I heard that urine and hair tests for heavy metals (including Lead) were not considered “real” or “useful” results. Why is this?

ByTamara Posted: Updated:
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For those new to the Lead Safe Mama website:

Tamara Rubin is a multiple-federal-award-winning independent advocate for childhood Lead poisoning prevention and consumer goods safety, and a documentary filmmaker. She is also a mother of Lead-poisoned children (two of her sons were acutely Lead-poisoned in 2005).

  • Tamara owns and runs Lead Safe Mama, LLC — a community collaborative woman-owned small business for childhood Lead poisoning prevention and consumer goods safety.
  • Since 2009, Tamara has been using XRF technology (a scientific testing method) using the exact instrumentation employed by the U.S. Consumer Product Safety Commission to test consumer goods for toxicants (specifically heavy metals — including Lead, Cadmium, Mercury, Antimony, and Arsenic).
  • Since July of 2022, the work of Lead Safe Mama, LLC has been responsible for 5 product recalls (FDA and CPSC).
  • All test results reported on this website are science-based, accurate, and replicable.
  • Items that Lead Safe Mama, LLC reports on are tested multiple times to confirm the results published (for each component tested).
  • Tamara’s work was featured in Consumer Reports Magazine in February 2023 (March 2023 print edition) and The Guardian in November 2023.

Here’s a urine test from a 13-year-old boy in Pennsylvania:

A urine test from a 50-year-old woman in California:

“I’ve heard that urine and hair tests for heavy metals (including Lead) were not ‘real’ or ‘useful’ test results. Why is this?”

I have personally heard urine and hair test results for heavy metals (including Lead) derided and dismissed by professionals in the Lead poisoning prevention community often enough that, as a full-time Lead poisoning prevention advocate, I assumed those assertions likely reflected some solid, well-established, undisputed truth — presumably based on a consensus of informed or irrefutable scientific opinion.

Two years ago my perspective shifted. Around that time I helped a handful of families through my work — families who, as it would turn out, shared some intriguing correlations that prompted further inquiry. These multiple separate, unrelated cases forced me to re-examine my opinion about the potential value of these tests, ultimately turning it on its head!

Here is a link to an article characterizing one of these tests as useless and potentially dangerous:

Here are some articles with different perspectives and additional information:

  1. August 2015 — Is challenge testing valid for assessing body metal burden? By Joseph Pizzorno
  2. June 2009 — The benefit of pre- and post-challenge urine heavy metal testing: Part 2
  3. March 2009 — The benefit of pre- and post-challenge urine heavy metal testing: Part 1
  4. August 2017 — Assessment of Typical Heavy Metals in Human Hair of Different Age Groups and Foodstuffs in Beijing, China
  5. April 2002 — The pitfalls of hair analysis for toxicants in clinical practice: three case reports.

Here’s my current thinking on this type of testing
(including how my opinion was shifted):

Before we dive into this conversation, the most important point to note is that the potential impact of aggregate exposure to toxicants in consumer goods within the home (including dishes, bedding, and other items typically used every day by people) HAS. NOT. BEEN. STUDIED. The potential for specific exposure sources to show up in various testing methodologies (hair tests, urine tests, blood tests), hasn’t seen further study, either.  Any of the above studies are outside the realm of inquiry of the impact of chronic, long-term, daily human exposure to toxicants in consumer goods.

Families across the country often come to me after they have explored and exhausted all of the local, regional, and federal resources available — without getting any answers (or identifying the source(es) of a variety of health impacts for their children or their entire families):

  • In most cases, these families have already spoken with their local health departments (cities, states, counties) and have not found answers.
  • In most cases, they have already talked to a variety of doctors (family doctors, medical specialists, sometimes alternative medicine practitioners — such as naturopaths, acupuncturists, etc.), and still not found answers about the sources of the illnesses (often after a child or other family member has received a medical diagnosis of confirmed or suspected Lead-poisoning).
  • In almost every case, they have done extensive testing (both of their bodies and their homes) and still have not found answers.
  • In some cases, families have been referred directly by a physician or someone at a health department who is familiar with my work

I am found (probably 99% of the time — for the portion of my work where I help families one-on-one) by families at the end of an incredibly exhaustive search in their journey looking for answers about a particular ailment, a cluster of symptoms, or as-yet-unidentified source of confirmed exposure to heavy metals.

These families invariably have already done blood Lead testing, and/or urine testing for metals (either provoked and unprovoked), and/or hair testing. Many of these families have also had a full assessment of their home by a private or publicly-funded certified hazard assessor — looking for things like Lead, Asbestos, Radon, and Mold. Some have also gone down the Lyme disease rabbit hole. All want answers and help assembling the pieces of what they have learned into a coherent scenario that makes sense, and includes an effective course of action in the effort to identify and eliminate possible primary or contributing sources of ongoing exposure to neurotoxic heavy metals in their environment.
 

And what’s Tamara’s role in all of this?

As with the work I publish on this website, I help families determine if the consumer goods in their homes contain neurotoxic heavy metals, and are thus possible sources of exposure in their lives. When I work with families one-on-one (remotely or in person) they usually want to share their medical test results with me (even though I emphasize, and they understand, that I am not a doctor!). It’s always really interesting how what we find (in terms of the presence of toxicants in a family’s possessions) tends to correlate directly with what has shown up in the test results from their doctors.
 
Urine tests (provoked and otherwise) and hair tests have been seen (in my work and the work of others who do consulting similar to what I do) to be more and more valuable tools in identifying contaminants to look for in the home (regardless of any other context these tests are being used for — including their intended use as a medical diagnostic tool and their ability [or lack thereof] to identify ailments or exposures correlative to a specific blood Lead level, for example).
 

For your consideration:

In looking at the two tests at the top of the page, one of the individuals tested positive for Antimony while the other did not. Based on my experience, the sorts of things I would expect to find in the home of the person who tested positive for Antimony (and expect to likely not find in the home of the person who tested negative) is a range of the following items (which I would then suggest the person find Antimony-free replacements for, if they are interested in removing Antimony from their lives):
  • Plastic food packaging (especially peanut butter jars and similar)
  • Synthetic bedding (pillows, mattresses, and blankets made of synthetic fibers or filled with Poly-fil)
  • Any furniture or other items treated with flame-retardant chemicals
  • Stuffed animals or toys made of synthetic fibers and filled with Poly-fil (especially if these toys are slept with or mouthed/ chewed on at all)

Whether or not a definite, measurable health benefit would certainly follow after removing these items from their lives is unknown. The fact that Antimony causes cancer in rats, and has many demonstrable negative human health implications (especially at higher/industrial levels) is known. Unfortunately, it is also indisputable that the human health impacts of prolonged exposure to trace levels of Antimony (often found in a variety of household products) have not yet been well studied either. 

  • Has the Antimony in the bedding of one person contributed to the Antimony in their blood? Maybe. Can this be proved beyond a doubt? Much harder to say.
  • Would the family be more comfortable (especially if they have a child who already has known and diagnosed health impacts from heavy metals — like Lead poisoning) knowing their bedding is all-natural (organically-grown and chemically untreated wool, cotton, silk, hemp, etc.) and not likely to (even potentially) contribute any heavy metals to the bloodstream of their child? Definitely!
  • Should they be allowed access to that information and given the choice as a consumer? Yes — of course!
  • Did their urine (or hair) test lead them down this path of research or inquiry toward a healthier lifestyle (choosing non-toxic products)? Probably.
  • Does that mean the urine test (that their doctor chose to order) may have clear value — despite its being regarded by many in the medical community as “controversial” (in terms of the extent of any definite medical diagnostic utility (at least as of this 2013 linked article)? Yes, I think so.

And also for your consideration:

To further illustrate the above concepts and considerations:

#1) In the black and white photo example above (a urine test), the results are positive for a low level of Arsenic, and a high level of Lead. This family lived in a newer construction house. This family had an extensive collection of wooden antique objects that tested positive for Arsenic in the finish. This family was eating off of very high-Lead-content antique dishware.

#2) In the example (color photo) below (a hair test), the child tested positive for a very high level of Antimony. The family was sleeping in a family bed that tested positive for Antimony at approximately 3,000 ppm (a very high level of Antimony for a modern bed). There was also Antimony in his pillows, blankies (that he snuggled with all day and each night), and his couch. His parents shared that the child (non-verbal with significant disabilities) spent most of his time naked (allowing for possibly more exposure opportunities to Antimony from these sources via higher than-normal skin contact with Antimony-contaminated household items than might otherwise be the case). As the focus of my work is usually on Lead (Pb), I would not have thought to look for Antimony in the items noted above, but the hair test his parents shared with me (the image below) prompted a certain level of curious concern and it was then (starting with my first visit to this family) that I began looking for (and recording) Antimony levels in consumer goods across the board.

Continue reading below the image.

#3) With the urine test example below, the child tested positive for a high level of Lead — despite living in a newer construction house. High levels of Lead were subsequently found in the dishes and glasses the child used every day.

Why are these tests discredited when they appear to possibly provide useful correlative information?

It’s my understanding that lobbying in the blood Lead testing arena has potentially impacted (negatively biased) the perception of the potential utility/ value/ legitimacy of urine and hair testing (as well as other alternative testing methodologies) in helping to identify (and eliminate) exposure sources for various contaminants.
 
This negative perception bias has resulted in reactions (at least within the childhood Lead poisoning advocacy community) always along the lines of: “Meh, that’s not real testing and there is no way to interpret it.” And therefore, “It is not valid or useful information.”
 

This perception is misguided and lacks a broader focus

Despite that perception (and general understanding by nearly everyone who works professionally in the Lead poisoning prevention community especially), I have found reviewing these tests to be very valuable in the “detective work” involved in what I do.
 
I now always encourage my clients (again, clients who are usually families who have exhausted all available public health and medical resources in trying to find answers) to pull together any and all test results for metals that their doctor can make available to them (blood, hair, and urine) so (outside of whatever potential medical implications that they discuss with their doctors) we can review and compare the results together to see if any clues or insights can be concluded from that information — specifically insights into which toxic metals we might want to be on the lookout for (and try to eliminate) in the consumer goods present in their homes.
 

Everything starts with the family doctor

As I said, in almost all cases that I work on, these tests have been ordered by (and reviewed with) the family’s doctor. Often — with families who contact me — the doctor also states that they “cannot make sense of” the test results (or they do “not know what to do” with the information once they have collected it).
 
Families come to me for help when they have been turned away from others with no answers or insights, reflecting either an inability to identify the exposure source(es) and/or an inability to identify any next steps to reduce or eliminate continued/ ongoing exposure.
 
In my public speaking events, I often talk about the value of a doctor who makes house calls. I think in the widespread practice of a bygone era — house calls by a savvy, alert medical doctor might have found some of the things I look for now, like potentially toxic consumer goods (say an old Lead-painted antique changing table, or chalking Lead lines in an antique Tiffany lampshade hanging over the breakfast table!). But once we (as a culture) stopped the practice of doctors making house calls, we separated doctors from a valuable source of insight into potential health impacts on their patients: The place where we spend the most time — our homes. Doctors no longer automatically (intimately/ empirically) connect their patient’s health with their home, and that lack of intuitive interconnected awareness has left patients (and doctors) not fully grasping the implications of test results that might have otherwise, perhaps, quickly provoked an understanding.
 

I’m not a doctor — and conversely, doctors don’t do what I do — but our work is complementary.

I don’t know how many times I need to say this to make sure folks understand this but I am not a doctor. What I do does not fall within the realm of anything done by any doctor. My consultations with families are not “about” their test results (for urine, hair, blood, etc.) My consultations with families are about considering the “stuff” in their lives that may be potential sources of exposure to the most common metallic toxicants — Arsenic, Lead, Antimony, Cadmium, and Mercury — in their homes. This happens to interconnect well with information provided by the doctor and often fills the gap (to some degree) that has been left by the abandonment of a family doctor practicing house calls.
 
Said another way, I do not evaluate the test result of a client for the medical implications of those results, but their urine or blood test results often inspire their subsequent inquiry (after conversations with their doctor) into the potential source of any toxicant exposure. The effort to make sense of their test results from a medical perspective is wholly distinct and separate from the fact that they are looking for objects that may be sources of heavy metals in their home (so they can eliminate those sources). As consumers, they should have a right to know about (despite manufacturers and vendors of products, including vendors of antiques, not always having that information available for consumers).
 
Families are consulting with their doctors about their test results and consulting with me about toxicants in their consumer goods — usually, it’s just very interesting correlative information.
 

Here’s why these test results can provide valuable insights (despite the opinion expressed in the article from 2013 above)

There is a specific distinction here that is different from what the article (linked above) is discussing. The article discusses purely medical implications. In the inquiries I do, we are not looking at the results of a urine test to come to diagnostic conclusions or prognosis or treatment implications about the human being (the person who excreted the urine), but to see if they may be correlative to test results of objects in the environment — separating the medical impacts from the presence of the toxicant in consumer goods in the home (be it Lead, Arsenic, Antimony or whatever).
 

Knowledge is power

Once a family has this information, they can choose what, if anything, to do about it. However, I know from experience that if you have a child with health impairments that are suspected to be from Lead exposure, for example, as a parent it can provide huge peace of mind to remove everything from the home that has any amount of Lead!
 
My husband calls this the “shotgun approach”: While you might not know a specific source of a confirmed exposure, or how much of a role a particular source has played in the total overall exposure, or you may not even know which heavy metal might be causing which health impacts — knowing you can make choices and having the knowledge of what you can remove from your home (if you so choose) to reduce identified potential exposure sources is a powerful tool.
 

A baseline can be an important tool, too

Separately, it is my opinion (again, not as a doctor but as a mother of Lead-poisoned kids) that it’s always good to have a baseline test for yourself or your child.
 
While the medical community is still (or “still” as of 2013 per the article linked above) not 100% certain about the potential health implications of these sorts of tests (hair tests or provoked/ unprovoked urine tests), having a baseline test for a specific person that can be compared to a later test for that same person (either after a known or suspected exposure incident or after elimination of potential exposure sources) seems to be a useful tool.  
 
As parents of Lead poisoned children, my husband and I always regret that we did not have a baseline blood Lead test for our children (from before the incident that acutely poisoned our son Avi). Our county was not making this sort of testing widely available to the community before our children were poisoned and our doctor never once offered to test our children (in my 9 years of parenting before my children were poisoned). Having a baseline (which may come out as negative) is a valuable tool in anyone’s health journey (again, as overseen by a doctor)!
 
As always, thank you for reading and for sharing these articles. Please let me know if you have any questions.
 
Tamara Rubin
#LeadSafeMama
 
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10 Comments

  1. Very insightful article!! Wondering if you’ve heard of this laboratory which conduct heavy metals testing via urine or a drop of blood using a lancet, all taken at home and available direct to consumer??
    https://www.zrtlab.com/test-specialties/heavy-metals-nutrients/
    They say they use mass spectrometry, not sure how accurate if only using a drop of dried blood from prick vs traditional venous draw. I believe the prick test analyzers are known to come back higher than when done venously? Anyway, perhaps there’s some opportunity for an affiliate relationship, if you like their testing. You have all the moms/followers who would love to order direct and monitor children’s levels over time which is hard since blood draws r no fun for kids and doctors push back even ordering them. Also, I couldn’t t find a clinic that did the blood prick initial screening. Thanks for all you do!!!

    Reply

  3. This is quite helpful for parents trying to do what’s best for their child. I think it’s also very helpful to inform parents that lead testing for children is usually free, under health insurance. Thanks to Obamacare, even high-deductible HSA plans offer free, preventative care, such as annual physical exams and vaccinations. Under age 18, I think lead testing is considered part of a regular physical, if the parent indicates they have a concern about possible exposure to lead. Last I read, doctors will do lead testing automatically if a child lives in a zipcode identified as high risk for lead exposure.

    I fear that many parents would like for their kids to get tested at some point, but don’t realize it’s free, for now, on their health plan. All they have to do is ask their pediatrician for it.

    Reply

  5. Tamara,
    Thank you for the work you’re doing and the awareness you’ve created. I am interested in learning more about exposure paths or methodologies. The presence of a material is certainly a concern but understanding and learning to prevent exposure is key for me. Any reference you can share would be appreciated.

    John

    Reply

  6. I have never heard of these tests being discredited per se as analytical lab methods are very well advanced–just potentially difficult to interpret the results because you have to have baseline data to compare against and urine is very short term and hair is comparatively long term. High results can be eyeballed but lower level results have to be compared against baseline levels based on the heavy metals that normally occur naturally in fruits and vegetables as well as other daily environmental exposures. A person who does organic food growing in undepleted soils is generally going to have higher heavy metals levels that someone who lives on mostly processed foods but the former is necessarily going to be unhealthier than the latter–the opposite should be true. So it takes an experienced practitioner to interpret the results and not unnecessarily raise red flags when the measured levels could reflect normal healthy living with the unavoidable daily uptakes in our somewhat polluted environment we live in.

    Reply

  7. Good article. My integrative doctor that believed in this testing explained the benefits of doing an unprovoked urine test and a provoked urine test. If the body is not releasing toxins like heavy metals well, the unprovoked may only show low levels which can be deceptive. If followed by a provoked test it will show what the body has stored in tissue and bone. It’s important to do both to get a clear picture.

    Reply

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