Mercury Toxicity and Systemic
Elimination
The following paper has been a long time in the
making. I first wrote it nearly three years ago and it was initially
rejected by the Lancet and the British Medical Journal but was published
last month in the Journal of Nutritional and Environmental Medicine (March
2001).
The end of the article has the bibliography which took
quite awhile to compile and has 124 of the best litreature documentation I
could find on mercury detoxification.
Dr. Klinghardt is widely recognized as one of the most
knowledgeable physicians in mercury detoxification and it was a privilege
to be able to help him with this paper.
Later this month on April 24 I will be involved in a
press conference that will announce massive additional lawsuits relating
to the toxicity of mercury. These lawsuits have the potential to make the
tobacco issue look like small potatoes as the liabilities could run in the
trillions of dollars.
Abstract
This paper reviews the published evidence supporting
amalgam toxicity and describes practical and effective clinical techniques
that facilitate mercury elimination. A litreature review is provided which
documents effective mercury elimination strategies to reduce mercury
toxicity syndromes.
Considering the weight of evidence supporting mercury
toxicity, it would seem prudent to select alternate dental restoration
materials and consider effective mercury elimination strategies if mercury
toxicity is present.
Mercury Exposure And Toxicity
Is A Prevalent And Significant Public Health Threat.
Chronic mercury exposure from occupational,
environmental, dental amalgam, and contaminated food exposure is a
significant threat to public
health.1
Those with amalgam fillings exceed all occupational exposure allowances of mercury
exposure of all European and North American countries. Adults with four or
more amalgams run a significant risk from the amalgam, while in children
as few as two amalgams will contribute to health problems.2 In most children, the largest source of
mercury is that received from immunizations 3 4
5 6 or that transferred to them in utero from their mother.7 8
Dental Amalgams Are A Major
Source Of Mercury Toxicity
A single dental amalgam filling with a surface area of
only 0.4 sq.cm is estimated to release as much as 15 micrograms of mercury
per day primarily through mechanical wear and evaporation.1 9 10 11
The average individual has eight amalgam fillings and
could absorb up to 120
micrograms of mercury per day
from their amalgams. These levels are consistent with reports of 60
micrograms of mercury per day collected in human feces.12 By way of contrast, estimates of the daily absorption of
all forms of mercury from fish and seafood is 2.3 micrograms and from all
other foods, air and water is 0.3 micrograms per day. 13 Currently, Germany, Sweden and Denmark severely restrict
the use of amalgams.1
A "silver" filling, or dental amalgam, is not a true
alloy. Amalgams are made up of 50% mercury.
The amalgam also consists of 35% silver, 9% tin, 6% copper and
a trace of zinc.6 More than 100 million
mercury fillings are placed each year in the U.S. as over 90% of dentists use
them for restoring
posterior teeth.14
The mercury vapor from the amalgams is lipid soluble
and passes readily through cell membranes and across the blood brain
barrier. 15 The vapor serves as the
primary route of mercury from amalgams into the body. It is clear that
amalgam mercury transfers to human tissues, accumulates with time, and
presents a potential health
threat. The mercury escapes continuously during the entire life
of the filling primarily in the form of vapor, ions but also abraded
particles.16 17 Chewing, brushing, and
the intake of hot fluids stimulates this release.18 19 20
Statements made by dental authorities which claim that
the amount of mercury exposure encountered by patients from dental
amalgams is too small to be harmful, are contradicted by the
litreature.21
Animal studies show that radioactively labeled mercury
released from ideally placed amalgam fillings appear quickly in the
kidneys22, brain and wall of the
intestines.23 The fact that mercury
amalgam fillings are banned in some European
countries is strong evidence of the clinical toxicity of this
material.
Any metal tooth restoration placed in the mouth will
also produce electrogalvanic effects. When dissimilar metals are placed in
the oral cavity they exert a battery-like effect because of the
electroconductivity of the saliva. The electrical current causes metal
ions go into solution at a much higher rate, thereby increasing the
exposure to mercury vapor and mercury ions manyfold. Gold placed in the
vicinity of an amalgam restoration produces a 10-fold increase in the
release of mercury.24
Mercury's Long Half-Life In
The Central Nervous System
Mercury in the central nervous system (CNS) causes
psychological, neurological, and immunological problems in humans.25 26 27 Mercury bonds very firmly to
structures in the CNS through its affinity for sulfhydryl-groups on amino
acids. Other studies have shown that mercury is taken up in the periphery
by all nerve endings and rapidly transported inside the axon of the nerves
(axonal transport) to the spinal cord and brainstem.28 29 30 Unless actively removed, mercury has an extremely
long half-life of somewhere between 15 and
30 years in the CNS.1 31
Mercury Toxicity
Symptoms
The overt clinical effects resulting from toxic
exposure to mercury have been clearly described.32 33 The scientific litreature shows that amalgam fillings
have been associated with a variety of problems such as Alzheimer's
Disease,34 35 autoimmunity,36 37 38 kidney dysfunction,39 infertility,40 41 42
polycystic ovary syndrome, 43
neurotransmitter imbalances,44
food allergies,45 multiple
sclerosis,46 thyroid problems,47 and an impaired immune system.48
Patients with many amalgam fillings will also have an
increase in the prevalence of antibiotic resistant bacteria.49 Subclinical neuropsychological and motor
control effects were also observed in dentists who had documented high
mercury exposure levels.50 51 Amalgam use
may also be related to fatigue, poor memory and certain psychological
disorders.52
There has been a recent epidemic of autism in the
US53 54 and many investigators believe
that this may be partially related to the increased exposure infants have
had to mercury through the preservative thimerosal that was included in
nearly all vaccines until recently.55
The nervous
system is more sensitive to mercury toxicity than any other
organ in the body. Mercury has recently been documented to be associated
with arrhythmias and cardiomyopathies as hair analysis showed
mercury levels to be 20,000 higher in those with these cardiac
abnormalities.56 Mercury exposure has
also been associated with other neurological problems such as
tremors,57 insomnia, polyneuropathy,
paresthesias, emotional lability, irritability, personality changes,
headaches, weakness, blurred vision, dysarthria, slowed mental response
and unsteady gait.1 58 59
Systemic Mercury
Elimination
There are a number of that have been
demonstrated to have clinical utility in facilitating the removal of
mercury with someone who has demonstrated clinical signs and symptoms of
mercury toxicity. The urine and feces are the main excretory pathways of
metallic and inorganic mercury in humans.1 60
The most important part of systemic elimination is to
remove the source of mercury.
For most this involves amalgam removal. Individuals
should seek a dentist who is specially trained in this area as improperly
removed amalgam may result in unnecessarily high exposure to mercury.61 The following is a summary of the most
effective that have been documented in the peer-reviewed
litreature.
DMPS
DMPS (Sodium 2,3-dimercaptopropane-1-sulfonate) is an
acid-molecule with two free sulfhydryl groups that forms complexes with
heavy metals such as zinc, copper, arsenic, mercury, cadmium, lead,
silver, and tin. DMPS was developed in the 1950s in the former Soviet
Union and has been used to effectively treat metal intoxication since the
1960s there.62 It is a water-soluble
complexing agent.
Because it had potential use as an antidote for the
chemical warfare agent, Lewisite, it was not available outside of the
Soviet Union until 1978, at which time Heyl, a small pharmaceutical
company in Berlin, Germany started to produce it. It has an abundance of
international research data and an excellent
safety record in removing mercury from the body63 and has been used safely in Europe as
Dimaval for many years.64 65 66 67
DMPS is registered in Germany with the BGA (their FDA)
for the treatment of mercury poisoning but is still an investigational
drug in the United States.68
The best and only brand of DMPS that should be used is
Heyl from Germany. Great care should also be exercised in making certain
the DMPS is compounded properly from the pharmacist. If the DMPS contacts
metal during it will be oxidized, so the compounding pharmacist must use
nonmetal needles must be used in preparing the product.
DMPS Can Be Used To Eliminate
Mercury Systemically
The use of DMPS to treat mercury toxicity is well
established and accepted. 69 70
71 DMPS has clearly demonstrated elimination effects on the
connective tissue.72 73 The DMPS dose is
3-5 mg /kg of body weight once a month which is injected slowly
intravenously over five minutes. DMPS-stimulated excretion of all heavy
metals reaches a maximum 2-3 hours after infusion and decreases thereafter
to return to baseline levels after 8 hours.74
DMPS Safety
DMPS is not mutagenic, teratogenic or
carcinogenic.75 Ideally intravenous DMPS
should never be used in patients that still have amalgam fillings in
place, although investigators have done this as diagnostically, as a
one-time dose, without complications.76
DMPS appears in the saliva and may mobilize significant amounts of mercury
from the surface of the fillings and precipitate seizures, cardiac
arrhythmias, or severe fatigue.
One should use DMPS with great caution and NEVER
use it in patients with amalgam fillings. Ideally DMPS should be
administered after 25 grams of ascorbic acid administered intravenously.
This will minimize any potential toxicity from the DMPS.
Even though DMPS has a high affinity for mercury, the
highest affinity appears to be for copper and zinc77 and supplementation needs to be used to not avoid
depleting these Beneficial minerals. Zinc is particularly important when
undergoing mercury chelation.78 DMPS is
administered over a five-minute period since hypotensive effects are
possible when given intravenously as a bolus.79 80 Other possible side
effects include allergic reactions and skin rashes.
DMSA
DMSA (meso-2, 3-dimercaptosucccinic acid) is another
mercury chelating agent. It is the only chelating agent other than
cilantro and d-penicillamine81 that
penetrates brain cells. DMSA removes mercury both via the kidneys and via
the bile.82 The sulfhydryl groups in both
DMPS and DMSA bind very tightly to mercury.
DMSA has three distinct
disadvantages relative to DMPS.
First, DMPS appears to remain in the body for a longer time than
DMSA.83
Secondly, DMPS acts more quickly than DMSA, probably because its
distribution is both intracellular and extracellular.84
Thirdly, preparations of DMPS are available for intravenous or
intramuscular use, while DMSA is available only in oral form.85 Since succinic acid is used in the citric
acid cycle inside the cell, DMSA has been suspected for displacing mercury
towards the inside of the cell86 after
binding mercury somewhere on its way from the intestine to the succinic
acid deficient cell.
We propose therefore that DMSA be used late in the mercury elimination process,
after the connective tissue mercury load has been reduced with
DMPS. The standard dose of DMSA is 5-10 mg/kg twice a day for two weeks.
The DMSA is then stopped for two weeks and then the cycle is repeated.
Chlorella
Algae and other aquatic plants possess the capacity to
take up toxic trace metals from their environment, resulting in an
internal concentration greater than those of the surrounding waters.87 This property has been exploited as a means
for treating industrial effluent containing metals before they are
discharged, and to recover the bioavailable fraction of the metal.88
Chlorella has been shown to develop resistance to
cadmium contaminated waters by synthesizing metal-binding proteins.89 A book written for the mining industry,
Biosorption of Heavy Metals,90 details
how miners use these organisms to increase the yield of precious metals in
old mines. The mucopolysaccharides in chlorella's cell wall absorb rather
large amounts of toxic metals similar to an ion exchange resin.
Chlorella also enhances mobilization of mercury
compartmentalized in non-neurologic structures such as the gut wall,91 muscles, ligaments, connective tissue, and
bone.
High doses of chlorella have
been found to be very effective in Germany for mercury
elimination.
Chlorella is an important part of the systemic mercury
elimination program, as approximately 90% of the mercury is eliminated
through the stool. Using large doses of chlorella facilitates fecal
mercury excretion. After the intestinal mercury burden is lowered, mercury
will more readily migrate into the intestine from other body tissues from
where chlorella will effectively
remove it.
Chlorella is not tolerated by about one-third of
people due to gastrointestinal distress. Chitosan can be effectively used
as an alternative in these individuals. Chitosan makes up most of the hull
of insects shellfish and also bind metals like mercury from the lumen of
the intestines.93 94 95
Cilantro
Omura determined that cilantro
could mobilize mercury and other toxic metals rapidly from the
CNS.96 97
Cilantro mobilizes mercury, aluminum, lead and tin
stored in the brain and in the spinal cord and moves it into the
connective tissues. The mobilized mercury appears to be either excreted
via the stool, the urine, or translocated into more peripheral tissues.
The mechanism of action is unknown. Cilantro alone
often does not remove mercury from the body; it often only displaces the
metals form intracellularly or from deeper body stores to more superficial
structures, from where it can be easier removed with the previously
described . The use of cilantro with DMSA or DMPS has produced an
increase in motor nerve function.98
Potentiating
Adequate sulfur stores are
necessary to facilitate mercury's binding to sulfhydryl groups.
Many individual's sulfur stores are greatly depleted
which impairs sulfur containing chelating or complexing , such as
DMPS or DMSA, effectiveness as they are metabolized and utilized as a
source of sulfur. Sulfur containing natural substances, like garlic99 100 and MSM (methylsulfonylmethane) may also
serve as an effective agent to supply organic sulfur for
detoxification.101 Fresh garlic is
preferred as it has many other recently documented Benefits.102 103 104 The garlic is consumed just below
the threshold of social unacceptability, which is typically 1-2 cloves per
day.
Antioxidants
Vitamin
E doses of 400 I.U per day have been
shown to have a protective effect
when the brain is exposed to methyl-mercury.68
105 Selenium, 200-400 mcg daily,106 107
108 109 is a particularly important trace mineral in mercury
elimination and should be used for most patients.
Selenium facilitates the function of glutathione, which is also important in
mercury detoxification.110 111 112 Some
clinicians find repetitive high dose intravenous glutathione useful,
especially in neurologically compromised patients.
There is a suggestion in a rat model that lipoic acid
may also be useful,113 but some
clinicians are concerned about the potential of lipoic acid to bring
mercury into the brain early in the stages of chelation, similar to DMSA
and N-acetylcysteine (NAC), which has also been used in mercury
chelation.114 Doses
larger than 50-100 mg per day should be used with caution.
Vitamin C is also a helpful
supplement for mercury elimination as it will tend to mobilize mercury
from intracellular stores.115 116 117 118 119 120
Some clinicians will use it intravenously in doses of
25-100 grams IV in preference to DMPS and DMSA.
Hyaluronic acid
(HA) is a major carbohydrate component of the
extracellular matrix and can be found in the skin, joints, eyes and most
other organs and tissues.121 HA is
utilized in many chemotherapy protocols as a potentiating agent.122 HA is also being utilized for many novel
applications in medicine.123 124 Personal
experience has shown that the addition of 2 ml with the DMPS tends to
improve the excretion of mercury by two to four fold with virtually no toxicity.
Conclusion
We have described the significant toxicities
associated with mercury amalgams and treatment that both authors
have used successfully over the past two decades to eliminate mercury and
resolve many chronic health complaints. Considering the weight of evidence
supporting amalgam toxicity it would seem prudent to select alternative
dental restoration materials.
|
Joseph Mercola, DO.
Medical Director
Optimal Wellness Center
1443 W. Schaumburg
Schaumburg, IL
60194 |
Dietrich Klinghardt, M.D.,
Ph.D.
Medical Director
American Academy of Neural
Therapy
2802 E.Madison #147
Seattle, WA 98112
|
| 
