After absorption lead in the body traverses the vascular space with some lead excreted by the kidney and some being deposited in bone. Once deposited the lead can persist for years. During periods of increased bone turnover the lead may be mobilized.
Increased bone turnover can be seen in:
(1) hyperthyroidism
(2) hyperparathyroidism
(3) pregnancy and lactation, which can impact the fetus
(4) osteoporosis
The diagnosis of lead toxicity can be challenging because:
(1) the exposure to lead may have been decades ago
(2) the amount of lead may fluctuate based on the rate of burn turnover
L x-ray fluorescence can measure the amount of lead in bones.
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