What Depletes Your Body of Copper?: A Guide to Causes and Risk Factors

October 21, 2025 •

5 min read

While dietary copper deficiency is rare, affecting only a fraction of the population, a 2017 study reported the case of a patient with excessive alcohol consumption who developed a severe copper deficiency, demonstrating how various risk factors can deplete your body of copper. Understanding these causes is crucial for preventing serious health complications associated with low copper levels.

Quick Summary

Zinc supplementation, bariatric surgery, chronic malabsorption, excessive iron intake, and genetic disorders are primary causes of copper depletion. These factors interfere with copper absorption or metabolism, leading to potential deficiency.

Key Points

Excessive Zinc Intake: High-dose, long-term zinc supplementation can directly inhibit copper absorption by altering a key intestinal protein, making it a common cause of acquired deficiency.
Bariatric and GI Surgeries: Surgical procedures like Roux-en-Y gastric bypass bypass the duodenum, the primary site of copper absorption, significantly increasing the risk of deficiency post-surgery.
Malabsorption Syndromes: Chronic conditions such as celiac disease and Crohn's disease damage the intestinal lining, impairing overall nutrient absorption, including copper.
High Iron Intake: Excessive iron, often from long-term high-dose supplements, can antagonize copper absorption, disrupting the copper-dependent metabolic pathways and potentially causing anemia.
Genetic Factors: Inherited disorders like Menkes disease cause severe copper deficiency from birth due to a mutation that prevents proper copper transport into the bloodstream.
Chronic Alcoholism: Long-term heavy alcohol use can lead to copper depletion through malnutrition and potential interference with copper metabolism and absorption.
Certain Medications: Drugs that chelate heavy metals or alter stomach acid can reduce copper levels in the body over time.

Introduction to Copper's Crucial Role

Copper is an essential trace mineral involved in a wide array of physiological processes, from energy production and iron metabolism to maintaining a healthy nervous and immune system. Although the body only requires a small amount, a persistent deficiency can lead to serious health issues, including anemia, neurological problems, and bone abnormalities. While most people get enough copper from their diet, specific conditions and lifestyle factors can significantly disrupt the body's copper balance.

Zinc Overload: A Common Cause of Copper Depletion

One of the most frequent and preventable causes of acquired copper deficiency is excessive zinc intake. Zinc and copper compete for absorption in the intestines via the same pathway, a process mediated by a protein called metallothionein. When zinc intake is high, it stimulates increased production of metallothionein, which has a higher affinity for copper. This results in the metallothionein trapping copper and preventing its absorption, leading to a functional copper deficiency. This is a particular risk for individuals who take high-dose zinc supplements over a prolonged period, or for those who use excessive amounts of zinc-containing products like denture cream. The recommended daily intake of zinc should not exceed the Tolerable Upper Intake Level (UL) of 40 mg for adults, as higher doses can disrupt the copper-zinc ratio.

Bariatric Surgery and Impaired Absorption

Gastric bypass and other bariatric surgeries are major risk factors for copper depletion. The majority of copper absorption takes place in the stomach and the duodenum (the first part of the small intestine). Procedures like Roux-en-Y gastric bypass reroute the digestive tract, causing food to bypass these key absorption sites. Over time, this significantly reduces the body's ability to absorb dietary copper, leading to a deficiency. Patients undergoing these surgeries require lifelong monitoring and supplementation to prevent nutritional deficiencies, including copper. The risk is particularly high in procedures like biliopancreatic diversion with duodenal switch, where deficiency has been reported in up to 90% of patients.

Malabsorption Syndromes and Chronic GI Disorders

Conditions that cause chronic intestinal malabsorption can severely compromise copper levels. Diseases like celiac disease, Crohn's disease, and other inflammatory bowel diseases damage the lining of the small intestine, impairing its ability to absorb nutrients effectively. In addition, other gastrointestinal issues such as chronic diarrhea, short gut syndrome, or small intestinal bacterial overgrowth (SIBO) can also lead to copper depletion over time. In these cases, the underlying gastrointestinal disorder must be treated and managed, often in conjunction with copper supplementation, to restore normal levels.

The Role of Excess Iron

While often a cause of anemia itself, a less-known effect of excess iron intake is its antagonistic relationship with copper. High dietary iron can interfere with copper transport and absorption, effectively increasing the body's copper requirement. This can occur with high-dose iron supplementation, and it is a particular concern for vulnerable populations like pregnant women and children who receive iron supplements. When copper is deficient, the body's ability to properly utilize iron for red blood cell formation is also impaired, as a copper-dependent enzyme (ceruloplasmin) is necessary for iron metabolism. This can result in an anemia that is unresponsive to iron supplementation alone.

Inherited Genetic Disorders

Rarely, copper deficiency can be caused by genetic conditions. Menkes disease is an inherited disorder caused by a mutation in the ATP7A gene, which impairs the transport of copper from the intestinal cells into the bloodstream. Infants with this condition suffer from severe copper deficiency and associated neurological, connective tissue, and developmental problems. Occipital Horn Syndrome, a milder variant, also involves a defect in the same copper-transporting enzyme. These genetic factors are distinct from acquired deficiencies but highlight the critical role of copper transport proteins.

Lifestyle and Other Factors

Several other elements can contribute to copper depletion, often in conjunction with other underlying issues:

Excessive Alcohol Consumption: Chronic alcoholism is often associated with poor nutrition and malabsorption. Ethanol can also directly impact the metabolism of trace elements like copper and zinc, and case reports have documented severe copper deficiency in heavy drinkers.
High Phytate or Fiber Diets: Some components found in plant-based foods, such as phytates and fiber, can bind to minerals and potentially reduce their absorption. While most vegan diets provide sufficient copper, individuals with extremely high intake of these compounds and otherwise low copper status may be at risk.
Certain Medications: Some drugs can interfere with copper absorption. Histamine blockers, which reduce stomach acid, may inhibit copper uptake, and chelating agents used to treat heavy metal toxicity (including Wilson's disease) are designed to deplete copper.

Comparison of Major Copper Depleting Factors


Factor	Mechanism of Depletion	Primary Population at Risk
Excess Zinc Intake	Zinc competes with copper for absorption in the small intestine, leading to increased metallothionein production that sequesters copper.	Individuals taking high-dose, long-term zinc supplements or using excessive zinc-containing products like denture cream.
Bariatric Surgery	Surgical modification of the digestive tract bypasses the duodenum, where most copper absorption occurs.	Patients who have undergone Roux-en-Y gastric bypass, biliopancreatic diversion, or other bariatric procedures.
Malabsorption Syndromes	Chronic damage to the intestinal lining impairs the small intestine's ability to absorb copper and other nutrients effectively.	Patients with celiac disease, inflammatory bowel disease (Crohn's), or short bowel syndrome.
Excess Iron Intake	High levels of dietary or supplemental iron can interfere with copper transport and absorption through competitive and metabolic pathways.	Pregnant women, individuals with iron deficiency anemia on high-dose supplements, or those with genetic hemochromatosis.
Genetic Disorders	Mutations in copper-transporting genes (like ATP7A) prevent the body from absorbing and utilizing copper from the diet.	Infants and children with Menkes disease or Occipital Horn Syndrome.
Chronic Alcoholism	Associated poor nutritional intake, malabsorption, and direct metabolic effects of ethanol contribute to low copper status.	Individuals with long-term, heavy alcohol use.

Conclusion

While a balanced diet typically provides sufficient copper, several factors can disrupt this delicate balance. From the surprisingly common issue of excessive zinc supplementation to the profound impact of bariatric surgery and genetic disorders, the pathways to copper depletion are varied and complex. Recognizing the risk factors associated with acquired copper deficiency—like malabsorption, alcoholism, and high iron intake—is the first step toward prevention. Maintaining the proper balance of essential minerals is vital for preventing the potentially irreversible neurological damage and other complications that can arise from low copper levels. If you are in a high-risk group or experience unexplained neurological symptoms, anemia, or other related issues, consulting a healthcare professional for a mineral assessment is highly recommended.

Visit the NIH Fact Sheet for Health Professionals on Copper for more in-depth scientific information.

Frequently Asked Questions

Yes, taking high-dose zinc supplements over a prolonged period is a common cause of acquired copper deficiency. Zinc and copper compete for absorption, and too much zinc can inhibit the absorption of copper in the intestines.

Bariatric surgeries, especially Roux-en-Y gastric bypass, reroute the digestive system so that food bypasses the duodenum, the main site of copper absorption. This permanently reduces the body's ability to absorb copper from food.

Not necessarily. Many plant-based foods, such as nuts, seeds, and whole grains, are good sources of copper. In fact, some studies show that vegans may have a higher copper intake than meat-eaters. However, the bioavailability can be affected by factors like high phytate intake.

Excess iron intake can inhibit copper absorption, and conversely, copper is necessary for the proper utilization and transport of iron in the body. A deficiency in copper can therefore lead to iron deficiency anemia that does not respond to iron supplements alone.

Yes, chronic and excessive alcohol consumption is a known risk factor for copper deficiency. This is often linked to general malnutrition and malabsorption associated with heavy drinking.

Copper deficiency can cause a condition known as myeloneuropathy, which affects the spinal cord and peripheral nerves. Symptoms include numbness and weakness in the limbs, poor balance, and an unsteady gait, often mimicking a Vitamin B12 deficiency.

Malabsorption syndromes such as celiac disease, inflammatory bowel disease like Crohn's disease, and cystic fibrosis can lead to copper depletion due to intestinal damage. Genetic conditions like Menkes disease also prevent proper absorption.