Imperial Collage Healthcare


Test Background
Trace elements can be essential or toxic. Trace element toxicity can occur as a result of occupational exposure, environmental exposure or iatrogenic toxicity. Any organ can be affected: the central nervous system, liver, kidneys, muscles or circulatory system. All elements can be toxic in excess. Those most commonly associated with toxicity include: aluminium, lead, arsenic, cadmium, mercury, thallium, barium, germanium, tellurium, tin, antimony, osmium and uranium. Thallium is a colourless, odourless, tasteless salt in solution which is highly toxic. Thallium is readily absorbed through the gut, inhalation and/or contact with the skin and thus has been used as a poison. Thallium acts by disrupting the binding of potassium to the Na+/K+/ATPase. It leads to the disruption of gradient formation important for the normal activity of nerve and muscle cells.
Sources of thallium include: manufacturing processes, old rodent poisons/insecticides. Accidental toxicity is now unlikely. The majority of recent reported cases tend to be due to deliberate poisoning.

Clinical Indications
Symptoms include: nausea/vomiting, incontinence, abdominal pain, pancreatic damage, muscle weakness, headaches, neurological symptoms and coma.
2-3 weeks after the initial exposure, hair loss usually occurs. Many of the subsequent symptoms may be confused with Guillain-Barré syndrome, porphyria, SLE, botulism or other poisoning.

Reference Range

Blood : <5 nmol/L
Urine : <1 μmol/mol creatinine

Sample Required
Blood: EDTA (lavender top) or heparin (green top)Urine: random sample or 24 hour collection

Sample Volume
Blood: 0.5 mL Urine: 0.5 mLor 24 hour urine collection

Turnaround Time
2 weeks

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