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Ceruloplasmin

A copper-carrying protein made by the liver. The level is mainly used, together with other tests, to look into Wilson disease and other copper problems.

AI-verified against cited sources. Awaiting expert reviewLOINC 2064-4

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The usual range for Ceruloplasmin depends on sex. Choose female or male above to see where you stand.

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What it is

Ceruloplasmin is a protein your liver makes by attaching copper to it. Most of the copper in your blood travels on ceruloplasmin, which carries it to the parts of the body that need it. Copper helps your body make energy, use iron and support brain development. The test measures how much ceruloplasmin is in your blood. It cannot diagnose a condition on its own.

Why it matters

A low ceruloplasmin can be one clue to Wilson disease, a rare inherited condition in which copper builds up in the liver, brain and other organs. But many people with a low result don't have Wilson disease, and a result in the usual range does not rule it out. It is also used to look into too little copper, for example from malnutrition or malabsorption, and Menkes disease in babies. Your clinician reads it with copper tests in blood and urine and with other findings.

If it’s low

A low result does not diagnose anything on its own. It can be a sign that the body isn't handling copper properly or that the liver is making less protein. Many people with a low result do not have Wilson disease.

Common causes

  • Severe liver disease
  • Kidney disease
  • Too little copper because of malnutrition or malabsorption, for example celiac disease
  • Taking too many zinc supplements, which can affect how well the body uses copper
  • Wilson disease (a rare inherited condition), though levels are sometimes in the usual range with it
  • Menkes disease (rare, in infants)

What can help

  • Ask which other tests, such as serum copper, 24-hour urine copper, liver tests or an eye exam, would help put the result in context
  • Review your supplements, including zinc, with your clinician

If it’s high

A level above your lab's range is most often a sign of inflammation, pregnancy or estrogen, not a copper problem. High levels do not always mean a condition that needs treatment.

Common causes

  • Pregnancy
  • Birth control pills or estrogen therapy, including estrogen for menopause
  • Infection, inflammation or injury
  • Some long-lasting conditions, including rheumatoid arthritis and some blood cancers
  • Heart disease

What can help

  • Ask whether pregnancy, a hormone medicine or an illness could explain the result
  • Ask whether it makes sense to recheck once you are well

Usual ranges

What labs print as the reference range, by who was tested. Ranges differ a little between labs, so the range on your own report is the one your result is judged against.

The usual range depends on sex. Choose women or men to see the one that applies.

What can affect your result

  • Pregnancy, birth control pills and estrogen therapy raise ceruloplasmin
  • Infection, inflammation or injury raise it
  • Sex and age: ranges are higher in adult females and differ in children
  • Lab method and range differences, especially for females (Labcorp 19–39 mg/dL, Mayo 20–51 mg/dL)
  • Zinc supplements, liver and kidney disease and nutrition problems can lower copper handling
  • Pregnancy, birth control pills and estrogen therapy can raise ceruloplasmin (MedlinePlus).
  • Infection, inflammation and injury can raise it (MedlinePlus); ceruloplasmin is an acute-phase protein.
  • ARUP rejects EDTA plasma and hemolyzed samples. Mayo and ARUP prefer a fasting sample (Mayo: 4 hours) but do not require it.

When to talk to a clinician

See your clinician promptly if a low result comes with yellow skin or eyes, dark urine, swelling in the belly or legs, tremor, stiff muscles, trouble with speech, swallowing or coordination, or new anxiety, depression or confusion. A baby with floppy muscles, seizures, slow growth or sparse, colorless, easily tangled hair should be seen promptly by the baby's clinician. Call 911 or your local emergency number for seizures, fainting or severe confusion.

Questions you could ask

  • Why was this test ordered, and what would different results change?
  • Could pregnancy, hormones or inflammation explain a high level?
  • Should we recheck once things settle?
  • Which other tests, such as serum copper or 24-hour urine copper, would help put this result in context?
  • Could my diet, supplements or another health condition explain a low level?

Questions people ask

Does a normal ceruloplasmin rule out Wilson disease?

No. Current practice guidance says a result in the usual range does not exclude Wilson disease, and many people with a low result do not have it. Clinicians combine ceruloplasmin with other tests, such as 24-hour urine copper, an eye exam, liver tests and sometimes genetic testing.

Why is my ceruloplasmin high?

Pregnancy, birth control pills, hormone therapy, infection, inflammation and injury can all raise it, and high levels don't always mean a condition that needs treatment. Your clinician can tell you what is likely in your situation.

Why do the ranges for women and men differ?

Labs print higher upper limits for adult females than for males. Estrogen raises ceruloplasmin, which may be part of the reason, so women's ranges are shifted up. Use the range printed on your own report.

Show the science and sources

Units

  • 1 mg/dL = 1 mg/dL
  • 1 mg/dL = 0.01 g/L

Open the Ceruloplasmin unit converter

Is a change real?

Ceruloplasmin naturally varies about 4.9% from test to test in the same healthy person. Between two results from the same lab, a change of roughly 15% or more is unlikely to be day-to-day noise or lab variation (95% reference change value). Source: The European Biological Variation Study (EuBIVAS): a summary report.

For clinicians and researchers

Ceruloplasmin is a copper-binding serum ferroxidase made in hepatocytes, where the copper-transporting ATPase ATP7B loads copper into the nascent protein. In Wilson disease, loss of ATP7B function leaves apoceruloplasmin, which has a shorter half-life, so steady-state serum levels are lower. The 2022 AASLD practice guidance (summary: Hepatology Communications 2023) states that values in Wilson disease are typically below 14 mg/dL (normal above 20 mg/dL), that many patients with a low value do not have Wilson disease, and that a normal value does not exclude it, so ceruloplasmin alone cannot establish the diagnosis. The same guidance pairs it with basal 24-hour urinary copper, slit-lamp examination, liver tests and ATP7B genetics. Ceruloplasmin is an acute-phase protein and rises with estrogen and pregnancy. Immunoassays (nephelometry at Mayo, immunoturbidimetry at ARUP) measure the protein, not its copper-dependent oxidase activity, so they do not separate holo- from apoceruloplasmin. Adult female intervals are higher than male ones at all three labs checked. Assay and lab intervals differ, so compare with the range on your own report.

LOINC 2064-4 (primary), 47600-2. Specimen: serum-or-plasma.

Sources

  1. Ceruloplasmin (test 001560), sample report, Labcorp
  2. Ceruloplasmin (test 001560), Labcorp
  3. Pediatric Testing Reference Ranges, Labcorp
  4. Ceruloplasmin, Serum (test ID CERS), Mayo Clinic Laboratories
  5. Ceruloplasmin (test 0050160), ARUP Laboratories
  6. Ceruloplasmin Test, MedlinePlus, National Library of Medicine
  7. Wilson disease: a summary of the updated AASLD Practice Guidance, Hepatology Communications (2023)

AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. How we build and check these pages.

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