Other names: Non-caeruloplasmin-bound copper; 24-hour urine copper; Free copper; Cu; Hepatic copper; Total copper

Copper is a mineral, which is essential for healthy body functioning. Copper is used in the production of certain types of enzyme; these enzymes have a variety of important roles in the body, including metabolising iron, creating melanin, forming connective tissue and being involved in the operation of the nervous system. Copper is taken into the body by eating certain foods; examples of foods that contain copper include nuts, shellfish, wholegrain foods, mushrooms and dried fruits. Abnormalities in the levels of copper in the body are rare but they can contribute to serious illnesses, including Wilson’s disease.

When is the test used?

The test is used to measure the levels of copper in the blood; the test is primarily used to test for Wilson’s disease, which is a rare inherited condition that affects copper metabolism. The test is usually ordered when a patient displays symptoms associated with Wilson’s disease; these include:

  • Jaundice
  • Fatigue and tiredness
  • Weakness
  • Tremors
  • Changes in emotional state of mind
  • Difficulty walking
  • Problems with swallowing
  • Nausea
  • Abdominal pain

Additional tests may also be carried out in order to helps doctors reach an accurate diagnosis; usually, caeruloplasmin levels may also be tested and the doctor may also ask for a liver biopsy if they suspect there is a problem with the liver.

How is the test performed?

The test is performed by collecting a sample of blood from a vein in the arm; a needle is inserted into the vein and the blood is drawn out and collected in a syringe. Once the sample has been collected, it will be bottled, labelled with the patient’s name and sent away to the laboratory for analysis.

A 24 hour urine sample may also be carried out and the doctor may request a liver biopsy test.

What do the test results mean?

Abnormal copper levels cannot be used to reach a diagnosis alone so further tests will be ordered; the results of the tests will be analysed as a whole.

Low levels of copper in the blood, coupled with high levels in the urine and low caeruloplasmin levels may indicate that the patient has Wilson’s disease. Decreased levels of blood and urine copper levels and caeruloplasmin levels may indicate a copper deficiency.

High levels of copper in the blood and urine and average or high levels of caeruloplasmin usually indicate that the patient has a condition which is affecting the excretion of copper from the body, such as liver disease.

Certain types of medication may also cause copper levels to increase; these include oral contraceptives, Phenobarbital and carbamazepine. Some health conditions, including some forms of cancer and rheumatoid arthritis, may also cause levels of copper to rise. Conditions such as cystic fibrosis, which affect absorption, may cause levels of copper to decrease.

Specific Blood Tests

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