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Total Copper (Blood)

Does this test have other names?

Total copper serum test 

What is this test?

This test measures the total amount of copper in your blood. Normally, most of the copper in your blood is carried by a protein called ceruloplasmin.

Adults have 50 and 80 milligrams (mg) of copper in their body, mostly in muscle and the liver. Copper helps make melanin, bone, and connective tissue, and helps with many other processes in your body. You normally get copper through your diet, in foods like organ meats, especially liver; seafood; beans; and whole grains. You get rid of copper in your bowel movements and urine.

Various medical problems can disrupt normal copper levels, causing you to have too little copper, a condition called copper deficiency, or too much copper, called copper toxicity. 

Because a normal diet contains plenty of copper, copper deficiency is unlikely except in certain circumstances. It can occur in malnourished children, especially premature babies who don't get nutritional supplements. Children with this condition tend to have bone abnormalities and fractures. Copper deficiency can also result from a rare genetic disorder called Menkes kinky hair syndrome. This syndrome interferes with copper absorption. Copper deficiency can lead to problems with connective tissue, muscle weakness, anemia, low white blood cell count, neurological problems, and paleness.

Too much copper can be toxic. You can get too much copper from dietary supplements, from drinking contaminated water, and from exposure to fungicides that contain copper sulfate. You can also have too much copper if you have a condition that stops the body from getting rid of copper. For example, Wilson's disease keeps the liver from storing copper safely and from sending copper out of the body in your stool. Excess copper in the liver overflows and builds up in the kidneys, brain, and eyes. This excess copper can kill liver cells and cause neurological damage. Wilson's disease is fatal if untreated. Excess copper can also interfere with how your body absorbs zinc and iron. 

Why do I need this test?

Your doctor may order this test if you have symptoms of either copper deficiency or copper toxicity.

Signs and symptoms of copper deficiency can include:

  • Anemia

  • Neutropenia, or a low level of white blood cells called neutrophils

  • Osteoporosis

  • Paleness

  • Hair with less pigment than normal

Children with copper deficiency through malnutrition or another condition may have vascular aneurysms, central nervous system problems, stunted growth, poor muscle tone and muscle weakness, and hypothermia.

Symptoms of copper toxicity include:

  • Abdominal pain

  • Diarrhea

  • Vomiting

In more severe forms, copper toxicity can lead to:

  • Heart and kidney failure

  • Liver damage

  • Brain disease or disorder

  • Death

Signs and symptoms of Wilson's disease include:

  • Anemia

  • Low white blood cell count

  • Kayser-Fleischer rings, which are brown rings around the cornea that are visible to a doctor during an eye exam

If you have Wilson's disease, your doctor  may order this test to make sure your treatment is working. 

What other tests might I have along with this test?

Your health care provider might also check for possible copper deficiency, copper toxicity, or Wilson's disease with these tests:

  • Blood ceruloplasmin

  • 24-hour urine test for copper

  • Hepatic copper, or measuring copper in a liver biopsy

The level of copper in your blood can be related to many different conditions, including liver problems or inflammation. 

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses to do the test. Even if your test results are different from the normal value, you may not have a problem. To learn what the results mean for you, talk with your health care provider.

The normal range for total copper in the blood is 70 to 140 micrograms per deciliter (mcg/dL).

A low concentration of copper could mean that you have

  • Kidney disease

  • A nutritional deficiency

  • Inability to absorb copper

In Wilson's disease, blood levels of copper are low even while copper builds up to toxic levels in the liver and other organs. An exception is the person with Wilson's who has acute liver failure. In this case, the level of copper in the blood may be higher than normal.

Any of the following conditions could cause your test result to be high:

  • Copper toxicity from taking in too much copper, perhaps through water or dietary supplements

  • Anemia

  • Biliary cirrhosis, a liver disease

  • Hemochromatosis, a condition in which your body absorbs too much iron

  • Hyperthyroidism, or overactive thyroid

  • Hypothyroidism, or underactive thyroid

  • Infection

  • Leukemia

  • Lymphoma

  • Rheumatoid arthritis 

How is this test done?

The test requires a blood sample, which is drawn through a needle from a vein in your arm.

Does this test pose any risks?

Taking a blood sample with a needle carries risks that include bleeding, infection, bruising, or feeling dizzy. When the needle pricks your arm, you may feel a slight stinging sensation or pain. Afterward, the site may be slightly sore.

What might affect my test results?

Pregnancy, oral contraceptives, infection, inflammation, and stress can all increase the copper levels in your blood. The medications corticosteroids and corticotropin can reduce your copper levels.

How do I get ready for this test?

You don't need to prepare for this test. But be sure your doctor knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.