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What to Know About Low Ceruloplasmin

Medically Reviewed by Melinda Ratini, DO, MS on June 29, 2021

Ceruloplasmin is an important protein your body makes. Low levels of ceruloplasmin in your blood can cause changes in your body and energy levels. This can affect your day-to-day functions and cause problems with the way your body absorbs nutrients. It can also signal an inherited disorder called Wilson’s disease. 

What Is Ceruloplasmin?

Ceruloplasmin is a protein your liver makes. It carries copper, a vital nutrient, to the rest of your body. Copper plays an important role in your body’s development, health, and functions.   

Copper helps your body: 

  • develop vital organs like the brain
  • create new blood vessels, 
  • build strong bones
  • develop hormones
  • assist with the function of your immune system
  • create the pigmentation in your skin (melanin) 

We usually get enough copper from our daily diet. Foods like shellfish and nuts are high in copper. But copper can be toxic if there’s too much present in your body, or if it builds up in your organs. This is why you may need a copper level test.

How Low Ceruloplasmin Can Affect Health

Copper gets distributed throughout your body via ceruloplasmin. When you have low levels of ceruloplasmin, copper can’t get distributed as it should. 

You may experience these symptoms and disorders due to low ceruloplasmin levels:

  • Nausea
  • Pain in the abdominal area
  • Constant feeling of tiredness or fatigue
  • Changes in your behavior
  • Yellowing of the eyes and skin (jaundice)
  • Feeling of shakiness (tremors)
  • Difficulty walking 
  • Difficulty swallowing 
  • Anemia
  • Nerve dysfunction (neuropathy) 
  • Loss of control of bodily movements (ataxia)
  • Involuntary muscle movements and abnormal posture (dystonia)

Low levels of ceruloplasmin can be caused by several different factors: 

  • Long-term liver disease
  • Improper nutrition (malnutrition)
  • Inability to absorb nutrients from food (malabsorption)
  • Disorders that cause kidney damage (nephrotic syndrome)
  • Disorder that makes your body unable to distribute copper (Menkes syndrome)
  • Disease that causes copper to build up inside organs and tissue (Wilson’s disease)

Wilson’s Disease

Wilson’s disease is inherited. Each parent must carry the gene in order for you to develop it. 

When you have Wilson’s disease, your body isn’t able to distribute or eliminate copper effectively. That can lead to copper building up in different areas of your body, which can be toxic. Wilson’s disease usually appears from childhood until age 40. It can be managed and treated, especially if it’s caught early.

Some symptoms of Wilson’s disease are: 

  • Jaundice
  • A light brown or golden discoloration of the eyes (Kayser-Fleischer rings)
  • Poor coordination or stiff muscles
  • Difficulty speaking and swallowing
  • Behavioral changes
  • Fluid buildup in the legs and abdomen
  • Fatigue
  • Bruising

Wilson’s disease is often managed by chelation therapy. The therapy works by taking prescribed medications like penicillamine and trientine. In your body, these medicines bind to metals like copper and remove them. 

Zinc in several forms can also be prescribed to combat the effects of excess copper, depending on the individual case. 

A liver transplant could be the last resort when dealing with Wilson’s disease. 

Ceruloplasmin Blood Test

If you're showing symptoms of low or toxic copper levels, your healthcare provider might order a ceruloplasmin blood test. This involves taking a blood sample and examining it in a laboratory to see how much ceruloplasmin protein is in your blood. It can help your doctor understand what’s going on inside your body and make a diagnosis. 

There’s usually no special preparation needed for this test. It’s important you tell your doctor any medications or drugs you're taking, as it could affect your test results. Blood ceruloplasmin tests are commonly taken along with a urine copper level test. 

Blood sample. A healthcare professional will take a blood sample from you. That involves puncturing a vein, usually in the arm, with a needle and withdrawing blood. There are few risks associated with drawing blood: 

  • Feeling lightheaded 
  • Fainting 
  • Blood gathering under the skin (hematoma)
  • Slight risk of infection due to broken skin 

The proper level of ceruloplasmin in your blood will vary according to your age, any hormonal medicine you might be on, or if you're pregnant. 

The normal range of ceruloplasmin in the blood for adults is as follows: 

  • 220 to 400 milligrams (mg) per liter (L) for a male or 250 to 600 mg/L for a female 
  • 270 to 660 mg/L if on oral contraceptives such as estrogen
  • 300 to 1200 mg/L if pregnant
WebMD Medical Reference

Sources

SOURCES: 

‌Cleveland Clinic: “Wilson’s Disease.”

‌Mayo Clinic: “Wilson’s disease.”

‌Mount Sinai: “Ceruloplasmin blood test.”

‌NIH: “Copper.”

StatPearls: “Biochemistry, Ceruloplasmin.”

‌University of Rochester, Medical Center: “Ceruloplasmin (Blood).”

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