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Test Code HMNA Heavy Metals, Nails

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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Nail


Necessary Information


Indicate source of nails (fingernails or toenails) if known



Specimen Required


Supplies: Hair and Nails Collection Kit (T565)

Source: Fingernails or toenails

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.


Specimen Minimum Volume

0.05 g

Specimen Stability Information

Specimen Type Temperature Time
Nail Ambient (preferred)
  Frozen 
  Refrigerated 

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

Day(s) Performed

Wednesday

CPT Code Information

82175

83655

83825

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.

Report Available

2 to 14 days

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Method Name

Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)