Overview
The Ceruloplasmin Test is a blood test used to measure the amount of ceruloplasmin, a copper-carrying protein made by the liver. This protein plays an important role in transporting copper and regulating both copper and iron metabolism in the body.
Doctors commonly recommend this test when they suspect problems with copper metabolism, particularly Wilson’s disease, or other liver-related conditions.
Understanding ceruloplasmin levels helps diagnose and monitor disorders where copper either builds up excessively in the body or is not properly used.
What Is the Ceruloplasmin Test?
Ceruloplasmin is a blue-colored protein that carries about 95% of the copper present in the blood. It also acts as an enzyme (ferroxidase) that helps in the oxidation of iron from its ferrous form (Fe²⁺) to ferric form (Fe³⁺), which can then bind to another protein called transferrin for transport.
The Ceruloplasmin Test measures the concentration of this protein in blood. Abnormal levels may indicate:
- Low ceruloplasmin: Copper is not being properly incorporated or transported — often seen in Wilson’s disease.
- High ceruloplasmin: May indicate inflammation, infection, pregnancy, or use of estrogen-containing medications.
Where Is Ceruloplasmin Produced in the Body?
Ceruloplasmin is synthesized in the liver. Once produced:
- Copper binds to ceruloplasmin before being released into the bloodstream.
- This bound form helps regulate the body’s copper balance and prevents free copper from causing cell damage.
Therefore, any liver dysfunction can affect ceruloplasmin levels because the liver is the primary site of its production.
Main Functions and Importance
Ceruloplasmin plays several important biological roles that help maintain the body’s mineral balance and overall health:
- Copper Transport:
About 95% of blood copper is carried by ceruloplasmin. It ensures copper is delivered safely to where it’s needed — such as in enzymes and tissues. - Iron Metabolism (Ferroxidase Activity):
Ceruloplasmin acts as a ferroxidase enzyme, converting iron from Fe²⁺ to Fe³⁺ form so it can bind with transferrin, the main iron-transport protein.
This process helps prevent iron from building up in tissues and supports healthy red blood cell formation. - Antioxidant Function:
Ceruloplasmin helps protect cells from oxidative stress and free radical damage — harmful molecules that can damage tissues and contribute to aging or disease. - Maintaining Copper-Iron Balance:
It keeps the body’s copper and iron levels stable, both of which are vital for enzyme activity, energy production, and immune function.
Causes of Low Ceruloplasmin Levels
Low levels of ceruloplasmin may indicate problems with copper metabolism, liver function, or nutritional status. The main causes include:
- Wilson’s Disease:
- A genetic disorder that prevents the body from properly removing excess copper.
- Copper builds up in the liver, brain, and eyes, causing damage.
- It is the most common cause of low ceruloplasmin.
- Severe Liver Disease:
- Conditions such as cirrhosis, chronic hepatitis, or liver failure reduce the liver’s ability to make ceruloplasmin.
- Malnutrition or Protein Deficiency:
- Since ceruloplasmin is a protein, inadequate protein intake can reduce its production.
- Nephrotic Syndrome:
- A kidney condition where proteins are lost through urine, leading to decreased protein levels in blood.
- Menkes Disease:
- A rare genetic disorder that affects copper absorption and transport, leading to low copper and ceruloplasmin levels.
Symptoms of Low Ceruloplasmin Levels
Symptoms depend on the underlying cause, most commonly Wilson’s disease. Typical signs include:
- Neurological Symptoms:
Tremors, poor coordination, slurred speech, difficulty walking, or involuntary movements. - Psychiatric Symptoms:
Mood swings, depression, personality changes, or behavioral problems. - Liver Symptoms:
Enlarged liver, jaundice (yellowing of skin/eyes), fatigue, and signs of liver damage (hepatitis or cirrhosis). - Kayser–Fleischer Rings:
Copper deposits that appear as golden-brown rings around the cornea (visible in an eye exam). - General Symptoms:
Weakness, fatigue, and anemia due to disturbed iron metabolism.
Causes of High Ceruloplasmin Levels
High ceruloplasmin levels can occur due to several physiological or pathological reasons:
- Pregnancy:
Levels naturally increase during pregnancy due to hormonal changes and higher estrogen levels. - Estrogen-containing Medications:
Birth control pills or hormone replacement therapy can increase ceruloplasmin production. - Infections or Inflammation:
Ceruloplasmin is an acute-phase reactant, meaning its level rises in response to inflammation, injury, or infection. - Certain Cancers:
Such as Hodgkin’s lymphoma, or other malignancies where inflammation and metabolic changes increase protein synthesis.
Symptoms of High Ceruloplasmin Levels
High levels of ceruloplasmin usually do not cause specific symptoms on their own.
However, the underlying condition that causes the rise may produce symptoms, such as:
- Fever or fatigue (due to infection or inflammation)
- Swelling or pain (from inflammatory disorders)
- Symptoms related to pregnancy or hormonal changes
- Lymph node enlargement (in cancers like Hodgkin’s lymphoma)
Reference Ranges
Reference ranges may slightly differ by lab method, but generally are:
- Adults: 20 – 50 mg/dL
- Low Levels: < 20 mg/dL (suggestive of Wilson’s disease or other copper metabolism issues)
- High Levels: > 50 mg/dL (may occur in pregnancy, infection, or inflammation)
Your doctor will interpret your results in context with other copper-related tests, such as:
- Serum copper levels
- 24-hour urinary copper excretion
- Liver function tests
Sample Type and Test Method
- Sample Type: Blood (serum or plasma)
- Test Method: Immunoturbidimetric or nephelometric assays are commonly used.
- Fasting: Not required for this test.
The test is simple — a small blood sample is taken from your arm and analyzed in the lab.
Test Preparation
- No fasting or special preparation is required.
- Inform your doctor if you are pregnant or taking birth control pills, as these can raise ceruloplasmin levels.
- Mention any liver disease, genetic disorders, or copper supplements you are taking.
When to Consult a Doctor
You should see a doctor if you experience:
- Neurological problems (tremors, poor balance, or speech issues)
- Yellowing of eyes/skin (jaundice)
- Behavioral or mood changes
- Persistent fatigue or weakness
- Unexplained liver test abnormalities
- Family history of Wilson’s disease or copper disorders
Early testing can prevent organ damage and help manage symptoms effectively.
Important Word Explanations
- Ceruloplasmin: A copper-binding protein made in the liver, responsible for transporting copper in blood.
- Wilson’s Disease: A genetic disorder where copper accumulates in tissues, causing liver and brain damage.
- Kayser–Fleischer Rings: Copper deposits seen in the eyes, typical of Wilson’s disease.
- Ferroxidase: An enzyme activity that helps convert iron for proper transport in the body.
- Acute-phase Reactant: A protein that increases in response to inflammation or infection.
- Nephrotic Syndrome: A kidney disorder that causes loss of protein in urine.
~END~