To begin this discussion, one fundamental key point must be understood:
EXCESS COPPER GETS STORED IN THE CELLS AND TISSUES, NOT THE BLOOD!
"The transport system of the blood absolutely does NOT provide a
reliable correlation of tissue mineral levels at the cellular level."
"The total serum or plasma copper concentration is generally insensitive to detection of copper overload"
"Excess of copper does not necessarily show up in the blood. In an evaluation of 30 patients with normal serum and urine levels but unusually high hair copper levels the following symptoms were present: apprehension, poor concentration, severe depression, insomnia, irritability, memory lack and profound mental fatigue, in addition also somatic (bodily) problems."
Blood is merely a transport system, it is not where minerals get stored.
Imagine a highway leading through a busy town. On an overhead bridge is a camera. If the camera takes a snapshot of the highway at a busy time, is that proof that the town itself is crowded? Not necessarily. What if all those cars are simply passing through town and never stopping? Likewise, if the camera takes a snapshot of the traffic and the highway is empty, does that mean the town is empty? Of course not! The snapshot could be taken at night when the crowded town is sleeping, or there could be construction on the highway which has closed the access road. In both scenarios, the snapshot of highway traffic is a very poor indicator of what is truly happening in the town. Blood is similar. It carries the various metals / toxins / minerals / nutrients either to where they're needed, or it will take them to be excreted. However, along the way, and especially if the body's detox pathways are not perfectly efficient, some of those minerals and metals and toxins get stored in the cells and tissues.
Let's take lead for example. If a person were to have a significant acute exposure to lead, and he were to be tested for lead within a week of exposure, likely his blood test would show a high level of lead, and doctors would catch it. Now let's say the blood test instead was done two months after his lead exposure. Do you think the blood test will still show a high level of lead? While it's possible some small elevation may appear, more likely than not the blood serum will show normal, in other words - the lead is gone. Is it really though? Has is magically all disappeared? Of course not! This is because, not only is blood merely a transport system, it is also homeostatic. The blood must return to a tight nutrient range in order to protect the body; if it didn't we would die. With too much of a mineral or metal the blood will attempt to remove it, either through excretion, or by storing it away in tissue. And so, 30 to 40 days after that acute lead exposure, the serum can appear completely normal even though toxic levels of lead have been deposited and stored away in tissues of the liver, bones, hair, teeth, etc.
Another very obvious example would be with potassium. Let's say you were to eat a bag of bananas the morning of your blood test. Likely your blood serum would show high potassium. However that's just a snapshot in time, when in reality your cellular potassium may be dangerously low. We can see the caution here in how looking at a blood test to determine mineral needs can be dangerous - based on the blood test the practitioner would say avoid potassium as your level is too high, while the person wise enough to look at the tissue level (through HTMA as we'll discuss later) will clearly see the body's true deficiency of, and requirement for, potassium.
The same warning is true for the body's two most important minerals, calcium and magnesium. Severe osteoporosis can develop without significant calcium changes appearing in the blood. Meanwhile the magnesium level can be affected by something as simple as how long or tight the tourniquet is applied - magnesium will rise due to tissue hypoxia. Not only that, but the body will rob the cells, tissues, and bones of magnesium in order to maintain a 'healthy' blood level of magnesium. What this means is that the blood status of magnesium can appear completely healthy even when the cells are completely starved of magnesium. Similarly, when the blood level of calcium drops to low, calcium is robbed from the bone to boost the blood level – the blood level still appears fine even though deficiency is happening in the bone. It is insanity that doctors continue to rely on the blood level of these nutrients, especially when you add to the fact that less than 1% of the body's magnesium is even in the blood to begin with!
In terms of copper - blood's homeostatic nature will ensure that excess copper is quickly removed from the blood, but this doesn't mean it magically disappears from the body. If a patient is being exposed to an immediate source of copper, such as a copper IUD, chances are the blood may show an elevated level. But once that IUD is removed (or the immediate source of exposure taken away), the blood will naturally return to normal, even though loads of toxic bio-unavailable copper is now stored in the body's tissues. In fact, we might even see the blood serum level of copper being low in a copper toxic person. If copper has accumulated and is tightly stored in the tissues, and adrenal function is too weak to mobilize that stored copper, it's not going to show up in the blood!
With this background, why on earth are so many practitioners still so reliant on the mineral level that shows up in the blood, without ever stopping to examine the tissue level? As a direct result of such practice, misdiagnosis runs rampant, and the lack of awareness to copper toxicity simply persists. Not only is such tunnel vision ignorant and irresponsible, but also dangerous, and as long as people continue to focus on serum blood results, the mass confusion surrounding this epidemic will only continue. There are so-called 'experts' online who are so focused on blood test results, and their trusting audience then spends a fortune in time and money getting all the suggested blood panel lab tests - serum this, plasma that, ceruloplasmin - only to discover even more confusion as they try to interpret the results, once again ignoring that copper excess is stored in tissue, not blood. Blood is certainly invaluable for many markers of disease and health conditions, but NOT when it comes to measuring mineral status! At best, if the timing is right, a blood test may catch copper toxicity, but certainly far more often than not it will miss it. Copper toxic individuals very often receive blood tests results that show 'normal' and are falsely diagnosed as 'healthy'. As Dr. Eck points out, "If you have high levels of a certain mineral, like copper, held tightly in storage, why on earth would you expect the copper to show up in the blood - unless it is being released?!"
Copper needs to be bound to a transporter protein (either ceruloplasmin or metallothionein), otherwise it becomes bio-unavailable, does not enter the cell where it needs to be, and instead gets accumulated in a bio-unavailable form in the body's tissues. The problem again with the standard blood serum testing procedure is that it ignores not only the accumulated bio-unavailable copper stored in the tissues, it also ignores the copper content within the cells. The following quote is by Dr. Carolyn Dean, MD, ND speaking about the inadequacy of serum tests. While in the quote she is referring to magnesium, the same is very much true for copper: "A serum test for magnesium is actually worse than ineffective, because a test result that is within normal limits lends a false sense of security about the status of the mineral in the body. It also explains why doctors don't recognize magnesium deficiency; they assume serum magnesium levels are an accurate measure of all the magnesium in the body."
Meanwhile, people are commonly told to simply calculate their free vs bound copper to understand their copper status. Not only is this confusing for most people, but it is also largely unreliable. Consider the following:
"Serum free copper concentrations have historically been calculated, often cited as the copper index or non–ceruloplasmin-bound copper. The calculation is based on the total serum copper concentration less the product of the serum ceruloplasmin concentration and a factor correlating to the amount of copper bound per milligram of ceruloplasmin. A reference interval for the index is routinely identified as less than 10 µg/dL (1.6 µmol/L). Limitations of the calculated copper index include the assumption that ceruloplasmin is saturated, that ceruloplasmin and copper methods are not defined by the calculation, and that the proportion of copper bound to proteins other than ceruloplasmin is not considered in the calculation. Analytic methods for ceruloplasmin are known to produce variable results that will contribute to significant errors in the calculation of the copper index, making it unreliable and insensitive." 
A urine test on the other hand shows what the body is excreting. When the body is excreting copper, then elevated copper levels will show on a urine test. If the urinalysis is performed during this time of excretion, it will catch the copper toxicity problem, and it can also be useful for showing how much copper (or any mineral/metal) is being excreted. But once again, what is being excreted is very different from what is being STORED. The stored copper is NOT being excreted, rather it is tightly stored in various organs and soft tissue of the body, particular the liver and the brain, yet won't show up in a urine test. Even urine challenge testing usually only reaches superficial areas of toxicities and can miss much of the tightly stored copper. Not only that, but chelation can also stir up and redeposit toxins in vital organs, while also being excessively hard on the kidneys (since this method forces toxins out through the kidneys rather than through the bile).
"HTMA is the best lab tool to detect copper toxicity and its effect on the broader nutrient mineral pattern that is related to both physical and mental health." ~Dr. Malter, PhD
"The HTMA is the window into our physiology, our psychology, and revealing our pathology."
~Dr. Robert Selig
The central issue of copper toxicity is stored copper in the cells and tissues. If we want to know the stored tissue level, blood tests and urine tests certainly aren't the answer (though they may in some cases be useful as a secondary source of information if you suspect copper toxicity or are on a detoxing program). Of course one could do a liver biopsy which would provide excellent evidence of tissue levels, however being both expensive and invasive it is not a viable or realistic option for most. Hair, however, being a form of soft tissue, provides a great window into what is happening inside the body at the tissue level.
As copper passes through the blood, either to be utilized, excreted, or stored, it gets picked up in the hair follicle. An inch or so of hair taken closest to the scalp provides approximately a three-month window into the mineral and metal status of the body. As such, it is not prone to the hour to hour fluctuations that affect the blood reading. More importantly, the hair reflects the tissue level, which is what we want to know in terms of our minerals status. Another major advantage that Hair Tissue Mineral Analysis offers is data on the key ratios between mineral pairs as determined through the exhaustive research in the 1970s and 80s by Dr Eck and Dr Watts, the pioneers of the Science of Nutritional Balancing. When it comes to rebalancing minerals, or assessing mineral status, looking at any one mineral level in isolation explains very little. Take magnesium, for example. If the hair chart shows high magnesium, is it really high? Not necessarily, as stress depletes magnesium and most people are magnesium deficient. However, if we look at the ratio between sodium and potassium, known as the stress ratio, and we see a high Na/K ratio, we know that the individual is under a lot of stress, and that the high magnesium level is representing an intracellular loss of magnesium which shows up high in the hair but indicates magnesium deficiency. This is just one example of the importance of looking at the bigger picture, and not just one mineral level in isolation. The same can be said for assessing the copper status. A copper toxic individual can have either high (overt) copper showing up in the hair, or he may have low (hidden / latent) copper. Hidden copper toxicity occurs when high levels of copper are stored in various body tissues but have not yet been released to show up in the hair. Therefore, we MUST look at what is happening with the other mineral levels and ratios in order to determine copper status...and the correction of copper. For example, when copper appears low in the HTMA, we can look at other key indicators such as a high calcium, low potassium, a Ca/K ratio over 10, low molybdenum (<.003), low Na/K, and a number of other levels and ratios to understand what may be happening with copper. This underscores the importance of the HTMA practitioner understanding these various markers, otherwise they could easily look at the low copper level and suggest the client needs to consume more, when in fact doing so would only compound the problem.
"[HTMA] may be the most important health test that exists… Only when you and your doctor know for sure your mineral status and important ratios can you adapt your diet, minerals and supplements to work toward proper balance."
~Dr. Robert Thompson, MD
"Excess copper has a distinctive effect on the HTMA mineral pattern and on the overall mineral system. A high soft tissue calcium level, a low potassium level and a very high Ca/K ratio are the major mineral effects of an elevated copper level. The thyroid slows, diminishing energy production, often producing depression and ADD types of symptoms. When even more copper builds up in the brain, schizoid and psychotic reactions may also manifest. " ~Dr. Rick Malter, Ph.D.
"An excess of copper can contribute to many symptoms: e.g., depression, spaciness, paranoia, alternating moods, anxiety, panic, fearfulness, schizophrenia, phobias, etc. However, individuals may have any or all the above signs and symptoms of a copper toxicity and yet not have a high tissue copper level on a tissue mineral test."
~ The Eck Institute of Applied Nutrition & Bioenergetics, Ltd.
Though this may all sound very complex (and it is...especially when copper is 'hidden' on the HTMA), the trained HTMA practitioner is able to deduce a goldmine of information from an HTMA profile, including:
Unfortunately, most allopathic doctors tend to negate HTMA, as the nutritional approach to healing health conditions at the source is overshadowed by the pharmaceutical approach to simply bury symptoms. Most doctors are not adequately trained in nutrition, let alone the intricacies of how mineral imbalances affect physical and mental health. They are obsessed with measuring the blood level of minerals, including the serum copper level, without stopping to question what the cellular level is - the level that actually matters! Many broader thinking practitioners are now adopting HTMA as they learn the importance of it. While this is certainly a step in the right direction, it also necessitates a warning. At present, any doctor is able to open an account at an HTMA testing lab and request a test. This presents a problem if that practitioner attempts to diagnose or prescribe based on the charts, without adequate training. This does happen frequently though, and the unsuspecting patient sees poor results. The doctor (and patient) then dismiss HTMA because it 'failed'. However this is not the fault of the test, but rather a lack of dedication on the part of the practitioner to verse himself in this essential testing tool. HTMA charts appear deceptively simple, yet are infinitely complex. No amount of medical training qualifies an individual to be able to quickly assess an HTMA chart, without having been trained in HTMA as well. Please ensure that the HTMA practitioner you are working with has indeed been trained in HTMA and is experienced in dealing with copper toxicity.
If HTMA is so important, why don't more practitioners use it? For most, it's simply a lack of training in how to apply HTMA data and concepts, as HTMA interpretation is extremely complex. Copper toxicity is among one of the most misunderstood conditions in the world today, largely due to this resistance by many in the medical field to adopt HTMA into their toolbox. The very fact that blood testing is still done so prolifically as the primary determinant of toxicity - with almost no mention of HTMA - goes to show a most basic lack of understanding behind copper toxicity on the part of practitioners. As long as blood remains the primary go-to screening tool for mineral imbalance, the true extent of copper toxicity will never be recognized. Sadly, HTMA has a history of vicious smear campaigns directed against it, aimed at suppressing this most important of screening tools, and as a result has cost people who could have otherwise benefited from proper testing. In 1985 and again in 2001, JAMA published two studies which on the surface seemed to dismiss the accuracy and reliability of HTMA, and these results were widely publicized, and to this day are still being widely referenced as justification for not using HTMA. The tragic irony is that the hard data from the studies in fact validated the excellent accuracy of HTMA, as well as copper toxicity in the samples, however neither the author nor the editors were able to recognize it as they themselves did not understand how to use HTMA or what to look for. The studies, when using the data from approved labs, in fact validated the very opposite of what the authors claimed. However, to arrive at the finding that HTMA was not reliable, the authors of the studies, in one case used a mere 2 person sample size, in another used an illegally operating lab to obtain skewed results, and in both cases violated almost all proper sampling and testing protocol and were run by people untrained in HTMA. In fact, the doctor behind the first study, who continues to run a number of websites nicely disguised to mislead the public and attack the consumer's right to informed choice, has been shown to have almost zero credibility, and in fact a California Appeals Court declared him to be "biased and unworthy of credibility”. However, given his title as a ‘doctor’, those that don’t take the time to research further fall victim to his writings. The authors of the aforementioned studies (and the media) also largely ignored the thousands of peer-reviewed references that support HTMA, or the fact that HTMA is used routinely by various heads of government and world class athletes who have access to the very best medical care. Those who dismiss HTMA are doing so based on their own lack of understanding, reluctance to learn, or ulterior motive. Dismissing HTMA as pseudo-science shows complete ignorance on the person making such a claim, and begs the question 'what is their agenda?'. Though human hair has been accepted as an effective tissue for biological monitoring of toxic heavy metals by the US Environmental Protection Agency and is being used for this purpose throughout the world, when it comes to copper toxicity suddenly this fact becomes ignored.
When correcting any condition through nutrition, or when taking supplements, we must recognize that nutrients do not operate independently from other nutrients. Having a clear picture, as presented through HTMA, is essential prior to supplementation, and makes supplementation and corrective guidance much more practical, meaningful, manageable and safer. Understanding one's various mineral levels should be an essential first step to any dietary, weight loss, or health restoration program. Hair Tissue Mineral Analysis, tested through either ARL or TEI labs (labs that do NOT pre-wash the hair samples), and assessed by a practitioner trained in understanding mineral ratios, is the best approach. Other labs that wash the hair sample (which most other labs do) are not recommended here as the washing procedure throws off several key levels and ratios.
HTMA provides essential indicators that, when properly interpreted, can show the presence of a hidden copper toxicity problem, and provides the evidence-based information necessary to properly detox copper while balancing other mineral levels at the same time - a necessary part of the process. Any other approach to treating copper toxicity without this 'bigger picture' of other various minerals is really taking a blind approach to treatment, and dangerously exposes the patient to other mineral levels being thrown off in the process which in turn can greatly exacerbate the psychological and physical changes that occur in the patient. This underscores the importance of frequent monitoring of mineral levels throughout the detoxification process, something that can only be accurately achieved via HTMA. [Click here to learn more about HTMA or to order an HTMA test]. While the HTMA will tell you what's happening in your body, you can also get your tap water tested here to see if your drinking water is contributing to your load of copper and other heavy metals).
"With slow oxidizers, one gets biounavailable copper problems. Here one has a combination of too much free copper floating around, but a deficiency of available or bound copper. This may be due to adrenal exhaustion causing impairment of ceruloplasmin synthesis in the liver, and perhaps deficiencies of other copper transport proteins such as metallothionein." ~Dr. Wilson, M.D.
Oxidation types (metabolic types) are based upon the work of Dr. George Watson, Ph.D, who was able to detect distinct patterns and differences between what he termed slow oxidizers and fast oxidizers (a similar concept to slow metabolizers and fast metabolizers). These patterns are easily identifiable through an HTMA profile, and also show a clear connection with the three stages of stress (Dr. Hans Selye). For simplicity sake, there are two main metabolic types, slow and fast. The fast metabolizer, with an overactive thyroid and adrenals, is releasing energy too quickly, running himself out of fuel. The slow metabolizer is releasing energy too slowly – basically he doesn’t have enough. The slow metabolizer will typically have elevated levels of calcium, magnesium and copper (with low sodium and potassium), while inversely the fast metabolizer will have elevated sodium and potassium (with lower calcium, magnesium and copper). Infinite combinations result of course within these two broad descriptions. What's important to understand however is that almost all copper toxic individuals represent as slow metabolizers. Copper not only leads to a slowing of metabolism, but the slowing metabolism in turn spirals the copper accumulation higher as the copper is not being used as quickly as it would be in a Fast type.Simply put, copper accumulates as metabolism slows down. Sluggish adrenals and thyroid will allow copper to build up. As mentioned though, copper is also a major reason why these glands slow down, so it's a vicious cycle. Traits of slow metabolizers often include fatigue, depression, apathy, low blood sugar, adrenal insufficiency, and hypothyroid. These traits are clearly explainable through the various mineral ratios presented on the HTMA profile. The more extreme the slow metabolizer pattern is, the more apparent symptoms such as depression, despair, withdrawal, and apathy / emotional numbness become.
Understanding one's metabolizer type (and the key ratios shown on the HTMA) is paramount to creating a healthy recovery protocol and nutritional program. Although specifics will vary person to person, slow metabolizers typically need more potassium, zinc, vitamin A and Vitamin C, while avoiding calcium, copper, and Vitamin D. More discussion on healing and detoxing from copper toxicity is presented on the Healing page.
Above is a great example of copper toxicity on an HTMA. Not all patterns will be this obvious as sometimes the toxicity issue is hidden with a low copper reading. However here we can see without any question the extreme level of copper in this person's slow metabolic type pattern, combined with exhausted adrenals and sluggish thyroid as indicated by the low Na and K readings and K in relation to Ca. This patient's primary symptoms included depression, anxiety, brain fog, racing mind, allergies, and substantial fatigue /low energy, all which can be seen with this pattern. Up until this test the patient had a 2 year history on a copper IUD preceded by 12 years on the birth control pill.
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