Ceruloplasmin
The protein that carries most of the copper in the blood and helps handle iron. Its most important use is a low level as a clue to Wilson's disease (copper overload); it also behaves as an inflammation marker, so it rises non-specifically too.
What it measures
Ceruloplasmin is a protein made by the liver that carries around 90% of the copper in the blood, and it also plays a role in iron metabolism. Its clinically important direction is usually a low level, because ceruloplasmin is the central test — together with copper studies — in Wilson's disease, an inherited disorder in which copper accumulates harmfully in the liver and brain; a low ceruloplasmin is a key part of that diagnosis. A low level also occurs in copper deficiency, severe liver disease and protein loss, and in a rare condition (aceruloplasminaemia) that affects iron. In the other direction, ceruloplasmin is an acute-phase protein, so it rises non-specifically with inflammation, infection, pregnancy and oestrogen (the pill or HRT) — which is why a 'normal' or high value doesn't fully exclude Wilson's if inflammation is masking it. It is always interpreted with copper (in blood and urine) and the clinical picture.
What a high value can mean
- Inflammation or infection — ceruloplasmin is an acute-phase protein and rises non-specifically.
- Pregnancy, oestrogen (the pill or HRT).
- A high level is rarely the point of the test — the important direction is low, and inflammation can mask a truly low level.
What a low value can mean
- Wilson's disease — the key clinical use; a low ceruloplasmin with copper studies supports the diagnosis of copper overload.
- Copper deficiency — from excess zinc, malabsorption or previous bariatric surgery.
- Severe liver disease or protein loss.
- Aceruloplasminaemia — a rare inherited disorder affecting iron handling.
- In newborns — normally low in the first months of life.
When to discuss with a doctor
Ceruloplasmin is a targeted test, not a routine one. Its main role is in suspected Wilson's disease — considered in a young person with unexplained liver disease or new neurological or psychiatric symptoms — where a low ceruloplasmin, alongside serum and urine copper and an eye examination, supports the diagnosis of a treatable condition. Because inflammation raises ceruloplasmin, a normal result does not fully exclude Wilson's, and the whole picture is weighed by a specialist. It is also relevant when investigating copper deficiency. Mediora.AI shows ceruloplasmin alongside copper and liver markers so the pattern is read together; the interpretation belongs with hepatology or neurology.