What Depletes Copper from the Body? A Comprehensive Guide

October 26, 2025 •

4 min read

According to the Linus Pauling Institute, acquired copper deficiency in humans is uncommon, but when it does occur, it can lead to severe health issues. Numerous factors can cause this depletion, often involving impaired absorption or excessive loss of the mineral. This guide explores the various culprits behind copper depletion, from dietary interactions to medical conditions.

Quick Summary

Excessive zinc intake, certain medications, and malabsorption disorders like celiac disease can significantly deplete copper. Other factors include bariatric surgery, certain genetic conditions, and malnutrition. Understanding these causes is crucial for preventing and managing low copper levels.

Key Points

Excessive Zinc Intake: Taking too much zinc through supplements or other products can significantly inhibit copper absorption by upregulating the protein metallothionein.
Gastrointestinal Surgery: Procedures like gastric bypass can lead to malabsorption by reducing the area of the small intestine where copper is typically absorbed.
Malabsorption Disorders: Chronic conditions such as celiac disease and Crohn's disease can damage the intestinal tract, hindering the body's ability to absorb copper.
Genetic Conditions: Rare genetic disorders, including Menkes disease, directly impair the body's copper transport mechanisms, causing severe deficiency.
Chelating Medications: Certain drugs, like penicillamine used for Wilson's disease, are designed to bind with and eliminate copper from the body.
Chronic Illnesses: Conditions causing heavy protein loss, like nephrotic syndrome, can lead to increased copper excretion through the urine.
Nutritional Deficiencies: Extreme cases of malnutrition or diets lacking copper, especially in infants, can lead to primary copper depletion.

Dietary and Nutrient-Related Causes of Copper Depletion

Copper absorption and retention are influenced by several dietary and nutrient-related factors. While a balanced diet typically provides sufficient copper, imbalances can significantly impact its levels.

Excessive Zinc Intake

One of the most well-documented causes of copper depletion is excessive intake of zinc. Zinc and copper compete for absorption in the small intestine. The mechanism involves the upregulation of a protein called metallothionein, which binds to both zinc and copper but has a stronger affinity for copper. High levels of zinc increase metallothionein production, causing it to sequester copper within intestinal cells and prevent its transport into the bloodstream. This trapped copper is then eliminated from the body via the feces. This effect is so pronounced that zinc is used therapeutically to reduce copper absorption in patients with Wilson's disease, a genetic disorder involving copper overload.

Zinc supplementation: Regular, high-dose zinc supplementation, often taken for immune support or macular degeneration, is a common cause of this interaction. The tolerable upper intake level (UL) for zinc in adults is 40 mg per day, and exceeding this for prolonged periods increases the risk of copper deficiency.
Zinc-containing products: Some products, such as denture creams, contain high levels of zinc and have been linked to copper depletion in chronic users.

Other Nutritional Interactions

High Iron Intake: Excessive dietary iron can also decrease copper absorption. Studies have shown that infants consuming high-iron formula absorb less copper compared to those on low-iron versions.
High Fructose Diets: Animal studies have shown that very high fructose diets can worsen the effects of copper deficiency, though this is less clear in humans at normal consumption levels.
Phytates and Fiber: Certain copper-binding factors, like phytate (found in plant-based foods), can potentially reduce copper absorption.

Medical Conditions and Surgical Procedures

Several health issues and surgical interventions can lead to copper depletion by impairing absorption or increasing excretion.

Malabsorption Disorders

Conditions that affect the small intestine's ability to absorb nutrients can lead to copper deficiency.

Celiac Disease: An autoimmune disorder triggered by gluten that damages the small intestine lining, impeding nutrient absorption.
Crohn's Disease: A type of inflammatory bowel disease that causes chronic inflammation of the digestive tract.
Cystic Fibrosis: A genetic disorder causing thick mucus buildup, which can block the pancreatic ducts and impair the digestion and absorption of nutrients, including copper.
Chronic Diarrhea: Prolonged or severe diarrhea, often seen in infants recovering from malnutrition, can lead to nutrient loss and copper depletion.

Surgical Interventions

Bariatric Surgery: Weight-loss surgeries like gastric bypass significantly alter the digestive tract. By bypassing a large portion of the stomach and duodenum, they reduce the surface area available for copper absorption. This is a common and serious cause of acquired copper deficiency in adults.

Kidney Disease

Proteinuria: Conditions causing heavy proteinuria, a high level of protein in the urine, can lead to increased urinary excretion of copper, particularly the copper-binding protein ceruloplasmin.

Genetic and Inherited Conditions

Some genetic disorders directly interfere with copper metabolism, causing depletion despite adequate dietary intake.

Menkes Disease: This is a rare, X-linked recessive disorder caused by a defective gene (ATP7A) responsible for copper transport. It severely impairs intestinal copper absorption, leading to severe systemic deficiency and neurodegeneration.

Medications and Therapeutic Agents

Certain drugs can interfere with copper absorption or increase its excretion.

Penicillamine: Used to treat Wilson's disease and rheumatoid arthritis, this chelating agent binds to copper and promotes its elimination.
Antacids and Proton Pump Inhibitors: Medications that reduce stomach acid can hinder copper absorption, as an acidic environment is required to free copper from food for proper uptake.
Trientine: Another chelating agent used for Wilson's disease that, like penicillamine, can deplete copper levels.

Comparison of Common Copper Depletion Factors


Factor	Mechanism of Depletion	Primary Cause	Risk Severity
Excess Zinc Intake	Upregulates metallothionein, which traps copper in intestinal cells, preventing absorption.	Supplemental use, denture creams.	High, especially with prolonged, high doses.
Bariatric Surgery	Reduces the surface area of the small intestine, leading to malabsorption.	Surgical procedure for weight loss.	High, often requires lifelong monitoring and supplementation.
Malabsorption Disorders	Damages the intestinal lining, impairing nutrient uptake.	Celiac disease, Crohn's disease, cystic fibrosis.	Variable, depends on the severity and management of the condition.
Genetic Disorders	Inherited defects in copper transport or metabolism pathways.	Menkes disease (ATP7A mutation).	High to severe, often evident from infancy.
Chelating Drugs	Binds to copper and promotes its excretion from the body.	Penicillamine, Trientine (for treating Wilson's disease).	High, as it's the intended purpose of the treatment.

Conclusion

While copper deficiency is not common in the general population, several factors can deplete copper from the body. Excessive zinc intake, malabsorption disorders, and bariatric surgery are among the most frequently identified causes. Certain genetic disorders and medications also play a significant role. Recognizing these potential causes is critical, especially for individuals with risk factors, to allow for early diagnosis and appropriate intervention. Maintaining a balanced intake of minerals and consulting with a healthcare provider can help prevent serious complications associated with copper depletion, such as neurological issues, anemia, and weakened bones. For those at high risk, regular monitoring of copper status may be necessary to ensure long-term health.

Frequently Asked Questions

Yes, excessive zinc intake is one of the most common causes of acquired copper deficiency. Zinc competes with copper for absorption in the intestines, and high levels of zinc stimulate the production of metallothionein, which preferentially binds and traps copper, preventing its absorption.

Bariatric surgeries, particularly gastric bypass, alter the digestive anatomy by bypassing parts of the stomach and small intestine. This significantly reduces the area available for nutrient absorption, leading to deficiencies in various minerals, including copper.

Neurological symptoms of copper depletion can include myelopathy (spinal cord disease) leading to a spastic gait and sensory ataxia, peripheral neuropathy, and in some cases, optic neuropathy. These symptoms often mimic those of vitamin B12 deficiency.

Yes, prolonged use of antacids and other acid-reducing medications can decrease copper absorption. An acidic stomach environment is crucial for separating copper from food, a process that is inhibited when stomach acid is lowered.

Menkes disease is a rare, inherited genetic disorder that impairs the body's ability to transport and distribute copper due to a mutation in the ATP7A gene. It results in severe copper deficiency despite sufficient dietary intake.

Yes, hematological issues are a classic sign of copper deficiency. These can include anemia (often unresponsive to iron supplements), neutropenia (low neutrophil count), and leukopenia.

Diagnosis typically involves measuring serum copper and ceruloplasmin levels, which are often low in deficiency. However, these levels can be affected by other conditions like inflammation, so additional tests such as erythrocyte superoxide dismutase (SOD) activity may also be used.