Most of the copper in the body is located in the liver, bones, and muscle, but traces of copper occur in all tissues of the body. The liver excretes excess copper into the bile for elimination from the body. Copper is a component of many enzymes, including ones that are necessary for the following:
Copper deficiency may be acquired or inherited.
Copper excess (toxicity) may also be acquired or inherited (as Wilson disease).
Copper deficiency is rare among healthy people. It occurs most commonly among infants who are
Some male infants inherit a genetic abnormality that causes copper deficiency. This disorder is called Menkes syndrome.
In adults, copper deficiency may be caused by
Disorders that impair absorption of nutrients (malabsorption disorders, such as celiac disease, Crohn disease, cystic fibrosis, or tropical sprue)
Weight-loss (bariatric) surgery
Consumption of too much zinc, which reduces the absorption of copper
Symptoms of copper deficiency include fatigue, anemia, and a decreased number of white blood cells. Sometimes, osteoporosis develops or nerves are damaged. Nerve damage can cause tingling and loss of sensation in the feet and hands. Muscles may feel weak. Some people become confused, irritable, and mildly depressed. Coordination is impaired.
Menkes syndrome causes severe intellectual disability, vomiting, and diarrhea. The skin lacks pigment, and the hair is sparse, steely, or kinky. Bones may be weak and malformed, and arteries are fragile, sometimes rupturing.
Consumption of excess copper is rare. People may consume small amounts of excess copper in acidic food or beverages that have been in copper vessels, tubing, or valves a long time.
Consuming even relatively small amounts of copper may cause nausea, vomiting, and diarrhea. Large amounts, usually consumed by people intending to commit suicide, can damage the kidneys, inhibit urine production, and cause anemia due to the rupture of red blood cells (hemolytic anemia) and even death.
Rarely, liver damage or cirrhosis occurs in children. It probably results from drinking milk that has been boiled or stored in corroded copper or brass vessels.
If large amounts of copper were consumed, the stomach is pumped.
If copper toxicity has caused problems such as anemia or has damaged the kidneys or liver, dimercaprol is injected into a muscle, or a drug that binds with copper, such as penicillamine, is given to remove excess copper. Children with liver damage are treated with penicillamine.
If used early, hemodialysis (a procedure that filters the blood) may be effective.
Occasionally, death occurs despite treatment.