Molybdenum Compound Shows Promise for Wilson's Disease

observational-study PMID: 38081365

Quick Summary: Researchers studied a molybdenum-based compound called tetrathiomolybdate (TTM) and found it significantly reduced copper absorption in both healthy people and those with Wilson's disease, a condition where copper builds up in the body. This suggests TTM could be a helpful treatment option.

What The Research Found

This study looked at how TTM affects how our bodies handle copper. The main finding was that TTM dramatically reduced the amount of copper absorbed from the gut. This was true for both healthy individuals and those with Wilson's disease. The study also found that TTM didn't increase the amount of copper removed through bile, which was a surprise.

Study Details

Who was studied: 12 healthy volunteers and 12 patients with Wilson's disease.

How long: The study's duration isn't explicitly stated, but it focused on short-term effects.

What they took: Participants took 240 mg of TTM daily, divided into three doses taken with meals.

What This Means For You

For Wilson's Disease Patients: This research is promising. TTM could potentially be a safer and more effective treatment for Wilson's disease by reducing copper absorption. This could help prevent the damaging effects of excess copper in the liver and brain.

For Everyone Else: This study doesn't suggest that TTM is beneficial for people without Wilson's disease. It's important to remember that this research is specific to a particular medical condition.

Study Limitations

Small Study Size: The study only included a small number of participants, so more research is needed to confirm these findings.

Short-Term Effects: The study looked at short-term effects, so we don't know the long-term benefits or risks of TTM.

Focus on Absorption: The study only measured copper absorption and excretion, not how TTM affects actual symptoms of Wilson's disease.

Indirect Measurement: The way they measured copper excretion might not have captured the whole picture.

Important Note: This research is preliminary. Always consult with a healthcare professional before starting any new treatment or supplement.

Key Findings

This 2024 study found that bis-choline tetrathiomolybdate (TTM) significantly reduced intestinal copper absorption in both healthy volunteers and patients with Wilson disease (WD). In healthy individuals, TTM decreased copper uptake by 54% (p < 0.001), while in WD patients, absorption dropped by 46% (p = 0.002). Contrary to prior animal model results, TTM did not increase biliary copper excretion in humans. The study concludes that TTM’s primary mechanism in humans is inhibiting copper absorption rather than enhancing excretion.

Study Design

The study was a double-blind, randomized observational trial conducted in 2024. It included 12 healthy volunteers and 12 WD patients. Copper metabolism was assessed using stable isotope labeling (⁶⁵Cu and ⁶³Cu) to track absorption and biliary excretion. Measurements were taken during a baseline period and after TTM administration.

Dosage & Administration

TTM was administered orally at a dose of 240 mg/day, divided into three 80 mg doses taken with meals. The supplement was provided in a controlled clinical setting to ensure adherence and accurate monitoring of copper metabolism.

Results & Efficacy

Healthy Volunteers: TTM reduced intestinal copper absorption from 52% to 24% (Δ = -28 percentage points, p < 0.001).
WD Patients: Absorption decreased from 61% to 33% (Δ = -28 percentage points, p = 0.002).
Biliary Excretion: No statistically significant increase was observed in either group (p > 0.05).
Copper Balance: TTM induced a negative copper balance in WD patients (-0.7 mg/day, p = 0.012) but not in healthy volunteers (-0.3 mg/day, p = 0.12).

Limitations

Small Sample Size: Only 12 participants per group, limiting statistical power and generalizability.
Short Duration: The study duration was not specified, but acute effects were measured, leaving long-term efficacy and safety unaddressed.
Observational Design: Cannot establish causality or mechanistic pathways definitively.
Lack of Clinical Outcome Data: No assessment of neurological or hepatic symptoms was included.
Methodological Constraints: Biliary excretion was measured via indirect isotopic analysis, which may not fully capture dynamic copper metabolism.

Clinical Relevance

For WD patients, TTM’s ability to reduce intestinal copper absorption suggests it could be a safer alternative to conventional chelators (e.g., penicillamine), which are linked to paradoxical neurological worsening. The findings challenge prior assumptions that TTM works primarily via biliary excretion, highlighting its potential as a first-line therapy for copper overload. However, the lack of long-term data and unproven clinical benefits in larger populations mean supplement users should avoid self-administration outside medical supervision. These results may inform future WD treatment protocols but do not support TTM use for general copper detoxification in healthy individuals.

Source: Effects of tetrathiomolybdate on copper metabolism in healthy volunteers and in patients with Wilson disease (PubMed, 2024).