Wilson’s disease is a rare genetic disorder that causes excessive amounts of copper to accumulate in your liver, brain, and eyes.

Copper is an essential mineral that helps support brain health and maintain a healthy immune system and metabolism.

Normally, your body can remove excess copper, but with Wilson’s disease, copper builds up to toxic levels that can damage your organs.

In combination with medications, diet plays an important role in managing Wilson’s disease and preventing complications from the condition.

This article explains what to eat and avoid with Wilson’s disease and provides a sample Wilson’s disease diet menu.

wilson's disease diet

Causes and risk factors

Wilson’s disease is a rare genetic disorder caused by a mutation in the ATP7B gene, which codes for transporting excess copper out of the body.

This mutation causes a toxic buildup of copper in the liver and other organs, especially the brain, kidneys, and eyes.

Wilson’s disease is kind of similar to hemochromatosis, except with hemochromatosis, excessive amounts of iron — rather than copper — accumulates in the body.

Wilson’s disease affects approximately 1 in 30,000 people worldwide, and 1 in 90 people are estimated to carry the mutated gene (1).

You must inherit a copy of the affected gene from each parent to have Wilson’s disease.

Symptoms

The symptoms of Wilson’s disease vary widely depending on the severity and the organs affected, but they usually relate to the brain and liver (1).

Brain-related symptoms include:

  • tremors
  • muscle stiffness
  • trouble speaking
  • personality changes
  • anxiety
  • hallucinations

Liver-related symptoms include:

  • vomiting
  • weakness
  • stomach distention
  • leg swelling
  • yellowing of the skin or eyes
  • itchiness

Copper can also become deposited in the cornea — or the front surface of the eye — to form a green-to-brownish ring, called the Kayser-Fleisher ring.

The symptoms of Wilson’s disease tend to appear between the ages of four and 45 (1).

Diagnosis and treatment

To diagnose Wilson’s disease, your doctor will review your health history and any symptoms that you have been experiencing.

In addition, your doctor may perform various tests to confirm a diagnosis or rule out other conditions that present similar symptoms.

Tests can include (1):

  • eye exam to check for Kayser-Fleisher rings
  • a blood test to check your liver function
  • a blood test to check your level of ceruloplasmin, a protein that carries copper through the blood
  • urine test to measure the amount of copper in your urine
  • genetic testing
  • liver biopsy to check liver copper levels
  • imaging tests to view your brain

These tests can also help your doctor identify any complications from Wilson’s disease like fatty liver or liver cirrhosis to develop the best treatment plan for you.

Treatment usually involves taking medications that lower copper levels by increasing the elimination of copper from the body or by reducing its absorption from food.

Wilson’s disease diet

Due to the rarity of the condition, limited studies have been conducted on the role diet plays in managing Wilson’s disease.

However, in combination with taking medications, a low copper diet has traditionally been recommended to help lower high copper levels and maintain normal levels.

In either case, clinical guidelines recommend that people with Wilson’s disease follow a low copper diet unless they receive zinc supplements (2).

In high doses, zinc inhibits the absorption of copper (3).

However, high doses of zinc can cause iron deficiency anemia, a condition in which you lack enough red blood cells to carry oxygen to your body’s tissues (4).

Therefore, limiting your intake of copper may help reduce the dose of zinc or other medications you need to maintain healthy copper levels while reducing your risk of anemia.

In addition to a low copper diet, making other dietary changes can also help prevent or reduce liver damage, which occurs when copper levels are too high.

Foods to limit

Despite the limited information available on the role diet plays in managing Wilson’s disease, limiting your intake of high copper foods, added sugars, and alcohol may help you better manage the condition.

High copper foods

Depending on your copper levels, you may need to restrict foods and drinks high in copper.

Foods high in copper include (5):

  • beef liver
  • oysters
  • chocolate
  • potatoes
  • mushrooms
  • cashews
  • carb
  • sunflower seeds
  • tofu
  • chickpeas

Added sugar foods

Left untreated, Wilson’s disease can cause liver cirrhosis, a condition that occurs when your healthy liver cells become damaged and scarred.

With liver cirrhosis, it’s important to limit your intake of added sugars, which can cause further liver damage when eaten in excess (5).

Even if you haven’t developed liver cirrhosis, you should still limit your intake of added sugars as part of a healthy diet.

Unlike the sugar found naturally in dairy and fruit, added sugar is added to foods and beverages during the manufacturing process.

Added sugar examples include:

  • regular soft drinks
  • candy
  • cakes
  • cookies
  • pies
  • fruit drinks
  • dairy desserts
  • many kinds of breakfast cereals

Alcohol

Heavy alcohol use can damage your liver and lead to liver cirrhosis over time.

As such, you should completely abstain from alcohol if you have liver cirrhosis.

If your liver is healthy, drinking in moderation — defined as one drink per day for women and two per day for men — is likely OK (6).

However, keep in mind that certain alcoholic beverages can be high in copper (7).

Low copper foods to eat

You may benefit from eating low copper foods if you have high levels of the mineral.

But identifying which foods are low in copper can be difficult.

This is because the Food and Drug Administration (FDA) does not require food labels to list copper unless copper has been added to the food.

To provide you with different options, here are some examples of low copper foods (8):

  • Fruits: Most fruits, including apples, bananas, berries, and oranges.
  • Vegetables: Most vegetables, including tomatoes, lettuce, broccoli, and carrots.
  • Grains: rice, pasta, grits, oatmeal
  • Dairy: yogurt, milk, cheese
  • Protein: beef, chicken, turkey, salmon, cod, eggs,
  • Oils and fats: olive oil, canola oil, butter, margarine
  • Beverages: tea and coffee

Per 100-gram serving, these foods contain less than 10% of your daily value. For reference, foods that provide 20% or more of your DV for copper are considered to be high sources of the nutrient (5).

Avoid cooking with copper cookware or drinking out of copper mugs as the copper from these items can leech into your foods and drinks.

One-day sample Wilson’s disease diet

Here is a one-day sample Wilson’s disease diet that contains low copper foods:

Breakfast: Oatmeal topped with a sliced banana and a spinach and cheese omelet.

Snack: Greek yogurt with apple slices.

Lunch: Lasagna and lettuce salad.

Snack: Tuna salad as a dip with pita chips and fresh veggies.

Dinner: Vegetable beef soup and cheesy garlic bread.

The bottom line

Wilson’s disease is a rare genetic disorder that causes a toxic buildup of copper in the liver and other organs, especially the brain, kidneys, and eyes.

Although there are limited studies on the role diet plays in managing Wilson’s disease, following a low copper diet can help lower high copper levels and maintain normal levels in combination with medications.

Along with a low copper diet, limiting your intake of added sugars as part of a healthy diet is beneficial for Wilson’s disease. Drinking in moderation is likely OK unless you have liver cirrhosis, in which case you should avoid it.


Gavin Van De Walle, MS, RD, LN
Gavin Van De Walle, MS, RD, LN

Gavin Van De Walle holds a master's degree in human nutrition and bioenergetics. He is a registered dietitian who aims to arm the public with evidence-based nutrition recommendations so they can make their own educated and informed health decisions.