Metal Detoxification
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©Metal Detoxification
CUSTOMER FAVORITES
for Metal and Oral
Chelation
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 Toxic Metals
by J Krohn , MD and F. Taylor, MA
See Customer Favorites to the left for product recommendations
Approximately 80 elements are classified as metals. The physical properties of metals include high reflectivity, electrical and thermal conductivity, and strength. In a water solution, metals can give up a negative particle, or electron, to form a positively charged ion, a cation. It is this property that determines the biological activity and toxicological characteristics of each metal. Metals are frequently used in the workplace, and some substances such as pesticides. This section will discuss the most commonly encountered toxic metals.
Although metals are categorized as heavy, trace, essential, nonessential, or toxic, there is much overlapping between these categories. Heavy metals have a specific gravity greater than 4 or 5.
Trace metals, found in minute quantities in the body, are also essential metals, and are necessary for proper functioning of the body. However, essential metals can be toxic, depending on the amount. For example, copper, iron, and cobalt are all needed by the body, but can be toxic in high amounts. Nonessential metals are not necessary for proper metabolism of the body, and they may also be toxic.
Metals can be inhaled as fumes or dust particulates, and particles less than i micron may be absorbed from the lung's alveoli into the bloodstream. Metals can also be ingested in food or water. The gastrointestinal tract may absorb metals if they are sufficiently soluble. A person's age, nutritional status, the amount of food in the intestines, and the intake of metals competing for absorption in the body (for example, zinc and cadmium) affect the absorption rate of metals. More metals are absorbed when less food is present. The chemical form (an element or a compound) of the metal in the body also determines how much metal will be absorbed.
Most metals are excreted through the kidneys, but some are reabsorbed by the kidney tubules. Many metals are bound to plasma proteins and amino acids. Reabsorption is determined by the pH of the urine, the type of protein or amino acid to which the metal is attached, and whether other metals are competing for the same tubular reabsorption site. The gastrointestinal tract also excretes metals. Lead, cadmium, and mercury are absorbed from the blood into the intestines. Metals that are attached to the cells lining the gi tract are excreted when these cells are shed. Metals are also deposited in the hair and are a reliable indication of the body burden of that metal.
Metals can be acutely or chronically toxic. Chronic toxicity is much more difficult to diagnose. In chronic toxicity, a person is exposed to small doses over a long period of time. Symptoms may not develop for months to years. Acute toxicity symptoms may be different from those of chronic toxicity. For example, acute inorganic mercury toxicity may cause nausea, headache, diarrhea, and abdominal pain, while chronic inorganic mercury toxicity causes difficulty in swallowing; abnormal vision, hearing, taste, and smell; and poor coordination in the arms and legs.
Metals inhibit the activity of many enzymes and they can bind to vitamins. Toxic metals may displace essential metals. They tend to accumulate in target organs, and when the level exceeds the threshold level for that organ, symptoms result. Many of the organs affected are those that are normally involved in the detoxification procedures to eliminate the metal from the body, including the kidney, the gastrointestinal tract, and the liver. Metals are often toxic to the organs that cannot detoxify them.
II ALUMINUM
Aluminum exposures in industry are from metal dust, welding fumes, aluminum-soluble compounds, aluminum alkyls, and aluminum pyro powder. Coal-fired power plants, metal smelters, cement manufacturing plants, and waste incinerators are all sources of aluminum contamination. Aluminum forms clumps or floes with organic material, and it is often used in water-treatment plants in the form of alum to remove organic material.
Aluminum is found in soft-drink cans, most antacids, other medications, paints, table salt, white flour, animal and plant food, fireworks, and deodorants.
Aluminum in Over-the-Counter Drugs
Some antacids contain from 35 to over 200 milligrams of aluminum per dose, and a person taking antacids could ingest as much as 5,000 milligrams of aluminum a day. Patients with kidney disease can develop aluminum poisoning from taking aluminum antacids and must take aluminum-free preparations. Buffered aspirin contains aluminum. Antidiarrheal medications, hemorrhoid medications, vaginal douches, and lipstick may all contain aluminum.
Aluminum
Aluminum is the third most abundant element on earth and the most abundant metal. At one time aluminum
was very difficult to extract from ore and was considered a very valuable metal. Napoleon's state dinnerware
was made from aluminum. When an easy and inexpensive extraction process was discovered in 1886, it
became a common and readily available metal.
Many people use aluminum foil when cooking. Aluminum is used as a leavening agent in cake mixes, dough, and baking powders. Processed, sliced cheese products of ten contain aluminum. Teas may contain aluminum, and acidic foods in aluminum containers can leach out the metal. Acidic and alkaline foods can leach aluminum from aluminum cooking pots. Aluminum increases in concentration as it moves up the food chain. Livestock accumulates aluminum, which is then ingested by people. People ingest on average between 5 and 100
milligrams of aluminum daily from all sources.
Drinking water can also be contaminated with aluminum. Acid rain can leach aluminum from soil, rocks, and sediments in lake bottoms. In northeastern North America, the amount of aluminum in surface water has increased tenfold in the past 80 years. In many Scandinavian lakes, there have been massive fish die-offs because of high aluminum concentrations. Aluminum also enters the body through inhalation, absorption through the skin, and by gastrointestinal tract absorption. It is excreted in the urine and bile.
Aluminum dust and aluminum pyro powders can be toxic to the lungs. Aluminum oxide exposure has caused pulmonary fibrosis (thickening and scarring of lung tissue) and emphysema. Aluminum builds up in the body as a person ages. Chronic, long-term exposure can cause weak bones, anemia, and abnormalities in calcium, magnesium, and phosphorous metabolism.
Aluminum also interferes with the normal metabolism of nerve cells. Laboratory animals exposed to aluminum may develop neurofibrillary tangles (degenerated nerve cells) as are found in Alzheimer's disease, a loss of memory progressing to dementia. Patients with Alzheimer's may have normal aluminum levels in the brain, blood, and cerebrospinal fluid, but the neurofibrillary tangles will have abnormally high concentrations. However, aluminum has not been proven to cause Alzheimer's disease.
II CADMIUM
A major source of cadmium exposure is dust from automobile tire erosion. It is also produced from burning waste. Cadmium is found in industrial effluents, plastics, fertilizers, auto exhaust, the coating on nails, rechargeable batteries, solder, coffee, soft or acidic water, and tobacco smoke.
Cadmium is poorly absorbed from the gastrointestinal tract, but inhaled cadmium is absorbed readily. Once absorbed, cadmium is bound to a protein known as metal lothionein, which is found in the major organs and protects the body against cadmium's toxic effects. Cadmium accumulates primarily in the kidneys and secondarily in the liver. The half-life of cadmium is 20 years, which means that after 20 years, 50 percent of the original amount of cadmium remains in the body. When cadmium reaches a threshold level, damage to the kidney tubules can occur. Some cadmium is excreted in both the urine and feces, but the mechanism is not understood.
Structurally similar to zinc, cadmium causes damage by displacing or replacing zinc (an essential trace metal) in over 200 enzymes. Cadmium is absorbed more easily when a person has a zinc deficiency.
Cadmium is toxic to the lungs. Acute exposure to cadmium dust or fumes can cause death, while chronic exposure can cause emphysema. Other symptoms of chronic cadmium exposure include liver damage, anemia, high blood pressure, weak bones, bone pain, and shrinking of the testicles.
II LEAD
All humans now have lead accumulations in their bodies. We are exposed to lead from the soil, air, and water. Lead occurs in two forms: inorganic lead and alkyl lead (formerly used in gasoline). Inorganic lead is used in battery manufacturing and reclamation, radiator repair, the printing industry, firing ranges, copper smelting,
paint and pigment manufacturing, the plastics industry, and the rubber industry.
Until 1977 when it became regulated, lead was used in paint for pigmentation and to reduce weathering. Leaded paint in older buildings can peel, flake, and chip off, then be ingested by children. Children may also mouth objects contaminated with lead from dust and soil. Soil as far away as 10 feet from a building can be contaminated with lead paint.
Lead
Lead poisoning is thought to have occurred since Roman times when wine goblets made of lead were in common use. Because lead has a low melting point, it was one ofthefrst metals smelted. Lead has been used extensively and investigated more thoroughly than any other metal.
Water from leaded pipes, soldered plumbing, and water-cooling systems are additional sources of lead. Lead levels are higher in the morning when the water has been in contact with the lead plumbing all night, so it is important to let water run for a few minutes before using it.
The gastrointestinal tract and the lungs absorb lead. The absorption of lead from the lungs depends on the particle size. Absorption from the gi tract depends on the amount of calcium, iron, fat, and protein in the diet. Infants and children absorb more lead than do adults. When lead is absorbed, the blood transports it to the organs of the body where it is transferred into the bones. Bones and teeth store 90 percent of the lead in the body. The rest is found in the kidneys and liver. Lead storage in the bones may protect other organs from lead poisoning,
but provides a source for remobilization when the body is under physiologic stress, such as during pregnancy, lactation, or chronic disease.
Blood levels give an indication of recent lead exposure, but do not indicate the total body burden of lead. Hair analysis of lead levels is a more accurate indicator. (See chapter 7 for a discussion of hair analysis.) Lead is excreted by the gi tract, urine, and the shedding of skin and hair. Infants excrete more through the gi tract than do adults.
Lead poisoning causes fatigue, lethargy, insomnia, anemia, hypertension, depression, irritability, headaches, tremor, and memory loss. It also causes subtle behavioral effects. Acute exposure can lead to renal failure, severe gi symptoms, and acute brain symptoms such as coma. GI tract symptoms include abdominal pain and constipation. Chronic exposure to lead can result in intellectual impairment.
In addition, lead affects the central nervous system, peripheral nervous system, gi tract, and kidneys. It causes motor peripheral neuropathy (damage to nerves that control movement). It has caused decreased fertility, spontaneous abortion, stillbirth, and increased infant mortality. Males with toxic levels of lead have decreased sperm counts and a loss of sex drive.
Children are more sensitive to the effects of lead than are adults. Chronic lead levels have been studied by examining shed baby teeth. Dr. Herbert Needleman at the University of Pittsburgh found that children with higher lead levels had lower iq levels and more learning disabilities. When retested five years later, those children had attended more special education classes.
A person can develop lead poisoning from small doses over a long period of time. The lead level considered toxic has been lowered from 158 micrograms per deciliter (mcg/dl) in 1930 to 10 mcg/dl in 1990. People with blood lead levels above 25 mcg/dl require treatment.
Metallic Mercury Poisoning
Metallic Mercury Poisoning
In 1999,16-year-old twin boys were admitted to a Texas hospital with generalized weakness, intermittent headache, erythema (redness) on both legs, feet, and hands, and intense itching of the legs and feet. Their behavior was occasionally uncooperative. A urine heavy metal screen showed a mercury level 0/289 microliters (the normal level is less than 10). The boys had found an old blood pressure manometer, had removed the mercury, and had been playing with itfrequently after school for a period of several weeks. They underwent chelation therapy to remove the mercury and gradually returned to their previous level of health. The Centers for Disease Control have reported many cases of mercury poisoningfrom contact with metallic mercury or its vapors during the 19805 and 79905.
II MERCURY
Mercury occurs in three forms: metallic or elemental, inorganic, and organic. Each form has different toxicological characteristics.
I METALLIC OR ELEMENTAL MERCURY
Metallic mercury is soluble in organic solvents but not in water. It is used in thermometers, electric switching devices, gauges, vacuum pumps, pressure-sensing devices, and in amalgams (silver fillings) used in dentistry.
Mercury is the only metal in liquid state at room temperature and it vaporizes readily. When mercury vapor is inhaled, some is changed to inorganic mercury and some stays in the metallic or elemental form, which is more lipid-soluble. This form of mercury crosses the blood-brain barrier, where it accumulates in the brain. Mercury can damage brain cells, particularly sensation and motor nerve cells. Metallic mercury can also accumulate in the kidneys and adversely affects kidney function.
Exposure to metallic mercury can cause lung damage, with inflammation of the alveoli, bronchioles, and the bronchi. Inhaling mercury fumes may cause fever, chills, shortness of breath, and a metallic taste in the mouth. This is known as metal fume fever and can also occur with the inhalation of other metals. Children younger than 30 months of age have died from pulmonary complications after inhaling mercury vapors.
Metallic mercury is poorly absorbed from the gastrointestinal tract, so there is no danger for children who swallow mercury if a thermometer is broken in the mouth. As much as 204 grams of elemental mercury have been ingested without systemic toxic-ity. Handling mercury is very dangerous, however, as it is readily absorbed through the skin.
After a mercury-containing dental filling is placed, low levels of mercury release for several years. Chronic metallic mercury toxicity causes tremor, gingivitis (inflammation of the gums), and erethism (an abnormal state of excitement), which contributes to insomnia, shyness, memory loss, emotional lability, nervousness, and anorexia.
Mad Hatters
Nineteenth-century hatters used mercury to cure beaver hides. Because of their exposure to metallic mercury, they developed neuropsychiatric symptoms and thus the term "mad as a hatter" developed.
I INORGANIC MERCURY
A portion of metallic mercury changes to inorganic mercury in the body. Inorganic mercury is also a constituent of dry cells (batteries) and is used as a detonator for explosives. The most famous form of inorganic mercury is a salt called mercurous chloride, commonly known as calomel. Calomel was used for centuries as a primary medication. Physicians prescribed it
orally to treat most major illnesses.
Sources of External Toxins
Approximately 10 percent of an oral dose of inorganic mercury is absorbed by the gi tract. Inorganic mercury salts damage
the mucous membranes of the mouth, throat, esophagus, and stomach. They also cause gastroenteritis with abdominal pain, vomiting, and bloody diarrhea. Mercury salts tend to accumulate in and damage the kidney, with decreased or no urination occurring in about half of cases. The organs of elimination of inorganic mercury are the gi tract and the kidney, although the mechanism is not understood well.
Although inorganic mercury crosses the blood-brain barrier poorly, chronic toxicity causes behavioral changes, such as tremor, emotional instability, insomnia, depression, and irritability. I ORGANIC MERCURY
Microorganisms can convert metallic mercury and inorganic mercury into organic mercury. Organic mercury compounds are lipid-soluble and volatile, and can be absorbed through the lungs. They are also absorbed through the skin.
The most significant compound is methyl mercury, which crosses the placenta and can accumulate in the fetus. Organic mercury also crosses into breast milk in toxic amounts. Over 90 percent of methyl mercury is absorbed from the gi tract because of its lipid solubility. Methyl mercury moves to all body cells, but concentrates in the liver, kidneys, blood, brain, hair, and skin. Hair levels correlate with blood levels, and are a good indicator of exposure.
With chronic exposure, methyl mercury toxicity develops gradually. Methyl mercury inhibits the synthesis of acetylcholine, the major neurotransmitter in the body, causing difficulty with concentration, loss of short-and long-term memory, depression, constriction of visual fields, poor coordination and an abnormal gait, numbness of the hands and feet, deafness, slurred speech, tremors of the hands, weakness, paralysis, decreased sense of smell and taste, and fatigue. The prognosis for improvement is poor, because the body is able to excrete only about i percent of its organic mercury burden per day.
Organic mercury was used in the past to treat syphilis and as a diuretic. Today it is used as an antiseptic and a preservative. Mercurochrome is an organic mercury antiseptic which, when applied to large burns, has caused death in children. Organic mercury is also used as a fungicide, in embalming preparations, and in insecticide manufacturing. Until 1990, interior latex paint contained organic mercury as an anti-mildew agent.
Most organic mercury exposure comes from the diet and it can be concentrated in the food chain. Many people have been poisoned by eating grain treated with an organic mercury fungicide and intended for plant seed only, not for human consumption.
In 1953 through 1960 in Minimata Bay, Japan, 25 infants were born with severe intellectual impairment caused by their mothers consuming fish contaminated with organic mercury from a factory discharge.
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