Copper is more than a metal used to cover pipes. It’s present in the human body in small amounts and helps the body perform needed functions in the brain, blood, and more.

At least 12 enzymes exist in the body that doctors call “cuproenzymes.” These are dependent on copper to function. An example is tyrosinase, which the body uses to make melanin, a compound present in the skin cells. The body also depends on copper to break down iron.

Doctors call a copper deficiency in the blood “hypocupremia.” According to the British Medical Journal, the condition is often underdiagnosed.

Copper deficiency can be hard for doctors to diagnose because the symptoms are like many other conditions. For example, the symptoms associated with copper deficiency are similar to those of vitamin B-12 deficiency.

Low copper levels can affect a person’s immune system and energy levels. Examples include:

  • always feeling cold
  • easy bone breakage
  • easy bruising
  • fatigue
  • getting sick easily or frequently
  • pale skin
  • poor growth
  • skin inflammation
  • skin sores
  • unexplained muscle soreness

Very low copper levels can cause problems with muscle movement as well.

Because the body mostly absorbs copper in the stomach and then in the small intestine, problems with either organ often affect a person’s ability to absorb copper.

Many times, copper deficiency is the result of stomach surgery that can affect absorption.

Zinc supplementation is also a common cause of copper deficiency. This is because zinc and copper compete for absorption in the stomach, with zinc being the usual winner. As a result, copper isn’t absorbed.

Because copper plays an important role in melanin formation, a lack of copper can affect a person’s hair. Melanin is important for pigmentation (color) of a person’s hair. Therefore, some doctors theorize that low copper levels could affect a person’s hair color, potentially leading to premature graying hair.

However, the links between copper and hair color changes and hair loss haven’t been widely studied. A 2013 study found no connection between blood copper levels and alopecia areata, a condition that causes hair loss. (Zinc, another trace metal, has been linked with potentially leading to hair loss.)

To diagnose copper deficiency, a doctor takes a health history and asks what kinds of medications and supplements you’re taking. They consider your symptoms when evaluating you for a copper deficiency. They may consider if you have risk factors.

These include:

  • excess zinc supplementation
  • history of bariatric surgery, such as gastric bypass
  • history of gastrectomy (surgical removal of a part or all of the stomach)
  • history of upper gastrointestinal surgery
  • malabsorption syndrome, such as celiac or inflammatory bowel disease, where a person may not fully absorb all the nutrients in their food

A doctor may also order a blood test for plasma copper levels to determine if your blood copper levels are low. This test isn’t a definitive diagnostic test for copper deficiency because other factors can falsely elevate a person’s blood copper levels. Doctors usually consider copper levels to be severely deficient if they’re less than 30 percent of the expected normal range.

Initial treatment of copper deficiency may depend on why your copper levels are low in the first place. For example, if you’re taking too much zinc, you may just need to cut down on zinc supplements.

Doctors often recommend a copper supplement as adequate treatment. Copper supplements on the market include copper gluconate, copper sulfate, and copper chloride.

Taking about 2 milligrams (mg) of copper per day may help to correct a deficiency, but your doctor will let you know the right dosage for you. Increasing your intake of copper-rich foods may also help.

If your deficiency is severe and your doctor is concerned that your body won’t absorb copper supplements, they may prescribe intravenous (IV) copper treatments.

According to the British Medical Journal, correction of copper deficiency can take anywhere from 4 to 12 weeks.

The average daily recommended intake for copper is about 0.9 mg. Most people go over this amount in their daily diets. The most common sources of copper in foods are found in breads and cereals. The best food sources of copper include:

  • oysters (6 medium, cooked): 2,397 micrograms (mcg)
  • crab meat (3 ounces, Alaskan king): 1,005 mcg
  • cashew nuts (1 ounce, raw): 622 mcg
  • sunflower seeds (1 ounce, dry roasted): 519 mcg

Whole-grain bread and pasta, broccoli, potatoes, and bananas are also high in copper.

The most common complications of copper deficiencies are anemia, pancytopenia, and ataxia:

  • Anemia is a condition where a person’s red blood cells are low. This affects the amount of oxygen delivered to organs and tissues.
  • Pancytopenia is a condition where all three major cellular parts of the blood are low. These include red blood cell, white blood cell, and platelet counts. This condition can affect the body’s immune system and overall health.
  • Ataxia is the loss of control of body movements. This occurs with low copper levels because a person’s nervous system is affected.

Other, less-common complications of copper deficiency include problems with bone development, loss of pigment in the hair and skin, and affected growth.

Copper deficiency is a rare condition, but it can occur, especially in individuals who have had stomach surgery. Fortunately, the condition is highly treatable through dietary changes as well as copper supplements.

If your copper levels are very low, talk to your doctor about the best treatments. Your levels can usually be corrected in a few weeks.