Copper
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- Also Known As:
- Cu
- Urine Copper
- Blood Copper
- Free Copper
- Hepatic Copper
- Formal Name:
- Copper
- 24-hour urine
- blood
- and liver (hepatic) tissue

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At a Glance
Why Get Tested?
To measure the amount of copper in your blood, urine, or liver tissue; to help diagnose and monitor Wilson disease; sometimes to identify copper deficiency or excess
When To Get Tested?
When you have jaundice, fatigue, abdominal pain, behavioral changes, tremors, or other symptoms that a healthcare practitioner thinks may be due to Wilson disease or, rarely, to copper deficiency or excess; at intervals when you are being treated for a copper-related condition
Sample Required?
A blood sample is obtained by inserting a needle into a vein and/or a 24-hour urine sample is collected. Care must be taken, especially with a 24-hour urine sample, not to contaminate the sample with an external source of copper. Talk to your healthcare practitioner and/or the laboratory that will perform the test about necessary precautions. If a urine or blood copper test result is higher than expected, your healthcare practitioner may have the test repeated with a new sample to confirm the findings. Sometimes a healthcare practitioner performs a liver biopsy.
Test Preparation Needed?
None
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The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.
If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.
Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called “normal” values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.
While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are “within normal limits.”
For more information, please read the article Reference Ranges and What They Mean.
What is being tested?
Copper is an essential mineral that the body incorporates into enzymes. These enzymes play a role in the regulation of iron metabolism, formation of connective tissue, energy production within cells, the production of melanin (the pigment that produces skin color), and the function of the nervous system. This test measures the amount of copper in the blood, urine, or liver (hepatic).
Copper is found in many foods including nuts, chocolate, mushrooms, shellfish, whole grains, dried fruits, and liver. Drinking water may acquire copper as it flows through copper pipes, and food may acquire it when people cook or serve food in copper dishes.
- Normally, the body absorbs copper from food or liquids in the intestines, converts it to a non-toxic form by binding it to a protein, and transports it to the liver.
- The liver stores some of the copper and binds most of the rest to another protein called apoceruloplasmin to produce the enzyme ceruloplasmin. About 95% of the copper in the blood is bound to ceruloplasmin, and most of the rest is bound to other proteins such as albumin.
- Only a small amount is normally present in the blood in a free (unbound) state.
- The liver eliminates excess copper into the bile and it is removed from the body in the stool. Some copper is also eliminated in the urine.
Both excess and deficiency of copper are rare. Wilson disease, a rare inherited disorder, can lead to excess storage of copper in the eyes, liver, brain, and other organs. Copper excess (toxicity) can also occur with absorbing large amounts over a short period of time (acute exposure) or various amounts over a long period (chronic exposure).
Copper deficiency may occasionally occur in conditions associated with severe malabsorption, such as cystic fibrosis and celiac disease, and in infants exclusively fed cow-milk formulas. It can also occur in malnourished children as well as people who megadose zinc-containing vitamins.
A rare X-linked genetic condition called Menkes kinky hair syndrome leads to copper deficiency in the brain and liver of affected infants. The disease, which affects primarily males, is associated with seizures, delayed development, abnormal artery development in the brain, and unusual gray brittle kinky hair.
Common Questions
View Sources
Sources Used in Current Review
Sloan, Joshua DO, Feyssa, Eyob, MD, MPH, FACP, Staros, Eric B, MD. (2017 February 16) Copper. Medscape. Available online at https://emedicine.medscape.com/article/2087780-overview#showall. Accessed February 2020.
Menkes Syndrome. U.S. National Library of Medicine Genetics Home Reference. Available online at https://ghr.nlm.nih.gov/condition/menkes-syndrome. Accessed February 2020.
Wilson Disease. National Organization for Rare Disorders. Available online at https://rarediseases.org/rare-diseases/wilson-disease/. Accessed February 2020.
Copper, Serum. Mayo Clinic Laboratories. Available online at https://www.mayocliniclabs.com/test-catalog/Clinical+and+Interpretive/8612. Accessed February 2020.
Total Copper (Blood). University of Rochester Medical Center. Available online at https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=total_copper_blood. Accessed February 2020.
Tavill, Anthony S. (2017 August) MD. Wilson’s Disease. Cleveland Clinic Center for Continuing Education. Available online at http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/wilson-disease/. Accessed February 2020.
Sources Used in Previous Reviews
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry. AACC Press, Washington, DC. Bankson, D. Chapter 35, Vitamins and Trace Elements: Assessment of Micronutrient Status through Laboratory Testing. Pp. 399 410.
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp. 292-295.
Alexander, D. (2006 March 2, Updated). 24-hour urine Copper/Cu. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003604.htm. Accessed 7/21/07.
McGee, W. (2007 March 2, Updated). Copper in diet. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002419.htm. Accessed 7/25/07.
Perez, E. (2006 October 23, Updated). Copper poisoning. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002496.htm. Accessed 7/25/07.
(2004). Copper. ATSDR Division of Toxicology ToxFAQs [On-line information]. Available online at http://www.atsdr.cdc.gov/tfacts132.html. Accessed 7/25/07.
(2007 February 13, Updated). Menkes Disease Information Page. NINDS [On-line information]. Available online at http://www.ninds.nih.gov/disorders/menkes/menkes.htm. Accessed 7/25/07.
(2007 February 14). Zellweger Syndrome Information Page. NINDS [On-line information]. Available online at http://www.ninds.nih.gov/disorders/zellweger/zellweger.htm. Accessed 7/25/07.
Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition]. Pp. 441.
Copper. Merck Manual of Medical Information Second Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/print/sec12/ch155/ch155c.html. Accessed 7/17/07.
Das, S. and Ray, K. (2006 October 13). Wilsons Disease: An Update. Medscape from Nature Clinical Practice Neurology [On-line information]. Available online at http://www.medscape.com/viewarticle/543866. Accessed 7/27/07.
Turnlund, J. (2007 July, Reviewed). Copper. Linus Pauling Institute Micronutrient Research for Optimum Health, Micronutrient Information Center, Oregon State University [On-line information]. Available online at http://lpi.oregonstate.edu/infocenter/minerals/copper/. Accessed 9/16/07.
(2006 August 1). Copper. MedlinePlus Health Information, Herbs and Supplements [On-line information]. Previously available online at http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-copper.html. Accessed 9/16/07.
Barnes, N. et. al. (2005). The copper-transporting ATPases, menkes and wilson disease proteins, have distinct roles in adult and developing cerebellum. Medscape from J Biol Chem. 2005; 280(10): 9640-5 (ISSN: 0021-9258) [On-line abstract]. Available online at http://www.medscape.com/medline/abstract/15634671?src=emed_ckb_ref_0. Accessed 9/16/07.
Shim, H. and Harris, Z. L. (2003 May). Supplement: 11th International Symposium on Trace Elements in Man and Animals, Genetic Defects in Copper Metabolism. J. Nutr. 133: 1527S-1531S [On-line journal article]. Available online at http://jn.nutrition.org/cgi/content/full/133/5/1527S. Accessed 9/16/07.
Greco, F. (Updated 2009 January 20). 24-hour urine copper test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003604.htm. Accessed December 2010.
McMillin, G. and Roberts, W. (Updated 2010 May). Wilson Disease. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/WilsonDz.html?client_ID=LTD#tabs=0. Accessed November 2010.
Haldeman-Englert, C. (Updated 2010 September 10). Wilson’s disease. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000785.htm. Accessed November 2010.
Johnson, L. (Revised 2008 August). Copper. Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merckmanuals.com/professional/sec01/ch005/ch005c.html?qt=wilson disease&alt=sh#sec01-ch005-ch005c-534. Accessed November 2010.
McMillin, G. et. al. (2009 August 25). Direct Measurement of Free Copper in Serum or Plasma Ultrafiltrate. Medscape Today from American Journal of Clinical Pathology. 2009;131(2):160-165. [On-line information]. Available online at http://www.medscape.com/viewarticle/707416. Accessed November 2010.
Kaler, S. (Updated 2009 May 28). Menkes Kinky Hair Disease. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/946985-overview. Accessed November 2010.
(© 1995-2010). Unit Code 8612: Copper, Serum. Mayo Clinic, Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/8612. Accessed November 2010.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 292-295.
Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER, Bruns DE, eds. St. Louis: Elsevier Saunders; 2006, Pp 556-559, 1126-1130, 1378-1379.
Sloan, J. and Feyssa, E. (2014 March 4). Copper. Medscape Drugs & Diseases [On-line information]. Available online at http://emedicine.medscape.com/article/2087780-overview. Accessed December 2014.
Johnson, L. (Revised 2013 April). Copper Deficiency and Toxicity. Merck Manual Professional Edition [On-line information]. Available online through http://www.merckmanuals.com. Accessed December 2014.
Haldeman-Englert, C. (2013 January 4). 24-hour urine copper test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003604.htm. Accessed December 2014.
(© 1995–2014). Copper, Serum. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/8612. Accessed December 2014.
Strathmann, F. (Updated 2014 March). Trace Minerals. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/TraceMinerals.html?client_ID=LTD#tabs=0. Accessed December 2014.
Gilroy, R. (Updated 2014 May 2). Wilson Disease. Medscape Drugs & Diseases [On-line information]. Available online at http://emedicine.medscape.com/article/183456-overview. Accessed December 2014.
(Last updated: 3/8/2011) Genetic and Rare Diseases Information Center (GARD). Menkes Disease. Available online at http://ghr.nlm.nih.gov/condition/menkes-syndrome. Accessed January 2015.
(Reviewed March 2009) Genetics Home Reference. Menkes Syndrome. Available online at http://rarediseases.info.nih.gov/gard/1521/menkes-disease/resources/1. Accessed January 2015.
(Reviewed January 2014) Linus Pauling Institute. Micronutrient Information Center, Copper. Available online at http://lpi.oregonstate.edu/infocenter/minerals/copper/#deficiency. Accessed January 2015.
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