Found an interesting article with studies that were done on patients with acute and chronic metal toxicity where sweat was measured from sauna therapy.  Metals were measured to be in the sweat and often in higher amounts than the urine.  It was also noted that the sweat contained higher amounts of the metals when a chelator was given.

Has anyone tried a systematic sauna program to replace or in cojunction with their Cutler protocol?  I am initiating a program designed by Hubbard, starting off extremely slow.  I am on day two and feel like if I keep going, I amy make some substantial headway with my mercury issues.

I would like to continue this sauna therapy, and then attemtp Cutler's protocol for any that may be in the brain.  I appreciate anybody chiming in, thanks!

http://www.hindawi.com/journals/jeph/2012/184745/

"Arsenic accumulates highly in the skin, and causes characteristic skin lesions, but little information is available on levels in sweat. Yousuf et al. recently found that excretion of arsenic was greatest from the skin of patients with skin lesions, slightly but not statistically significantly lower from arsenic-exposed controls, and severalfold lower from nonexposed controls [29]. Genuis et al. measured numerous toxic elements in blood plasma, urine, and sweat of 20 study subjects (10 healthy and 10 with chronic health problems) [3]. The maximum sweat arsenic concentration was 22 μg/L. On average, arsenic was 1.5-fold (in males) to 3-fold (in females) higher in sweat than in blood plasma; however, arsenic was excreted at lower concentrations in sweat than in urine [3].

Cadmium in sweat was examined in six studies [3, 22, 28, 30–33], with concentrations in sweat ranging from <0.5–10 μg/L [28] to 0.36–35.8 μg/L [3]. Stauber and Florence concluded that sweat may be an important route for excretion of cadmium when an individual is exposed to high levels [22, 28], a finding that was confirmed by observing that the total daily excretion of cadmium was greater in sweat than in urine [3, 32]. The maximum cadmium concentration observed in sweat was 35.8 μg/L [3].

Lead was examined in eleven studies [3, 22, 26–28, 33–38]. In 1973, Hohnadel et al. suggested that “sauna bathing might provide a therapeutic method to increase elimination of toxic trace metals” [38]. In two males, 36% and 50% of sweat lead was of molecular weight > 30,000, as measured by ultrafiltration, suggesting excretion of organic complexes rather than simple ions [22]. Lead excretion was lower in females taking birth control medications compared with females not taking medications, or males [28]. Haber et al. found that prolonged endurance workouts (rowing) ameliorated elevated blood lead levels in exposed workers but did not alter levels in control subjects and did not affect urine levels [26]. They suggested that the elimination route was not urine, but potentially sweat or/and bile. Omokhodion and Crockford carried out several studies of trace elements in sweat, including a study of lead ingestion by two human participants [34]. Sweat lead levels did not increase immediately with elevated blood lead, although the authors make reference to an older study with longer followup wherein lead in underarm pads doubled in the five days following ingestion. Omokhodion and Howard also reported higher lead in sweat of exposed workers compared with unexposed controls [35], and in another study that sweat and blood lead levels were the only two variables that correlated among blood, urine, sweat, and saliva [36]. The English abstract of a 1991 case report in Russian indicated that sauna increased excretion of toxic elements and resulted in clinical improvements [27]. Sweat lead levels up to 283 μg/L have been observed in nonoccupationally exposed subjects [38] and up to 17,700 μg/L in workers [37], where it is noted that lead in sweat may partially originate from material absorbed within the skin that was not removed by pretest cleaning protocols [35]. Indeed, although dermal application of lead via hair follicles, sweat ducts, and diffusion does not result in immediate increases in blood or urine lead concentrations, dermal absorption was demonstrated using the Pb-204 isotope [43], lead powder, and salt [37].

Mercury. In 1973, Lovejoy et al. noted that exposure to mercury does not always correlate with urine mercury levels and that elimination by other routes such as sweat may be an explanation [41]. They suggested, “sweating should be the initial and preferred treatment of patients with elevated mercury urine levels.” In a 1978 case report, a severely poisoned worker was rescued with chelation therapy, followed by a regimen of daily sweat and physiotherapy over several months during which the sweat mercury level returned to normal and the patient recovered [40]. Robinson measured mercury in sweat repeatedly in two volunteers, observing sweat to urine concentration ratios ranging from less than 0.1 to greater than 5. Sweat mercury concentrations varied widely from day to day, and there was no correlation with urine levels. Sweat mercury levels of 1.5 μg/L were observed by Genuis et al. [3] and 1.4 μg/L by Robinson and Skelly [39].
4. Discussion

Arsenic, cadmium, lead, and mercury may be excreted in appreciable quantities through the skin, and rates of excretion were reported to match or even exceed urinary excretion in a 24-hour period. This is of particular interest should renal compromise limit urinary excretion of toxic elements.

Most of the research identified was over 20 years old, and collection methods varied widely. Although authors described thorough precleaning methods, sweat concentrations measured in research settings are not well validated and varied according to the location on the body, collection method, and from day to day according to other variables such as hydration. Sweat contains metals not only from the blood plasma, but also evidently originating from dermal layers (particularly with significant dermal exposures, as for workers in welding, smelting, or battery manufacturing). It would appear that large variabilities in measured concentrations, apart from collection methods as mentioned above, were likely the result of differences in excretion amongst widely varying individuals with ranges of body burdens, genetic polymorphisms affecting detoxification efficiency, and physiological states, coupled with necessarily crude if simple experimental techniques. These variations were very much greater than would be expected due to limitations of analytical methods. Although analytical methods have improved over the years, analysis of these metals was commonplace at the time of the studies. Authors generally reported analytical methods rigorously or provided references to thorough descriptions and included internal standards and some indication of sensitivity.

The observation that between a third and a half of lead in sweat may be associated with high-molecular-weight molecules [22] merits replication, including examination of additional toxic elements and characterization of the associated molecules previously observed. Excretion of these large molecules also suggests that sweating may be a means of excretion of metals complexed with natural or synthetic chelating agents.

Yousuf et al.’s recent study demonstrating a 2 : 1 molar ratio of zinc : arsenic and increased vitamin E in skin secretions suggests potential therapeutic supplementation to accommodate these biochemical requirements. Vitamin E, zinc, and other nutrients are required for methylation and detoxification of arsenic within the body, and vitamin E supplementation improves the skin manifestations in arsenicosis [29].

From an occupational health perspective, lead, and presumably other toxic elements, may be absorbed via the skin, which supports showering at work and further suggests the possibility of purging workers’ skin by washing with a chelating agent (e.g., EDTA rinses extracted lead from workers’ skin in methods validation experimentation [38]). It is unknown if sweating during the workday may affect dermal absorption, or if forced sweating at the end of the workday would be beneficial. It is also unknown if increased blood flow to the skin could possibly enhance absorption into the bloodstream, or if worker health could be optimized by a combination of workplace skin cleaning and sweating interventions.

Sweating has long been perceived to promote health, not only accompanying exercise but also with heat. Worldwide traditions and customs include Roman baths, Aboriginal sweat lodges, Scandinavian saunas (dry heat; relative humidity from 40% to 60%), and Turkish baths (with steam). Infrared saunas heat exposed tissues with infrared radiation, while air temperatures remain cooler than in other saunas.

Sweating is a long-standing, if recently forgotten, aspect of mercury detoxification. Various strategies used to maintain the mercury mining workforce have been explored over the centuries. In Spain and colonies, long the western world’s primary sources of mercury, sending ill workers to warmer climes away from the exposure to drink weak beer (the hydrogen peroxide catalase oxidation of elemental mercury to ionic mercury is competitively inhibited by alcohol, increasing mercury in exhaled breath [44]) and to work in the heat (presumably to sweat out the “vapors”) was a common and effective strategy centuries ago; tremors, salivation, and mouth ulcers resolved generally within a few weeks [45].

With acclimatization and regular use, the sauna is generally well tolerated by all ages [46], though medical supervision may be recommended during initial sessions for children, the elderly, or those with compromised health. Varying qualities of evidence indicate potential short- and long-term improvements for cardiovascular, rheumatological and respiratory conditions; contraindications include unstable angina pectoris, recent myocardial infarction, severe aortic stenosis, and high-risk pregnancy [15, 46]. Sweating is not only observed to enhance excretion of the toxic elements of interest in this paper, but also may increase excretion of diverse toxicants, as observed in New York rescue workers [47], or in particular persistent flame retardants [48] and bisphenol-A [49].

Optimizing the potential of sweating as a therapeutic excretory mechanism merits further research. To date, the large body of research into homeostasis of the most common metals (sodium, potassium, and to a lesser extent, magnesium, calcium, and zinc) and conditioning or adaptation to regular sweating by athletes has not been matched with studies of excretion of trace elements. Limited research suggests indirectly that conditioning may not restrict excretion of nonessential elements. Combination therapies, such as administration of n-acetyl cysteine, vitamin C, a chelating agent, or low doses of ethanol (for mercury), to name a few possibilities, along with sauna and/or exercise therapy to induce sweating, may be fruitful avenues of investigation.

It has been noted that among people whose health is compromised by toxicants, heat regulatory mechanisms of the autonomic nervous system are often affected, resulting in a failure to sweat readily [3]. In these cases, along with diet and nutritional supplementation to remediate biochemical imbalances, interventions to consider include brushing the skin, niacin to assist with vasodilation, and exercise prior to sauna use [50]. Clinical experience is that with persistence and ample hydration patients do eventually start to sweat. This is often a sign that the autonomic nervous system function is beginning to improve. With enhanced ability to sweat, detoxification is facilitated, which can ultimately result in clinical improvement.

For biomonitoring and research purposes, modern validated methods are desirable to collect and measure elements in sweat, so this means of excretion may be considered in the context of other measures such as urine, blood, feces, and hair concentrations. Considerations for dry and wet collection methods were recently discussed in the context of essential solutes [51, 52].

Undoubtedly further research in this area would improve understanding, but the available evidence suggests that physicians could consider recommending sweating as tolerated via exercise (preferred) and/or use of a sauna as a low-risk, potentially beneficial treatment for individuals who may be experiencing effects of toxic elements, or for individuals with regular exposure to or accretion of toxicants.
5. Conclusions

Sweating offers potential and deserves consideration, to assist with removal of toxic elements from the body. As toxic elements are implicated in many serious chronic conditions, research is needed in patients with select conditions to evaluate the body burden and to test the efficacy of source removal, dietary choices and supplements, interventions that induce sweating, and treatments with drugs, all to enhance excretion of toxic elements with the goal of clinical improvement. There is a clear need for robust trials, appropriately sized to assess clinical outcomes, from which therapeutic protocols can be derived. Both biochemical and clinical outcomes should be examined in order to develop and monitor clinical interventions that are both safe and effective."