Copper Toxicity - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Copper toxicity (copperiedus) is caused by excessive levels of copper in the body tissues. It may occur due to ingestion of excess copper or may also result from genetic disorders like Menke’s disease and Wilson's disease. These genetic conditions are associated with altered transport and storage of copper ions in the body tissues.

Copper in trace amounts is essential for normal bodily functions. However, abnormal copper levels in the body may induce several pathological conditions and result in clinical symptoms. Signs of acute copper poisoning include abdominal pain, jaundice, diarrhea, melena, and vomiting. Severe complications involving multiple organs may occur in long-term exposure to high levels of copper.

What Is Copper?

Copper is considered a trace element required for the body's homeostasis of normal physiological processes. Copper plays a significant role in maintaining the normal health of hair, skin, and nails. However, only a small amount of copper is needed to maintain body functions. The human body obtains the required levels of copper from food sources rich in copper, like shellfish, leafy greens, whole grains, nuts, organ meats, potatoes, beans, and peanut butter.

What Is Copper Toxicity?

Even though copper is needed for physiological processes in the human body, excessive levels of this mineral result in adverse health effects. Usually, copper is bonded to proteins in the body, which is considered safe and healthy. However, at excessive levels, copper is found in an unhealthy and toxic, free or unbound form. Based on the etiology, copper toxicity can be of two types. They are:

• Acquired Toxicity - It may occur from different sources like eating copper sulfate (copper salts), drinking contaminated water, and using copper utensils. Acquired copper toxicity may also occur due to taking too much copper-rich dietary supplements and food items, using topical creams containing topical creams for burns, and consumption of large quantities of copper for suicidal attempts.

• Inherited Toxicity - In some individuals, copper toxicity may occur due to genetic conditions like Wilson's disease. It is an autosomal recessive condition characterized by excessive copper accumulation in the body. Wilson's disease occurs due to genetic mutations in the gene coding for the copper ATPase enzyme.

How Much Copper Do Humans Need?

The daily intake requirements of copper may vary with age. Babies and children need fewer quantities of this nutrient than adults. The recommended copper intake levels for each age group according to the United States national institute of health are given in the following table.

What Are the Causes of Copper Toxicity?

Copper toxicity may occur due to accidental consumption of contaminated water, foods cooked in copper cookware, or due to suicidal attempts. The most common sources of copper toxicity are the following.

• Ingesting too much copper-contaminated water. It may occur due to industrial waste, copper pipes, and improper disposal.

• Through contaminated food items. It may occur due to copper dishes, copper shakers, and drinkware.

• Some genetic disorders and medical conditions may affect the ability of the liver to filter copper resulting in copper toxicity. It includes:

  • Hepatitis.

  • Wilson's disease.

  • Rheumatoid arthritis.

  • Anemia.

  • Liver diseases.

  • Leukemia.

  • Thyroid issues.

  • Lymphoma.

What Are the Symptoms Associated with Copper Toxicity?

Common Symptoms-

• Fever.

• Feeling sick.

• Headaches.

• Diarrhea.

• Passing out.

• Block poop.

• Chills.

• Metallic taste.

• Weakness.

• Presence of blood in vomit.

• Abdominal cramps.

• Throwing up.

• Jaundice.

• Cough.

• Kayser-Fleischer rings.

Behavioral Symptoms -

• Sudden mood changes.

• Irritability.

• Depression.

• Overexcitement.

• Anxiousness.

• Concentration problems.

• Feeling overwhelmed.

Long-term Symptoms -

• Anemia.

• Muscle aches.

• Pain.

• Tremor.

• Involuntary movements.

• Speaking difficulties.

• Burning sensation.

• Shock.

Fatal Symptoms -

• Liver failure.

• Brain damage.

• Kidney failure.

• Heart failure.

What Are the Impacts of Copper Toxicity on Human Health?

Acute copper toxicity results in vomiting of blood (hematemesis), low blood pressure, vomiting, jaundice, black feces (melena), gastrointestinal problems, and coma. Hemolytic anemia is observed in some individuals using copper-containing creams for burns. Increased risk of hematologic effects is seen in people with glucose -6-phosphate dehydrogenase deficiency.

Chronic copper toxicity may damage the kidneys and liver and also cause neurotoxicity. However, the human body has some protective mechanisms to regulate copper stores from excess dietary copper intake. Thus excessive copper levels are associated with certain symptoms involving the protection mechanism. It includes fatigue, mood swings, irritability, concentration issues, and depression. Severe copper toxicity may cause fatal complications, including internal organ damage and excessive copper deposition in the liver, brain, and lungs.

How Can We Diagnose Copper Toxicity?

• Measuring blood copper levels.

• Physical examination.

• Evaluating vitamin B12 levels.

• Measuring ceruloplasmin levels.

• Urine tests to evaluate the amount of copper that is filtered.

• Liver biopsy.

What Are the Treatment Options for Copper Toxicity?

• Gastric Lavage - In this procedure, a suction tube is inserted into the stomach to remove the copper from the stomach and thus reduce toxic effects.

• Chelation - It involves the injection of chelating agents into the bloodstream to bond copper ions and facilitates their elimination.

• Medications - Oral medications like Dimercaprol and Pencillamine can be given to treat copper toxicity.

• Hemodialysis - In this process, copper-containing blood is filtered with the help of a device and returned to the body.

Conclusion

Copper toxicity results from excessive levels of copper in the body. In trace amounts, copper is necessary to maintain normal body function and can be obtained from a balanced diet. However, exposure to high copper levels may cause toxicity and adverse health effects. Acute toxicity manifests as generalized weakness, vomiting, melena, bloody vomit, and gastric irritations. In case of long-term exposure, there will be multiple organ involvement and resultant health effects. Properly evaluating the daily ingested copper levels must be done to avoid toxicity and adverse health complications.