Ceruloplasmin Test

What is a ceruloplasmin test?

A ceruloplasmin test is a blood test to measure your ceruloplasmin levels.

Ceruloplasmin is a protein your liver makes. It helps copper circulate throughout your body and plays an important role in making the iron that you get from food ready to move from your intestines to organs like your spleen. You need copper to help maintain energy and bone health. It also helps your body make the substance that gives your skin its pigment (melanin).

What is the purpose of a ceruloplasmin test?

Your healthcare provider may order a ceruloplasmin test if they suspect you have a genetic condition called Wilson disease. Wilson disease keeps your body from transporting copper effectively. If you have Wilson disease, you’ll likely have lower-than-normal levels of copper in your blood, but higher-than-normal levels of copper in your pee.

You may also have a ceruloplasmin test to diagnose conditions that cause low copper. You may have a copper deficiency because of:

• Malabsorption, when your body doesn’t absorb nutrients properly
• Malnutrition, when your eating habits don’t include enough nutrients
• Menkes disease, a rare, genetic condition where your body doesn’t absorb copper well
• Total parenteral nutrition, when you get all food and nutrients intravenously (through an IV)
• Eating a lot of foods containing zinc, which can prevent your intestines from absorbing the copper it needs

Why might I need a ceruloplasmin test?

You may need a ceruloplasmin test if you have a family history of Wilson disease. You may also need the test if you have symptoms of Wilson disease, including:

• Abdominal pain
• Anemia
• Difficulty walking
• Dysphagia (difficulty swallowing)
• Nausea
• Tremors
• Yellowish skin or eyes (jaundice)

Your healthcare provider may also test your ceruloplasmin levels if you have symptoms of copper deficiency (low copper levels), such as:

• Fatigue
• Osteoporosis
• Tingling or numbness in your hands or feet
• Washed out or pale skin (compared to your normal skin color)

How does a ceruloplasmin test work?

A ceruloplasmin test is a blood test. It lasts a few minutes. A phlebotomist:

1. Wraps an elastic band around your arm to locate a vein in your inner elbow or hand
2. Cleans your skin with an antiseptic
3. Inserts a small needle into the vein
4. Collects a small tube (vial) of blood
5. Removes the needle and places cotton and a bandage over the area

Ceruloplasmin tests are relatively painless for most people. You can go home or go about your normal activities immediately after the test.

If you feel anxious or fear needles, tell your healthcare provider before they begin. It may help to look away from the needle, practice deep breathing or lie down.

During a ceruloplasmin test, laboratory technicians often analyze a part of the blood called plasma, the liquid part of your blood. To get plasma, a healthcare provider separates the blood sample in a process called spinning (using a centrifuge). Spinning separates your blood into parts that a technician can analyze.

How do I prepare for this test?

There’s no special preparation for a ceruloplasmin test. In general, drinking plenty of water before a blood test can help a blood draw go more smoothly. Staying hydrated keeps your veins from tightening and reduces blood pressure changes.

What are the risks?

Like most blood tests, ceruloplasmin tests have few risks. You might have mild soreness, redness or bruising where the needle was in your arm. Usually, these symptoms go away within 24 hours.

What can I expect after?

Depending on the test results, your healthcare provider may recommend more tests to diagnose or rule out medical conditions. You may have urine tests, more blood tests or tests that check your liver function.

In rare cases, your healthcare provider may perform an operation to get a tissue sample from your liver and analyze it in a lab (liver biopsy). Liver biopsies may give more information about liver damage and copper levels. A liver biopsy can help diagnose Wilson disease, too.

What do the results of a ceruloplasmin test mean?

A ceruloplasmin blood test shows whether you have low, average (normal) or high ceruloplasmin levels. The result can help your healthcare provider find the cause of the symptoms you’re experiencing.

Normal ranges vary depending on your assigned sex at birth, if you take oral contraceptives and if you’re pregnant:

You can still be healthy but have test results that are outside of what’s considered “normal.”

Reference ranges can vary. Your healthcare provider is the best person to interpret your test results and tell you what they mean for you.

What does low ceruloplasmin mean?

Lower-than-normal ceruloplasmin levels may mean that your body isn’t using copper efficiently. It could point to:

• Kidney disease
• Liver disease
• Wilson disease
• Malabsorption or malnutrition
• Menkes disease

Sometimes, low ceruloplasmin points only to a copper deficiency and not an underlying disease.

What does high ceruloplasmin mean?

High-than-normal ceruloplasmin levels could mean you have irregularly high levels of copper. This can be a sign of:

• Angina
• Leukemia
• Hodgkin lymphoma
• Alzheimer’s disease
• Rheumatoid arthritis
• Lung cancer

Keep in mind that you can have high ceruloplasmin levels without having a medical condition. Ceruloplasmin levels may also increase because of inflammation, infection or injury. Pregnancy and birth control pills can both lead to high ceruloplasmin. 

When should I call my doctor?

You should call your healthcare provider if you have any questions about your test results. They can explain what your results mean and what the next steps are.

Also, call your provider if you have signs of a possible copper deficiency, including:

• Chronic (long-lasting) fatigue
• Loss of sensation or tingling in your feet or hands
• Pale or washed-out skin
• Brittle or weak bones that break easily