Wilson’s Disease Diet: What to Eat, Meal Plan, and More

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 3-day sample Wilson’s disease diet menu.

What is Wilson’s disease?

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 build-up 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 — accumulate in the body.

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).

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 high-copper foods.

Foods high in copper include (5):

• beef liver
• oysters
• chocolate
• potatoes
• mushrooms
• cashews
• crab
• sunflower seeds
• tofu
• chickpeas
• salmon
• whole-grain pasta
• avocado
• figs

These foods contain 20% or more of the daily value (DV) of copper per serving, making them high sources.

However, you would need to consume large amounts of plant-based sources of copper like beans and nuts to obtain an appreciable amount, whereas just 3 ounces of liver or shellfish contain 500–1,400% of the DV for copper (5).

As such, it may be more worthwhile to consistently restrict liver and shellfish from your diet rather than plant-based sources of copper (6).

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 consumed in excess (7).

Even if you haven’t developed liver cirrhosis, you should still limit your intake of added sugars as part of a healthy diet to reduce your risk of developing fatty liver, which can progress to liver cirrhosis.

Unlike the sugar found naturally in milk and fruit, added sugar is added during the manufacturing process.

Examples of foods with added sugars include:

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

You can identify which foods contain added sugars and in what amount by reading the nutrition facts label.

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.

You likely won’t know

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 (8).

However, keep in mind that certain alcoholic beverages can be high in copper (9).

Also, certain cocktails may contain added sugars, which can be especially harmful to your liver.

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 it has been added to the food.

To provide you with different options, here are some examples of low-copper foods (10):

• 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, 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 the DV for copper (5).

However, keep in mind that a low-copper food can turn into a high-copper food if you consume too much of it.

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

Copper from the corrosion of household plumbing, faucets, and water fixtures can also leach into drinking water.

Signs that your water contains high-copper levels include a metallic or unpleasant bitter taste or if you see a blue-green coating on plumbing fixtures.

3-day sample Wilson’s disease diet

Here is a 3-day sample Wilson’s disease diet that contains mostly low-copper foods:

Day 1

• Breakfast: scrambled eggs and oatmeal topped with a sliced banana
• Lunch: lasagna and a salad
• Snack: tuna salad as a dip with pita chips and fresh veggies
• Dinner: vegetable beef soup and cheesy garlic bread

Day 2 (vegan)

• Breakfast: vegan overnight oats
• Lunch: broccoli salad and roasted sweet potatoes
• Snack: apple slices and walnuts
• Dinner: black bean soup and white rice

Day 3

• Breakfast: cottage cheese on white toast with tomato and cucumber slice
• Lunch: roast beef sandwich and carrot sticks
• Snack: Greek yogurt with apple slices
• Dinner: grilled chicken, white rice, and sauteed green beans

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 allow you to maintain normal levels in combination with medications.

Plant-based sources of copper like beans and nuts are less of a concern than liver and shellfish, which you should consistently avoid since they contain very high levels of copper.

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.