Copper

The normal reference range for Copper is Serum copper is typically around 11-22 μmol/L, though it runs higher in women, in pregnancy and on the oral contraceptive pill because oestrogen raises the carrier protein caeruloplasmin. It is best interpreted alongside caeruloplasmin rather than in isolation.. Reference ranges may vary between laboratories, so always consult your healthcare provider for interpretation.

Helps identify deficiencies or excesses that can affect energy production and immune function.

High copper is most often a reflection of inflammation, infection or pregnancy, since copper is an acute-phase reactant carried by caeruloplasmin, which rises with oestrogen and inflammation. Genuine copper overload is rare but important — Wilson's disease is a genetic disorder of copper accumulation (though serum copper can paradoxically be low while tissue copper is high). Excess supplementation and cholestatic liver disease can also raise it.

Low copper can cause anaemia (that does not respond to iron) and a low neutrophil count, and in severe cases nerve damage. The leading causes are excessive zinc intake (high-dose zinc supplements block copper absorption), malabsorption from coeliac or Crohn's disease, prior bariatric surgery, and inadequate dietary intake. The rare genetic Menkes disease causes severe deficiency in infants.

Copper is not a routine test. It is measured when investigating unexplained anaemia or low neutrophils, suspected zinc-induced copper deficiency, neurological symptoms, or possible Wilson's disease — usually together with caeruloplasmin. It is monitored in people on long-term zinc or after bariatric surgery.