To detect and monitor a mineral deficiency or excess; sometimes to evaluate your nutritional status
When you have symptoms or signs of a mineral deficiency or excess; as indicated by your healthcare provider when you have a condition that affects mineral absorption, use, or storage
Trace mineral testing is usually performed on a blood sample obtained by inserting a needle into a vein in the arm. Sometimes a 24-hour urine collection is obtained. Special metal-free blood or acid-washed urine containers are used to minimize the potential for sample contamination by any outside sources of minerals. Rarely, hair may be collected or a biopsy may be performed to obtain a tissue sample to evaluate mineral deficiencies, excesses, and storage that have occurred over time.
Check with your healthcare practitioner to find out if fasting is needed before your test.
Trace mineral tests measure the concentration of specific minerals in a sample of blood, urine, or other body fluid or tissue. These minerals are substances that the body needs in minute amounts on a regular basis for normal functioning. They are absorbed from the diet and are used in the production of enzymes and hormones, in the regulation of glucose, and in the formation of bone, teeth, muscles, connective tissue, and blood cells. The minerals assist in the metabolism of proteins, fats, and carbohydrates, promote wound healing, and are vital for the transport of oxygen throughout the body.
Trace minerals are a subset of micronutrients and essential minerals. They include:
The World Health Organization lists iodine, iron, and vitamin A as the most important micronutrients in terms of global public health. In the United States, deficiencies and excesses of trace minerals are less common, although iron deficiency remains a potential problem.
Examples of causes of trace mineral deficiencies include:
Trace mineral excesses may be seen with:
Trace mineral tests are typically ordered individually to detect, evaluate, and monitor mineral deficiencies or excesses. A healthcare practitioner may select one or more tests based upon the signs and symptoms or underlying conditions the patient has.
Sometimes more than one test is ordered to detect a single deficiency or toxicity, such as copper and ceruloplasmin tests to evaluate the amount of copper in the body or a group of iron tests (iron, total iron binding capacity, and ferritin) with a CBC (complete blood count) to evaluate iron deficiency as a potential cause of anemia.
If a person is malnourished or has a condition associated with malabsorption, a practitioner may order several trace mineral tests for an initial evaluation, then order one or more tests periodically to monitor the person's nutritional status and/or the effectiveness of treatment.
If someone has an inherited condition that leads to excess concentrations of a mineral, or has been exposed to toxic concentrations, a test for such a mineral may be ordered to help detect and diagnose the condition. Additional tests may be ordered at intervals to monitor the person's condition.
With the possible exception of an iron test, trace mineral tests are not routinely ordered. Rather, they are ordered when a mineral deficiency or excess is suspected due to a person's medical history or signs and symptoms.
Depending on the mineral(s) that are lacking, signs and symptoms may include:
In children, deficiencies can cause congenital abnormalities, delay growth, and affect mental development and sexual maturation.
Excess amounts of trace minerals can cause signs and symptoms associated with toxicity that may range from mild to severe, such as:
One or more tests may be ordered periodically to monitor the status of a person with an underlying condition that causes malabsorption or the excess buildup of a trace mineral.
In general, low concentrations of a mineral indicate a deficiency and high concentrations indicate an excess. Successful treatment for a deficiency should show increasing mineral levels and a decrease in symptoms while treatment for mineral toxicity should show decreasing mineral levels and a corresponding decrease in signs and symptoms.
Trace mineral test results must, however, be interpreted with a degree of caution. Certain treatments for excess minerals can actually increase mineral concentrations in blood and urine samples temporarily. Some minerals, such as copper and zinc, may be increased temporarily due to infection, inflammation, or pregnancy, for example. The healthcare practitioner will interpret findings in conjunction with the person's symptoms and clinical history.
Trace minerals are found in varying concentrations in a wide variety of foods. Some forms of minerals are more "bioavailable" (or better absorbed) from an animal source than from a plant source, such as heme-iron found in meats versus non-heme iron found in vegetables, grains, and beans. Minerals are also added to foods to make them more readily available, such as "fortified" grains and cereals, fluoridated water, and iodized salt.
It is generally not necessary. Most people in the United States who eat a variety of foods will get a sufficient amount of trace minerals from their diet.
Trace mineral tests, with the exception of iron tests, are not performed on a routine basis. They are frequently performed at a reference laboratory, so the results are likely to take several days.
Talk to your healthcare practitioner about taking supplements. If you are deficient, supplements may be of benefit to you, but there is no strong evidence to suggest that they benefit the average individual and may, in fact, increase your risk of toxicity. Those who take excess zinc can inhibit their use of copper. People who store excess iron or copper in their bodies must restrict and monitor their intake of these minerals as the buildup can damage tissues and organs.
Macrominerals are minerals that are required in greater amounts than trace minerals. They include sodium, potassium, calcium, magnesium, chloride, and phosphorus. Some also include sulfur in this category.
Micronutrients include trace minerals, the fat-soluble vitamins A, D, E, and K, and the water-soluble vitamins C and B complex (biotin, folate, niacin, pantothenic acid, riboflavin, thiamin, B6 and B12).
Sources Used in Current Review
(2016 December 20, Updated). Vitamins and Minerals. NIH National Center for Complementary and Integrative Health. Available online at https://nccih.nih.gov/health/vitamins. Accessed on 12/20/17.
(2016 February 17, Updated). Zinc. National Institutes of Health Office of Dietary Supplements. Available online at https://ods.od.nih.gov/factsheets/Zinc-Consumer/. Accessed on 12/20/17.
(2016 February 17, Updated). Selenium. National Institutes of Health Office of Dietary Supplements. Available online at https://ods.od.nih.gov/factsheets/Selenium-Consumer/. Accessed on 12/20/17.
Johnson, L. (© 2017). Overview of Minerals. Merck Manual Consumer Version. Available online at http://www.merckmanuals.com/home/disorders-of-nutrition/minerals/overview-of-minerals. Accessed on 12/20/17.
(2015 March 31, Updated). Micronutrient Facts. CDC International Micronutrient Malnutrition Prevention and Control (IMMPaCt). Available online at https://www.cdc.gov/immpact/micronutrients/index.html. Accessed on 12/20/17.
Grenache, D. (2017 August, Updated). Trace Minerals. ARUP Consult. Available online at https://arupconsult.com/content/trace-minerals. Accessed on 12/20/17.
(2013 November 4, Updated). Chromium. National Institutes of Health Office of Dietary Supplements. Available online at https://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/. Accessed on 12/20/17.
Sources Used in Previous Reviews
Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 407-410.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 260-261, 292-295, 408-409, 634-637, 710-713, 746-747, 976-977, 1152-1155.
(Updated 2005 August 5). Chromium. National Institutes of Health, Office of Dietary Supplements, Dietary Supplement Fact Sheet [On-line information]. Available online at http://ods.od.nih.gov/factsheets/chromium.asp. Accessed April 2009.
(Updated 2007 August 24). Iron. National Institutes of Health, Office of Dietary Supplements, Dietary Supplement Fact Sheet [On-line information]. Available online at http://dietary-supplements.info.nih.gov/factsheets/iron.asp. Accessed April 2009.
(Updated 2004 August 1). Selenium. National Institutes of Health, Office of Dietary Supplements, Dietary Supplement Fact Sheet [On-line information]. Available online at http://dietary-supplements.info.nih.gov/factsheets/selenium.asp. Accessed April 2009.
(Updated 2009 January 21). Zinc. National Institutes of Health, Office of Dietary Supplements, Dietary Supplement Fact Sheet [On-line information]. Available online at http://dietary-supplements.info.nih.gov/FactSheets/Zinc.asp. Accessed April 2009.
Johnson, L. (Reviewed 2008 August). Mineral Deficiency and Toxicity The Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec01/ch005/ch005a.html?qt=trace%20mineral&alt=sh. Accessed March 2009.
Johnson, L. (Reviewed 2008 August). Minerals and Electrolytes. The Merck Manual of Medical Information – Second Home Edition [On-line information]. Available online at http://www.merck.com/mmhe/sec12/ch155/ch155a.html. Accessed March 2009.
McMillin, G. (Updated 2008 September). Trace Minerals. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/GastrointestinalDz/NutritionalAssessment/TraceMinerals.html. Accessed April 2009.
L. Aills, et al. (2008 March 12). ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient. Surgery for Obesity and Related Diseases 4 (2008) S73-S108 [On-line information]. PDF available for download at http://www.asbs.org/Newsite07/resources/bgs_final.pdf. Accessed April 2009.
World Health Organization. Micronutrient deficiencies. Available online at http://www.who.int/nutrition/topics/ida/en/. Accessed on Mar. 24, 2013.
Baratz, R. S. (2011 February 11, Reviewed). Hair Analysis Panel Discussion. Agency for Toxic Substances & Disease Registry. Available online at http://www.atsdr.cdc.gov/HAC/hair_analysis/Appendix_c_robert.html. Accessed on Mar. 24, 2013.
Table 5-1 Trace Minerals. Merck Manual. PDF available for download at http://www.merckmanuals.com/media/professional/pdf/Trace_minerals.pdf. Accessed on Mar. 25, 2013.
National Institutes of Health. Dietary Supplement Fact Sheet: Iron. Available online at http://ods.od.nih.gov/factsheets/Iron-HealthProfessional/. Accessed on Mar. 25. 2013.
Mayo Clinic. A Vitamin A Day Might Not Keep The Doctor Away. Mar. 14, 2012. Available online at http://www.mayoclinic.org/news2012-mchi/6760.html. Accessed Mar. 26, 2013.