Copper & Zinc Balance Vital for Inflammation, Sleep & More
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We often talk about nutrients in terms of their individual benefits. But the truth is that essential vitamins and minerals actually function as part of an inter-connected web. A bit like an extended family, they often work together, sometimes pull apart and the relationships can be complex when you start to scratch beneath the surface.
One particularly important nutrient relationship is the one between copper and zinc. And whilst it’s important to maintain optimum levels of both copper and zinc individually, it’s also crucial to pay close attention to the ratio between the two. This is because when your copper: zinc ratio is out of balance health problems can happen as a result. Read on to find out more.
Takeaway no. 1 : Zinc and copper are essential nutrients that must be included in the diet
Zinc has many crucial roles to play in the body but is perhaps best known for its involvement in immune function, reproduction, growth and development, wound healing, antioxidant functions and for a proper sense of taste and smell. Zinc cannot be stored in the body in significant amounts so you need to consume it regularly in your diet. Animal products provide the richest sources of zinc so anyone following a plant-based diet is at higher risk of deficiency. Zinc is present in every cell, organ, bone, tissue, and fluid in the body and needed as a co factor for over 300 different enzymes so there are many and wide ranging possible signs of deficiency. Zinc can have toxicity and side effects when taken in high doses for a long period of time.
Less well known than zinc, but no less important is copper - a vital co-factor in many enzymes and biochemical processes in the body, including those involved in antioxidant defence, immune function, energy production, connective tissue, neurotransmission and iron balance. Symptoms of low copper may include bone and connective tissue problems, neurological dysfunction and anaemia. Elevated copper levels can contribute to increased oxidative stress, and in high levels, copper can become toxic. Copper toxicity is rare and most frequently associated with a rare inborn error of metabolism called Wilson’s Disease that causes copper overload.
Takeaway no. 2 : The relative balance between copper and zinc is crucial too
These two minerals work hand-in-hand for many important jobs but they are also antagonists. This means that if one is too high it can cause the other to become too low and vice versa. Maintaining a proper balance between copper and zinc is therefore crucial as an excess of one can lead to deficiency of the other. In fact, excess copper and deficient zinc is one of the most common trace element imbalances in the human body. It’s important to note that oral hormonal contraceptives are associated with elevated plasma copper levels (hypercupremia).1,2 It’s also important to be aware that high zinc can deplete copper, so if you are taking supplemental zinc, especially at a higher dose, you need to consider your copper intake too. Fortunately, many foods that are high in zinc are rich sources of copper too. Copper deficiency has also been reported following chronic use of excessive amounts of zinc-containing denture creams. As you can see, this relationship is complex, but one to be aware of. The ratio of copper to zinc is widely considered to be a more useful marker of health status than each mineral alone.3
Takeaway no. 3 : Zinc and copper are both involved in antioxidant defence systems
Free radicals are harmful compounds that can cause damage and destruction if left unchecked. Both copper and zinc are needed for an important antioxidant enzyme called superoxide dismutase (SOD) that helps to fight free radicals and reduce oxidative stress; the ratio between the two is vital for keeping this enzyme functioning optimally. When copper is high and zinc is low this can lead to increased oxidative stress and impaired activity of this antioxidant enzyme and many others.
Takeaway no. 4 : An imbalanced copper: zinc ratio may be associated with inflammation, sub-optimal brain health, increased risk of infection, disturbed sleep, cardiovascular health problems and more
A balanced copper: zinc ratio may help to support immune function, fight infection and keep inflammatory processes balanced. Research shows that during times of chronic inflammation and poor health there is often an imbalanced copper: zinc ratio (higher copper & lower zinc). A 2017 study found decreased levels of zinc, reduced activity of the SOD enzyme and a higher copper: zinc ratio to be associated with higher inflammation in patients with inflammatory bowel disorder (IBD).4 Optimal brain health also relies on a balanced copper: zinc ratio. In a 2017 meta-analysis, researchers looked into the association between copper, zinc and Alzheimer’s Disease.5 They found copper levels were significantly higher and zinc levels were significantly lower (high copper: zinc ratio) in Alzheimer’s Disease than healthy controls. Some research has also shown an association between a high copper: zinc ratio and autism & ADHD.6 In one study, researchers found that as the severity of autism increased, so too did the copper: zinc ratio.7
In a 2022 study published in Biometals, researchers assessed the association between Cu:Zn ratio and the risk of incident pneumonia. They found that in middle-aged and older Finnish men, increased serum Cu:Zn ratio and Cu concentrations are each associated with an increased risk of incident pneumonia.8
An imbalanced copper: zinc ratio has also been reported in disturbed sleep,9 a higher risk of physical disability in the elderly6 and even in patients with heart failure.10
Takeaway no. 5 : Studies show associations between copper: zinc ratio and cancer outcomes
In a 2023 population-based cohort study a total of 1998 patients with breast cancer were followed for 9 years. Researchers analysed serum levels of copper and zinc and their ratio at the time of diagnosis and found a higher copper: zinc ratio was associated with lower overall survival.3 Further research, including large-scale studies have found associations between high levels of serum copper, low serum zinc and poor cancer survival.11-13
Takeaway no. 6 : Ensure your diet contains good sources of both copper and zinc
And finally, it goes without saying that clearly the ratio between copper and zinc is an important one. As is usually the case, nature has done the hard work for us and the good news is that many rich food sources of zinc are also good sources of copper. You will get good levels of both copper and zinc in a varied, balanced diet that prioritises nutritious wholefoods cooked from scratch. The richest food sources of zinc are animal products such as meat, fish, seafood, dairy and eggs. You’ll find copper in organ meats, shellfish, nuts, seeds, wheat bran and wholegrains.
And if you’re taking dietary supplements you’ll need to consider the copper: zinc ratio here too. Most high quality multivitamins will do the thinking for you and contain both zinc and copper in a balanced ratio to support the body’s needs for both.
References:
1. Von Studnitz, W, Berezin D. Studies on serum copper during pregnancy, during the menstrual cycle, and after the administration of oestrogens. Acta Endocrinol (Copenh), 27 (1958), pp. 245-252
2. Castro MA, Coca LP, et al. Hypercupremia secondary to oral contraceptives: Report of 2 cases. Endocrinologia, Diabetes Y Nutricion (English ed.) Vol 64 Issue 9. pages 509-511 (November 2017)
3. Bengtsson Y, Demircan K, et al. Serum copper, zinc and copper/zinc ratio in relation to survival after breast cancer diagnosis: A prospective multicenter cohort study. Redox Biol 2023 Jul; 63: 102728
4. Mohammadi E, Qujeg D et al. Evaluation of serum trace element levels and superoxide dismutase activity in patients with inflammatory bowel disease: translating basic research into clinical application. Biol Trace Elem Res. 2017 Jun; 177(2): 235-240
5. Li DD, Zhang W et al. Serum copper, zinc, and iron levels in patients with Alzheimer’s Disease: a meta-analysis of case-control studies. Front Aging Neurosc. 2017 Sep 15; 9:300
6. Viktorinova A, Ursinyova M et al. Changed plasma levels of zinc and copper to zinc ratio and their possible associations with parent and teacher symptoms in children with attention deficit hyperactivity disorder. Biol Trace Elem Res. 2016 Jan; 169(1):1-7
7. Li So, Wang JL et al. Serum copper and zinc levels in individuals with autism spectrum disorders. Neuroreport. 2014 Oct 22;25(15): 1216-20
8. Kunutsor SK, Voutilainen A, et al. Serum copper-to-zinc ratio and risk of incident pneumonia in Caucasian men: a prospective cohort study. Biometals. 2022 Oct; 35(5): 921-933
9. Luojus MK, Lehto SM et al. Serum copper, zinc and high-sensitivity C-reactive protein in short and long sleep duration in ageing men. J Trace Elem Med Biol. 2015 Oct; 32:177-82
10. Alexian I, Parissis J, et al. Clinical and echocardiographic correlates of serum copper and zinc in acute and chronic heart failure. Clin Res Cardiol. 2014 Nov; 103(11): 938-49
11. Fang A P, Chen PY, et al. Serum copper and zinc levels at diagnosis and hepatocellular carcinoma survival in the Guangdong Liver Cancer Cohort. Int. J. Cancer. 2019;144(11):2823–2832.
12. Leone N, Courbon D, et al. Zinc, copper, and magnesium and risks for all-cause, cancer, and cardiovascular mortality. Epidemiology. 2006;17(3):308–314.
13. Wu T, Sempos CT, et al. Serum iron, copper and zinc concentrations and risk of cancer mortality in US adults. Ann. Epidemiol. 2004;14(3):195–201.
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