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TOXIC METALS IN YOUR BODY Many metals like calcium, magnesium, iron, copper, zinc, manganese and others are very important nutrients for normal and healthy bodily function. They provide structural components for cells and tissues such as calcium and magnesium create part of the cell wall, copper creates part of collagen structure, iron creates part of the structure of hemoglobin, zinc creates a part of DNA binding proteins. Each of these metals also play very important roles in chemical reactions such as the manufacture of ATP, the fundamental energy currency of most living organisms; the recycling of antioxidants to prevent cellular damage by free radical materials, the manufacture and activation of enzymes, the activation of ion channels in cell membranes and many others. Unfortunately, if in excess these metals can also become toxic and actually inhibit the processes they are supposed to support. They can also inhibit or block other metals from doing their job. Excess iron blocking copper and manganese, calcium blocking potassium are typical examples. Balance is the key for all nutrient metals. On the other hand, there are metals that do not generally play any nutritive role in our health or bodily function. These are usually considered toxic metals and include lead, cadmium, arsenic, mercury, aluminum, uranium, antimony, nickel on occasion, as do titanium and tin. The major toxic metals are lead, arsenic, cadmium mercury and aluminum. These toxic metals play no known nutritive role in human and animal health, but they play significant roles in human and animal dis-ease. These metals directly damage biochemical reactions, displace nutritive metals, inhibit enzyme function, injure tissue and create havoc in living processes. Toxic metals are an everyday part of life with the widespread dissemination of toxic metals by government and industry in the environment, by mining operations, war debrix, wild fires, and natural disasters. The CDC does set threshold standards(supposed “safe” or “no action is needed” levels) for various metals leaving the impression that until the toxic metal level gets to that threshold level, no toxicity problems or adverse effects will be encountered. The standard practice procedure for evaluating metals is testing blood levels of various toxic metals, lead for example, noting whether or not the metal, lead in this case, is above threshold level, >10 microgram/deciliter in the case of lead. If it is not, the doctor does nothing and “believes” that none of the symptoms which the patient might be experiencing are related to lead. If the test value is above 10ug/dl the doctor deems this elevated and suggests lifestyle modifications and queries the patient to determine if this is acute exposure. The doctor makes this assumption largely because obvious, specific, smoking gun, acute learning disabilities in children are thought to not occur until 40 ug/dl. Little understanding is given to the fact that metal toxicity, lead in this case, is not an all or nothing problem. Lead exerts adverse effects on the nervous system in the parts per billion concentrations or 0.233 ug/dl BLLs. The CDC states that IQ scored are affected at 7ug/dl BLL or less. The best test to determine potential heavy metal burden is a stimulated metal test meaning that the patient takes an oral or IV chelating agent and then collects their urine for 8 to 24 hours sending it into the lab for evaluation of metal content. Interestingly enough, the December 1995 issue of Pediatric Annals in an article on pesticides in children, states that unstimulated heavy metal evaluation are of little or no value, yet ,unstimulated tests (typical blood lead test) are the norm. The CDC states that venous blood levels of lead are the preferred test for recent or ongoing lead exposure, but not for past exposures. In fact, the CDC states that BLLs often under-repreesent the total body burden because most lead is stored in the bone and may have “normal” levels isn the blood. It is possible that patients with a high body burden under physiological stressful circumstances may show elevated BLLs from the release of lead stored in the bones. CDC stats show that the average child BLL ages 1-5 was 1.9 ug/dl in 2002, down from 15.0 ug/dl in 1976-1980 (before leaded gasoline was banned) The average adult 18-74 years of age BLL was 14.2 ug/dl from 1976-1980 dropping to 3.0 ug/dl in 1988-1991, again a reflection of leaded v. non-leaded gasoline emissions. Yet, the CDC states that if an adults BLL is 20ug/dl or more, “unusual exposure is likely occurring and should be interrupted, if possible, expecially for fertile and pregnant females.” Unfortunately, most doctors take this information and recommendations from CDC as absolutes and do nothing to address the subclinical and subtle clinical manifestations of toxic metal poisoning. Common symptoms of acute lead poisoning are loss of appetite, nausea, vomiting, stomach cramps, constipation, difficulty in sleeping, fatigue, moodiness, headache, joint or muscle aches, anemia and decreased sexual drive. More severe symptoms include damage to the nervous system, including wrist or foot drop, tremors, and convulsions or seizures. Chronic lead poisoning may result after leas ha accumulated over time. Long after exposure has ceased, some physiological event such as illness, pregnancy, stress may release this stored lead from the bone and produce adverse effects such as impaired hemoglobin synthesis, central and peripheral nervous system function, hypertension, reproductive problems and damage to the developing fetus. (http://www.cdc.gov/nceh/lead/grants/Florida/LSGuide4-01%5B1%5D.pdf Landrigan, 1989) Consider for a moment a dripping faucet in your house. If you watch it you see a drip, drip, drip and think that it is not much water so I don’t need to fix the faucet. Over the course of several months, you notice that your electric and water bills have increased. The accumulation of drops of water, add up to a significant amount of water over time. This is the same with toxic metals in our bodies. Think for a moment the blood levels of lead noted by CDC for people during the period when we used leaded gasoline in all automobiles. For some people this equated to decades of lead accumulation by the drip, drip, drip method. Now that these people are in their senior years experiencing fatigue, memory loss, coordination problems, decreased libido and other symptoms, they are told just mean they are getting older. Though they are getting older, these symptoms are not necessarily due to aging, in fact should not be. We must consider the resurfacing of the stored lead or other metals. People living in the Great Lakes region are breathing mercury with every breath of air they take in. this accumulates over time and resurfaces as kidney, liver, heart and nervous system problems just like the lead can. Some people have both lead and mercury accumulation in the body. It is the same consideration regarding arsenic , cadmium, aluminum or other toxic metal. Key to this discussion is the reality that research suggests that there is really no “safe” level of toxic metals. Any amount of toxic metal affects the body. It simply depends upon how much each individual can tolerate before they have functional consequence. This varies with other metal stressors, nutrition, diet, lifestyle and medications. These toxic metals in and of themselves stress the body, especially the immune system and nervous system. Toxic metals are a component or consideration in every new patient evaluation we do. It may not be the primary issue causing the patient’s primary complaint, but it frequently is a contributing factor in the patient’s recovery from the primary complaint.