LabCorp and its Specialty Testing Group, a fully integrated portfolio of specialty and esoteric testing laboratories.
To detect excessive exposure to mercury
When you have signs and symptoms of mercury poisoning or have been exposed to mercury; to monitor occupational exposure to mercury
A blood sample drawn from a vein in your arm and/or a random or 24-hour urine sample may be collected. Rarely, another sample such as hair, breast milk, or nails may be tested.
None needed; however, consult with your healthcare provider or laboratory about urine collection to avoid sample contamination.
Mercury is an element that can be toxic in various forms, which are tested in different samples:
Mercury is found in small quantities throughout the environment. It is released by the breakdown of minerals in rocks and soils and as a byproduct of fossil fuel combustion and waste incineration. It is inhaled with the air that we breathe, absorbed through the skin, and ingested with food. Mercury is also used in some mirror coatings, pharmaceuticals, and agricultural chemicals. Energy efficient compact fluorescent light (CFL) bulbs contain small amounts of mercury, which is also used to make electrical equipment, wire, and switching devices.
The tiny amounts to which the vast majority of people are exposed do not generally cause health concerns. However, people may develop mercury-related symptoms or complications if they are exposed to dangerous concentrations of mercury, such as might be found at a hazardous waste site, or are exposed to mercury over long periods of time, especially if they work with heavy metals on the job.
Exposure to excessive amounts of mercury can be toxic. The amount of mercury absorbed by an individual and its effects on the person's health depends on the type of mercury, its concentration, and the nature of exposure. According to the Agency for Toxic Substances and Disease Registry (ATSDR), very little metallic mercury (less than 0.01%) is absorbed by the body, even if it is swallowed. However, if the same mercury is inhaled as a vapor, about 80% is absorbed into the bloodstream.
About 95% of methyl mercury, which is the type found in fish and other seafood, is absorbed by the digestive tract. The most common source of human exposure to methyl mercury is eating contaminated seafood. Fish that come from contaminated waters and large predator fish that have eaten smaller fish may have significantly increased levels of methyl mercury. It is important to know the source of the fish that you consume and to limit the quantity of large predator fish eaten.
Once mercury is absorbed, the body may deposit it in a variety of body organs, including the kidneys and brain. The body will slowly rid itself of mercury through the urine and stool, but if an excessive amount accumulates, it can permanently damage the kidneys, nervous system, and brain.
Pregnant women with elevated levels of mercury can pass it on to their unborn baby, affecting development of the baby's brain, kidneys, and nerves especially. Mercury can also be passed from mother to baby through breast milk during nursing.
Mercury testing is used to detect the presence of an excessive amount of mercury in a person's blood and/or urine sample. It may be ordered by a healthcare practitioner to determine whether a person has had short-term exposure to a toxic level of mercury (acute exposure) or has been exposed over an extended period of time (chronic exposure). Testing may also be used to monitor those who may be exposed to mercury in the workplace.
To test for the various forms of mercury, more than one type of sample may be collected and tested.
Other general laboratory tests may be used to help evaluate the health of various organ systems in someone who has been exposed or thought to be exposed to toxic levels of mercury. Some examples include a comprehensive metabolic panel (CMP) and a complete blood count (CBC).
Mercury testing may be ordered when a person has signs and symptoms suggesting excessive exposure to mercury. Acute signs and symptoms may include:
Those who are chronically exposed may have nonspecific symptoms that involve the lungs, kidneys, and nervous system. Some of the chronic symptoms may include:
Testing may also be ordered even in the absence of symptoms when it is known that a person has been exposed to mercury in order to help evaluate the extent of the exposure.
Mercury measurements may be ordered on a regular basis to monitor people who work in industries that use mercury. It may be ordered, along with tests to detect lead and/or other heavy metals, for individuals who work with a variety of potentially hazardous materials.
Levels of mercury in blood and urine are normally very low. A test result showing no mercury or a low level indicates that it is likely that the person tested has not been exposed to excessive levels of mercury, at least not in the window of time that the test is measuring.
An increased blood level suggests a relatively recent exposure to mercury. In general, a blood level greater than 10 mcg/L indicates an unusual level of exposure for someone who does not regularly work with mercury.
In contrast to levels of mercury in the blood, a 24-hour urine sample gives more of an average past history of exposure to metallic or inorganic mercury. Normal urine levels are typically less than 10 mcg/L for someone without risk of occupational exposure. (For information on occupational exposure levels, see the Related Content section.)
Levels of mercury in either the blood or urine will not indicate the form or quantity of mercury to which a person was exposed.
An increased level of mercury in hair testing may indicate exposure to increased levels of methyl mercury, but hair samples are rarely used because of issues involving testing standardization, sample contamination, and the fact that hair is subject to many pre-analytical variables (hair exposure to dyes, bleach, shampoo, etc.).
Measures have been taken in recent years to reduce and control the public's exposure to mercury. Stricter regulations and recommendations have lowered the amounts allowable in the air, water, soil, food, and in the workplace.
The high levels of mercury found in certain fish may harm the developing nervous systems in unborn babies and young children. The U.S. Food and Drug Administration (FDA) recommends that pregnant women, women who may become pregnant, young children, and nursing mothers avoid eating fish with increased mercury levels, such as shark, swordfish, king mackerel and tilefish. It advises these groups to eat fish that are usually found to have lower levels of mercury such as canned light tuna, shrimp, or salmon. (See the Related Content section for their advice.)
Thimerosal is an organic mercury compound that has been used in small amounts as a preservative in some vaccines. Although it is generally regarded as safe, the use of thimerosal is now being phased out. Thimerosal is no longer used as a preservative in any childhood vaccine, except for the influenza vaccine.
Yes. Dental amalgams (teeth fillings) are made up of about 50% metallic mercury. Some people feel that the tiny amount of mercury vapor released when a person chews may affect their health, but internationally most major health organizations feel that the amalgams are safe at this time. The U.S. Food and Drug Administration (FDA) has determined that dental amalgams are safe for adults and children over age 6. A few countries have begun to restrict their use as a precaution.
Predator fish, those that eat other fish, have higher levels of mercury. Some of these include shark, swordfish, tilefish, and king mackerel. Some fish with lower levels of mercury include shrimp, canned light tuna, pollock, salmon, and catfish.
In addition to avoiding consumption of fish known to harbor higher levels of mercury, you can avoid purchase and use of consumer products that contain mercury, such as thermostats and thermometers, and alternative medicines that contain mercury. These include some Hispanic folk remedies and Ayurvedic herbal preparations. Dispose of batteries, light-up novelty toys, thermometers, thermostats, and other mercury-containing items, including compact fluorescent light bulbs (CFLs), in hazardous waste facilities. Finally, exercise caution when handling CFLs, especially if you break one.
Sources Used in Current Review
Olson, D. (2017 August 13, Updated). Mercury Toxicity. Medscape Neurology. Available online at https://emedicine.medscape.com/article/1175560-overview. Accessed on 10/06/18.
(© 1995–2018). Mercury, Blood. Mayo Clinic Mayo Medical Laboratories. Available online at https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8618. Accessed on 10/06/18.
(2018 February 16, Updated). Health Effects of Exposures to Mercury. US Environmental Protection Agency. Available online at https://www.epa.gov/mercury/health-effects-exposures-mercury. Accessed on 10/06/18.
(2018 September 10, Updated). About Mercury. Agency for Toxic Substances and Disease Registry, Don’t Mess with Mercury. Available online at https://www.atsdr.cdc.gov/dontmesswithmercury/about_mercury.html. Accessed on 10/06/18.
Heller, J. et. al. (2017 September 23, Updated). Mercury poisoning. MedlinePlus Medical Encyclopedia. Available online at https://medlineplus.gov/ency/article/002476.htm. Accessed on 10/06/18.
Adal, A. and Wiener, S. (2018 August 24, Updated). Heavy Metal Toxicity. Medscape Emergency Medicine. Available online at https://emedicine.medscape.com/article/814960-overview. Accessed on 10/06/18.
Brooks, M. (2018 May 24). AHA Advisory Recommends Fish Twice Weekly for CV Health. Medscape Medical News. Available online at https://www.medscape.com/viewarticle/897212. Accessed on 10/06/18.
(2017 November 1, Updated). Methylmercury in Fish. MotherToBaby. Available online at https://mothertobaby.org/fact-sheets/methylmercury-pregnancy/. Accessed on 10/06/18.
Sources Used in Previous Reviews
Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.
(2004 August 02, Updated). Public Health Statement for Mercury. Agency for Toxic Substances and Disease Registry (ATSDR) [On-line information]. Available online at http://www.atsdr.cdc.gov/toxprofiles/phs46.html through http://www.atsdr.cdc.gov.
Severson, T. (2003 May 12, Updated). Mercury. MedlinePlus Health Information, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002476.htm.
Severson, T. (2003 April 30, Updated). Mercuric chloride. MedlinePlus Health Information, Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002474.htm.
(© 2004). Mercury. ARUP's Guide to Clinical Laboratory Testing [On-line information]. Available online at http://www.aruplab.com/guides/clt/tests/clt_al12.jsp#2124716.
Baratz, R. (2003 June 26). Dubious Mercury Testing. Quackwatch [On-line information]. Available online at http://www.quackwatch.org/01QuackeryRelatedTopics/Tests/mercurytests.html.
Wellbery, C. (2004 April 15). Can Vaccines Containing Thimerosal Cause Autism? American Family Physician, Tips from Other Journals [from Hviid A, et al. Association between thimerosal-containing vaccine and autism. JAMA October 1, 2003;290:1763-6.] [On-line journal]. Available online at http://www.aafp.org/afp/20040415/tips/7.html.
Cain, A. (2004 August 04, Updated). Mercury: A Brief for the Binational Strategy Implementation Workgroup, Frequently Asked Questions about Mercury Fever Thermometers. Great Lakes Binational Strategy Implementation Workshop [On-line information]. Available online at http://www.epa.gov/glnpo/bnsdocs/hg/thermfaq.html.
(2004 May) NIAID Research on Thimerosal. NIAID Fact Sheet [On-line information]. Available online at http://www.niaid.nih.gov/factsheets/thimerosal.htm.
(2002 December 31). Consumer Update: Dental Amalgams. U.S. FDA, CDRH Consumer Information [On-line information]. Available online at http://www.fda.gov/cdrh/consumer/amalgams.html.
(2007 July 24). Sushi lovers cautioned over mercury levels in tuna. MedlinePlus from Reuters Health Information [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/news/fullstory_52573.html. Accessed on 8/12/07.
Preidt, R. (2007 June 14). Antiques Can Pose a Mercury Danger Today. MedlinePlus from HealthDay [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/news/fullstory_50928.html. Accessed on 8/12/07.
(2007 August 7). Mercury, Health Effects. Environmental Protection Agency [On-line information]. Available online at http://www.epa.gov/mercury/effects.htm. Accessed on 8/12/07.
Perez, E. (2006 December 6, Updated). Mercury. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002476.htm. Accessed on 8/12/07.
Perez, E. (2006 July 18 Updated). Methylmercury poisoning. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/001651.htm. Accessed on 8/12/07.
Xue, F. et. al. (2007 March 12). Maternal Fish Consumption, Mercury Levels, and Risk of Preterm Delivery. Medscape from Environ Health Perspect. 2007;115(1):42-47. [On-line information]. Available online at http://www.medscape.com/viewarticle/553133 through http://www.medscape.com. Accessed on 8/12/07.
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry. AACC Press, Washington, DC. Pg 474.
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Pp 722-724.
Tietz Textbook of Clinical Chemistry and Molecular Diagnostics Burtis CA, Ashwood ER, Bruns DE, eds. 4th edition, St. Louis: Elsevier Saunders; 2006.
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference, 8th Edition: Mosby, Inc., Saint Louis, MO.
Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. McPherson RA, Pincus MR, eds. Saunders Elsevier: 2007.
LaDuo, J. Occupational and Environmental Medicine, 2nd ed, 1997 Pp. 421-423.
(Updated September 3, 2010) Department of Health and Human Services, The Center for the Evaluation of Risks to Human Reproduction. Mercury. Available online at http://cerhr.niehs.nih.gov/common/mercury.html. Accessed May 2011.
(Updated March 3, 2011) Agency for Toxic Substances and Disease Registry. Public Health Statement for Mercury. Available online at http://www.atsdr.cdc.gov/phs/phs.asp?id=112&tid=24. Accessed May 2011.
(February 2009) Agency for Toxic Substance and Disease Registry. Evaluating for Mercury Exposure: Information for Health Care Providers. PDF available for download at http://www.atsdr.cdc.gov/mercury/docs/Physician_Hg_Flier.pdf. Accessed May 2011.
(Updated September 21, 2009) Olsen D. Mercury. Medscape article. Available online at http://emedicine.medscape.com/article/1175560-overview. Accessed May 2011.
(Updated September 11, 2009) Diner B. Mercury Toxicity in Emergency Medicine. eMedicine article. Available online at http://emedicine.medscape.com/article/1175560-overview. Accessed May 2011.
(Updated June 30, 2010) Tan D. Pediatric Mercury Toxicity. eMedicine article. Available online at http://emedicine.medscape.com/article/1009691-overview. Accessed May 2011.
(February 2, 2009) MedlinePlus Medical Encyclopedia. Mercury. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/002476.htm. Accessed May 2011.
Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER, Bruns DE, eds. St. Louis: Elsevier Saunders; 2006, Pp1381-1382.
(December 9, 2009) National Institute of Allergy and Infectious Diseases. Vaccines, Thimerosal in vaccines. Available online at http://www.niaid.nih.gov/topics/vaccines/research/Pages/vaccines.aspx. Accessed May 2011.
Jamshid Eshraghi, PhD. Director, Chemistry Division. Massachusetts State Public Health Laboratory.
Mercury, Blood. Mayo Clinic. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8618. Accessed September 26, 2014.
David Olson. Mercury Toxicity Clinical Presentation. Medscape. Available online at http://emedicine.medscape.com/article/1175560-clinical. Last Updated March 8, 2013. Accessed September 26, 2014.
Vaccine Education Center: Vaccines and Thimerosal. Children's Hospital of Philadelphia. Available online at http://www.chop.edu/service/vaccine-education-center/vaccine-safety/vaccine-ingredients/thimerosal.html. Reviewed March 2014. Accessed September 26, 2014.
About Dental Amalgam Fillings. U.S. Food and Drug Administration. Available online at http://www.fda.gov/medicaldevices/productsandmedicalprocedures/dentalproducts/dentalamalgam/ucm171094.htm. Last updated June 6, 2014. Accessed September 26, 2014.
Mercury. Tox Town. National Institutes of Health. Available online at http://toxtown.nlm.nih.gov/text_version/chemicals.php?id=17. Accessed September 26, 2014.
Reducing Your Exposure to Mercury. Oregon Environmental Council. Available online at http://www.oeconline.org/our-work/healthier-lives/pollutioninpeople/solutions/mercury. Accessed September 26, 2014.
(February 14, 2013) Centers for Disease Control and Prevention. Emergency Preparedness and Response, Mercury. Available online at http://emergency.cdc.gov/agent/mercury/. Accessed October 2014.