quicksilver scientific clinical mercury testing [compatibility mode]
TRANSCRIPT
Mercury Tri-Test: Mercury Speciation Analysis and Compartment-Ratio Analysis for Body Burden and Excretion Indices WITHOUT
Provocation
Christopher W. Shade, PhDAndrew Elias, CLSSBB
Quicksilver Scientific, LLCLafayette, CO 80026
(303)531-0861www.quicksilverscientific.com
Mercury Testing• Most Common method now is the “Challenge Test”
– No information on form of mercury– Large dose of potentially harmful chelation compound– No information on excretion capacity– Misleadingly believed to reveal “Body Burden”
• Quicksilver Scientific Tri-test uses Mercury Speciation Testing (separation of forms of mercury) and comparisons of different sample types– Clearly Reveals source of mercury and bodily levels– Gives index of excretion ability for each form of mercury
Forms and Sources of Mercury
• MeHg - Methylmercury– Organomercurial; found in fish; Also formed
in gut from amalgam mercury
• Hg0 – Elemental Mercury– The metal form; liquid and gas forms; dental amalgam
• HgII – Inorganic Mercury– The salt, formed by oxidation of Hg0 in blood and mouth
• EtHg - Ethylmercury– Synthetic organomercurial; antimicrobial– Ends up mostly as inorganic mercury
Pathways In – Dental Amalgam
Hg0 breaks down to inorganic mercury (HgII).
Hg0 distributes throughout body and nervous
system.
Image from the International Academy of Oral Medicine and Toxicology.
HgII accumulates in the nervous system, liver,
and kidney.
Hg0 released from amalgam and inhaled with 80% uptake in the lungs.
Amalgams: Pathway of Exposure
80% Uptake
Pathways In – Fish Consumption
MeHg
MeHg
Chemical reactions in the gut add MeHg to an amino
acid.
Fish contaminated with methylmercury (MeHg) get
eaten.
MeHg diffuses out of the gut and circulates
throughout the body, because it gets mistaken
as an amino acid.
Methylmercury accumulates in
the body.
Seafood: Pathway of Exposure
95% Uptake
Pathways In – Vaccines
EtHg
HgII
accumulates in the body.
EtHg distributes throughout the body and
nervous system.
EtHg probably does not leave the body, but enters tissues and breaksdown into inorganic mercury
(HgII).
Ethylmercury (EtHg) enters the blood through
vaccination
EtHg leaves the blood after a few days.
Vaccination: Pathway of Exposure
100% Uptake
Pathways Out – Methylmercury
Pathways Out – Inorganic Mercury
Both Intestinal and Kidneys
Mercury Speciation Testing• Patented Mercury Analysis Technique
separates methyl and inorganic mercury– Shows different sources (fish vs. amalgam)– US Patent #7,285,419 B2
• Comparison between matrices shows excretion or retention of mercury
• Only clinical lab in the world offering Mercury Speciation Analysis
Challenge Tests – What do they mean? Are They Necessary?
Mercury Industry Workers
Dentists
Controls (Amalgam)
Amalgam-free Referents
Industrial workers 3-4 yrs on job, versus dentists 10-30 yrs on the job and amalgam bearers with 10-30 yrs with fillings
Mercury Industry Workers
Dentists
Controls (Amalgam)
Amalgam-free Referents
If challenge reflected long-term body burden, the long-term dentists would have moved closer to the short-term industrial workers…but it did not
Challenged Urine correlated well with pre-challenged urine and pre-challenged plasma
Chelation therapy – Dump from blood followed by reloading from cellular
burden
Chelators drain the blood metals through the kidneys. After cessation of use, the tissues replenish the blood
Mercury Speciation Testing
• Separates the two main forms of mercury in the human body (Methyl and inorganic mercury)– Once separately measured, ambient
measurements reveal a lot without challenge tests
Testing for Hg – Forms Present in Different Samples
1. Ambient1. Blood – MeHg + HgII (MeHg larger)2. Hair – MeHg only3. Urine – HgII (little bit of MeHg)4. Stool – MeHg + HgII
2. Provoked1. Urine – MeHg + HgII
Blood Testing
• Old Dictum – blood is only recent exposure, 3-days• Reality
– 3-day residence only the quick decay after a large dose
– For MeHg, Steady state develops after initial decay; Then blood reflects body burden!
• Real Problem– Most labs detection limits too high to see dynamics– Need sensitive equipment!
H
HH
Hg
Fish Consumption12 hr peak and fast decay over 24hrs
Clarkson et al., Arch. Env. Health, 1980
Fish ConsumptionSlow 160 day return to baseline
After initial peak and decay, Blood reflects Body Burden!
Mercury Speciation Testing
H
HH
Hg
Mercury Speciation Testing and Compartment Ratio Testing
Ambient Measurement Suite1. Blood – MethylHg + Inorganic Hg2. Hair – >95% MethylHg
-Compare to blood MethylHg for excretion measurement
3. Urine – >95% Inorganic Hg-Compare to blood inorganic mercury for
excretion measurement
Blood Mercury Speciation
Methyl Hg
Inorganic Hg
Total Hg
Methylmercury levels with comparison to laboratory average
Inorganic Mercury levels with comparison to laboratory average
Sum of 2 forms = total Hg with comparison to laboratory average and color coded CDC population averages
Compartment Ratio Analysis: Patient #1 – HealthyLow Levels and Good Excretion Profiles
Methyl Hg
Inorganic Hg
Total Hg
Low Methyl and average Inorganic Hg
Good MethylHg excretion
Good Inorganic Hg excretion
Compartment Ratio Analysis: Patient #2: Dentist with Chronic Intestinal Inflammation
B elo w A verage Excret io n of blood mercury through the hair.
A verage Excret io nof blood mercury though the hair (290:1).
Indication of Mercury Excretion Ability
0
400
800
1200
1600
2000
2400
2800
0 2 4 6 8 10
Blood MeHg (ng/mL)
Hai
r MeH
g (n
g/g)
Methyl Hg
Inorganic Hg
Total Hg
Very High Methyl and Inorganic Hg
Bad Inorganic Hg excretion
Bad MethylHg excretion
Compartment Ratio Analysis: Patient #3: Dentist – Kidney Problem from Long-term Hg vapor Exposure
0 0.5 1 1.5 2 2.5
Concentration of Mercury (ng/mL or ug/L)
HgT
Hg(II)
MeHgPatient BloodQS Average
A verage Excret io nof blood mercury though the hair (290:1).
B elo w A verage Excretio n of blood mercury through the hair.
Indication of Mercury Excretion Ability
0
400
800
1200
0 1 2 3 4 5
Blood MeHg (ng/mL)
Hai
r MeH
g (n
g/g)
Indication of Kidney Mercury Excretion Ability
0.000.501.001.50
2.002.503.003.504.004.505.00
0 0.5 1 1.5Blood Hg(II) (ng/mL)
Urin
e H
g(II)
(n
g/m
L)
Go o d H g(II) Excret io n Line (7:1)
Methyl Hg
Inorganic Hg
Total Hg
Normal Methyl and Very High Inorganic Hg
Good MethylHg excretion
Bad Inorganic Hg excretion
Compartment Ratio Analysis: Patient #4 –Likely Methyl Hg Detox Enzyme Deficiency
Bad MethylHg excretion
Quicksilver Scientific Tri-test
• Clearly Reveals source of mercury• NO provocation (chelation) agents used• Gives index of excretion ability for each form
of mercury for informed treatment options