In episode 33, we continue the series on assessing and managing nutritional status. This time we talk about copper. Copper deficiency can cause anemia that is very difficult to tell apart from iron-deficiency anemia, osteoporosis, histamine intolerance, high cholesterol, and a variety of mental effects resulting from neurotransmitter imbalances. Serum copper and ceruloplasmin are excellent tools for assessing nutritional status, but are confounded by inflammation, birth control, menopausal status, and hormone replacement therapy, making it necessary to look at the diet, lifestyle, digestive problems, and other factors that make copper deficiency plausible.  I discuss how to protect yourself from the small risk of copper in your drinking water, and why I think many claims about excess copper outside the context of frank toxicity are misleading. Everything converges on the practical questions of what to do in these situations. You can find the show notes to this episode at chrismasterjohnphd.com/33. This episode is brought to you by Kettle and Fire Bone Broth. Use the link kettleandfire.com/chris to get $10 off your first order. This episode is also brought to you by US Wellness Meats. Head to grasslandbeef.com and enter "Chris" at checkout to get 15% off your order as long as the final price is over $75 and you order fewer than 40 pounds of meat. You can use "Chris" to get the same discount twice. In this episode, you will find all of the following and more: 0.00.35 Cliff Notes; 0.10:25 A case of copper deficiency? 0.14.00 Biochemical and physiological roles of copper (monoamine and diamine oxidases, MAO and DAO, lysyl oxidase, dopamine hydroxylase/beta-monooxygenase, peptidylglycine alpha-amidating monooxygenase, cytochrome C oxidase, superoxide dismutase, ceruloplasmin, hephaestin, metabolism of histamine, tyramine, polyamines, serotonin, norepinephrine, dopamine, conversion of dopamine to adrenaline, production of neuropeptides such as oxytocin, vasopressin, gastrin, neuropeptide Y, cholecystokinin, collagen synthesis, energy production, prevention of osteoporosis and neutropenia, immune support, cholesterol metabolism, antioxidant defense, mental health, and much more); 0:18:55 Copper's intimate relationship with iron; 0:30:10 What is the best marker of copper status (covers copper in serum, plasma, red and white blood cells, and platelets, ceruloplasmin, and other copper-dependent enzymes); 0:33:38 Effect of inflammation on ceruloplasmin; 0:35:10 Effect of estrogen on ceruloplasmin; 0:43:18 Causes of deficiency  0:43:50 How much copper do we need? 0:43:45 Best food sources; 0:48:30 Variation within food sources according to soil; 0:51:00 Zinc supplementation; 0:51:53 Digestive problems (SIBO, Celiac, antacids, proton pump inhibitors, PPIs, gastric bypass); 1:00:52 How to treat deficiency; 1:02:01 Which form of copper to use (oxide, sulfate, glycinate, etc)? 1:04:10 Toxicity: copper-mediated oxidative stress; 1:05:22 Wilson's Disease; 1:08:15 Infants and copper absorption; 1:11:00 Contribution of water to toxicity; 1:16:50 One case of supplement megadosing leading to liver failure; 1:17:30 Toxicity claims based on serum Cu or serum ZN/CU ratio are not reliable; 1:20:50 Summing up