Trace minerals panel

ND-recommended test reviewed: trace minerals panel.
Indications reviewed: fatigue, general wellness; no malabsorption or long-term nutrition-support risk factor identified.
Not ordered. Rationale discussed: no validated indication for routine trace-element panel screening without a recognized risk factor. Ref: ESPEN 2022 micronutrient guideline.
Patient informed test available privately via ND. Patient given info page: https://labs.ajaxharwoodclinic.com/trace-minerals/patient
Revisit if: a malabsorptive condition or long-term parenteral/enteral nutrition need is identified.

Indicated when

• —Monitoring trace-element status (e.g., selenium, zinc, copper) in a patient on long-term parenteral or enteral nutrition, with a malabsorptive condition, or with another recognized risk factor for micronutrient deficiency, as part of structured nutritional monitoring [1]

Not indicated when

• —Routine screening for fatigue, hair loss, or general wellness without a malabsorption, restrictive-diet, or long-term nutrition-support risk factor
• —As a branded 'intracellular micronutrient' panel (e.g., SpectraCell-type testing) to guide supplementation in a patient without a recognized nutritional risk factor: no source fetched in this session, including the prior nd-landscape.md sweep, verified this type of testing as validated or as commonly marketed through Ontario ND channels (see evidence_notes)

Why not

A generic 'trace minerals' panel bundles analytes (which can include selenium, manganese, chromium, and others depending on the lab) that individually have different evidence bases and different reasons to be checked. Ordered without a specific risk factor, this kind of panel is prone to returning borderline results for one or more of its many components, prompting supplementation or repeat testing without a clear clinical question being answered. The ESPEN micronutrient guideline notes that inflammation affects interpretation of micronutrient levels generally, which is a particular problem for a panel run with no specific illness context to interpret it against [1].

Better first step

If there is a recognized risk factor (long-term parenteral/enteral nutrition, malabsorption, bariatric surgery, restrictive diet), test the specific trace element(s) relevant to that risk (e.g., zinc, copper, selenium individually) rather than a broad, non-specific panel; the individual analytes (Cu, Zn, Mg) already have their own dedicated records in this catalogue.

Typical ND rationale

An ND may order a trace minerals or intracellular micronutrient panel reasoning that subtle mineral deficiencies (selenium, manganese, chromium, and others) can contribute to fatigue, immune issues, or metabolic problems that standard bloodwork misses, and that a broad panel is an efficient way to screen for this.

Ontario coverage & CONO orderability

OHIP status

uninsured

A generic 'Trace Minerals' or 'trace elements' line does not appear by name anywhere in the 2026 Schedule of Benefits for Laboratory Services (only individual analytes such as magnesium, zinc, and copper are separately listed, and are covered in this catalogue's own records). Selenium, manganese, and chromium likewise do not appear by name. This is recorded as unverified rather than uninsured, since the Schedule's individual mineral listings may cover component analytes ordered separately. Coverage update (reconciliation pass): LifeLabs' Non-OHIP Billable Test List (2025, republished by an Ontario hospital lab) lists this test as patient-paid in community labs. This is secondary evidence, not a ministry statement.

CONO orderable

Yes — CONO list #122

CONO list item 122, blood: 'Trace Minerals,' a single generic panel line. Selenium, manganese, and chromium do not appear as separate CONO line items under those names; if a patient's requisition lists one of them individually, it is not independently confirmed CONO-orderable in this session and should be treated as matching only the generic 'Trace Minerals' item 122, not a dedicated code.

Linked conditions

• tired ↗

Counselling script

“A broad trace minerals panel is mainly useful for people on long-term feeding support or with a condition that affects nutrient absorption. Does either of those apply to you? If not, I wouldn't order this panel for fatigue or wellness, since a panel with many minerals often turns up a borderline result that's hard to act on. Let's look at more targeted options if there's a specific concern.”

Revisit if

• —Long-term parenteral or enteral nutrition is started
• —A malabsorptive condition or bariatric surgery is diagnosed

References

1. [1]European Society for Clinical Nutrition and Metabolism (ESPEN) (2022). ESPEN micronutrient guideline. linkESPEN proposes structured monitoring and management strategies for trace elements and vitamins in at-risk diseases, noting the impact of inflammation on interpretation
2. [2]Ontario Ministry of Health (2026). Ontario Health Insurance Plan: Schedule of Benefits for Laboratory Services (effective April 1, 2026). linkCommunity lab tests are insured only when ordered under the Schedule by an authorized prescriber
3. [3]Government of Ontario (e-Laws) (2026). Health Insurance Act, R.R.O. 1990, Reg. 552: General, s. 22 (insured laboratory services). linkA lab test is insured only when ordered by a physician, midwife, or NP who has clinically assessed the patient
4. [4]Ontario Ministry of Health (2026). Ontario Health Insurance Plan: Schedule of Benefits for Laboratory Services (effective April 1, 2026). linkTests ordered by anyone other than an authorized provider, including NDs, are not insured services
5. [5]LifeLabs (republished by Norfolk General Hospital laboratory) (2025). LifeLabs Non-OHIP Billable Test List (republished by Norfolk General Hospital laboratory, effective 2025). linkListed as a non-OHIP (patient-paid) test at LifeLabs Ontario, 2025