Leis, Jessica. Vitamin A. KNH 413 – Medical Nutrition Therapy II. Miami University, Oxford, Ohio, Spring 2013. Copper 1. What is the nutrient? Copper 2. What is the RDA/DRI for the nutrient? There is no RDA for copper. However, normal daily recommended intakes are as follows: Birth to 3 years of age: 0.4 to 1 milligram (mg) per day 4 to 6 years: 1 to 1.5 mg per day 7 to 10 years: 1 to 2 mg per day Adolescent and adult males: 1.5 to 2.5 mg per day Adolescent and adult females: 1.5 to 3 mg per day 3. How is the nutrient metabolized? Copper is needed in the body for normal growth and health. It is needed to help the body absorb iron and is important for keeping nerve function/cells and your immune system healthy. Copper also helps form collagen, a key part of bones and connective tissue, can help your body use sugar, and plays a key role in the skin pigment melanin. 4. What are food sources of the nutrient? Copper is found in a variety of foods, including organ meats (especially liver), seafood, beans, nuts, and whole-grains. Additional copper may come from drinking water from copper pipes, using copper cookware, and eating farm products sprayed with coppercontaining chemicals. Copper may be decreased in foods that have high acid content and are stored in tin cans for a long time. 5. What disease states alter the nutrients metabolism? Conditions that may increase your need for copper include: Burns Diarrhea Intestinal disease Kidney disease Pancreatic disease Stomach removal Continuing stress Lack of copper may lead to anemia and osteoporosis. 6. What are the tests or procedures to assess the nutrient level in the body? Blood copper tests along with ceruloplasmin are used to help evaluate a person's condition. If these tests are abnormal, then they may be followed by a 24-hour urine copper test to measure copper excretion and a hepatic (liver) copper test to evaluate copper storage. Sometimes a free (unbound) blood copper test is also ordered. 7. What is the drug –nutrient interactions? Drug-nutrient interactions include: NSAID (nonsteroidal anti-inflammatory drugs) – copper binds to NSAIDS (like ibuprofen) and appears to enhance anti-inflammatory activity Penicillamine – (used to treat Wilson’s disease and rheumatoid arthritis) reduces copper levels Allopurinol – (used to treat gout) may reduce copper levels Cimetidine – (used to treat ulcers and GERD) may elevate copper levels in the body leading to damage to the liver and other organs Nifedipine – may lower concentration of copper in red blood cells after use Zinc – high levels of supplemental zinc taken over extended periods of time may result in decreased copper absorption in the intestines and copper deficiency 8. How is the nutrient measured? Copper is measured in milligrams; the average level of copper stored in the body is from 50 to 120 mg, most of which is in the liver. 9. What is the Upper Tolerable Limits? Upper tolerable limit for copper is 10 mg 10. What are they physical signs of deficiency? Deficiency is relatively uncommon. Serum copper levels and ceruloplasmin levels may fall to 30 percent of normal in cases of severe deficiency. Most markers are biochemical, but less common physical signs include loss of pigmentation, neurological systems, and impaired growth. 11. What are physical signs of toxicity? Copper toxicity is rare in the general population. Acute copper poisoning can occur through contamination of beverages in storage in copper-containing containers, as well as from contaminated water supplies. Symptoms also include: abdominal pain, nausea, vomiting, diarrhea. More serious signs include severe liver damage, kidney failure, coma or death. Of most concern from a nutritional standpoint is the possibility of liver damage resulting form long-term exposure to lower doses of copper. Individuals with genetic disorders affecting copper metabolism (Wilson’s disease, etc) are at risk for toxicity. Wilson’s disease is an inherited disorder that causes too much copper to accumulate in your liver, brain, and other vital organs. Resources http://www.mayoclinic.com/health/wilsons-disease/DS00411 http://lpi.oregonstate.edu/infocenter/minerals/copper/ http://frantzmd.info/Alternative%20Medicine/Tolerable%20Upper%20Limits.htm http://labtestsonline.org/understanding/analytes/copper/tab/test http://www.umm.edu/altmed/articles/copper-000951.htm http://www.umm.edu/altmed/articles/copper-000296.htm