For everything from anemia, to headaches, to allergies, to having healthy bones, and just feeling great all the time, copper is an incredibly important nutrient. And this is how to know if you’re getting enough. Hi. I’m Dr. Chris Masterjohn of chrismasterjohnphd.com. And this is Chris Masterjohn Lite, where the name of the game is “Details? Shmeetails. Just tell me what works!” And today we’re going to talk about how to manage your copper status, make sure that you get enough, not too much, and fix any problems and make sure that whatever your solutions are, they’re working. So copper, when you do not have enough, you can get anemia that looks just like iron deficiency anemia but isn’t, or that looks just like B12 and folate deficiency anemia but isn’t. In fact, you can get malabsorption of iron from copper deficiency that actually causes iron deficiency, and the problem might not be that you don’t have enough iron in your diet, it might be that you’re not getting enough copper in your diet to absorb the iron, so you could have anemia from that as well as the many other problems of iron deficiency itself. You can have low white blood cells, especially neutrophils. You can have high cholesterol, you could get osteoporosis because copper is needed to support your bones. You could get histamine intolerance or a greater burden of allergies than you would otherwise have. You could have poor pigmentation of your skin and hair, and neurotransmitter imbalances, like low adrenaline or high serotonin, that might leave you feeling like you’re not your best. So what do you do about this? Well, the first thing is look at your diet and see whether the dietary pattern that you have is supporting getting enough copper. The absolute best sources of copper are liver, oysters, shiitake mushrooms, pure chocolate, not the stuff watered down with sugar and milk, and spirulina. A tier below that of very good sources of copper are most shellfish besides oysters, remember oysters are the best, whole grains, legumes, and potatoes. Diets that are low in these foods are likely to contribute to a copper deficiency, but soil variation is very large, and all these foods, if they’re grown in low-copper soil, could be much less likely to give you enough copper. And if you’re consuming—if you’re not consuming enough of those foods and you are consuming foods from copper-deficient soils, then that makes you very predisposed to copper deficiency. Zinc supplementation, especially over 45 milligrams a day and with a zinc-to-copper ratio greater than 15-to-1, can be a cause of copper deficiency. Impaired methylation can be a cause of copper deficiency, and I’ll link in the description of this episode to my methylation resources. Other sources of copper deficiency that are not dietary in nature include the use of antacids, proton pump inhibitors, gastric bypass surgery, and any digestive problems that are focused on the upper part of the GI tract, like the stomach and the upper part of the small intestine. And although there’s limited evidence for this, it seems to be the case that high doses of vitamin C can impair copper absorption. On the other hand, there is copper toxicity. In general, from diet I do not believe copper toxicity is a concern. If you are supplementing with copper over 10 milligrams, that could pose a potential risk of copper toxicity. I think it’s best to keep copper supplements under 10 milligrams, preferably under 3 milligrams a day, and it’s always best to get your copper from food, and when you do, you’re benefitting by the fact that the copper is mixed with other minerals, especially zinc, which protects against copper toxicity. So it’s extremely unlikely to get copper toxicity from food. There are high copper levels in certain water systems, but when they get to the point where they can cause copper toxicity, usually drinking that water is going to make you nauseated, and it’s usually leaving blue colors all over the place. If it’s really bad, you can see the blue even coming out in your clothing. And so usually you have a warning sign, and certainly using a water filter will generally protect you against too much copper coming from your water supply. The most important test of copper status is serum copper. This can be supplemented with serum ceruloplasmin. They tend to go together, and so you’re usually not getting additional information by combining them. And serum copper tends to be more sensitive to deficiency, so you always want to at least get serum copper, but it can be helpful to corroborate it with serum ceruloplasmin. But always get serum copper. Give that the priority. In general, low serum copper and low serum ceruloplasmin indicate a copper deficiency most of the time. From what I’ve seen, I think you want to tend to be in the middle of the range because I have seen indications of copper deficiency when people are in the lower 20 or 30 percent of the range. It’s important to note a couple of limitations to these tests. First of all, estrogen increases serum ceruloplasmin and tends to increase serum copper as well, and that means that there’s going to be some fluctuation of copper levels with the menstrual cycle. And copper levels are generally twice as high during pregnancy as they are for women who are not pregnant. And using hormone replacement therapy, estrogen in HRT can raise copper levels by 30 to 90 percent. And unfortunately, there really isn’t any clear research to develop a separate reference range for women experiencing high estrogen under these conditions, so what we can say is that if your copper levels are running a little high and you can explain it with estrogen, you can probably dismiss it because it’s normal. It’s probably all the more true in women than in men that you want to be at least towards the middle of the range for copper because if you’re at the low end of the range, and that might be close to deficiency, that’s all the more true if you would expect your estrogen levels to be bringing the copper up higher. There are two genetic disorders of copper metabolism: Menkes disease and Wilson’s disease. Both of these can look like copper deficiency because the serum copper levels and ceruloplasmin levels can be low, but you can have copper overload in certain specific tissues, and which tissues those are is different for Menkes disease and Wilson’s disease. But measuring urine copper can be very useful in identifying these diseases because usually the urine copper is elevated in those diseases despite the low serum levels. So, those are the rare caveats to serum copper being the most useful test, but urine copper can often distinguish those diseases from the typical picture. If you identify a copper deficiency, the best thing to do is to solve it at the root of the problem. In some cases, that might be due to an absorption problem, and it might be due to excessive supplementation of zinc or high doses of vitamin C. If so, you want to work on removing those problems. If the problem is a dietary one because you’re not consuming enough copper-rich foods, then the overwhelmingly best thing to do is to work the copper-rich foods into your diet. Again, those are liver, oysters, shiitake mushrooms, chocolate, and spirulina as the very top foods. And the other good sources include most non-oyster shellfish, whole grains, legumes, and potatoes. So eat more of those foods. This is especially important because although there’s not a ton of evidence around it, the copper that you get from foods is a different form than what you get in supplements. Usually the—to be technical about it, the oxidation state is different. And it appears to be the case that the food copper is the ideal form that is utilized much more effectively, and that means that you’re always going to get a better deal from getting copper in foods than you are from supplements. With that said, there are case reports out there making it very clear that 7 milligrams of copper from a supplement over the course of a few months is highly effective at curing the anemia or the low white blood cells that occur in copper deficiency. And so certainly, if you cannot get your copper levels up with food, supplements are an effective means of fixing the deficiency. True copper toxicity is very unlikely outside of extreme over-supplementation, or consuming highly polluted waters, or the genetic diseases that, Menkes and Wilson’s disease that can lead to copper toxicity in certain tissues. In the case of true copper toxicity, working with a health care practitioner through chelation therapy is the necessary course of action. In most cases, if you have a reason to suspect a mild overload of copper from overuse of supplements in the past, I think the best thing to do is to use zinc supplementation to get your zinc levels up along the lines of how I described doing so for toxic heavy metals, and I’ll link to that episode in the description of this one. This episode is brought to you by Ancestral Supplements. Our Native American ancestors believed that eating the organs from a healthy animal would support the health of the corresponding organ of the individual. Ancestral Supplements has a nose-to-tail product line of grass-fed liver, organs, bone marrow, and more. All in the convenience of a capsule. For more information or to buy any of their products, go to ancestralsupplements.com. This episode is brought to you by Testing Nutritional Status: The Ultimate Cheat Sheet. Everything you could ever need to know to optimize your nutrition all in one place. Easier to find and use than ever before. Get your copy at chrismasterjohnphd.com/cheatsheet. Use the code LITE5. That’s all capitals LITE, the number 5. Use the code LITE5 to get five dollars off. The audio of this episode was enhanced and post-processed by Bob Davodian of Taurean Mixing. You can find more of his work at taureanonlinemixing.com. All right, I hope you found this useful. Signing off, this is Chris Masterjohn of chrismasterjohnphd.com. This has been Chris Masterjohn Lite. And I will see you in the next episode.