Trace Minerals

  • Diagnosis
  • Screening
  • Background
  • Lab Tests
  • References
  • Related Topics

Indications for Testing

  • Deficiency – patient with chronic illness, malabsorption, or postbariatric surgery
  • Toxicity – patients with known exposure (eg, industrial accident)

Laboratory Testing

  • Order testing based on clinical scenario and/or presence of symptoms
    • Nutritional deficiency – fasting serum or plasma testing
      • RBC testing has limited usefulness in assessing dietary intake
    • Toxicity – urine testing
      • Not recommended for assessing current nutritional status
  • Not recommended in the general population
  • May be indicated in at-risk populations or for those on chronic parenteral feeding

The primary trace minerals of nutritional significance are chromium, copper, selenium, and zinc. Signs and symptoms of toxicity correlate with routes of exposure, specific elemental forms to which a person is exposed, and whether exposure is acute or chronic. Deficiencies of these minerals may exist in the following:

  •  Patients with
    • Chronic illness (eg, HIV)
    • Malabsorption syndrome
    • Unbalanced diet or parenteral nutrition
    • Pica
  • Postbariatric surgery patients
  • Preterm infants

Individual Trace Minerals

Tests generally appear in the order most useful for common clinical situations. Click on number for test-specific information in the ARUP Laboratory Test Directory.

Chromium, Serum 0098830
Method: Quantitative Inductively Coupled Plasma-Mass Spectrometry

Limitations 

Fasting morning specimens are best to avoid postprandial fluctuation 

Copper, Serum or Plasma 0020096
Method: Quantitative Inductively Coupled Plasma-Mass Spectrometry

Limitations 

Elevated with inflammation, infection, pregnancy, birth control pills

Copper may be lowered by corticosteroids, zinc, malnutrition, malabsorption

Copper, Serum Free (Direct) 0020596
Method: Quantitative Inductively Coupled Plasma-Mass Spectrometry

Limitations 

Fasting morning specimens are best to avoid postprandial fluctuation

Selenium, Serum or Plasma 0025023
Method: Quantitative Inductively Coupled Plasma-Mass Spectrometry

Limitations 

Fasting morning specimens are best to avoid postprandial fluctuation 

Selenium, RBCs 2013011
Method: Quantitative Inductively Coupled Plasma-Mass Spectrometry

Selenium, Urine 0025067
Method: Quantitative Inductively Coupled Plasma-Mass Spectrometry

Zinc, Serum or Plasma 0020097
Method: Quantitative Inductively Coupled Plasma-Mass Spectrometry

Limitations 

Depressed with inflammation, infection, pregnancy, birth control pills, and steroids

False elevations with hemolysis

Fasting morning specimens are best to avoid postprandial fluctuation

Zinc, RBC 2006460
Method: Quantitative Inductively Coupled Plasma-Optical Emission Spectrometry

General References

Institute of Medicine of the National Academies. Summary Tables, Dietary Reference Intakes. Otten JJ, Hellwig JP, Meyers LD. Dietary Reference Intakes The Essential Guide to Nutrient Requirements, Washington, DC: National Academies Press, 2006.

Kirby M, Danner E. Nutritional deficiencies in children on restricted diets. Pediatr Clin North Am. 2009; 56(5): 1085-103. PubMed

Kumar N. Neurologic presentations of nutritional deficiencies. Neurol Clin. 2010; 28(1): 107-70. PubMed

Marian M, Sacks G. Micronutrients and older adults Nutr Clin Pract. 2009; 24(2): 179-95. PubMed

Schweitzer DH, Posthuma EF. Prevention of vitamin and mineral deficiencies after bariatric surgery: evidence and algorithms. Obes Surg. 2008; 18(11): 1485-8. PubMed

Shah MD, Shah SR. Nutrient deficiencies in the premature infant. Pediatr Clin North Am. 2009; 56(5): 1069-83. PubMed

Suskind DL. Nutritional deficiencies during normal growth. Pediatr Clin North Am. 2009; 56(5): 1035-53. PubMed

References from the ARUP Institute for Clinical and Experimental Pathology®

Bornhorst JA, Hunt JW, Urry FM, McMillin GA. Comparison of sample preservation methods for clinical trace element analysis by inductively coupled plasma mass spectrometry. Am J Clin Pathol. 2005; 123(4): 578-83. PubMed

Haglock-Adler CJ, Strathmann FG. Simplified sample preparation in the simultaneous measurement of whole blood antimony, bismuth, manganese, and zinc by inductively coupled plasma mass spectrometry Clin Biochem. 2015; 48(3): 135-9. PubMed

Lin C, Wilson A, Church BB, Ehman S, Roberts WL, McMillin GA. Pediatric reference intervals for serum copper and zinc. Clin Chim Acta. 2012; 413(5-6): 612-5. PubMed

Medical Reviewers

Last Update: August 2016