Treating acute and/or chronic metal toxicityLetter to editor from Dr. Ben Boucher - BSC., MD This letter is written to clarify and educate regarding recent articles in the Cape Breton Post on heavy metal toxicities and those affected. I am a physician who has had a special interest in metal toxicities since l990. Firstly, there can exist either acute and/or chronic metal toxicity. Acute toxicity occurs from short-term exposure to a sufficient quantity of a toxic metal to produce toxic effects. The degree of toxicity can be determined by blood levels in these cases. Chronic toxicity occurs over an extended period of time usually from lower levels of exposure. Metals move from blood to tissues over a short period of time. They accumulate and have very long half-lives. Harmful health effects of long-term exposure can be minimal symptomatically. The more insidious and more devastating effects of chronic metal exposure and accumulation result from free radical pathology. Heavy metals create extremely high free radical activity, which can cause and/or contribute to a wide variety of diseases from cataracts to cancer and from the oxidation of lipids (creating bad cholesterol) to the deterioration of the nervous system. Chronic toxic metal accumulation can be determined best by hair and urine analysis. Essential metal levels can also be tested in urine. Furthermore, a test dose (provocative) of a chelating agent can remove metals deposited in body tissues. The urine levels of metals before and after the test dose is compared and this determines which metals are stored and can be removed. Chelation therapy using appropriate agents is then used to treat the chronic metal toxicity. Essential metals (e.g calcium, iron, zinc, selenium, manganese, etc.) are required for good health. Some essential metals such as iron, manganese, copper and others can be toxic when in excess. Toxic metals such as lead, cadmium, arsenic, aluminum, etc., are not required physiologically and sufficient levels can cause the previously described diseases and more. MSI probably provides coverage for acute toxicities, which are unusual. A case of chronic iron overload (toxicity) occurred in one patient several years ago who had sideroblastic anemia. He couldn't have phlebotomies (an MSI insured service commonly used to treat chronic iron overload and/or hemachromatosis, both examples of chronic iron toxicity) because of his anemia. This patient had an MSI covered abdominal infusion of an iron chelating agent (desferoxamine) for a few years. These are examples of precedents of insured chronic metal detoxification. Heavy metals (especially lead, cadmium, beryllium, antimony, arsenic) can be excreted from the smoke stacks of coal-fired activities such as smelting and power generation. People inhale metals from such polluted air and buildings that take in this air and recirculate it compound the problem. Metals from this smoke settles on land and water in the surrounding areas. The water table is then affected. Chronic human accumulation can result from consumption of affected water (drinking and cooking) and food. Years of fossil fuel burning has probably polluted a considerable amount of what is also recognized as one of the most beautiful islands in the world. Concerning the affected people who work(ed) at the New Waterford Hospital, I can offer the following plausible explanation. The building is approximately 40 years old. It has probably accumulated toxic metals over the years through its air exchange system by intaking polluted air. Were filters adequate enough or ducts cleaned often enough to prevent continuous air recirculation of these metals? This chronic metal exposure to workers in the building could result in chronic toxic metal accumulation and tissue storage. When poorly isolated renovations occurred, a possible acute exposure could have resulted from elevated levels of air particulates over the six week renovation. This acute toxic metal exposure could have pushed chronically affected personnel over their total body burden. Symptoms of metal toxicity could then have surfaced. Testing for metals now in that environment would not be the same as evaluating the situation during the renovations. Blood test for metals at this point in time is also useless. The patients that I have seen have shown a similarity in their toxic metal urine profiles both in pre and post proactive tested urines. The metals are those associated with coal fired industrial pollution. I have heard that other employees have shown similar urine metal profiles, some with elevated toxic metals in non-provoked urine. Chelation therapy (binding metals to other substances to extract and excrete them) is the most commonly used method of removing toxic metals other than using phlebotomies to remove excess iron. It should not be confused with the supposed controversial use of chelation therapy to remove calcium from arterial plaques and thus improve circulation. This therapy, like many others, has its proponents and detractors. It is not accepted as mainstream therapy because no large double blind studies have been done to prove its evidence-based benefits. Then again, approximately 20 per cent of all medical therapies do not have the same evidence based support but they are still commonly used. Experiential evidence has accumulated from thirty years of chelation therapy to thousands of patients around the world for coronary and peripheral vascular disease. The evidence is such that in August/02 the National Institutes of Health (USA) undertook a $30 million, five year, 2400 patient double blind study on the use of chelation therapy for arteriosclerosis. I hope this information is beneficial to the readers of this newspaper. Dr. Ben Boucher - BSC., MD |