Friday, March 25, 2016

Heavy Metals: Toxicity Explained

Dear Readers,

This post was written by Ami Ingram, MD, the newest addition to the Vaughan Integrative Medicine (VIM) team.

- Dr. Vaughan

Environmental factors play an important part in the overall health and wellness of individuals and contribute significantly to community health. There is now a greater awareness of environmental toxins because of the publicity surrounding the Flint, Michigan water crisis. If you followed the news, you are aware of the toxic levels of lead in Flint’s water supply. While there are many sources of environmental toxins, one of the most prevalent is heavy metals.

Heavy metals are naturally occurring elements that have a high atomic weight and a high density compared to water. Some heavy metals are required in varying amounts by living organisms for proper cellular function; these metals include iron, cobalt, copper, manganese, molybdenum, and zinc. Other heavy metals include aluminum, antinomy, arsenic, beryllium, bismuth, cadmium, lead, mercury, nickel, platinum, thallium, thorium, tin, tungsten, and uranium. Many of these metals now have a wide distribution in the environment because they are used in industrial, domestic, agricultural, medical and technological applications. All metals are toxic at higher concentrations. The potential for a metal to become toxic depends on factors including the dose, the pathway of exposure, along with the age, gender or at the nutritional status of the individuals exposed to the metals.

Heavy metals become toxic when they accumulate to the point that they disrupt metabolic functions. This happens in two ways:

1. They accumulate and thereby disrupt function and vital organs and glands such as the heart, brain, kidneys, bone, liver, etc.

2. They displace the vital nutritional minerals from their original place, thereby hindering their biological function. For example, lead can displace iron and inhibit the body's ability to make hemoglobin.

The degree to which an individual will experience the symptoms of heavy metal toxicity vary greatly from person to person. Children and the elderly are more susceptible to experiencing symptoms. Some individuals never develop symptoms because they are genetically predisposed to more efficiently detoxifying the body. Other people may not show symptoms of toxicity for many years and late in life develop a chronic degenerative disease that is sometimes the result of slow ongoing exposure to toxins.

The American Academy of Environmental Medicine and the American College for the Advancement of Medicine teach that exposure to heavy metals contributes to an individual’s chance at being affected by cardiovascular disease, some cancers, and many neurodegenerative diseases including Alzheimer's, multiple sclerosis, ALS (Lou Gehrig's disease), and many other autoimmune diseases.

Each of the heavy metals has a slightly different effect on the body. Common symptoms of heavy metal toxicity include:
  • altered metabolism,
  • asthma and chronic lung disease,
  • cancer,
  • damaged immune system,
  • high blood pressure,
  • atherosclerotic cardiovascular disease – resulting in heart attacks, strokes, per referral vascular disease, and congestive heart failure,
  • neurodegenerative diseases,
  • psychiatric illnesses,
  • kidney and liver damage,
  • reproductive system diseases in both men and women, and
  • skin disorders.
The Agency for Toxic Substances and Disease Registry (ATSDR) provides information and fact sheets on many substances that are considered toxic including heavy metals, how exposure to the toxins occurs, and how they can impact human health. Three of the most common heavy metals that impact people's health are cadmium, lead, and mercury; here’s information from ATSDR on these three heavy metals:

CADMIUM

Cadmium is a natural element in the earth's crust. It is usually found as a mineral combined with other elements such as oxygen (cadmium oxide), chlorine (cadmium chloride), or sulfur (cadmium sulfate, cadmium sulfide). All soils and rocks, including coal and mineral fertilizers, contain some cadmium. Most cadmium used in the United States is extracted during the production of other metals like zinc, lead, and copper. Cadmium does not corrode easily and has many uses, including batteries, pigments, metal coatings, and plastics.

Exposure:

  • Exposure to cadmium happens mostly in the workplace where cadmium products are made, for example a battery factory.
  • Living near industrial facilities which release cadmium into the air.
  • Cadmium is used in cigarette production therefore smoking cigarettes or breathing cigarette smoke exposes individuals to this potential toxin. 
  • Eating foods containing cadmium; low levels are found in all foods (highest levels are found in shellfish, liver, and kidney meats). 
  • Drinking contaminated water.
  • Breathing fumes from combustion of petrol and other fossil fuels (cadmium oxide is one of the main by-products of combustion). Living near or exercising along major roadways can cause exposure to high amounts of cadmium.
  • Yellow paints, especially oil paints are high in cadmium. 

Health Risks from Over-Exposure:


  • Breathing high levels of cadmium can severely damage the lungs. Eating food or drinking water with very high levels severely irritates the stomach, leading to vomiting and diarrhea.
  • Long-term exposure to lower levels of cadmium in air, food, or water leads to a buildup of cadmium in the kidneys and possible kidney disease. Other long-term effects are lung damage and fragile bones.
  • The Department of Health and Human Services (DHHS) has determined that cadmium and cadmium compounds are known human carcinogens.
LEAD

Lead is a naturally occurring bluish-gray metal found in small amounts in the earth's crust. Lead can be found in all parts of our environment. Much of it comes from human activities including burning fossil fuels, mining, and manufacturing. Lead has many different uses. It is used in the production of batteries, ammunition, metal products (solder and pipes), and devices to shield X-rays. Because of health concerns, lead from gasoline, paints and ceramic products, caulking, and pipe solder has been dramatically reduced in recent years.


Exposure:

  • Eating food or drinking water that contains lead. Water pipes in some older homes may contain lead solder. Lead can leach out into the water.
  • Spending time in areas where lead-based paints have been used and are deteriorating. Deteriorating lead paint can contribute to lead dust.
  • Working in a job where lead is used or engaging in certain hobbies in which lead is used, such as making stained glass.
  • Using health-care products or folk remedies that contain lead.

Health Risks from Over-Exposure:

The effects of lead are the same whether it enters the body through breathing or swallowing. Lead can affect almost every organ and system in your body. The main target for lead toxicity is the nervous system, both in adults and children. Long-term exposure of adults can result in decreased performance in some tests that measure functions of the nervous system. It may also cause weakness in fingers, wrists, or ankles. Lead exposure also causes small increases in blood pressure, particularly in middle-aged and older people and can cause anemia. Exposure to high lead levels can severely damage the brain and kidneys in adults or children and ultimately cause death. In pregnant women, high levels of exposure to lead may cause miscarriage. Highlevel exposure in men can damage the organs responsible for sperm production.

MERCURY

Mercury combines with other elements, such as chlorine, sulfur, or oxygen, to form inorganic mercury compounds or "salts", which are usually white powders or crystals. Mercury also combines with carbon to make organic mercury compounds. The most common one, methylmercury, is produced mainly by microscopic organisms in the water and soil. More mercury in the environment can increase the amounts of methylmercury that these small organisms make.

Metallic Mercury is a dense liquid that vaporizes easily at room temperature. Metallic mercury is not easily absorbed into unbroken skin. However, it vaporizes, even at room temperature. The higher the temperature, the more vapors are released. Mercury vapors are colorless and odorless, though they can be seen with the aid of an ultraviolet light.

Metallic mercury is used to produce chlorine gas and caustic soda, and is also used in thermometers, dental fillings, and batteries. Mercury salts are sometimes used in skin lightening creams and as antiseptic creams and ointments.

Exposure:

  • Eating fish or shellfish contaminated with methylmercury.
  • Breathing vapors in air from spills, incinerators, and industries that burn mercury-containing fuels.
  • Release of mercury from dental work (silver fillings) and medical treatments.
  • Breathing contaminated workplace air or skin contact during use in the workplace.
  • Practicing rituals that include mercury.

Health Risks from Over-Exposure:

The nervous system is very sensitive to all forms of mercury. Methylmercury and metallic mercury vapors are more harmful than other forms, because more mercury in these forms reaches the brain.

Exposure to high levels of metallic, inorganic, or organic mercury can permanently damage the brain, kidneys, and developing fetus. Effects on brain functioning may result in irritability, shyness, tremors, changes in vision or hearing, and memory problems.

Short-term exposure to high levels of metallic mercury vapors may cause effects including lung damage, nausea, vomiting, diarrhea, increases in blood pressure or heart rate, skin rashes, and eye irritation.

Very young children are more sensitive to mercury than adults. Mercury in the mother's body passes to the fetus and may accumulate there.

Mercury's harmful effects that may be passed from the mother to the fetus include brain damage, mental retardation, incoordination, blindness, seizures, and inability to speak. Children poisoned by mercury may develop problems of their nervous and digestive systems, and kidney damage.

More information on these and other heavy metals and other toxins are available on the ATSDR’s website at http://www.atsdr.cdc.gov/. This is an important resource provided by this federal public health agency of the U.S. Department of Health and Human Services. The website includes information on ways to reduce the risk of exposure to toxins and what type of testing is available to determine if someone has been exposed to a toxin and the level of exposure. The best action concerning heavy metals and other toxins is to actively follow precautions to avoid exposure. However, there are actions that most people can take to help reduce their body’s toxic load, especially from a integrative medical perspective.

Healthy Choices for Reducing Heavy Metal Toxicity 
One a heavy metal has been introduced into the body, the use of a chelator is necessary to pull the metal from the bonds it has created with other nutrients in the body. Chelating agents bind to heavy metal toxin ions and then get removed from the body through regular excretory channels. Mainstream medical uses pharmaceutical components for chelation therapy. Without additional training in toxicology and chelation therapy, patients may experience serious side effects. Integrative practitioners will be familiar with both pharmaceutical and non-pharmaceutical agents that can help the body clear out heavy metal toxins. Specifically, these practitioners are familiar with the Medical Management Guidelines for Acute Chemical Exposure which recommends chelation therapy with specific agents be used in certain cases for specific toxins. In her article, Chelation: Harnessing and Enhancing Heavy Metal Detoxification—A Review (The Scientific World Journal, Volume 2013 (2013), Article ID 219840), Margaret E. Sears writes about natural alternatives and some supplements to aid the body in removing heavy metals. These include:

  • Cilantro
  • Chlorella
  • Selenium
  • N-acetyl-cysteine 
  • Glutathione
  • Fiber
  • Alpha Lipoic Acid
  • Methionine
  • Taurine
Depending on the degree of toxicity and what metals are present, an integrative practitioner can best advise on which therapy to use and what the dosing should be. Integrative medical providers will also create a treatment plan to promote improved bowel movement and ways to replace trace minerals that are affected by chelation therapies.

Individuals experiencing autoimmune disease and certain neurodegenerative disease may benefit from testing for heavy metal toxicity. Integrative physicians routinely test for heavy metals and other toxins and can develop patient-specific treatment plans. There are toxins in our environment; they don’t have to have a significant role in your health, your family’s health, or your community’s health. Know your risk factors, know how to protect yourself, and know how to support your body in staying clean.

A simple provoked urine test can provide details on the heavy metals to which someone has been exposed and that have been absorbed into the body. Testing is available for both adults and children. Call your preferred integrative doctor and see when you can get tested!

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