Copper and ceruloplasmin

Copper (Cu)

Copper is an essential traceelement that is involved in:
✔ Formation of hemoglobin (together with iron).
The work of antioxidant enzymesEnzymes are proteins that accelerate chemical reactions in the body. They ensure the occurrence of metabolic processes such as food digestion, energy release, cell formation, and many others. (superoxide dismutase, cytochrome c oxidase).
✔ Synthesis of collagenCollagen is a fibrillar protein, one of the main building elements of the body. It constitutes a significant part of connective tissues such as skin, tendons, joints, bones, and cartilage. Collagen provides strength, elasticity, and structural integrity to these tissues, giving them the ability to resist stretching. and elastin (important for skin, blood vessels, bones).
✔ Functioning of the nervous system (participates in the synthesis of neurotransmitters).
✔ Energy exchange (mitochondrial respiration).

Ceruloplasmin

Ceruloplasmin is a copper-containing proteinthat:
✔ Transports 90% of the copper in the blood.
✔ Participates in iron metabolism (oxidizes Fe2⁺ to Fe3⁺ to bind to transferrin).
✔ It has antioxidant properties (protects cells from oxidative stress).

Symptoms of copper and ceruloplasmin deficiency

Causes of the deficit:

Genetic disorders (Menkes disease -a mutation in the ATP7A gene ).
Long -term parenteral nutrition (without copper).
Excess zinc (competing for intestinal absorption).

Symptoms:

Anemia (not treatable with iron).
Fragility of blood vessels and bones (violation of collagen synthesis).
Neurological disorders (seizures, developmental delay in children).
Depigmentation of the skin and hair (disruption of tyrosinase).
Reduced immunity (frequent infections).

Symptoms of excess copper and ceruloplasmin

Causes of excess:

Genetic disease Wilson-Konovalov disease (violation of copper excretion).
Chronic liver diseases (cirrhosis, cholestasis).
Copper poisoning (rare).

Symptoms:

Liver damage(hepatitis, cirrhosis).
Neurological disorders (tremor, dysarthria, dementia).
Kaiser-Fleischer rings (greenish-brown rings around the edge of the cornea).
Mental disorders (depression, psychosis).

Norms in analyses

Copper in the blood (serum)

Group	Norm (mcg / dl)	Norm (mmol / l)
Adults	70–140	11–22
Children	50–120	8–19
Pregnant women	90–230	14–36

Ceruloplasmin in the blood

Group	Norm (mg / dl)	Norm (g / l)
Adults	20–60	0.2–0.6
Children	15–50	0.15–0.5

Copper in daily urine

Norm: < 50 mcg/day (< 0.8 mmol/day).
For Wilson’s disease: > 100 mcg / day.

When are tests scheduled?

Suspected Wilson’s disease (neurological symptoms + liver damage).
Anemiathat cannot be treated with iron.
Assessment of nutrition status (with parenteral nutrition).
Diagnosis of Menkes ‘ disease in children (hypotension, developmental delay).

What should I do if there are deviations?

With a copper deficiency:

Diet: liver, seafood, nuts, cocoa.
Supplements: copper gluconate (2-4 mg / day).

If there is an excess of copper (Wilson’s disease):

Chelators (penicillamine, trientin).
Zinc (blocks the absorption of copper in the intestines).
Diet: avoid copper-rich foods (chocolate, mushrooms, shellfish).

Examples of interpretation

Copper in the blood = 30 mcg / dl + anemia → deficiency, need supplements.
Ceruloplasmin = 10 mg / dl + Kaiser-Fleischer rings → Wilson’s disease.

Conclusion

Copper and ceruloplasmin are key elements for antioxidant protection, iron metabolism, and nervous system function.
🔹 Rules:

Copper: 70-140 mcg / dl (serum),
Ceruloplasmin: 20-60 mg / dl.
Deficiency causes anemia, neurological disorders.
Excess (Wilson’s disease) leads to liver and brain damage.
Treatment: diet, chelators (in excess), copper supplements (in deficiency).

Important: If Wilson’s disease is suspected, check the copper in the urine and the level of free copper in the blood.