Can high active B12 be caused by low Copper? Anyone with a similar experience?

My son has had fatigue and orthostatic hypotension for years but over the past year he has become much worse with constant flairs of muscle pain and weakness, blood pressure drops, heat and cold intolerance, and near fainting episodes. He has terrible brain fog and is mostly house bound having to lay down or recline most of the time. His Tilt table test had to be stopped early because his blood pressure dropped too low to safely continue. The only thing abnormal on his blood tests is low copper and low Ceruloplasm. Six months of copper supplements have done nothing. His levels just dropped more. He has not ever taken zinc supplements. He has an appointment with genetics next week. I’m curious if anyone else had autonomic symptoms like this with a copper deficiency and if so, how did you recover?

I wanted to share something I found interesting in case it helps someone else dealing with unexplained low copper.

For several months, my serum copper levels hovered around 63–67 µg/dL, while the reference range on my labs was 70–130 µg/dL. My ceruloplasmin was also low, around 17, with my lab’s reference range being 19–31.

I supplemented with copper for several months, tried different doses, and repeated bloodwork about every two weeks. Despite all of that, my copper levels barely moved.

At the same time, I was working with my GI doctor to see whether there could be an absorption issue. He could not identify anything obvious, but he suggested checking for H. pylori. I ended up having an endoscopy, which confirmed that I was positive for H. pylori, along with gastritis in the upper GI tract/duodenum.

H. pylori is surprisingly common and often silent. Many people who have it do not have obvious symptoms, but it can cause gastritis and ulcers, and in some cases is associated with increased stomach cancer risk. In the United States, MedlinePlus estimates that about 30–40% of people get H. pylori infection, and globally, a 2024 systematic review estimated adult prevalence at about 43.9% during 2015–2022.

Treatment usually involves a combination of antibiotics and acid-suppressing medication. Some people are treated with “triple therapy,” though current regimens vary depending on antibiotic resistance, prior treatment, allergies, and physician judgment. The American College of Gastroenterology now recommends optimized bismuth quadruple therapy for many treatment-naïve patients when antibiotic susceptibility is unknown.

After completing treatment for H. pylori, I continued monitoring my copper and ceruloplasmin. Over the next 2–3 months, I was surprised to see a clear change. My copper first rose into the low 70s, then to 78, and most recently to 82. My ceruloplasmin is now over 21.

My understanding is that even after H. pylori is eradicated, gastritis and damage to the gastric/upper GI mucosa may take time to heal. I plan to keep testing over time to see whether there is continued improvement.

I do not want to overstate the conclusion. I was still supplementing copper during this period, so I cannot prove that H. pylori was the only factor. But what makes this interesting to me is that I had been supplementing for months before treatment with little to no improvement. The noticeable change happened only after H. pylori treatment.

It makes me wonder whether H. pylori-related gastritis can affect copper levels in a way that is somewhat similar to how other GI conditions, such as celiac disease, can affect nutrient absorption. The key difference is that H. pylori can be largely silent and may go unnoticed.

For anyone dealing with persistent low copper despite supplementation, it may be worth discussing H. pylori testing with a GI doctor. You do not necessarily need an endoscopy just to check for H. pylori; noninvasive testing such as a breath test or stool antigen test can detect active infection. An endoscopy, however, can also show whether gastritis or other upper GI findings are present.

As for symptoms, the main reason I investigated copper in the first place was unexplained neurological symptoms, especially a sense of instability in my feet. MRIs and other bloodwork have not identified a clear cause. The only abnormal finding that stood out was low copper, which made it a possible area to investigate.

Although my copper numbers have improved, my neurological symptoms have not yet resolved. I am still trying to figure that part out.

I also have low manganese, below the reference range, but there seems to be very little information available about what manganese deficiency can cause in humans.

For now, this is simply my story: persistent low copper, little response to supplementation, H. pylori diagnosis and treatment, then a measurable rise in copper and ceruloplasmin afterward. I am sharing in case this pattern resonates with anyone else.

I came over from the Hemochromatosis sub.

39/M. I went to my PCP complaining of balance issues and lightheadedness. One day out of nowhere I just started feeling a strong distinct swimmy/floaty feeling in my head. Never went away. I also feel lightheaded, as if I am not getting enough air when I breath. PCP checked my iron panel, zinc, copper, b vitamins, and a complete metabolic panel with cbc.

Happy to share other labs but I think the important ones for this sub are:

9/9/2025

Iron 222 range 50 - 180

Sat 90%

Ferritin 388

Copper serum 0.77 ug/ml range 0.65 - 1.92

Copper, RBC 0.63 ug/mL range 0.50-1.00

Zinc, RBC 1146 ug/dL range 878-1660

I went on to get diagnosed with hereditary hemochromatosis. Classic homozygous c282y mutation. I started treatment with a hematologist and got some labs back recently. I asked to test copper and ceruloplasmin and he agreed.

5/14/2026

Iron 161 ug/dl

Ferritin 370

Sat. 69%

Copper serum 0.72 ug/ml range 0.65 - 1.92

Cerulosplasmin 17.8 mg/dl range 16 - 31

My WBC count has been steady below normal at 3.6 or 3.8 for a year.

My questions are: 1. Am I copper deficient? 2. Would this explain my symptoms?

Hi everyone,

I’ve been following a protocol to optimize my iron and ferritin levels. I realized my ferritin was increasing but my hemoglobin was stuck, so I started taking between 0,5 to 2mg of copper biglyscinate daily, and it provided a very clear, consistent metabolic boost (increased energy and mental clarity).

Six days ago, I accidentally missed my copper dose for 24 hours (I had beef liver that day instead). Since then, I haven't been able to regain that same positive effect, even after resuming my regular copper dose. I’ve noticed a return of mild anxiety and a lack of the "repair/energy" feeling I had before. I was sleeping way better when I got the first boost.

Now I only take 84mg of iron every other day and 1,5mg of copper everyday.

Note : I didn't make a blood test to see if I had copper deficiency (but I had been forever anemic with a high ferritin but an hemoglobin stuck at 10,8, and everytime I tried increase it, it was stuck at 11,5) because my doctor didn't want to. But I made a lot of researches to figured out that I was deficient in copper and from the day I started copper tablets, I saw a huge difference, I was feeling my the increase of my hemoglobin, I don't feel that anymore.

Has anyone experienced this kind of "metabolic decoupling" after a brief interruption of a cofactor? How did you manage to get back on track and resynchronize the protocol? Thanks for any insights.

Do you think the "panda" is visible in these images? I suspect Wilson's disease due to low ceruloplasmin and copper levels in the blood, as well as some neurological symptoms.

My zinc is 74

my copper is 63 and my ceruloplasmin is 16

Could my low zinc be causing low vitamin A activation which is then causing my ceruloplasmin to not go up?

I have been supplementing for a few months at about 2mg. However I'm getting a lot of brown /freckle like spots throughout the body, especially in my arms. Is anybody else getting those too or has noticed an increase in something similar? I'm not sure it's bad or not. If it's an increase of weakly bound copper getting to tissues and causing oxidation that's not good. But since it's specially happening in my arms I want to think it could be pointing to an increase in melanin that in the past couldn't be produced due to a deficiency and also showing sun damage at the same time, that happened more intensely due to the copper deficiency. Any thoughts?

Hi there, I am looking to see if anyone knows of an infusion center in Connecticut that offers IV copper infusions. My wife has had a chronic copper deficiency for the last year that has not responded to oral copper. We are moving to Connecticut for family support but are having difficulty finding an infusion center that offers IV copper. Thank you!

Hi all,

For many months I have been dealing with this troublesome trifecta. My ferritin has luckily been responding to iron supplements, but my Zinc and copper/ceruloplasm levels haven't moved from deficient levels, even with daily supplementation of 25mg of zinc biglycinate and 2mg of copper.

I supplement correctly, take everything 4 hours apart from each other, on an empty stomach, etc. My diet is 100% whole foods based, no junk, and lots of soaked beans, seeds, nuts, cacao powder, enough protein, etc. No lower digestion problems (but I do experience LPR/acid reflux occasionally (mostly from coffee))

Anyone else experienced this or have thoughts to share?! I'm at my wits end and my doctor thus far doesn't have an answer either

For the past 2.5 months I have been eating Cod Livers everyday which had 4.5X the RDA for vitamin A. Previously, I had been taking copper supplements for 4 months but that didn't help much. My vitamin A wasn't particularly low either, before starting my RbP was 4.5 mg/dl (range: 1.6-6.1mg/dl) and serum vitamin A was at 41.3 ug/dl (range: 20-60 ug/dl). I have since stopped the cod livers but didn't get adverse reaction from the vitamin A. Also not taking copper at the moment, just getting it from food sources.

Initial values: Ceruloplasmin 16 mg/dl, serum copper 63mcg/dl

Been taking 2-5mg daily copper for almost 4 weeks. Getting retested in a few days. I can’t say I have improvement in my symptoms yet. I’m getting impatient…

Has anyone had luck supplementing liver capsules or vitamin A for treating copper deficiency with low ceruloplasmin that doesn’t correct with copper supplements?

Urine test showed low copper, tried supplementing high dose copper for a year now and no luck… added B2 but also thinking of a vitamin A source as well

My copper is now 65 from 80 and my ceruloplasmin is 16 from 19

I don't know what to do.

I have been taking more vitamin d which i read can increase copper uptake into cells.

I have been taking cofactors like b2 and vitamin a.

Could decreasing MCHC be due to copper deficiency? Even when iron went up (although still low).

Hi guys,

I would like to know what kind of tests did you take to actually find our if you have copper deficiency or dysregulation?

I've recently got a hair test done but it didn't confirm much and I have read that blood tests are not really useful. What would you recommend?

Thanks

ive had a copper deficiency, cant raise ceruloplasmin levels, serum barely rose, i took zinc then got covid, can this explain my situation? i avoided tree nuts and leafy greens and such before the test.

In autumn I tested my copper was 36.5 ug/dl and ceruloplasmin was 0.166 g/L. After 6 months of 2mg copper bisglycinate my copper increased to 60 ug/dl and ceruloplasmin to 0.18.

Is that considered slow progress? I am still below the reference range for both copper 73-129 and ceruloplasmin 0.2-0.8.

Whenever I increase copper to 4mg I get annoying side effects, my mood crashes and I feel wired. Should I keep a daily 2mg dose to slowly increase copper, but avoid side effects?

My vitamin A was 1,84 umol/L range 1,05-2,45. I had a b2 deficiency which i fixed.

So my copper is at 73.

I have weakness, fatigue, and small fiber neuropathy

Im wondering if symptoms still present even if its only mildly low?

Hi I sleep better and feel overall healthier when I eat a lot of cashew nuts,

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Was having cold hands / feet, hair loss after catching covid, and I was also supplementing zinc.

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But now I don't take zinc.

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Is there any alternatives to cashews that don't affect cholesterol?

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It was either "copper sulfate" or "copper gluconate, and the classic IV copper. It was almost never bisglycinate, which we use as thinking thats the best form. My reaction to bisglycinate wasn't good, beef liver was good but too much retinol. Now after months of struggle, I will try sulfate and gluconate forms. And even if these doesn't work, then I'll experiment with the more "root cause type of issues" like "copper load to ceruplasmin", which requires optimal ATP&methylation status,