Treatment for Wilson’s disease

What are the aims of Wilson's disease treatment?

Wilson’s disease treatment aims to reduce the amount of copper in the body to prevent damage. And to protect liver and brain function.

Wilson’s disease treatment has two stages.

• Stage 1 – copper removal.

Aims to get rid of extra copper that built up in the body before diagnosis. This usually takes about a year.

• Stage 2 – ongoing treatment.

Aims to stop copper building up again and causing permanent damage.

Back to top

Chelation to remove copper

Copper chelators are the first-choice treatment for most children and adults with Wilson’s disease.

Copper chelators stick to copper in the blood and help to remove it from the body in pee (urine). They are usually used in the first stage of treatment and might also be used in the second stage.

These medicines cannot repair damage to the liver or brain. But they can stop more damage happening and allow the liver to repair itself. Over time this can also improve brain symptoms.

Chelators work best when there is not already very severe damage.  So it is important to start treatment for Wilson’s disease as soon as possible.

Treatment is lifelong. Medicines must be taken every day even if there are no symptoms.

All these medicines can have side effects. Doctors use a “low and slow” treatment. This means starting with a low dose and slowly increasing it. Patients have regular checks to see how well the medicine is working and if there are any side effects.

Find out about taking these medicines in pregnancy

Back to top

Zinc

Zinc can reduce the amount of copper the body gets from food.

It is usually used if someone:

• Has Wilson’s disease but does not have a build-up of copper and may not have any symptoms yet. For example, if someone was tested because a family member was diagnosed.
• Has already had treatment with a copper chelator and it has removed a lot of copper from the body.

In some cases zinc is also used for people with symptoms affecting their nerves.

Most people taking zinc will not have side effects. Side effects are more likely when the medicine is first taken and go away over time.

Side effects can include:

• heartburn
• increased risk of portal hypertension when changing from chelators to zinc

It is possible to buy zinc supplements, But you should always talk to your medical team before trying any supplements. It is very important that the correct type and dose of zinc is used if it is treating Wilson’s disease.

Find out about taking zinc in pregnancy

Back to top

Diet

You cannot treat Wilson’s disease just by changing your diet. But diet can help in the early stages of treatment.

In stage 1 of treatment the aim is to get copper out of your body. To help, people with Wilson’s disease should avoid or reduce eating high copper foods.

High copper foods include:

• shellfish
• dark chocolate
• cocoa powder
• mushrooms
• liver
• other offal and organ meats

Cooking in uncoated copper pans could also increase the amount of copper in food.

Once the condition is more stable it may be possible to go back to eating some of these foods. This usually takes about a year.

You might also need to take some supplements such as vitamins and iron.

Some supplements can change how Wilson’s disease medicines work. So always talk to your medical team before making dietary changes.

You can also talk to them if you are struggling with what to eat. This can be especially difficult is you are trying to cope with other medical problems at the same time. You can for a referral to an NHS dietician for specialist advice.

The Wilson’s disease support group also have more information on diet.

Back to top

Monitoring and check-ups for Wilson’s disease

Everyone with Wilson’s disease should have regular appointments and tests to check on their condition.

Once the condition is stable these will be every 6 to12 months.

Check-ups will be more often in the early stages of treatment. Or if the condition is not stable.

Regular check-ups will include:

• copper level tests
• blood tests to check on the liver, kidneys and blood clotting
• an ultrasound scan to look at the liver

Anyone with cirrhosis, should also have regular checks for:

• varices (swollen veins in your digestive system)
• a type of liver cancer called hepatocellular carcinoma.

Find out more about cirrhosis.

Back to top

Liver transplant for Wilson’s disease

In rare cases, Wilson’s disease is treated with a liver transplant.

 Doctors usually only suggest a liver transplant if:

• the liver is badly damaged (decompensated cirrhosis) and other treatments cannot help
• brain symptoms keep getting worse, even with treatment
• someone has sudden (acute) liver failure

Sometimes, doctors might also suggest a transplant to help with severe brain symptoms.

Some people cannot have a liver transplant. Lots of tests and checks are done before someone can be put on the transplant list. These look to see how safe the transplant would be and how likely it is to work.

After a liver transplant for Wilson’s disease

A liver transplant can cure Wilson’s disease but has long term effects of its own.

After a liver transplant, the new liver will have a normal amount of copper in it.

The liver will also have the donor’s genes, including the working version of the Wilson’s gene. So it will be able to make the Wilson’s protein and deal with copper normally.

Over time this can improve symptoms in other parts of the body, including brain symptoms. But this can take months or even years.

The variant version of the gene will still be in the rest of the body. This will not cause Wilson’s disease. But it could be passed on.

Find out about the the Wilson’s protein, the Wilson’s gene and how the condition is inherited.

After the transplant there is no need to carry on taking medicines for Wilson’s disease. But anyone who has had a transplant must take immunosuppressant medicines for life. These stop the immune system attacking the new liver.

Find out more about life after a liver transplant

More information about liver transplants

We have lots more information about liver transplants.

Find out more here.

Back to top

Treatments for the symptoms of Wilson’s disease

Wilson’s disease can cause a huge range of symptoms. Doctors will try to treat these as well as treating the build-up of copper.

Nerve and mental health symptoms

There are lots of treatments that can help with nerve and mental health symptoms. The right combination of treatments will be different for everyone. But you should not have to just put up with nerve or mental health symptoms because you have Wilson’s disease.

• Always tell your Wilson’s medical team if you have any new or different symptoms.
• Always tell your GP or other doctors that you have Wilson’s disease if they are prescribing you other medicines or treatments.

Some children with Wilson’s disease will need extra support at school. You can find out more about this on our living with Wilson’s disease  page.

Liver symptoms

Liver damage does not cause any symptoms in the early stages. But in some cases Wilson’s disease can cause serious liver damage. This is called cirrhosis. You can find out more about cirrhosis, it’s complications and how they are treated here.

Back to top

Next:

Living with Wilson’s disease

Everyone’s experience of Wilson’s disease will be different. Always talk to your specialist medical team for personal advice.

Our information aims to be clear, up-to-date, and useful. We work with people living with liver disease and clinicians to make our information.

• How we make our information 

Share your thoughts on this information

If you have any feedback or would like a full list of references, you can also let us know by emailing patient-info@britishlivertrust.org.uk.

Clinical reviewer: Dr William Griffiths, consultant hepatologist, Cambridge University Hospitals NHS foundation trust.

Publication date: December 2025

Next review: December 2028