Deficiency and toxicity: Copper toxicity has been the subject of great concern in recent years. High copper levels, especially when associated, as they often are, with low zinc levels, have been described in a wide variety of conditions. Whether this is incidental, a cause of these problems, or a result of them is not known for certain. Problems of copper toxicity may include stress and anxiety states, joint and muscle pains, psychological depression, mental fatigue, poor memory, lack of concentration, insomnia, manic depression, schizophrenia, senility, epilepsy, autism, hypertension, stuttering, hyperactivity in children, premenstrual syndrome, preeclampsia of pregnancy, and postpartum psychosis. Until further research clarifies the problems of copper toxicity, it is wise to check levels of copper (and zinc) in people with these conditions as well as those with alcoholism, cancer, and infectious diseases. The World Health Organization (WHO) still states that copper is nontoxic.

Hair levels of copper are not very helpful in detecting increased body copper because external contamination from the fungicides and algicides used in swimming pools or hot tubs may leave copper on the hair, causing misleading test results. However, hair copper is suggestive of body state, such that if hair (or blood copper) levels are elevated, it is wise to check the 24-hour urine copper level or the blood ceruloplasmin level. Red blood cell copper levels may be a good test to measure increased copper levels as well; serum copper levels may be easier for detecting deficiency.

Symptoms of mild copper toxicity may be classified as hypochondriac or "neurotic" ones. Fatigue, irritability, nervousness, depression, and learning problems are some common symptoms. Higher levels of copper intoxication can lead to nausea, vomiting, diarrhea, liver damage, gingivitis, dermatitis, or a discoloration of the skin and hair. In their book Trace Elements, Hair Analysis and Nutrition (Keats Publishing, 1983), Drs. Richard Passwater and Elmer Cranton describe a case of three women who lived together in a house with copper pipes. All presented symptoms of fatigue, irritability, muscle and joint aches, and headaches, and all had elevated copper levels. They were treated successfully with increased levels of zinc and manganese, which compete with copper for absorption and also help eliminate copper through the bile and urine. Carl Pfeiffer, M.D., suggests using zinc (50 mg.), manganese (3 mg.), and vitamin B6 (50 mg.) daily without supplemental copper to increase copper excretion. If copper levels are very high, treatment with penicillamine or chelation therapy with ethylenediaminetetraacetic acid (EDTA) may be needed. In Europe, a compound called Dimeval (di-mercapto-succinic acid) may be used to lower copper levels.

A genetic disorder called Wilson's disease affects copper metabolism and leads to low serum and hair copper with high liver and brain copper levels. This can be a serious and even fatal problem unless treated by chelating agents; penicillamine is most often used as it binds copper in the gut and carries it out. A low-copper diet and more zinc and manganese in the diet and as supplements will also help reduce copper levels. Menke's disease is a rare problem of copper malabsorption in infants. In this condition, which can often be fatal, decreased intestinal absorption causes copper to accumulate in the intestinal lining.

Copper deficiency has long been considered unlikely even with a suboptimal diet because it was thought to be readily available from foods. Newer surveys seem to suggest that, with soil deficiency and poor diet, the average dietary intake is now less than 1 mg. per day. Our bodies require more than this. A recent study revealed that 75 percent of those evaluated had less intake than the 2 mg. RDA. Many authorities feel that intake below 2 mg. is still sufficient, especially when drinking water from copper pipes.