What not to eat with Wilson's disease for a healthy, low-copper diet

November 24, 2025 •

3 min read

Wilson's disease, a rare genetic disorder, affects approximately 1 in 30,000 people globally and causes a dangerous accumulation of copper in the body. To manage this condition effectively alongside medical treatment, it is critical to know what not to eat with Wilson's disease to minimize dietary copper intake.

Quick Summary

An inherited disorder, Wilson's disease requires a lifelong, low-copper diet to prevent dangerous copper buildup in organs. Key foods to avoid include shellfish, liver, nuts, and chocolate, which contain high copper concentrations. Careful dietary management, often with a dietitian, is essential for minimizing health risks.

Key Points

Avoid High-Copper Foods: Strictly eliminate organ meats (liver), shellfish, nuts (especially cashews), chocolate, and certain mushrooms to prevent copper buildup.
Mind Hidden Sources: Be cautious of copper from cookware, potentially high-copper water from plumbing, and supplements containing copper.
Choose Low-Copper Alternatives: Opt for safe food choices such as refined grains, white meat poultry, eggs, dairy, and most fresh fruits and vegetables.
Consult a Dietitian: Work with a professional to create a personalized meal plan, especially for vegetarian/vegan diets, which often rely on high-copper protein sources.
Prioritize Medication: Remember that dietary restriction is a supportive measure and not a substitute for lifelong medication, which is the primary treatment for Wilson's disease.
Be Mindful of Supplements: Always check supplement labels and avoid those containing copper, including most prenatal vitamins.

The Importance of a Low-Copper Diet

Wilson's disease is an inherited condition that impairs the body's ability to excrete excess copper, causing it to accumulate in the liver, brain, and other vital organs. Over time, this copper buildup can lead to severe liver damage, neurological problems, and other health issues. While lifelong medication is the cornerstone of treatment, dietary restrictions are a crucial supportive measure, especially during the initial phase of therapy. By consciously limiting the intake of high-copper foods, patients can help reduce the overall copper load on their body.

High-Copper Foods to Strictly Avoid

Certain foods are exceptionally high in copper and should be avoided entirely by individuals with Wilson's disease. These are non-negotiable items that can significantly increase the risk of complications.

Organ Meats: Liver, kidney, and heart are among the highest dietary sources of copper. A single serving of liver, for instance, can contain a massive amount of copper, overwhelming the body's impaired excretion mechanisms.
Shellfish: This includes oysters, clams, lobster, and crab. Shellfish are notorious for their extremely high copper content and are universally listed as a food to abstain from.
Chocolate and Cocoa: Dark chocolate, cocoa powder, and products containing them are high in copper and should be removed from the diet.
Nuts: Many nuts, particularly cashews, almonds, and macadamia nuts, contain significant amounts of copper.
Mushrooms: Some varieties of mushrooms are high in copper and should be avoided.
Dried Fruits: Commercially dried fruits like prunes and raisins can have concentrated levels of copper.

Other Sources of Copper to Be Mindful Of

Beyond the most obvious high-copper foods, several other items and environmental factors can contribute to copper intake. Awareness of these is key to effective management.

Beans and Legumes: Many dried beans and peas, such as soybeans, black beans, and lentils, contain moderate to high levels of copper. The copper content can vary regionally.
Whole-Grain Products: Unlike refined white flour products, whole-grain breads, bran cereals, and wheat germ contain more copper and should be limited.
Water Supply: If a home has copper plumbing, the tap water can contain elevated copper levels, especially after standing for several hours. Testing the water and flushing pipes before use is recommended.
Cookware: Using unlined copper pots, pans, or utensils can leach copper into food, particularly when cooking acidic dishes. These should be avoided.
Supplements: Many multivitamins and mineral supplements contain copper. Patients must always check labels and only use supplements approved by their healthcare provider.

Dietary Considerations for Special Cases

Managing a low-copper diet can be particularly challenging for certain groups, such as vegetarians or pregnant women. A consultation with a registered dietitian is crucial for creating a balanced, low-copper meal plan.

Vegetarians and Vegans: Many plant-based protein sources like soy products (tofu, tempeh) and legumes are high in copper. While the fiber and phytate in these foods can reduce copper bioavailability, a dietitian can help ensure adequate protein without excess copper. Eggs and dairy, which are generally lower in copper, can be safe protein options for vegetarians.
Pregnant Women: Prenatal vitamins almost always contain copper and should be avoided. Pregnant patients with Wilson's disease must work closely with their hepatologist and obstetrician to find a safe alternative and manage their dietary needs.

Comparing High- and Low-Copper Food Choices


Food Group	Foods to Avoid (High Copper)	Safer Alternatives (Low Copper)
Protein	Liver, shellfish, pork, lamb, dark meat poultry	Beef, eggs, white meat chicken/turkey, most fish
Grains	Whole-grain bread, wheat bran, oatmeal, millet	Refined white bread, white rice, white pasta, corn cereals
Vegetables	Mushrooms, potatoes with skin, sweet potatoes, vegetable juice	Broccoli, carrots, cucumbers, cauliflower, lettuce, most fresh vegetables
Fruits	Dried fruits (raisins, prunes), avocados, nectarines	Apples, berries, citrus fruits, melons, canned fruit
Snacks/Treats	Chocolate, nuts, nut butters	Carob, most candies, fruit sorbet, low-copper baked goods

Conclusion

For individuals with Wilson's disease, a carefully managed diet is a vital part of a comprehensive treatment plan. The goal is to minimize the intake of foods and liquids high in copper to reduce the burden on the body's compromised copper excretion pathway. Strict avoidance of exceptionally high-copper foods, like liver and shellfish, combined with awareness of moderate-copper sources and hidden environmental factors, is essential. Ongoing monitoring and collaboration with a healthcare team, including a hepatologist and a registered dietitian, are necessary to ensure the diet remains both safe and nutritionally sound. Never discontinue medication or modify your diet without professional guidance. For additional resources and support, consider visiting the Wilson Disease Association website.

Frequently Asked Questions

You should completely avoid high-copper foods such as liver and other organ meats, shellfish (like oysters and crab), nuts, chocolate, and certain mushrooms.

Most nuts are high in copper and should be avoided. This includes cashews, almonds, and macadamia nuts. It's best to consult your dietitian for any exceptions or safe portion sizes.

If you have copper plumbing, your tap water can contain copper. It is advisable to have your water tested. In the meantime, run the water for a few moments before using it, or consider using filtered or distilled water, especially during the initial treatment phase.

Vegetarian and vegan diets can be challenging because many plant-based protein sources, such as soy products and beans, are high in copper. It is highly recommended to work with a dietitian to ensure your diet is balanced and doesn't lead to high copper intake or malnutrition.

Yes, it is crucial to check all supplement labels, as many contain copper. You should only take supplements approved by your healthcare provider. This is especially important for women who are pregnant or planning to become pregnant, as prenatal vitamins are often high in copper.

No, a low-copper diet is a supportive measure, not a cure. Lifelong medication, such as chelation therapy or zinc, is the cornerstone of treatment. You must continue taking your prescribed medications as directed by your doctor.

A single instance of eating a high-copper food is unlikely to cause immediate harm, especially for those on long-term medication. However, consistent consumption poses a significant risk. If you are concerned, consult your healthcare provider or dietitian.