Tracey O’Shea: “Are we going to learn about metal toxicity testing? Chris has referred to it but has not specified what he uses. I have used limited serum testing before chelation therapy, a test for mercury, lead, and calcium. Is this reliable?”
Heavy metal testing is not covered in ADAPT right now. [Chris] has talked about it with me many times about wanting to kind of create some curriculum on this. I think it’s a little difficult because things change often and there’s a lot of nuance to heavy metal testing, and it really can, like, the treatment of heavy metal toxicity can be tedious and a little dangerous, too, I think, if you’re not familiar or comfortable with some of the more, like, intense treatments like chelation therapy, so I’ll just mention a little bit about what we use in practice and just try to give you a little bit of information. We generally start with the Quicksilver Lab; that’s our preferred lab for testing for heavy metals. The Quicksilver Blood Metals Panel is a blood metals panel, as it sounds, and that tests for red blood cell nutrients and minerals, and it also will test for a variety of heavy metals like cadmium, lead, mercury, arsenic, [and] antimony, and that’s kind of a good place to start. If the patient has amalgam fillings or did have amalgam fillings, but mostly, like, if they currently still have them, then we’ll add the Quicksilver Mercury Tri-Test. This is saliva, hair, and blood, and this helps differentiate the type of mercury from organic mercury to inorganic mercury, so organic mercury from, like, fish or the environment versus inorganic mercury. That does have a variety of sources, but the number one is amalgam fillings. So it does help differentiate where the mercury is coming from.
So, if you get the blood metals panel back, which gives you mercury, but it just gives you one value, it combines all the mercuries together. So if that’s high, then that can sometimes be an indication to do the Tri-Test that’s mercury only, [which] looks at three different bodily fluids or sources to look and help differentiate between the different types of mercury. So those are what we use hands down, like, we don’t do any of the serum testing through LabCorp or through Quest. We use the Quicksilver. Chris is much more comfortable with their methodology and they do have more of a narrow range, so it helps. I think it’s a little bit more representative of what a Functional Medicine approach should be for dealing with heavy metals is optimization of health and optimization of what’s the minimum amount of heavy metals we want in our body. There doesn’t seem to be any healthy level of lead or heavy metal in the body, but it’s not always possible to get everyone down to zero; in fact, let’s say it’s probably improbable to try to look for a zero amount of lead. It’s really difficult to do, but the Quicksilver test[s] are often looking for ongoing exposure or exposure within the last three months or so because this is looking at serum and hair, so it’s not going to really be representative of, like, really old exposure in the body. So that can be a limitation of the Quicksilver test, and if we are concerned that there is old metal, like, old stored body burden of lead, that tends to be where lead is hiding is in your tissues. The body’s defense mechanism is to take the heavy metals that are in the blood and stored in the tissues because that is the body’s way of trying to protect itself is to kind of wall off and store away the heavy metals, so you may not get an accurate representation of the total body burden in the Quicksilver test, and the next step that we do to find out body burden of heavy metals is to look at a provoked urine test. We use the Doctor’s Data Toxic Metals Panel. This does involve using a chelating agent. Usually, we use DMSA on our end. We also combine it with EDTA. There are some studies and research that show priming the body with glutathione for 30 days prior to taking the test. It can help protect and mobilize metals as well as doing EDTA prior to taking the DMSA on the same day. I won’t go into all the instructions, [as] it’ll just get pretty tedious, but we use the Doctor’s Data provoked urine test, pretest for pre-provoked, and then six-hour collection after you’ve taken the DMSA, and that gives us a real[ly] good representation or the best that we have available of total body burden of heavy metals and that can really make a difference with knowing [if] this is an old exposure, [and] what is the value of that old exposure, and interpreting those is a little tedious. We’ve had to really talk to a number of different specialists, including Dr. Quigg and Dr. Shade, to really get their take on what levels to treat of stored body burden of lead and mercury, and so it’s a little nuanced. I’m really hoping that we can try to get out that material. I’ll bring it up to Chris again and see where we’re at as far as getting that into the curriculum and content, but I hope that just gives you a little bit of information, at least. I think the Quicksilver Blood Metals Panel and the Quicksilver Tri-Test is a good place to start, especially if you’re not familiar with chelating and you’re not familiar with [the] provoked urine test, I think the Quicksilver place is a good place [to] start.