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Test ID HMNA Heavy Metals, Nails


Necessary Information


Indicate source of nails (fingernails or toenails), if known



Specimen Required


Supplies: Hair and Nails Collection Kit (T565)

Specimen Volume: 0.2 g

Collection Instructions:

1. Prepare and transport specimen per the instructions in the kit or see Collecting Hair and Nails for Metals Testing.

2. Clippings should be taken from all 10 fingernails or toenails.


Secondary ID

31070

Useful For

Detection of nonacute arsenic, mercury, and lead exposure

Profile Information

Test ID Reporting Name Available Separately Always Performed
ASNA Arsenic, Nails Yes Yes
PBNA Lead, Nails Yes Yes
HGNA Mercury, Nails Yes Yes

Method Name

Inductively Coupled Plasma Mass Spectrometry (ICP-MS)

Reporting Name

Heavy Metals, Nails

Specimen Type

Nail

Specimen Minimum Volume

0.05 g

Specimen Stability Information

Specimen Type Temperature Time
Nail Ambient (preferred)
  Frozen 
  Refrigerated 

Clinical Information

ARSENIC

Arsenic circulating in the blood will bind to protein by formation of a covalent complex with sulfhydryl groups of the amino acid cysteine. Keratin, the major structural protein in hair and nails, contains many cysteine residues and, therefore, is one of the major sites for accumulation of arsenic. Since arsenic has a high affinity for keratin, the concentration of arsenic in nails is higher than in other tissues.

 

Several weeks after exposure, transverse white striae, called Mees' lines, may appear in the fingernails.

 

MERCURY

Once absorbed and circulating, mercury becomes bound to numerous proteins, including keratin. The concentration of mercury in nails correlates with the severity of clinical symptoms.

 

LEAD

Nail analysis of lead can be used to corroborate blood analysis.

Reference Values

ARSENIC

0-15 years: Not established

≥16 years: <1.0 mcg/g of nails

 

LEAD

<4.0 mcg/g of nails

Reference values apply to all ages.

 

MERCURY

0-15 years: Not established

≥16 years: <1.0 mcg/g of nails

Cautions

No significant cautionary statements

Day(s) Performed

Tuesday

Report Available

2 to 8 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

82175- ASNA

83655- PBNA

83825- HGNA

NY State Approved

No