Ceruloplasmin Test
The ceruloplasmin test checks how much ceruloplasmin protein is present in your blood. This protein is produced in the liver and binds with copper to transport it across the body.
Copper is a trace mineral essential for:
- Producing energy
- Building healthy blood vessels
- Plays a role in producing melanin, the natural pigment that gives color to the skin, eyes, and hair
- Helping the body use iron properly
- Supporting brain development
- Maintaining strong immune and nervous systems
Food sources of copper include:
- Shellfish (oysters, crabs)
- Nuts and seeds
- Beef liver and other organ meats
- Wheat-bran cereals
- Chocolate
The majority of copper in the bloodstream is attached to ceruloplasmin. Checking ceruloplasmin levels helps determine if the body has a deficiency or excess of copper.
Also called: ceruloplasmin blood test, CP test, serum ceruloplasmin, copper oxidase, or ferroxidase.
What is the Test Used For?
Doctors usually order a ceruloplasmin test together with copper blood and urine tests. It is used to:
- Helps in diagnosing Wilson’s disease – a rare genetic condition in which the body fails to eliminate excess copper. This leads to copper buildup in the liver, brain, eyes, and other organs, which can cause damage and may become life-threatening.
- Detect copper deficiency, which may be caused by:
- Malnutrition (lack of essential nutrients in the diet)
- Malabsorption disorders like celiac disease (difficulty absorbing nutrients)
- Menkes syndrome (also called Menkes disease) – a rare inherited condition in infants that disrupts the body’s ability to properly utilize copper. Symptoms begin in the first few months of life.
- Excess zinc supplementation, which blocks copper absorption.
- To track and evaluate treatment progress in patients who have already been diagnosed with copper imbalance.
Why Do I Need a Ceruloplasmin Test?
This test may be advised if symptoms point toward Wilson’s disease. Although the disorder is present from birth, signs usually emerge when copper starts accumulating in the organs, most often between the ages of 4 and 40, but it can appear sooner or later.
Symptoms of Wilson’s disease include:
- Digestive and liver symptoms:
- Nausea and vomiting
- Upper abdominal pain
- Dark urine and/or pale stools
- Jaundice (yellow skin/eyes)
- Fluid swelling in belly, legs, or feet
- Itchy skin
- Blood-related symptoms:
- Hemolytic anemia (rapid breakdown of red blood cells)
- Neurological symptoms:
- Tremors
- Muscle stiffness
- Jerky, uncontrolled movements
- Difficulty speaking, swallowing, or with physical coordination
- Mental health changes:
- Anxiety
- Depression
- Personality changes
- Psychosis
- Eye signs:
- Appearance of green, golden, or brown rings around the iris of the eye (known as Kayser-Fleischer rings)
Testing may also be advised if Wilson’s disease runs in your family, even when no symptoms are present.
The test may also be recommended if you develop symptoms that suggest copper deficiency, including:
- Low white blood cell count (neutropenia)
- Osteoporosis (weak bones that break easily)
- Fatigue
- Pale skin
- Tingling in hands and feet
Infants and Menkes syndrome
Babies may need testing if Menkes syndrome is suspected. Symptoms usually appear at 2–3 months of age:
- Pale, fragile, or colorless hair that breaks easily and tangles
- Weak/floppy muscles
- Seizures
- Poor growth and slow weight gain
Without treatment, most children with Menkes syndrome die in early childhood. Early treatment in the first month of life may extend survival, though the disease often progresses.
What Happens During the Test?
- A healthcare professional inserts a small needle into a vein in your arm.
- Blood is drawn into a test tube or vial.
- The process takes less than 5 minutes.
- When the needle is inserted or removed, you might experience a brief sting or pinch.
Do I Need to Prepare?
No special preparation is required. You don’t usually need to fast; normal eating and drinking are allowed unless your doctor gives different instructions.
Are There Any Risks?
The risks are very small and include:
- Minor pain or stinging during the blood draw
- Small bruise or swelling at the puncture site
- Rarely, infection or excessive bleeding
Lab Consumables and Equipment Used
To perform the ceruloplasmin test, laboratories use:
- Vacutainer blood collection tubes (serum separator tubes)
- Disposable sterile syringes and needles
- Tourniquet
- Alcohol swabs, gauze, and cotton balls for sterilization
- Centrifuge machine (to separate serum)
- Ceruloplasmin reagent kits (commonly immunoturbidimetric or nephelometric)
- Biochemistry analyzer (for quantitative measurement)
- Micropipettes and sterile tips
- Standard lab safety equipment (PPE) such as gloves, masks, and laboratory coats
What Do the Results Mean?
Ceruloplasmin levels are interpreted with other copper tests (serum copper, urine copper, genetic testing, sometimes liver biopsy).
Low ceruloplasmin levels may mean:
- Wilson’s disease (though levels may appear normal in some cases)
- Menkes syndrome
- Severe liver disease
- Kidney disease
- Copper deficiency from poor nutrition or malabsorption
High ceruloplasmin levels may mean:
- Heart disease
- Rheumatoid arthritis
- Leukemia
- Hodgkin lymphoma
- Infection, inflammation, or injury
- Pregnancy
- Birth control pill use or estrogen hormone therapy
- Excess copper in diet rarely causes high ceruloplasmin.
Reference Ranges for Ceruloplasmin Levels
| Group | Normal Range (mg/dL) |
|---|---|
| Adult men | 15 – 30 |
| Adult women | 20 – 40 |
| Pregnant women | 30 – 60 |
| Children | 20 – 40 |
| Infants (0–6 months) | 15 – 45 |
(Note: Reference ranges may vary slightly depending on the laboratory and method used. Always check the lab’s own reference values.)
Frequently Asked Questions (FAQs)
No, fasting is not required.
Usually within 1–3 working days, depending on the lab.
No. Diagnosis requires other tests like blood/urine copper levels, genetic tests, and sometimes a liver biopsy.
Yes. Estrogen-containing medicines like birth control pills or hormone replacement therapy can raise ceruloplasmin levels.
Yes, though pediatric-sized tubes are used. It is commonly performed for suspected Menkes syndrome.
The doctor will review your medical history, symptoms, and additional test findings. Treatment will be based on the cause, which may include copper supplements, chelation therapy, or specific dietary changes.
Disclaimer
This content is meant for educational use only and is not a substitute for professional medical guidance, diagnosis, or treatment.. Always consult your doctor or a qualified healthcare provider for questions about your medical condition, test results, or treatment options.
📚 References
- Mayo Clinic. Ceruloplasmin test. Available at: https://www.mayoclinic.org
- MedlinePlus (U.S. National Library of Medicine). Ceruloplasmin blood test. Available at: https://medlineplus.gov/lab-tests/ceruloplasmin-test
- National Institutes of Health (NIH) – Genetic and Rare Diseases Information Center (GARD). Wilson disease. Available at: https://rarediseases.info.nih.gov/diseases/7790/wilson-disease
- Cleveland Clinic. Ceruloplasmin blood test. Available at: https://my.clevelandclinic.org/health/diagnostics/22642-ceruloplasmin-blood-test