What Makes You Deficient in Copper? A Comprehensive Guide

October 21, 2025 •

3 min read

While relatively rare in healthy individuals, a number of factors can lead to a deficiency in copper, also known as hypocupremia. This essential trace mineral is crucial for many bodily functions, and its deficiency can lead to serious health problems, making it vital to understand the root causes.

Quick Summary

Copper deficiency is caused by malabsorption from gastric surgery or intestinal diseases, excess zinc intake, poor diet, and genetic disorders like Menkes disease.

Key Points

Excessive Zinc Intake: High zinc consumption is a leading cause of acquired copper deficiency due to competitive absorption in the gut.
Gastric Surgery Risk: Patients who have undergone bariatric surgery or other upper GI surgeries are highly susceptible to malabsorption-induced copper deficiency.
Malabsorption Disorders: Chronic intestinal conditions like celiac disease and inflammatory bowel disease can impair the body's ability to absorb copper from food.
Menkes Disease: A severe, inherited genetic disorder that results in systemic copper deficiency due to defective transport from birth.
Neurological Consequences: Copper deficiency can cause irreversible neurological damage, including myelopathy and neuropathy, if not treated early.
Blood Abnormalities: Hematological issues like anemia and neutropenia are common signs of deficiency and often respond well to copper supplementation.

Copper is a vital micronutrient the body needs for functions including red blood cell formation, iron metabolism, nervous system health, and immune function. While a balanced diet usually provides sufficient copper, certain conditions can impair absorption or increase requirements, leading to a deficiency.

Causes of Copper Deficiency

Factors that can disrupt the body's copper balance include issues with absorption, dietary intake, and genetics.

Malabsorption and Gastrointestinal Issues

Copper is primarily absorbed in the stomach and small intestine. Conditions or procedures altering this process can cause deficiency. High-risk individuals include those with:

Bariatric surgery: Procedures like Roux-en-Y gastric bypass bypass the main absorption area in the duodenum, making deficiency a known complication.
Gastrectomy: Removal of part or all of the stomach reduces the absorption surface.
Malabsorption syndromes: Chronic conditions such as celiac disease and inflammatory bowel disease can damage the intestinal lining and hinder copper absorption.
Chronic diarrhea: Severe, persistent diarrhea can prevent adequate nutrient absorption.

Excessive Zinc Intake

Overuse of zinc is a common cause of acquired copper deficiency. Zinc and copper compete for intestinal absorption. High zinc levels increase metallothionein production, which binds more strongly to copper, trapping it in intestinal cells. This can result from high-dose zinc supplements, certain denture creams, or ingesting zinc-containing items.

Genetic and Inherited Conditions

Genetic defects can prevent proper copper transport or metabolism. Menkes disease, a rare X-linked disorder due to an ATP7A gene mutation, causes defective copper transport and severe systemic deficiency from birth. Occipital Horn Syndrome is a milder variant.

Insufficient Dietary Intake

Dietary deficiency is uncommon in healthy adults but can affect specific groups. This includes premature infants fed low-copper formulas or only cow's milk, patients on long-term intravenous nutrition without supplementation, and individuals with severe malnutrition or extremely restricted diets.

Copper Deficiency vs. Vitamin B12 Deficiency

The neurological symptoms of copper deficiency can resemble those of vitamin B12 deficiency, potentially leading to misdiagnosis. Key distinctions are shown in the table below:


Feature	Copper Deficiency (Hypocupremia)	Vitamin B12 Deficiency
Common Causes	Bariatric surgery, excess zinc, genetic disorders (Menkes)	Pernicious anemia, malabsorption (e.g., Crohn's), vegan diet
Neurological Symptoms	Sensory ataxia (gait issues), peripheral neuropathy, optic neuropathy	Myelopathy, paresthesias, sensory ataxia, cognitive changes
Hematological Symptoms	Anemia (microcytic, normocytic, macrocytic), neutropenia	Macrocytic anemia (megaloblastic)
Diagnostic Markers	Low serum copper and ceruloplasmin levels	Low serum B12, elevated MMA and homocysteine
Treatment Response	Hematological issues respond well; neurological damage may be irreversible	Most symptoms, including neurological, are reversible with treatment
Bone Marrow Findings	Vacuolated precursors, ring sideroblasts	Megaloblastic changes

Diagnosis and Treatment

Diagnosis involves blood tests for serum copper and ceruloplasmin levels, and potentially further gastrointestinal investigation for malabsorption. Treatment focuses on:

Addressing the cause: Stopping excess zinc or managing a malabsorption disorder is crucial.
Copper supplementation: Oral supplements are used for mild to moderate cases, with intravenous replacement for severe deficiency.
Dietary changes: Increasing intake of copper-rich foods is beneficial.
Prognosis: Hematological issues often improve with supplementation, but neurological damage can be permanent, emphasizing early diagnosis.

Conclusion

Understanding what makes you deficient in copper is vital for prevention and treatment. Though uncommon, deficiency can have serious health consequences, particularly neurological. Identifying risk factors like bariatric surgery, excess zinc, and malabsorption disorders is key for early detection. Timely diagnosis and intervention can manage symptoms and prevent further neurological decline. Consider copper status when evaluating unexplained blood or neurological issues. The National Institutes of Health (NIH) offers resources on micronutrient deficiencies.

Food Sources Rich in Copper

Include these foods to help maintain adequate copper levels:

Shellfish: Oysters and crab are very high in copper.
Organ meats: Beef liver is a concentrated source.
Nuts and Seeds: Cashews, almonds, and sesame seeds are good sources.
Legumes and Grains: Lentils, chickpeas, and whole grains provide copper.
Chocolate: Dark chocolate is a notable source.
Vegetables: Potatoes, mushrooms, and leafy greens also contribute copper.

Frequently Asked Questions

Yes, gastric bypass and other bariatric procedures often lead to malabsorption, making copper deficiency a recognized complication. These surgeries alter the digestive tract, preventing copper from being absorbed effectively.

Zinc and copper compete for the same absorption pathways in the gut. Excessive zinc intake, often from supplements, leads to the overproduction of a protein called metallothionein, which binds copper and prevents it from being absorbed into the body.

Yes, Menkes disease is a rare genetic disorder caused by a mutation in the ATP7A gene. It severely impairs the body's ability to absorb and distribute copper, leading to a life-threatening systemic deficiency from infancy.

Copper deficiency can cause a variety of neurological problems, including a myelopathy (spinal cord disease) that results in difficulty walking and sensory ataxia, as well as peripheral neuropathy and optic neuropathy.

Yes, chronic malabsorption syndromes such as celiac disease, inflammatory bowel disease, and cystic fibrosis can damage the intestines, reducing the body's capacity to absorb trace minerals, including copper.

The most common hematological signs are anemia (which can be microcytic, normocytic, or macrocytic) and neutropenia (low white blood cell count). These can sometimes be mistaken for other bone marrow disorders.

Treatment involves addressing the root cause, such as stopping excessive zinc intake. For correcting the deficiency, oral copper supplements are used for mild cases, while severe deficiencies may require intravenous copper replacement.