Copper
What is Copper?
Copper may play a role as an antioxidant, protect against neurological conditions, and act as a treatment for some ASD symptoms. Some research has shown a significant alteration of trace elements in the gut microbiome of individuals diagnosed with ASD, but other research shows there is no difference in copper levels for children with autism.
Copper is an essential trace mineral / metal that can be found in certain foods and available as a dietary supplement.
It is involved with many enzymes that have a role in energy production, iron metabolism, and the synthesis of connective tissue and neurotransmitters.
Copper is involved in making new blood vessels, regulation of gene expression, brain development, skin coloration, and immune function. Copper is stored in the skeleton and muscle and absorbed in the small intestine. This process helps protect our bodies from toxicity and deficiency [1].
Food Sources of Copper
Liver
Apples
Recommended Intake
These recommendations are based on the Recommended Dietary Allowance (RDA), which is the average daily level of intake sufficient to meet the nutrient recommendations of nearly all (97-98%) of healthy individuals.
Males and Females
1-3 years: 340 mcg
4-8 years: 440 mcg
9-13 years: 700 mcg
14-18 years: 890 mcg
19-50 years: 900 mcg
51+ years: 900 mcg
Deficiency
Copper deficiency is very uncommon. However, copper deficiency is still a risk for some populations.
Common Symptoms of Copper Deficiency Include:
Fatigue
Weakness
Problems with memory
Brittle bones
Pale skin
Vision loss
Individuals at iIncreased Risk of Copper Deficiency Include:
Celiac Disease
Menkes Disease
Wilson’s Disease
Children who are selective eaters
Premature infants
Especially low birth weight
Short bowel syndrome
Toxicity
If copper toxicity is reached symptoms will include:
Damage to the liver
Abdominal pain
Nausea
Vomiting
Diarrhea
There are no known interactions with copper and medications.
The Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects. These levels reference dosing from supplement only and does not include food intake.
Males & Females
1-3 years: 1,000 mcg
4-8 years: 3,000 mcg
9-13 years: 5,000 mcg
14-18 years: 8,000 mcg
19 + years: 10,000 mcg
Copper Supplements
Copper can be found as an isolated supplement or in a combination, such as in a multivitamin, though we generally suggest choosing a multivitamin without copper (and iron) due to the risk of toxicity and potentially inhibiting the absorption of other minerals. We generally suggest increasing copper foods as the first approach to increasing copper levels and consider supplements second (and only if a blood test confirms copper levels are low).
If you do decide to supplement, with copper, here are a few options (please be mindful of the dose to not exceed your child’s Upper Limit. Supplementing above the Upper Limit may cause copper toxicity)
Capsules
Pure Encapsulations Copper Citrate (not suitable for those avoiding corn)
Liquid
Note: All supplements are linked to Amazon for convenience, however, buying supplements on Amazon does not guarantee quality, as there are many “unverified resellers” selling nutrition supplements. To buy supplements that are verified to be sent directly to the consumer, you can create an account on the Autism Dietitian FullScript and search for the respective supplement under “Catalog”.
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
Copper & Autism in the Research
Copper Levels
There was no significant difference found in copper levels between children who had ASD and who did not [2].
Concentrations of copper, lead, arsenic, zinc, mercury, calcium and magnesium in hair were significantly higher in the ASD group than in the control group [3].
There was no significant difference in whole blood Cu, Zn/Cu ratio, Fe, or Mg between the group with ASD and the group without ASD [4].
Parental Age
Advanced maternal and paternal age, toxic chemical exposure, maternal diabetes, and possibly altered zinc-copper cycles have suggested an increase in offspring vulnerability to ASD. Both zinc and copper have been associated with ASD traits [7].
Neurological Function
Copper is a possible antioxidant and adjuvant treatment to ASD symptoms, and it may also play a role in other neurological conditions like Alzheimer’s [5].
This meta-analysis suggests that while increased levels of blood copper might be associated with depressive disorder, hair samples did not show a significant difference [6].
A large body of evidence indicates that dysregulation of biometals (Fe, Cu, Zn) and their interactions with amyloid precursor protein (APP) and Aβ amyloid may contribute to Alzheimer's disease [8].
Copper and the amyloid precursor protein (APP) derivative (s-APP-alpha) has roles as an antioxidant and a possible adjuvant in the treatment of some ASD symptoms [5].
Copper and the Gut
There were significant alterations in trace elements and gut microbiota profiles of Chinese children with ASD. Concentrations of lead, arsenic, copper, zinc, mercury, calcium and magnesium were significantly higher in the ASD group than in the control group [3].
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[1] Copper fact sheet for consumer. Nih.gov. Accessed February 2, 2021. https://ods.od.nih.gov/factsheets/Copper-Consumer/
[2] Guo M, Li L, Zhang Q, et al. Vitamin and mineral status of children with autism spectrum disorder in Hainan Province of China: associations with symptoms. Nutr Neurosci. 2020;23(10):803-810. doi:10.1080/1028415X.2018.1558762
[3] Zhai Q, Cen S, Jiang J, Zhao J, Zhang H, Chen W. Disturbance of trace element and gut microbiota profiles as indicators of autism spectrum disorder: A pilot study of Chinese children. Environ Res. 2019;171:501-509. doi:10.1016/j.envres.2019.01.060
[4] Wu LL, Mao SS, Lin X, Yang RW, Zhu ZW. Evaluation of Whole Blood Trace Element Levels in Chinese Children with Autism Spectrum Disorder. Biol Trace Elem Res. 2019;191(2):269-275. doi:10.1007/s12011-018-1615-4
[5]Santos G, Borges JMP, Avila-Rodriguez M, et al. Copper and Neurotoxicity in Autism Spectrum Disorder. Curr Pharm Des. 2019;25(45):4747-4754. doi:10.2174/1381612825666191217091939
[6]Ni M, You Y, Chen J, Zhang L. Copper in depressive disorder: A systematic review and meta-analysis of observational studies. Psychiatry Res. 2018;267:506-515. doi:10.1016/j.psychres.2018.05.049
[7]Bölte S, Girdler S, Marschik PB. The contribution of environmental exposure to the etiology of autism spectrum disorder. Cell Mol Life Sci. 2019;76(7):1275-1297. doi:10.1007/s00018-018-2988-4
[8]Pilozzi A, Yu Z, Carreras I, et al. A Preliminary Study of Cu Exposure Effects upon Alzheimer's Amyloid Pathology. Biomolecules. 2020;10(3):408. Published 2020 Mar 6. doi:10.3390/biom10030408
Authors
Suzy Morris, Dietetic Intern
Sheila Nguyen, Dietetic Intern
Brittyn Coleman, MS, RDN/LD, CLT