Copper

Hair Copper (Cu) levels are usually indicative of body status with two exceptions: (1) addition of exogenous Cu (occasionally found in hair preparations or algaecides in swimming pools/hot tubs), and (2) low hair Cu in Wilson’s or Menkes’ diseases. In Wilson’s disease, Cu transport is defective and Cu accumulates, sometimes to toxic levels, in intestinal mucosa, liver and kidneys. At the same time, it is low in hair and deficient in other peripheral tissues. In Menkes’ disease, the activity of Cu dependent enzymes is very low. Cu supplementation is contraindicated in these diseases. Cu is an essential element that is required for the activity of certain enzymes. Erythrocyte superoxide dismutase (SOD) is a Cu (and zinc) dependent enzyme; lysyl oxidase which catalyzes crosslinking of collagen is another Cu dependent enzyme. Adrenal catecholamine synthesis is Cu dependent, because the enzyme dopamine beta-hydroxylase, which catalyzes formation of norepinephrine from dopamine, requires Cu. Symptoms of Cu deficiency include: elevated cholesterol, increased inflammatory responses, anemia, bone and collagen disorders, reproductive failure, and impaired immunity. Possible reasons for a Cu deficiency include: intestinal malabsorption, insufficient dietary intake,molybdenum excess,zinc excess, and chelation therapy. Cu status is adversely affected by excess of antagonistic metals such as mercury, lead, cadmium, and manganese. Confirmatory tests for Cu deficiency are serum ceruloplasmin to rule out Wilson’s disease (ceruloplasmin is deficient in Wilson’s disease), a whole blood or packed red blood cell elements analysis, and a functional test for Cu (barring zinc deficiency) is measurement of erythrocytes SOD activity. Erythrocyte SOD activity is subnormal with Cu deficiency.

Hair Copper (Cu) levels are usually indicative of body status, except that exogenous contamination may occur giving a false normal (or false high). Common sources of contamination include: permanent solutions, dyes, bleaches, and swimming pools/hot tubs in which Copper compounds have been used as algaecides.

Copper is an essential element that activates specific enzymes. Erythrocyte superoxide dismutase (SOD) is a Copper (and zinc) dependent enzyme; lysyl oxidase which catalyzes crosslinking of collagen is another Copper dependent enzyme. Adrenal catecholamine synthesis is Copper dependent, because the enzyme dopamine beta-hydroxylase, which catalyzes formation of norepinephrine from dopamine, requires Copper.

If hair Copper is in the normal range, this usually means tissue levels are in the normal range. However, under circumstances of contamination, a real Copper deficit could appear as a (false) normal. If symptoms of Copper deficiency are present, a whole blood or red blood cell elements analysis can be performed for confirmation of Copper status.