I. Chemical and physical Properties of Mercury A. Symbol Hg, for Hydraargyrum -- liquid silver, or watery silver (silver symbol is Ag) B. Liquid ( changes from solid state) at -38.9 0 C., -38.020 F. i.e. mercury is a liquid at the temperature of iced tea C. 13.5 x heavier than water II. Ancient history A. Known to Ancient Chinese, Hindus, Egyptians, and Greeks: 1. Pliny described the diseases of Hg miners 2. Well recognized as a toxin throughout history B. Source: Mineral Cinnabar (HgS, sulfite of mercury), recovered from land mines. 1. Worlds oldest mine in Almaden Spain, still providing 15% of annual world production 2. Spanish miners ills have been well documented 3. Victorian tall hat makers were well known to be toxic II. Uses of the various forms of Mercury A. Elemental Form Hg and Salts HgCl, etc. 1. Dental Amalgams "silver fillings" a. 70 % of the adults in the western world have amalgams b. 100 tons of Hg a year, are used by U.S. dentists c. several formulae: 50-52% Hg, 22% Ag, 12% Cu, and Zn and Sn (mercury, silver, copper, zinc, and tin). d. ADA, (American Dental Association) until a few months ago (as of date 7/97), held two patents on the formulae. Sold them. * 2. Liquid in thermometers, barometers, b.p. meters, silent switches, kids light up sport shoe, lab. equipment, batteries, electrodes, etc. 3. Fulminates of Hg : detonators of explosives (Hg(ONC)) 4. Sublimates : antibacterial salts a. Cleansers (1) for walls and floors of hospitals, laboratories, nursing homes, (2) and for instruments. b. Calomel (mercurous chloride salt): used internally as purgative (for parasites and fungicide.) 5. Preservatives in vaccines (Thimersan): Flu vaccine, D.P.T. on up to newest ones, Hepatitis B and Hemophilus 6. Fungicide and pesticides, and mildewcides (Hg2Cl2, ) and other salts a. a violent poison : two recent laboratory sudden deaths (hours) b. Uses: (1) Outdoor textiles and fabrics (2) Control of Dutch Elm disease (3) Turf fungal-disease control (4) In-can additives to Latex Paint (5) Disinfectant of commercial farm seeds: (problems since 1952 have finally changed this)* 7. Vermilion pigment (no longer allowed in U.S.) 8. Manufacture of paints and plastics, in dye industry, etc. 9. Burning fossil fuel (entire petroleum, and solvent industry) B. Organic forms : Alkyl mercurials --- methyl, ethyl and aryl 1. Uses a. Cosmetics (1) In Mexico (very heavy levels: do not use them) (2) In hair coloring : major brand in the U.S. (C.) b. Cultural use as aphrodisiac, sprinkled on floor in Folk rituals c. Medical use: (1) Ointments and creams: yellow and gray ointments for eyes and skin (2) Lotions and tinctures: (a) Calomel (oral purgative and fungicide) Caladryl (b) Mercurochrome, (painted umbilical stump), (c) Merthiolate (painted on raw wounds and hot tonsils) (3) Treatment for syphilis from 1500's (a) Arsenicals replaced it in 1900 (b) Penicillin replaced arsenic in 1940 (4) Diuretic in 1900's (mercurial salicylate) (5) Homeopathic use: try to avoid any molecules at all (6) In injectables (a) ACE - adrenocortical extract , injectible from Switzerland (still used in Mexico: recently stopped here) * (b) Vaccines: flu, et. al. (c) Rhogam (antigen given to Rh negative mother after a Rh + baby, 2. Conversion to Methylmercury a. Air borne mercury (1) Industrial use puts 55 tons of Methyl mercury into the air each year: (a) Chicago is the worst (b) No place is safe. (2) Volcanoes and forest fires are major mercurial loading events to the air (3) The industrial uses and rain after natural events discharge mercurial forms into the waterways, creeks, streams, and lakes; eventually the ocean. b. Water borne: methylmercury is the common poison (1) Created when the inorganic forms enter fresh water and saturate ocean sediment. (2) Studied : (a) first in fish and predatory birds, in Sweden in 1950's: due to effects of wildlife (b) later in epidemics of illness in Swedish men (3) Sources to humans: until 1996, thought to store chiefly in (a) bottom feeders (scavengers and shell fish) (b) largest ocean fish: tuna, blue fin marlin, shark and swordfish * IV. Physiology of methylmercury in the human A. Entrance into our body 1. Elemental Hg goes through alveolar bone and through mucous membranes of oral cavity : a. soluble in saliva b. galvanization by dissimilar metals in bridges, crowns, gold c. Streptococcus mutans in mouth converts Hg0 to methylmercury 2. Elemental mercury vaporizes from the dental amalgams during drinking and chewing:* a. electron micrographs show droplets on the surface of the filling b. breath analyzer tests 3. Swallowed with the saliva, laden with soluble ions 4. Enters through skin 5. Inhaled, going directly into blood stream, during dental polishing and repair 6. Through GI (gastrointestinal) mucosa, bypassing most bowel detoxication a. Bacteria in bowel make methyl-Hg from the inorganic forms and salts of mercury, which: (1) Alters bowel flora: reduces numbers of beneficial bacteria (a) decreases SCFA that feed our lining cells (b) fosters the growth of yeasts * (c) allows colonization by amoebas and parasites (2) Creates bacterial antibiotic resistance (fosters bad bacteria) (3) Damages enzymes systems of the GI mucosa : (a) decreases the 25 % of detoxication done there (b) decreases sIgA (secretory immune globulin A) so we do not resist the bad bacteria: they infect us (c) adds to the effect of leaky bowel syndrome, creating food allergies b. eating fish gives methyl-Hg directly eating 2 cans of tuna per day will give acute toxicity 7. Crosses all lipid membranes a. Cell walls (70 % lipid and 30% protein) are penetrated b. Myelin sheath, the insulation of nerves is eroded (associated with MS, and other de-myelinating degeneration) * c. Blood brain barrier (BBB) is traversed (1) 800 % increase in the incidence of brain cancer ( ? Nutrasweet) (2) Produces massive brain effects : (a) encephalitis effects of sudden heavy exposures (acute) as in Minimata Disease (b) encephalitis long term slow effects similar to vaccine effects (chronic) B. Biochemical effects: 1. Depresses MAO (monoamine oxidase, an enzyme of brain function) causing the characteristic depressions of Hg toxicity. 2. Combines with SAM (s-adenysylmethionine) in the enzyme systems of all biologic life 3. Binds to the heme ring (porphyrin) ring of hemoglobin and myoglobin (part of the muscle protein) a. Anemia b. Fibromyalgia 4. Decreases mitochondial production of energy: CFIDS a. Immune system has to operate on energy b. CFIDS is: chronic fatigue and immune deficiency syndrome 5. Hg attaches to the SH (sulfhydryl group ) a. in enzymes and deactivates or reduces the rate of reaction of the enzymes b. in the proteins in blood, which account for 10-50 % of antioxidative capacity of the blood c. reduces the antioxidant functions both in the blood and inside cells. 6. Hg inactivates thiolic antioxidative compound: glutathione, which has the principle role in rejuvenating Vit E for cyclic reuse. 7. Hg effects oxygen transfers (intracellular peroxide functions) a. Hg inactivates SOD : interferes with oxygen transfer b. Hg inactivates catalase: (1) slows oxygen transfer (2) inhibits kill effect on "resistant staph" related to skin infections in nurses, hospitals 8. Hg forms insoluble complex with selenium (Se): a. Se is a cofactor for glutathione peroxidase b. Se is a cofactor in tetra-iodothyroidine deiodinase: leading to Reverse T3 syndrome c. Se prevents fibrocystic breast disease, other cysts 9. Hg causes decreased liver transformation of ATPase :mitrochondrial enzyme that produces our energy a. Heart failure is now defined as energy failure so fibers can't contract. b. Chronic fatigue : mitochondrial energy failure 10. Hg interferes with DNA synthesis ( i.e. messes up our genes): a. mutations, birth defects: California Law b. cancer 11. Hg blocks receptor sites for progesterone & interferes with estrogen a. interferes with reproductive functions b. bone metabolism c. heart function 12. Causes thyroid malfunction (Se enz. for Reverse & T3 and other modes) 13. Causes adrenal malfunction 14. Hg found to be neurotoxic: inhibiting polymerization of brain tubulin : a. Alzheimer's b. MS etc. c. Peripheral neuropathy 15. Sets stage for, or causes, "autoimmune disease" 16. Hg blocks ATPase (stalls energy cycles) 17. Hg blocks P450 enzymes (vast family of detox enzymes in the liver) 18. Hg blocks glutathione peroxidase and glutathione reductase 19. Mercury load both causes and is worsened by deficiency of minerals 20. Elemental Hg, when detoxified by the thiols (glutathione) is converted to methyl mercury which is just as toxic as elemental. if redundant...... blame it on the mercury C. Significance: 1. The human body was not designed to handle mercury 2. We have no mechanism to rid our bodies of it naturally a. damages the kidney in effort to clear after heavy exposure: accounts for significance decrease of renal function as we age b. interferes with liver detoxication of other toxins, as we attempt detox in Phase I , leading to the spreading phenomenon of MCS multiple chemical sensitivity) c. excreted through the hair, nails, and skin --- if we are able to, requires (1) active sulfhydryl pump to excrete, (2) adequate mineral stores example D. History of Mercury Poisoning: 1. Chronic poisoning was a. recognized by Pliny, and in the Spanish miners in 1700, b. not a wide spread problem until Hg became widely used in the industrial revolution (1830) c. was not recognized in a medical sense until 150 years ago (1850): Mad Hatters disease of "Alice in Wonderland" (1889) Lewis Carroll 2. 20th century recognition of acute disease a. Minimata Disease 1956: The classic disease of massive contaminated water from industrial pollution (1) blood cell binding: total anoxia (lack of oxygen) (2) encephalitis with massive neurological damage b. Grain fungicide exposures in Iraq (1956-72), and elsewhere including the U.S. 3. Current recognition of chronic disease a. preponderance of exposures was overwhelmingly dental until 1996 b. EPA study revealed toxicity of all fish: fresh and ocean V. Dental use of Mercury A. American experience: 1. Elemental and methylmercury was widely recognized as toxic 2. Amalgam, i.e. a mixture of metals a. started in Paris in 1820: b. Hg barred from dental use (1) rejected as it expanded and fractured the teeth. (2) widely appreciated to be toxic: from 1848 -1900. (3) ADA was formed to censure the use of mercury in dentistry (4) Original word "quack" came from "a user of quicksilver " 3. Brothers Crawcour a. came to New York in 1833 with a "cheap filling" b. chased out: because dentist knew Hg was toxic (competition?) 4. 1848, 11 dentists in N.Y. suspended from their society for using amalgam: reflected the common attitude 5. Began to bill amalgams as "silver fillings" (cheap for common man) 6. In 1910's said it was no longer toxic as it was "stabilized" meaning it wouldn't expand and crack teeth 7. Toxicity was lost in the controversy during stress of WW I and WW II B. European experience: 1. Current speculation: might not have had WW I WW II if not for mercury toxicity in the leaders and people 2. Scientist studied themselves: German Alfred Stock recorded his own illness: Stage i. Fatigue. Diminished working capacity. Irritability. Slight swelling of nasal mucous membranes. Stage ii. Extreme fatigue. Lack of concentration. Impaired memory for names, numbers, etc. Irritability and moodiness. Sensation of a sheer stupidity.. Nasal obstruction with dryness (stuffy nose). Nasal discharge, viscous, sticky sometimes bloody. Tinnitis. Hearing impairment. Headache, often frontal. Stomatitis, bleeding gums on brushing Irregular heart activity Sometimes diarrhea Frequent urination Slight tremor State iii. Headache Dizziness & vertigo Tremor Mental incapacity Despondency and depression Back pain Dysiuria Colitis and diarrhea Nasal catarrh with bloody crusts Loss of smell Stomatitis Bleeding gums Paradentosis and loose teeth Increased salivation Pharynigitis and laryngitis 3. Swedes, the most instrumental in showing accumulative effects a. in 1950 recorded association with wildlife decline: not much concern for those matters then b. in 1981 (30 years later) started it over again c. reviewed all the old literature and history d. showed liquid mercury droplets on the amalgam surface after chewing g. corrosion chemist studied his own interaction with Hg and gold crowns h. oral galvanism of dissimilar metals: the electrical charge causes neurological problems i. correlated amount of Hg in the brain with amount of amalgams in mouth C. Comparisons : 1. American have short memories for historical lessons 2. Americans are more gullible: 3. Americans have perhaps more neural storage of mercury VI. History in the Scientific Literature A. 1970 : Immune dysregulation (see Dysregulation Chart figure) B. 1981: Lauren: "the most Important depressive elements on the immune cells" in this order Hg++, CU++, Mn++, Co++. decreases lymphocyte transformation (part of function) while Ni and Pb, increase proliferation of the WBC C. 1985: HgCl2 and CH3HgCl decrease thymidine incorporation into DNA of lymph D. 1986: T cells autoreactor causes autoimmune disease E. 1988: Increases T cells and causes deficit in T suppresser levels: combining depressed immune system with increased freq. of infection and increase attack on self causing allergy and the spreading phenomenon of MCS F. 1991 Glomerulonephritis in rats: antibody to kidney produced in this disease remember acute hepatic necrosis G. 1991 WHO reported the acute toxic effects due to the Iraq grain events Most USA. data came from these studies: and at first they only looked at acute (sudden, overwhelming) H. Follow-up of the acute Murimata and Iraq cases taught that: 1. If one survives the acute exposure, illness will ensue and become chronic 2. and since it does not clear after time ACCUMULATION causes Chronic disease H. 1980 + Finns, Sweden banned use VI . BOMBSHELLS A. 1996 EPA of U.S.A. published Mercury Study Report to Congress VOL. I-8 stating: 1. There is no safe level of mercury 2. The fetus is the toxic dump for a. heavy metals b. excess in general, including "recreational drugs" 2. No fish / seafood is safe. 3. Hg is the second most toxic element on earth follows Plutonium (radioactive Bomb of WW II) 4. Hg is worse than Lead: a. but mercury and lead are additive b. Lethal dose concept : LD50 , LD1 LD100 LD50 dose to kill 50% of the study group LD1 dose to kill 1% of the study group LD1 Hg + LD 1 Pb = 100%. Highly synergistic B. EPA was asked about legislation to stop Hg use in the USA "Litigation, not legislation" was the answer: reading from Queen VII . How to determine your mercury load A. Hair: 1. Depends on detoxication ability: sicker patients can not push it into the hair 2. Is accurate, if one is able to excrete it (except for C. hair products) B. RBC: useful only for acute and recent exposures C. Whole blood : 1. for acute exposure only 2. cleared from the blood as fast and possible, in anyway possible D. Chelation challenge with DMPS 1. Terms: a. 2.3-Dimercapto-1-Propane Sulfonic Acid, Na salt b. Dimival® from German Company -- Hyel : standard for 40 years c. Russian DMPS: 75 % pure 2. Procedure: after history and physical exam (with notes to neuro findings) a. Obtain base-line minerals in urine and hair b. Get basic lab :SMAC with ferritin, Mg, lipids, CBC, T7 with TSH, UA c. Compute renal ability to excrete creatinine (% function of kidney) d. Give serial dilution dose of DMPS under the tongue to assay allergy e. Give supplements for two weeks f. Obtain UCG (pregnancy test) when appropriate g. Give 20 min DMPS IV: dose based on weight and kidney function h. Collect 24 hour urine for minerals excretion (1) Assess output of Hg (a) if over .5 ppb proceed with Hg removal treatment (b) If less than .5 ppb, and very sick (i) give amino acid + mineral IVs and oral supplements (ii) Detox liver, bowel, treat for yeast, etc. (iii) repeat the DMPS challenge in 2-3 weeks (c) Repeat the DMPS challenge and collect urine and measure VII. How to remove the mercury burden : treatment A. Repeat DMPS IV each 2-6 weeks, depending on fragility of person expected actual Cumulative Hg Urinary output curve with DMPS treatment B. Required supplementation: 1. Se 200 micrograms/day (no Kelp unless analyzed for Hg first) Chlorella: southern algae (pond scum) with cracked shell (a). found to move Hg from cells into fluids (b). dose 3-4 x daily, to tolerance (c). double usual dose on day of Hg removal & DMPS IV 2. Vit E , mixed tocophorals, 400-800/day 3. Vit C 1000-5000mg.day 4. Cystine Cysteine (as in n-acetylcysteine) may move it around, but not out 5. Glutathione : 300-600 mg/day div. dose a. binds with methylmercury b. excreted as Hg mercapturic acid in the urine c. not to be used in diabetics who are insulin dependent 6. Garlic: ratio of 1:1 with Chlorella 7. These minerals if low on any analysis a. Zn, Cu, Mn, Cr, Mg, Na, Fe, etc. b. Note: there is a constant Mg deficit when Hg is present. c. No amount of oral and IV will make up for the drain. d. One can not detox with a low sodium (na) e. Hg displaces Zn, Cu, f. inhibits Fe absorption g. no colloidal minerals (Pchem size to great for absorption) 8. Herbals: Liver detox: Silymarin and immune support, ecchinacea 9. Vitamins, especially Bs 10. EFA, Omega 3 & 6 (essential for membrane maintenance, cell walls) If fish oil is used, it needs a negative assay for Hg 11. Eat only organic foods : see attachment: 12. Use Cilantro in abundance 13. High protein diet (Atkins, Sears) 14. Hypericum, as needed 15. Repeat the lab evaluations at least each 3 months of treatment 16. Treat until urine recovery is below .5 ppb a. average need for DMPS is 17-30 + injections b. incomplete treatment is as bad as no treatment VIII. Possible ill effects: A. Rash: denotes mercury in the skin, binding with the DMPS Treatment: B12 IM , 1-2 cc q 2-3 hours through 24 hours, or until it stops. B. Wipe out : headaches, fatigue: denotes mercury moving and causing symptoms Treatment: GSH (reduced glutathiones) 25/mg/kg, one dose C. Rebound reaction: feels good for several days, then feels bad again: 1. Due to recompartmentalization. 2. Will stop after enough is removed. D. If one has allergies and neurologic symptoms as detox proceeds, it could flare and then improve (i.e. the reverse of the above # C) E. The T-cell count will improve as one goes through treatment: esp. noted in CFIDS IX. The FDA protocol is different in that it : A. Involves much more extensive use of the lab: see the attachment B. Requires proof that mercury 1. is not being excreted before the DMPS is given 2. is excreted after the DMPS is given 3. that DMPS provides improved objective parameters of improvement X. Summary A. Mercury is not meant to be in the human body: causes gross malfunctions B. Mercury may be one of the primal root causes of 1. many of our classical old diseases heart disease, neuroses, psychoses, cancer, gum disease with tooth loss, thyroid and adrenal dysfunction, etc. 2. most of out "new" 20th Century Diseases: Allergies, Chronic fatigue and CFIDS, Chronic Candidiasis, Leaky bowel syndrome, Fibromyalgia, food allergies, MCS, anxiety and panic attacks, etc. C. Mercury must be removed before the above diseases can be successfully approached or resolved D. DMPS has a 40 year record of safety and efficacy in removal of mercury E. It should be available to any competent doctor to use for those who need it F. The FDA protocol is expensive, as it needs to be, in order to prove efficacy and safety G. If one can not afford the FDA protocol 1. he/she may seek safe treatment without the extensive lab 2. he/she understands that the risk is future non-availability of the product H. If one seeks treatment, they should be willing to sign a release stating that: 1. they judge themselves to have symptoms compatible with mercury toxicity 2. they have been informed of the need for mercury removal and 3. they understand the differences in the FDA protocol and the abbreviated protocol 4. they are willing to undertake the abbreviated protocol