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Ceruloplasmin Test
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lab Tests

Ceruloplasmin Test

The ceruloplasmin test measures the levels of a copper-carrying protein in your blood, primarily used to help diagnose Wilson disease and other copper-related disorders.

Overview

Ceruloplasmin is a protein made by the liver that carries copper through the bloodstream. Copper is a vital mineral used for energy production, blood vessel formation, and maintaining healthy nervous and immune systems. Because most copper in the blood is bound to ceruloplasmin, this test helps identify conditions involving abnormal copper levels.

What is it used for?

The test is most often used to diagnose Wilson disease, a rare genetic disorder that prevents the body from removing extra copper, leading to toxic buildup in the liver, brain, and eyes. It may also be used to diagnose low copper levels caused by:

  • Malnutrition or malabsorption (e.g., celiac disease).
  • Menkes syndrome, a rare genetic disease affecting copper usage in infants.
  • Excessive intake of zinc supplements.

Symptoms of Copper Imbalance

Wilson Disease (High Copper):

  • Nausea, vomiting, and abdominal pain.
  • Jaundice (yellowing of skin/eyes), dark urine, or light-colored stool.
  • Tremors, stiff muscles, or coordination issues.
  • Mental health disorders (anxiety, depression, or psychosis).
  • Green, gold, or brown rings around the irises.

Menkes Syndrome (Low Copper in Infants):

  • Colorless, thin, tangled hair.
  • Floppy muscles and seizures.
  • Slow weight gain and growth.

Understanding Results

Results must be interpreted alongside other tests, such as copper levels in blood or urine, and your medical history.

  • Lower than normal levels: May indicate Wilson disease, Menkes syndrome, severe liver or kidney disease, or malnutrition.
  • Higher than normal levels: May be linked to heart disease, rheumatoid arthritis, leukemia, Hodgkin lymphoma, or general inflammation/infection. Note that pregnancy, birth control pills, and estrogen therapy can also elevate levels.

The test is performed via a standard blood draw from a vein in your arm, which takes less than five minutes and carries minimal risk.

Frequently Asked Questions

Estrogen, found in birth control pills and hormone replacement therapy, as well as the physiological changes of pregnancy, naturally increase the production of ceruloplasmin by the liver. This can lead to higher-than-normal test results that are not indicative of disease. If you are taking these medications or are pregnant, your healthcare provider will interpret your results in the context of these expected elevations to avoid a false positive for conditions like inflammation or liver disease.
low ceruloplasmin level is a strong indicator for Wilson disease, but it is not diagnostic on its own. Low levels can also result from severe liver damage, malnutrition, or Menkes disease. To confirm Wilson disease, your provider will typically order additional tests, including a 24-hour urine copper collection, a slit-lamp eye exam to check for Kayser-Fleischer rings, and a liver biopsy if necessary. These combined results are required to distinguish Wilson disease from other causes of low copper.
If low ceruloplasmin is linked to malabsorption issues like celiac disease, the primary focus is treating the underlying gut condition to improve nutrient absorption. While copper-rich foods like shellfish, organ meats, nuts, and seeds can support levels, dietary changes alone may not be sufficient if absorption is impaired. Your provider may recommend copper supplements, but these should only be taken under medical supervision, as excessive copper intake can be toxic, especially if the underlying cause is not fully managed.
High ceruloplasmin levels are often a non-specific marker of inflammation or tissue damage rather than a direct sign of a specific disease. They can be elevated in conditions such as rheumatoid arthritis, leukemia, Hodgkin lymphoma, or acute infections. In many cases, if the level is only mildly elevated and you have no other symptoms, it may be benign or related to a temporary inflammatory response. Your provider will look at your overall health picture to determine if further investigation is needed.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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