Heavy Metal Testing

What is heavy metal testing?

Heavy metal testing includes a group of tests that measures the levels of possibly harmful metals (like lead or mercury) in your blood, urine, hair, fingernails, stool (poop), or other body tissues.

Heavy metals are found naturally in the environment. They're also found in certain medicines, supplements, and foods. Chemicals used in industry and farming may also contain heavy metals, which can end up in the air, soil, and water.

Because heavy metals are just about everywhere, it's normal to have some level of them in your body. But if that level gets too high, it can cause heavy metal poisoning, which can be deadly.

Heavy metals can get into your body if you:

• Breathe them in. This can happen if you work in an environment where there are a lot of heavy metals in the air, such as construction sites or battery manufacturing plants.
• Eat or drink them. This can happen if you live in an area with contaminated soil, eat foods with high levels of certain metals (such as mercury in fish), or drink water from a building with lead pipes or older plumbing.
• Absorb them through your skin. This can happen if you frequently interact with items with high amounts of lead in them, such as lead pipes, toys with lead paint, and certain imported medicines with high levels of mercury.

Poisoning from heavy metals can happen slowly over time or suddenly if you are exposed to a large amount of heavy metal all at once.

The most commonly tested heavy metals are:

• Lead
• Mercury (including organic mercury from fish)
• Arsenic
• Cadmium
• Chromium

You or your child may have heavy metal testing for one type of metal, or you or your child may have a test for a group of metals, called a “heavy metal panel.”

Other metals that may be tested include:

• Aluminum
• Barium
• Beryllium
• Bismuth
• Cobalt
• Copper
• Creatinine
• Gold
• Iron
• Manganese
• Nickel
• Platinum
• Selenium
• Silicon
• Silver
• Thallium
• Tin
• Uranium
• Zinc

Depending on what metals your health care provider is checking for, testing can also be done with samples of your urine, fingernails, hair, stool (poop), or tissue from certain organs such as your liver and kidneys. But blood and urine are the samples that are most commonly used for heavy metal tests.

Other names: heavy metals panel, toxic metals, heavy metal toxicity test

What is it used for?

Heavy metal testing is used to:

• Help diagnose heavy metal poisoning if you have long-term effects of this condition. These long-term effects can include changes in your behavior, or difficulties with thinking and memory, and organ damage. However, the effects of metal poisoning can vary depending on the type of metal, how much of it is in your body, and your age.
• Screen for heavy metal poisoning if you've been exposed to heavy metals (especially lead, mercury, or arsenic) but don't have any symptoms. The highest risk for serious, long-term health problems from heavy metals is during fetal growth and a child's development. That's because even very low levels of lead can damage a fetus or child's developing brain and cause long-term growth and learning problems.
• Monitor levels of certain heavy metals if you have heavy metal poisoning and your provider wants to see if your treatment is working.

To diagnose heavy metal poisoning, a provider will use your or your child's test results along with any symptoms and exposure history.

Why do I need heavy metal testing?

Your provider may order heavy metal testing if you had a possible exposure to heavy metal or if you have symptoms of heavy metal poisoning. Symptoms of heavy metal poisoning depend on the type of metal and how much exposure you had. Your symptoms may include:

• Nausea and vomiting
• Abdominal (belly) pain
• Diarrhea
• Tingling in the hands and feet
• Shortness of breath
• Chills
• Muscle weakness
• Memory loss or changes in behavior
• Arrhythmia, a problem with the rate or rhythm of your heartbeat

If your job involves heavy metals, your employer may require regular testing to help monitor workplace safety. You may have a higher risk of exposure if you work:

• Construction
• At a battery manufacturer
• As a plumber
• With stained glass, pesticides, or metal plating

Children under the age of 6 may need to be tested for lead poisoning if they have a risk of exposure to lead, even when they don't have symptoms. A child's risk of lead exposure is higher if they spend time in homes built before 1978, when lead-based paint was still used. These homes may have lead in household dust from old chipping or peeling paint. Lead from old paint and other old sources may also remain in the soil, especially in older neighborhoods of some cities.

Young children tend to be exposed when they touch surfaces or soil with lead and put their hands in their mouths. Your child's provider may recommend lead testing based on your child's possible exposure to lead and where you live. Some state and local governments require all children to be tested for lead.

What happens during heavy metal testing?

Depending on which type of metal your provider is testing for, a health care professional will take a sample of:

• Blood
• Urine
• Hair
• Fingernails
• Stool
• Organ tissue

For a blood sample, your provider will collect blood from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

For a urine sample, a health care professional may give you a cleansing wipe, a small container, and instructions for how to use the “clean catch” method to collect your urine sample. It's important to follow these instructions so that germs from your skin don't get into the sample:

1. Wash your hands with soap and water and dry them.
2. Open the container without touching the inside.
3. Clean your genital area with the cleansing wipe:
   • For a penis, wipe the entire head (end) of the penis. If you have a foreskin, pull it back first.
   • For a vagina, separate the labia (the folds of skin around the vagina) and wipe the inner sides from front to back.
4. Urinate into the toilet for a few seconds and then stop the flow. Start urinating again, this time into the container. Don't let the container touch your body.
5. Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.
6. Finish urinating into the toilet.
7. Put the cap on the container and return it as instructed.

If you have hemorrhoids that bleed or are having your menstrual period, tell your provider before your test.

Your provider may ask you to collect your urine over a 24-hour period. For this test, you will be given a special container to collect your urine and instructions on how to collect and store your samples. Your provider will tell you what time to start. The test generally includes the following steps:

1. To begin, urinate in the toilet as usual. Do not collect this urine. Write down the time you urinated.
2. For the next 24 hours, collect all your urine in the container.
3. During the collection period, store the urine container in a refrigerator or cooler with ice.
4. 24 hours after starting the test, try to urinate if you can. This is the last urine collection for the test.
5. Return the container with your urine to your provider's office or the laboratory as instructed.

For a nail or hair sample, your provider will use scissors or clippers to cut off a small piece of your nail or hair. Your provider will usually collect a hair sample from near your scalp.

For a stool sample, your provider will probably give you a container or kit with instructions on how to collect the sample. There are different ways to collect the stool samples so follow the instructions carefully. In general, you'll need to:

• Label the container with your name, the collection date, and time.
• Collect a stool sample as instructed. This usually involves using a clean, dry container, or special paper or plastic wrap placed over the toilet to catch the stool.
• Make sure the stool doesn't mix with any urine, toilet paper, or water from the toilet.
• Close the container tightly.
• Wash your hands well with soap and water.
• Return the container according to the instructions. This is important to get an accurate test result. If you are unable to return the container right away, you should refrigerate your sample until you're ready to deliver it.

If you're collecting a sample from diapers, you'll get special instructions for using plastic wrap inside of a clean diaper. In certain cases, a provider may use a swab to take a stool sample from the rectum.

For a sample of organ tissue, your provider will perform a biopsy. During a biopsy, your provider will remove a small sample of tissue for testing. There are many ways to do a biopsy, though they aren't done as often as other types of tests for heavy metal testing. In general, a biopsy may be done using:

• A hollow needle inserted through your skin. Imaging tests, such as ultrasound, may be used to guide the needle:
  • A fine needle aspiration biopsy uses a very thin needle to remove a sample of cells and/or fluid.
  • A core needle biopsy uses a larger needle to remove a sample.

Will I need to do anything to prepare for the test?

Some fish and shellfish contain high levels of mercury, so you should avoid eating seafood for 48 hours before your test.

Are there any risks to the test?

There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

There is also very little risk to having a urine or stool test or to having a small piece of your nails or hair removed for testing.

It's common to have some bruising and temporary discomfort after a biopsy. Possible risks include:

• Infection, which can be treated with antibiotics
• Bleeding at the biopsy site

Your provider will give you instructions for how to care for a biopsy area and manage any discomfort. If you're having general anesthesia, talk with your provider about how it may affect you.

What do the results mean?

Higher than normal levels of heavy metal in your test sample may mean that you have heavy metal poisoning, but not always. Even if you don't have symptoms, you may still need to avoid all exposure to that metal. You or your child may also require additional tests to confirm or rule out heavy metal poisoning and check the health of certain organs, such as your kidneys.

Depending on the heavy metal and your condition, you may also need treatment to help your body get rid of the heavy metal as quickly as possible. In certain cases, your provider may recommend chelation therapy. For this therapy, you'll take medicine by mouth or have an injection (shot) of a medicine that helps remove the metals from your body through urine (pee). In certain cases, chelation medicine is given through an IV (intravenous) line.

Chelation therapy can have serious side effects, so it's important to think about the risks and benefits.

Normal or low levels of heavy metal in your test sample usually mean that you don't have heavy metal poisoning. However, some heavy metals leave your bloodstream quickly and are stored in your tissues. So, if you have symptoms, your provider will likely order more tests to check for heavy metals in samples of your urine, hair, skin, or fingernail clipping.

Talk with your provider to learn what your results mean.

Learn more about laboratory tests, reference ranges, and understanding results.