Test | In Range | Out Of Range | Units | Reference |
---|---|---|---|---|
Aluminum (Al) | 1.9 | ug/g creat | < 2.5 | |
Antimony (Sb) | < dl | ug/g creat | < 0.2 | |
Arsenic (As) | 10 | ug/g creat | < 75 | |
Barium (Ba) | 0.4 | ug/g creat | < 7 | |
Beryllium (Be) | < dl | ug/g creat | < 1 | |
Bismuth (Bu) | < dl | ug/g creat | < 2 | |
Cadmium (Cd) | 0.5 | ug/g creat | < 0.8 | |
Cesium (Cs) | 8.3 | ug/g creat | < 9 | |
Gadolinium (Gd) | < dl | ug/g creat | < 0.5 | |
Lead (Pb) | 1.3 | ug/g creat | < 2 | |
Mercury (Hg) | 0.5 | ug/g creat | < 3 | |
Nickel (Ni) | 4.4 | ug/g creat | < 8 | |
Palladium (Pd) | < dl | ug/g creat | < 0.1 | |
Platinum (Pt) | < dl | ug/g creat | < 0.1 | |
Tellurium (Ti) | < dl | ug/g creat | < 0.5 | |
Thallium (Ti) | 0.1 | ug/g creat | < 0.5 | |
Thorium (Th) | < dl | ug/g creat | < 0.03 | |
Tin (Sn) | 0.4 | ug/g creat | < 4 | |
Tungsten (W) | < dl | ug/g creat | < 0.4 | |
Uranium (U) | < dl | ug/g creat | < 0.03 | |
Creatinine | 149 | mg/dL | 45 - 225 |
This analysis of urinary elements was performed by ICP-Mass Spectroscopy following acid digestion of the specimen. Urine element analysis is intended primarily for: diagnostic assessment of toxic element status, monitoring detoxification therapy, and identifying or quantifying renal wasting conditions. It is difficult and problematic to use urinary elements analysis to assess nutritional status or adequacy for essential elements. Blood, cell and other elemental assimilation and retention parameters are better indicators of nutritional status.
"Essential and other" elements are reported as mg/24 h; mg element/urine volume (L) is equivalent to ppm. "Potentially Toxic Elements" are reported a s ug/24 h; ug element/urine volume (L) is equivalent to ppb.
All "Potentially Toxic Elements" are reported as ug/g creatinine; all other elements are reported as ug/mg creatinine. Normalization per creatinine reduces the potentially great margin of error which can be introduced by variation in the sample volume. It should be noted, however, that creatinine excretion can vary significantly within an individual over the course of a day.
If one intends to utilize urinary elements analysis to assess nutritional status or renal wasting of essential elements, it is recommended that unprovoked urine samples be collected for a complete 24 hour period. For provocation (challenge) tests for potentially toxic elements, shorter timed collections can be utilized, based upon the pharmacokinetics of the specific chelating agent. When using EDTA, DMPS or DMSA, urine collections up to 12 hours are sufficient to recover greater than 90% of the mobilized metals. Specifically, we recommend collection times of 9 - 12 hours post intravenous EDTA, 6 hours post intravenous or oral DMPS and, 6 hours post intravenous bolus administration of DMSA. What ever collection time is selected by the physician, it is important to maintain consistency for subsequent testing for a given patient.
If an essential element is sufficiently abnormal per urine measurement, a descriptive text is included with the report. Because renal excretion is a minor route of excretion for some elements, (Cu, Fe, Mn Zn), urinary excretion may not influence or reflect body stores. Also renal excretion for many elements reflects homeostasis and the loss of qualities that may be at higher dietary levels than is needed temporarily. For these reasons, descriptive texts are provided for specific elements when deviations are clinically significant. For potentially toxic elements, a descriptive text is provided whenever levels are measured to be higher than expected. If no descriptive text follow this introduction, then all essential element levels are within acceptable range and all potentially toxic elements are within expected limits.
Reference intervals and corresponding graphs shown in this report are representative of a healthy population under non-provoked conditions. Descriptive texts appear in this report on the basis of measured results and corresspond to non-challenge, non-provoked conditions.
Chelation (provocation) agents can increase urinary excreation of metals/elements. Provoked references intervals have not been established therefore non-provoked reference intervals shown are not recommended for comparison purposes with provoked tests results. Provoked results can be compared wsith non-provoked results (non reference intervals) to assess body burden of metals and to distinguish between transient exposure and net retention of metals. Provoked results can also be compared to previous provoked results to monitor therapies implemented by the treating physician. Additionally, CA-EDTA provoked results can be used to calculate the EDTA/Lead Excretion Ratio (LER) in patients with elevated blood levels.
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