Heavy Metal Toxicities(Chelation) Metals that have no safe amount in the human system may be stored within the body (fat cells, central nervous system, bones, glands, and hair) and may have negative health effects. Any level of these toxic metals is not normal. The level usually needs to rise above the established safety ranges to actually manifest in health problems. However, there is an individual variation and high normal levels may aggravate one person and not another. This is due to the genetic status and detoxification capabilities of each person. SYMPTOMS Wide varieties of possible symptoms exist. Any toxic metal in the body can manifest in a wide variety of confusing symptoms. Symptoms that manifest depend on the type of metal, toxicity, the age of the individual, that is, children are more susceptible to toxic metal damage, the extent of exposure, and the presence of antagonistic or productive elements that inhibit absorption, binding, and the effects of toxic metals. For example, calcium deficiency aggravates lead toxicity and the more normal levels of calcium in the body act to protect the system against lead toxicity. The most common heavy metal toxicities are lead, cadmium, mercury, and nickel. Aluminum is not a heavy metal and it’s absorbed and removed from the body by different mechanisms or may be associated with a metallic taste in the mouth. POSSIBLE SIDE EFFECTS OF EACH ARE THE FOLLOWING: Lead: Poor bone growth and development, learning disabilities, fatigue, poor test performance, irritability, anxiety, high blood pressure, weight loss, increased susceptibility to infection, ringing in the ears, decreased cognitive function, concentration, and spelling skills, headaches, gastrointestinal problems, constipation, muscle and joint pain, tremors, and overall general decreased immune functioning. Cadmium: poor concentration, irritability, headaches, high blood pressure, benign, usually noncancerous enlargement of the prostate gland, increased risk of cancer, hair loss, learning disabilities, kidney and liver disorder, skin disorders, painful joints. Mercury: Cognitive and memory problems, irritability, fatigue, insomnia, gastrointestinal disorders, irrational behaviors, numbness, tingling, muscle weakness, impaired vision and hearing, allergic conditions, asthma, and multiple sclerosis related to dental amalgyms. Also see University of Calgary’s web site for a video explaining how mercury fills dendrites in the brain, which may be one of the causes for increased Alzheimer’s now seen in this century. Nickel: Fatigue, respiratory illness, heart conditions, rash, psoriasis, frequent headaches. Aluminum: Headaches, cognitive problems, learning disabilities, osteoporosis, ringing in the ears, colic, hyperactivity in children, ataxia or abnormal walking pattern. Alzheimer’s disease is also worth noting. POSSIBLE ROUTES OF EXPOSURE TO AND CONTAMINATION FROM THE ABOVE METALS Lead: Cigarette smoke, using paint that is lead-based, especially in poor housing or older homes, using and cooking food in ceramic glazes that are lead-based,living in old homes that may have elevated lead air levels, contaminated water, canned food, especially fruit in lead-soldered cans, which leach lead into the food, certain bonemeal supplements, and insecticides. Cadmium: Cigarette and pipe smoke, instant coffee and tea, nickel cadmium batteries, contaminated water, fungicides, pesticides, and many plastics. Mercury: Mercury-based dental amalgam fillings, laxatives that contain calomel, some hemorrhoidal suppositories, inks used by some printers and tattoo artists, some paints, some cosmetics, and many products that contain small amounts of mercury, such as fabric softeners, wood preservatives, some drugs, and in some plastics and contaminated fish. Nickel: Many pieces of jewelry that contain nickel and are worn next to the skin create some absorption. Some metal cooking utensils have nickel added to them, even stainless steel, which is mostly common in cooking acidic foods. Cigarette smoke, hydrogenated fat (as nickel is the catalyst in manufacturing), some refined foods, and fertilizers. Aluminum: Aluminum-containing antacids, many over-the-counter drugs and boosters that contain aluminum, aluminum cookware, and aluminum foil, especially when preparing extra-acidic foods, antiperspirants, most commercial baking powders, and contaminated water. TREATMENT REGIMEN: It is very important to note that treatment regimens vary significantly and tailored to each specific individual’s medical condition and their circumstance of exposure. Providing a complete history of the person, including their occupation, hobbies, recreational activities, and environment, is especially critical in diagnosing heavy metal toxicity and note of amalgams is also important. Patients are always evaluated for the acute risk of chronic exposure. THERAPEUTIC MODALITIES TO REMOVE HEAVY METAL TOXICITIES: HEAVY METAL TOXIC PROVOCATIVE URINE CHALLENGE Therapies to remove heavy metal from humans include chelation and decontamination procedures, as well as supportive measures often used in examination. These therapies can be very complex and highly individualized, tailored to the specific needs of each patient. Chelation Therapy: Chelation is a chemical process with applications in many areas, including medical treatment, environmental site rehabilitation, water purification, and so forth. Chelation therapy, simply defined, is the process by which a molecule encircles and binds, or attaches to the metal, and removes it from the tissue. Depending on the drug used, chelation agents specific to the heavy metal evolved are either given intravenously or orally. Chelation agents used include DMSA and EDTA. DMSA is an old chelating agent and is used for lead and mercury toxicity. At times, DMPS is also used orally. EDTA is one of the oldest chelating agents, coming into prominence around the 1950s. EDTA has an affinity for mostly lead. The patient receives a provocative urine challenge with EDTA, DMPS, or DMSA. After review of the findings, the personalized program is instituted to level the patient’s heavy metal toxic load as much as possible. Chelation therapy is usually the treatment for mercury poisoning, using DMSA. Lead toxicity is usually treated with a combination of DMSA and EDTA. Aluminum toxicity is usually treated with EDTA. Cadmium responds to DMSA. PREVENTING HEAVY METAL POISONING Occupational exposure can be reduced by the engineering solutions that address the manufacturing process, collection or removing fumes, reducing dust, and substituting other materials where possible. For example, in recent years the pottery industry has replaced several of the components in their products that are used as dishes or food containers. In most the countries, laws have passed to detect workers setting limits. In the home, practical measures include raising the awareness of possible exposure. Think carefully about the necessity of having products that contain toxic metals around the house or in the garage, such as fertilizers, fungicides, insecticides, and related poisons. Lead-based paint, refinishing chemicals, household cleaners, hobby supplies, photographic chemicals, and batteries are also absorbed. Use alternatives when possible. Medicines and personal health care products should be stored well out of the location of children and products without mercury or heavy metals should be used. Avoid bringing toxic materials into your home or on your clothing or shoes. Consider the cumulative exposure from cookware, storage containers, medicines, foodstuffs, and the environment. Please remember that dental amalgams are 50% mercury and can be a major source of mercury toxicity in our fillings. Heavy metal toxicity and exposure to heavy metals is an increasing problem. Please call our office if you wish to have a heavy metal test or wish to have a consultation concerning this. Dean Silver, M.D.