Zinc and Copper: Do You Need to Take Copper With Zinc?

No, you do not automatically need to take copper with zinc. Zinc changed a copper enzyme marker in trials at 50 mg a day and above, and clinical copper deficiency appeared at 150 mg a day taken for months; the NHS says "Do not take more than 25mg of zinc supplements a day unless advised to by a doctor", and that line exists for this reason.^{1, 2, 3} UK adults need about 9.5 mg of zinc a day for men, 7 mg for women and 1.2 mg of copper, from food.¹ No UK or EU document sets a zinc-to-copper ratio. This page belongs to the Wellgard zinc guide and the vitamins and minerals guide.

Does zinc lower your copper?

At high doses, yes. The EU's Scientific Committee on Food describes the mechanism: high zinc intakes increase the synthesis of metallothionein in the cells lining the gut, and "Metallothionein avidly binds copper and when mucosal cells are rich in this protein, little copper is able to traverse the cells into the body."² The table shows the threshold: at 50 mg a day a copper-dependent red-cell enzyme (ESOD) falls while plasma copper and caeruloplasmin, the copper-carrying protein, hold steady.^{4, 5, 6} In a metabolic unit, a diet of only 3 mg of zinc a day disturbed the copper indices of 21 postmenopausal women more than 53 mg a day did.⁷ Clinical copper deficiency is a different threshold: the Committee concluded that the overt effects, "anaemia, neutropaenia, impaired immune responses", "are evident only after feeding zinc in the form of dietary supplements in excess of 150 mg/day for long periods", its examples being patients with sickle cell anaemia and coeliac disease given 150 mg a day for 23 and 10 months.²

Why does the NHS say 25 mg?

The NHS wording: "Taking high doses of zinc reduces the amount of copper the body can absorb. This can lead to anaemia and weakening of the bones."¹ The UK Expert Group on Vitamins and Minerals took 50 mg a day as the lowest dose with an observed effect, applied an uncertainty factor of 2, and set a Safe Upper Level of 25 mg a day "for supplemental zinc for daily consumption over a lifetime", noting that the effect at 50 mg "is not apparent in all studies"; the EU committee reached the same figure, pregnancy included.^{2, 3} The 25 mg is a total across every product, so add up the labels. How much zinc a day gives the UK figures by group; can you take too much zinc covers the other effects.

Is there a right zinc to copper ratio?

No. Neither the NHS page, the UK Expert Group report nor the EU opinion gives a zinc-to-copper ratio; the 10:1 and 15:1 figures that circulate online appear in none of them, and no trial we read set out to find one.^{1, 2, 3} Copper has its own NHS line: "Having 10mg or less a day of copper is unlikely to cause any harm. This includes copper from food, water and supplements."¹ The common forum question, what ratio suits 50 mg of zinc, has a dose answer: 50 mg is double the NHS line, and that is the thing to raise with a GP or pharmacist.

Why do eye formulas pair zinc with copper?

Because of their dose. The Age-Related Eye Disease Study gave 3,640 people aged 55 to 80 with signs of age-related macular degeneration 80 mg of zinc as zinc oxide (which type of zinc is best) with 2 mg of copper as cupric oxide for an average of 6.3 years; antioxidants plus zinc reduced the odds of progression to advanced disease (odds ratio 0.72, 99% CI 0.52 to 0.98).⁸ The copper was there because 80 mg of zinc, more than three times the NHS supplement line, was expected to lower it, a trial dose for a diagnosed group under an eye specialist. Zinc contributes to the maintenance of normal vision, the GB register's wording for zinc itself. Even with copper in the formula, cases occur: a 2026 report describes a 70-year-old woman on a long-term eye formula with six months of pins and needles, unsteadiness and falls and undetectable serum copper, who was walking independently again two months after stopping it and replacing copper and thiamine.⁹ A worry about that zinc dose is a question for the specialist who recommended it.

What happened with denture creams?

Four denture wearers who used "very large amounts of denture cream chronically" developed high zinc, low copper and neurological disease; the creams held about 17,000 to 34,000 micrograms of zinc per gram.¹⁰ In a UK case, a 50-year-old man with four years of unsteadiness, anaemia, low white cells and serum copper of 1.1 µmol/L was traced to heavy use of a zinc-containing fixative; his bone marrow recovered within three months of switching fixative and starting copper, but there was "no clinical improvement in neurological presentation".¹¹ No supplement delivers zinc on that scale; the cases show the nerve damage can be permanent.

What are the signs of low copper, and who is at risk?

Copper helps "produce red and white blood cells" and "trigger the release of iron to form haemoglobin", so the first signs are anaemia and a low white-cell count with repeated infections.¹ Then numbness and tingling in the feet and hands, an unsteady walk and falls, which a review of 55 published cases says "closely mimics" the spinal cord damage of vitamin B12 deficiency; its risk factors were previous upper gastrointestinal surgery, zinc overload and malabsorption, and copper replacement normalised the blood while "any neurological recovery was partial".¹² So the people at risk are those on 50 mg or more a day for months, anyone with previous stomach or bariatric surgery or a malabsorption condition, and people with Wilson's disease, where zinc is used deliberately to block copper under a specialist.^{2, 12} In public forums copper was the most common worry among experienced zinc users, almost all of it anxiety about a dose ("I'm worried I depleted all my copper", from a woman taking 46 mg a day in pregnancy) rather than a diagnosed deficiency. At 46 mg the worry is fair; the answer is the 25 mg line, not a copper tablet.

When does a blood test matter?

If you have taken 50 mg a day or more for months, or your products add up past 25 mg, and you have any of the signs above, see your GP and say what you take. The tests that confirm copper deficiency are serum copper and caeruloplasmin, both low; urinary copper is typically low too, which distinguishes it from Wilson's disease.¹² ESOD, the enzyme in the 50 mg trials, is a research marker, not a routine NHS test.^{4, 5} Below 25 mg a day with no symptoms, nothing we read suggests a test. Spreading numbness, repeated falls or marked breathlessness need a GP, or 111 when the surgery is closed.

Should you take zinc and copper every day, and when?

The NHS figures are daily amounts, so taking zinc every day within them is as intended: up to 25 mg a day from supplements, with copper from food covering the 1.2 mg and 10 mg a day the level the NHS calls unlikely to cause harm.¹ Taking them together is fine: multivitamins combine both, and the eye trial gave them in one tablet.⁸ No study we read compared morning with evening. Zinc on an empty stomach is the usual cause of nausea, so take it with a meal.⁶ And the NHS says iron, calcium and zinc supplements "can affect ciprofloxacin. Leave 2 hours in between taking supplements and your dose of ciprofloxacin tablets or liquid"; for other antibiotics, iron, calcium and penicillamine, ask the pharmacist (what should you not take with zinc).¹³ Signs of zinc deficiency covers the opposite problem.

Frequently asked questions

Can too much zinc cause low copper?

Yes. A copper enzyme marker fell at 50 mg a day within six to ten weeks; copper deficiency with anaemia and low white cells occurred at 150 mg a day for 10 to 23 months.^{2, 4, 5}

Should I take copper if I'm taking zinc?

Not automatically. At or below the NHS 25 mg line no UK or EU document suggests it. If a doctor has put you on a higher zinc dose, ask whether copper should be checked.^{1, 2, 3}

What should you not take with copper and zinc?

Leave two hours between zinc and ciprofloxacin; tell the pharmacist about other antibiotics, iron, calcium or penicillamine; and count the zinc in every product so the total stays within 25 mg.¹³

Sources

1. NHS. Vitamins and minerals: others (copper and zinc). nhs.uk.
2. Scientific Committee on Food. Opinion on the tolerable upper intake level of zinc, 2003. efsa.europa.eu.
3. Expert Group on Vitamins and Minerals. Safe Upper Levels for Vitamins and Minerals, 2003, zinc. gov.uk archive.
4. Fischer PW, et al. Effect of zinc supplementation on copper status in adult man. American Journal of Clinical Nutrition, 1984. PubMed 6486080.
5. Yadrick MK, et al. Iron, copper, and zinc status: response to supplementation with zinc or zinc and iron in adult females. American Journal of Clinical Nutrition, 1989. PubMed 2912000.
6. Samman S, Roberts DC. The effect of zinc supplements on plasma zinc and copper levels and the reported symptoms in healthy volunteers. Medical Journal of Australia, 1987. PubMed 3547053.
7. Milne DB, et al. Low dietary zinc alters indices of copper function and status in postmenopausal women. Nutrition, 2001. PubMed 11527655.
8. Age-Related Eye Disease Study Research Group. High-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8. Archives of Ophthalmology, 2001. PubMed 11594942.
9. Goodrich Z, Schneider J. Zinc-associated copper deficiency myelopathy: a case report. Clinical Neuropharmacology, 2026. PubMed 42757636.
10. Nations SP, et al. Denture cream: an unusual source of excess zinc, leading to hypocupremia and neurologic disease. Neurology, 2008. PubMed 18525032.
11. Barton AL, et al. Zinc poisoning from excessive denture fixative use masquerading as myelopolyneuropathy and hypocupraemia. Annals of Clinical Biochemistry, 2011. PubMed 21525151.
12. Jaiser SR, Winston GP. Copper deficiency myelopathy. Journal of Neurology, 2010. PubMed 20232210.
13. NHS. Taking or using ciprofloxacin with other medicines and herbal supplements. nhs.uk.

General information, not medical advice.