Copper Deficiency in 2026: Symptoms, Causes, Zinc Supplements and When to Get Tested
Perhaps you have taken a zinc supplement every day for a year or two, and recently added a hair or skin formula that also lists zinc. Perhaps you have coeliac disease, or had weight-loss surgery a few years ago, and you are reviewing your nutrition. Or a blood test has shown anaemia or a low white cell count, and copper has been mentioned as something to check.
Copper deficiency is uncommon in otherwise healthy people [3]. It becomes more likely in a few specific situations: long-term high zinc intake, conditions that reduce absorption from the gut, and some types of stomach or bowel surgery [3][4]. In those situations a copper blood test can be useful. Without them, most people do not need one [2].
This guide covers symptoms, causes, the link with zinc, what a copper test can tell you and what to do with the result.
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What is copper and why does your body need it?
Copper is an essential trace mineral. The NHS says adults aged 19 to 64 need 1.2mg a day, which most people get from a varied diet [1]. Copper is built into enzymes that help with [1][3].
Making red and white blood cells, and releasing iron so it can be used to make haemoglobin, the protein in red blood cells that carries oxygen.
Normal nerve function, including making some of the nervous system's chemical messengers.
Energy production inside cells.
Connective tissue, the framework that supports skin, blood vessels and bone.
Protecting cells from oxidative damage, through copper-containing antioxidant enzymes.
Because so little is needed, copper problems are more often linked to poor absorption than to diet.
Copper deficiency symptoms: what should you look out for?
Clinically significant copper deficiency mainly affects the blood and the nervous system [5][6].
Blood changes: anaemia, which can cause tiredness, weakness or breathlessness, and a low white blood cell count, particularly low neutrophils (neutropenia), the cells that help fight infection [4][5]. These are sometimes found first on a routine blood test.
Nerve problems, usually with more prolonged deficiency: numbness or tingling in the feet or hands, unsteadiness, and difficulty with balance, coordination or walking [4].
Less common features of severe or long-standing deficiency include loss of pigment in skin or hair, weaker bones and more frequent infections [3] and, rarely, vision problems [5].
Some people have no obvious symptoms. Tiredness, tingling and poor balance also have many causes, and copper deficiency is one of the less likely ones. If you feel persistently tired, start with your GP, who can review your history, medicines and supplements and arrange basic tests. Copper becomes relevant if one of the risk factors below applies.
What causes copper deficiency?
Inherited copper disorders exist, but most copper deficiency is acquired during life [6].
Taking too much zinc
High zinc intake reduces how much copper the gut can absorb. The NHS warns that this can lead to anaemia and weakening of the bones, and advises not taking more than 25mg of zinc supplements a day unless a doctor advises it [1]. Reported cases have involved zinc supplements and, less obviously, heavy long-term use of zinc-containing denture creams [3][4]. Zinc from food does not usually cause a problem. The next section looks at this in more detail.
Coeliac disease and other malabsorption conditions
Copper is absorbed in the upper gut, so conditions that damage or bypass this area can reduce absorption [4]. People with coeliac disease appear to have an increased risk, and severe malabsorption from other causes can have the same effect [2][3]. Having one of these conditions does not mean you are deficient. It is a reason to keep copper in mind if your symptoms or blood results point that way.
Previous stomach or bowel surgery
Upper gastrointestinal surgery is a recognised risk factor, and bariatric (weight-loss) surgery is a growing cause [4][6]. British Obesity and Metabolic Surgery Society guidelines recommend checking copper at regular intervals after sleeve gastrectomy, gastric bypass and duodenal switch, and suggest considering a check at least once a year [7]. If you have had one of these operations, your bariatric team or GP should already be monitoring your nutrition.
Inadequate intake
Copper is found in foods such as nuts, shellfish and offal [1]. Low intake alone is an unusual cause in adults, so a particular diet is not a reason to assume your copper is low.
Other medical circumstances
Some hospital treatments, such as prolonged kidney replacement therapy in intensive care, can also lead to deficiency and are monitored by the teams involved [6]. In about a fifth of reported cases of copper-related nerve damage, no cause is found [4].
The connection between zinc and copper
This is the risk factor most people can do something about.
Someone might start a zinc tablet for their skin or immunity. Later they add a hair supplement, then a multivitamin. Each lists zinc, and the daily total is now several times what they intended. None of these products is harmful in itself. The question is whether the dose, the length of time, your health and your total intake together give a reason to look at copper.
A sensible supplement review:
Check the zinc content of each product, in milligrams per daily dose.
Add up the total across everything you take, including multivitamins.
Note how long you have been taking them. Months or years of high intake matter more than a short course.
Ask a pharmacist or your GP to review your supplements, especially if you take several or have a health condition.
Do not start copper tablets to "balance" zinc without clinical advice. Too much copper can also cause harm [1].
If a doctor has prescribed zinc, do not stop it without speaking to them. If your review shows long-term intake above the NHS limit, or you have symptoms or blood results that fit, a copper test becomes worth discussing.
Can copper deficiency cause anaemia?
Yes. Copper helps release iron so it can be used to make haemoglobin, and copper-dependent enzymes are needed for the body to use iron [1][5]. So anaemia can occur when copper is low [5]. Copper deficiency can also lower the white cell count, and it has sometimes been mistaken for a bone marrow disorder called myelodysplastic syndrome [4].
Anaemia is common and usually has another cause, such as low iron, vitamin B12 or folate, or blood loss. A clinician will usually start with a full blood count and iron studies, adding copper and caeruloplasmin if you have a risk factor or the usual causes have been ruled out. A copper test on its own does not replace that investigation.
Copper deficiency and nerve health
Copper deficiency can damage the spinal cord and the nerves to the limbs, a condition called copper deficiency myelopathy. It closely resembles the nerve damage caused by vitamin B12 deficiency and typically causes difficulty walking because of poor sensation and balance [4]. Blood counts usually recover well with treatment, but nerve damage may only partly improve, which is why timely diagnosis matters [4][5].
Numbness, tingling and balance problems usually have other causes. If you develop new or worsening nerve symptoms, see your GP promptly rather than ordering a blood test yourself. If you cannot get an appointment and are worried, call NHS 111. Call 999 in an emergency.
How is copper deficiency diagnosed?
Diagnosis usually starts with a blood test for copper, interpreted alongside other results and your circumstances [2].
About 95% of the copper in your blood is carried by a protein called caeruloplasmin [2]. Total serum copper therefore rises and falls with caeruloplasmin. Several things raise both [2]:
Pregnancy.
Oestrogen, including the combined contraceptive pill and HRT.
Inflammation or a significant infection.
Some medicines, such as carbamazepine and phenobarbital.
So a result taken during an infection, or while taking oestrogen, may not reflect your usual copper status. A low result can reflect deficiency, but low copper is also seen in other conditions, such as Wilson's disease (see below) [2]. Samples can be contaminated by copper from outside sources, so care is needed during collection, and an unexpectedly high result may need repeating [2].
No single blood marker reliably measures the body's copper status [3]. A copper result can show that something needs a closer look, but not the cause [2]. A clinician may add caeruloplasmin, zinc, a full blood count, vitamin B12 or a 24-hour urine copper collection.
Is a copper blood test worth getting?
Lab Tests Online UK, run by the Association for Laboratory Medicine, states that general screening for copper is not recommended or necessary [2]. Testing earns its place when there is a specific reason.
Testing may be worth discussing if:
you have taken more than the NHS limit of 25mg of zinc supplements a day for a long time [1]
you have coeliac disease or another condition that affects absorption [2][3]
you have had sleeve gastrectomy, gastric bypass, duodenal switch or other upper gut surgery [4][7]
a clinician is investigating unexplained anaemia or a low white cell count
a clinician has asked you to get a copper result.
Testing is unlikely to be necessary if you eat a varied diet, take no high-dose zinc, and have no relevant symptoms, blood results or risk factors.
The useful question is whether you have a specific reason to look at your copper status. Reading about copper deficiency is not, on its own, a reason.
Copper blood testing at Juvenology Clinic
At Juvenology Clinic in Maidstone, we offer a Copper Blood Test for people who have a specific reason to check their copper status.
Copper Blood Test: £66
What it measures: total serum copper, reported against the laboratory's reference range.
What it does not include: caeruloplasmin, calculated non-caeruloplasmin-bound copper, zinc, a full blood count or 24-hour urine copper. A Zinc Blood Test and a Full Blood Count are available separately.
How the sample is taken: a venous blood sample from your arm, collected into a trace-element tube. Finger-prick sampling is not used for copper because of the contamination risk.
Where: at the clinic on King Street, Maidstone, or at a partner collection location by arrangement. We confirm the collection option, any collection fee and the expected turnaround time before you book.
What the price covers: laboratory analysis and the laboratory report with its reference range.
People who might consider it include someone who has taken high-dose zinc for a long time and wants a result to discuss with their GP or with me, someone with coeliac disease or previous gut surgery whose clinician has suggested checking copper, and someone whose GP has asked for a copper result as part of investigating a blood count. These are examples, not a recommendation that everyone in these groups should test.
The test measures serum copper. It does not diagnose copper deficiency by itself, identify the cause of an abnormal result or rule out every condition involving copper. An abnormal result may need further assessment and tests, which your GP may arrange.
Interpretation is optional and priced separately. You can add a personalised written interpretation report (£50) or book a results consultation with me (£100). If you would like to talk through whether testing makes sense before you order, a general consultation is £50 for 30 minutes. These are not prescribing appointments. If a result suggests you need medical follow-up, I will recommend that you see your GP and, with your consent, can give you a letter for them.
If you have a specific reason to investigate your copper levels, you can read more about the Copper Blood Test, including what it measures and how sample collection is arranged.
How to prepare for a copper blood test
Fasting is not usually required. We will pass on any laboratory instructions.
Tell us if you are pregnant or take the contraceptive pill, HRT or another oestrogen-containing medicine [2].
List any zinc, copper or multimineral supplements, with doses and how long you have taken them.
Mention any recent infection or inflammatory flare. Inflammation can raise copper, so it may be better to wait until you are well [2].
Do not stop prescribed medicines or change your supplements before the test unless a healthcare professional advises it. A result taken on your usual routine is easier to interpret.
What happens if copper levels are low?
A low result is a starting point. The usual next steps are to:
check the result against the laboratory's reference range
consider your symptoms and medical history
review zinc and other supplements, including how long you have taken them
decide whether further tests are needed, such as caeruloplasmin, zinc or a full blood count
discuss the result with your GP or another appropriate clinician
look for the underlying cause.
Treatment depends on the cause and severity. If high zinc intake is responsible, reducing it under medical guidance is often part of the plan. Copper replacement, when needed, should be supervised by a clinician who chooses the dose and monitors your blood results [5][6]. Do not start copper supplements because you suspect a deficiency.
Copper, healthy ageing and longevity
What is established: copper is essential for blood cell formation, iron use, connective tissue and antioxidant defence, and deficiency causes recognisable blood and nerve problems [1][3][4]. Too much copper can damage the liver and kidneys. The NHS says 10mg a day or less from all sources is unlikely to cause harm [1].
What is still emerging: copper is being studied in relation to oxidative chemistry, brain ageing and Alzheimer's disease, with mixed findings. There is very little clinical evidence on copper supplements, and one trial in people with mild Alzheimer's disease found no difference in cognition after 12 months [3]. This research does not support taking copper to prevent disease or slow ageing.
What a copper test is not: it is not a biological age test, a measure of longevity or a guide to how fast you are ageing. Our guide to longevity tests in the UK explains what those tests can and cannot show.
Copper excess and Wilson's disease
Wilson's disease is a rare inherited condition in which copper builds up in the liver and brain. Around 1 in 30,000 people have it, and symptoms can start at any age [8]. It is diagnosed using several tests, including copper levels and genetic tests [8].
In Wilson's disease, blood copper is often low even though copper is accumulating in the body [2]. A serum copper result on its own can neither confirm nor rule out Wilson's disease, and our Copper Blood Test is not designed to investigate it. If a close relative has been diagnosed, speak to your GP, as close family members should be tested [8]. The same applies if you have unexplained liver problems.
Yellowing of the skin or the whites of the eyes needs an urgent GP appointment or a call to NHS 111 [9]. Confusion or a swollen abdomen also needs prompt medical assessment. Call 999 in an emergency.
Frequently asked questions
What are the symptoms of copper deficiency?
Copper deficiency mainly affects the blood and nerves. It can cause anaemia, with tiredness and weakness, and a low white blood cell count. More prolonged deficiency can cause numbness, tingling, poor balance and difficulty walking [4][5]. These symptoms are not specific to copper, and most people with them have another cause, so start with your GP.
Can taking zinc cause copper deficiency?
Yes, if intake is high for a long time. High zinc intake reduces how much copper the gut absorbs, which can lead to anaemia and weaker bones [1]. The NHS advises not taking more than 25mg of zinc supplements a day unless a doctor advises it [1]. Zinc from a normal diet does not usually cause this. Check the total across all your supplements.
Can copper deficiency cause anaemia?
Yes. Copper helps release iron so it can be used to make haemoglobin, so low copper can cause anaemia [1][5]. It can also lower white blood cells [4]. Anaemia has many more common causes, so it should be investigated properly, usually starting with a full blood count and iron studies.
How do you test for copper deficiency?
The usual first test is serum copper from a venous blood sample. Because most blood copper is carried by caeruloplasmin, results are affected by pregnancy, oestrogen, inflammation and some medicines [2]. A clinician may add caeruloplasmin, zinc, a full blood count or urine copper. An abnormal result points to further investigation rather than a diagnosis [2].
Is a copper blood test suitable for everyone?
No. General screening for copper is not recommended [2]. Testing makes sense when there is a specific reason, such as long-term high-dose zinc, coeliac disease or another absorption problem, previous gut surgery, or a clinician investigating abnormal blood counts. If none of these apply, you are unlikely to need one.
Does Juvenology's Copper Blood Test include caeruloplasmin?
No. The test measures total serum copper only. It does not include caeruloplasmin, calculated non-caeruloplasmin-bound copper, zinc, a full blood count or urine copper. If your result is abnormal, a clinician may request caeruloplasmin and other tests alongside it.
Does the test include a consultation?
No. The £66 price covers laboratory analysis and the laboratory report with its reference range. A personalised written interpretation report (£50) and a results consultation (£100) are optional and priced separately. If a result suggests you need medical follow-up, we will recommend that you see your GP.
Can I use a home finger-prick kit?
No. Copper is easily contaminated during collection, so this test needs a venous blood sample in a trace-element tube, taken at our Maidstone clinic or, by arrangement, at a partner collection location.
Do I need to fast?
Fasting is not usually required. We will let you know if the laboratory asks for anything different. Tell us about pregnancy, oestrogen-containing medicines, supplements and any recent infection, as these can affect the result.
Can a copper blood test diagnose Wilson's disease?
No. Wilson's disease is diagnosed using a combination of tests, including copper studies and genetic testing [8]. Blood copper is often low in Wilson's disease, so a serum copper result on its own cannot confirm or rule it out [2]. If you are concerned, or a close relative has the condition, speak to your GP.
Is copper testing right for you?
Copper deficiency is uncommon in otherwise healthy people. It becomes relevant when long-term zinc intake, an absorption problem, gut surgery or an abnormal blood count gives a specific reason to look. Tiredness or tingling on their own are not evidence of deficiency, and new nerve symptoms need your GP first.
If you do have a reason to check, it helps to know what the test measures and how you will get the result interpreted before you order. The Copper Blood Test page sets out the price, what is included, how sample collection is arranged and the optional interpretation services.
About the author
Marina Kostadinova-Yankova is the founder of Juvenology Clinic in Maidstone, Kent. She is a nurse with more than 25 years of nursing experience and qualified in Bulgaria in 1999. Read more about Marina.
This article is general information and does not replace individual medical advice. Speak to your GP or a pharmacist about symptoms, medicines or supplements. In an emergency, call 999. Information checked in October 2026.
References
NHS. Vitamins and minerals: others (copper and zinc). Last reviewed 3 August 2020.
Lab Tests Online UK (Association for Laboratory Medicine). Copper. No review date shown; accessed October 2026.
National Institutes of Health, Office of Dietary Supplements. Copper: fact sheet for health professionals. Updated 18 October 2022.
Jaiser SR, Winston GP. Copper deficiency myelopathy. Journal of Neurology. 2010;257(6):869–881. doi:10.1007/s00415-010-5511-x.
Myint ZW, Oo TH, Thein KZ, Tun AM, Saeed H. Copper deficiency anemia: review article. Annals of Hematology. 2018;97(9):1527–1534.
Altarelli M, Ben-Hamouda N, Schneider A, Berger MM. Copper deficiency: causes, manifestations, and treatment. Nutrition in Clinical Practice. 2019;34(4):504–513.
O'Kane M, Parretti HM, Pinkney J, et al. British Obesity and Metabolic Surgery Society guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery: 2020 update. Obesity Reviews. 2020;21(11):e13087.
Liver UK. Wilson's disease. Last reviewed December 2025.
NHS. Jaundice. Last reviewed 22 January 2024.
