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Mark Hyman, MD
Practicing physician and pioneer in functional medicine
Posted: March 13, 2010 10:34 AM
After my recent blog on mercury, I'm sure many of you are depressed and discouraged about mercury and its toxic effects. The bad news is today I am going to review more of mercury's toxic effects and expand on what I learned at the medical conference on mercury I mentioned in my last blog ...
But the good news is I will provide you with a clear, three-step plan to help your body detoxify from mercury and other heavy metals and recover your health. I have used this same plan successfully and safely with hundreds and hundreds of patients over the last 10 years -- and it's the same process I used myself to overcome mercury toxicity!
But first, let's look at the data presented at "The Impact of Mercury on Human Health and the Environment" conference.
Mercury and Autism: Part One
Last year, I talked a little bit about the link between mercury fillings and autism. Now I'd like to discuss mercury's effects on this condition in greater detail.
Boyd Haley, Ph.D., from the University of Kentucky Medical Center, is a vociferous opponent of dental amalgams. The toxicology literature and decades of his own research fuel his fervor.
The National Institutes of Health (NIH) funded his research for 25 years until he began to seriously call into question the safety of dental amalgams, the use of thimerosol (another form of mercury) in vaccines, and their correlation with autism.
His work is now funded by the private Wallace Foundation, run by the son of President Truman's vice-president, Henry Wallace, who died of ALS and who had been frequently exposed to mercury-containing fungicide on grain.
Dr. Haley believes that fish is not as big a contributor to mercury toxicity in humans as amalgams because methylmercury is generally excreted quickly while mercury vapor from amalgams is not.
At the conference he reported on the dramatic rise in autism rates. The numbers were stunning -- over 900 percent in less than a generation in California and 714 percent nationwide. The dramatic increase in autism rates in California was due in part to the introduction of the hepatitis B vaccine in 1990 and an increase in the overall vaccination schedule.
In 1999, thimerosol was removed from these vaccines as parents gained increased awareness of the danger it poses. You see, thimerosol is quickly converted to ethyl mercury in the body, where it moves rapidly from your blood to your brain. In the first three quarters of 2004 -- five years after thimerosol was removed from vaccines -- the data showed a decline in the incidence of autism in California for the first time.
Dr. Haley has observed that the lowest level of mercury is found in the birth hair of the most severely affected autistic children (i).
Interestingly, the four to one ratio of autism in males to females may, in part, be due to the effects of testosterone on mercury excretion. Antibiotics also prevent excretion of mercury, and antibiotic use is higher among autistic children.
Dr. Haley also reported on data showing a synergistic effect of heavy metals. For example, the dose of lead and mercury that would cause death in 1 out of 100 people is magnified when you are exposed to both lead and mercury, leading to a lethal dose 100 percent of the time when combined, even at low levels. You can find more information on this at Dr. Haley's website: www.trustfoundation.org.
As compelling as Dr. Haley's presentation was, it is only the beginning of the story that connects mercury exposure to autism ...
Mercury and Autism, Part Two
Jane El Dahr, M.D., is the Chief of Pediatric Allergy, Immunology, and Rheumatology at Tulane University Health Sciences Center. She also discussed the possible link between thimerosol in vaccines and autism. (The data she presented is available at www.safeminds.org). In California, rigorous standards for reporting autism have been put in place because social benefits are tied to accurate diagnosis -- so the increases there are very likely to be accurately recorded.
During the first 25 years this reporting was put in place, 6,527 cases of autism were reported. But then the rates skyrocketed. It took only 3 years during the 1990s to add another 6,596 cases. From 1987 to 1998 there was a 273 percent increase in autism cases in California!
In response, the Centers for Disease Control (CDC) and the American Academy of Autism released an "Autism Alarm" stating that 1 in 166 children in the US have autistic spectrum disorder (ASD). Currently, one-sixth of all children under the age of 18 have a developmental disability. That means nearly 20 percent of the population may suffer from this problem and may not be able to be productive members of society as a result.
Much of this could be due to mercury toxicity.
That's not just a guess -- it's based on the analysis of the actual doses of thimerosol received by children after the change in the vaccination schedule mentioned above. In people with a genetic susceptibility, such as a defect in the enzymes responsible for detoxifying heavy metals, prenatal and early postnatal exposure to mercury leads to neurologic damage resulting in autistic symptoms (ii).
Acrodynia, or "pink baby syndrome," from exposure to calomel or mercury in teething powder has similar symptoms to autism, providing us yet another link between mercury exposure and autism.
Other potential sources of early exposure in fetuses or infants include maternal amalgams, fish consumption, eardrops, and nasal drops. But vaccines may be more problematic than all of these. They present a significant source of mercury exposure in Rho-gam, influenza vaccines during pregnancy, and childhood immunizations.
It has been found that the maximum exposure from these vaccines in the first six months of life is 187.5 micrograms of mercury -- far exceeding limits set by the World Health Organization (WHO) and The Environmental Protection Agency (EPA).
According to the EPA, the "safe" daily level of mercury exposure for a five kilogram, two-month-old infant is 0.5 micrograms or 0.1 micrograms per kg. But these limits are set for methyl mercury primarily from fish, not for ethyl mercury from vaccines. The typical two-month vaccination schedule for a baby includes DTP, Hib, and HepB. Combined, these vaccines contain 62.5 micrograms of mercury.
That's a whopping 125 times the EPA limits for a single day exposure!
Like lead, there may be NO safe level -- and children are more susceptible to toxic effects than adults.
Dr. El Dahr said that there appears to be correlation between immune system malfunctioning in both autism and mercury toxicity. These specific immune abnormalities have been found in 30 to 70 percent of autistic children.
So what do we do about all of this mercury in our children and the resulting health problems?
Mercury in Children: Assessment, Diagnosis, and Treatment
Stephanie Cave, M.D., is on the clinical faculty of Louisiana State University Medical School, and since 1996 has treated over 2,300 children with autistic spectrum disorder. Her recent book, What Your Doctor May Not Tell You About Children's Vaccinations, outlines the data and debate in this highly charged field.
Dr. Cave reported on the increased incidence of autism in the last 30 years -- up from one out of 10,000 children to one out of 150 children and one of just 30 males in the United States.
The major toxicity from mercury that contributes to this epidemic, she said, is its ability to severely inhibit enzyme function and structural integrity.
At the conference, Dr. Cave critiqued a well-publicized study in the Lancet, which concluded that there was no toxic effect from thimerosol. She pointed out numerous problems with this study, including the fact that it used various amounts of thimerosol exposure and only involved 33 people.
Another study published in the Journal of the American Medical Association also reported no increased risk of autism with thimerosol (iii). But the problem with this study was that the authors were affiliated with the state-run Statens Serum Institute. Eighty percent of the Institute's profits are from vaccines! The methodology was also called into question because of inconsistencies in their reporting system (iv).
Yet another study had even more ominous findings. A case control study of 221 children with autism and 18 controls found that after a DMSA challenge test, vaccinated autistic children had THREE times the level of mercury in their urine compared to controls (v).
The question that remains is how these kids with ASD should be treated. Dr. Cave reviewed her approach ...
Besides taking a developmental history, she does a thorough laboratory evaluation, testing for numerous things. Her treatment protocols include casein- (from dairy), gluten-, allergy- and seafood-free diets, removal of amalgam fillings, and detoxification support.
Key to the treatment is careful detoxification of heavy metals after repletion of cellular nutrients, repair of gut dysfunction, and enhancement of liver detoxification chemistry. Supplements and treatments may include multivitamins and minerals, essential fatty acids, magnesium, digestive enzymes, Coenzyme Q10, and antioxidants like selenium, zinc, and vitamins C, E, and A.
She also suggests bowel ecology restoration which may include anti-fungal drugs, antibiotics, herbs, probiotics, and glutamine.
Enhancement of liver detoxification is facilitated by Epsom salt baths, magnesium sulfate creams, and oral, intravenous, or topical glutathione.
Mercury and other heavy metal detoxification is achieved after a DMSA provocation challenge of 20mg/kg with a 10-hour urine collection. DMSA is given at a dose of 10mg/kg every eight hours for three days, with 11 days off. The cycle is repeated four times, followed by another provocation challenge test.
The results of this protocol were impressive. Dr. Cave presented a number of cases where these treatments showed significant benefit and reductions in autistic symptoms!
But autism isn't the only disease related to mercury toxicity. There are many others.
Mercury and Adult Illness: From Alzheimer's to Heart Failure
We've now seen the devastating effects that mercury toxicity can have on kids. The effects on adults are no less severe.
Robert Nash, M.D., is a practicing neurologist and the Chairman of the American Board of Metal Toxicology. At the conference, he reviewed mercury-associated diseases, mechanisms, controversies, and therapeutic options.
He suggests the toxic effects of mercury spread across a broad spectrum of diseases including autism, Alzheimer's disease, ALS, multiple sclerosis, Parkinson's disease, neurodevelopmental diseases, nephrotoxicity, and cancer.
The mechanism of mercury toxicity in the adult brain may be related to proteins involved in mercury excretion, including glutathione, glutathione transferase, metallothionine and ApoE. Mercury depletes glutathione and ascorbate (vitamin C), and inhibits thiamine (B1) and pyridoxine (B6).
Mercury can also affect the central nervous system by concentrating in the spinal fluid, and the kidneys by reducing concentrating capacity. And it inhibits nerve growth, and passes easily through the placental barrier. The chemical can also reduce nerve function and communication, which can lead to the development of neurofibrillary tangles -- a common feature of Alzheimer's. In fact, recent findings suggest that the gene Apo E 4 may increase the risk for Alzheimer's because it has an impaired ability to bind with mercury and transport it from the brain.
Dr. Nash suggests that most, if not all, abnormal biochemistry in the Alzheimer's brain can be mimicked by mercury. He further concludes that, biologically, the case of mercury as a cause of Alzheimer's disease is more complete than that for thimerosol-related causation of autism.
According to Dr. Nash mercury toxicity and retention is enhanced by factors found in the diet, antibiotics, other toxicants such as cadmium and lead, and genetic susceptibilities. So no level of mercury exposure from amalgams can be considered without risk!
In addition to the compelling evidence linking Alzheimer's to mercury toxicity, research shows it may also be linked to cardiovascular disease.
Two studies have reported increased risk of heart attack while another has shown no risk. And the data presented on heart failure from unknown causes is very compelling as well. Biopsy samples found 22,000 times the level of mercury in people with heart failure from unknown causes compared to controls whose heart failure was caused by virus, heart attacks, or high blood pressure (vi).
One of my patients had this exact problem. She had no reason for heart failure -- but at 62, she was facing a heart transplant. When I discovered that she had mercury toxicity and treated her, she began to thrive again. Her cardiac function dramatically improved by 130 percent!
Despite all this bad news about the effects of mercury, Dr. Nash concluded on an optimistic note ...
First, he suggested that there appears to be a subset of the population that cannot effectively excrete mercury and is at greater risk than the general population. This susceptibility is likely due to genetic differences, diet, exposure to other toxicants, antibiotic use, etc.
Given that susceptibility, he argued that mercury is a risk factor in many diseases -- but can be safely measured. And he said that the body can be detoxified of mercury, mitigating some of its toxic effects. Of course, more studies should be done to shed light on this important topic. But we are on our way to finding answers to this important health concern.
I know some of what I have reviewed these last two weeks was pretty science heavy. But I wanted to take the time to share this fascinating research with you because I believe it's so important. I want people to know that just because this topic is mostly ignored by conventional medicine and dentistry, it isn't any less critical or relevant to our health or our children's health.
More importantly: It CAN be treated!
In my practice, I have seen the benefits of detoxifying from mercury. My patients have recovered from dementia, chronic fatigue, fibromyalgia, Parkinson's disease, heart failure, diabetes, obesity, multiple sclerosis, depression, autoimmune diseases like colitis and rheumatoid arthritis, and many other problems. Of course, that doesn't mean that mercury is THE cause of these conditions, but simply one of the many causes that has to be considered.
So now that you understand the powerful effect mercury can have on your health, let's review how you know if you have mercury toxicity, and then how to treat it.
Diagnosing and Treating Mercury Toxicity
The first thing to understand is that identifying mercury problems and detoxifying from them (or any other kind of heavy metal poisoning) has to be done VERY carefully and under the supervision of a physician trained in the techniques of metal detoxification, but it can be done safely and effectively with an educated doctor's assistance.
What follows is a three-step plan to find out if you are suffering from mercury poisoning and detoxifying from it. Understand that this approach has to be done carefully and systematically to make sure you get your body ready for removing the metals.
Step 1: Getting Ready for Detoxification
This process can take a few months, and I can't stress enough how important this preparation step is. It is accomplished by optimizing your nutritional status and detoxifying ability. Once this is done you will begin mobilizing and binding the metals in your body and excreting them through your urine, bile, stool, and sweat.
Here is what I recommend to my patients.
1. Optimize your gut function. Eliminate the common food allergens (dairy, gluten, corn, eggs, etc.), taking probiotics and enzymes for one to two months before detoxifying.
2. Optimize your nutritional status for detoxification. Use healthy fats (omega-3 fats, olive oil, and flax oil), amino acids (which boost all your liver's detoxification capacity), and minerals, particularly zinc and selenium (which help your body detoxify metals).
3. Enhance your liver's detoxification pathways. Take folate and vitamins B12 and B6 and eating sulfur-containing foods such as broccoli, collards, kale, daikon radish, garlic, onions, and omega-3 eggs.
4. Start sauna therapy. Make sure you take adequate electrolyte and mineral replacements to prevent dehydration and mineral loss from the sweat.
5. Optimize elimination routes for metals including your urine, stool, and sweat. Use fluids, fiber, and saunas.
Step 2: Integrate Additional Steps to Support Detoxification
At this stage you can integrate the following to support your liver detoxification pathways even more:
• Alginate from seaweed (this binds to metal in the gut)
• Selenium, zinc, n-acetylcysteine, lipoic acid, milk thistle, and garlic
Step 3: The Metal Detoxification Period
• Find a biological dentist (www.iaomt.org) to evaluate the extent of your mercury fillings and options for replacing them.
This can be done slowly over time, but must be done VERY carefully and only under a trained biological dentist's supervision to avoid burdening yourself with more mercury during the removal process.
• Get a test to assess your total body load of mercury. This is called a challenge or provocation test. This is done with a doctor's prescription and under a doctor's supervision. The easiest and safest way to do this is to take 500 mg of DMPS in one dose first thing in the morning after emptying your bladder, followed by a six-hour urine collection. DMPS is a prescription drug and is not FDA-approved in the US, although it has been approved and used for decades in Europe.
The other option is to use DMSA, which is FDA-approved. It pulls out a lot less mercury and needs to be taken at a dose of 30 mg/kg for the challenge test. I find this is not as effective to get a true reading on what is in the body.
• Use binding agents to pull the mercury out of your body. There is a lot of controversy about the best way to do this. But after helping people detox from heavy metals for 10 years, I've found the safest and most effective treatment is oral DMSA.
It is taken as follows: One 100 to 250 mg capsule of DMSA orally three times a day before meals. Take it for three days. Then take 11 days off. Do this for six months. Then recheck your level of mercury through the challenge test.
• Do saunas daily -- especially on those days when doing DMSA.
• Consider getting intravenous vitamins and antioxidants for three months while undergoing this process this to administer glutathione, phospholipids, vitamin C, and B vitamins to boost detoxification. This is harder to get, but can help the process work better and help you feel better throughout the process.
• Drink enough filtered water and fluids to make urine clear.
• Make sure you have bowel movements twice a day. This is very important or you will reabsorb mercury from the gut. You can add ground flax seeds to shakes or foods, or take one to two 150-mg magnesium citrate capsules twice a day if you are not going regularly. You can also try even stronger laxatives if you have to such as senna or cascara.
• Consider whey protein to boost glutathione if you are not allergic to dairy.
Understand that I am simply sharing my experience and knowledge with you here. I recognize this is a controversial area. Unfortunately, there are no large controlled studies looking at this problem. I am working on getting studies on this and other areas of systems medicine and functional medicine funded so we can have better answers. For now, we have to go with what we know and the experience and knowledge of many physicians over many years of doing this.
Realize that we DO know how to help you detoxify effectively and deal with the effects of low level mercury toxicity! While it may be difficult you MUST find a doctor skilled at dealing with heavy metal toxicity to undergo the protocol above safely.
What I have outlined in this blog are only my guidelines. They may be the same or similar to what you find others are using. What is essential is that you get assistance. I DO NOT recommend you detoxify from mercury without a doctor's supervision!
But I DO recommend you find out if mercury toxicity is a problem for you. It is an essential step to achieving lifelong vibrant health.
Now I'd like to hear from you...
Are you surprised by the links between mercury and conditions like Alzheimer's disease?
Do you agree with childhood vaccinations? Why or why not?
Have you tried detoxifying from mercury? What was your experience?
Please let me know your thoughts by adding a comment below.
To your good health,
Mark Hyman, M.D.
(i) Holmes AS, Blaxill MF, Haley BE. Reduced levels of mercury in first baby haircuts of autistic children. Int J Toxicol. 2003 Jul-Aug;22(4):277-85.
(ii) S Bernard. Autism: A novel form of mercury poisoning. Medical Hypothesis. 2001:56 (4): 462-471.
(iii) Hviid A. Association between thimerosal containing vaccine and autism. JAMA. 2003; 290: 1763-1766.
(iv) Rimland B, Bernard S. Letters. JAMA. 2004; 291:180-181.
(v) Bradstreet J. A case-control study of mercury burden in children with autistic spectrum disorders. Journal of American Physicians and Surgeons. Volume 8 Number 3 Summer 2003.
(vi) Frustaci A, Magnavita N, Chimenti C, Caldarulo M, Sabbioni E, Pietra R, Cellini C, Possati GF, Maseri A. Marked elevation of myocardial trace elements in idiopathic dilated cardiomyopathy compared with secondary cardiac dysfunction. J Am Coll Cardiol. 1999 May;33(6):1578-83.
Mark Hyman, M.D. practicing physician and founder of The UltraWellness Center is a pioneer in functional medicine. Dr. Hyman is now sharing the 7 ways to tap into your body's natural ability to heal itself. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on Youtube and become a fan on Facebook.