Also known as:Trace Elements; Micronutrients; Microminerals; Essential Minerals
Formal name:Trace Minerals
Related tests:Chromium; Copper; Ceruloplasmin; Fluoride; Iodine; Iron Tests; Manganese; Molybdenum; Selenium; Zinc; Vitamin B12 and Folate; Vitamin D
Why Get Tested?
To detect and monitor a mineral deficiency or excess; sometimes to evaluate your nutritional status
When to Get Tested?
When you have symptoms or signs of a mineral deficiency or excess; as indicated by your health care provider when you have a condition that affects mineral absorption, use, or storage
A blood sample drawn from a vein in your arm; sometimes a 24-hour urine sample; rarely, a hair sample, tissue sample, or another body fluid sample
Test Preparation Needed?
Check with your health care practitioner to find out if fasting is needed before your test.
How is it used?
Trace mineral tests are typically ordered individually to detect, evaluate, and monitor mineral deficiencies or excesses. A health care practitioner may select one or more tests based upon the symptoms or underlying conditions the patient has.
Sometimes more than one test is ordered to detect a single deficiency or toxicity, such as with copper and ceruloplasmin together 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.
When is it ordered?
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.
Deficiencies in trace minerals can cause a range of symptoms, depending on the mineral(s) that are lacking. Symptoms may include:
- Nausea, vomiting, and/or diarrhea
- Muscle weakness
In children, deficiencies can cause congenital abnormalities, delay growth, and affect mental development and sexual maturation.
acute and chronic excesses of trace minerals can cause symptoms associated with toxicity that may range from mild to severe. They can cause:
- Skin rash or pigmentation
- Hair loss
- Peripheral neuropathy
- In severe cases, kidney or liver failure, shock, coma, or an increased risk of lung cancer
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.
What does the test result mean?
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 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 by infection, inflammation, pregnancy, or various diseases and conditions. The health care practitioner will interpret findings in conjunction with the person's symptoms and clinical history.
Is there anything else I should know?
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.
What is being tested?
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:
- Fluoride (usually included but rarely tested)
Trace mineral deficiencies may occur as a result of insufficient food, insufficient variety of food, and/or mineral deficiencies in the soil where food is grown. 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 significant problem. Deficiencies may occur with:
- Insufficient intake - such as from malnutrition or a restricted diet. Sometimes seen when someone receives only intravenous nutrition.
- Insufficient absorption - may be seen with a variety of chronic conditions, such as celiac disease, associated with malabsorption or with surgeries that remove part of the stomach or intestines.
- Inability to use - some people may not be able to properly utilize one or more trace minerals.
- Increased use/need - pregnant women, children, and those recovering from an illness or injury may require increased nutritional support.
- Increased loss - an example is the loss of iron that occurs when red blood cells are lost due to acute or chronic bleeding.
- Interference - an example is the decrease in copper often associated with an excess of zinc.
Trace mineral excesses may be seen with:
- Too much intake - this may be chronic or acute, due to taking supplements or to accidental or occupational exposure.
- Decreased loss - with conditions such as kidney and liver disease, the body may not be able to remove trace minerals at a normal rate. With some inherited conditions, the body may store minerals in tissues and organs, which can cause damage. An example includes the overabundance of copper storage seen in Wilson disease.
How is the sample collected for testing?
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.
Blood and urine samples best reflect recent mineral intake. 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.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
Talk to your health care practitioner; fasting is preferred for some tests.
- Should everyone be tested for trace minerals?
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.
- How long will it take to get the results of my test?
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.
- Should I take mineral supplements?
Talk to your health care provider 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.
- What other minerals are required by the body?
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.
- What other micronutrients are required by the body?
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).
© 2017 American Association for Clinical Chemistry, republished from Lab Tests Online.*
Descriptions of clinical laboratory tests were originally prepared for use on Lab Tests Online, an award-winning patient education website on clinical laboratory testing. Lab Tests Online is produced by the American Association for Clinical Chemistry (AACC), a global scientific and medical professional organization dedicated to clinical laboratory science and its application to healthcare. The Lab Tests Online website is developed in collaboration with other laboratory professional societies and is funded in part through corporate sponsorships.