Copper (Cu)
Copper is an essential trace element. It is required for ferro-oxidase activity which is an essential stage for incorporation of iron into haem. Copper is absorbed in the intestines and then transported to the liver, where it is stored or used in the production of a variety of enzymes. Caeruloplasmin is a copper-containing enzyme that plays a role in the body’s iron metabolism. In the blood, 95 % is bound to caeruloplasmin and 5 % is free. It is used in conjunction with serum copper assay to help diagnose Wilson’s disease and evaluate copper metabolism.
Iatrogenic deficiency (eg. total parenteral nutrition, excess zinc replacement, bariatric surgery)
Inborn errors (eg. Wilson’s and Menkes diseases).
Decreased serum copper and caeruloplasmin, plus an elevated urinary copper are seen in Wilson’s disease.
Monitoring of chelation therapy for treatment of Wilson’s disease and/or copper overload
Symptoms including: anaemia, nausea with abdominal pain, jaundice, dysphagia, tremors, behavioural changes, Kayser-Fleischer rings and tremors
Serum
| Adult | 12.0 – 20.0 µmol/L |
| 0 – 4 months | 1.4-7.2 µmol/L |
| 4 – 6 months | 3.9-17.3 µmol/L |
| 6 months – 9 years | 11.1-27.4 µmol/L |
| 9 years – 13 years | 11.3-23.7 µmol/L |
| 13 years to 19 years | 9.1-22.5 µmol/L |
Urine
| <0.3 µmol/L |
| <76 nmol/mmol creatinine |
| <0.7 µmol/24hr |
Copper absorption is blocked by zinc. Patients on long-term zinc replacement may suffer from copper deficiency.
Grossly haemolysed plasma or serum samples are unsuitable for this assay.
Record last updated
September 8, 2025
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