Copper, Anxiety & “Adrenal Fatigue”: The Unseen Connection

Author: Rohan Smith | Functional Medicine Practitioner | Adelaide, SA

Quick Answer

If you feel “wired but tired” (tired in your body but mentally switched on), one possible contributor is a copper–zinc imbalance. Copper is an essential trace mineral, but when copper is elevated relative to zinc, it may promote a more “stimulated” neurochemical state in some people. Copper is required for dopamine beta-hydroxylase—an enzyme involved in converting dopamine into norepinephrine (a key stress neurotransmitter)—so shifts in copper handling may influence catecholamine balance and stress arousal. (1,2)

Clinically, higher copper and lower zinc have been reported in some people with anxiety and mood symptoms, though this does not prove causation and individual results vary. (3,12) In practice, the goal is not to label copper as “bad”, but to identify whether your copper transport and mineral balance may be contributing to symptoms such as racing thoughts, inner tension, and poor stress tolerance.

Core Concept

Copper is essential, but balance and transport matter

Copper supports brain and immune function, connective tissue enzymes, and antioxidant systems. Problems usually relate to balance (copper relative to zinc) and handling (how copper is transported and buffered), rather than copper alone. (4)

Why copper–zinc balance may relate to anxiety

Copper is a cofactor for enzymes involved in catecholamine metabolism, including dopamine beta-hydroxylase (dopamine → norepinephrine). (1,2) Because norepinephrine is part of the body’s stress response, shifts in catecholamine balance may be experienced as heightened arousal (racing thoughts, restlessness, a “fight-or-flight” feeling) in susceptible individuals. (7)

Observational research has reported patterns of higher copper and lower zinc in subsets of people with anxiety and depressive symptoms. (3,12) This does not mean copper is the sole cause of anxiety, but it supports investigating mineral status when symptoms and history fit.

Stress signalling and “adrenal fatigue” language

“Adrenal fatigue” is a common colloquial label for feeling depleted after prolonged stress, but it is not a formal medical diagnosis. A more accurate framing is HPA-axis dysregulation (hypothalamic–pituitary–adrenal axis)—a stress system that coordinates adrenaline/norepinephrine signalling and cortisol output. (7,8) When stress systems remain activated for long periods, people may experience reduced stress tolerance, sleep disruption, and energy volatility. (8)

Ceruloplasmin and “free copper” (in simple terms)

Ceruloplasmin is a major copper-carrying protein. When ceruloplasmin is low, a greater proportion of copper may circulate in less tightly bound forms (sometimes referred to clinically as “free copper”), which has been linked to oxidative stress pathways in neurological disease research. (5,6) This is not a standalone diagnosis, but it can add context when assessing copper handling patterns.

Solution/Test

At Elemental Health and Nutrition (Adelaide), assessment focuses on patterns rather than single numbers. Depending on your case, testing may include:

• Serum copper and plasma zinc (ratio/pattern interpretation can be more informative than either marker alone). (3,12)
• Ceruloplasmin to help interpret copper transport/buffering patterns. (5,6)
• Stress physiology testing when symptoms suggest altered stress signalling or circadian disruption (for example, cortisol rhythm assessment). (7,8)

If mineral patterns are a good fit clinically, additional mineral balance testing may be considered as an adjunct. This is not a replacement for medical care and is interpreted in context with symptoms, history, and conventional markers.

For stress-pattern evaluation, some clients choose adrenal rhythm testing to better understand day–night cortisol patterns and nervous system load. (7,8)

When to Consider

Consider discussing copper–zinc balance and stress signalling with a qualified clinician if you have a “wired but tired” pattern plus several of the following:

• Mental/neurological: racing thoughts (especially at night), irritability, inner tension, brain fog
• Sleep/energy: daytime fatigue with evening “second wind”, unrefreshing sleep
• Mood: anxiety with physical symptoms (palpitations, tremor, agitation) or low mood alongside anxiety. (3,12,13)
• Hormonal context: symptoms emerging or shifting after starting estrogen-containing oral contraceptives (which can raise serum copper and ceruloplasmin). (9–11)
• Digestive context: chronic digestive symptoms plus risk factors for altered zinc status (for example, long-term acid suppression can impair zinc absorption in some people). (14–16)
• Environmental context: potential exposure to elevated copper in household water (more likely with certain plumbing/water conditions). (17)

Next Steps

• Don’t self-prescribe high-dose minerals. Zinc and copper supplementation can be harmful if misapplied. Work with a qualified clinician to interpret labs and decide on dosing.
• Start with history + pattern-matched testing. If symptoms fit, consider copper, zinc, and ceruloplasmin markers, plus stress rhythm assessment when indicated. (3,5–8)
• Review key modifiers. Hormonal contraception, chronic stress load, sleep disruption, digestive factors, and possible environmental exposures can all influence mineral patterns. (7–11,14–17)
• Rule out red flags. If you have chest pain, fainting, severe panic symptoms, suicidal thoughts, or rapidly worsening symptoms, seek urgent medical care.

Key Insights

• Copper is required for enzymes involved in catecholamine metabolism (dopamine → norepinephrine), which may influence stress arousal in susceptible individuals. (1,2,7)
• Higher copper and lower zinc have been reported in some people with anxiety and mood symptoms, supporting pattern-based assessment rather than guesswork. (3,12,13)
• “Adrenal fatigue” is not a formal diagnosis; HPA-axis dysregulation and allostatic load provide a more evidence-aligned framework for stress-related symptoms. (7,8)
• Oral contraceptives can raise serum copper and ceruloplasmin—important context when symptoms begin or change. (9–11)
• Digestive factors and long-term acid suppression may impair zinc absorption in some individuals, potentially shifting mineral status over time. (14–16)

Ready to Calm Your Nervous System?

If you’re feeling “wired but tired” and standard results keep coming back “normal,” a mineral-pattern and stress-physiology review may help clarify what’s driving your symptoms. You can explore testing options in Adelaide with Rohan Smith at Elemental Health and Nutrition, including adrenal rhythm testing and adjunctive mineral balance testing.

Book a consultation to discuss whether copper–zinc balance and stress signalling are relevant in your case.

Related reading: biochemical drivers of anxiety

References

1. Rahman MK, Nagatsu T, Kato T. Dopamine-β-hydroxylase (DBH), its cofactors and other biochemical factors. J Neural Transm (Vienna). 2009. (1)
2. Nelson KT, Prohaska JR. Copper deficiency in rodents alters dopamine β-mono-oxygenase activity, mRNA and protein level. Br J Nutr. 2008. (2)
3. Russo AJ. Decreased zinc and increased copper in individuals with anxiety. Nutrition and Metabolic Insights. 2011. (3)
4. An Y, Li J, Zhang X, et al. The role of copper homeostasis in brain disease. Int J Mol Sci. 2022;23(22):13850. (4)
5. Wang B, Wang X, Wang H, et al. Does ceruloplasmin defend against neurodegenerative diseases? Front Neurosci. 2019. (5)
6. Squitti R, Salustri C, Siotto M, et al. Ceruloplasmin fragmentation is implicated in “free” copper deregulation in Alzheimer’s disease. J Alzheimers Dis. 2008. (6)
7. Tsigos C, Chrousos GP. Hypothalamic–pituitary–adrenal axis, neuroendocrine factors and stress. J Psychosom Res. 2002;53(4):865–871. (7)
8. McEwen BS. Stress, adaptation, and disease: allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44. (8)
9. Babić Ž, Tariba B, Jukić I, et al. Relevance of serum copper elevation induced by oral contraceptives: a meta-analysis. Toxicology. 2013. (9)
10. Carruthers ME. Raised serum copper and caeruloplasmin levels in subjects taking oral contraceptives. Br Med J. 1966. (10)
11. Sontakke AN, Tare RS, Pingle SK, et al. Changes in serum ceruloplasmin levels with commonly used contraceptives. Indian J Clin Biochem. 2004. (11)
12. Maes M, De Vos N, Demedts P, et al. Lower serum zinc in major depression in relation to inflammatory markers. J Affect Disord. 1999. (12)
13. Lai J, Moxey A, Nowak G, et al. The efficacy of zinc supplementation in depression: systematic review of randomised controlled trials. J Affect Disord. 2012. (13)
14. Farrell CP, Morgan M, Rudolph DS, et al. Proton pump inhibitors interfere with zinc absorption and zinc body stores. Gastroenterol Res. 2011. (14)
15. Serfaty-Lacrosniere C, Wood RJ, Voytko D, et al. Hypochlorhydria from short-term omeprazole treatment does not inhibit intestinal absorption of minerals including zinc from food in humans. J Am Coll Nutr. 1995;14(4):364–368. (15)
16. Sturniolo GC, Molokhia MM, Shields R, et al. Inhibition of gastric acid secretion reduces zinc absorption in humans. J Am Coll Nutr. 1991. (16)
17. Harvey PJ, et al. Widespread copper and lead contamination of household drinking water, New South Wales, Australia. Environ Res. 2016. (17)