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Serum Copper levels are useful in determining contributing factors to symptoms of depression, ADHD, hallucinations, and to determine copper/zinc ratio. It is used, along with serum ceruloplasmin and urine copper to test for Wilson disease.
Serum ceruloplasmin is an acute-phase reactant type protein, and since it binds a large portion of serum copper, both serum copper and ceruloplasmin increase under the influence of inflammatory conditions and estrogen.
Serum copper is therefore elevated in pregnancy, in patients on estrogens and estrogen-containing contraceptive drugs, in rheumatoid arthritis, and a number of other pathologic entities. It may be low with low serum proteins as in nephrosis, malabsorption, and malnutrition without necessarily reflecting inadequate liver copper stores. It is reduced under the influence of ACTH or glucocorticoids, or valproate3 therapy. Elevations in liver tissue copper are found in Post Partum Depression, Wilson disease but may occur also in other types of liver disease, especially primary biliary cirrhosis.
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