Copper is a mineral found in trace amounts in all tissues in the body. Although only a small amount is needed, copper is an essential nutrient that plays a role in the production of hemoglobin (the main component of red blood cells), myelin (the substance that surrounds nerve fibers), collagen (a key component of bones and connective tissue), and melanin (a dark pigment that colors the hair and skin). Copper also works with vitamin C to help make a component of connective tissue known as elastin.

Copper can act as both an antioxidant and a pro-oxidant. As an antioxidant, it scavenges damaging particles in the body known as free radicals. Free radicals occur naturally in the body and can damage cell walls, interact with genetic material, and possibly contribute to the aging process as well as the development of a number of health conditions. Antioxidants can neutralize free radicals and may reduce or even help prevent some of the damage they cause.

When copper acts as a pro-oxidant at times, it promotes free radical damage and may contribute to the development of Alzheimer's disease and, possibly, cervical dysplasia (precancerous lesions of the cervix which forms the opening to the uterus). Maintaining the proper dietary balance of copper (along with other minerals such as zinc and manganese) is important. Your doctor or dietitian can help you do this.

Signs of possible copper deficiency include anemia, low body temperature, bone fractures and osteoporosis, low white blood cell count (the cells that help fight infection), irregular heartbeat, loss of pigment from the skin, and thyroid disorders. Infants who are deficient in this mineral tend to have poor feeding habits and lack proper growth.

Anemia

Copper supplementation may be beneficial for individuals with anemia (a condition characterized by low hemoglobin levels) because this mineral works together with iron to form hemoglobin.

Arthritis

Animal studies suggest that oral copper supplements reduce the development and progression of arthritis. Many people with arthritis (both rheumatoid and osteo) apply copper solutions to their skin or wear copper bracelets in hopes of relieving pain and inflammation associated with this joint condition. Reports of success with these methods, however, are mixed, but one study from the 1970s did show that the copper bracelets worked better than placebo bracelets. Sweat can interfere with how well the topical copper solutions and bracelets work.

Burns

When skin is burned, a substantial percentage of micronutrients, such as copper, selenium, and zinc may be lost. This increases the risk for infection, slows the healing process, prolongs the hospital stay, and even increases the risk of death. Although it is unclear which micronutrients are most beneficial for people with burns, many studies suggest that a multivitamin including copper and other minerals may aid in the recovery process.

Inflammatory Bowel Disease (IBD)

Given the nature of IBD, including ulcerative colitis and Crohn's disease, which is characterized by bloody diarrhea, people with this condition can easily lose essential vitamins and minerals, such as copper. When treating IBD, clinicians often recommend a multivitamin containing essential minerals.

In addition, inflammatory bowel disease may be related to damage caused by free radicals. In fact, copper levels may be low in the inflamed tissue of those with IBD, particularly Crohn's disease.

Finally, lab rats deficient in copper tend to have elevated blood sugar levels over time, indicating a possible connection between low copper and diabetes. A study including people with diabetes, however, found very different results. Copper levels were higher in people with diabetes compared to those without. In fact, the higher the copper, the more likely the person was to have complications from the diabetes including retinopathy (damage to the retina of the eye), high blood pressure, or vascular disease.

Among the best dietary sources of copper are:

• Seafood (such as oysters, squid, lobster, mussels, crab, and clams)
• Organ meats (such as beef liver, kidneys, and heart)
• Nuts and nut butters (such as cashews, filberts, macadamia nuts, pecans, almonds, and pistachios)
• Legumes (such as soybeans, lentils, navy beans, and peanuts)
• Chocolate (such as unsweetened or semisweet baker's chocolate and cocoa)
• Enriched cereals (such as bran flakes, shredded wheat, and raisin bran)
• Fruits and vegetables (such as dried fruits, mushrooms, tomatoes, potatoes, sweet potatoes, bananas, grapes, and avocado)
• Blackstrap molasses
• Black pepper

Multivitamins that include minerals generally provide copper. But, copper is also available as an individual oral supplement. Copper is also available as a healing bracelet and in topical solutions.

The most effective way to obtain sufficient amounts of copper is through the diet. Proper absorption and metabolism of copper requires an appropriate balance with the minerals zinc and manganese. The following lists provide the recommended daily dietary intake of copper for children and adults.

Pediatric

• Infants birth to 6 months: 200 mcg (AI)
• Infants 7 to 12 months: 220 mcg (AI)
• Children 1 to 3 years: 340 mcg (RDA)
• Children 4 to 8 years: 440 mcg (RDA)
• Children 9 to 13 years: 700 mcg (RDA)
• Children 14 to 18 years: 890 mcg (RDA)

Copper supplements should not be given to children.

Adult

• 19 years and older: 900 mcg (RDA)
• Pregnant females: 1000 mcg (RDA)
• Breastfeeding females: 1,300 mcg (RDA)

Adults taking copper supplements should also take zinc supplements (8 to 15 mg of zinc for every 1 mg of copper) as an imbalance of these two minerals can cause thyroid problems.

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider.

Excessive copper intake can cause nausea, vomiting, stomach pain, headache, dizziness, weakness, diarrhea, and a metallic taste in the mouth. Copper toxicity is rare but can cause heart problems, jaundice, coma, and even death.

Copper overload may occur from using copper cookware and from water supplied by copper pipes on a regular basis. Copper can leach out of pipes into water, especially hot water, if it sits in copper pipes for an extended period of time. It is best to always cook with cold water. Flushing the system by running cold water for 2 to 3 minutes is an effective way to reduce copper. Also, it is best to avoid unlined copper cookware since copper can leach into acidic foods such as vinegar, tomato, or citrus. If you have blue-green stains around your faucet or sink, or if you detect a metallic taste to your water, you may want to have your water tested by a certified laboratory.

Children and individuals with Wilson's disease, a hereditary syndrome that results in an accumulation of copper in the brain, liver, kidneys, and eyes, should not take copper supplements. Because high intakes of zinc and iron can impair absorption of copper, zinc has been used to decrease copper in people suffering from of Wilson's disease.

If you are currently being treated with any of the following medications, you should not use copper supplements without first talking to your healthcare provider.

Birth Control Medications and Estrogen following menopause
Birth control medications and estrogen replacement for post-menopausal women can increase blood levels of copper. Therefore, copper supplements are not appropriate and may be cause for concern in individuals taking either of these medications.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Copper binds to NSAIDs (such as ibuprofen and naproxen) and appears to enhance their anti-inflammatory activity.

Penicillamine
Penicillamine (a medication used to treat Wilson's disease and rheumatoid arthritis) reduces copper levels that may be the intended use, as in the case of Wilson's disease.

Allopurinol
Test tube studies suggest that allopurinol, a medication used to treat gout, may reduce copper levels.

Cimetidine
Animal studies show that cimetidine, a medication used to treat ulcers and gastric esophageal reflux disease (when acid from the stomach enters the esophagus and causes heartburn and indigestion), may elevate copper levels in the body leading to damage of the liver and other organs.

Aggett PJ. An overview of the metabolism of copper. Eur J Med Res. 1999;4:214-216.

Antoon AY, Donovan DK. Burn Injuries. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics. Philadelphia, Pa: W.B. Saunders Company; 2000:287-294.

Asseth J, Haugen M, et al. Rheumatoid arthritis and metal compounds—perspectives on the role of oxygen radical detoxification. Analyst. 1998;123:3–6.

Berg G, Kohlmeier L, Brenner H. Effect of oral contraceptive progestins on serum copper concentration. Eur J Clin Nutr. 1998;52(10):711-715.

Berger MM, Spertini F, Shenkin A, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a double-bline, placebo-controlled trial. Am J Clin Nutr. 1998;68(2):365-371.

Camara K, Danao-Camara T. Awareness of, use and perception of efficacy of alternative therapies by patients with inflammatory arthropathies. Hawaii Med J. 1999;58(12):329-332.

Christen Y. Oxidative stress and Alzheimer's disease. Am J Clin Nutr. 2000;71(2):621S-629S.

Clemente C, Russo F, Caruso MG et al. Ceruloplasmin serum level in post-menopausal women treated with oral estrogens administered at different times. Horm Metab Res. 1992;24:191.

Crews MG, Taper LJ, Ritchey SJ. Effects of oral contraceptive agents on copper and zinc balance in young women. Am J Clin Nutr. 1980;33:1940.

Cunningham JJ. Micronutrients as nutriceutical interventions in diabetes mellitus. J Am Coll Nut. 1998;17(1):7-10.

De-Souza DA, Greene LJ. Pharmacological nutrition after burn injury. J Nutr. 1998;128:797-803.

Dorea JG, Ferraz E, Queiroz EF. [Effects of anovulatory steroids on serum levels of zinc and copper]. Arch Latinoam Nutr. 1982;32(1):101-110.

Garrison Jr RH, Somer E. The Nutrition Desk Reference. 3rd ed. New Canaan, Conn: Keats Publishing Inc; 1995:188–192.

Geerling BJ, Badart-Smook A, Stockbrügger RW, Brummer R-JM. Comprehensive nutritional status in recently diagnosed patients with inflammatory bowel disease compared with population controls. Eur J Clin Nutr. 2000;54:514-521.

Geerling BJ, Stockbrugger RW, Brummer R-JM. Nutrition and inflammatory bowel disease: an update. Scand J Gastroenterol. 1999;34(suppl 230):95-105.

Hardman JG, Gilman AG, Limbird LE, eds. Goodman and Gilman's Pharmacological Basis of Therapeutics. 9th ed. New York, NY: McGraw-Hill; 1996:1325–1326.

Horwitt MK, Harvey CC, Dahm CH Jr. Relationship between levels of blood lipids, vitamins C, A, and E, serum copper compounds, and urinary excretions of tryptophan metabolites in women taking oral contraceptive therapy. Am J Clin Nutr. 1975;28(4):403-412.

Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press; 2001. Accessed at http://books.nap.edu/books/0309072794/html/177.html.

Kirschmann GJ, Kirschmann JD. Nutrition Almanac. 4th ed. New York: McGraw-Hill;1996.

Klein D, Lichtmannegger J, Heinzmann U, Summer KH. Dissolution of copper-rich granules in hepatic lysosomes by D-penicillamine prevents the development of fulminant hepatitis in Long-Evans cinnamon rats. J Hepatol. 2000;32(2):193-201.

Lih-Brody L, Powell SR, Collier KP, Reddy GM, Cerchia R, Kahn E, et al. Increased oxidative stress and decreased antioxidant defenses in mucosa of inflammatory bowel disease. Digest Dis Sci. 1996;41(10):2078-2086.

Linder MC. Copper. In: Ziegler EE, Filer LJ, eds. Present Knowledge in Nutrition. 7th ed. Washington, DC: International Life Sciences Institute; 1996:307-319.

Malkiel S, Har el R, Schwalb H, et al. Interaction between allopurinol and copper: possible role in myocardial protection. Free Radic Res Commun. 1993; 18(1):7-15.

Mazzetti I, Grigolo B, Borzai RM, Meliconi R, Facchini A. Serum copper/zinc superoxide dismutase levels in patients with rheumatoid arthritis. J Clin Lab Res. 1996;26(4):245–249.

Meyer NA, Muller MJ, Herndon DN. Nutrient support of the healing wound. New Horizons. 1994;2(2):202-214.

Miche H, Brumas V, Berthon G. Copper(II) interactions with nonsteroidal antiinflammatory agents. II. Anthranilic acid as a potential. OH-inactivating ligand. J Inorg Biochem. 1997 Oct;68(1):27-38.

Milanino R, Marrella M, Crivellente F, Benoni G, Cuzzolin L. Nutritional supplementation with copper in the rat. Effects on adjuvant arthritis develoment and on some in vivo- and ex vivo-markers of blood neutrophils. Inflamm Res. 2000;49(5):214-223.

Naveh Y, Weis P, Chung HR, et al. Effect of cimetidine on tissue distribution of some trace elements and minerals in the rat. J Nutr. 1987;117:1576-1587.

Olivares M, Uauy R. Copper as an essential nutrient. Am J Clin Nutr. 1996;63:791S–796S.

Otomo S, Sasajima M, Ohzeki M, Tanaka I. Effects of D-penicillamine on vitamin B6 and metal ions in rats [in Japanese]. Nippon Yakurigaku Zasshi. 1980;76(1):1-13.

Pennington JA, Schoen SA. Total diet study: estimated dietary intakes of nutritional elements. Int J Vitam Nutr Res. 1996;66:350–362.

Physicians' Desk Reference. 54th ed. Montvale, NJ: Medical Economics Co., Inc.; 2000:1776-1778.

Pizzorno JE, Murray MT. Textbook of Natural Medicine. Vol 1. 2nd ed. Edinburgh: Churchill Livingstone; 1999.

Rottkamp CA, Nunomura A, Raina AK, Sayre LM, Perry G, Smith MA. Oxidative stress, antioxidants, and Alzheimer's disease. Alzheimer Disease Assoc Disorders. 2000;14(Suppl 1):S62-S66.

Shils ME, Olson JA, Shike M, Ross AC. Modern Nutrition in Health and Disease. 9th ed. Baltimore, Md: Williams & Wilkins; 1999:241–252.

Southwood TR, Malleson PN, Roberts-Thomson PJ, Mahy M. Unconventional remedies used for patients with juvenile arthritis. Pediatrics. 1990;85(2):150-154.

Sturniolo GC, Mestriner C, Lecis PE, et al. Altered plasma and mucosal concentrations of trace elements and antioxidants in active ulcerative colitis. Scand J Gastroenterol. 1998;33(6):644-649.

Struthers GR, Scott DL, Scott DG. The use of 'alternative treatments' by patients with rheumatoid arthritis. Rheumatol Int. 1983;3(4):151-152.

Thomson SW, Heimburger DC, Cornwell PE, et al. Correlates of total plasma homocysteine: folic acid, copper, and cervical dysplasia. Nutrition. 2000;16(6):411-416.

Tyrer LB. Nutrition and the pill. J Reprod Med. 1984;29(7 Suppl):547-550.

Uauy R, Olivares M, Gonzalez M. Essentiality of copper in humans. Am J Clin Nutr. 1998;67(5 suppl):952S–959S.

Walker WR, Beveridge SJ, Whitehouse MW. Dermal copper drugs: the copper bracelet and cu(II) salicylate complexes. Agents Actions Suppl. 1981;8:359-367.

Walker WR, Keats DM. An investigation of the therapeutic value of the 'copper bracelet'-dermal assimilation of copper in arthritic/rheumatoid conditions. Agents Actions. 1976;6(4):454-459.

Walter Rm jr, Uriu-hare JY, Olin KL, Oster MH, Anawalt BD, Critchfield JW, Keen CL. Copper, zinc, manganese, and magnesium status and complications of diabetes mellitus. Diabetes Care. 1991;14(11):1050-1056.

Wapnir RA. Copper absorption and bioavailability. Am J Clin Nutr. 1998;67(5):1054s.

Werbach MR. Nutritional Influences on Illness. 2nd ed. Tarzana, Calif: Third Line Press; 1996:655–680.