What is the role of lab testing in the diagnosis of heavy metal toxicity?

Updated: Dec 31, 2020
  • Author: Adefris Adal, MD, MS; Chief Editor: Sage W Wiener, MD  more...
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Specific laboratory testing for metals should be undertaken when the likelihood of toxicity is significant, based on a history and/or symptoms consistent with excessive exposure. See the relevant articles for more detailed recommendations regarding the most reliable testing measures for individual metal toxicity, as follows:

When specific testing is indicated, samples should be sent in metal free containers.

Hair analysis is not generally reliable and rarely indicated.

Patients should be instructed to abstain from seafood and seaweed products prior to testing for metals such as arsenic and mercury, since elevated concentrations in patients who have not done so for at least several days to 1-2 weeks may simply reflect nontoxic organic forms ingested in the diet. Samples with elevated concentrations may also be sent for speciation for either of these metals to determine the relative contributions of organic forms versus inorganic forms.

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