AACopper All American Made!

In what food source is the nutrient found?

Copper is found in many foods. The best food sources are organ meats (especially liver), seafood, nuts, and seeds. Other good sources are whole grain products, wheat bran, and cocoa products. Some foods have lower levels of copper but can add copper to the diet because they are consumed frequently. These include tea, potatoes, milk, and chicken.

How does the nutrient affect the body?

Copper helps the body make hemoglobin, which is needed to carry oxygen in red blood cells. It serves as a part of many body enzymes and helps the body produce energy in the cells. It is important in the development of tissues in the bone, lung, and circulatory system. It helps maintain a healthy nervous system.

Information

Copper deficiency is rare but not unknown. It is sometimes caused by a lack of copper in the diet. It is more likely a result of genetic problems or from consuming too much zinc. Copper deficiency can severely disrupt growth and metabolism.

The Recommended Daily Allowance (RDA) of copper for adult men and women is 900 micrograms. The Tolerable Upper Intake Level (UL) is the highest level of daily nutrient intake that is likely to pose no risk of harm for almost all people. The adult UL for copper is 10 milligrams per day. Harmful effects of too much copper from dietary sources are extremely rare in the United States. But toxicity from supplements is possible. Excessive copper intake can cause liver damage.

"Draft for Public Comment"

Public Health Statement for

Copper

CAS#
7440-50-8

September 2002
This Public Health Statement is the summary chapter from the Toxicological
Profile for Copper. It is one in a series of Public Health Statements
about hazardous substances and their health effects. A shorter version,
the ToxFAQs™, is also available. This information is important because
this substance may harm you. The effects of exposure to any hazardous
substance depend on the dose, the duration, how you are exposed, personal
traits and habits, and whether other chemicals are present. For more information,
you may call the ATSDR Information Center at 1-888-422-8737.

This public health statement tells you about copper and the effects of
exposure.

The Environmental Protection Agency (EPA) identifies the most serious
hazardous waste sites in the nation. These sites make up the National
Priorities List (NPL) and are the sites targeted for long-term federal
cleanup activities. Copper has been found in at least 884 of the 1,613
current or former NPL sites. However, the total number of NPL sites evaluated
for this substance is not known. As more sites are evaluated, the sites
at which copper is found may increase. This information is important because
exposure to this substance may harm you and because these sites may be
sources of exposure.

When a substance is released from a large area, such as an industrial
plant, or from a container, such as a drum or bottle, it enters the environment.
This release does not always lead to exposure. You are exposed to a substance
only when you come in contact with it. You may be exposed by breathing,
eating, or drinking the substance, or by skin contact.

If you are exposed to copper, many factors determine whether you’ll be
harmed. These factors include the dose (how much), the duration (how long),
and the route of exposure (how you come in contact with it). You must
also consider the other chemicals you’re exposed to and your age, sex,
diet, family traits, lifestyle, and state of health.

1.1 What is copper?

Copper is a reddish metal that occurs naturally in rock, soil, water,
sediment, and, at low levels, air. Its average concentration in the earth’s
crust is about 50 parts copper per million parts soil (ppm) or, stated
another way, 50 grams of copper per 1,000,000 grams of soil. Copper also
occurs naturally in all plants and animals. It is an essential element
for all known living organisms including humans and other animals at low
levels of intake. At much higher levels, some toxic effects can occur.

Metallic copper can be easily molded or shaped. The reddish color of
this element is most commonly seen in the U.S. penny, electrical wiring,
and some water pipes. It is also found in many mixtures of metals, called
alloys, such as brass and bronze. Many compounds (substances formed by
joining two or more chemicals) of copper exist. These include naturally
occurring minerals as well as manufactured chemicals. The most commonly
used compound of copper is copper sulfate. Many copper compounds can be
recognized by their blue-green color. When we speak of copper, we will
not only be referring to copper metal, but also to compounds of copper
that may be in the environment.

Copper is extensively mined and processed in the United States and is
primarily used as the metal or alloy in the manufacture of wire, sheet
metal, pipe, and other metal products. Copper compounds are most commonly
used in agriculture to treat plant diseases, like mildew, or for water
treatment and as preservatives for wood, leather, and fabrics. For more
information on the properties and uses of copper, please see Chapters
4 and 5.

1.2 What happens to copper when it enters the environment?

Copper can enter the environment through releases from the mining of
copper and other metals, and from factories that make or use copper metal
or copper compounds. Copper can also enter the environment through domestic
waste water, combustion of fossil fuels and wastes, wood production, phosphate
fertilizer production, and natural sources (for example, windblown dust,
from native soils, volcanoes, decaying vegetation, forest fires, and sea
spray). Therefore, copper is widespread in the environment. About 1,400,000,000
pounds of copper were released into the environment by industries in 2000.
Copper is often found near mines, smelters, industrial settings, landfills,
and waste disposal sites.

When copper is released into soil, it typically becomes strongly attached
to the organic material and minerals in the top layers of soil and does
not move very far when it is released. When copper is released into water,
the copper that dissolves can be carried in surface waters either as free
copper or, more likely, bound to particles suspended in the water. Because
copper binds so strongly to suspended particles and sediments, it typically
does not enter groundwater. Copper that enters water eventually collects
in the sediments of rivers, lakes, and estuaries. Copper is carried on
particles emitted from smelters and ore processing plants, and is then
carried back to earth through gravity or in rain or snow. Copper is also
carried into the air on windblown metallurgical dust. Indoor release of
copper comes mainly from combustion processes (for example, kerosene heaters).

Copper does not break down in the environment. Copper can be found in
plants and animals, and at high concentrations in mussels and oysters.
Copper is also found in a range of concentrations in many foods and beverages
that we eat and drink, including drinking water. You will find additional
information on the fate of copper in the environment in Chapters 5 and
6.

1.3 How might I be exposed to copper?

Copper is common in the environment. You may be exposed to copper by
breathing air, drinking water, eating food, and by skin contact with soil,
water, and other copper-containing substances. Most copper compounds found
in air, water, sediment, soil, and rock are so strongly attached to dust
and dirt or imbedded in minerals. However, you can still be exposed to
copper upon ingestion of water or soil that contains copper or, to a lesser
extent, by inhalation of copper-containing dust. Some copper in the environment
is less tightly bound to particles and may be taken up by plants and animals.
Soluble copper compounds (those that dissolve in water), which are most
commonly used in agriculture, are more likely to threaten your health.
When soluble copper compounds are released into lakes and rivers, they
generally become attached to particles in the water within approximately
1 day. This could lessen your exposure to copper in water, depending on
how strongly the copper is bound to the particles and how much of the
particles settle into lake and river sediments.

The concentration of copper in air ranges from a few nanograms (1 nanogram
equals 1/1,000,000,000 of a gram) in a cubic meter of air (ng/m3) to about
200 ng/m3. Near smelters, which process copper ore into metal, concentrations
may reach 5,000 ng/m3. You may breathe high levels of copper-containing
dust if you live or work near copper mines or processing facilities.

You may be exposed to high levels of soluble copper in your drinking
water, especially if your water is corrosive and you have copper plumbing
and brass water fixtures. The average concentration of copper in tap water
ranges from 20 to 75 parts copper per billion parts water (ppb). However,
many households have copper concentrations of over 1,000 ppb. That is
more than 1 milligram per liter of water. This is because copper is picked
up from copper pipes and brass faucets when the water sits in the pipes
overnight. After the water is allowed to run for 15-30 seconds, the concentration
of copper in the water decreases.

The average concentration of copper in lakes and rivers is 4 ppb. The
average copper concentration in groundwater is similar to that in lakes
and rivers; however, monitoring data indicate that some groundwater contains
higher levels of copper. This copper is generally strongly attached to
particles in the water. Lakes and reservoirs recently treated with copper
compounds to control algae or receive cooling water from a power plant
may have high concentrations of dissolved copper. Once in natural water,
much of this copper soon attaches to particles or converts to forms that
can settle into sediments. This can limit exposure to copper unless the
sediments are stirred; for example, by the resuspension and swallowing
of sediments by swimmers in recreational waters.

Garden products containing copper that are used to control certain plant
diseases are also a potential source of exposure. For example, you can
find copper compounds in some fungicides.

Soil generally contains between 2 and 250 ppm copper, although concentrations
close to 17,000 ppm have been found near copper and brass production facilities.
High concentrations of copper may be found in soil because dust from these
industries settles out of the air, or wastes from mining and other copper
industries are disposed of on the soil. Another common source of copper
in soil results from spreading sludge from sewage treatment plants. This
copper generally stays strongly attached to the surface layer of soil.
You may be exposed to this copper by skin contact. Children may also be
exposed to this copper by eating the dirt and dust generated therefrom.

Food naturally contains copper. You eat and drink about 1 milligram (1/1,000
of a gram) of copper every day. Copper is essential in your diet for good
health.

While some hazardous waste sites on the NPL contain high levels of copper,
we do not always know how high it is above natural levels. We also do
not know what form it is in at most of these sites. However, evidence
suggests that most copper at these sites is strongly attached to soil.

You may be exposed to copper in the workplace. If you work in the industry
of mining copper or processing the ore, you are exposed to copper by breathing
copper-containing dust or by skin contact. If you grind or weld copper
metal, you may breathe high levels of copper dust and fumes. Occupational
exposure to forms of copper that are soluble or not strongly attached
to dust or dirt would most commonly occur in agriculture, water treatment,
and industries such as electroplating, where soluble copper compounds
are used.

For more information on the potential for exposure to copper, please
refer to Chapter 6.

1.4 How can copper enter and leave my body?

Copper can enter your body when you drink water or eat food, soil, or
other substances that contain copper. Copper can also enter your body
if you breathe air or dust containing copper. Copper may enter the lungs
of workers exposed to copper dust or fumes.

Copper rapidly enters the bloodstream and is distributed throughout the
body after you eat or drink it. Other foods eaten with copper can affect
the amount of copper that enters the bloodstream. Your body is very good
at blocking high levels of copper from entering the bloodstream. We do
not know how much copper enters the body through the lungs or skin. Copper
then leaves your body in feces and urine, mostly in feces. It takes several
days for copper to leave your body. Generally, the amount of copper in
your body remains constant (the amount that enters your body equals the
amount that leaves). More information on how copper enters and leaves
the body is presented in Chapter 3.

1.5 How can copper affect my health?

To protect the public from the harmful effects of toxic chemicals and
to find ways to treat people who have been harmed, scientists use many
tests.

One way to see if a chemical will hurt people is to learn how the chemical
is absorbed, used, and released by the body; for some chemicals, animal
testing may be necessary. Animal testing may also be used to identify
health effects such as cancer or birth defects. Without laboratory animals,
scientists would lose a basic method to get information needed to make
wise decisions to protect public health. Scientists have the responsibility
to treat research animals with care and compassion. Laws today protect
the welfare of research animals, and scientists must comply with strict
animal care guidelines.

Copper is essential for good health. However, exposure to higher doses
can be harmful. Long-term exposure to copper dust can irritate your nose,
mouth, and eyes, and cause headaches, dizziness, nausea, and diarrhea.
If you drink water that contains higher than normal levels of copper,
you may experience vomiting, diarrhea, stomach cramps, and nausea. Intentionally
high intakes of copper can cause liver and kidney damage and even death.
We do not know if copper can cause cancer in humans. EPA has determined
that copper is not classifiable as to human carcinogenicity.

More detailed information on the health effects of copper in animals
and humans can be found in Chapter 3.

1.6 How can copper affect children?

This section discusses potential health effects from exposures during
the period from conception to maturity at 18 years of age in humans.

Exposure to high levels of copper will result in the same types of effects
in children and adults. We do not know if children are more susceptible
to the toxicity of copper than adults. Studies in animals suggest that
children may have more severe effects than adults; we do not know if this
would also be true in humans. There is a very small percentage of infants
and children who are unusually sensitive to copper. We do not know if
copper can cause birth defects or other developmental effects in humans.
Studies in animals suggest that ingestion of high levels of copper may
cause a decrease in fetal growth.

1.7 How can families reduce the risk of exposure to copper?

If your doctor finds that you have been exposed to significant amounts
of copper, ask whether your children might also be exposed. Your doctor
might need to ask your state health department to investigate. The greatest
potential source of copper exposure is through drinking water, especially
in water that is first drawn in the morning after sitting in copper piping
and brass faucets overnight. To reduce copper in drinking water, run the
water for at least 15-30 seconds before using it.

1.8 Is there a medical test to determine whether i have been exposed
to copper?

Copper is normally found in all tissues of the body, blood, urine, feces,
hair, and nails. High levels of copper in the blood, urine, hair, and
nails can show that you have been exposed to higher than normal levels
of copper. Tests to measure copper levels in the body are not usually
available at a doctor’s office because they require special equipment.
Although these tests can show that you have been exposed to higher than
normal copper levels, they can not be used to predict the extent of exposure
or potential health effects. More detailed information on the measurement
of copper is provided in Chapters 3 and 7.

1.9 What recommendations has the federal government made to protect human
health?

The federal government develops regulations and recommendations to protect
public health. Regulations can be enforced by law. Federal agencies that
develop regulations for toxic substances include the Environmental Protection
Agency (EPA), the Occupational Safety and Health Administration (OSHA),
and the Food and Drug Administration (FDA). Recommendations provide valuable
guidelines to protect public health but cannot be enforced by law. Federal
organizations that develop recommendations for toxic substances include
the Agency for Toxic Substances and Disease Registry (ATSDR) and the National
Institute for Occupational Safety and Health (NIOSH).

Regulations and recommendations can be expressed in not-to-exceed levels
in air, water, soil, or food that are usually based on levels that affect
animals; then they are adjusted to help protect people. Sometimes these
not-to-exceed levels differ among federal organizations because of different
exposure times (an 8-hour workday or a 24-hour day), the use of different
animal studies, or other factors.

Recommendations and regulations are also periodically updated as more
information becomes available. For the most current information, check
with the federal agency or organization that provides it. Some regulations
and recommendations for copper include the following:

EPA has determined that drinking water should not contain more than 1.3
mg copper per liter of water (1.3 mg/L). EPA has developed regulations
on the amount of copper released by industry.

OSHA has set a limit of 0.1 milligrams/cubic meter (mg/m3) of copper
fumes (vapor generated from heating copper) and 1.0 mg/m3 of copper dusts
(fine metallic copper particles) and mists (aerosol of soluble copper)
in workroom air to protect workers during an 8-hour work shift (40-hour
workweek).

The Food and Nutrition Board of the Institute of Medicine has developed
recommended dietary allowances (RDAs) of 340 micrograms (µg) of
copper per day for children aged 1-3 years, 440 µg/day for children
aged 4-8 years, 700 µg/day for children aged 9-13 years, 890 µg/day
for children aged 14-18 years, and 900 µg/day for adults. This provides
enough copper to maintain health. Further information on regulations and
guidelines pertaining to copper is provided in Chapter 8.

1.10 Where can I get more information?

If you have any more questions or concerns, please contact your community
or state health or environmental quality department or
Agency for Toxic Substances and Disease Registry
Division of Toxicology
1600 Clifton Road NE, Mailstop E-29
Atlanta, GA 30333
Web site: http://www.atsdr.cdc.gov

* Information line and technical assistance
Phone: 1-888-42-ATSDR (1-888-422-8737)
Fax: 1-404-498-0057

ATSDR can also tell you the location of occupational and environmental
health clinics. These clinics specialize in recognizing, evaluating, and
treating illnesses resulting from exposure to hazardous substances.

* To order toxicological profiles, contact
National Technical Information Service
5285 Port Royal Road
Springfield, VA 22161
Phone: 1-800-553-6847 or 1-703-605-6000

References

Agency for Toxic Substances and Disease Registry (ATSDR). 2002. Toxicological
profile for copper - draft for public comment. Atlanta, GA: U.S. Department
of Health and Human Services, Public Health Service.

"Thyroid and immune system health are crucially dependent upon copper.
As far as I can see now, copper deficiency is the most important factor
in the development of hyperthyroidism. Virtually all hypers in the hyperthyroidism
group have found that copper supplementation reduced their symptoms, usually
within hours or a few days at most. Most have reported that within three
to six months of beginning copper supplementation, they have been able
to significantly reduce their intake of antithyroid drugs. While copper
is the big story in hyperthyroidism, it is not the whole story. If it
were, it would have been discovered years ago. Proper copper metabolism
interrelates with and depends upon many other nutrients." [John Johnson,
iThyroid.com]

Circulation
Aneurysm / Weakened Arteries
Copper deficiency can contribute to some cardiovascular risks. Aortic
aneurysms may be a genetic condition related to a defect in the ability
to store or absorb copper. Copper is a cofactor for lysyl oxidase, an
enzyme that is responsible for the connective tissue integrity by cross
linking elastin. Elastin is the main material of several important organs,
which include blood vessels, spinal discs, lungs, and skin. In theory
if you have a family or personal history of aneurysms, consider taking
2-4mg of copper per day, especially if significant amounts of zinc have
been or are being consumed.

Men are more susceptible to aneurysms than young women, probably because
estrogen increases the efficiency of copper absorption. However, women
can be affected by this problem after pregnancy, probably because women
must give the liver of their unborn babies large copper stores in order
for them to survive the low milk copper.

Anemia (Iron deficiency)
Copper deficiency, due to its effects on ceruloplasmin, may cause an iron-deficiency
anemia which can only be corrected with copper supplementation as it impairs
iron absorption, reduces heme synthesis and increases iron accumulation
in storage tissues. [J Orthomol Med 4( 2): pp.99-108, 1989]

Increased Risk Of Stroke
A copper deficiency has been associated with weakening of connective tissue
that can be a contributing factor for the development of cerebral aneurysms
and hemorrhagic strokes.

Arrhythmias/Dysrhythmias
Ventricular premature beats have disappeared after supplementation with
copper in a few cases. In one of these people, supplementing with zinc
made the arrhythmia worse, confirming previous observations that excessive
zinc intake may lead to copper deficiency and arrhythmia.

Digestion
Hemorrhoids
A copper deficiency has been associated with weakening of connective tissue
that can be a contributing factor for the development of hemorrhoids.

Hormones
Hypothyroidism
There are a limited number of studies that suggest low copper levels may
reduce thyroid function. In cases where hypothyroidism is not responding
properly to medication, make sure that copper levels are normal.

Inflammation
Chronic Inflammation
Lab Values
Low White Count
Copper deficiency needs to be included in the differential diagnosis of
anemia and/or neutropenia in individuals with suspected copper deficiency.
[ American Journal of Hematology, 1995;48: pp.45-47]

Pain
Low Back Pain
A copper deficiency has been associated with weakening of connective tissue
that can be a contributing factor for the development of slipped or herniated
discs.

Below:
• Introduction
• Requirements/Sources
• Therapeutic Dosages
• Therapeutic Uses
• Safety Issues
• Interactions You Should Know About
• References

- Introduction

The human body contains only 70 to 80 mg of copper, but its an essential
part of many important enzymes. Coppers possible role in treating disease
is based on the fact that these enzymes cant do their jobs without it.
However, there is little direct evidence that taking extra copper can
treat any disease.

- Requirements/Sources

# Although a precise dietary requirement for copper has not been determined,
the Estimated Safe and Adequate Daily Dietary Intake is as follows Infants
under 6 months, 0.4 to 0.6 mg
6 months to 1 year, 0.6 to 0.7 mg
# Children 1 to 3 years, 0.7 to 1.0 mg
4 to 6 years, 1.0 to 1.5 mg
7 to 10 years, 1.0 to 2.0 mg
11 to 18 years, 1.5 to 2.5 mg
# Adults 19 years and older, 1.5 to 3.0 mg

Marginal copper deficiency appears to be common in Western diets.1 Excessive
zinc intake reduces copper stores in the body.2

Oysters, nuts, legumes, whole grains, sweet potatoes, and dark greens
are good sources of copper. Drinking water that passes through copper
plumbing is a good source of this mineral, and sometimes it may even provide
too much.

- Therapeutic Dosages

The typical adult supplemental dosage of copper is 1 to 3 mg daily.

- Therapeutic Uses

Copper has been proposed as a treatment for osteoporosis, based primarily
on studies that found benefit using mixtures of various trace minerals.3,4

One researcher, L. M. Klevay, has claimed in more than a dozen papers
that copper deficiencies increase the risk of high cholesterol and heart
disease, but he has failed to supply any real evidence that this idea
is true. A double-blind clinical trial of copper supplements for reducing
heart disease risk found no benefit.5

Similarly, copper has long been mentioned as a possible treatment for
osteoarthritis and rheumatoid arthritis, but there is as yet no real evidence
that it works.

- Safety Issues

Copper is safe when taken at nutritional dosages, but these should not
be exceeded. As little as 10 mg of copper daily produces nausea, and 60
mg may cause vomiting. Maximum safe dosages of copper for young children,
pregnant or nursing women, or those with severe liver or kidney disease
have not been determined.

- Interactions You Should Know About

If you are taking

* Antacids or other medications that reduce stomach acid, or the drug
ethambutol: You may need extra copper.
* Zinc: You need to make sure to get enough copper.
* Iron supplements, manganese, high doses of vitamin C, or antacids: Your
ability to absorb copper may be impaired.6
* Oral contraceptives: It might not be advisable to take extra copper.
* Copper: You may need extra manganese.

- References

1. Werbach M. Foundations of nutritional medicine. Tarzana, CA: Third
Line Press, 1997: 54.

2. Werbach M. Foundations of nutritional medicine. Tarzana, CA: Third
Line Press, 1997: 170–171.

3. Saltman PD, et al. The role of trace minerals in osteoporosis. J Am
Coll Nutr 12(4): 384–389, 1993.

4. Strause L, et al. Spinal bone loss in postmenopausal women supplemented
with calcium and trace minerals. J Nutr 124: 1060–1064, 1994.

5. Jones AA, DiSilvestro RA, Coleman M, and Wagner TL. Copper supplementation
of adult men: effects on blood copper enzyme activities and indicators
of cardiovascular disease risk. Metabolism 46: 1380–1383, 1997.

6. Werbach M. Foundations of nutritional medicine. Tarzana, CA: Third
Line Press, 1997: 169–171, 206.

By Elizabeth Tracey MS
WebMD Medical News

Jan. 28, 2000 (Baltimore) — The type of copper found most often in vitamins
and supplements, called cupric oxide, is not a type the body can absorb
easily, according to a report published in the December issue of the Journal
of Nutrition. "Studies on animals have shown conclusively that cupric
oxide is totally worthless," says David H. Baker, PhD, the paper’s
author. "Yet my survey of all the products on the market reveals
that the majority of them are still using [it] to provide copper."

Baker, a professor of comparative nutrition at the University of Illinois
at Urbana, is concerned that some people taking copper in this form, along
with higher doses of vitamin C or zinc, could actually develop copper
deficiency. Vitamin C and zinc are known to inhibit the body’s ability
to absorb and use copper — even the copper naturally present in food.

According to Baker, copper has a role in many bodily processes, including
blood pressure control, cholesterol and glucose metabolism, and enzyme
function. Low copper levels have been implicated in heart disease and
osteoporosis.

Baker has conducted numerous studies himself and has looked at the scientific
literature on the role of copper in human health. "Copper is simply
too important to human health to continue to use cupric oxide in supplements,
on which many people depend," he concludes.

"Inadequate copper levels are quite possible in teen-agers and those
on diets, as well as vegetarians, since the best sources of dietary copper
are of animal origin, and the copper found in plant materials is not very
available. These people may think they are getting adequate copper in
supplements, but that’s not usually true."

Baker suggests that manufacturers may use the inadequate form of copper
because it occupies less space in a supplement tablet. Other sources of
copper that provide the body with the mineral in a form that it can use
are available. "The resulting pill may be larger, but at least it
will furnish (copper) in a form that can be utilized." Cupric oxide
is no longer used in animal feeds and supplements.

Making sure that the copper in supplements is adequate has been a complicated
process, according to Baker. New information may lead to a revision of
current recommendations for intake. Current recommendations call for an
Estimated Safe and Adequate Daily Dietary Intake (ESADDI) of from 1.5
to 3.0 mg. Low copper intakes based on current recommendations have been
reported for several population groups, including infants and older adults.

Jennifer Otten, communications specialist and spokesperson for the Food
and Nutrition Board of the Institute of Medicine, National Academy of
Sciences, tells WebMD that the old recommendation will be updated when
a new report on the micronutrients is released next summer. "Our
new paradigm expands on the old RDA and looks at the role of additional
factors, such as food components, and is called a DRI, for Dietary Reference
Intake."

Otten adds, "Our group has been producing RDAs for the last 50 years,
and now we will provide DRIs. These are simply recommendations, however,
not government regulations and may have no impact on manufacturing practices.
Conforming to these recommendations puts the onus back on the manufacturer."

Vital Information:

* Copper plays a role in blood pressure control, cholesterol and glucose
metabolism, and enzyme function.
* Teen-agers, people on diets, and vegetarians may not be getting enough
copper.
* Most supplements contain cupric oxide, a form of copper that is not
easily absorbed by the body.

Page 1
The Importance of Copper in Tissue
Regulation and Repair : A Review
By Edward M. Jackson, Ph.D
Wound healing continues to be a major
medical problem. In the United States alone
there are 29 million inpatient hospital
procedures, 2.3 million burn cases, 2 million
chronic diabetic ulcers resulting in 40,000 leg
amputations annually and 1.1 million severe
fractures. In addition, approximately 6
million decubitus ulcers occur both in and
out of hospitals. The increase in cosmetic
surgery including laser resurfacing and hair
transplantation coupled with number of 40
million men and 20 million women who are
balding, augments the importance and
necessity to both understand wound
healing and enhance natural repair
processes. This article reviews the
importance of copper in tissue repair and
summarizes recent clinical studies
supporting the use of topical copper
peptide containing dressings
Copper is the third most abundant trace
metal in the human body, following iron and
zinc. Copper is bound in human plasma
and is carried by the carrier protein,
ceruloplasmin. Copper can also be
delivered by low molecular weight peptides
such as glycyl-L-histidyl-L-lysine.
Peptide Copper Complexes
It has been known for some time that
copper is essential to the strength and
flexibility of skin, vasculature and connective
tissue. However, in the past 2 decades
studies in animals and in cell cultures have
demonstrated the importance of peptide
copper complexes in tissue repair.
Studies in animals indicate that peptide
copper complexes accelerate tissue repair
by being liberated from plasma proteins.
Glycosaminoglycans (GAGs) synthesis and
collagen synthesis in human fibroblast cells
are sentinel characteristics of the
postinflammatory phase of tissue repair.
Specifically, peptide copper complexes
stimulate GAGs formation in human
fibroblasts in culture by preferentially
stimulating extracellular dermatan sulfate
and cell layer associated heparin sulfate.
However, hyaluronic acid synthesis was not
stimulated. Collagen synthesis is clearly
stimulated by peptide copper complexes.
Its importance in tissue repair is obvious.
In addition to GAGs and collagen
synthesis, peptide copper complexes are
also powerful leukocyte chemoattractants
which reduce the potential for infection at
the tissue repair site. Finally, peptide copper
complexes are angiogenic.
Clinical Studies on Tissue Repair
The clinical studies on diabetic ulcers
showed a significantly increased average
rate of wound closure, increased average
percent of healing of the wound area,
significant closure and healing of plantar
ulcers (73% for the treatment, 10% for
controls), with a significantly lower
incidence of ulcer infections (7% for
treatment, 34% for controls.)
In Mohs’ surgery patients, wound closure
rate increased and the time to 100% healing
decreased relative to the vehicle group.
Conclusion
The occurrence of copper as a common
natural element in healthy individuals has
now been used to study the use of topically
applied copper complexed with a family of
peptides.
Strong evidence accumulated in animal
and cell culture models has now been
corroborated in human tissue regulation
and repair as exemplified by wound healing
and hair growth.
Utilization of peptide copper complexes in
medicine and dermatology, therefore,
represents a leading edge in clinical
knowledge and applications.
Acknowledgement
The author is indebted to ProCyte
Corporation of Redmond, WA for supplying
the data base for this article and for their
technical comments on the manuscript.
Page 2
Note: The statistics in the introduction are
from the National Center for Health Statistics
and the Health Care Financing
Administration, U.S. Department of Health
and Human Services, the American Cancer
Society and the American Diabetes
Association.
References:
1.
Recommended Dietary Allowances
, 10
th
edition,
National Research Council, National Academy
of Sciences, 1989.
2. Pickart L, Thaler M:
Nature New Biology
243:85-87, 1973.
3. Raju KS, et al: Ceruloplasmin, copper ions and
angiogenesis.
J Nat Cancer Instit
69(5):1183-
1188, 1982.
4. Trachy RE, Packard S, Uno H, Pickart L: The
fuzzy rat, a model of iatrogenic hair growth, and
the effect of PC1031 (GHK-Cu),
J invest
Dermatol
96:579 ff, 1991.
5. Trachy RE, Uno H, Packard S, Patt LM:
Quantitative assessment of peptide-copper
complex induced hair follicle stimulation using
the fuzzy rat. (chapter 17) In:
Dermatologic Res
Tech
, Boca Raton, FL: CRC Press, 1996.
6. Trachy RE, Patt LM, Duncan GM, Kalis B:
Phototrichogram analysis of hair follicle
stimulation: A pilot clinical study with a peptide
copper complex. (chapter 16) In:
Dermatologic
Research Techniques
, Boca Raton, FL: CRC
Press 1996.
7. Trachy R, Patt L, Duncan G, Kalis B: Clinical
and experimental evidence of hair growth
stimulation resulting from treatment with
Tricomin®, a peptide-copper complex, poster
presentation at The Annual Symposium on the
Biology of the Skin, Snowmass, CO; 1992.
Edward M. Jackson, Ph.D., is president of Jackson
Research Associates, Inc., a research and
development company located in Sumner, Wash.,
where he serves as a consultant to the consumer
products industry. He is a member of the editorial
board for Cosmetic Dermatology.

* Copper is an essential nutrient, particularly important during fetal
development.
* Copper deficiency is more common than copper toxicity, although both
conditions are possible.
* Copper is vital for collagen formation, which means that copper is essential
for bone formation and repair, skin formation and repair, and growth/maintenance
of many other tissues incorporating collagen.
* Copper is crucial for nervous system development and is involved in
the synthesis of neurotransmitters.
* Copper is involved in maintaining the balance of other metals in the
body, such as zinc and molybdenum.
* Copper is necessary for maintaining the elasticity of blood vessels.
* Copper is important for proper functioning of the immune system
* In addition to the activities listed above, copper participates in many
other enzymatic chemical reactions in the body (e.g., activation of melanin,
absorption of iron, free radical neutralization).
* Too much copper can damage the liver and kidneys.
* Vitamin C and zinc inhibit the body’s absorption of copper.

How Does Copper Enter the Body?

* If you have copper plumbing, most of your exposure is probably from
your water. This is especially true if your water is corrosive (i.e.,
you don’t have scale buildup). Letting the faucet run for 15-30 seconds
will purge most of the copper from the lines (as well as harmful lead
from solder and fixtures).
* Copper is found in many foods, including shellfish, liver, nuts, red
wine and chocolate.
* You can absorb copper through the air you breathe.
* You can absorb copper across your skin when it is present in the air,
water, soil, or jewelry.
* Certain household and gardening chemicals contain copper, such as fungicides
and algae control products. You can be exposed through skin contact or
by breathing vapors.

Internet References

* Are Copper Bangles Good for You? Just Eat Better! - Life Extension Foundation
looks at the health effects of copper bracelets.
* BBC News: Copper Vital to Development - The BBC reports on a study indicating
that a genetic defect in copper metabolism may lead to some miscarriages.
* Copper and Your Health - Although the main purpose of this article is
to discuss copper in drinking water, the Wisconsin Department of Natural
Resources offers a lot of information on the health effects of copper
and discusses US EPA regulations regarding copper in the environment.
* Copper…an essential mineral for good health - This is an excerpt from
Rare Earths: Forbidden Cures, 1994 (pp. 315-327).
* Copper Deficiency - The Analyst discusses copper deficiency and provides
a glossary of terms used in discussing health effects of copper.
* CopperInfo.com - This is comprehensive copper resource, with information
about copper in health and nutrition and a host of other copper-related
subjects.
* Copper in Health - The International Copper Study Group provides lots
of facts and figures relating to health effects of copper and has links
to other information about copper.
* Copper in Human Health - This Internet version of a CDA UK publication
has lots of information about copper and human health as well as references
to support its statements.
* Copper’s Beneficial Role in the Body - This is a PDF chart that illustrates
some of the uses of copper in the body.
* Copper’s Unique Features and Benefits - The New Zealand Copper Council
summarizes some of the characteristics of copper.
* Diseases and Conditions - Copper - The Discovery Health Channel provides
a basic overview of the health effects of copper, including listing the
US RDA for copper.
* Public Health Statement for Copper - The Agency for Toxic Substances
and Disease Registry offers a comprehensive fact sheet on the health effects
of copper.
* WedMD - Most Supplemental Copper Worthless - Most copper supplements
contain a type of copper not readily absorbed by the body. Additionally,
high vitamin C and/or zinc intake can lead to copper deficiency.

Books About Copper and Health (Alphabetical Order)

Beyond the Copper Bracelet: What You Should Know About Arthritis (The
Charles Press Series on Chronic Diseases) by Louis A. Healey, Kenneth
R. Wilske, Bob H. Hansen

Biology of Copper Complexes (Experimental Biology and Medicine) by John
R.J. Sorenson (Editor)

Copper and Zinc in Inflammation (Inflammation and Drug Therapy Series,
Vol 4) by R. Milanino (Editor), G. P. Velo (Editor), Kim D. Rainsford
(Editor)

Copper Bioavailability and Metabolism (Advances in Experimental Medicine
and Biology, 258) by Constance Kies (Editor)

Copper Bracelet and Arthritis by Helmar H. Dollwet

Copper in the Environment, Part 2: Health Effects by Jerome O. Nriagu

cover
Copper Transport and Its Disorders: Molecular and Cellular Aspects (Advances
in Experimental Medicine and Biology, 448) by Arturo Leone (Editor), Julian
F. B. Mercer (Editor)

Dietary Reference Intakes: For Vitamin A, Vitamin K, Arsenic, Boron, Chromium,
Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium
National Academy Press

Inflammatory Diseases and Copper (Experimental Biology and Medicine, 2)
by John R. Sorenson (Editor)

Oncogenes and Human Cancer Blood Groups in Cancer Copper and Inflammation
Human Insulin (Progress in Clinical Biochemistry and Medicine, Vol 2)
by T.L.J. Boehm

Why Am I Always So Tired?: Discover How Correcting Your Body’s Copper
Imbalance Can Keep Your Body from Giving Out Before Your Mind Does by
Ann Louise Gittleman, Ann Louise Gittlemen, Melissa Diane Smith (Contributor),
Michael Rosenbaum

Wilson’s Disease for the Patient and Family: A Patient’s Guide to Wilson’s
Disease and Frequently Asked Questions About Copper by MD George J. Brewer,
M. D. George J. Brewer

Zinc and Copper in Clinical Medicine Hardcover published by Aperture

Zinc and Copper in Medicine 678 pages, publisher: C. C. Thomas