The Three Pillars of Heavy Metal Detoxification
June 19, 2016
Story at-a-glance
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By Dr. Mercola Mercury is a pernicious neurotoxin. Removing it, however, needs to be done with great care, lest you cause even more problems. Chris Shade, Ph.D., is probably one of the foremost experts in the world on the subject of heavy metal detoxification, and in this interview, he shares his wisdom on this important topic. Shade received his Ph.D. from the University of Illinois Urbana-Champaign where he studied the environmental transformations of mercury. He's developed a patented liquid chromatographic mercury speciation technology that differentiates and identifies the exactly source of your mercury — whether it's from your dental amalgams, or from eating contaminated seafood. He's also involved in developing new lipid-based delivery systems for nutraceuticals, including liposomes and micro-emulsion systems to address the need for effective and affordable detoxification.
The Mercury Tri-TestIn your body, glutathione is the dominant agent that binds to and helps move mercury (and other heavy metals) out of your tissues. Part of effectively eliminating mercury involves methods that help upregulate certain aspects of your chemistry that then mobilizes and moves the mercury out. I actually used Shade's diagnostic tests and detox processes about five years ago to help me detox from mercury amalgams, and was able to cut my mercury level down to normal, quite quickly. The test he developed is called the Mercury Tri-Test, because it looks at three different kinds of samples: blood, hair, and urine. You always have more mercury in your tissues than in your blood. But there's a steady state or ratio between what's in your blood and what's in your tissues. Hair is an excretion marker for methylmercury, while urine is an excretion marker for inorganic mercury. These levels should be directly proportional to the levels in your blood.
What the Blood to Urine Ratios IndicateThe reason for this has to do with retention toxicity. If two people have 10 amalgams, the sicker of the two will be the one whose urine output of mercury is lower; typically due to damage to the active transport system in the proximal tubules of the nephrons. More specifically, when the mercury in your blood rises above the 1:7 ratio to the urine, it means your proximal tubule transporters in your kidneys have been damaged. Your kidneys filter everything in your blood. After the general filtration, in the proximal tubules your body resorbs ions and nutrients it needs to keep, while toxins are actively shuttled out into the urine flow.
The Difference Between Inorganic Mercury and MethylmercuryThe Mercury Tri-Test is the only clinical test out there that differentiates between the inorganic form of mercury (typically found in amalgam fillings) and organic mercury or methylmercury (from fish), allowing you to tailor the most ideal detoxification protocol for your situation. While many believe all mercury is the same, this is not necessarily the case. Inorganic mercury is much more toxic to the extracellular matrix and thus to connective tissues. If you're having joint problems or fibromyalgia-like pain, you need to work on getting rid of this inorganic mercury, and you need to make sure your kidney transporters are working well. Metylmercury is a less cytotoxic (toxic to the cells) form of mercury. If you only have methylmercury in your body, it's all going through glutathione conjugation to your liver, and on to your GI tract. On the cellular level, the inorganic mercury, is more disruptive because it can bind to more sulfhydryl groups and disrupt more chemistry than methylmercury can.
Primary Sources of Mercury ExposureSeafood is essentially the sole source of methylmercury. However, it's a major source of mercury, and it can be problematic if you eat a lot of seafood. The type of seafood you eat also plays a big role. At the top of the food chain, a shark might have 4 parts per million (ppm) to 10 ppm methylmercury in its tissues. According to Shade, swordfish is routinely 1 to 5 ppm, and tuna is routinely in the 1 to 2 ppm range Toward the bottom of the food chain you have sardines and anchovies, which may contain 1 to 10 parts per billion (ppb) of methylmercury, or nearly 1,000 times less mercury. Wild salmon like Coho and sockeye can be in the 10 to 100 ppb range — a hundred-plus-fold lower level than high-level shark, tuna, and swordfish. Depending on the fish you compare, there could be a thousand-fold difference between the mercury levels. To put that into perspective, it's like eating 1,000 pounds of anchovies versus 1 pound of shark. So if you eat fish on a regular basis, it's really important to look for species known to be low in mercury.
Inorganic mercury exposure is dominantly from dental amalgam and the breakdown of fish-based mercury into the inorganic form. Airborne mercury is the third and least troublesome source. Exceptions include some older buildings, such as old medical, dental, agricultural, and scientific buildings, where mercury levels could be quite significant. How Mercury Damages Your HealthInorganic mercury and cadmium are the two heavy metals that cause the most damage to your kidneys. They tend to build up there, causing a downward spiral where the more damage there is to the proximal tubules, the more metals accumulate, and the more damage is created. Many have suffered damage from doing chelation for this reason. By using the Tri-Test, you can determine whether chelation is a good idea or not. When you take a chelating agent, such as DMSA, you solubilize a lot of mercury in the form that needs to be filtered out through the proximal tubules. This can be a risky type of mercury detoxification and typically isn't necessary. Nevertheless, if you choose to use it, make sure you are working with a highly skilled clinician in this area. This is because if your kidneys are not working properly, then mercury gets bound up, causing inflammatory damage around the kidneys, which can actually worsen the problem by causing chronic renal insufficiency. (On a side note, a relatively low-protein diet [typically less than 40 to 50 grams per day] can be a beneficial strategy if you have kidney problems such as this.)
The Importance of Optimizing Your GI TractFortunately, there are solutions to these problems, and Shade's work has led to treatment strategies that are far safer and more effective than earlier detox methods used by many alternative practitioners, including myself and Shade.
In short, when there's inflammation and/or toxin build-up in the GI tract, the movement of toxins from the liver and the GI tract ceases, and everything gets shuttled over to the kidneys. Unless you can open up that liver-GI path, you end up overloading your kidney with toxins. Then, if you try to mobilize all that mercury with a chelator, it all hits the kidneys and cause even more damage. So part of the solution is to "clear out" the GI path first. Detox Step 1: Optimize Your Filtration MechanismsIntestinal Metal Detox (IMD) is a powerful mercury and heavy metal chelator, hundreds of times more potent than chlorella. It helps take the pressure off your kidneys by restoring the natural dominant detox pathway — from your liver to your GI tract and out through fecal excretion. So the first part of the detox involves clearing the metal out of your GI tract with specific metal binders. The primary endotoxin binder is charcoal, and clay binds to aflatoxin. Ideally, you'll want to use a combination of IMD/chlorella, charcoal, and clay to cover all the bases. Quicksilver Scientific is the sole source for IMD. Chlorella, charcoal and clay can be found in most health food stores and grocery stores.
Remember, detoxing involves moving the toxin out of the cell; squeezing the toxin out of the cell into your blood circulation, and then filtering out the metals through your kidneys, liver, and GI tract. However, you need to begin by assessing your filtration capacity before you start moving toxins out of your tissues. If you're feeling awful, it means toxins are building up in circulation faster than they're being filtered out. To ensure your filters are working properly, begin by supporting your kidneys, liver, and GI tract, and use binders to capture and eliminate metals and toxins in your GI tract. Classic herbs known to support healthy liver and kidney function include: dandelion, milk thistle, and bitters like gentian and myrrh. For added kidney support, cranberry (a diuretic), solidago (goldenrod), and corn silk can be used. Shade's favorite is goldenrod. General kidney and liver support formulas are also viable options. Adding burdock will help clear your blood. Dandelion is a good all-around option as it supports blood, liver, and kidney. Be sure to drink lots of water to flush the toxins out. Detox Step 2: Address Detoxification BiochemistryNext, you need to optimize the metabolic biochemistry needed for detoxification. That biochemistry involves glutathione and the enzymes and transporters that work with it, such as the enzyme glutathione S-transferase (GST), which is responsible for catalyzing and moving the mercury off the cellular proteins onto the glutathione. There are several well-known nutraceuticals that help accomplish this. The most well-known and most reliable is lipoic acid. R-lipoic acid is the biologically active form, which is the most useful. Alpha-lipoic acid does work, but that's a mixture of R-lipoic acid and S-lipoic acid, the latter of which actually works against the process. So R-lipoic acid (sometimes also called R-alpha-lipoic acid) is the one to look for.
Which Is Best? Precursors or Direct Delivery or Glutathione?If everything is working well in your body, you can simply use precursors to glutathione, like N-acetylcysteine (NAC) which will support glutathione production. If things aren't working well, Shade recommends using a direct delivery of glutathione. It's important to realize that most oral glutathione supplements do not work. It's simply going to break down to its constituent amino acids, so it's not an effective intervention. Shade recommends and uses a nanoliposomal glutathione that absorbs under your tongue and is far easier and less expensive than IV glutathione. Again, whether you can make do with precursors or need direct delivery of glutathione has a lot to do with how well your glutathione system is working, and your current state of health. Poor immune function is a sign of glutathione insufficiency, and a tip-off that a precursor might not be enough. In studies on HIV positive patients, 1,000 times more precursor than glutathione was necessary to restore cellular function in those with active disease.
Leave Chelation for LastThe chelating agent EDTA is a powerful biofilm breaker. When taken systemically it opens up biofilms throughout your body, revealing various organisms to your immune system. As a result, you may experience immune reactions. A lot of the fatigue that people feel when chelating is in fact due to immune reactions to organisms, and is reflective of systemic biofilm-based infections. According to Shade, "If you're not having success with detox, you need to go after microbial injections almost every time." Also, it's important not to indiscriminately chelate for lead. If you go through the glutathione system upregulation discussed above, you're not just getting mercury, cadmium, and arsenic out. You're also getting a whole host of other toxins, including fluorinated, brominated, chlorinated hydrocarbons, pesticides, and herbicides.
Addressing Toxic Metals Besides MercuryTo detect heavy metals besides mercury, Shade uses an inductively coupled plasma mass spectrometry (ICP-MS) scan of blood for nutrient and toxic metals. This is important, because you need to have your nutrient metals in order before you can go after toxic metals. Most of the toxic metals displace zinc, and zinc drives many important metabolic reactions. If you have low zinc, you're not going to be able to detoxify metals well. If you have high copper and low zinc, you will present symptoms of heavy metal poisoning, and it will be synergistically toxic with any heavy metals present in your system. High calcium and low magnesium stops detoxification by restricting magnesium-dependent transporters and by putting you in a state of chronic inflammation. You also need to have adequate molybdenum, selenium, and lithium in order to detoxify.
Three Pillars of DetoxificationThe three pillars of detoxification in general and metal detoxification in particular are: 1. Cleanse and clear your GI tract of metals and toxins using a thiol-functionalized silica (Intestinal Metal Detox, or IMD) with a practitioner, or chlorella, plus charcoal and clay, which bind to all the other toxins. Herbs like dandelion and goldenrod are good for added liver and kidney support. Burdock and dandelion helps clear your blood. Be sure to drink extra water to flush the toxins out. Remember, if you're detoxing and feeling really unwell, you need to clear more toxins out of your GI tract and blood. When you do that, back off your Nrf2 upregulators, and instead take more GI binders, and more liver and kidney supporting herbs. Drink a lot of water. When you're feeling clear again, restart the Nrf2 upregulators. 2. Glutathione optimization. Increase glutathione levels either by using precursors (such as N-acetylcysteine [NAC], or a liposomal glutathione formulation. 3. Nrf2 upregulation in the cells using R-lipoic acid, polyphenols, and sulfur-based compounds from cruciferous vegetables and alliums. The Ayurvedic herb haritaki is beneficial, as are sulforaphane (broccoli seed extract), and allicin and diallyl disulfide (garlic). All of these upregulate Nrf2 and aids detoxification. Last but not least, remember that detoxing is a marathon, not a sprint. Start all your doses low and work your way up. Do not jump in and do too much all at once. Typically, detoxing will take anywhere from three to 12 months; sometimes longer. Also, pulse the treatment on and off, or else it will lose its effectiveness.
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