Articles:

Mercury Part II: Getting rid of the poison...

by Mark Hyman, M.D.
December 5, 2006
www.ultrametabolism.com/blog/

After my last blog, I'm sure that many of you are depressed and discouraged about mercury and its toxic effects.

The bad news is, I am going to review more of these effects and the things I learned at the medical conference on mercury.

But the good news is, I will leave you with a clear plan on how to help your body detoxify from mercury and recover your health.

I have done this successfully and safely with hundreds and hundreds of patients over the last 10 years — and with myself!

Now, let's get back to the presentations from the conference.

Mercury and Autism, Part One

Last week, 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.

He reported the dramatic rise in autism rates.

The numbers were stunning — over 900 percent in less than a generation in California and 714 percent nationwide.

He reported on the dramatic increase in autism rates in California since the introduction of the hepatitis B vaccine in 1990 and an increase in the overall vaccination schedule.

In 1999, thimerosol was removed from vaccines as parents gained increased awareness of the issue.

In the first three quarters of 2004, the data showed a decline in the incidence of autism in California for the first time.

Dr. Haley also reported on the toxicity of thimerosol.

It is quickly converted to ethyl mercury in the body, where it moves rapidly from blood to brain.

He has observed that the lowest level of mercury is found in the birth hair of the most severely affected autistic children (i).

The 4 to 1 ratio of autism in males to females may be in part 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.

Mercury and Autism, Part Two

Jane El Dahr, M.D., is the Chief of Pediatric Allergy, Immunology, Rheumatology at Tulane University Health Sciences Center. She talked more about the possible link between thimerosol in vaccines and autism (the data is available at www.safeminds.org).

In California, rigorous standards for reporting of autism were in place because social benefits were tied to the accurate diagnosis — so the increases there are very likely to be real.

During the first 25 years of reporting, 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 additional cases. From 1987 to 1998 there was a 273% increase in autism cases in California!

The CDC and 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 is nearly 20 percent of the population who may not be able to be productive members of society.

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.

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.

Other potential sources of early exposure in the fetus or infant include maternal amalgams, fish consumption, eardrops, and nasal drops.

But vaccines may be even more problematic.

They present a significant source of mercury exposure in Rho-gam, influenza vaccines during pregnancy, and childhood immunizations.

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 WHO and EPA.

According to the EPA, the "safe" daily level of mercury exposure for a 5 kilogram, 2-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 2-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.

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 1 out of 10,000 children to 1 out of 150 children and 1 of just 30 males in the United States.

The major toxicity form mercury, she said, is its ability to severely inhibit enzyme function and structural integrity.

Dr. Cave critiqued a well-publicized study in "The Lancet" (ii), which concluded that there was no toxic effect from thimerosol.

She pointed out numerous problems with this study, including the facts 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).

The problem?

The authors of the study were affiliated with the state- run Statens Serum Institut. Eighty percent of its profits are from vaccines!

The methodology was also called into question because of inconsistencies in the reporting system (iv).

Another study had 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).

So how should kids with ASD be treated?

Dr. Cave reviewed her approach.

Besides taking a developmental history, she does a thorough laboratory evaluation, testing for numerous things.

Dr. Cave's 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, digestive enzymes, Coenzyme Q10, and antioxidants like selenium, zinc, and vitamins C, E, and A.

Bowel ecology restoration 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 8 hours for 3 days, with 11 days off. The cycle is repeated 4 times, followed by another provocation challenge test.

The results?

Dr. Cave presented a number of cases where these treatments showed significant benefit and reductions in autistic symptoms!

Mercury and Adult Illness: From Alzheimer's to Heart Failure

You can see the devastating effects that mercury toxicity can have on kids.

But what about adults?

Robert Nash, M.D., is a practicing neurologist and the Chairman of the American Board of Metal Toxicology. He reviewed mercury-associated diseases, mechanisms, controversies, and therapeutic options.

Toxic effects, he suggests, spread across a broad spectrum of diseases — including autism, Alzheimer's disease, ALS, multiple sclerosis, Parkinson's disease, neurodevelopmental diseases, nephrotoxicity, and cancer.

How is this possible?

Well, 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.

Mercury also inhibits nerve growth, and passes easily through the placental barrier.

It 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.

What about mercury from amalgam fillings?

Dr. Nash concludes that 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!

Mercury toxicity may also be linked to cardiovascular disease.

Two studies have reported increased risk of heart attack while another has shown no risk.

However, the data presented on heart failure from unknown causes is very compelling.

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).

In fact, one of my patients had this exact problem.

She had no reason for heart failure — but at 62, she was facing a heart transplant.

Why?

Well, I discovered that she had mercury toxicity and treated her.

Now, she is thriving — and has dramatically improved her cardiac function by 130 percent!

Despite all this bad news, 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.

He said that the body can be detoxified of mercury, mitigating some of its toxic effects.

More studies should shed light on this important topic.

Well, that's the end of the research section of this blog.

I know some of it was pretty science-heavy and a little tough to comprehend.

But 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 important or relevant to our health or our children's health.

And 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, 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 let's review how you know if you have mercury toxicity, and then how to treat it.

First, this has to be done carefully and under the supervision of a physician trained in the techniques of metal detoxification, but it can be done safely and effectively.

So here is how you find out if you are toxic. It has to be done systematically and carefully to make sure you get your body ready for removing the metals. I can't stress enough how important this preparation step is.

This is done by optimizing your nutritional status and detoxifying ability, then mobilizing and binding the metals in your body, then excreting them through the urine, bile, stool, and sweat.

Here is what I recommend to my patients.

GETTING READY FOR DETOXIFICATION (this process can take a few months)

1. First optimize your gut function.

Eliminate the common food allergens (dairy, gluten, corn, eggs, etc.), taking probiotics and enzymes for 1 to 2 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, as well as supplements such as alpha-lipoic acid and n- acetylcysteine.

4. Use herbal support for detoxification.

These include chlorella, cilantro, garlic, and milk thistle.

5. Start sauna therapy.

Make sure you take adequate electrolyte and mineral replacements to prevent dehydration and mineral loss from the sweat.

6. Optimize elimination routes for metals including your urine, stool, and sweat.

Use fluids, fiber, and saunas.

ADDITIONAL STEPS TO SUPPORT DETOXIFICATION

* Dragon Naturals Cilantro Tincture. Take 2 drops in hot water before a meal twice a day

* Chlorella. Start with one pill three times a day and then build up to 3 three times a day for 3 months if tolerated - take 30 minutes before meals and at bedtime.

* Supergarlic 6000 by Metagenics (or an equivalent product). Take 1 twice a day

* Hepatothera forte (or an equivalent product). Take 1 capsule twice a day by Prothera (Selenium, n- acetylcysteine, lipoic acid, milk thistle)

DURING 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.

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 6-hour urine collection.

This 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.

* The treatment then is quite simple.

There is a lot of controversy about the best way to do this. But after doing this 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 for 3 days on, 11 days off. Do this for 6 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 3 months while doing 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, or even a stronger laxative if you have to, such as senna or cascara.

* Consider whey protein to boost glutathione if not allergic to dairy.

That's it!

I am simply sharing my experience and knowledge with you. And I recognize that this is a controversial area.

You also must find someone skilled at dealing with this in order to do it safely. These are only my guidelines. They may be the same or similar to what you may find others using.

Most, importantly, get assistance.

I DO NOT RECOMMEND YOU DETOX FROM MERCURY WITHOUT A DOCTOR'S SUPERVISION!

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.

But realize that we DO know how to help you detoxify effectively and deal with the effects of low level mercury toxicity!

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(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 n children with autistic spectrum disorders. Journal of American Physicians and Surgeons, Volume 8 Number 3 Summer 2003.