FACTS ABOUT MERCURY, DENTAL AMALGAMS and DETOXIFICATION OF INCREASED BODY BURDEN OF MERCURY | Robert A. Erickson, M.D., F.A.A.F.P.
Introduction
The pollution of our air, water, and food supply with mercury is a recognized health hazard, and the US and other governments have set guidelines to reduce its impact on the environment. Up until several years ago mercury in the form of thimerosal was used as a preservative in vaccines. It has been removed from childhood vaccines but still remains in some adult vaccines such as the flu vaccine. Our attention in this paper is on “internal pollution” of our bodies with mercury.
Mercury is found in two basic forms: inorganic and organic. Inorganic mercury is found in nature. Organic mercury is mercury that has been processed through a living system. As mercury leaks out into your digestive tract, bacteria that are normally present will change this inorganic mercury into a form of mercury called methyl mercury which is hundreds of times more toxic than inorganic mercury, or even arsenic.
Mercury exposure can permanently damage the brain, kidneys, and developing fetus. The EPA (Environmental Protection Agency) has reported that approximately 630,000 newborns in the United States had unsafe amounts of mercury in their blood which had derived from contaminated cord blood. The report suggests that mercury accumulates in the umbilical cord blood at a level higher than in the blood of the mother. This means that a woman whose mercury blood level was around 3.5 ppb could have a newborn with a mercury concentration greater than 5.8 ppb, the current safety limit for mercury. About one out of every six women of childbearing age has enough mercury in her blood to fit into that category and pose a threat to her fetus according to the statistics presented by researcher and author of the paper, Dr. Kathryn Mahaffey. Certain species of fish (tilefish, shark, swordfish, tuna, king mackerel) contain high concentrations of mercury and the FDA has issued warnings to pregnant women to avoid these species.
Mercury can also be found in cosmetics, contaminated well or drinking water, emissions from electric power plants, and batteries to name a few. U.S. dentists use an estimated 100 tons of mercury per year.
What are the symptoms of mercury poisoning or exposure?
There are over one hundred known symptoms of mercury toxicity, most of them vague. They include irritability, depression, bouts of anger, anxiety, numbness or tingling in extremities, frequent urination at night, unexplained fatigue, cold hands and feet (even in warm weather), stomach upset or heartburn, colitis, abdominal pain, constipation, sleep disturbances, headaches, unexplained chest pain, heart attack, heart palpitations and arrhythmias, dizziness, speech disorders, leg cramps, clumsiness, bad breath and metallic taste in mouth, bleeding gums to name a few. It is not known what role mercury toxicity may play in MS (multiple sclerosis) and ALS (amyotrophic lateral sclerosis or Lou Gehrig’s disease). Dr. Boyd Haley, a professor of chemistry at the University of Kentucky, has multiple research articles published associating mercury dental amalgams with Alzheimer’s disease.
Mercury and dental fillings
“Silver fillings” or amalgams are really a mixture of 50% mercury, 35% silver, 13% copper and traces of tin and zinc. Until the mid-1980′s dentists assumed no mercury vapor was released from amalgam fillings. Since then studies have proven a significant level of mercury vapor is released by simply chewing your food. Mercury is a poison that doesn’t belong in your mouth, and it accumulates over time. It’s absorbed from tooth fillings through the mucous membranes of the mouth. Countries such as West Germany, Sweden, and Australia do not allow the use of mercury fillings where they are viewed as a dangerous health hazard.
Dr. D.W. Eggleston published a study using brain autopsy specimens showing a direct correlation between the accumulated level of brain mercury and the number of fillings in the cadaver’s mouth. The more fillings, the more mercury.
According to the World Health Organization, the average daily absorption of mercury from dental amalgam is from 3 to 17 micrograms per day, compared to a maximum of 2.6 micrograms from all other sources combined. Other researchers contend that just one amalgam filling can release as much as 40 micrograms per day.
Why are some dentists still using mercury amalgams?
The ADA’s (American Dental Association) position is that mercury amalgam is biologically safe in your mouth. What is being taught in dental schools is that the mercury is bound to the silver in the amalgam and does not escape to poison the patient. In the April 2006 issue of JAMA (Journal of the American Medical Association) a report on the ‘safety’ of mercury dental amalgams in children was presented. This report was supported by the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health. In this study 2 groups of children were followed for 5-7 years B those who received mercury containing dental amalgams to fill cavities, and those who received composite fillings. The report concluded that children whose cavities were filled with dental amalgam containing mercury “had no adverse health affects . . .” The report did acknowledge that the amalgam filling group had higher levels of mercury in their urines than the group of children who received non-mercury containing composite fillings for the first two years, but this higher excretion became equal after two years. The report did not explain this reduction in excretion of mercury. In my opinion, this reduction in excretion of mercury by the kidneys in the mercury amalgam group of children was due to the toxic effect of mercury on the kidneys. This study was flawed for a number of other reasons (see my September 2006 newsletter).
The ADA Council on Dental Materials sensibly warns dentists that the mercury vapor that comes out of scrap amalgam is extremely dangerous and a no-touch technique for handling the amalgam is taught. They also insist that dentists store mercury in tightly sealed containers, avoiding heating mercury or amalgam, and perform yearly mercury determinations on all dental office personnel. But why does the ADA say a mercury amalgam is safe in your mouth and the EPA (Environmental Protection Agency) says when amalgam is taken out of your mouth it is a toxic waste and must be handled a certain way to protect dental personnel from getting mercury poisoning!
Why hasn’t my dentist told me about this?
A growing number of states now require informed consent for patients regarding the presence of mercury in amalgam fillings and about its negative health effects. In medicine, if a drug has a 1 in a 1000 chance of causing an adverse reaction, the patient is informed of the risks and benefits. This is called “informed consent.” The ADA has deemed it unethical for any dentist to tell a patient to have their mercury amalgams removed for health reasons. The ADA has spent large sums of money prosecuting dentists who say that mercury is poisonous and who refuse to place it in their patient’s mouths. In my opinion, their concern is over the tremendous financial liability it places all dentists, the ADA, and the amalgam manufacturers in. Many dentists avoid using mercury amalgams, recognizing there are much safer materials available for patients and they also wish to avoid exposures themselves that could be harmful.
What is Dr. Erickson’s experience in this area?
Since the late 1990′s I have been involved in the treatment of patients with chronic bio-accumulation of mercury and other toxic metals. I attend conferences where the issues of chronic environmental exposures adversely impacting health are discussed, and how best to diagnose and treat them.
In addition, I am a Diplomat of the American Board of Clinical Metal Toxicology (previous named the American Board of Chelation Therapy), having passed both written and oral Board exams. What I have found is no two persons are alike, and each person’s treatment protocol must be individualized based on age, medical condition, severity of the heavy metal burden, the ability of the person to detoxify and excrete the metals, psychological factors, lifestyle, etc. This is not a simple treatment. You probably want to know how long the process will take. Generally, the minimum time is six to eight months, although in fragile patients it might take several years of intermittent therapy to complete. Each heavy metal comes out in a specific order and often “pockets” of stored toxic metals release months or even a year into the treatment process. We use periodic provocative urine challenge tests to monitor a patient’s progress. Hair analyses for toxic metals are used as a screening tool to document exposure, but not body burden. Traditional medicine does not recognize these tests, relying on whole blood heavy metal assays to document an acute toxicity.
Acute mercury toxicity vs. chronic accumulation
Acute toxicity from mercury is rare, and most traditionally trained physicians have no awareness of how to look for bio-accumulation from low dose exposures to these metals over a long period of time. Because the metals are joined with the tissues in the body, they do not show up in blood tests or urine tests, and require a special type of testing of urine after a chelating agent is given to release them from the tissues. For example, methyl mercury stays in the blood for only 24 hours before it is distributed to various tissues in the body and can no longer be measured in the blood.
Why detoxify mercury?
Mercury has no known physiological function in the human body. In spite of what the EPA (Environmental Protection Agency) and other governmental health agencies would have us believe, in my opinion there is no such thing as a “safe” amount of toxic metal because microscopic amounts of these poisons affect us on a cellular level. Although our understanding of all the mechanisms of action that toxic metals affect is incomplete, we do have knowledge about several mechanisms. In a brilliant but very technical report Metals In Medicine by Robert A. Nash, M.D. (published in Alternative Therapies July/August 2005. Vol. 11. No. 4), twelve different mechanisms of damage to our health were outlined. Toxicant metals can cause bioelectrical short circuits, damaging body function. Metals can combine with proteins creating metal-protein complexes that our body’s immune system sees as a foreign invader. This results in our immune systems attacking our own tissues, resulting in autoimmune disorders and allergies. Toxic metals act to deplete glutathione and vitamin C, our two most important anti-oxidants that help prevent cancer and keep our immune systems strong. Toxic metals alter brain function. Mercury, in particular, causes neurofibrillary tangles identical to those seen in Alzheimer’s disease. Mercury and lead also cross the placental barrier, allowing these poisonous metals into the unborn baby. Toxic metals decrease dopaminergic brain activity leading to degeneration of nerve and brain cells. Toxic metals also damage DNA directly and can lead to cancer.
Mercury in low levels can result in decreased senses of touch, hearing, vision and taste, as well as a metallic taste in the mouth. Fatigue, lack of appetite, numbness in the extremities, headaches, hypertension, irritability and excitability, immune suppression, and anemia can also occur. It can also cause a lack of libido and sexual response. In severe cases, psychosis, manic behavior and autoimmune dysfunction and renal failure are seen. There is also an association between mercury containing dental amalgams and intra-oral cancers.
Are your symptoms due to an increased body burden of mercury or other toxic metals?
This is a very complex area that I will try to summarize.
Toxicity is based on 2 factors: 1) the amount of toxic substance(s); 2) the genomic factors (genetics) of the person and their ability to detoxify the substance. For example, two people have identical blood alcohol levels. One person is clinically drunk and the other is not.
Acute toxicity is often easy to diagnose after an acute exposure to the toxic substance. Chronic toxicity, which by its very nature, is difficult to diagnose as it occurs over a long period of time (sometimes decades) with exposure to very low levels of toxins that bioaccumulate in your tissues. Further complicating this is the concept of total body burden of multiple toxins that are in our environment. Multiple different toxins can act synergistically together, having a much greater toxic effect than each would individually. We often see this in medicine with patients taking multiple different drugs, where one drug increases the toxicity of another drug. Keeping these factors in mind, we do not know whether a person’s symptoms will improve until after all their known sources of heavy metals are removed (e.g. dental amalgams, fish consumption, environmental toxin exposures, etc.) and until their body is also detoxified. It has been my experience with patients who have increased body burdens of toxic metals who decide to undergo physician supervised elective/preventive detoxification of metals, that over 85% of these patients have had very good to dramatic improvement, with less than 5% having little improvement once therapy was completed. This includes a wide spectrum of patients, including those with diabetic neuropathy and also multiple sclerosis. My experience has been that the most dramatic improvements are in the lifting of chronic fatigue, brain fog, asthma, and with muscle weakness and pain previously diagnosed as fibromyalgia. But this is no guarantee that your symptoms will resolve should you elect to undergo treatment.
Some of my sickest patients have had only mild elevations of their urine or hair mercury levels. This group of patients often have immune problems such as asthma, fibromyalgia, skin rashes, multiple chemical sensitivities. Transitional metals such as mercury are unstable and can bind to proteins in a person’s body, creating a foreign protein. The body’s immune system is stimulated and “attacks” the foreign protein-metal complex. An allergy, rather than toxicity, can cause symptoms. Dr. Vera Stejskal is an Associate Professor of Immunology at the University of Stockholm in Sweden. She is an expert on mercury allergy and toxicity and has developed a test called MELISA which diagnoses allergy to mercury and other heavy metals. She has brought this technology to the United States. Her web site is www.melisa.org and you may want to read the articles on this site. We can order this test for you.
Should mercury dental amalgams be replaced with non-toxic material?
The World Health Organization position is there is no “safe” level of mercury in human beings. I agree. I would, for this reason recommend that a person who wishes to remain healthy, have any mercury amalgams removed according to proper protocol, and not to have mercury amalgams placed in the future. If you have cancer, diabetes, thyroid disease, multiple sclerosis, or any other immune system disorder, removal of mercury amalgams in my opinion is critical. Your dentist may be a traditional dentist and not agree with this viewpoint and you will have to make decisions as to what is proper for you and your health. I don’t have any of these diseases and I have had my amalgams removed to protect my immune system. I further recommend using only a dentist who is experienced in safe amalgam removal, as improper amalgam removal will make a bad situation worse. Ask the dentist if he/she is a “mercury-free dentist.” Ask your dentist if they use a rubber dam, nasal oxygen, high volume suction, a removal by quadrants rather than all at once, and if they do compatibility testing for dental materials before they replace your amalgams. If your dentist answers “no” to these questions or is still putting mercury in patients, I would be concerned. I also suggest high dose intravenous vitamin C be given following each amalgam removal. Vitamin C is a weak chelating agent and will help remove the mercury spilled during the dental procedure. This needs to be done within 2 hours of completion of your dental procedure. If you cannot afford removal at this time, or if your condition is very fragile and doesn’t allow amalgam removal currently, there are still options to reduce the level of mercury in your body.
Can’t I just have my dentist remove my fillings?
There is a specific protocol recommended to safely remove dental amalgams. Some dentists are not aware of this protocol. During the removal the dental drill will vaporize mercury, potentially releasing a large amount into the body, making your condition worse than what it currently is. Using a rubber dam reduces the risk of swallowing mercury amalgam pieces that break off during the procedure. So there are specific steps which must be followed in order to reduce your exposure. Also, just removing your fillings does not take care of the mercury in your tissues. You would need to undergo a detoxification process to remove this.
How do I get mercury out of my body?
An oral medication called DMSA (meso-2,3-dimercaptosuccinic acid) can be used to reduce an increased body burden of mercury . DMSA binds with mercury, arsenic, and lead, and allows the removal of these metals from the body. It is believed DMSA does not cross the blood-brain barrier, but indirectly pulls mercury and other heavy metals out of the brain. It is excreted primarily by the liver and to a lesser degree by the kidneys. DMSA must be absorbed through the gastrointestinal tract to be effective. If a person’s digestive system is impaired, DMSA may not work. DMSA has not been show to have a significant effect on the urinary elimination of calcium, iron, or magnesium, but zinc excretion doubled in studies done by the drug company. This is different than the experience with EDTA chelation.
DMSA can be custom formulated as to dose by a compounding pharmacist, based on your weight and condition. DMSA was developed to treat lead poisoning in infants and children and is approved by the FDA for this purpose. It is marketed under the name of Chemet. It has been used safely for over 30 years in large numbers of patients and has relatively little side effects, but it can cause nausea. It complexes easily with mercury, especially organic mercury, and the other metals mentioned. DMSA therapy may take anywhere from several months to several years to reduce a body burden of mercury.
Intravenous DMPS (2-3-dimercaptopropane-1-sulfonate) is a highly effective chelating agent for mercury. This drug is not approved by the FDA as it is manufactured in over seas, but it is allowed to be imported into this country as a safe medication for compounding. It is usually given monthly and is primarily excreted by the kidneys.
There are other medications which can remove mercury that I mention for completeness: BAL and D-Penicillamine, but they are rarely used.
Are special supplements needed during treatment?
The answer is “yes.” Chelating agents do not work just by themselves. Your body’s detoxification pathways must also be supported nutritionally if you are to excrete the bound heavy metals. Otherwise, they will stay inside your body and be recycled. The rate at which you detoxify will determine in large part the degree of symptoms you experience during the treatment process. We are not in a race and we want to keep the detox symptoms tolerable. You may feel some of the following symptoms, depending upon what metal you are excreting: fatigue, headaches, body aches or flu-like symptoms, nausea, diarrhea, foul smelling stools or urine, anxiety, depression, heart palpitations, and muscle weakness (especially as the mercury is coming out).
Dr. Erickson will look at your lab work and clinical situation and custom tailor a nutritional support program for you. In some cases it is started at 4 weeks before taking the DMSA or IV DMPS. It is also important to take this nutrition on a daily basis between oral chelation treatments, but not on the days you are taking DMSA or receive IV DMPS as it may bind to the minerals in the supplements, and not the toxic metals. There is also an intravenous nutritional protocol that is used following guidelines from the American Board of Clinical Metal Toxicology.
Dietary considerations
Dr. Erickson recommends that your diet contain an increased level of complex carbohydrates, to include fresh fruits and vegetables, organic when ever possible. If you have trouble with grains (they may contain a pesticide or fungicide some patients react to), try organically certified grains and whole breads, or sprouted breads that do not contain flour. We find if you have a diet 50% complex carbohydrates, at least 20% high protein foods including nuts and organic chicken, and no more than 30% fat, you will do better. For patients on an Adkin’s type of program, this is not the time to be worrying about your weight. You will have less detox symptoms with the carbohydrates binding the toxins in the intestine on their way out.
· JUICING. It provides your body something no supplement can B namely, fresh plant enzymes that will help greatly in the detox process and give you an energy boost. Use organic vegetables and fruits. I recommend drinking an 6- 8 oz. glass in the morning and an 6- 8 ounce glass in the evening (start with 1 glass a day for a few days to get used to this). Try an equal mix of organic carrots, celery, and zucchini (with the skins on) for detoxification support. Celery-apple juice relieves inflammation and body aches, and helps nervous tension. Cucumber juice or watermelon juice (including the skins/rinds) acts as a diuretic/flush. And buying frozen or bottled stuff doesn’t work the same.
· NO SEAFOOD. Period. Lean protein foods such as Maverick or grass-fed beef (no more than 7% fat), lamb, turkey, and Empire Brand Kosher chicken or Springer Mountain Chicken (no hormones, chemicals, etc.) should be used.
· FATS. No more than 30% of calories should come from fats, and these should be the “good” fats from butter or olive oil (see my September 2011 Newsletter on healthy and unhealthy fats). Do not deep fry foods. Bake or broil.
· CRUCIFEROUS VEGETABLES. Eat foods with a high sulfur content, as this tends to bind mercury. Eggs (from free roaming chickens, no antibiotic in feed), cauliflower, broccoli, cabbage, Brussels sprouts, garlic and onions all have a high sulfur content. These foods help in the detoxification process.
· WATER. I suggest purified mineral or spring water, or distilled water (if you add the missing minerals). Add lemon or lime juice to the water. Drink 6 eight ounce glasses of water a day to help flush toxins.
· NO ALCOHOL. (Depletes B vitamins and acts as an additional toxic load on the liver).
· NO SUGAR. This means avoidance of cakes, pastries, cookies, candy, soda pop, and anything that says “High Fructose Corn Syrup or Sugar Added.” Sugar stresses your adrenals and pancreas further, and is not good for your immune system. If you need a natural sweetener, buy Stevia in liquid or powder at a health food store. Ask us about Standard Process Food Bars if you have a sweet tooth or snacks are needed.
Other things that can help
Removing heavy metals is a major undertaking. It is important to treat yourself well during this time, as most people feel more tired and have some symptoms related to the detoxification. Here are some additional things I have found helpful:
· Give Thanks every day. We all have a lot to be thankful for. Get adequate rest. Take a short 30 minute nap in the afternoon if you need to.
· Do not go on a diet during this time. Fat dumping of stored toxins will add to symptoms.
· Walk every day 20 minutes. Vigorous exercise is not needed, but it’s okay to continue an exercise program if you’re used to one.
· Sauna therapy, especially an infra-red sauna can be very helpful in removing toxins and increasing body temperature in patients with thermoregulatory dysfunction so their enzyme systems can function more normally. Talk to Dr. Erickson about this before doing on your own. If you have a serious medical problem such as heart disease, diabetes, high blood pressure, etc. do not do this without direct medical supervision.
· Take one day at a time. Stress has an adverse affect on health. Be kind to yourself as you go through this treatment. Some days will be better than others. When you are having a tough day, just remember you are taking one step at a time to improved health, and you’re that much closer to where you want to be.
Summary
Traditional medicine and dentistry do not recognize mercury amalgams as a potential health hazard or increased body burdens of toxic metals as a health problem. Many CAM (complementary and alternative medicine) physicians, integrative physicians such as myself, and holistic dentists are not in agreement with this viewpoint for the reasons outlined in this paper and elsewhere. The decision to reduce your body burden of mercury through a physician supervised elective/preventive program of mercury detoxification and/or to have your mercury-containing dental amalgams replaced with non-toxic material is a decision only you can make. A list of references is provided at the end of this paper as well as websites you may wish to investigate. You will also be given a DVD on mercury amalgams from a biological dental perspective, produced by IAOMT. I encourage you to view this DVD. Please feel to share this DVD with family and friends.
“Mercury compounds have no known normal metabolic function and their presence in the cells of living organisms, including human beings represents contamination . . . all such contamination must be regarded as undesirable and potentially hazardous” — the conclusion of the National Research Council of the U.S.A. in their 1978 report “An assessment of Mercury in the Environment.”
References
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