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Copper Toxicity Checklist PDF
Copper Toxicity Checklist PDF
Copper toxicity is common in the United States. hTMA studies show that a NOTE: Any medication that interferes with the excretion of copper through the
large percent of the population has excessive tissue copper levels. This can intestinal track via the liver and gallbladder can induce copper toxicity. These
vary geographically due to high copper or low zinc soils and hard or soft water include estrogen hormones, psychotropics, sedatives, tranquilizers, diuretics, anti-
regions. Below are some common effects of excess copper. hypertensive, anti-diabetic, oral hypoglycemic agents, anti-convulsives, analgesics,
anti-inflammatory agents, anti-fungal preparations and others.
Please check the symptoms below that you have now or have had in the past.
If you suspect copper toxicity and would like to consult with a medical practitioner, or get a hTMA toxicity screen, please contact http://healthelite.org/
References
Watts, D. L., Ph.D., 1989, The Nutritional Relationships of Copper, Journal of Orthomolecular Medicine, V. 4, No. 2
Malter, R., Ph. D., 2003, The Strands of Health, A Guide to Understanding Hair Mineral Analysis
Pfeiffer, C. C., Ph. D., M.D., 1975, Mental and Elemental Nutrients, Keats Pubishing Inc., The Brain Bio Center, Princeton NJ
healthelite
Mertz, W., 1897, Trace Elements in Human and Animal Nutrition, U.S. Department of Agriculture
Watts, D. L., Ph.D., 1995, Trace Elements and other Essential Nutrients
| COPPER WHEELS
Copper is a constituent of many enzymes including cytochrome c oxidase, superoxide dismutase,
ceruloplasmin, dopamine B-hydroxylase, lysyl oxidase and monoamine oxidase. An imbalance of copper
relative to other nutrients can disrupt the activity of these important enzyme functions. In regards to copper
status within the body, it should be noted that excess copper is just as serious as copper deficiency.
The following graphics illustrate some of copper’s biological antagonistic relationships (arrows indicate
antagonistic effect). In the case of excessive tissue copper burden, increased intake of these antagonistic
vitamins and nutritional minerals may be of benefit. However, prolonged intake of these specific vitamins
and/or minerals, singularly or in combination, can produce a copper deficiency, especially if the nutritional or
tissue copper status is already marginal. Conversely, copper toxicity or prolonged intake of copper can
antagonize these same specific vitamins and minerals. It should be noted that antagonism with another
nutrient can occur via competition on an absorptive level (intestinal absorption) or metabolic level (cellular),
producing compartmental displacement, or increasing requirements.
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For Further Information, please refer to "The Nutritional Relationships of Copper, Watts, D.L., Journal Of Orthomolecular
Medicine, 4, 2, 1989
99
Journal of Orthomolecular Medicine Vol. 4, No. 2, 1989
toid arthritis almost always reveal a low tissue while elevated tissue copper is found with
copper level. The more chronic cases show high chronic viral infections. Presently it is not clear
iron/copper ratios. An elevated tissue iron/copper whether infectious conditions cause the TMA
ratio can also indicate a chronic bacterial copper abnormalities, but it is strongly suspected
infection. Rheumatoid arthritis can be secondary that copper status can predispose an individual to
to and sometimes caused by an infectious agent either a viral or bacterial infection. The indication
resulting in copper depletion or a disturbance in that copper can be a causative factor in the
copper balance. It is also well known that incidence of viral or bacterial infections is
spontaneous remission of rheumatoid arthritis reflected in studies by Luster and co-workers.
occurs in conditions associated with increased They report that estrogen has an enhancing or
copper retention such as pregnancy and biliary suppressing effect upon the immune system.28
obstruction.20 An Australian study (Walker, et al) Thus the relationship between copper and
demonstrated improvement of symptoms of estrogen cannot be overlooked. It has also been
rheumatoid arthritis by absorption of copper reported that women have an increased
through the skin from the wearing of copper susceptibility to viral infections prior to
bracelets. menstruation (at which time estrogen and copper
TMA studies clearly show that individuals levels are high) and an increased tendency toward
with some forms of rheumatoid arthritis, have bacterial infections directly following
increased copper requirements. However, TMA menstruation (at which time estrogen and copper
studies have revealed that tissue copper levels are levels fall). Generally speaking, we find that
above normal in patients with osteoarthritis. This copper deficiency causes a disturbance in cellular
can be explained by the calcium-copper-vitamin immunity, while copper excess causes a
D relationship discussed later. disturbance in humoral immunity.
This information indicates that any factor that
Infections — Bacterial antagonizes copper retention can be considered as
Infections are known to affect mineral having anti-viral properties. Those that are
metabolism and requirements.21 During a synergistic such as vitamin D, B1, B12, and B10,
bacterial infection iron is sequestered into storage which enhance copper retention, can be consi-
tissue (reticuloendothelial-bone-spleen-liver). dered as having anti-bacterial properties (see
This is a normal response since bacteria require figure 1 and 2). As an example, vitamin A, which
iron in order to proliferate; therefore, the body is considered to be an anti-infectious vitamin, can
removes this nutrient source from the serum. 22 23 specifically be categorized as anti-viral. This is
Secondarily, serum copper rises due to its also true of vitamin C and zinc. However, zinc,
removal from storage tissues thereby improving vitamin C, and vitamin A are mutually
the capability to mount an attack and overcome antagonistic to copper; if taken in excessively
the invading organism. The opposite is seen in high dosages by individuals with a copper
the tissue mineral concentrations. In chronic deficiency, they can actually promote infectious
infectious states, the tissue iron increases while processes — especially those of bacterial origin.
the tissue copper decreases. This tissue mineral TMA studies have shown that chronic
pattern (elevated iron/copper ratio), is strongly candidiasis is frequently associated with copper
indicative of a chronic infection. The most excess. Therefore, minerals and vitamins
common source of chronic infections have been antagonistic to copper can be considered to have
dental abscesses often present for years without anti-fungal and anti-yeast properties (see figure 1
the patient's knowledge. and 2).
most of which are of the catabolic or highly infarcts. Klevay has reported that a relative
metastatic type. High tissue iron/ copper may or copper deficiency may contribute to ischemic
may not be present depending upon the type of heart disease.36 A deficiency of copper relative
malignancy. There have been reports that tissue to zinc produces a decrease in HDL (high
iron accumulation is found in tissues and lymph density lipoproteins) and an increase in LDL
nodes with Hodgkins disease.29 TMA research is (low density lipoproteins).37
revealing the increased requirements for copper in Copper excess may also contribute to
some malignancy conditions. The necessity for cardiovascular problems from hypercho-
copper is obvious due to its role in respiratory lesterolemia, which is associated with hy-
enzyme systems and its participation in superoxide pothyroidism. Copper in excess has adverse
dismutase activity, which helps protect the cell effects upon thyroid activity and zinc status.
from damage from oxygen toxicity. Cytochrome c
oxidase, the terminal oxidase in the electron Orthopedic Disturbances and Copper
transport chain, is copper dependent. A reduction Imbalance
in cytochrome c oxidase activity results in the As mentioned previously, adequate copper is
mitochondria becoming enlarged and deformed required for the normal production and integrity
with advanced copper deficiency. Animal studies of elastin and collagen, which are components
have confirmed the effects of some copper of ligaments and the nucleus pulposus of the
compounds as an anti-neoplastic agent. The intervertebral disc. Other minerals and vitamins
addition of copper decreased tumor growth, are also involved in collagen and elastin
decreased metastasis, and increased survival of synthesis. As an example, vitamin C is required
animals with certain types of neoplasms.30 Several for the hydroxylation of proline to hydroxy-
reports indicate that serum copper levels rise with proline, which forms chains of tropollo-gen.
the severity of some malignancies and return to Vitamin C, iron, and manganese are all
normal with remission.31 32 involved in the conversion of lysine to
hydroxylysine. Manganese is required for the
Osteoporosis activity of glactosyltransferase and
One of the early signs of copper deficiency is glucosyltransferase, and zinc is involved in
osteoporosis.33 34 A number of enzymes involved in protein synthesis. Each of these nutrients is
collagen synthesis and cross-linking of the organic affected by copper (see figure 1 and 2).
matrix of bone require copper. Bone changes in Davies38 reported studies of lathyrism, which
copper deficiency include a loss of trabecular apparently produces copper deficiency resulting
formation with thinning of the cortex. It is common in structural skeletal abnormalities including
to find low tissue levels of calcium in conjunction scoliosis, spondylosis, and kyphoscoliosis.
with low tissue levels of copper on TMA studies. Excessive tissue copper is also associated
Through TMA studies, osteoporosis has been with structural skeletal defects. Pratt and
linked with both copper deficiency and copper Phippen reported findings in which elevated
excess and has been categorized as type I or type II hair copper occurred with idiopathic scoliosis. 39
osteoporosis respectively.35 Copper and estrogen probably act
synergistically in contributing to scoliosis.
Cardiovascular During pregnancy, estrogen is known to
The structure and integrity of the vascular produce relaxation of the pelvic ligaments at the
system is intimately related to copper. An adequate sacroiliac joints and symphysis pubis40 in
amount of copper is required for the production of preparation for the birthing process. The
the enzyme lysyl oxidase, which is involved in the resulting elasticity allows less resistance for the
quality and quantity of elastin formation and fetus when passing through the birth canal. The
collagen cross-linking. Therefore, copper effect of estrogen is, of course, not confined
deficiency is related to vascular defects such as only to the pelvis. By antagonizing or
aneurysms, heart enlargement, heart failure, and producing
101
Journal of Orthomolecular Medicine Vol. 4, No. 2, 1989
deficiencies of other nutrients (see figure 1 and conditions commonly seen with low tissue copper
2), copper elevation also contributes to levels. These include gout, hypertension,
ligamentous laxity throughout the skeletal antibiotic sensitivity, hyperactivity,
structure. Therefore, any factor that contributes to hyperglycemia, emotional disturbances (manic
increased copper retention such as, oral disorders), type I insomnia, and increased
contraceptive and IUD use, pregnancy, sympathetic neuroendocrine activity.
cholestasis, etc., can result in structural skeletal
instability and ligamentous laxity. Factors Contributing to Copper Deficiency
Neurological Minerals
Copper deficiency is known to affect the Figure 1 shows the minerals that are
central nervous system. Reports of animal studies antagonistic to copper.49 50 Prolonged high intake
have shown defects in myelination with copper of these elements, singularly or in combination,
deficiency.41 Observation of TMA studies has can produce a copper deficiency, especially if the
shown low tissue copper levels in multiple nutritional or tissue copper status is marginal. The
sclerosis patients. Douglas, et al, confirmed this nutritional minerals shown in figure 1 can be used
finding in their report, in which they found in the treatment of copper toxicity. Copper
significant differences in hair copper levels in supplementation, however, can aid in decreasing
forty multiple sclerosis patients compared to the toxic effects of some heavy metals as well as
forty-two controls.42 Similar observations have inhibiting their absorption. A report by Fields, et
been seen on TMA patterns of patients with al, revealed that copper is adversely affected by
Parkinson's disease. Information from animal the consumption of fructose. Copper deficiency
studies strongly suggests that copper deficiency was exacerbated in animals fed fructose, and
can be a factor in Parkinson's disease in humans, contributed to fatty degeneration of the liver.
since dopamine levels were found low in both
copper deficient animals and patients with Vitamins
Parkinson's.43 Vitamins that are considered antagonistic to
Menkes disease, also known as Steely Hair copper are shown in figure 2. Excessive intake of
disease is an inherited inborn error of copper any one or combination of these vitamins can
metabolism in infants. Infants with this condition contribute to or exacerbate an existing copper
manifest most of the conditions described with deficiency. The opposite may also occur: excess
copper deficiency. This condition is usually fatal copper intake or retention may produce a defi-
with a life expectancy of about two years. ciency of any one or combination of these
Diagnosis is difficult since these children appear vitamins or increase their requirements.
relatively normal after birth and may not manifest It is interesting to note a similarity of copper
severe symptoms for several weeks or months.44 deficiency to vitamin C deficiency. Many
This condition emphasizes the need for changes as a result of copper deficiency can be
nutritional monitoring of the fetus through the described as "scurvy-like". Indeed many
mother. Baumslag has stated the practicality of symptoms of copper and vitamin C deficiency are
using TMA for this purpose. Copper similar and can be difficult to distinguish. High
supplementation of the mother should provide vitamin C intake should be approached with cau-
this nutrient to the fetus since copper easily tion until copper status is evaluated since vitamin
crosses the placenta.45 C is known to affect copper antagonistically,51 52
53
Other conditions reported to be related to and/or enzymes that require copper. The
copper deficiency include suppression of immune biochemical defects of copper deficiency can be
response46 (cellular), celiac disease, cystic described as a copper deficient scurvy (CDS).
fibrosis of the pancreas,47 and loss of Although the mechanisms of the biochemical
pigmentation of the hair and skin.48 defects
TMA studies have revealed other
102
The Nutritional Relationships of Copper
Figure 1 Figure 2.
of CDS are different from those caused by vitamin deficiency, include vitamin D, B1, B12, C, and
C deficient scurvy, CDS can be produced by folic acid (B10). Supplementation of synergistic
excessive vitamin C intake. Conversely, vitamin C vitamins can aid in reducing the effects of copper
requirements are increased by excessive copper deficiency and in restoring copper balance. As an
intake or tissue accumulation. example, increased adrenal corticosteroid
production decreases copper retention56 as well
Endocrine Factors as antagonizes vitamin D metabolism.57 Vitamin
Copper is normally excreted by the liver via D can antagonize the effect of excessive
adrenal stimulation. It has been demonstrated that corticosteroid production, thereby improving
copper excretion is increased by the copper retention. This concept can be applied in
administration of adrenal steroids.54 55 Increased helping to reduce the side effects of steroid
activity of the sympathetic endocrines tend to therapy.
increase the elimination of copper or increase its The synergistic minerals to copper include
requirements due to increased metabolic demands. calcium, cobalt, selenium, sodium, and iron. The
The sympathetic endocrines include the thyroid, rickettsial bone changes that occur with copper
adrenal cortex (glucocorticoids), adrenal medulla, deficiency are probably related to the copper-
and anterior pituitary. vitamin D-calcium relationship.
Some vitamins and minerals are both
Nutrients Synergistic to Copper synergistic and antagonistic. This is due to their
Rarely does a single nutrient deficiency develop co- relationship with copper in metabolic
exclusively. Other nutritional deficiencies and functions such as the requirement for adequate
excess are always involved. Referring to figure 1 amounts of iron and copper for hemoglobin
and 2, we can see the potential of vitamin and production. But excessive iron intake antagonizes
mineral toxicity that can develop in the presence copper absorption on an intestinal level.
of copper deficiency. As an example, the need for
vitamin A, C, B6, B3, and B5 is reduced in a Copper Toxicity
copper-deficient state. Conversely, hyper- Copper toxicity is common in the United
vitaminosis of most of these vitamins can be States. TMA studies show that a large percent of
reduced by supplying adequate amounts of copper. the population has excessive tissue copper levels.
We can see particularly that the adverse effects of This varies geographically due to high copper or
hyper-vitaminosis A can be decreased by copper low zinc soils and hard or soft water regions. The
supplementation. Synergistic vitamins, those use of copper water pipes and dental prosthesis
whose requirements are increased by copper
103
Journal of Orthomolecular Medicine Vol. 4, No. 2, 1989
have contributed greatly to increased copper synergistic vitamins and minerals previously
intake. Copper also enters the food chain through discussed can also contribute to copper toxicity.
the addition of copper to animal feeds and use of These factors should be explored in relation to
copper in spraying vegetables and grains for the Wilson's disease, an inborn error of metabolism
prevention of fungus and algae growth.58 Reports resulting in toxic amounts of copper
have shown that copper intake in the United accumulation in the liver due to a lack of
States is approximately three to five milligrams Ceruloplasmin. Elevated hair copper levels do
per day. The copper intake in India is higher, not occur with Wilson's disease, but copper accu-
averaging almost six milligrams per day and in mulation in tissues and organs other than the liver
some areas as much as thirteen milligrams.59 eventually develops. Excessive copper retention
We have learned that metabolic differences will often develop in the eye, producing the
allow greater copper retention in some Kayser-Fleischer rings in the cornea which is a
individuals than others, even with the same diagnostic sign of this disease. Increased copper
exposure. We have observed through TMA accumulation has also been noted in individuals
studies that vegetarians appear to have a greater with sickle cell anemia.65
tendency to retain copper than non-vegetarians. A reduction or blockage in biliary excretion
Henkin60 reported that patients with adrenal can increase copper accumulation, even if copper
insufficiency had higher serum copper levels, intake is not excessive. This type of copper
which improved with hormonal therapy. An accumulation may develop over prolonged
increase in parasympathetic neuroendocrine periods involving several years. Excess estrogens
activity would predispose an individual to an are known to contribute to gall bladder stasis as
increased copper burden due to a decrease in well as cholesterol and calcium stone formation.
copper excretion. The parasympathetic The development of gallstones is found to have a
endocrines include the pancreas, parathyroid, and higher incidence in women, especially those who
anabolic steroids. Copper is a sedative mineral, have been pregnant.66 67 Elevation in estrogen
which when in excess, stimulates anabolic levels during pregnancy68 and oral contraceptive
activity and increases parasympathetic activity. use have been reported to consistently produce
TMA studies frequently reveal elevated tissue defects in the excretory functions of the liver.69
copper in women taking oral contraceptive agents Increased copper retention can develop as a result
which has been confirmed by others,61 62 as well of viral infections such as mononucleosis and
in women with copper interuterine devices. Since hepatitis.70 High tissue copper levels are
copper levels are noted to rise especially during frequently observed in individuals with a history
the last trimester of pregnancy, it is not unusual of these conditions. Whether excess tissue copper
to find multigravid women with excessive tissue causes viral manifestation or viral infections
copper accumulation, particularly if their cause elevated tissue copper accumulation is
pregnancies were not widely spaced. This will speculative at this time, but one wonders if the
also contribute to inherited copper toxicity in anti-viral effects of zinc could be due to the
children. antagonism of copper by zinc.
Copper toxicity can occur when there is a
deficiency of the antagonistic nutrients shown in Medications That May Contribute to Copper
figure 1 and 2, especially vitamin B6, B3, B5, A, Toxicity
and the minerals zinc and iron. The requirements The main excretory route for the removal of
for these nutrients are known to increase during copper is through the intestinal tract; therefore,
pregnancy, with oral contraceptive use, and any factor that inhibits intrahepatic or
estrogen therapy.63 Krishnamachari reported that extrahepatic excretion can potentially contribute
in individuals suffering from pellagra (B3 to copper toxicity. There are many medications
deficiency), copper absorption was increased. 64 other than estrogens that can contribute to choles-
Excessive intake of many of the tasis. These include phenothiazine derivatives,
104
The Nutritional Relationships of Copper
105
Journal of Orthomolecular Medicine Vol. 4, No. 2, 1989
Press, N.Y., 1977. 53. Hill CH, Starcher B: Effects of Reducing Agents
35. Watts DL: Determining Osteoporotic Tendencies on Copper Deficiency in the Chick. /. Nutr., 85,
from Tissue Mineral Analysis of Human Hair, 1965.
Type I and Type II. Townsend Newsletter For Drs. 54. Evans GW, Cornatzer WE: Biliary Copper
Aug./Sept., 1986. Excretion in the Rat. Proc. Soc. Exp. Biol. Med.
36. Klevay LM: Coronary Heart Disease: The 136, 1971.
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1975. Vol. II. Hoekstra, W.G., et al, Eds. Univ. Park
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Cholesterol Metabolism. Advances in Nutritional 56. Ibid.
Research. Draper, H.H., Ed. Plenum Pub., N.Y., 57. Klim RG et al: Intestinal Calcium Absorption in
1971. Exogenous Hypercorticism. Role of 25(OH) D and
38. Davies IJT: The Clinical Significance of the Corticosteroid Dose. /. Clin. Invest., 60, 1977.
EssentialBioligicalMetals. Charles Thomas, Pub., 58. Scheinberg IH, Sternlieb I: Copper Toxicity and
Ill, 1972. Wilson's Disease. Trace Elements in Human
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Level in in Idiopathic Scolosis, Preliminary Academic Press, N.Y., 1976.
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107
Journal of Orthomolecular Medicine Vol. 4, No. 2, 1989
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108