Copper: What Your Lab Value Reveals

What is copper?

Copper is a trace element that is important for cell metabolism. It also helps the body to absorb iron from the gastrointestinal tract.

Copper is absorbed through food from the small intestine. Relevant amounts of copper are contained in nuts, meat, beans and cereal products, for example. People absorb around four milligrams of the trace element per day through their diet. The body’s copper content is between 50 and 150 milligrams.

In the blood, copper binds to the transport protein albumin, which transports it to the liver. There, the trace element can be bound to coeruloplasmin and transported to where it is needed. Excess copper is mainly excreted with the bile and thus via the intestine, and in smaller quantities via the kidneys with the urine and partly via breast milk.

When are copper levels determined?

Copper – normal values

The copper level can be measured in the blood serum. It is expressed in micrograms per deciliter (µg/24h) or micromoles per liter (µmol/l). The following standard values apply:

Gender or age

Standard value

Premature babies

17 – 44 µg/dl

2.7 – 7.7 µmol/l

0 to 4 months

9 – 46 µg/dl

1.4 – 7.2 µmol/l

4 to 6 months

25 – 110 µg/dl

3.9 – 17.3 µmol/l

7 to 12 months

50 – 130 µg/dl

7.9 – 20.5 µmol/l

1 to 5 years

80 – 150 µg/dl

12.6 – 23.6 µmol/l

6 to 9 years

84 – 136 µg/dl

13.2 – 21.4 µmol/l

10 to 13 years

80 – 121 µg/dl

12.6 – 19.0 µmol/l

14 to 19 years

64 – 117 µg/dl

10.1 – 18.4 µmol/l

Women

74 – 122 µg/dl

11.6 – 19.2 µmol/l

men

79 – 131 µg/dl

12.4 – 20.6 µmol/l

Sometimes the copper content in the urine is also determined. A simple urine sample is not taken, but the urine is collected over 24 hours. The copper concentration in this 24-hour urine collection is then measured in the laboratory. It is normally 10 – 60 µg/24h or 0.16 – 0.94 µmol/24h.

Copper deficiency in the blood occurs in the following cases:

  • Wilson’s disease (copper storage disease)
  • Menkes syndrome (congenital disorder of copper absorption in the intestine)
  • Nephrotic syndrome (combination of various symptoms caused by kidney damage)
  • Malnutrition, for example with artificial feeding (especially in newborns and infants)

Diarrhea and stomach cramps often accompany copper deficiency. Symptoms of iron deficiency anemia often occur additionally because the copper deficiency impairs iron absorption in the intestine.

When are copper levels elevated?

Too much copper is found in the blood in the following cases:

  • acute inflammation
  • liver diseases
  • Acute blood cancer (acute leukemia)
  • certain forms of anemia (aplastic anemia)
  • thyrotoxicosis (acute, life-threatening metabolic derailment, especially in people with hyperthyroidism)

If the concentration of copper in the body is greatly increased, this is also referred to as “copper poisoning”.

Too much copper in the urine indicates the copper storage disease Wilson’s disease.

What to do if the copper level is increased or decreased?

If the copper level in the blood or urine is too high or too low, the doctor will try to determine the cause. This may require further laboratory tests and examinations, for example the determination of coeruloplasmin. If the cause is found, suitable treatment will be initiated if possible. The copper level can then also return to normal.