Thursday, November 11, 2010

Mercury in the body . . .

My naturopath wanted to test me for mercury. Mercury contamination, he said, is a major cause of rheumatoid arthritis, thyroid problems ("I cannot state 100%, but I am quite sure . . . almost with 100% assurance: Every patient of mine who has suffered a thyroid problem, whether hypo- or hyper-, autoimmune or otherwise, I have found to have elevated levels of mercury in the body.") . . . indeed, many of the issues I have faced or am facing right now.

He said there are two ways of testing for mercury. One is called unprovoked; the other, provoked. The unprovoked test simply measures how much mercury is excreted in a person's urine over a 24-hour period; the other uses a chelating agent (my naturopath prefers an infusion of DMPS (sodium salt of 2,3-dimercapto-1-propane sulfonic acid)) to "provoke" the release of mercury and then a collection of urine.

"The problem with an unprovoked test is that mercury and other heavy metals have very strong affinities for different organs within the body. Once there, they don't let go. They do their damage, but you won't necessarily find them floating around in the body for excretion. You have to use agents to get them to release from the tissues where they are hiding." [Understand that I'm not quoting him exactly. But I am attempting to give the gist of what he said.]

Based on his input, I agreed to have the test. But I thought I would ask my conventional doctor at Kaiser whether he would authorize a test. Maybe I could save some money if I could get the test through my insurance provider!

To my mild astonishment, my Kaiser doctor agreed and set me up for that test in addition to a few others--one of which, also, is urine-based.

One minor complicating factor: the other urine-based test requires a different collection bottle. So I would have to collect urine for two days.

I figured that would be fine. I would get the microalbumin collection done one day, turn it in to the Kaiser lab, get the chelating agent injection after that from my naturopath, then do the urine collection for the mercury.

So I finished my microalbumin collection and turned it in, went to my naturopath, and then found him discouraging me from using Kaiser for the mercury test: "If you have any elevated levels of mercury within you, you will shock your doctor. He is used to unprovoked, unchelated numbers." And, moreover, "chelated urine collection should proceed for only 6 hours."

"That's fine," I said. "So I will simply not do the collection for Kaiser."

Four days later, however, I got my test results from Kaiser and the lab had analyzed the one collection for both microalbumin and mercury.

Mercury was at less than 4 mcg/L, well within the "standard range."

Well, by that point I had long since turned in my 6-hour collection of chelated urine.

I just got those results. Mercury: 29 mcg/g creatinine. Reference range (based on unchelated/unprovoked tests): less than 3 mcg/g creatinine--so about 10 times higher than "acceptable." Cadmium and Lead, too, were high (though just--and I mean "just"--outside the reference range. Antimony was at the top edge of the reference range. Everything else was either undetectible (11 metals) or well within the acceptable reference range (6 metals).

I just had hair, blood and another small urine sample sent to a different lab to determine whether the mercury in my system is methylated (from organic sources--most likely fish) or inorganic (amalgam tooth fillings? broken mercury thermometers? playing with the stuff when I was a kid? a broken fluorescent bulb?). The tests are also supposed to determine whether my kidneys are up to handling a heavy release of mercury if we go forward with chelation therapy.

Meanwhile, I realize I have some research to do. (Is that surprising?) What I have discovered in just the last few hours has put me in a mood to look for some alternative to the therapy--DMPS infusions (one per week for four weeks, then one every-other-week for six weeks)--my naturopath is suggesting.

Of minimal concern, frankly, is the fact that DMPS is not approved by the FDA. The FDA is not necessarily the world leader in pharmaceutical evaluation. DMPS, I am given to understand, is (and has been, for quite some time) used rather commonly in Germany.

More disturbing to me are other claims against DMPS chelation. For example:
  • There are numerous reports concerning the toxicity of DMPS (despite Dr. John Cline's remarks about its safety being so great that it is freely available, without a prescription, in Germany). (One alarming collection of anecdotes may be found here.)
     
  • There are far fewer such adverse reports for DMSA by mouth, I am told.

    And while we're talking about DMSA, we ought to note that . . .
     
  • DMSA is FDA-approved. Whereas, as already noted, DMPS is not.
     
  • DMSA (according to some sources) is more effective than DMPS for removal of mercury, lead, and arsenic.
     
  • DMSA passes the blood-brain barrier and removes mercury; DMPS does not. (Methylmercury is especially attracted to and toxic to neurons, so having a chelating agent that can cross the blood-brain barrier is extremely important!)
     
  • DMSA is much more convenient to use. ("The usual adult dose for mercury removal is 500 mg DMSA (five 100 milligram capsules) on an empty stomach on first arising in the morning with a glass of water or juice, and no food for another 30 minutes. This dose is taken 3 days per week with at least one day between each dose. Monday, Wednesday and Friday is a convenient schedule. This is continued for 3 months. Then wait another month without DMSA before retesting mercury levels" (John A Cranton, ARNP). My naturopath, meanwhile, has told me that DMPS chelation will take 10 injection/infusions over the course of a minimum of 16 weeks (four months).)
     
  • DMSA is much less expensive. Between the cost of the DMPS and the doctor's office charges, I understand, DMPS is at least 10 times more expensive.
     
  • And then, of course, there is the fundamental charge that provoked testing is simply a bunch of poppycock to begin with. (A charge countered by others that "[t]he quantity of heavy metal returned [by the provocation test] has generally correlated well to the symptom severity of the patients [they] have seen. Furthermore, the changes in metal excretion with this provocation test have corresponded well to the changes in symptom severity of the patients [they] have seen" (Mercury Toxicity and the Use of DMPS Chelation, John C. Cline, MD, Medical Director, Oceanside Medical Clinic)
But when all is said and done, I am struck with the claim by Elmer M. Cranton, MD, that "Scientific research shows that once a source of excessive mercury exposure is eliminated, half of the remaining mercury in the body is excreted naturally in less than 3 months, with no treatment whatsoever. Even methyl mercury is naturally eliminated from the brain. Mercury is eliminated normally in urine, feces, hair, skin, sweat, bile, etc. One year after excessive exposure has been eliminated, 95 percent or more of the excess mercury is gone from the body with no specific treatment."

I sense Jana's summary of what should--or should not--be done with DMPS is level-headed and appropriate. If you're considering DMPS therapy, I strongly encourage you to read her brief article.
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