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Summary
In this episode, I discuss copper overload, a common yet often overlooked contributor to various mental health issues, including postpartum depression and ADHD. The referenced data comes from the Walsh Research Institute, which studied nutrient levels in 30,0000 people with brain related symptoms, and found a small handful of nutrient imbalances repeated showing up. Copper overload was the one of those imbalances. I explain the relationship between copper and zinc, and how elevated copper can impact neurotransmitter functioning. I also address the symptoms of high copper, potential causes for its elevation, methods for assessing copper levels, and treatment strategies to manage copper overload effectively Takeaways
00:00 Understanding Copper Overload 10:36 Identifying Symptoms and Conditions Related to Copper 21:10 Assessing and Treating Copper Overload As always, I welcome any comments and questions, as these help guide the information that I share. Transcript Intro: Welcome to the Holistic Psychiatry podcast. I'm Courtney Brown-Snyder, a physician and holistic child and adult psychiatrist. In this episode, I'll be talking about copper overload. Now this is something that I've talked about in the past, but I want to revisit it because it is such a common culprit when it comes to brain related symptoms. The Walsh Research Institute found that 95 % of women with postpartum depression, anxiety, or psychosis have been found to have relatively high copper. 68 % of those with ADHD have been found to have a copper-zinc imbalance. Copper overload is one of the biotypes of depression. It can also contribute to high anxiety, including panic and episodic rage or tantrums, whether that's diagnosed as intermittent explosive disorder or disruptive mood disorder. So as you can imagine based on that, there are many people that are being impacted by high copper and could potentially benefit from recognizing that elevated copper, which is quite treatable, could be contributing to their symptoms. So in this episode, I'll talk about what copper is. I'll talk about reasons it can become elevated. I'll discuss its relationship with estrogen, though boys and men can also have high copper. I'll talk about common conditions and when I suspect high copper may be an issue. And I'll talk about how we assess copper, what the lab testing looks like, and what treatment looks like. So let's get started. Medical Disclaimer This podcast and newsletter are for educational purposes and not intended or implied to be a substitute for professional medical advice, diagnosis or treatment for either yourself or others, including, but not limited to patients that you are treating. If you're a practitioner, please consult your own physician for any medical issues you may be having. to start, copper is a trace metal. Copper (02:19.414) It's something that should be in our body. It's in our water source. It's in a number of different, it's in various foods and within our body, just like other minerals such as zinc, it's something that should be regulated. And we have genetics that contribute to how well we regulate copper. So what I'm talking about today doesn't necessarily affect everyone. It can affect those who have difficulty regulating copper or who because of other reasons are getting very high exposure or are dealing with what is called high oxidative stress. And this is where our bodies inherent antioxidants which help us mitigate insults such as toxicity, inflammation, trauma, when those antioxidants have become depleted. Then that can contribute to things like high copper. Symptoms So generally symptoms of high copper would be potential symptoms. People don't have to have all of these would be insomnia, inattention or brain fog, hyperactivity, high anxiety, depression. There can be physical symptoms like fatigue, headaches, muscle tension and muscle aches. There can be sensitivity to food dyes and sensitivity to shellfish. Now, if people have, for example, psychosis that could also add fuel. So it really can reach any of the psychiatric conditions. How Copper Impacts Neurotransmitters But first, how does copper contribute to brain symptoms? How does it impact neurotransmitter functioning? So copper is a cofactor in the conversion of dopamine to norepinephrine. What this means is that we need copper to help the enzyme that converts dopamine, a neurotransmitter, to norepinephrine, another neurotransmitter. Now dopamine we need for mood, for motivation, for attention, and norepinephrine is somewhat like adrenaline, and that is needed for energy and for mood as well. (04:41.486) So if someone has high copper, they could become depleted in dopamine relative to norepinephrine. So if we're depleted in dopamine, that could look like depression and attention, lack of motivation. And if we have an excess of norepinephrine or adrenaline, that could look like insomnia, anxiety, hyperactivity, irritability, or even rage. Reasons For Copper Overload So why would copper be elevated? First, it could be exposure, and this could be to someone eating a lot of chocolate. It's also high in shellfish. There are some supplements, including multivitamins, that contain copper. Again, this might be fine for some individuals, but for people that have problems regulating copper or who already have high copper from other exposures, this could be problematic. Other foods would include things like avocado, organ meat. However, these are not as high as chocolate and shellfish. We can also get copper in well water. It's particularly high. In fact, copper is in all water sources, all municipal water sources and has gone up over the years. Again, it's not considered a toxic metal. It's a trace metal, that's not necessarily affecting everyone. Copper can be in copper jewelry, copper thermoses. It can also be in algae treatments used in some swimming pools. Separately, we have in our body one of the major antioxidants is called metallothionein proteins. These are at the blood, the gut blood barrier and the blood brain barrier, and they are what keep toxic metals out. (06:46.112) They also regulate copper and zinc and keep integrity of our gut lining and our blood brain barrier. So if we don't have adequate metallothionine proteins, we can have problems with toxic metals. We can also have problems regulating copper and zinc, and we can have permeability contributing to autoimmunity, or even again permeability at the gut, at the blood brain barrier, which is what keeps problematic things out. In order to make metallothionines, we need adequate levels of zinc. So someone could have weakness genetically, but separately, someone could have low zinc contributing less metallothionine and then elevated copper. So zinc is what keeps copper in check. Reasons someone could have low zinc could be dietarily, there's less zinc over time in our soil and thus in crops. Pyrrole disorder is something that would cause a depletion in zinc. As we age, we become more depleted in zinc. And some people just aren't absorbing zinc and other nutrients particularly well. Another reason copper could become elevated is because of high oxidative stress, again our body dealing with some type of insult, whether it be toxins, inflammation, trauma, that's depleting us in our antioxidants. Now if we're dealing with oxidative stress, those metallothionines could be busy taking care of something else and not dealing with regulating copper and zinc and so copper could become elevated. High copper is a marker for oxidative stress. And lastly, though not insignificant, is the relationship between copper and estrogen. So we need, so during pregnancy, as estrogen levels go up, copper levels will go up and this is because copper is needed to vascularize, create blood vessels for the placenta. After delivery, the copper levels go down or they should go down. (09:10.658) However, if someone has problems genetically regulating copper and zinc, they could stay high. And this is why there's such a strong association with postpartum depression, anxiety, and psychosis. But it's not just pregnancy that contributes to elevations in estrogen. Some women will have higher estrogen levels for other genetic reasons. Some women are on birth control and some women are on hormone replacement. So if they happen to also have problems regulating copper, that added estrogen could be causing their copper to ramp up. And that doesn't necessarily happen immediately, but it could be escalating over time and contributing to brain symptoms. I should have mentioned too that a copper source can also be a copper IUD. So IUDs may have have an estrogen component, but copper IUDs also still exist and that can be a direct source of copper. Conditions that Can Suggest High Copper So in my practice, when I tend to suspect high copper in a child or an adult, it could be for a number of reasons, including a woman having postpartum depression, anxiety, or psychosis. Next, if I see anyone with ADHD, whether that's an adult or a child, or even ADD, I would expect that they're going to have a copper zinc imbalance, which I'll talk about the labs shortly. I also suspect copper overload if there is a young girl who is starting puberty or in the middle of puberty or a teenager who's onset of symptoms appeared to correlate with rising levels of estrogen. So if a child is going along fine, not having any symptoms, and then they hit puberty, and then all of a sudden, this girl is starting to have inattention, depression, anxiety, I would suspect copper could be at play. Anyone with temper, rage, a diagnosis of intermittent explosive disorder, or disruptive mood disorder, I would highly suspect high copper. (11:34.764) Any woman who has a copper IUD and having brain-related symptoms, anyone who has started birth control or hormone replacement and then started to have either an increase or a new onset of brain symptoms, I would suspect high copper. Anyone with a more severe mental health condition, suggesting high oxidative stress such as those on the autism spectrum or anyone with schizophrenia or bipolar disorder or even dementia in the form of Alzheimer's. If someone has a panic disorder or very high palpable anxiety, I would suspect high copper. And if someone has a family history that has postpartum depression, ADHD or individuals with explosive tempers, I would suspect or wonder about copper. Assessment So how do I assess copper overload? So for anyone that I see with brain related symptoms, I would be looking at the Walsh Research Institute labs. And these include serum copper, ceruloplasm, and this is a protein that binds copper, plasma zinc, Also, I would look at whole blood histamine for methylation or methylation profile and crypto pyro test in addition to just basic labs someone might have for routine physical. But specific to copper would be the serum copper, the ceruleplasmin and the plasma zinc. Based on the serum copper, if it's elevated, that would indicate high copper. But the range that we use is much tighter than a typical lab range. So if, for example, you've had lab work done and you look at your lab work and you've had a serum copper in the past, by chance, maybe you had a functional medicine doctor check that. Typically conventional doctors wouldn't be looking at that. (13:48.591) You might note that you're falling within the normal range. However, when they looked at 30,000 people with brain related symptoms and identified these common imbalances, they weren't necessarily out of a typical lab range. They were relatively low compared to those who did not have brain symptoms, or in this case relatively high in the case of copper. So aside from looking at the serum copper in the range that we use, we would also calculate a percent free copper and this is based on how much copper is not bound to that ceruloplasmin protein and based on that we come up with another value. This is the percent free copper. Someone could have a normal value for serum copper based on the ranges that we use, and still have a high percent free copper. Then based on the serum copper and the percent free copper, we have a copper index or a free copper index. And this gives us another way of looking at it. So for example, if someone has relatively, they don't have high copper and it's relatively low, they could have a high percent free copper, but since their copper is so low, Even if amount of that being free might not be significant, this is why we do the index. We also look at the copper-zinc ratio. norm, more ideally, they're fairly close to one-to-one, but when someone has elevated copper, often their zinc is low and there's a big discrepancy. And again, this is what they found to be very common in individuals with ADHD diagnosis. So aside from the lab values, we're also looking at that in the context of someone's symptoms, someone's traits, in relation to with the other Walsh imbalances, which have their own lab values, own traits, own symptoms. Treatment So how do we treat high copper? The most direct way that we treat it would be to lower one's exposure and to use a nutrient protocol. A nutrient protocol is a combination of supplements, vitamins and minerals that are put together individually based on someone's nutrient imbalances. So with copper overload, zinc is particularly important to help with the production of those metallothionine proteins so that they can regulate the copper and the zinc. B6, I usually use P5P, is also important for helping support metallothionein proteins and strong antioxidant support, again, because there's often high oxidative stress, sort of lower exposure, that could mean someone stopping taking copper supplementation, starting to use water filtration, not any water filtration, but water filtration that specifically takes out copper. It could mean even stopping birth control or hormone replacement. If that is contributing to the escalation in copper, now this can be tricky in some situations and it's not always possible to be able to stop those. We do the best we can and for some women that is not enough, the nutrient protocol and removing other sources of exposure and they still may have difficulty bringing that copper down as long as they're on added estrogen. Now I do see a number of teenage girls who were put on birth control because of problems related to their periods. Maybe it was excessive cramping, heavy bleeding or even mood changes and they have benefited from the birth control for that reason. But the likelihood is the reason they had those symptoms in the first place was because of high copper and the added estrogen while it may be helping hormonally, is nonetheless causing their copper to go higher and then they're having new, if not exaggerated brain symptoms. So if we can get them on the nutrient protocol, bring their copper down, the hope is certainly that then they would not need to be on the birth control, at least for that reason. (18:19.305) So I mentioned limiting exposure, when possible removing added estrogen exposure. It can also mean lowering oxidative stress. So I see a number of people who have mold toxicity and as they're being treated, as I'm treating them for mold toxicity, their copper related issues can start to improve even though I'll also have them on a protocol of nutrients to bring down their copper. Their need for those nutrients and for that zinc can often lessen as the source of oxidative stress, in this case mold, starts to improve. And also in some cases we need to add additional nutrients to bring down copper. One would be molybdenum. This is something we don't use in children and it can be quite dramatic in how it brings down copper, which is part of why we will monitor copper values, even with zinc, we'll monitor copper and zinc values to make sure that things are where we want them and that the copper isn't getting too low, but molybdenum is more likely to do that. Another intervention that may be needed can be what's called MT promoter. This is metallothionine, promotion therapy and this is basically a proprietary blend of amino acids and glutathione that can help supporting and forming those metallothionein proteins. Of course this depends on there being adequate amounts of zinc so we don't start it until someone's reached a certain threshold for their zinc level and B6 is also particularly important for that MT promoter to be effective. (20:42.223) And then lastly, I would say we address, we're also addressing other imbalances when present. And most of the people I see don't simply have copper overload. They very often have in combination with that, a methylation imbalance, which will need its own targeted nutrients and or elevated pyroles. Again, pyroles can cause low zinc, low zinc can contribute to high copper. So when we put together a nutrient protocol, it's based on someone's lab values, their symptoms, their age, their weight, and we're putting together a protocol based on that information. If we start the nutrient protocol, specifically zinc too quickly and mobilize that copper too rapidly, that can cause a worsening of the various symptoms that someone is having from copper. So normally I will start a protocol gently over three to four weeks. So as far as the response times, most people will respond on the full protocol at about three to four weeks, but then a more full response by two months. Now, of course, it depends on how high someone's copper is. I see some people who have quite dramatic elevations in copper and then some people who have it just above what we would consider optimal and are having significant symptoms nonetheless. Obviously to bring down their copper wouldn't take as long. But either way we tend to see most people have significant benefit. It doesn't mean that there can't be other root causes that are even not nutrient based. Again, things like mold toxicity or trauma or early attachment disruption or gut microbiome imbalances. There's a number of other things that I consider, but because this is so common along with the other Walsh imbalances, this would be quite foundational to consider. There's a number of other things that I consider, but because this is so common along with the other Walsh imbalances, this would be quite foundational to consider. So if you've had problem So if you've had problems with temper, if you've had problems with ADHD or insomnia or high anxiety or postpartum depression, anxiety, or even psychosis, or have simply not so simply necessarily had depression, then it certainly is worth considering if copper overload could be at play. I hope this information has been useful to you or someone that you know or care about. If you want to take a deeper dive into copper overload, have deeper information on my Substack newsletter. If you would like to receive this newsletter in your mailbox, please consider subscribing at Courtney Snyder,MD.com, where I have information about my treatment practice, but also my nonpatient consultations that I offer nationally and internationally, and I have my more recent discovery calls available as well. Thank you for listening and I look forward to connecting with you in a future episode. Until then, take care. As always, I welcome your thoughts and questions. Until next time, Courtney
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One of the copper sunrises here this week - from my window.
By Courtney Snyder, MD
This comment was in response to my 2015 blog post, "Copper Overload: Too Much of a Good Thing”: “I am a primary care physician in Dublin and I attended the Dr Walsh course in Sydney in 2006. I learned a great deal there and I use his work almost every day. High copper in women is very common in Ireland and it is quite easy to bring it down after the first month of treatment. I have been to courses all over the world from Harvard to Cambridge but the course in Australia was the most useful of them all. Every week I utterly change the life of some people and it is a real privilege to have that opportunity.” He effectively articulates what many of us Walsh-trained physicians experience.
Recap
In the previous newsletter, I explored copper overload, its causes, symptoms, and the situations where I suspect high copper levels. These include postpartum depression, ADHD, panic, anger, rage, agitation, hormonally related mood changes or anxiety, autism spectrum disorder, paranoid schizophrenia, Alzheimer's disease, and Parkinson's disease. |
Courtney Snyder, MDFor anyone experiencing brain symptoms. This blog (and weekly newsletter) is your guide to demystifying root causes and learning about surprising paths to healing. From a holistic - functional adult and child psychiatrist dedicated to helping people heal and thrive. Categories
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