What is a ceruloplasmin test?

A ceruloplasmin test measures the amount of ceruloplasmin in a sample of your blood. Your liver makes ceruloplasmin by attaching copper to a protein. Your liver releases the ceruloplasmin into your bloodstream so it can carry copper to the parts of your body that need it.

Copper is a mineral that your body uses for many important processes, including making energy, blood vessels, and melanin (the substance that gives your skin and eyes their color). Copper helps your body use iron, and it supports brain development. It helps keep your nervous and immune systems healthy, too.

You need only small amounts of copper to stay healthy. Most people get enough copper from the foods they eat. Good sources of copper include shellfish, nuts and seeds, beef liver and other organ meats, wheat-bran cereals, and chocolate.

Normally, most of the copper in your blood is part of ceruloplasmin. So, ceruloplasmin testing can help diagnose conditions that involve having too much or too little copper in your body.

Other names: CP, ceruloplasmin blood test, ceruloplasmin, serum, copper oxidase, ferroxidase

What is it used for?

A ceruloplasmin test is most often used with other tests to help diagnose Wilson disease. Wilson disease is a rare genetic disorder that prevents the body from removing extra copper.

Wilson disease can lead to a harmful buildup of copper in the liver, brain, eyes, and other organs. The high levels of copper can severely damage organs and become life-threatening

Ceruloplasmin tests may also be used to help diagnose conditions that cause low levels of copper. Although low levels of copper are uncommon, they may be caused by conditions such as:

• Malnutrition, a condition that happens if your diet doesn't include enough vitamins, minerals, and other key nutrients.
• Malabsorption, a condition in which your body has trouble absorbing nutrients from the food you eat. Many diseases can cause malabsorption, including celiac disease.
• Menkes syndrome, also called Menkes disease, a rare, incurable genetic disease that affects the body's ability to use copper. Symptoms usually show up in the first few months of life.
• Taking too many zinc supplements, which can affect how well your body can use copper

If a person has been diagnosed with too much or too little copper in their blood, regular ceruloplasmin testing may be used to monitor their condition and to check whether treatment is working.

Ceruloplasmin tests are mostly used with tests that measure copper levels in blood and/or urine (pee).

Why do I need a ceruloplasmin test?

Your health care provider may order a ceruloplasmin test if you have symptoms of Wilson disease. Even though people are born with the disease, the symptoms don't appear until copper builds up in your liver, brain, or other organs. This usually happens between ages 4 and 40, but symptoms can appear earlier or later in life.

Wilson disease can cause many types of symptoms depending on which parts of your body are affected. For example:

• Nausea and vomiting
• Pain in your upper abdomen (belly)
• Urine that's a darker color than usual and/or stool (poop) that's a lighter color
• Jaundice, a condition that causes your skin and eyes to turn yellow
• A type of anemia, called hemolytic anemia, that destroys red blood cells faster than your body can make them
• Swelling from fluid buildup in your belly, lower legs, or feet
• Itchy skin
• Trouble with speech, swallowing, or physical coordination
• Tremors
• Stiff muscles and/or sudden jerky movements you can't control
• Mental health disorders, including anxiety, depression, or psychosis
• Green, gold, or brown rings around your irises (the colored part of your eyes)

If you have a family history of Wilson disease, you may need a test even if you don't have symptoms.

You may also need this test if you have symptoms that could be a sign of too little copper, such as:

• Abnormally low levels of white blood cells called neutrophils
• Osteoporosis, a condition that causes bones to become weak and break easily
• Fatigue
• Tingling in your hands and feet
• Pale skin

Your baby may need a ceruloplasmin test if they have symptoms of Menkes syndrome. Symptoms usually show up when babies are about two or three months old. They may include:

• Hair that is colorless, thin, breaks easily, and becomes unusually tangled
• Floppy muscles
• Seizures
• Slow weight gain and growth

Without treatment, most children with Menkes syndrome die within the first few years of life. If treatment is given in the first month after birth, some children may live longer. But even with treatment, the disease still tends to get worse over time.

If you have been diagnosed with abnormal copper levels, you may need regular ceruloplasmin testing to check your condition and to see how well your treatment is working.

What happens during a ceruloplasmin test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a ceruloplasmin test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

The results of a ceruloplasmin test alone cannot diagnose any conditions. The meaning of your test results will depend on the results of other tests, including tests that measure the amount of copper in your blood and/or urine.

To make a diagnosis, your provider will consider all your test results along with your symptoms, medical history, and family history. Ask your provider to explain what your ceruloplasmin levels say about your health.

In general, lower than normal ceruloplasmin levels may mean your body is not able to use copper properly. Low ceruloplasmin may be a sign of:

• Wilson disease, although ceruloplasmin levels are sometimes normal with this disease
• Menkes syndrome
• Severe liver disease
• Kidney disease
• A lack of copper caused by malnutrition and/or malabsorption

Higher than normal ceruloplasmin levels may be linked to:

• Heart disease
• Rheumatoid arthritis
• Leukemia
• Hodgkin lymphoma
• Infection, inflammation, or injury

But high levels of ceruloplasmin don't always mean you have a condition that needs medical treatment. Pregnancy, birth control pills, and certain medicines, including estrogen therapy to treat menopause, may cause high blood ceruloplasmin. Too much copper in your diet rarely causes high ceruloplasmin.

If you have questions about your results, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.