Courtney Snyder, MD
Who knew...copper, the essential trace element important in the synthesis of neurotransmitters, respiration, immune function, energy metabolism and growth, could wreak so much havoc on the mind and body?
I never gave much thought to copper until it presented itself to me in the most delightful way...a dream of a copper tiled ceiling - the most memorable dream I've had. Copper ... "associated with the goddess Aphrodite/Venus in mythology and alchemy, ...symbolic of love, balance, feminine beauty and artistic creativity." So taken with this dream, I painted a mantel copper.
We eventually moved and left that copper mantel and dream behind. Ten years later copper resurfaced at the Walsh Research Institute where Dr. William Walsh was teaching about copper overload - one of the most common biochemical imbalances found in brain related disorders. "In most persons, blood copper levels are kept in a narrow range through the action of metallothionein, ceruloplasmin, as well as other proteins. Unfortunately, many persons have a genetic inability to regulate copper levels and a serious copper overload can result." - William Walsh, PhD.
It is well understood that neurotransmitters play a role in psychiatric conditions. It is less well known that nutrients impact neurotransmitters.
Copper is a cofactor in the synthesis of norepinephrine:
DOPAMINE---------------> NOREPINEPHRINE (adrenaline)
Copper, Vitamine C and Oxygen
Because of this, when copper is elevated, dopamine levels decrease and norepinephrine levels rise. Having these neurotransmitters out of balance can be at play in a whole range of problems including anxiety, panic, bipolar disorder, depression, ADHD, and autism. This doesn't mean that all depression (or these other diagnoses) are caused by copper overload. Dr. Walsh's database of chemistries on 10,000 psychiatric patients, show for example, there are five biochemical phenotypes of depression - undermethylation, overmethylation, copper overload, pyrroluria and toxic metals. His research did find, however, that overwhelmingly women with postpartum depression had elevated copper levels.
The reason for this? - A strong relationship between estrogen and copper. Copper promotes the production of blood vessels (important if a woman's body thinks she's about to carry a baby). When estrogen goes up (ie. puberty, pregnancy, or with birth control pills or hormone replacement) - there's no problem....unless a woman can't normalize copper afterwards. This can be compounded with each pregnancy and likely explains the tragic news stories of seemingly healthy women who in the midst of a postpartum psychosis harm their children. Much less extreme would be the women who have emotional or other health problems that begin after the birth of their child. This can also be the culprit for girls who develop inattention, anxiety, panic or depression around the onset of puberty.
The rest of the body is not necessarily spared. When you consider that copper is neuro-excitatory (think copper wires conducting electricity), it's not surprising that too much is associated with muscle and joint pain, headaches, brain fog and other symptoms often associated with fibromyalgia. Too much copper can also interrupt the cell's energy cycle and cause fatigue, ie. chronic fatigue syndrome. When you consider that copper promotes vascularization, it makes sense that many women with fibroids, excessive menstrual bleeding and even cancer very often have an abundance of copper (for tumors to grow, they need blood vessels - for blood vessels to grow, they need copper).
Men and boys can have copper overload as well. This may look like hyperactivity, inattention, impulsiveness...sometimes even anger or violence. A mother and son with copper overload can have very different manifestations.
While I've mentioned genetic vulnerabilities and estrogen, there are other exposures that can raise copper including multivitamins with copper and drinking water, especially if from copper pipes or well water. Copper is also in some algae treatments for swimming pools and high in certain foods such as chocolate, seafood, avocado, beans, nuts, lamb and organ meat. When copper overload seems to be affecting multiple family members - ie. a child, a parent and a even a grandparent (copper is being studied in both Alzheimer's and Parkinson's), there is likely a genetic defect related to metallothionein, but a shared exposure is also possible.
If copper overload is so prevalent, why isn't it being identified and treated in conventional medicine? First - physicians rarely check copper levels unless they are looking for the rare and most extreme form of copper toxicity called Wilson's Disease. If they did check levels, many cases of copper overload would not be identified. The Pheiffer/Walsh normal range that we (those who have trained with the Walsh Research Institute) use is narrower than the range provided by most labs. The way we measure copper is by checking serum copper levels and ceruloplasmin (a protein that binds copper). From these, we calculate the percentage of free/unbound copper. It is this free copper that is causing the problems. Someone can have a normal copper level (using a standard lab range, or even the Pheiffer/Walsh range) and still have very high free copper. Through the work of Dr. Walsh, it was found that normalizing to this more specific range could significantly improve symptoms for a large number of people.
Aside from high copper foods, other dietary factors can also be at play, such as zinc and/or protein deficiency. Zinc helps regulate copper and protein is necessary to have enough ceruloplasmin to bind with copper.
So, what can be done? I'd like to say, "zinc, zinc, zinc...." however, it's more complicated than that. Knowing someone's zinc level is helpful, otherwise you may not know how much (if any) zinc they need. Too much zinc, too quickly can rapidly mobilize copper and a cause worsening of symptoms. Excess zinc can cause anemia. We use other nutrients as well to help normalize copper. Knowing Vitamin D levels and thyroid functions are also important. If abnormal, these will need to be corrected in order to more easily correct the copper overload. In short, treatment involves:
As for my copper dream - I was pregnant with my daughter at that time. Thanks to copper, there was a good blood supply for her and she grew into a healthy baby. It's likely, however, that is when my own copper levels were starting to rise. Eventually, I would reach that copper ceiling and for me that meant severe headaches, muscle pain, fatigue and a range of neurologic symptoms that I was previously unable to find help for. But for checking my own levels upon returning home from my training, I may have never known, just as many others may never know.
Post Script - Sometime after writing this post, I discovered that I also mold toxicity and realized this was likely another factor in my elevated copper).
To find a physician trained in treating copper overload, (or if you are a physician interested in training in the evaluation and treatment of biochemical imbalances), visit walshinstitute.org.
I'm a conventionally trained child, adolescent and adult psychiatrist. My current approach to health is both holistic (pertaining to the whole person) and functional (addressing the root causes of illness). I write this blog to share what I've learned.