Too much mercury? Too little iron? New ARUP resource offers guidance on lab testing for element toxicity or deficiency

Trace minerals including iron shown as elemental symbols under a microscope
January 8, 2019

A comprehensive new Trace and Toxic Elements resource available free to the public at arupconsult.com offers expert laboratory testing information about 18 common elements, from iron to zinc.


Elements are in the food we eat and the water we drink. We encounter them at work and at play.

Having too little of some is bad, but so, too, is having too much of others.

How do laboratory tests help clinicians determine the difference?

ARUP Laboratories offers dozens of tests clinicians use to assess deficiency or overload of trace and toxic elements. To help clinicians choose the best test for a given circumstance, ARUP Consult has published a comprehensive new resource that offers expert testing information about 18 common elements, including arsenic, iron, lead, mercury and zinc, to name a few.

The new resource aligns with our goal as an academic reference lab to share the expertise we have at ARUP and the University of Utah to advance laboratory medicine.

Brian Jackson, MD, ARUP medical director of business development, IT and Support Services

Trace and Toxic Elements, available free to the public online at arupconsult.com, features information summarized from cited governmental and medical sources. Kamisha Johnson-Davis, PhD, ARUP medical director of clinical toxicology, contributed her own expertise and reviewed the resource, which describes each element, its biologic function (if there is one), sources of exposure, signs and symptoms of either deficiency or excess, and recommended dietary intake, if applicable.

The resource describes which tests and specimen types are best for diagnosing potentially toxic exposure to an element at one extreme and deficiency at the other. It discusses appropriate testing in specific circumstances, such as for patients diagnosed with Wilson disease, or who have had bariatric surgery.

“The goal was to create a resource to provide essential clinical information on trace and toxic elements that would be used to help support patient care and be readily accessible to the general public,” Johnson-Davis said.

ARUP Client Services agents in the past year have gotten more questions about testing for elements, which prompted the ARUP Consult team to work with Johnson-Davis on the resource, said Brian Jackson, MD, ARUP medical director of business development, IT and support services. “The new resource aligns with our goal as an academic reference lab to share the expertise we have at ARUP and the University of Utah to advance laboratory medicine,” said Jackson, who also is ARUP Consult’s executive editor.

Trace and Toxic Elements is one of dozens of ARUP Consult topics presented in a new format that aims to optimize the online tool for use at the point of care and on mobile devices.

Disease-related testing topics in the new format include a Quick Answers for Clinicians feature that uses an FAQ approach to answer commonly asked questions.

ARUP Consult, which first launched in 2007, also has been redesigned with a dynamic, left-side menu for ease of navigation on a phone or other mobile device. All content, including complex tables and test menus, is coded to adapt for easy readability regardless of the platform on which it is being viewed.

Johnson-Davis also worked with the ARUP Consult team on a new Emergency Toxicology resource. Other topics new to Consult include Gastric Bypass – Bariatric Surgery Postoperative Monitoring and Prolonged Clotting Time Evaluation.

ARUP Consult also has begun adding Test Fact Sheets, which provide test-specific diagnosis and interpretation information.

Users may subscribe to receive either monthly or quarterly emails about updates and additions to ARUP Consult. The Consult team also welcomes feedback and suggestions at arupconsult@aruplab.com or by clicking the Feedback button that appears on any arupconsult.com page.

Lisa Carricabaru, managing editor, ARUP Decision Support

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