Copper Poisoning and Adrenal Fatigue Syndrome

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM

Read Part 1

Diagnosis of Copper Poisoning / Toxicity / Overload

Copper poisoning and Adrenal FatigueSymptoms of acute copper poisoning include vomiting, hematemesis, hypotension, coma, jaundice, and hemolytic anemia. This is when the copper level is extremely high. Below that level of copper, a state of copper toxicity exists. Laboratory results for higher than normal copper are detected, and the person is symptomatic. The damages of copper toxicity affect primarily the liver and kidneys, with liver and kidney function tests showing the compromised evidence. At a lower level, a person can be symptomatic, but laboratory testing for copper or hair analysis may be only marginally high or normal. Some practitioners use the term toxicity and overload interchangeably, depending on the severity of the presenting clinical condition.

Almost all of the copper in the body is bound to carrier proteins. The level of unbound copper is almost zero. The best means of testing for copper toxicity are 24-hour urine copper or serum ceruloplasmin level tests. Red blood cell copper levels may be a good test to measure increased copper levels as well. Copper test results must be evaluated in context and are usually compared to ceruloplasmin levels. Abnormal copper results are not diagnostic of a specific condition but indicate the need for further investigation for copper poisoning. Ceruloplasmin may also be elevated whenever inflammation or severe infections are present. Interpretation is often made more complicated as a result. Both ceruloplasmin and copper are increased during pregnancy and with estrogen and oral contraceptive use.

Hair mineral testing can also be helpful, but this test is not without its pitfalls. Improper sample collection and contamination can lead to inaccurate results. To complicate matters even further, these tests do not reveal excess copper in the tissues, as the copper has not yet been released. Also the result does not reflect what is happening in the body in real time. Depending on laboratory tests alone without a detailed history and clinical correlation can lead to incomplete assessment, possible misdiagnosis, and wrong interpretation of data.
< h2>Copper and the Adrenal Glands

When our bodies are under a constant stream of stress, either emotionally, psychologically or physically it takes a heavy toll on the body. When stressed the body responds by going into the fight-or-flight response and the adrenal glands start producing adrenaline, cortisol and aldosterone. The aldosterone causes the body to retain more copper and sodium, while the kidneys are excreting zinc and magnesium. When this process occurs only sporadically in situations of real or perceived emergencies or stressful situations, the body is able to recover. However, the issue is when this occurs over a long period of time, such as in the case of adrenal fatigue, as the body continues to retain the copper thereby causing copper overload within while continuing to negatively affect the nervous system.

The liver is the main organ responsible for detoxing the body of any excess amounts of copper; however, when the liver and the adrenal glands are impaired, toxic levels of metals (including copper) build up and are stored in the body eventually becoming very problematic. High amounts of copper further stimulate the nervous system, which takes a further toll on the already burdened adrenal glands. This vicious cycle of events continues as the liver and adrenal glands are compromised.

Copper Poisoning and Adrenal Fatigue Syndrome

Chronic stress or acutely stressful events can overwhelm the normal anti-stress function of the adrenal glands. When this occurs, symptoms can include the lack of exercise tolerance and energy, salt craving, insomnia, irritability, dependency on sugar fixes and coffee to get through the day as well as insomnia in the earlier stages (Stages 1 and 2). As Adrenal Fatigue Syndrome (AFS) progresses to advanced stages (Stages 3 and 4), more severe symptoms such as hypoglycemia, depression, cardiac arrhythmia, orthostatic hypotension, severe insomnia, metabolic imbalances, waking up in the middle of the night, and anxiety sets in.

Copper poisoning and Adrenal Fatigue SyndromeCopper overload can mimic some symptoms of adrenal fatigue as well as worsen symptoms making it difficult to differentiate between the two unless accompanied by a detailed history. Having a proper history completed by an experienced clinician is the key.

Sufferers who have been struggling with Adrenal Fatigue Syndrome and fail to recover can consider copper toxicity as a contributing factor. As mentioned before, copper toxicity is usually a problem that the body can overcome with its own internal self-regulating mechanism. It is therefore rare for copper imbalance to be the sole and only cause of all the symptoms of advanced Adrenal Fatigue Syndrome. More often than not, copper overload is one of many contributing factors. Remember we are referring to advanced stages of AFS and not the early stages when symptoms of AFS are usually quite mild and that of copper toxicity is clinically subtle. Blindly embarking on a witch-hunt exercise targeting copper as the culprit and root cause of fatigue can be very expansive, confusing, and potentially worsen AFS in the end.

It is important to remember that even if there is a close association between two events such as excessive copper and adrenal fatigue, one should be careful not to jump too quickly to conclude that the cause of adrenal fatigue is excessive copper. This is because many other imbalances can also present in similar ways, including zinc, sodium, potassium, mercury, and cadmium. Imbalance of any of these also has massive ramifications throughout the body, giving rise to symptoms mimicking AFS.

Just because there is an association does not mean that there is a clear cause and effect involved. The recovery path for each specific imbalance is quite different and often conflicts with each other. Blind trial and error approaches can ultimately worsen adrenal fatigue if not managed with care. For example, both high copper and low potassium can present with anxiety. Yet the treatment is very different. With low potassium, the treatment calls for restriction of salt in addition to potassium replacement because salt directly opposes potassium. However, in the setting of adrenal fatigue, more salt is indicated. Likewise, anxiety caused by excessive copper calls for an increase in zinc as a counter balance to copper. Yet, zinc can be quite stimulatory for those in advanced stages of AFS and can trigger adrenal crashes. It is clear that such a balancing act is complicated. It comes as no surprise that most self-navigation efforts fail and in fact worsen the overall adrenal fatigue.

Copper Poisoning and Advanced Adrenal Fatigue Syndrome

By the time most people consider copper overload as the culprit of their fatigue, the body is by and large very weak and decompensated. The body has usually already gone through years of failed recovery efforts, along with extensive use of anabolic hormones such as testosterone and estrogen, glandular, vitamins, and herbs including licorice, rhodiola, ashwagandha, ginseng, maca and green tea during this period. Most are therefore in a state of advanced adrenal fatigue (Stage 3 or higher). Paradoxical reactions and body sensitivities are quite prominent while the body is flooded in a sea of adrenaline as the body’s fight-or-flight response is in full throttle. Nutritional reserves are low as well as a lower threshold for triggering adrenal crashes as compared to people in earlier stages of AFS.

The conventional correctional approaches for copper poisoning usually involves a combination of reduced intake of copper by lifestyle and dietary pathways, consuming nutritionally balancing compounds such as high doses of zinc, some form of detoxification modality such as liver cleanses and flushes or colonics, and chelation options using green foods and medications. These standard therapies may help those with early and mild stages of AFS when the body is still strong and can sustain the onslaught of such aggressive balancing efforts to reduce copper levels, the same cannot be said for those in advanced stages of AFS. In fact, unless very carefully titrated and unless one proceeds very slowly, severe and unpleasant adrenal crashes are a definite risky side effect that few can avoid. One may be rendered bedridden for days or weeks in these cases of major crashes.

Summary: Copper Poisonin

Too much copper results in copper poisoningWhile copper poisoning or overload may be associated with Adrenal Fatigue Syndrome, it is seldom the sole cause but usually part of a broader picture of many other factors that may contribute to or worsen AFS. Most sufferers of AFS are in the advanced stages before their exhaustive but failed recovery efforts drive them to consider copper overload as a culprit. Laboratory testing can be helpful but clinical correlation and history is key. Reliance on tests alone can be misleading. Therapeutic approaches vary on the degree of AFS present. Those with mild AFS can consider copper balancing nutrients such as zinc, vitamin C, manganese and others. Those with advanced AFS should refrain from such approaches until the adrenals are well healed to avoid setbacks and adrenal crashes. Aggressive enemas, chelation, cleanses, and detoxification should also be avoided.

Read Part 1

© Copyright 2015 Michael Lam, M.D. All Rights Reserved.

Copper poisoning



    Hello Dr Lam!
    Can a Copper IUD (For Birth ControL) incrase the risk of having copper-zinc imbalance?

  • Mr. Sick says:

    Hello Dr. Lam,

    you wrote “Yet, zinc can be quite stimulatory for those in advanced stages of AFS and can trigger adrenal crashes.” This is very interesting for me, since I cannot tolerate Zinc in the long run.
    At first, I feel better taking it (mood wise). But after a few days, I get insomnia. I will wake up in the middle of the night and feel very alerted. I f Icontinue the Zinc supp, this problem will intensify.
    Similar stuff is happening, when I take Magnesium. At first it’s nice, after a few days: insomnia.

    What does this mean? Does this mean I don’t have a copper but an ordinary AFS problem? How do I fix this

    I checked my copper and zinc levels a few weeks ago and both were barely in the lab range (like range is 11 – 22 and my result is 11,3)

    Please help. I want Mg and Zinc work for me.

  • AJ says:

    Thanks interesting – I also have leaky gut purr olé issues etc but my dr has put me on a compounded medication called primer Pyrrole undermethylated formula and am looking for diet

  • McGee says:

    I see that copper overload is dangerous. Are there any other particular metals I should worry about?

    • Dr.Lam says:

      All metals , when excessive, can be dangerous, including iron, zinc, manganese and calcium . Magnesium is probably the one that is ‘safest’ and the majority of people are deficient. Too much magnesium can cause diarrhea. If you pay attention to your water source and food quality, mineral overload is usually not a problem.

      Dr Lam

  • Al says:

    Can excess copper in the body cause skin discoloration?

  • Melanie says:

    Hi, I have hashimotos, MTHFR, weak adrenals and possibly pyroluria. I’ve started to increase zinc according to my doctor’s advice and four weeks later I am experiencing cystic acne on my face, more fatigue, a slight cold and a cold sore. Is it possible that I have high levels of copper that are being ‘dumped’ by the increase in zinc? many thanks for any advice ?

  • lakshmi says:

    Dear Dr Lam
    can the fatigued adrenal recover fully to function properly after removal of copper toxicity

    • Dr.Lam says:

      It all depends on the person and to what degree the body is sensitive to copper overload. That is no set rule, and that is why you need to continued to be monitored by your provider along the way. Generally speaking, revovery is not 100% if you are in advance stages of AFS due to extensive damage, but that does not mean you cannot function normally and live a relatively normal life which should be the immediate goal.

      Dr Lam.

  • Cindy says:

    “These standard therapies may help those with early and mild stages of AFS when the body is still strong and can sustain the onslaught of such aggressive balancing efforts to reduce copper levels, the same cannot be said for those in advanced stages of AFS. In fact, unless very carefully titrated and unless one proceeds very slowly, severe and unpleasant adrenal crashes are a definite risky side effect that few can avoid.”

    Can you expound on this? How does a practitioner ‘carefully titrate’ and decide how slowly to proceed? Is this done by watching symptoms or reactions to treatment or some other testing? Is the same treatment of decreasing copper exposure/intake and increasing zinc used for advanced stages?

    Taking the facts of this article into consideration, is it possible to treat AFS in advanced stages remotely? If not, how does an AFS sufferer find a “local” practitioner?

    Many Thanks!

    • Dr.Lam says:

      Your questions are good one and the answer is simple: it all comes down to detailed history and clinical experience. The body sends you signal, but most people dont know how to read, but instead rely on lab test which is not very sensitive in real time. Whether advance AFS can be dealt with remotely depends on the case, as everyone is different. We have a remote program, but one has to qualify.

      Dr Lam