It was during my Neurology electives when I saw a young patient who had been doing well on treatment. His seizures had stopped, his liver was better, and things were stable. But recently, he had another seizure. When we talked to him, we discovered he had started eating more chocolate and nuts again — easy-to-miss history, especially in younger patients.
This information helped us think carefully: was it the diet, or was it time to adjust his medications? Sometimes, checking simple things like diet first can help avoid unnecessary changes in treatment.
Following the "COPPER" rule is a simple but important way to help keep Wilson disease better controlled over time. And whenever there’s a new symptom, it’s always a good idea to ask about recent diet changes.
An easy way to remember what foods to avoid is by thinking of the word "COPPER":
- C – Chocolate: Tasty, but packed with copper.
- O – Organ meats: Liver and kidneys have very high copper levels.
- P – Peas and legumes: Beans, lentils, and peas can sneak in extra copper.
- P – Peanuts and other nuts: Healthy for many, but risky for Wilson disease.
- E – Edible mushrooms: Mushrooms soak up copper from the soil.
- R – Rock oysters and shellfish: Seafood like oysters is loaded with copper.
References:
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Wilson Disease Overview. niddk.nih.gov
- European Association for the Study of the Liver (EASL) Clinical Practice Guidelines. Wilson’s disease. Journal of Hepatology (2012).