Assessment of heavy metal toxicity
Exposure to heavy metals
Heavy metals we may be exposed to includes:
There are many ways we are exposed to metals. Some are well known such as mercury in large fish and amalgam fillings. Aluminum is often added to table salt, or can be absorbed into food cooked on aluminum foil. Drinking water can contain heavy metals including lead. A listing of all the metals and sources of exposure are beyond the scope of this page. Nonetheless it should be understood that we live in a world where we are all exposed to metals and other toxins. Sometimes the source of exposure is obvious, sometimes it is not.
After exposure to toxins we rely on our body's immune system, protective barriers (such as GI mucosa) and detoxification pathways to protect us. If these systems are overwhelmed toxins become stored inside of us, where they can enter cells and cause damage.
How to test for heavy metals?
Five different methods which will be covered:
- Blood tests
- Urine metal tests
- Urinary porphyrin tests
- Hair analysis
- Kinesiology (or muscle testing)
Blood tests for heavy metals
In people who are chronically sick for no apparent reason conventional doctors at time will test for levels of heavy metals. This is a good test for acute exposure. However the body will not keep high levels of metals circulating in the blood stream for long. So this is a poor test for long term or chronic exposure.
Urine metal tests
Urine metal tests are commonly ordered by natural health-care practitioners and "functional medicine" doctors. Specialty labs such as Doctors Data and Genova Diagnosis offer this test. This is an excellent way to see what metals are being spilled out into the urine. Just like with blood tests, this will normally not show much except in cases of acute exposure. To get around this provoking agents are typically given to get the body to dump metals out in the urine before taking the test. Often this has been the chelating agent DMSA. This used to be available over the counter, but several years ago the FDA disallowed that. For provocation I've use the supplement Porphrazyme from Biotics, which is an excellent heavy metal detoxifier.
Porphyrins are metabolites produced in the production of hemoglobin. Exposure to certain toxins can interrupt these pathways and cause metabolites to spill out into the urine. This testing is thus and indirect assessment of toxic burden on the body. Unlike the direct urine metal test a provoking agent is not requires. It also gives an indication of the effect of some non-metal toxins on the body.
Typically I prefer porphyrin over urine metal tests. The porphyrin tests is more of an overall assessment of the burden on toxicity on the body. It does not require a provoking agent and given some insight into the impact of other environment toxins on the body.
Hair analysis is a somewhat disputed method of testing for toxicity. Interpretation of results can be difficult as hair levels of minerals do not necessarily reflect how much is in the body. For example, a metal may be very high and causing symptoms, but test low on hair analysis because the body is not able to detoxify it. There are also different labs, which handle the hair differently which may effect results. The lab I use is Doctors data and interpret labs based on guidelines established by Andrew Hall Cutler. At times hair analysis can be an easy and inexpensive way to test for metal toxicity and other mineral imbalances.
Muscle Testing (at times called Applied Kinesiology) is a diagnostic technique which uses challenges against muscle strength to determine areas or causes of weakness in the body. There are many different ways to use manual muscle testing, what is discussed here is only one method that some practitioners may use. For testing weakness against toxic substance or allergens the person being tests can hold a vial or the substance and have it placed on them. The practitioner then tests and indicator muscle for weakness. If the muscle locks it means the substance is not a problem. If the muscle goes weak then the substance is. This is by no means a direct test for levels of a toxin, nor does weakness mean that the substance is the cause of a person's symptoms. It's also possible to have false negatives (a substance that is a problem tests strong), the reasons for which and how to uncover these is beyond the scope of this article. Nonetheless, muscle testing techniques can be a valuable tool to determine which toxins may be causing symptoms and what supplements or herbs can be used to help the body overcome it. Muscle testing is best used when performed by a trained practitioners and within context of other assessment techniques (detailed history and appropriate lab tests).
Metal testing - putting it all together
All cases begin with a solid history and consideration of all symptoms. Only then should a decision be made on what tests are needed to run, if any at all. Typically after taking a history I'll do some Kinesiology tests for common metals and other toxins. For relatively simple cases this may be that is needed before putting together a plan. For more complicated cases I use porphyrin tests for a general overview of toxic burden on body. Hair analysis is for looking more specifically at metals and mineral issues. There are practitioners who use urine metal tests to establish need for detoxification. I don't use urine metal tests that way since I don't have access to DMSA. Regardless, there are plenty of other assessment tools available without needing to resort to a toxic chelating drug.