Are You Getting Enough Copper in Your Diet?

By: Pallavi Vathiar. Practicing Clinical Nutritionist, Mumbai.


We look to the past civilizations that used copper to kill bacteria without knowing the mechanisms behind it – the Ancient Egyptians who used copper in wounds, the Ancient Greeks who used it in plumbing, and the seafaring explorers who used it to store drinking water. But there is actually a far, far more ancient use of copper to combat infection: Our own innate immune system.

The innate immune system is not as specific as the adaptive – it does not target specific pathogens – but it is the first line of defense against infection.

Along with all living things, we have a complex immune system that helps our bodies seek out and destroy pathogens. There are actually two immune system branches: Innate and adaptive.

The adaptive immune system releases antibodies that are specifically able to kill a pathogen. Vaccines build upon these adaptive mechanisms to protect us from some infections (1).

So where does copper fit in?

All living things use copper as a trace micronutrient in many aspects of metabolism. It is a very versatile element to use to speed up the break down and building up of molecules. Our bodies have complex systems to regulate the amount of copper, keeping it at a healthy level known as homeostasis. It is important to regulate the level of copper, since too much can lead to cell death.

Copper helps in various bodily functions:

  • Energy production
  • Connective tissue formation
  • Iron metabolism
  • Central nervous system
  • Melanin formation
  • Antioxidant functions
  • Regulation of gene expression

Cross sectional study by Manipal University, India found that an adequate copper nutritional status is necessary for normal iron metabolism and red blood cell formation. Anemia is a clinical sign of copper deficiency, and iron has been found to accumulate in the livers of copper-deficient mammals, indicating that copper is required for iron transport to the bone marrow for red blood cell formation (2).

Copper deficiency

While a copper deficiency is rare, some health conditions and other factors can increase the risk such as genetic defects of copper metabolism, central nervous system (CNS), inflammation of the optic nerve, malnutrition, surgical removal of parts of the digestive system, diseases of the intestines or kidneys, cystic fibrosis and celiac disease could lead to the need for supplements of cupric oxide (3).

Serum copper and ceruloplasmin levels may fall to 30% of normal in cases of severe copper deficiency.

Hypocupremia (low copper content in blood) is also observed in genetic disorders of copper metabolism, such as aceruloplasminemia and, paradoxically, in Wilson’s disease, which are not linked to dietary copper deficiency. One of the most common clinical signs of copper deficiency is an anemia that is unresponsive to iron therapy but corrected by copper supplementation (3).

Causes of deficiency in infants

Copper deficiency has been seen in infants who consume cow’s milk instead of formula. Cow’s milk has a low copper content. Children under 1 year should be ideally breast fed and if not, fed manufactured formula. Cow’s milk does not have the required nutrients for a human infant (4).

Since copper is stored in the liver, deficiencies develop slowly over time.

Cupric Oxide_ Aid Overall Health

Cupric oxide is used by specific enzymes to help in the production of energy, to create collagen and elastin, to metabolize iron, and in many functions of the brain and central nervous system. Cupric oxide is found in health supplements such as vitamins and health aid treatments (5).

Anaemia and Cupric Oxide

There is a connection between copper and iron absorption. It is thought that the body needs copper to use iron effectively.

Iron helps the body to carry oxygen to the cells. Anaemia is a lack of enough iron in the red blood cells, and some forms of anaemia respond only to copper supplements (6)


Copper is needed to form collagen, which is used to make bone. Osteoporosis, a disease which causes brittle bones, has been observed in cases of copper deficiency.

A 1994 study published on the National Institutes of Health’s medical publications showed an increase in bone density only when trace minerals such as copper, zinc and manganese were used in conjunction with calcium supplements.

Further studies are being conducted to explain the exact nature of the relationship between cupric oxide and bone loss (7).

Side Effects of Cupric Oxide

Cupric oxide has no reported side effects outside of high levels that result in toxicity. Anyone who feels they are experiencing side effects from copper should stop taking the supplement immediately and discuss the side effects with a doctor. (5)


Copper is a mineral that is needed in the body in small doses but has the ability to become toxic at high levels. Additional supplements of copper beyond what you should get in your normal diet should be discussed with a doctor.


Copper supplements are available, but it is best to first try to obtain essential vitamins and minerals through food in order to reduce the risk of an imbalance.

Very few people need to take a copper supplement. Additionally, the nutrients in food work together to create an effect that is more significant than that achieved by taking individual nutrients in isolation.

Most multivitamin supplements contain 2 mg of copper, which is halfway along the Safe and Adequate Range of Intake fixed by the Food and Nutrition Board (FNB).


Copper supplements can interact with the following:

  • Birth control pills and hormone therapy
  • Non-steroidal anti-inflammatories (NSAIDS), such as aspirin and ibuprofen
  • Penicillamine, used to reduce copper levels in Wilson’s disease
  • Allopurinol, a gout treatment
  • Cimetidine, or Tagamet, use for gastric ulcers and gastric reflux
  • Zinc supplements_ These products may reduce or increase levels of copper in the blood, leading to an imbalance (8).

Copper Toxicity

Copper toxicity is rare in the general population.

Symptoms of acute copper toxicity include abdominal pain, nausea, vomiting, and diarrhoea; such symptoms help prevent additional ingestion and absorption of copper. More serious signs of acute copper toxicity include severe liver damage, kidney failure, coma, and death. Of more concern from a nutritional standpoint is the possibility of liver damage resulting from long-term exposure to lower doses of copper (3).

Increased serum copper levels have been linked with a higher risk of cardiovascular disease.

Water that contains more than 6 mg of copper per litre may cause stomach problems. If drinking water appears to trigger symptoms, the individual should see about getting it tested.

Keep all sources of copper out of the reach of children.

How much copper should I include on daily basis?

 While too much copper can cause serious toxicity, to be consumed in moderate is ideal.

According to ICMR, the Recommended Dietary allowance for Indians is 1.7 milligram of Copper per day (9).

Food sources

Copper is found in a wide variety of foods.

Cashew nuts contain copper and other than cashews some other good sources include:

  • Oysters and other shellfish
  • Whole grains
  • Beans
  • Potatoes
  • Yeast
  • Dark leafy greens
  • Cocoa or Semisweet chocolate
  • Dried fruits
  • Black pepper
  • Organ meats, such as kidneys and liver
  • Nuts and nut butters_ cashews and almonds
  • Seeds
  • Lentils
  • Mushrooms

Most fruits and vegetables are low in copper, but it is present in wholegrains, and it is added to some breakfast cereals and other fortified foods.



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