 
Postnatal depression has also been linked to high levels of Copper. This is because Copper concentration increases throughout pregnancy to approximately twice the normal value, and it take up to three months after delivery for Copper levels to return to normal. Since excess Copper is excreted through bile, Copper toxicity is most likely to occur in individuals with liver disease or other medical conditions where excretion of bile is compromised.

The toxic effects of high tissue levels of Copper are seen in patients with Wilson's disease, a genetic disorder characterized by Copper accumulation in various organs due to the inadequate synthesis of Ceruloplasmin (the protein that transports Copper through the blood) by the liver. Wilson's disease primarily affects the liver, kidneys, and brain causing degenerative physiological changes (including cirrhosis of the liver, muscular rigidity and spastic contraction, and emotional disturbances) that are fatal if untreated. The treatment of Wilson's disease involves avoidance of foods rich in copper and any supplements containing Copper and drug treatment with chelating agents that remove the excess Copper from the body.

The leaching of Copper from water pipes can increase its content in tap water. Cooking with Copper cookware can also increase the Copper content of foods.

Foods that require long cooking times can also have their Copper content substantially reduced. The cooking of navy beans, for example, can result in the loss of half their original Copper content. The processing of whole grains can also dramatically reduce Copper content. In wheat, for example, the conversion of the whole grain into 66% extraction wheat flour (where 34% of the original grain is removed from the flour and discarded) results in a drop of about 70% in the original Copper that was originally present.
Many vegetables and whole grains now appear to be lower in Copper than they were during the 1950’s. The depletion of Copper from soils is believed to be responsible for this lowered amount of Copper.

Factors that Affect Function

Unlike most minerals, Copper appears to undergo absorption up into the body from the stomach. Proper levels of stomach acid are important for this absorption. For this reason, individuals with compromised stomach acid (Hypochlorhydria) may be at increased risk of Copper deficiency.
In addition, Zinc competes with Copper in the small intestine and can interfere with its absorption therefore people who supplement with unnecessarily high levels of Zinc and lower levels of Copper may increase their risk of Copper deficiency.

Drug-Nutrient Interactions

Oral contraceptives (birth control pills) increase the absorption of Copper.
Copper may enhance the anti-inflammatory effects of the non-steroidal anti-inflammatory medications including Etodolac (Lodine), Ibuprofen, Nabumetone (Relafen), Naproxen, and Oxaprozin.
The following medications may cause a decrease in copper levels:

AZT (Azidothymidine, Zidovudine, and Retrovir) is used in the treatment of HIV infection and AIDS. AZT may reduce blood levels of Copper.
Famotidine (Pepcid, Pepcid AD) and Nizatidine (Axid, Axid AR) belong to the class of drugs known as histamine blockers, which prevent the release of acid into the stomach and are used in the treatment of ulcers and acid indigestions. Because Copper requires sufficient stomach acid for absorption, long-term use of Famotidine may lead to Copper deficiency.
Antacids (for example, Tums) may reduce Copper absorption by decreasing the amount of hydrochloric acid in the stomach.
Penicillamine (Cuprimine, Depen) is a chelating agent used to reduce toxic Copper deposits in people with Wilson's disease.

Nutrient Interactions

Vitamin C, Iron, and Manganese inhibit Copper absorption. Dietary Copper forms complexes with Molybdenum and Sulphur, which may also reduce the absorption of Copper. Zinc and Copper compete for absorption. Consequently, high doses of either mineral may cause a deficiency of the other.

Calcium and Phosphorous increase Copper excretion.
Because Copper deficiency is known to reduce the activity of Selenium dependent enzymes, it appears that Copper and Selenium also interact.

Health Conditions

Copper may play a role in the prevention and/or treatment of the following health conditions:
Allergies
Anaemia
Baldness
Bedsores
Heart Disease
HIV/AIDS
Hypothyroid disease
Leukaemia
Osteoporosis
Periodontal disease
Rheumatoid arthritis
Stomach ulcers

Copper in Dietary Supplements

What forms of Copper are found in dietary supplements?
As a dietary supplement, Copper is primarily found in complex with organic acids like Picolinic acid and Gluconic acid, and amino acids like Glycine and Lysine. In organic forms of copper, like Copper Sulphate, are also available. All of these delivery forms have merit, and the choice of a specific Copper supplement often depends on the need for amino acids or organic acids that are attached to Copper.

Food Sources

Copper is found in high concentrations in the following foods:
Liver
Shell fish
Dried brewer’s yeast
Olives
Nuts
Cereals
Meat, fish and poultry
Wholemeal bread
Dried fruits

Public Health Recommendations

In 2000, the Institute of Medicine at the National Academy of Sciences established new recommendations for Copper including Adequate Intake (AI) levels for infants up to one year old and Recommended Dietary Allowance (RDA)for all people older than 1 year old. The recommendations are as follows:

0-6 months: 200 micrograms
7-12 months: 220 micrograms
1-3 years: 340 micrograms
4-8 years: 440 micrograms
Boys 9-13 years: 700 micrograms
Girls 9-13 years: 700 micrograms
Boys 14-18 years: 890 micrograms
Girls 14-18 years: 890 micrograms
Men 19-70 years: 900 micrograms
Women 19-70 years: 900 micrograms
Men greater than 70 years: 900 micrograms
Women greater than 70 years: 900 micrograms
Pregnant women 14-50 years: 1000 micrograms
Lactating women 14-50 years: 1300 micrograms