Heavy Metal Testing

Heavy metals are natural metallic elements with the potential to be harmful to people. They may also be known as toxic metals. Heavy metal testing looks for elevated levels of these metals in the body.

A heavy metals panel test measures multiple heavy metals in one test sample. Testing frequently uses either a blood or urine sample, but heavy metals can also be detected in hair and fingernails.

This type of test is most often ordered when a person has symptoms of heavy metal poisoning or has been exposed to heavy metals. It may also be used as a standard screening for young children in some states.

Purpose of the test

A heavy metals panel can be used to determine if you have high levels of one or more toxic metals.

Low levels of some heavy metals like iron and zinc are important for health. Other metals may be found in the body at relatively low levels because of normal environmental exposure. However, unsafe concentrations of heavy metals can accumulate and trigger potentially serious symptoms in those who are exposed.

Buildup of toxic metals can occur over the short- or long-term, and heavy metal testing can help reveal unhealthy exposure. Testing can be done in multiple contexts including screening, diagnosis, and monitoring related to heavy metal poisoning.

• Screening is looking for indications of heavy metal poisoning in people who have not shown any symptoms. Screening may be used in people who are believed to have been exposed to toxic metals in their workplace or in children living in areas where home paint contains lead.
• Diagnosis is determining the cause of an illness in people who have symptoms. If a doctor believes that a patient may have heavy metal poisoning, testing may be able to confirm the diagnosis and help determine the source of heavy metal exposure.
• Monitoring is part of the follow-up process to evaluate the response to treatment in people who have previously been diagnosed with heavy metal poisoning.

What does the test measure?

Heavy metals can be measured individually or as part of a panel that tests for multiple compounds. Doctors can include specific metals in a panel test based on the situation, but the most common heavy metals panel includes testing for lead, mercury, arsenic, and cadmium. Examples of other metals that may be included are copper, zinc, chromium, thallium, aluminum, beryllium, cobalt, iron, bismuth, manganese, nickel, silver, selenium, silicon, and platinum.

For each toxic metal in the panel, the test provides a measurement of its concentration in the test sample. Levels for most metals are measured in micrograms (μg) and are reported per a unit of volume based on the type of test sample.

When should I get heavy metal testing?

Heavy metal tests are typically used when you have symptoms of heavy metal poisoning or have a suspected exposure to heavy metals. It is very important to talk with your doctor if you fit either of these categories.

Determining which metals to test for and which type of test sample to use can depend on the nature of your symptoms or possible exposure. Working with your doctor helps to make sure that you get the most appropriate testing.

If you have been exposed to heavy metals, your doctor can work with you and, if necessary, local poison control officials to find and eliminate the source of exposure.

Regulations around workplace exposure are overseen by the Occupational Safety and Health Administration, which can require testing of employees who may have been exposed to toxic metals at work.

How to get tested

Tests for heavy metals can analyze blood, urine, hair, or fingernails. Of these, blood and urine testing are more frequently used. The optimal form of testing depends on the metals being measured and whether the exposure is thought to be short-term (acute) or long-term (chronic).

The test is normally ordered by a doctor who has reviewed your situation including any symptoms and possible toxic metal exposures. Test samples are usually taken at a doctor’s office, clinic, or hospital, although some urine tests require you to collect all your urine over a 24-hour period. Once the sample is collected, it is analyzed in a qualified medical laboratory.

Can I take the test at home?

When the doctor orders a 24-hour urine test, you need to collect all of your urine during an entire day. This aspect of the test can take place at home, work, or other settings where you may need to go to the bathroom.

In addition, at-home test kits are available to detect heavy metals in the blood, urine, and hair. The test kit provides instructions for taking your sample and then sending it by mail to a laboratory where it can be analyzed. Most at-home test kits are panel tests with a predetermined list of heavy metals that are measured.

Sample contamination is a concern with at-home testing for heavy metals. To reduce the risk of sample contamination, choose an at-home test carefully and to closely follow any instructions about preparing your blood, urine, or hair to be sent to the lab.

While at-home tests are convenient, they may not be the right fit based on your potential exposure, and they can be inaccurate. Accordingly, it’s best to speak with a doctor to find the best test for you. If you have symptoms of heavy metal poisoning, you should talk to your doctor or call local poison control (1-800-222-1222) right away.

How much does the test cost?

The cost of heavy metal testing can vary based on multiple factors including the number of toxic metals in the panel, the type of test sample, where the test is conducted, and whether you have insurance coverage.

Costs can include office visits, technician fees for taking your test sample, and laboratory analysis. If the test is ordered by your doctor, some or all of these costs are often covered by insurance, although you may be charged a copay or deductible. Talk directly with your doctor and/or insurance provider for details about your coverage and expected costs.

The price of at-home testing also varies, but home testing kits are often available for under $200. However, these tests come with preset lists of metals to measure that may not reflect your situation. In addition, a test alone cannot diagnose heavy metal poisoning, so at-home tests do not eliminate the need to consult with your doctor.

Depending on the specific panel, toxic metal tests can be done with blood, urine, hair, or fingernails. Most cases involve testing with either blood or urine, and the sample is typically collected in a medical office. If you are requested to do a 24-hour urine sample, your doctor’s office will provide instructions and specimen containers to use throughout the day.

Before the test

Consuming seafood can sometimes cause a short-term rise in heavy metal levels, so you will normally be advised to avoid seafood for at least 48 hours prior to testing. Additional test preparation may be required depending on the metals being measured, so ask your doctor for specific pretest instructions.

During the test

During a blood test, a technician will use a needle to remove a small amount of blood from a vein in your arm. Before drawing blood, they will tie a tourniquet around your upper arm and disinfect the part of your arm where the needle will be inserted. This process takes less than a few minutes. There may be a quick sting when the needle is inserted or removed.

For a one-time urine test, you will be given instructions to urinate into a labeled receptacle. For a 24-hour urine test, you will be given special containers for collecting your urine during one full day.

Hair and fingernail samples can be taken and prepared by a laboratory technician. These tests are usually completed quickly and without any pain or other side effects.

Health professionals take special precautions when preparing your sample to make sure that no contamination takes place. For example, they use non-metal vials or containers that do not have traces of metals in them to hold test specimens.

Collecting a sufficient and uncontaminated sample can be more complicated when doing testing at home. If you take an at-home test, make sure to carefully read the instructions before taking the test. You should then follow those instructions exactly when you prepare your test kit.

After the test

After a blood test, a bandage may be applied to stop any bleeding, and you may need to keep this bandage in place for around an hour. Some people experience bruising around the puncture site, but serious pain or other side effects are rare. You can drive and resume normal activity after the test.

With other types of test samples, there are generally no side effects or other considerations after the test is complete.

Receiving test results

After your test sample is collected, it is sent to a laboratory where it may take several days to be processed and analyzed. In most cases, you should know your test results within a few business days. Your doctor’s office may call you about your results or suggest a follow-up appointment. You may also receive a copy of the test report in the mail or through an online health portal.

A similar time frame exists for at-home tests which must be shipped to a lab. Once your at-home test report is ready, you can usually access it online or through a smartphone app.

Interpreting test results

The test report should list each type of heavy metal on the panel and the measurement of each one in your case. This will normally be represented in micrograms (μg) by volume, such as per liter or deciliter.

Your test report may or may not list reference ranges. Some heavy metals do not have standard ranges, and the interpretation of the test depends on other factors like age, overall health, and presence of symptoms. In some cases, the summary of the test report may note if any heavy metals were detected at high levels.

Elevated levels alone do not necessarily prove heavy metal poisoning but may require you to avoid all sources of exposure to that metal. At the same time, normal levels on blood tests do not completely rule out heavy metal exposure since metals can quickly leave the bloodstream.

Your doctor is in the best position to explain your test result, what it means for your health, whether additional tests are necessary, and whether treatment of any kind is appropriate.

• Lead
• Mercury
• Iron
• Copper
• Lead Poisoning

Additional information about heavy metals and toxic exposures can be found in the following links:

• Occupational Safety and Health Administration: Toxic Metals
• Agency for Toxic Substances and Disease Registry: Toxic Substances Portal
• National Library of Medicine: Poisoning

Sources

Adal A. Heavy metal toxicity. Wiener SW, ed. Medscape. Updated December 31, 2020. Accessed April 13, 2021. https://emedicine.medscape.com/article/814960-overview.

Beauchamp G, Kusin S, Elinder CG. Mercury toxicity. In: Curhan GC, Traub SJ, eds. UpToDate. Updated August 31, 2020. Accessed April 14, 2021. https://www.uptodate.com/contents/mercury-toxicity.

Elinder CG, Traub SJ. Epidemiology and toxicity of cadmium. In: Curhan GC, ed. UpToDate. Updated September 6, 2019. Accessed April 14, 2021. https://www.uptodate.com/contents/epidemiology-and-toxicity-of-cadmium.

Fisher RM, Gupta V. Heavy metals. In: StatPearls. Updated October 12, 2020. Accessed April 13, 2021. https://www.ncbi.nlm.nih.gov/books/NBK557806/.

Goldman RH. Arsenic exposure and poisoning. In: Burns MH, ed. UpToDate. Updated October 8, 2020. Accessed April 14, 2021. https://www.uptodate.com/contents/arsenic-exposure-and-poisoning.

Goldman RH, Hu H. Lead exposure and poisoning in adults. In: Elmore JG, Traub SJ, eds. UpToDate. Updated March 17. 2020. Accessed April 14, 2021. https://www.uptodate.com/contents/lead-exposure-and-poisoning-in-adults.

MedlinePlus: National Library of Medicine. Heavy metal blood test. Updated December 10, 2020. Accessed April 13, 2021. https://medlineplus.gov/lab-tests/heavy-metal-blood-test/.

Occupational Safety and Health Administration. Lead. Date unknown. Accessed April 14, 2021. https://www.osha.gov/lead.

U.S. Genetic and Rare Diseases Information Center. Heavy metal poisoning. Updated April 27, 2017. Accessed April 13, 2021. https://rarediseases.info.nih.gov/diseases/6577/heavy-metal-poisoning.