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

Specimen Type
NailNecessary 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 daysReject 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)