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HelpTest Code HMNA Heavy Metals, Nails
Reporting Name
Heavy Metals, NailsPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Detection of nonacute arsenic, mercury, and lead exposure
Method Name
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
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.
Specimen Type
NailSpecimen Minimum Volume
0.05 g
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Nail | Ambient (preferred) | ||
| Frozen | |||
| Refrigerated | |||
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.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
Interpretation
Nails grow at a rate of approximately 0.1 inch/month. Nail keratin synthesized today will grow to the distal end in approximately 6 months. Thus, a nail specimen collected at the distal end represents exposure of 6 months ago.
ARSENIC
Nail arsenic above 1.0 mcg/g dry weight may indicate excessive exposure. It is normal for some arsenic to be present in nails, as everybody is exposed to trace amounts of arsenic from the normal diet.
The highest hair or nail arsenic observed at Mayo Clinic was 210 mcg/g dry weight in a case of chronic exposure, which was the cause of death.
MERCURY
Normally, nails contain less than 1 mcg/g of mercury; any amount above this indicates that exposure to more than normal amounts of mercury may have occurred.
LEAD
Normally, the nail lead content is below 4.0 mcg/g. While nail lead content above 10.0 mcg/g may indicate significant lead exposure, nails are also subject to potential external contamination with environmental lead. Ultimately, the nail lead content needs to be interpreted in addition to the overall clinical scenario including symptoms, physical findings, and other diagnostic results when determining further actions.
Day(s) Performed
Tuesday
Report Available
2 to 8 daysTest 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
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HMNA | Heavy Metals, Nails | 94574-1 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 2535 | Arsenic, Nails | 8157-0 |
| 2509 | Mercury, Nails | 8204-0 |
| 2506 | Lead, Nails | 8202-4 |
| PBNSC | Specimen Source | 31208-2 |
| HGNSC | Specimen Source | 31208-2 |
| ASNSC | Specimen Source | 31208-2 |
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 |