This article was first published in Let's Live! magazine, March 1999.

Sick and tired? Your symptoms may be caused by something you'd never suspect. Here's how a simple nutritional regimen can bring your body back into balance

Ten years ago nutritionist Ann Louise Gittleman didn't feel well and couldn't imagine why. "I was anxious, suffered from fitful nights of sleep because my mind wouldn't turn off, and I had a tired body that couldn't keep up with all the things my active mind wanted to do," Gittleman recalls. "This was confounding to me because health education is my life's work; I naturally stayed up to date on all the latest health information and I was doing everything right -- eating well, taking nutrient supplements, exercising and trying to get enough sleep. I kept asking myself, 'What in the world is going on here?' "

Eventually, after a few years of research, Gittleman identified the culprit behind her health problems: copper overload -- excess copper in the tissues. Copper is a mineral essential for health in minute amounts, but it can become problematic when our dietary and environmental exposure is excessive or when various factors interfere with the body's ability to excrete it. Then copper builds up in tissues, interferes with other nutrients, and wreaks havoc with health like any heavy metal.

"Copper overload actually is the cause behind the cause of many common health problems, including physical fatigue, mental racing, emotional highs and lows, anxiety, and reproductive problems," Gittleman says. " Most practitioners don't know anything about it, which is unfortunate because this condition is quite common, especially among women." Women are more prone to copper accumulation because the female hormone estrogen increases copper retention. Gittleman estimates that about three-quarters of the female clients she has consulted have had copper overload.

What Causes an Overload?
Excess copper in the tissues can develop for a variety of reasons. First, some people simply are more prone to copper buildup than others. The slower the metabolism of an individual, the more likely he is to develop copper overload, regardless of his copper intake, according to David L. Watts, D.C., Ph.D., director of research at Trace Elements, Inc., in Dallas, Texas, and author of Trace Elements and Other Essential Nutrients (Trace Elements, 1995).

Those who experience excessive stress or who have insufficiency of the adrenal glands also are more likely to develop high copper levels. This occurs because stress dramatically decreases levels of zinc, copper's primary antagonist, and it also weakens adrenal function. Weak adrenal glands don't produce adequate amounts of hormones to stimulate the liver to remove excess copper from the body, Watts notes.

Copper overload also occurs because many of us are exposed to unsuspected sources of environmental copper on a regular basis. Copper water pipes, for example, have been in widespread use in this country for the past three decades and they can leach copper into the water supply if the water is too acidic. In addition, copper compounds often are added to municipal drinking water and are sprayed on produce to prevent fungus and algae growth.

Dental fillings -- both the newer silver amalgams and some gold alloys -- also are significant sources of copper. They can release slow but steady levels of copper into the system, as can copper intrauterine devices.

Widespread use of estrogen medications such as the birth control pill is one of the main reasons for the prevalence of copper overload today, according to Rick Malter, Ph.D., a psychologist from Hoffman Estates, Illinois, who has been treating copper-related mental and emotional health problems for 18 years. The "pill" is known to increase copper levels and it has been prescribed for the past four decades. Women, consequently, have become increasingly copper-toxic, Malter points out, and copper-toxic women unknowingly pass copper excess onto their unborn children.

Finally, the shift in our diets away from zinc-rich meats and toward vegetarianism also has contributed to the development of copper overload. Zinc and copper work in a see-saw relationship in the body. Ideally, the two minerals should be in an 8:1 ratio in favor of zinc in the tissues. But plant foods such as soy products, beans, whole grains and nuts all are copper-heavy. When these foods are emphasized in the diet, the all-important zinc-copper ratio can become skewed, leading to the development of copper buildup.

How to Detect an Imbalance
Most people who have copper overload don't know it for several reasons. For one thing, the only type of copper toxicity recognized by conventional medicine is Wilson's disease, a serious disorder caused by an inborn error of copper metabolism. There's a wide range of mild to moderate to severe cases of copper toxicity that aren't Wilson's disease though, according to Michael Biamonte, N.D., of New York City.

The main way to detect varying degrees of high copper in the tissues is through tissue (or hair) mineral analysis. Most doctors and nutritionists aren't taught how to use hair mineral tests or how to correctly interpret their results, so copper overload is rarely diagnosed, Biamonte says. Some doctors do check copper levels in the blood or ceruloplasmin (copper-binding protein) levels but these tests don't show the presence of excess copper in the tissues.

The detection of copper toxicity can be tricky, even with hair mineral analysis. Some people who have copper overload initially don't test high in copper because the copper is tightly stored in tissues and hasn't yet been released into circulation and deposited in the hair. If copper levels are low or normal, copper overload still can be present but hidden. A poor zinc-to-copper ratio (in other words, high copper in relation to zinc, whether or not copper levels are high) can be a sign of hidden copper toxicity. For more information on determining copper overload through hair mineral analysis, have your health practitioner contact Trace Elements, Inc., at 1-800-824-2314.

Another way to determine copper overload is by assessing symptoms and risk factors. To get a good indication of whether you have copper excess, examine the two lists on this page. The more symptoms and risk factors that apply to you, the more likely it is you have copper overload.

What You Can Do About it
Treatment of copper overload involves a three-pronged approach: diet, nutrient supplementation and stress management. To treat copper overload with diet, the general strategy is to avoid high-copper foods and increase the intake of zinc-rich foods. (See the sidebar.) The diet should contain primarily lean sources of animal protein and lots of vegetables and should be as low in zinc-depleting alcohol, sugar, and refined grains as possible. It's important to get some protein at every meal to help the body make protein carriers needed to detoxify excess copper.

Eating more zinc-rich poultry and red meats can be difficult or unappealing for some who have copper excess. This is because the increase in dietary protein and zinc can stimulate copper elimination and make some people initially feel achy or more tired or emotional. If you have copper overload and have avoided meat for a long time, it's best to gradually add small amounts of fish, poultry and meats back into your diet to stimulate slow but steady copper elimination.

To complement the effects of a zinc-rich, low-copper diet, supplementation with copper-antagonistic nutrients also is needed to lower copper levels. Vitamins and minerals antagonistic to copper include: zinc, manganese, vitamin C, B-6, B-3, B-5 (pantothenic acid) and A. The amounts, types and combinations of these nutrients that should be taken must be determined individually according to the amount of excess copper in a person's tissues and his or her symptoms and risk factors. Sulfur-based alpha-lipoic acid also helps copper overload because it enhances detoxification. The following are typical daily amounts of supplements suggested for copper overload by Gittleman: 25-50 mg. zinc; 15-30 mg. manganese; 100-300 mg. vitamin B-6; 1000-3000 mg. vitamin C; and 30-60 milligrams lipoic acid. In addition to the specific nutrients listed, Gittleman also recommends a complete multi-vitamin/mineral complex without copper. [Editor's note: Most multi-vitamin/mineral supplements contain copper. If you have trouble finding a copper-free multiple, call Uni-Key Health Systems at 1-800-888-4353.]

A final integral part of overcoming copper overload is reducing stress levels to improve adrenal function. Weak adrenal function is a strong contributing factor to the body's inability to excrete excess copper and it is brought on by excessive stress. What causes stress in each of us though is unique. Something that evokes feelings of distress in one individual -- flying in an airplane, for example -- might not affect another. Therefore, to improve adrenal function, it's important to examine which things are particularly stressful to you and figure out how you can creatively cope with the ones you can't avoid. It also means setting your priorities and eliminating unnecessary or unimportant sources of stress -- obligations you no longer want to be involved in, for example. Lightening your stress load is key because it boosts adrenal function, which in turn helps the body eliminate copper properly.