Comprehensive Blood Elements (whole blood + serum elements)

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Turnaround Time: 3-5 days
CPT Code:
  • 82175, Arsenic; whole blood
  • 83018, Barium; whole blood
  • 82300, Cadmium; whole blood
  • 82310, Calcium (total); serum
  • 82310, Calcium; whole blood
  • 82495, Chromium; whole blood
Test Type: Kit-Based, Blood


Whole blood metals are the standard for diagnosis of lead, mercury or other metal toxicity or poisoning, and are also used to assess recent or ongoing exposure to potentially toxic elements. Serum elements are used to assess the status of key elements and electrolytes that have important functions in the extracellular fluid compartment of blood.

Whole Blood and Serum Elements tests are available separately or as part of the Comprehensive Blood Elements profile.

Detailed Information

Blood elemental analysis should be performed prior to the initiation of, and intermittingly during, metal detoxification. Toxic metals disrupt essential element metabolism and are antagonistic to some elements such as cadmium to zinc and lead to calcium. Further, commonly utilized metal detoxification agents can cause significantly increased urinary wasting of some essential elements. For example, EDTA has a very high affinity for zinc and manganese, and DMPS results in marked increases in copper excretion. Therefore, appropriate evaluation of essential element status is an integral component of safe and effective metal detoxification therapy.

Analysis of toxic elements/metals in whole blood is useful for assessment of recent or ongoing exposure to the toxins, but does not provide accurate information about net retention of toxic metals in the body. For example, blood lead levels peak about five hours after acute exposure and then decrease exponentially with a half-life in blood of about one month. Evaluation and elimination of ongoing exposure to toxic metals is another important component of efficient metal detoxification.

Accurate assessment of essential element status in the most appropriate compartment is highly recommended for determination of appropriate supplementation. The absorption, transport and metabolism of essential elements is highly integrated and regulated. Inappropriate supplementation or dietary imbalance of elements can have significant adverse health effects. For example, excess intake of zinc or molybdenum can result in copper deficiency and excess assimilation of manganese can have serious neurotoxic effects that are expressed as Parkinson's-like disease.

Whole blood analysis is an excellent test for measuring the levels of both intracellular and extracellular circulating elements. Extracellular elements have functions in serum/plasma or are transported to tissues in serum/plasma associated with specific proteins or albumen. Intracellular elements have very specific functions as obligatory constituents of metalloproteins/enzymes in red blood cells and lymphocytes. The red and white blood cells serve as surrogate cells representative of peripheral cells in general.

Some essential elements, such as selenium, are portioned in and have important physiological roles in both the intracellular and extracellular compartments. Likewise, the toxic metal lead is transported in both the fluid and cellular (red blood cells) compartments of blood. Therefore measurement of elements in both blood compartments permits a more complete evaluation of total blood element levels. In contrast, some essential elements/electrolytes such as calcium, sodium, potassium and iron are best assessed in serum because they are transported by serum proteins or have important functions in the extracellular compartment of blood.

Also, the differential analysis of some elements, such as magnesium, in both whole blood and serum can provide important clinical information about aberrant metabolism of this extremely important element that is involved in over 300 different intracellular reactions. Blood elemental analysis is available in whole blood, in serum and as a Comprehensive Blood Elements profile which is comprised of both whole blood and serum elements. It is highly recommended that blood and serum specimens be collected after an overnight fast to avoid the acute influence of a meal.


Performing Lab: DDINT

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