Mercury: A 21st Century Killer - Part II

Mercury: A 21st Century Killer-Part II

by Mitchell A. Fleisher, M.D., FAAFP, DcABCT

In Part One of this article we addressed the pathophysiology and the political issues concerning systemic mercury toxicity, particularly as it pertains to dental mercury amalgam, the primary source of mercury poisoning. The choice of methods for detoxification of mercury from the human body depends on the specific form of mercury to be removed, the target organ system and/or tissues involved, and the age and state of health of the patient.

Environmental and Dietary Precautions

First, it is prudent to remove sources of mercury contamination, if possible. Limiting (or avoiding altogether) certain high risk foods, such as shellfish, coastal and inland freshwater fish and oceanic, bottom-dwelling scavengers, such as flounder and skate, is a good first step. However, even deep-sea fish, such as tuna, swordfish, sea bass, and shark, may have significant degrees of mercury contamination. Fish that have comparatively lower mercury contamination include cod, halibut, pollack, mackerel, sardines, redfish and herring. Since mercury is primarily stored in fatty tissues, broiling the fish and discarding the juices is sensible. Commercially-raised poultry and eggs, which are raised on fish meal, and certain produce (especially tree fruit such as apples) that may have been sprayed with mercury-containing pesticides, should be carefully washed or eliminated from the diet. Avoidance of industrial white sugar in candy and processed foods is wise, since the oral bacteria promoted by these non-foods ferment sugar into organic acids. This increases the release of mercury and other toxic, heavy metals from amalgams. (1, 2) Moreover, it is very important to drink a minimum of one-half ounce per pound of body weight daily of fresh, non-fluoridated water to assist the body in flushing out toxins.

Another potential source of mercury toxicity is that found in certain medications, including allopathic, conventional drugs (like mercurochrome) and vaccinations containing thimerosal (sodium ethyl-mercurithiosalicylate) as a preservative. Additionally, some traditional Chinese and Ayurvedic botanical medicines have been found to be contaminated and/or adulterated. (3) However, by far, the single most significant source of systemic mercury toxicity in humans (confirmed by the World Health Organization and the U.S. Public Health Service) is dental mercury amalgam. (4, 5)

Measurement of Mercury in the Body

Mercury and other toxic heavy metals are primarily measured in hair, blood cells and urine samples. Hair analysis is an excellent, inexpensive screening tool, but does not provide information about the actual amount of mercury in the body, nor how much is mobilized by therapeutic intervention. Red blood cell analysis gives somewhat more information about tissue levels, but misses mercury bound in brain, bone and fatty tissues. By far, the most accurate, practical, clinical measurement of the relative total body burden of mercury is obtained through a provocative, 24-hour elemental urine analysis. In this procedure, a dose of DMSA and glycine is taken the evening before beginning the urine test. Mercury and other toxic heavy metals are extracted from their hiding places deep in the tissues. These toxins are then collected in the urine, thus giving a more accurate measure of total body burden. A useful medical history screening tool called the Mercury/Toxic Metal Sensitivity Questionnaire (Table 1), was designed by Dr. Keith Sehnert and associates to determine whether further laboratory evaluation is indicated. If someone scores "yes" in five or more of the questions, this should serve as an 'alert' warning to proceed with toxic heavy metal testing.

Get the Mercury Out of Your Teeth!

Deamalgamation, i.e., the careful and judicious removal of dental mercury-silver amalgams by a specially-trained, dental physician, and their replacement with hypoallergenic, non-metallic, composite, dental fillings, is the single most important step that anyone with mercury amalgams may take (Table 3 describes how to locate a specially-trained dentist). The removal of dental mercury amalgam is a step-wise process. It involves the determination of the electroconductivity of the fillings, which are removed in order from most to least electrically charged. This serves to diminish daily, chronic sublimation of mercury into the body tissues between dental appointments.

There are a number of accepted techniques to protect patients from acute toxic exposure to mercury vapors during deamalgamation. These protective techniques include: use of a nasal mask to deliver fresh air; a high speed, high intensity drill; cold water spray; two or more high vacuum suction cannulas to remove drill waste and vapors; frequent cleansing of the oral pockets by the dentist's gloved finger and gauze pad; and frequent rinsing of the mouth with water. Some dentists may recommend concomitant I.V. ascorbic acid (Vitamin C) during the procedure, to help chelate liberated mercury. (5) Special laboratory testing such as the Clifford Materials Reactivity Test (6) may also be performed to help select the appropriate non-mercury composite which will be used to replace the mercury fillings.

Homeopathic Detox

Homeopathic medicines have been purported, by skilled practitioners since the mid-nineteenth century, to help alleviate the general and local symptoms of mercury intoxification. A scientific research study, by Cazin et al. at the University of Paris School of Medicine in 1987, demonstrated that homeopathically potentized arsenic trioxide (Arsenicum album), in varying high dilutions, can significantly stimulate the elimination of arsenic from lab animals intentionally poisoned with this heavy metal toxin. (9) Another study, by Fisher et al. at the St. Bartholomew's Hospital Dept. of Clinical Pharmacology in London, again in 1987, revealed that homeopathically prepared lead (Plumbum metallicum) did not cause a significant change in urinary lead excretion compared against distilled water. The study further showed that DMPS (Dimercaptopropane sulfonate) produced a large increase in the urinary excretion of lead. (10) However, no such similar research has shown homeopathically prepared mercury (Mercurius solubilis) to enhance mercury excretion from the body.

The haphazard, 'cookbook' or 'shotgun' approach of prescribing a combination of homeopathic remedies allegedly for the purpose of mercury detoxification has not been proven by clinical studies to be effective and is not recommended. It is my very strongest recommendation, as an experienced, homeopathic physician, to avoid any health care provider who seeks to prescribe for you in this manner, as it may suppress, rather than cure the symptoms, and weaken your overall vitality. I highly recommend that you locate a homeopathic practitioner who will examine your state of health holistically, taking all of your physical, emotional and mental symptomology into account, and through careful case analysis, prescribe a specific, individualized, single, homeopathic medicine that will serve to strengthen your vitality and accelerate the detoxification process. (11)

Get the Mercury out of Your Body (and Brain)

Glutathione (GSH) is one of the most important nutrients for mercury detoxification. GSH is important for hepatic detoxification and for elimination of mercury and other fat-soluble, toxic heavy metals. GSH also serves as a systemic antioxidant. However, GSH is quite expensive and very unstable. Consequently, a more cost-effective means to increase liver and body stores of GSH is to use the amino acid, N-Acetyl-L-Cysteine (NAC). NAC is a sulfur-containing amino acid which can also chelate mercury to some degree. Glycine is another amino acid thought by some to augment mercury excretion.

MSM (Methylsulfonylmethane) is a natural dietary sulfur compound that provides bioavailable organic sulfur for the synthesis of sulfur-containing amino acids. MSM appears to be inert in the body tissues, is nonallergenic and virtually free of undesirable side effects. The minerals calcium, magnesium, iron, zinc, selenium and manganese can protect against organic and inorganic mercury poisoning. (7) Vitamin E works with selenium to help neutralize mercury. Zinc is important in the production of Metallothionein, present in L-Cysteine, which detoxifies mercury. Molybdenum decreases accumulation of mercury in the kidneys by increasing urinary excretion.

Chronic exposure to mercury vapor depresses adrenal gland stores of ascorbic acid (Vitamin C), thus diminishing the body's response to oxidative stress and infections. Supplemental Vitamin C, in both the water- and lipid-soluble forms, is critical to adequate, systemic mercury detoxification. Alpha-Lipoic Acid (ALA), Thioctic Acid, is a potent, universal antioxidant, being both water- and fat-soluble. It regenerates the endogenous antioxidants, Vitamins C and E, and Glutathione, and repairs tissue damage due to oxidative stress. Most importantly, lipoic acid substantially increases intracellular, reduced GSH.

Silymarin, a bioflavonoid found in Milk Thistle (Silybum marianum) extract, increases synthesis of hepatic GSH by as much as 35%, and is also a potent liver detoxifier and antioxidant. Garlic extract, containing high amounts of sulfur allyl compounds, particularly allicin, is helpful in the gradual removal of low levels of mercury from the body. Chlorella and Spirulina, chlorophyll-containing micro-activated algae, may also help detoxify both organic and inorganic mercury. Probiotics, such as Lactobacilli and Bifidobacteriae, are helpful in restoring normal, friendly bowel flora which are injured by mercury compounds, and serve to reduce gastrointestinal symptoms, including flatulence, constipation, diarrhea, and halitosis.

Finally, Activated Charcoal is often prescribed immediately before and after the deamalgamation procedure to help absorb and prevent enterohepatic recirculation of the liberated mercury. (8) (See EnteraKlenz, Table 2 for recommended VRP nutriceutical dosage regimens).

DMPS (2,3-Dimercapto-1-Propane-sulfonic Acid) is a drug that has been used since the 1950s in Europe and Russia as a mercury chelator. DMPS is available in Europe under the names Unithiol and Dimaval. DMPS is, as yet, unapproved for general, therapeutic usage by the FDA in the U.S., and is currently undergoing selective, clinical trials at various US medical office research sites to determine its actual safety and efficacy.

DMSA (2,3-Dimercaptosuccinic Acid) is an important, orally administered agent that has been used as an antidote for toxic heavy metal poisoning. Extensive clinical research by the Chinese, Japanese and Russians since the 1950s, has demonstrated that DMSA accelerates elimination of mercury from the brain and effectively removes mercury from the blood, liver and kidneys. DMPS, which is generally given by the I.V. route, is considerably less effective than DMSA and has more adverse side effects. DMSA has been approved for use in the U.S. for the treatment of lead intoxication in children, and is marketed as a pharmaceutical under the names Chemet and Succimer. At our current state of knowledge, it appears that DMSA is the pharmaceutical agent of choice for systemic mercury detoxification. (12,13,14,15)

Various protocols exist for the administration of DMSA. The dosage regimen recommended in conventional medicine for mercury toxicity, 10 mg per kg in divided doses of five to ten or more cycles of three days on and fourteen days off, may result in unnecessary adverse side effects. Another effective protocol that minimizes adverse effects is 500 mg every other day for a minimum of five weeks. If a person experiences adverse effects at that dose, a suggested alternative dose of 250 mg may be tried every other day for two to three weeks, followed by 500 mg every other day for a total of five weeks.

According to personal communications with Sir Arnold Takamoto, one of the world's foremost authorities on mercury's influence on chronic disease and cancer promotion, adequate mercury detoxification may require as long as two to three years or more, depending on the total body burden and state of health. Many experienced, chelation physicians find the protocol described in Table 4 to be well tolerated for prolonged therapy. (See Table 4 regarding use of DMSA).

References:

1. Pizzorno J and Murray M. Textbook of Natural Medicine. Churchill-Livingstone, 1993.

2. Ziff MF, Ziff S and Hanson M. Dental Mercury Detox. BioProbe, Inc., 1997.

3. Espinosa EC. Arsenic and Mercury in Traditional Chinese Herbal Balls. New Eng J of Med; 1995; 333: 803-804.

4. Lorscheider F, Vimy M, Summers AO et al. Mercury Exposure from "Silver" Tooth Fillings: Emerging Evidence Questions a Traditional Dental Paradigm. FASEB J; 1995; 9: 504-508.

5. Ziff MF, Ziff S and Hanson M. Dental Mercury Detox. BioProbe, Inc., 1997.

6. Clifford Consulting & Research, Inc. 2275-J Waynoka Rd., Colorado Springs, CO 80915; (719) 550-0008; Fax: (719) 550-0009; www.ccrlab.com.

7. Krohn J et al. The Whole Way to Natural Detoxification. Hartley & Marks, 1996.

8. Ziff MF, Ziff S and Hanson M. Dental Mercury Detox. BioProbe, Inc., 1997.

9. Bakshi JPS. Phoenix Repertory v1.01; Generalities chapter; MacRepertory v5.6.0, 2000.

10. Fisher P. et al. The Influence of the Homoeopathic Remedy Plumbum Metallicum on the Excretion Kinetics of Lead in Rats. Human Toxicol.; 1987; 6: 321-324.

11. National Center for Homeopathy Directory and American Institute of Homeopathy Directory, 2000. NCH, 801 North Fairfax St., Suite 306, Alexandria, VA 22314, (703) 548-7790, Fax: (703) 548-7792.

12. Klaassen CD. Heavy Metals and Heavy-Metal Antagonists; Chapter 69; pp. 1615-1637; in Goodman and Gilman's The Pharmacological Basis of Therapeutics (6th Ed.); 1980.

13. Aposhian HV. DMSA and DMPS – Water Soluble Antidotes for Heavy Metal Poisoning. Ann. Rev. Pharmacol. Toxicol.; 23: 193-215; 1983.

14. Pangborn JB. Mechanisms of Detoxification and Procedures for Detoxification. Doctor's Data, Inc., and Bionostics, Inc., Chicago, IL., (708) 231-3649.

15. Ziff MF, Ziff S and Hanson M. Dental Mercury Detox. BioProbe, Inc., 1997.

Editors Note:
Although EDTA (Ethylene-Diamine-Tetraacetic Acid), both orally and intravenously, has been well-documented as a chelator for many of the heavy metal toxins, especially lead, it is less effective for mercury when used alone. EDTA removes mercury from cell surfaces and from the blood, but not from within cells, whereas DMSA is very effective in removing intracellular mercury and lead, especially from the brain.

Many physicians use DMSA to first mobilize mercury from the brain, and follow with oral or intravenous EDTA to enhance excretion of the mercury from the body. Since DMSA and EDTA will also remove significant amounts of other minerals, mineral supplementation is strongly recommended prior to and throughout treatment with chelating agents.

Ward Dean, MD
VRP Medical Editor

Fight Mercury Toxicity!

DMSA

DMSA is a potent chelator of mercury and THE supplement of choice for systemic mercury detoxification. Recommended dosage is 1-3 capsules, on an empty stomach, every other day, or as directed by a physician. VRP recommends the use of a multimineral formula, such as Advanced Essential Minerals or Essential Minerals to replace vital elements depleted through chelation.

The information in this article is not intended to provide personal medical advice, which should be obtained from a medical professional, and has not been approved by the U.S. FDA.

Copyright 2000 by Vitamin Research Products, Inc. (VRP) The use of information found in Vitamin Research News for commercial purposes is prohibited without written permission from VRP.