Many thanks for your question regarding your client who has recently undertaken mercury filling removal and is experiencing weight gain and water retention. It is not clear from your question and health history summary what techniques were used for the mercury removal. This should only be undertaken by a qualified dentist experiencing in mercury removal. Of course, the weight gain and water retention may not be linked to the mercury removal but you mention that these symptoms become apparent shortly after the removal.
One key area to consider is kidney function – as she is water retentive you may wish to ask her GP to check kidney function. Aldosterone is influenced by the health of the adrenal glands as well, so do you suspect there may be an issue with dysregulation of the adrenals? Perhaps an adrenal test would be useful.
I agree as well with the comments that it would be important to rule out thyroid imbalance so do run a comprehensive thyroid screen on this client. This may be connected with the weight gain.
We have spoken about mercury detoxification previously within this Linked In forum so you may wish to look at previous discussions using the search function at the top right of the screen, but here is some useful information.
Mercury toxicity and treatment: a review of the literature. J Environ Public Health. 2012;2012:460508. Epub 2011 Dec 22. (http://tinyurl.com/7clxbqh).
Mercury toxicity and antioxidants: Part 1: role of glutathione and alpha-lipoic acid in the treatment of mercury toxicity. Altern Med Rev. 2002 Dec;7(6):456-71. (http://tinyurl.com/7efbpbb).
Biocompatibility of dental amalgams. Int J Dent. 2011;2011:981595. Epub 2011 Nov 23. (http://tinyurl.com/7amyenh)
Albeit there are clear clinical guidelines for treating acute heavy metal poisoning, no such guidelines exist for chronic exposure, regardless of the source. In the United States, the Agency for Toxic Substances and Disease Registry helps define these guidelines of acute exposures (http://tinyurl.com/d2ar3m). This can make not only testing difficulty to interpret but treatment to remove “suspected” heavy metals from the blood, organs and even the brain.
If you wish to look at mercury burden then Doctor’s Data provides one of the more sensitive urine tests. I would suggest doing a 24 hour collection, unprovoked. The patient should also avoid all supplements for 72 hours before the test and no seafood 1 week prior to the test (http://tinyurl.com/854lvcd). Some supplements or ingredients in supplements can act as chelating agents. Also, much seafood contains heavy metals, unfortunately, and this could cause spuriously elevated results (http://tinyurl.com/98j39w). This is available via Regenerus Labs in the UK.
Dawson EB, Evans DR, Harris WA, Teter MC, McGanity WJ. The effect of ascorbic acid supplementation on the blood lead levels of smokers. J Am Coll Nutr. 1999 Apr;18(2):166-70. (http://tinyurl.com/7dmguzk ).
If you would like to read more, see INTEGRATIVE / ENVIRONMENTAL MEDICINE STANDARD OF CARE GUIDELINES FOR INCREASED TOTAL BODY BURDEN OF TOXIC METALS, EDITED BY ROBBAN SICA, MD. (http://tinyurl.com/3xandf5) and Chelating agents for neurodegenerative diseases by Ward, et al. (http://tinyurl.com/c7n46qv).
There are a number of natural agents that can help with reducing the body burden. Proteins provide the important precursors to the endogenous metal detox and shuttle agents, such as coeruloplasmin, metallothioneine, glutathione and others. The branched-chain amino acids in cow and goat whey have valuable independent detox effects. Therefore, consider whey protein powder if you think this can be tolerated.
Metals attach themselves only in places that are programmed for attachment of metal ions. Mineral deficiency provides the opportunity for toxic metals to attach themselves to vacant binding sites. A healthy mineral base is a prerequisite for all metal detox attempts (selenium, zinc, manganese, germanium, molybdenum etc.). Just as important are electrolytes (sodium, potassium, calcium, magnesium), which help to transport toxic waste across the extra-cellular space towards the lymphatic and venous vessels.
Lipids (made from fatty acids) make up 60–80% of the central nervous system and need to be constantly replenished. Consider Lipid replacement supplements.
Without enough fluid intake the kidneys may become contaminated with metals. The basal membranes swell up and the kidneys can no longer efficiently filtrate toxins. Adding a balanced electrolyte solution in small amounts to water helps to restore intra-and extra-cellular fluid balance. But as mentioned above kidney function may be affected so support for kidney health may be useful as well as referring her back to the GP.
Chlorella can be a useful component of detoxification programmes but it is important to start with a low dose and build up gradually. Chlorella can help improve glutathione levels which is one of the reasons why it can be beneficial. Start with 1g and take 2-3 times daily and you can gradually build up to 3g at each dose. It can also be combined with coriander as well.
The primary process by which the body eliminates the insidious sulfhydryl reactive metals is through the formation of metal-glutathione complexes, of which greater than 90% are excreted into the bile. A preliminary study suggests that biliary/faecal excretion of mercury and lead may be markedly enhanced following high-dose intravenous administration of ascorbic acid, while urinary excretion is unaffected by this. Other orthomolecular or nutraceutical protocols may also enhance the faecal excretion of metals and hence potentially decrease burden on the kidneys.
Dirks MJ, et al. Mercury excretion and intravenous ascorbic acid. Arch Environ Health. 1994 Jan-Feb;49(1):49-52. http://tinyurl.com/nnxjb8a
Glutathione specifically has been shown to protect against renal damage resulting from inorganic mercury toxicity. The co-incubation of rat renal cells with glutathione and inorganic mercury was significantly more protective of renal cell injury when compared to inorganic mercury exposure alone. Antioxidant levels–specifically glutathione, vitamin E, and ascorbic acid–are depleted in renal tissue exposed to mercuric chloride (inorganic mercury), and the addition of glutathione increased levels of both vitamin E and ascorbic acid in renal cells exposed to mercuric chloride.
Lash LH, et al. Influence of exogenous thiols on inorganic mercury-induced injury in renal proximal and distal tubular cells from normal and uninephrectomized rats. J Pharmacol Exp Ther 1999;291:492-502. http://tinyurl.com/p8hfx5o
Divine KK, et al. Glutathione, albumin, cysteine, and cys-gly effects on toxicity and accumulation of mercuric chloride in LLC-PK1 cells. J Toxicol Environ Health A. 1999 Aug 13;57(7):489-505. http://tinyurl.com/nqc2l82
Glutathione and cysteine, acting as carriers of mercury, actually appear to control the rate of mercury efflux into bile; the rate of mercury secretion in bile appears to be independent of actual bile flow (ie increased bile flow will not lead to more mercury excretion). However, increasing bile levels of both glutathione and cysteine increases the biliary secretion of methylmercury in rats. Conversely, glutathione depletion inhibits biliary secretion of methylmercury in animal models and blocking glutathione production appears to shut down biliary release of mercury.
Agents such as chlorella, wheat grass, and spirulina also support detoxification by supporting glutathione levels and binding and preventing reabsorption in the colon. Avoidance of acidifying foods also may decrease heavy metal absorption. Porphyra-Zyme™ is not the same as chlorella and supplies botanical extracts and concentrates providing naturally occurring Chlorophyllin, Galactoglycerides, Chlorophyll (a and b), Phospholipids, Carotenoids, Sulfolipids, Plastoquinones (a, b, and c), Menadione, Cytochrome B6 and F, Plastocyanine, Ferridoxin and trace minerals. It can be used alongside chlorella.
There are other organs than just the liver and kidneys that play a role in heavy metal detoxification and elimination. The skin also plays a role in elimination of toxic metals via sweating. Support for your client with increased clean water to ensure hydration, dry skin brushing, and sweating therapies including low-intensity exercise or saunas will support this.
Regular bowel movements also are important, and a heavy metal or alternate detoxification program should not be initiated unless there are regular daily bowel movements. Without this there can be build up of toxins and reabsorption in the colon, and the microflora is also affected. Agents such as activated charcoal or bentonite clay also may help prevent reabsorption of toxins.
High blood pressure can be an independent risk factor for various health condition including heart disease and stroke so it is important she controls this.
Healthy Diet (DASH- or Mediterranean-Type Dietary Pattern). The Dietary Approaches to Stop Hypertension (DASH) diet is high in fruits, vegetables, nuts, and low-fat dairy products, and emphasizes fish and chicken over red meat. DASH is low in saturated fat, cholesterol, sugar, and refined carbohydrates, and is especially high in fiber (31 g/day) and potassium (4.7 g/day), factors that likely contribute to its efficacy for treating hypertension. A sodium-restricted DASH diet may be particularly effective.
Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. The New England journal of medicine. Apr 17 1997;336(16):1117-1124. https://tinyurl.com/yayouq48
Another approach that may also help with the weight gain is calorie restriction – she could try the fasting mimicking diet or 5:2 or simply cut back calories daily. Caloric restriction studies have demonstrated benefit for blood pressure, diabetes, metabolic syndrome, heart disease, and possibly for the prevention of cancer. Clinical studies generally restrict calorie intake by 10–30% compared with normal energy consumption. Studies of long-term caloric restriction in many species have demonstrated that it extends life and retards age-related diseases.
Palkowska E, Bartnikowska E, Owsiak D. [The use of low-caloric diet with modified fatty acids pool in the therapy of the metabolic syndrome]. Roczniki Panstwowego Zakladu Higieny. 2012;63(2):163-169. https://tinyurl.com/y7w58tkz
Losing weight generally will help with blood pressure as will stopping alcohol and focusing more on a low sodium / higher potassium diet. Magnesium, fish oils, quercetin are just a few examples of nutrients that may be helpful if it is not controlled via dietary and lifestyle means. Tackling stress and sleep disturbances is equally important.
So, at this stage I would consider some additional testing and include nutrients to support kidney and liver detoxification.
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. It is not intended for them all to be taken, but rather just those that you select. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Please consider these suggestions in light of the other clinical information pertaining to this individual. If you have any more information about the specific problems this individual is experiencing, further refinement of these suggestions may be considered. I hope this information is helpful, and if you have any further questions or information specific to the problems this individual is experiencing, please do provide feedback.
PorphyraZyme (BRC) – 4 mid am & mid pm, 2-3X per day on empty stomach.
Thiodox (ARG) – 1 with each meal – http://tinyurl.com/ztq8scu – contains N-Acetyl-L-Cysteine, L-Glutathione (reduced) and Lipoic Acid for detox phase II pathways
Whey Protein Concentrate (BRC) – 1-2 scoops daily – http://tinyurl.com/hslmdzg
Buffered Vit C capsules (ARG) – 1-2 caps morning and afternoon
Chlorella (Body Bio) – take 3-5 tabs, on empty stomach, once or twice daily
Cytozyme KD (BRC) – take 1-2 three times a day
I hope this helps with your client
Registered Nutritional Therapist Helen Perks is collaborating with Clinical Education to bring you the first-ever Functional Medicine book club for Practitioners.
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