Trace Elements

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Also known as: Trace Minerals; Micronutrients; Essential Minerals
Formal name: Trace Elements
Related tests: Chromium; Copper; Caeruloplasmin; Fluoride; Iodine; Iron tests; Manganese; Molybdenum; Selenium; Zinc; Vitamin B12 and Folate; Vitamin D

At a Glance

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 specific mineral deficiency or excess; as indicated when you have a condition that affects mineral absorption, use, or storage

Sample Required?

A blood sample drawn from a vein in your arm; sometimes a random or 24-hour urine sample; rarely, a tissue sample, or another body fluid sample

Test Preparation Needed?

Please check with your doctor to find out if you are required to fast before your test is performed.

The Test Sample

What is being tested?

Trace elements are a group of tests that measure specific minerals, primarily in the blood but sometimes in the urine or another bodily tissue or fluid. These minerals are substances that the body needs in tiny amounts on a regular basis for normal functioning. They enter the body through the diet and are used in the production of enzymes and hormones, the regulation of glucose, and the formation of bone, teeth, muscles, connective tissue, and blood cells. They assist in the metabolism of proteins, fats, and carbohydrates, promote wound healing, and are vital for the transport of oxygen throughout the body.

Trace elements are a subset of micronutrients and essential minerals. They include:

  • Chromium
  • Copper
  • Fluoride (usually included but rarely tested)
  • Iodine
  • Iron
  • Manganese
  • Molybdenumv
  • Seleniumv
  • Zinc
  • Trace element deficiencies can occur worldwide when there is insufficient food, insufficient variety of food, and/or mineral deficiencies in the soil that food is grown in. The World Health Organisation lists iodine, iron (and vitamin A) as the most important micronutrients in terms of global public health. In the United Kingdom, both deficiencies and excesses of trace minerals are rare. Deficiencies are sometimes seen with malnutrition and with conditions such as coeliac disease that are associated with decreased ability to absorb minerals. Deficiencies may occur with:

  • Insufficient intake – such as from a restricted diet. Sometimes seen when someone receives only intravenous nutrition.
  • Insufficient absorption – may be seen with a variety of chronic conditions associated with malabsorption and seen with surgery that removes part of the stomach or intestines.
  • Inability to use – some people may not be able to properly utilise one or more trace elements.
  • Increased use/need – pregnant women, children, and those that are recovering from an illness or injury may require increased nutritional support.
  • Increased loss – an example of this is the loss of iron that occurs when red blood cells are lost due to acute or chronic bleeding.
  • Interference/competition – an example of this is the decrease in copper that is associated with an excess of zinc.
  • Trace element 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 from the body at a normal rate. With some inherited conditions, the body may store minerals in tissues and organs, resulting in damage to them. An example of this is the storage of copper seen in Wilson’s disease.
  • How is the sample collected for testing?

    Trace element testing is usually performed on a blood sample obtained by inserting a needle into a vein in the arm. Sometimes a random or 24-hour urine collection may need to be collected. Special metal-free blood or acid-washed urine containers must be used to minimise the potential for sample contamination by any outside sources of minerals. Blood and urine reflect recent mineral intake. Rarely, a biopsy may be performed to obtain a tissue sample to evaluate trace element 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?

    Please check with your doctor to find out if you are required to fast before your test is performed.

    The Test

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    NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.