Also indexed as: Copper Overload, Hepatolenticular
Degeneration
An excess of copper in the body can lead to a long list of health
problems. According to research or other evidence, the following self-care steps may be
helpful in treating this rare genetic disorder:
- Try zinc
- Reduce dietary copper absorption by supplementing with zinc;
consult your healthcare provider to determine the correct amount to use
- Steer clear of copper
- Work with a nutritionist to make sure you avoid eating foods that
are high in copper
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full Wilson’s disease
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About Wilson’s disease
Wilson’s disease is a genetic disorder that results in excessive accumulation of copper in many parts of the body, particularly
the liver.
This condition is readily treatable, but if Wilson’s disease is left untreated, it
can be fatal.
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What are the symptoms?
Wilson’s disease is initially silent and may first be noticed as fatigue, absent
menstrual periods in premenopausal women, or repeated and unexplained spontaneous abortions.
In more advanced stages, there may be headaches, tremors, uncoordinated limb movements,
unsteady gait, drooling, difficulty swallowing, and joint pain. There also may also be strange
thought patterns with unusual behaviors.
Medical options
Over-the-counter zinc supplements are
sometimes used as maintenance therapy following
copper chelation with prescription medications, but not in combination with the
prescription medications used to treat Wilson’s disease, due to interactions.
Prescription drugs, such as trientine (Syprine) and oral penicillamine (Depen), are
commonly used to bind or chelate excess copper and remove it from the body.
Healthcare providers also recommend a low copper diet.
Dietary changes that may be helpful
Most foods contain at least some copper, so it is not possible to avoid the metal
completely. Foods high in copper, such as organ
meats and oysters, should be eliminated
from the diet. Some foods are relatively high in copper but are quite nutritious (for example,
nuts and legumes)—these foods should be eaten in
moderation by people with Wilson’s disease.
Grains contain significant amounts of copper but are important components of a healthful
diet, and dietary restriction may be neither wise nor necessary, particularly if zinc is
supplemented.
Vitamins that may be helpful
Zinc is known for its ability to reduce
copper absorption and has been used successfully in patients with Wilson’s
disease,1 with some trials lasting for years years.2 3
Researchers have called zinc a “remarkably effective and nontoxic therapy for
Wilson’s disease.”4 The U.S. Food and Drug Administration has approved
the use of zinc to treat Wilson’s disease for maintenance therapy following drug
therapy, although some scientists recommend that it be considered for initial therapy as
well.5
Zinc has also been used to keep normal
copper levels from rising in people with Wilson’s disease who had previously been
treated successfully with prescription drugs.6 Zinc (50 mg taken three times per
day) has been used for such maintenance therapy,7 though some researchers have used
the same amount of zinc to successfully treat people with Wilson’s disease who had not
received drug therapy.8
Zinc is so effective in lessening the body’s burden of copper that a copper
deficiency was reported in someone with Wilson’s disease who took too much (480 mg per
day) zinc.9 Nonetheless, zinc may not help everyone with Wilson’s disease.
Sometimes increased copper levels can occur in the liver after zinc
supplementation;10 however, leading researchers believe this increase is temporary
and may not be not harmful.11
Zinc supplementation (25 mg or 50 mg three times daily) has also been used to successfully
treat pregnant women with Wilson’s disease.12 Management of Wilson’s
disease with zinc should only be undertaken with the close supervision of a doctor.
Copper is present in several dietary
supplements, especially multimineral and
multivitamin-mineral preparations. Supplements containing even small amounts of copper
should be avoided by virtually all Wilson’s disease patients.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
References:1. Hoogenraad TU, Van den Hammer CJA, Van Hattum J. Effective treatment
of Wilson’s disease with oral zinc sulphate: two case reports. Br Med J
1984;289:273–6.
2. Cossack ZT. The efficacy of oral zinc therapy as an alternative to
penicillamine for Wilson’s disease. N Engl J Med 1988;318:322–3
[letter/review].
3. Brewer GJ, Dick RD, Johnson VD, et al. Treatment of Wilson’s
disease with zinc: XV long-term follow-up studies. J Lab Clin Med
1998;132:264–78.
4. Brewer GJ, Yuzbasiyan-Gurkan V. The use of zinc-copper metabolic
interactions in the treatment of Wilson’s disease. J Am Coll Nutr 1989;8:452
[abstract 103].
5. Hoogenraad TU. Zinc treatment of Wilson’s Disease. J Lab
Clin Med 1998;132:240–1 [editorial].
6. Brewer GJ, Hill GM, Dick RD, et al. Treatment of Wilson’s
disease with zinc. III. Prevention of reaccumulation of hepatic copper. J Lab Clin
Med 1987;109:526–31.
7. Brewer GJ, Yuzbasiyan-Gurkan V. Use of zinc-copper metabolic
interactions in the treatment of Wilson’s disease. J Am Coll Nutr
1990;9:487–91.
8. Brewer JG, Yuzbasiyan-Gurkan V, Lee D-Y, Appelman H. Treatment of
Wilson’s disease with zinc. VI. Initial treatment studies. J Lab Clin Med
1989;114:633–8.
9. Van den Hamer CJA, Hoogenraad TU. Copper deficiency in Wilson’s
disease. Lancet 1989;ii:442 [letter].
10. Van Caillie-Bertrand M, Degenhart HJ, Visser HKA, et al. Oral zinc
sulphates for Wilson’s disease. Arch Dis Child 1985;60:656–9.
11. Brewer JG, Yuzbasiyan-Gurkan V, Lee D-Y, Appelman H. Treatment of
Wilson’s disease with zinc. VI. Initial treatment studies. J Lab Clin Med
1989;114:633–8.
12. Brewer GJ, Johnson VD, Dick RD, et al. Treatment of Wilson’s
disease with zinc. XVII: treatment during pregnancy. Hepatology
2000;31:364–70.