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Toxic Metals and
Mental Health
by Mark D. Filidei,
DO
San
Francisco Preventative Medical Group
345 West Portal
Avenue
San Francisco, CA 94127
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The term “heavy metals” refers to elements of
specific weight characteristics. Toxic
heavy metals are, unfortunately, present in our air, water, soil, and food
supply as a byproduct of our industrialized society. In fact, contamination is so pervasive in our environment
that it is no longer a question of whether one has been exposed to toxins,
but rather the level of exposure. People
who have acute toxicity from heavy metals –
such as lead, mercury, arsenic, and cadmium – may exhibit obvious
and classical symptoms of poisoning.
But toxicity from chronic low-level exposure is much more insidious
in its presentation. Chronic
low-level exposure can lead to a wide array of problems, ranging from
neuropsychiatric disturbances such as aggressive behavior, memory loss,
depression, irritability, and learning deficits, to physical
manifestations such as liver and kidney dysfunction, fatigue, infertility,
gout, hypertension, headache, and candida (yeast) infections.
Even
though efforts are under way to curb the output of toxins and heavy metals
into the environment, the problem is far from being resolved.
Today, even in the United States, thousands of tons of toxic
industrial wastes, including heavy metals, are dumped into the environment
every year. We are left with a legacy of years of industrial pollution and
toxic substance use that haunts us to this day. Perhaps the two most widespread and significant heavy metal
toxins are mercury and lead.
Lead
It
is estimated that about 64 million homes in the United States still
contain lead paint and that 5 to 15 million of these have been identified
as "very hazardous" by the U.S. Department of Housing and Urban
Development. According to the
EPA, an estimated 1.7 million children are currently affected by lead
toxicity in United States, and almost 900,000 of all children affected are
under the age of six. This statistic is very important because the
symptoms of lead poisoning in children are strikingly similar to several
psychiatric "diseases" that are on the rise in the U.S.
Children with high lead levels can exhibit lower IQ scores,
learning disabilities, hyperactivity, aggressive or disruptive behavior,
and difficulty maintaining attention. A child exhibiting this type of
behavior today would likely be sent to a doctor's office, diagnosed with
attention deficit disorder, and promptly started on Ritalin or other
psychoactive drugs.
Children
with high lead levels are much more likely to drop out of school, have
reading disabilities, and exhibit criminal behavior.
Herbert Needleman, M.D., a professor of psychiatry and pediatrics
at the University of Pittsburgh, conducted a study of nearly 2,000
children in Boston. He found
that girls with elevated levels of lead were more likely to be dependent,
to be poor at concentration, and to "display an inflexible and
inappropriate approach to tasks," while boys were more likely to have
difficulty with simple directions and sequences of directions.
Dr. Needleman concluded: "…Our findings would appear to add
to the weight of evidence that even a lower level of exposure to lead, or
its correlates, place children at increased risk of difficulties in
school."
It
is important to note that childhood exposure to lead can result in adverse
effects well into adulthood. A study by Stokes, et al, showed that a group
of 281 young adults who had been exposed to lead as children showed
significant adverse neurobehavioral effects 20 years after environmental
exposure. While lead has been eliminated from the nation's gasoline
supply, the major source of contamination is lead-based paint, which was
composed of up to 50% lead. Flakes and microscopic dust from the paint
continue to contaminant homes for many years, and can be released in
larger amounts during renovations. Additional sources of lead include
water pipes, pesticides, factory emissions, cosmetics, and some folk
remedies.
In
addition to being a cellular toxin, lead competes with calcium in the
body, which can cause various malfunctions in calcium metabolism including
a decrease in neurotransmitter (chemicals that relay messages along nerve
cells) release and blockade of calcium channels. The central nervous
system appears to be affected to the greatest degree by lead toxicity, and
this can explain the many neuropsychiatric symptoms associated with
exposure to this heavy metal.
Why
are some people more susceptible to heavy metal toxicity than others?
One must always remember that each individual has a unique
physiology, and may have an inherently strong or weak detoxification
system to handle heavy metal exposure. In addition, poor nutrition, such as iron or calcium
deficiency, has been shown to exacerbate the symptoms of lead exposure.
Lead
can be absorbed through the gastrointestinal tract and also inhaled as
small particles. Chronic
exposure to lead can result in significant accumulation in the brain, soft
tissue, and bones. Lead that
has accumulated in the skeleton can remain there for many years, releasing
lead slowly back into the bloodstream over an extended period of time.
Neuropsychiatric
symptoms of chronic lead exposure include:
-
Headaches
-
Poor memory
-
Inability to concentrate
-
Attention deficit
-
Aberrant behavior
-
Irritability
-
Temper
Tantrums
-
Fearfulness
-
Insomnia
-
Lowered IQ
-
Difficulty with the reading, writing, language,
visual and motor skills
Mercury
Mercury
is considered by many to be even more toxic than lead.
Although mercury is poorly absorbed from the gastrointestinal
tract, mercury vapor is easily taken in through the lungs and readily
passes into the brain. Once
in the body, mercury also concentrates in the nerves, liver, and
especially the kidneys. Mercury
is a potent cellular toxin and is known to decrease neurotransmitter
production, disrupt important processes within the nerve cells, and
decrease important hormones such as thyroid and testosterone.
"Silver"
amalgam fillings are the major source of inorganic (does not contain
carbon) mercury exposure in humans, while seafood and fish constitute our
largest exposure to organic mercury compounds.
Amalgam fillings actually contain approximately 50% metallic
mercury, and they continuously release mercury vapor during chewing,
brushing, or when drinking hot beverages.
Studies have shown that exhaled air of subjects with amalgam
filling contains a significantly higher level of mercury than subjects
without amalgams, and there appears to be a direct correlation to the
number of amalgam fillings and the level of mercury found in both blood
and urine.
Although
the presence of higher levels of mercury in people with amalgam fillings
is not in dispute, there continues to be an intense debate regarding the
health effects of this finding. While
groups such as the FDA and the American Dental Association steadfastly
maintain that amalgam fillings are safe, a growing number of physicians
and researchers are convinced that mercury from amalgam fillings poses a
significant health hazard.
In
addition to amalgam fillings, common sources of mercury include
pesticides, laxatives, batteries, paper and pulp products manufacturing,
drinking water, and paint products.
Neuropsychiatric
symptoms associated with mercury toxicity include:
-
Insomnia
-
Nervousness
-
Hallucinations
-
Memory loss
-
Headache
-
Dizziness
-
Anxiety
-
Irritability
-
Drowsiness
-
Emotional instability
-
Depression
-
Poor cognitive function
Diagnosis
The
diagnosis of heavy metal toxicity must take into account the exposure
history, clinical signs and symptoms, and laboratory tests. While the CDC (Center for Disease Control) has steadily
dropped the "allowable level" of lead in the blood over the last
fifteen years, there remains a problem with using blood levels in the
first place. Blood levels may
not accurately reflect the total body burden of toxic metals.
High blood levels are usually only found in acute toxic metal
exposure, or in people exposed to high levels of toxins over a long period
of time. In chronic low level
exposure, however, the blood levels may actually be low due to
redistribution of the toxins throughout the body, while bone and other
tissue levels remain high.
Hair
analysis is another method of determining toxin exposure that is popular
with many clinicians. Hair
can be a good indicator of exposure because it grows slowly and
incorporates toxic metals into its structure over a long period of time,
and therefore may be a better measure of actual tissue levels.
There are arguments over the accuracy of hair analysis due to the
possibility of contamination from hair dyes, shampoo, and other factors.
Nevertheless, hair analysis can be a valuable screening tool if the
proper questions are asked and the proper steps are taken prior to its
use.
A
more accurate method for evaluating toxic metal burden is to do a urine
challenge test with a “chelating” agent.
Chelating agents bind to heavy metals throughout the body, and then
are excreted in the urine, taking the heavy metals with them.
In the urine challenge test, a chelating agent is administered and
then urine is collected and analyzed to determine the amount and type of
toxic metals that are excreted.
Treatment
The
good news is that effective treatments are available for heavy metal
toxicity. DMSA is an FDA-approved chelating agent that is particularly
useful in cases of mercury exposure (it is also approved for lead toxicity
in children), while EDTA is particularly useful for lead toxicity.
It should be noted that both of these agents remove other toxic
metals in addition to lead and mercury.
There are many different protocols used for heavy metal
detoxification, as well as other chelating agents, but that is beyond the
scope of this article. For more information on detoxification protocols
and testing, contact an alternative medicine physician familiar with these
procedures.
Summary
Toxic
heavy metals are found in the air we breathe, the food we eat, and the
houses we live in. Toxic
metal exposure can result in a wide array of common mental health
disorders that can mimic many psychiatric “diseases” and thus lead to psychoactive
prescription drug use or other unnecessary treatments.
Unfortunately, the majority of clinicians dealing with patients who
have mental health issues are unlikely to suspect heavy metal toxicity as
a cause of their patient’s problems due to a general lack of knowledge
of this subject in the medical community.
Unique biochemical, genetic, and nutritional factors can make
certain people more susceptible to the effects of toxic heavy metals, thus
each case must be handled on an individual basis.
Fortunately, the number of practitioners trained in
“functional” or “orthomolecular” medicine is on the rise, and
these practitioners are very familiar with the diagnosis and treatment of
problems associated with heavy metal toxicity.
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