A surprising number of people requested a post on heavy metals. They are certainly a nutritional issue in some parts of the world, and although they are not universal drivers of disease their toxic effects may add to pathologies more directly caused by the industrial diet. And our exposure to them is increasing1.
The term ‘heavy metal’ refers to a group of metallic chemical elements which have a relatively high density and are toxic at low concentrations, causing damage to multiple organ systems. They are also known or probable human carcinogens.
The grouping is rather arbitrary. It generally includes arsenic, cadmium, chromium, lead, mercury, nickel, strontium and thallium. Aluminium is an honorary member as it is toxic, although not particularly heavy. The transuranic metals are heavy, toxic and carcinogenic, but are conventionally placed in a super-heavy group of their own.
Many people believe they may be suffering from heavy metal intoxication.
This is partly because it is a favorite diagnosis on the altmed circuit, partly because much of the commercial analytical machinery used to test for these metals in tissue samples is not reliable, and partly because there are well-known real-world examples which linger in the public imagination.
The Minamata tragedy, when thousands of Japanese experienced mercury poisoning and around 900 died, was catapulted back into prominence by Johnny Depp’s 2020 film of the same name. This was a localized incident, caused by a single factory pouring mercury waste into Minamata bay.
Arsenic poisoning is a far wider (indeed global) health problem2 which has contributed to the death of tens and possibly hundreds of thousands in countries such Bangladesh, Cambodia, Vietnam, Chile and China, yet is altogether less well known. Maybe Sean Penn could do something useful for once.
Exposure to most heavy metals is generally local, and relates either to direct industrial exposure (ie those working in the smelting industry) or indirect exposure (ie those living down-wind of such plants). Overall, however, human exposure has risen as a result of the greatly increased use of these elements in industrial, agricultural, domestic and technological applications1.
The symptoms of heavy metal exposure are various, and not always very specific. They include:
*Arsenic – vomiting, abdominal pain, diarrhea, skin lesions, numbness and tingling of the extremities, muscle cramping
*Cadmium – body aches, chills, weakness, vomiting, diarrhea, abdominal pain, shortness of breath.
*Chromium – occupational asthma, eye irritation and damage, perforated eardrums, respiratory irritation, kidney damage, liver damage, pulmonary congestion and edema, upper abdominal pain, nose irritation and damage, respiratory cancer, skin irritation, and erosion
*Lead – high blood pressure, joint and muscle pain, difficulties with memory or concentration, headache, abdominal pain, mood disorders, reduced sperm count and abnormal sperm, miscarriage, stillbirth or premature birth in pregnant women.
- In children – headaches, muscle and joint weakness, tiredness, pallor, behavioral problems, loss of concentration, metallic taste in mouth, loss of appetite, weight loss, nausea and vomiting, constipation
*Mercury – tiredness, anxiety, depression, numbness and tingling of extremities, anxiety, depression, weight loss, memory loss, loss of concentration, poor peripheral vision, poor coordination, low muscle strength, mental health issues, damaged kidneys, difficulty breathing
*Strontium – nausea, vomiting, diarrhea and abdominal pain
*Thallium – hair loss, nausea and vomiting, diarrhoea, stomach pain, drowsiness, dizziness or weakness, high temperature, chills (shivering), loss of appetite, headache.
*Aluminium – confusion, muscle weakness, bone pain and fracture, lung problems, stomach and bowel problems, movement problems, brain disease, anaemia
This very brief review does not cover acute treatments for severe exposure, which are exclusively medical. Apart from basic removal from the source of poison, and washing, they include the use of iv and oral chelating agents, haemodialysis, blood transfusions, irrigation of the bowel and the acute management of symptoms. This post focusses instead on the mitigation of harm caused by low level exposures, and the use of pharmaconutritional tools suitable for self-administration.
There are specific pharmaconutritional tools which can be used to reduce the damage caused by exposure to aluminium and mercury. There is also a specific tool which is helpful in treating thallium and caesium poisoning, but although this can be obtained in non-medical formats its use by non-medically qualified persons is not recommended. While there are no specific antidotes available for the other metals, limited data supports the use of natural oral chelating agents.
This metal has a high affinity for silicic acid, binding with it to form the biologically inert compound aluminium silicate3-6. Orally administered silicic acid has been shown to reduce the uptake of aluminium from the gut, and to increase the renal excretion of aluminium7. Silicon is considered an essential element because of its ability to protect against aluminium toxicity3, 4, and appears to bind and effectively neutralize aluminium in the body8.
Mercury generally accumulates in humans exposed to organic compounds, typically methylmercury, which are more easily absorbed than are inorganic forms. Various strategies are used to remove mercury from the body including the chelating agents BAL (iv), Unithiol (iv) and Succimer (oral), all of which are drugs. Natural alternatives include N-acetylcysteine, an orally acting agent sold as a nutritional supplement in some countries, and selenium compounds which are available as supplements in most countries.
N-acetylcysteine (NAC) reacts with methylmercury, resulting in increased renal excretion9, 10 and a degree of neuroprotection10, 11. Selenium has a high affinity with mercury and forms biologically inert mercury selenium complexes10,12, thereby protecting against mercury-induced mitochondrial and DNA damage. Because mercury intoxication reduces the amount of available selenium in the body, selenium supplementation’s other vital role is the restoration of selenoprotein function10, 13. One preferred form of selenium is methyl selenocysteine, which can be usefully combined with NAC10, 13.
NAC may also be useful in reducing some of the harms caused by lead exposure14, but this is due to its antioxidant capacity rather than any ability to bind to or remove lead from the body.
Thallium / caesium
These metals can be removed from the body15 using the oral chelating agent Iron(III)-hexacyanoferrate(II), aka Prussian Blue. This simple inorganic compound is still used as a pigment in paint, paper and cloth, and can be purchased as a non-medical compound. Its use as a chelating agent however is strictly medical, as the toxicity of this compound makes it unsuitable for self-administration.
Arsenic, cadmium, chromium, lead, nickel
Intoxication with these metals is treated medicinally with iv chelating agents such as EDTA and DPA, and the orally active drugs DMSA and NTA. These drugs have reasonably well-defined therapeutic indices and should only be used in a clinical context. For self-medicators, and in cases of lower levels of exposure, there is also evidence which supports the oral and in-community use of the natural compounds humic and fulvic acid. These are formed via the microbial fermentation of humus, which is residual organic matter in soil.
Humic and fulvic complexes bind divalent and trivalent metal cations including lead16-20, cadmium21-23, chromium24, 25, mercury26, 27 and nickel28, 29. Less relevant for most (though one should not underestimate the lunatics in Washington), they also bind with uranium and plutonium30-33.
While much of the work cited here is pre-clinical, the totality of the reports indicates that the chelating effects of these organic compounds become clinically meaningful after long-term use, with measurable lowering of ie plasma levels emerging after a year or so of treatment. These chelators work slowly because they can bind only to the small fraction of the total body load of heavy metal that is passing through the enterohepatic cycle, and is briefly available in the gut.
Humic/fulvic complexes have not been standardized, and in all fairness are not very amenable to standardization. Among the more validated extracts are those from Lake Balaton, which have been through long-duration clinical trials in Hungarian hospitals20, 21.
If you suspect that you are being harmed by exposure to a heavy metal, you should start by ascertaining if this is indeed the case. Many therapists claim to be able to measure heavy metals in hair, urine or fecal samples, but the analytical methods required to test for these metals reliably and consistently are not widely available. Many systems used in the altmed community have not been properly validated.
Accredited analytical labs such as Vitas, which work to internationally recognized standards, are essential in proving or disproving the case.
If you are suffering from acute and / or severe intoxication, this is a matter which should be handled by your physician / health care establishment. If the level of intoxication is low, however, there are a limited number of strategies which you can utilize yourself.
Some of these (silicic acid, methyl selenocysteine) may produce symptomatic improvement within several months. Others (such as the humic / fulvic complexes), will take 12 – 18 months to produce measurable changes.
Theoretically, in the case of the latter compounds, it may be possible to speed up the process. One might expect these oral chelating agents to function more effectively if taken together with a fatty meal, as this promotes bile secretion34. The healthiest version of this would include oily fish such as herring or mackerel, or oily fish in liquid form.
You might achieve even better results by adding a mixed prebiotic component34,35; and you could, if you wished, monitor your progress by taking repeated blood tests over the designated period.
As a final audio antidote to heavy metal poisoning, consider AIC.
Next week: Matching accessories, and the well-tempered prostate.
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- Birchall JD. The interrelationship between silicon and aluminium in the biological effects of aluminium. Ciba Found Symp. 1992;169:50-61; discussion 61-8.
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- Ballatori N, Lieberman MW, Wang W. N-acetylcysteine as an antidote in methylmercury poisoning. Environ Health Perspect. 1998 May;106(5):267-71.
- Henry A. Spiller, Hannah L. Hays Marcel J. Casavant. Rethinking treatment of mercury poisoning: the roles of selenium, acetylcysteine, and thiol chelators in the treatment of mercury poisoning: a narrative review. Toxicology Communications Volume 5, 2021 – Issue 1 Pages 19-59 | Published online 10. Feb ’21
- Falluel-Morel A, Lin L, Sokolowski K, McCandlish E, Buckley B, DiCicco-Bloom E. N-acetyl cysteine treatment reduces mercury-induced neurotoxicity in the developing rat hippocampus. J Neurosci Res. 2012 Apr;90(4):743-50.
- Tinggi U, Perkins AV. Selenium Status: Its Interactions with Dietary Mercury Exposure and Implications in Human Health. Nutrients. 2022 Dec 14;14(24):5308.
- Joshi D, Mittal D, Shrivastav S, Shukla S, Srivastav AK. Combined effect of N-acetyl cysteine, zinc, and selenium against chronic dimethylmercury-induced oxidative stress: a biochemical and histopathological approach. Arch Environ Contam Toxicol. 2011 Nov;61(4):558-67.
- Kasperczyk S, Dobrakowski M, Kasperczyk A, Ostałowska A, Birkner E. The administration of N-acetylcysteine reduces oxidative stress and regulates glutathione metabolism in the blood cells of workers exposed to lead. Clin Toxicol (Phila). 2013 Jul;51(6):480-6.
- Lin G, Yuan L, Bai L, Liu Y, Wang Y, Qiu Z. Successful treatment of a patient with severe thallium poisoning in a coma using Prussian blue and plasma exchange: A case report. Medicine (Baltimore). 2019 Feb;98(8):e14629.
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