Preferred Sample Type

Urine Copper

Suitable Specimen Types

  • 24 Hour Urine Plain
20 mL aliquot of 24 hour specimen collected into plain container.

Sample Processing in Laboratory

Place in toxicology box in cold room.

Turnaround Time

2 weeks

Sample Stability


Urine Copper

General Information

Copper is an important trace element which funtions as a catalytic component of numerous enzymes and is also a structural component of other important proteins.

A deficiency of copper has been noted in a number of conditions including malnourishment, malabsorption syndromes, prematurity, cardiovascular disease and Menkes syndrome. Raised values are seen in inflammatory states and with steroid hormone therapy. When investigating Wilson Disease, plasma/serum copper measurement is only of value as an addition to plasma caeruloplasmin concentration and 24 hour urinary copper excretion.

Caeruloplasmin and 24 hour urinary copper should be used for the initial investigation of Wilson's Disease, due to the many potential problems of interpreting the serum copper concentration.

To distinguish Wilson's Disease from other forms of hepatic dysfunction, may require measurement of 24 hour urinary Cu excretion before and after penicillamine challenge. Consult this laboratory or the SAS Trace Elements Handbook.

Cu IUDs do not appear to increase excretion of or urine content of the element.

Patient Preparation

Indications - Hepato-biliary dysfunction (inc. Wilson's Disease), toxicity, occupational exposure.


Note that a spot urine is not suitable for Wilson's Disease investigations as the results are not easily interpreted.

Reference Range

Reference Ranges (pre-chelation)

Normal excretion usually <0.8 umol/24 hours.
Cholestasis, hepatic cirrhosis, covert Wilson's Disease >0.8 umol/24 hours
Patients with frank Wilson's Disease or acute hepatic crisis >1.6 umol/24 hours

(Source: SAS Trace Element Analysis, 4th Edition, 2006).



  • EQA Scheme?: Yes
  • EQA Status: NEQAS

The laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital form part of the services provided by University Hospitals Birmingham and are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link:

  • Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217
  • United Kingdom Health Security Agency laboratory is a UKAS accredited medical laboratory No.8213

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database:

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For further information contact Louise Fallon, Quality Manager, 0121 424 1235