Hair Test Interpretation: Finding Hidden Toxicities
by Andrew Hall
Cutler,
PhD, PE
(c) 2004, 2008 Andrew
Hall
Cutler
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Mercury poisoning is the
most common
heavy metal problem. It is also
difficult to diagnose because the exact problems it causes vary so much
from
person to person. There is also some confusion in the health care
community as
to how to interpret clinical laboratory test results.
There is intense controversy because the major cause of
mercury poisoning today is health care and many doctors understandably
find
this very upsetting. Given these
factors I am including a separate fairly long section on mercury. Additional descriptions can be found on
pages 25-29 of Amalgam Illness:
Diagnosis and Treatment or in the medical
literature1.
Reviewing some of the key factors noted in standard medical texts is a good place to start. Medical textbooks are conservative in the material they present. Controversy regarding the nature of mercury poisoning or the lack of utility of certain tests to detect it may be due to the emotionally charged nature of this subject, not to medical or scientific questions.
Erethism is generally mentioned
as the most
common and important finding in mercury poisoning.
Clinical Toxicology, Ford, first edition,
2001: "Erethism is a constellation of
signs
and symptoms, including shyness, emotional lability, nervousness,
insomnia,
memory problems, and inability to concentrate. "
Merritt's Textbook of
Neurology,
ninth edition 1995: "the psychological
changes which include timidity, seclusiveness and irritability have
been
referred to as ˜erethism."�
Textbook of Medicine, Cecil, seventh edition
1948: "Erethismus mercurialis, a peculiar psychic disturbance
characterized
by ready excitability
and a strange shyness in the presence of strangers, a symptom of great
interest
and importance; insomnia; headache; vertigo; mental depression and
dullness;
and, rarely, hallucinations."�
Erethism is the
constellation of
personality changes that appear early on in mercury poisoning, often
before
other symptoms are present.
Textbook of Clinical
Neurology,
Goetz, first edition, 1999: "Personality
changes can develop before
neurological signs appear. So-called "mercurial neurasthenia" may
develop for weeks or months before the patient seeks treatment. This
syndrome
consists of extreme fatigue, hyperirritability, insomnia, pathological
shyness,
and depression."�
I have included a
description of
mercury poisoning from an older textbook written in the days when
occupational
poisoning was common and doctors had to rely on clinical skills rather
than lab
tests to make good diagnoses.
Textbook of Medicine, Cecil, seventh edition
1948: "Tremors of the orbit, lips, tongue,
fingers and limbs. These are usually
moderately fine at first, but at intervals become a coarse and jerking. They may become very severe and in rare
instances involve contractions of the limbs of such violence as to
require
restraint. The tremor is
intentional and subsides during rest. Under
observation it may increase and diminish, rhythmically
recurring. When it is marked, the
patient may require assistance in eating and in other activities. Weakness of both the flexor and
extensor muscles of the hand and forearm has been reported, but marked
paresis
is rarely, if indeed ever, caused by mercury. Polyneuritis
is said to result occasionally from exposure to
mercury. No ataxia occurs and
reflexes are not notably affected."�
Modern medical textbooks
also make
it clear that mercury from "silver2"�
fillings is a potential hazard to both dental patients and the people
who work
in the dentist"™s office.
Harrison"™s textbook
of
internal
medicine,
14th edition 1998: "Low-level exposure from dental amalgams may
also be associated
with
adverse immunologic reactions."�
Cecil Textbook of
Medicine,
21st edition, 2000, "10% of
dental offices have excessive mercury vapor
levels; and accidental spillage can lead to mercury poisoning."�
Textbooks and journal
articles cover
some of the basic biochemical phenomena underlying mercury"™s ability
to
affect
the body in a wide variety of ways.
Textbook of Clinical
Neurology,
Goetz, first edition, 1999 lists
the following in a table on the effects of different heavy metals under
mercury: "Alters cell membranes; causes combination of: metabolic
disturbance,
disturbance of Ca+2 homeostasis,
oxidative injury, aberrant protein phosphorylation."�
In the journal Endocrinology, volume
89,
number 6, pages 1489-98 (1971) an article entitled Effect
of Mercury on Response of Isolated Fat
Cells to Insulin and Lipolytic Hormones by Jack M. George shows how
mercury
has physiological effects that can cause exactly the constellation of
problems
seen in type 2 non insulin dependent diabetes "“ elevated blood sugar,
insulin
resistance and weight gain.
One very important
question is
whether you have to continue to worry about mercury if a doctor has
told you
that you definitely don"™t have a problem with it, or that you have
something
else. Standard medical textbooks
make it clear that mercury poisoning is hard to diagnose and easy to
mistake
for something else.
Cecil Textbook of
Medicine,
21st edition, 2000: "With
mild exposure, the manifestations are likely to be subtle
and
diagnosis is difficult. Insomnia, nervousness, mild tremor, impaired
judgment
and coordination, decreased mental efficiency, emotional lability,
headache,
fatigue, loss of sexual drive, and depression are early manifestations
and are
often mistakenly ascribed to psychogenic causes."� In a separate
section, Cecil also says
"Chronic metal intoxication may also produce a dementing
syndrome."�
Clinical Management of
Poisoning
and Drug Overdose,
third edition, 1998, Haddad, Shannon and Winchester, eds.
"Chronic mercurialism may be
misdiagnosed as Parkinsonism, depression or Alzheimer"™s disease."�
Merritt"™s Textbook of
Neurology,
9th
edition, 1995: "Because of the prominent motor manifestations,
confusion with
ALS3 can occur."�
Because mercury poisoning
is hard to
diagnose, many doctors may order blood or urine tests for mercury. Textbooks point out that this is not
helpful.
Cecil Textbook of
Medicine,
21st edition, 2000, "Because
of the body"™s metabolism of mercury, blood and
urine levels may be unreliable."�
Textbooks are also clear
on the fact
that some children are very sensitive to mercury and become poisoned at
low
levels that don"™t bother others.
Clinical Toxicology, Ford, first edition,
2001: "Acrodynia ... Although
it is most often postulated
that the etiology of this syndrome is an idiosyncratic hypersensitivity
reaction
to mercury because of the lack of correlation with mercury levels, many
of the
symptoms resemble recognized mercury poisoning."�
With medical textbooks
saying that
mercury poisoning is difficult to diagnose and can cause a wide variety
of
problems, a thorough description of it is necessary.
Mercury"™s effects on
thought and
emotion cause the most troubling symptoms.
Mercury poisoning changes
people"™s
emotional responses to things.
Irritability, argumentativeness, avoidant behavior, anxiety,
shyness, being
easily embarrassed, and a desire to avoid strangers lead to social
withdrawal
and makes it difficult for them to relate to others. The victim
generally feel
that their behavior patterns are appropriate even when this is clearly
not so.
The argumentativeness may
reach the
point where it is impossible to hold a job or maintain most social
relationships.
Fatigue, lassitude and
depression
further limit social interaction.
The depression brings feelings of futility, hopelessness,
discouragement, and impending doom.
Minor problems become overwhelming and insurmountable, while
these
emotional changes themselves are frightening.
Feelings of enjoyment and
happiness
become less and less common. There
is no motivation for important tasks, fun activities, or day to day
routine.
Intelligence gradually
deteriorates. Previously bright
persons become dull and slow thinking.
They suffer from a progressive decline specifically affecting
short term
memory as well as the faculties for logical reasoning.
Thus their ability to do things like
balance the checkbook, do
math, or play chess suffers.
Thoughts become heavy, repetitive and pedantic.
Creative thinking becomes progressively more difficult.
Verbal expression suffers from an
inability to select the right words to convey their meaning.
"Brain
fog"� sets in with a poor ability to concentrate and
pay attention.
Men frequently become
quietly
depressive and withdrawn while women more often become anxious, shy, fearful and high strung.
Symptoms come and go over
a period
of months or years. Life seems to
progress in fits and starts, with periods of productivity and social
enjoyment
coming less and less often as poisoning progresses.
In severe cases, mercury
poisoning
can cause psychosis. Psychosis interferes with a person"™s thinking,
emotions,
memory, communication, behavior and interpretation of reality. When sufficiently impaired in all these
areas that they can not meet the ordinary demands of life, a person is
psychotic.
Psychotic people often
have very
disorganized behavior which may be childlike or infantile, an
inappropriate
mood for the situation they are in, poor ability to control their
impulses,
speak in an incoherent jumble of words, and may have delusions and
hallucinations (usually without an understanding of the fact that these
are not
real). Thought processes are often
quite disrupted, with the psychotic person"™s train of thought seeming
perfectly
logical to them but being at best very loosely connected as far as
anyone else
is concerned.
Mercury can impair the
brain"™s
electrical regulation and cause epilepsy (either grand mal or petit mal
varieties). Poor electrical
regulation that is not bad enough to cause epileptic seizures can cause
impulsivity
and sudden strong emotions not rationally related to what is going on. It can also cause sudden confusion or
disorientation or loss of train of thought.
Mercury affects the
senses. The most well known effect is
numbness
in the hands, feet, and around the mouth (the medical term for this is
stocking
and gloves parasthesia). There can
be a generalized reduction in sensitivity to touch and pain which is
often more
pronounced in children.
The sense of smell
becomes less
acute. While the ability to
perceive sound is not reduced the person loses the ability to pick
meaningful
sounds out of background. For
example, they are not able to understand speech directed at them at a
party, or
if music is playing.
The ability to focus the
eyes and to
control the iris progressively deteriorates, as
does convergence - the ability to bring both eyes to bear
on nearby objects so as to see one object with depth perception rather
than to
have double vision. People with
convergence problems have difficulty keeping their place while reading
and find
reading for long periods quite tiring.
Color vision may also
become less
acute and colors do not appear as bright.
Mercury poisoned children
typically
have learning or developmental disabilities and trouble relating to
peers. The poor visual convergence and
accommodation due to mercury poisoning is a common cause of dyslexia
and
reading difficulties.
Children who are poisoned
in infancy
or before birth may have hyperextensible joints, hypermobile hips, and
may lay
in crib with their feet up by their head.
Early physical symptoms
include
dizziness, tinnitus (ringing in
the ears), insomnia and daytime
drowsiness. The biological clock
runs slow. The poisoned person"™s
body wants to wake up late and stay up late. It
takes them a long time to "get going"� in the morning.
There may be a tendency
towards
diarrhea - often alternating with constipation, cold
hands and feet,
a tendency towards sweating (some people have the opposite
symptom and
do not sweat at all, which is more common in women), flushing or
reddening of
the skin - particularly on the face and neck. Some people blush
frequently, but
others do not blush at all..
Digestive disturbances are also common.
The skin becomes dry, athlete's foot and toenail fungus
progress, and the insides of the
ankles, particularly behind the ankle bone and a bit above it become
dry, itchy, flaky
and peel.
This becomes annoying enough to keep the victim up at night. There may also be hair loss.
Hair may thin out or it may fall out in
patches leaving bald spots.
Tremors eventually appear. There may be twitching of the
eyelids. Poor coordination of the
lips and tongue may render speech more difficult to understand.
Handwriting
deteriorates and eventually becomes illegible.
Mercury affects the blood
coagulation mechanism and leads to easy bruising and bleeding in some
people.
Women with mercury
problems often
have menstrual problems, irregularities, and may suffer from
infertility.
Mercury also interferes
with the
brain"™s regulation of water balance and causes excessive urination.
Mercury can reduce the
function of
the adrenal and thyroid glands.
Typically it does this enough to make the person miserable, but
not
enough to make laboratory tests abnormal.
Mercury poisons the
immune system,
making fighting off minor illnesses more difficult. Immune
dysregulation can
also lead to increased allergy, asthma and other respiratory
complaints. It is
also a common trigger for autoimmune conditions such as lupus, multiple
sclerosis or rheumatoid arthritis. In physiologic terms, mercury
poisoning
causes an imbalance between T helper type 1 and T helper type 2 cells
along
with reduced activity of natural killer (NK) cells.
This is the same problem that zinc deficiency causes and is
most likely due to an acquired zinc deficiency caused by mercury"™s
derangement
of mineral transport.
Heart racing (the medical
term is
tachycardia) is quite common in people with mercury poisoning. The heart rate may vary dramatically
over a period of a few minutes for no apparent reason.
Heart pain (angina) may occur. Doctors
may hear intermittent heart
murmurs and may find a flattened T wave or a prolonged QT interval on
an
EKG.
Mercury induced
derangement of
mineral transport almost invariably results in reduced body zinc levels
(usually
reflected by high hair zinc levels), poor zinc absorption, increased
loss of
zinc in the stool and urine, and difficulty concentrating zinc into
cells where
it is needed. People with low zinc
due to mercury problems typically need levels of zinc supplementation
that
would be excessive in normal individuals.
Mercury toxic people tolerate high level zinc supplementation
for
prolonged periods of many years.
Deranged mineral transport also typically results in a need for
large
amounts of magnesium and molybdenum.
Sometimes manganese or selenium is also needed, sometimes
excessive
selenium is retained. Copper
levels are usually somewhat high and copper supplementation is usually
harmful.
Blood and urine
porphyrins are often
elevated in mercury toxic people though this test is seldom performed
It is not unusual for MCV
and MCH on
a blood count (CBC) to be mildly elevated (suggesting B-12/folate
deficiency
anemia) in people with mercury poisoning, even when they have more than
adequate levels of B-12.
The liver enzymes AST and
ALT (also
called SGOT and SGPT) may be mildly elevated when a "chemistry panel"�
test is
done on someone with mercury poisoning, though this is not the rule.
Cholesterol may go up
quite a bit in
the earlier stages of mercury poisoning. In
some people it later falls due to inhibited steroid
synthesis, typically in conjuction with inability to make enough
cortisol and
DHEA for their body"™s needs.
Blood sugar may go up
(and may be
diagnosed as type 2 diabetes) due to mercury poisoning.
In chronic mercury
poisoning there
is seldom any evidence of the kidney problems which are present in
acute
poisoning.
The most common result
from a
person"™s doctor ordering standard tests like a CBC, chem panel,
urinalysis and
thyroid test on someone with a fairly serious mercury poisoning problem
is that
all the tests come back normal, or close enough that the doctor
doesn"™t
consider the results significant.
In certain circumstances
mercury
poisoning may be recognized in an 'acute' phase. For
example, after placement of fillings which extend below
the gumline, after placement or
replacement of several fillings,
after placement of a dissimilar metal crown or bridge over or
against
amalgam.. In this earlier phase
there may be red blood cells in the urine, greatly
elevated urinary porphyrins leading to pink - not
red-tinged - urine, burning
urination, as well as the above
symptoms. Very high exposure
levels cause nausea, loss of
appetite and diarrhea. In general
acute poisoning leads to much more pronounced physical symptoms and
much less
pronounced mental and emotional symptoms. As time progresses the mental
and
emotional symptoms slowly increase.
1)
The
review by Gerstner
and Huff (Clinical Toxicology of Mercury, Journal
of Toxicology and Environmental Health
volume 2, pages
491-526 (1997) )
is particularly good. Also the
descriptions in the 1948 and 1955 editions of Textbook of Medicine by Cecil are excellent though more modern
editions
have less useful descriptions. Any
pre-1972 edition of Diseases of Occupations by Hunter also contains accurate and
useful
descriptions of what mercury poisoned people are like.
For a firsthand description of mercury
poisoning see http://www.stanford.edu/~bcalhoun/AStock.htm.
2)
Silver
amalgam fillings
are 50% mercury, and approximately 30% silver plus 20% other materials.
It
would be more accurate to refer to them as mercury fillings.
3)
ALS is
amylotrophic
lateral sclerosis, also known as Lou Gherig"™s disease.
In the United Kingdom it is referred to
as motor neuron disease.
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Read some excerpts from
the book: |
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|
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|
Other books of
interest (vaccines cancer autism hormone balance etc) |
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