Alzheimer's And Copper

Could Copper Be One Of The Causes Of Alzheimer's?

By Marc Braman, MD, MPH
 
copper pipes 

Take Home:

Copper is great for wires and for conducting electricity, but it does not appear to be so great in our bodies -- especially our brains.  A number of lines of evidence are pointing to copper being potentially a cause of Alzheimer's disease.  While we wait for more definitive studies to be done, it would make sense to guard against excessive copper intake in the form of nutritional supplements and copper plumbing.
 

The Context

Let's put this into an overall context. Medscape.com is one of the leading websites for medical news and information. They had a recent feature story entitled “2011 top game changers in primary care.” Guess what the #1 game changer was. The #1 game changer was entitled “the dark side of vitamins and supplements.” Titles of subsections included “Calcium supplements and myocardial infarction: the evidence grows,” “Vitamin supplements associated with increased risk for death,” “Vitamin D may not protect from death, cardiovascular risk,” “Vitamin D supplements may raise the risk for prostate cancer.” With millions and millions of people taking nutritional supplements driving a $20+ billion industry, the issue of the impact on health of nutritional supplements is very important.

The unfortunate reality is that it is very difficult to get to the truth about the health impact of nutritional supplements. There is a number of reasons for this. Some of them include the following:

1. Lack of researchers' clinical skill. More often than not, those doing the formal studies do not spend that much time in clinical patient care. Unfortunately, this translates into poor application of the item being tested with the researchers not understanding the clinical issues. Unless you can do the basic process correctly, you'll never have an appropriate study.

2. Lack of quality in substance handling. Most pharmaceutical medications are fairly stable on the shelf. This is often not the case with nutritional supplements. Heat, light, and time will often degrade the nutritional ingredient so that it is either no longer present or becomes oxidized and actually harmful. I know of specific studies where handling issues led to patients taking pills that had no active ingredients remaining in them, so that when the researchers published their findings, they reported "no clinical difference," when in fact the study had no meaning because the patients had never actually received the active ingredients which were supposed to be the subject of the study. I believe similar kinds of things happen all too often.

3. Inappropriate form of active ingredient. Often researchers will use the standard or old form of a particular ingredient, such as vitamin E. More recent evidence indicates that vitamin E is actually a family of compounds, and taking only one isolate from the family is both sub optimal and does not reflect the best possible application at the time. Therefore it is very difficult to draw clinical conclusions based on a study using an old chemical form.

4. No substitute for treating the cause. People do like the magic pill concept. They seem much more willing to take a pill rather than change those things in their lives causing the problem. In practice this will often lead to people taking many nutritional supplements while inadequately changing their nutrition, physical activity, stress, and other lifestyle dynamics. This could easily lead to many unhealthful people taking nutritional supplements because they are sick and thus skewing the studies.

5. Pharmaceutical industry influence. I am not a fan of conspiracy theories or of people preaching that the system is out to get you and keep you sick so they can make lots and lots of money. However, there are elements in the health care system that are quite troublesome and that we should be aware of. The pharmaceutical industry in America is one of the largest industries on the planet and wields huge power. It has variably tried to take control of the nutritional supplement industry and or try to kill it completely. In essence, the nutritional supplement industry is a competitor. When major efforts have failed to take control of nutritional supplements as a whole, drugmakers have then tried to make all nutritional supplements sound or look evil and propose that they should not be sold. This crazy dynamic has made the whole system reel to and fro making all concerned rather uncertain about pretty much everything.

6. Research doubts. Medical research in general has experienced an alarming increase in influence by the pharmaceutical industry. The editors of many of the most esteemed medical journals have sounded warning cries that the pharmaceutical industry has far too much influence over their publications, while at the same time not being able to do anything to rectify the situation. Add to this the competition of a competing industry, and it makes one even more questioning of the research that is published. We must look very closely at how specific studies are funded, ties the researchers have to corporations, the monies they receive from them, who is doing the analysis, who is doing the writing, etc.

There are other issues but this is enough for now.

The Copper Hypothesis

At the annual conference of the American College of Nutrition's the presentation by former professor and mineral researcher George Brewer, MD, was entitled “Toxicity of Inorganic Copper from Drinking Water in the Causation of Alzheimer's Disease.” Dr. Brewer did disclose that there are some ways that he would benefit financially should this hypothesis prove to be true. He is older and has formally retired from his professorship.

It is important for this discussion to understand the difference between organic and inorganic copper. Organic copper is the form found naturally in food and is low in toxicity. Inorganic copper is the form found in drinking water from copper plumbing and the form found in nutritional supplements. It is also important to note that the presentation focused on copper in drinking water but it was clearly stated that the primary sources of inorganic copper in our society are both drinking water and nutritional supplements.

What Is Known 

Alzheimer's disease has a number of known risk factors, such as age, genetic cholesterol tendencies, certain iron management genes, and elevated homocysteine levels. It is hypothesized that a zinc deficiency or an inorganic copper excess may also contribute to Alzheimer's disease. It is important to understand that a century ago Alzheimer's disease essentially did not exist. It is an epidemic that seems to be prominent in developed countries. The question is what is producing it. The use of copper plumbing would seem to coincide with the increase in Alzheimer's.

Initial Animal Research Clues 

An interesting study was being conducted in rabbits. They were being fed a high cholesterol diet that helped produce brain plaques typical of Alzheimer's disease. Midway through the study the rabbits were moved across the country to another state and continued on the same diet. However, the rabbits stopped developing the Alzheimer's plaques in their brains. The researchers tried to figure out what the difference was. They discovered that in the first location the rabbits were being given tap water and in the second location the rabbits were being given distilled water. The level of copper from the original tap water was well within the EPA limits but seemed to be the only factor that was different and seemed to be reproducible in the animal model for plaque production. It is worrisome to note that over thirty percent of household drinking water in North America has enough copper in it to cause Alzheimer's disease in animal models.

It is important to realize that association does not prove causation. So we must look beyond timing issues to determine if one leads to the other. In the rabbit model the addition of 0.12 ppm (parts per million) of copper added to drinking water greatly increased Alzheimer's brain changes and greatly decreased mental abilities. The EPA allows 1.3 ppm, or about ten times the amount toxic to rabbits in our drinking water. In a 2006 human study those taking a copper-containing multivitamin along with eating a high-fat diet had 6 1/2 times the rate of mental decline compared to persons not taking copper-containing multivitamins. Other studies have shown that in Alzheimer's disease patients their free copper levels are significantly elevated. As copper levels go up, mental function goes down, and high copper levels predict future decline in mental function.

Does It Fit Physiologically?

What do we know about the physiology of Alzheimer's disease plaques that point to copper potentially being a problem? Many of the key molecules involved in the brain plaques of Alzheimer's bind copper. Certain Alzheimer's proteins bind copper in a way that the copper produces oxidative damage. Alzheimer's proteins bind both copper and cholesterol, oxidizing the cholesterol to a form that is toxic to brain cells. Animal studies have shown that these “safe” levels of copper in drinking water damage the systems that clear the toxic form of cholesterol from the nervous system. The nervous system then cannot rid itself of the substances damaging it.

Results for the Iowa Women's Health Study were published in October 2011. Skipping the technical jargon, they looked at the influence of different nutritional supplement ingredients on lifespan in women aged 55 to 69. Multivitamins were associated with an approximately 6% increase in risk of death, folic acid a 12% increase, B-complex and vitamins C, D, E were neutral, calcium was associated with it an 8% decreased risk of death, iron was associated with a 9% increase, but the big outlier was copper, which was associated with a 42% increased risk of death.

It is worth noting that two of the recognized risk factors for Alzheimer's disease, certain cholesterol genetics and homocysteine, both interact substantially with copper.

Copper In Supplements

During the presentation one of the things that came out clearly was that there really is no need to take copper as a nutritional supplement. Copper deficiency is extremely rare. So there really is no potential benefit to taking copper in supplement form, but there is huge potential harm.

Copper In Plumbing

It is important to understand that simply having copper plumbing does not automatically equate to high levels of copper in your drinking water. Much depends upon the pH of the water, which then determines to what degree the water will or will not leach copper from the pipes and into your drinking water. One of the things Dr. Brewer is now working with a for-profit company on is developing home testing kits to determine copper levels in the home.

Additional Thought

We all know that copper is an excellent conductor of electricity. It is what all the wiring in our homes is made out of, it is copper wire which is used to make electric motors and generators, etc. If we are, in fact, now having much higher levels of copper in our brains and bodies than we have ever had before, I believe we will need to look at the effect of frequencies and magnetic fields on our bodies and brains that may be augmented by these high copper levels. Many years ago, when I was first working with neurofeedback and some sensitive EEG equipment (measuring brain electrical activity), I became aware of the brain's exposure to magnetic fields from things all around us. When I had the electrodes on the patient's head, I discovered that if they were within a couple feet of a typical building wall that they had a huge 60 Hz signal on their body that was picked up by the equipment (electricity at the home level in America is alternating current that alternates 60 times a second). I had to physically move them away from the walls of the building that had electrical wiring running through them to get rid of the signal. It made me realize that there could be a significant physiologic effect from electricity, magnetic fields, and various electromagnetic frequencies that we typically do not think of. If, for instance, the electromagnetic fields from the electricity in our walls were inducing current in the copper in our brains this would likely be a very bad thing. I hope that research on this particular potential interaction can be performed in the near future.

Application

1. Unless you are taking megadoses of zinc, or have some very rare medical condition with copper deficiency, it is likely very unwise to take any supplements containing copper.

2. At this time testing your water for copper content may prove very challenging. If you know that your home is served by acidic water you may wish to put extra effort into researching your options for water evaluation.

3. It appears that the best remedy for excessive copper is zinc supplementation. This is challenging if you are not able to determine whether or not you have excessive copper. You should keep in mind that the upper limit for daily zinc supplementation is 45 mg per day for adults.
 

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Written 12/05/11.